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Biomedical subjects

V Rice

Publications and source records attributed to V Rice.

At least 19 recordsLinked to original sources
PubMed2001

Surgical outcomes after breast cancer surgery: measuring acute lymphedema.

BACKGROUND: Studies of lymphedema have used inconsistent measures and criteria. The purpose of this pilot study was to measure the onset and incidence of acute lymphedema in breast cancer survivors using strict criteria for limb evaluation. MATERIALS AND METHODS: Eligible women were those undergoing breast cancer surgery that included axillary staging and/or radiation therapy of the breast. Arm volume, strength, and flexibility were measured preoperatively and quarterly. Lymphedema was defined as a greater than 10% increase in limb volume. Additional strength and flexibility assessments were done at these times. RESULTS: In 30 evaluable patients, half underwent modified radical mastectomy and half lumpectomy, with half of the lumpectomy patients undergoing axillary node staging. Of the 30 patients 27% were Stage 0; the rest were Stage I (27%), IIA (13%), IIB (23%), and IIIA (7%). One subject was IIIB postoperatively. There were 2 women with a 10% or greater change in limb volume; the change was detected in one woman at 3 months (5% incidence) and in the second woman at 6 months (11% incidence). Both had undergone mastectomy and axillary dissection and one of these two women had symptoms of tingling and numbness in the affected arm that began at 3 months. Overall, 35% of the sample experienced symptoms by 3 months, which included numbness, aching, and tingling of the entire upper extremity, but without volume changes. The relationship between undergoing modified radical mastectomy and experiencing symptoms in the affected limb at 3 months was significant (P = 0.05). CONCLUSIONS: In this interim report strict methods of measurement and limb volume comparisons detected acute lymphedema at 3 months in 5% of the sample, and at 6 months in 11% of the sample. Furthermore, symptoms were detected in 35% without volume changes at 3 months postoperatively, which may warn of lymphedema occurrence within the next 3 months. This may assist clinical evaluation of symptoms in the postoperative period and support early referral to lymphedema experts.

Adult↗
PubMed2001

The critical care consortium. Maximizing continuing education dollars.

Facing the current challenges in health care delivery and tremendous changes predicted for the new millennium, educators must consider nontraditional approaches to meet the learning needs of critical care nurses. The education consortium, as described in this article, should be considered as one possible approach. Consortiums have the potential to enhance program quality, reduce costs, promote positive participant interaction, and strengthen community spirit. The consortium approach is not a panacea, but it has proven to be a successful model for critical care education.

Critical Care↗
PubMed1993

Effects of hyperglycemia on memory and hormone levels in dementia of the Alzheimer type: a longitudinal study.

The effect of hyperglycemia on hormone levels, metabolite levels, and memory performance was examined in 22 subjects with very mild and mild probable dementia of the Alzheimer type (DAT) and in 12 normal elderly adults. Subjects were tested in 3 plasma glucose conditions (fasting baseline, 175 mg/dl, and 225 mg/dl) at initial and 18-month follow-up sessions. Initially, adults with very mild DAT showed memory facilitation and elevations in plasma insulin in the 225-mg/dl glucose condition relative to baseline. At follow-up, very mild DAT patients whose dementia had progressed showed significant decreases in insulin and hyperglycemic memory facilitation. Changes in basal insulin and cortisol levels over time were correlated with memory changes for DAT subjects. These results suggest that glucoregulatory abnormalities may contribute to the pathophysiology of DAT.

Aged↗
PubMed1993

The effects of litter carrying on rifle shooting.

This study investigated whether the use of a shoulder harness would affect shooting accuracy after patient litter carrying. Two- and four-person teams, 12 male and 9 female soldiers, fired at targets before and after (1) a 15-minute bout of rapid, short litter carries and lifts, and (2) a moderate speed 30-minute litter carry with and without a harness for both types of carries. Shooting accuracy was 10% poorer (p < 0.05) after the 15-minute bout (mean +/- SD = 8.9 +/- 1.9 mm) than after the 30-minute carry (8.1 +/- 1.7 mm). Four-person teams using litter-carriage harnesses had 17% tighter shot groups (45.5 +/- 30.4 mm2) (p < 0.05) than four-person teams that did not use harnesses (54.5 +/- 26.1 mm2) and two-person teams with (56.3 +/- 29.1 mm2) or without harnesses (54.9 +/- 30.7 mm2). The harness can potentially improve shooting accuracy after litter carrying.

Adult↗
PubMed1991

Shock, a clinical syndrome: an update. Part 1. An overview of shock.

Shock is a major critical illness that involves almost every organ system. It is not simply a problem of decreased blood pressure. It is a problem of inadequate tissue perfusion. Part 1 presents an overview of the shock syndrome, including definitions, classifications, and cellular changes in shock.

Humans↗
PubMed1991

Shock, a clinical syndrome: an update. Part 3. Therapeutic management.

Supportive measures attempt to improve oxygen delivery to body cells. A patent airway, adequate ventilation, and supplemental oxygen are important prerequisites. Once oxygen is delivered to the alveolar/capillary interface, it must diffuse into the blood and be carried by adequate numbers of red blood cells. Hemoglobin in the red blood cells must bind with oxygen to carry it to the tissues; yet, the hemoglobin must release the oxygen to the cells in the peripheral capillaries. Cells must be able to use oxygen to produce energy and restore normal cellular function. Restoration of cellular function is a complex sequence that cannot be achieved with a single therapeutic intervention. The supportive management of the shock patient requires many different drugs and therapies to maintain tissue perfusion and to restore normal cellular function.

Blood Transfusion↗
PubMed1990

Nursing care planning. Overview and application to the patient in shock.

The systematic nursing process is an essential prerequisite for providing effective care for patients in shock. Nurses use assessment skills to identify actual and potential collaborative problems and nursing diagnoses. Once collaborative problems and nursing diagnoses are identified, the nurse develops appropriate individualized patient outcomes and plans care to accomplish the outcomes and resolve the problems. Nursing actions from the three domains may be included in the care plan. The evaluation phase assesses the adequacy of nursing actions in accomplishing the stated goals and returns the process to the stage of assessment. Application of the nursing care planning process to the patient in shock can be somewhat difficult because of the critical nature of the illness, complex assessment data, and rapidly changing interventions. It is indeed a challenge for the critical care nurse to integrate sound principles of nursing care planning into the busy intensive care environment, but the outcome of improved patient care is worth the effort.

Critical Care↗
PubMed1986

Nonprogression of coronary artery atherosclerosis in homozygous familial hypercholesterolemia after 31 months of repetitive plasma exchange.

The effects of plasma exchange performed every two weeks for 31 months in combination with diet and drug therapy were studied in a patient with receptor-defective homozygous familial hypercholesterolemia. Coronary angiography performed three years prior to commencing plasma exchange was compared to angiography 31 months after starting the program. Comparison of the angiograms taken six years apart showed no progression of coronary atheroma in the main left coronary artery in which a 30% narrowing was originally seen. An internal mammary artery-coronary artery bypass remained widely patent and showed no development of atherosclerosis. Plasma cholesterol levels were reduced 46% by plasma exchange, diet and drug compared to diet and drug alone. Achilles tendon xanthoma diminished significantly. It appears that plasma exchange combined with diet and drug therapy, while not producing regression of existing atheromatous lesions, does retard or prevent further progression.

Achilles Tendon↗
PubMed1985

Antiviral activity of 5-ethyl-2'-deoxyuridine against herpes simplex viruses in cell culture, mice, and guinea pigs.

The susceptibility of 3 laboratory strains and 24 clinical isolates of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) to 5-ethyl-2'-deoxyuridine was determined in plaque reduction assays in Vero cells. The median effective doses were 8.6 and 7.8 microM, respectively. The drug was less potent than acyclovir and other related antiviral drugs, but it had a high therapeutic index against both HSV-1 and HSV-2. Drug-resistant viruses were readily produced in cell culture. These variants were cross-resistant to acyclovir, 2'-fluoro-5-iodoaracytosine, and 2'-fluoro-5-methylarauracil but were susceptible to vidarabine or phosphonoformate. These findings confirm that the selective antiviral activity of 5-ethyl-2'-deoxyuridine is mediated by the virus-induced thymidine kinase. Oral or intraperitoneal administration of the drug at nontoxic doses was ineffective in protecting mice against intracerebral challenge with virus. Using implanted osmotic minipumps or coadministering the drug with dimethyl sulfoxide failed to decrease the mortality rate. In guinea pigs infected genitally with HSV-2, topical drug treatment was more effective than placebo in reducing lesion severity and other clinical and virological variables. These effects were noted whether the drug treatment was initiated 3 or 24 h after infection (ascertained serologically). Drug-treated animals had a significantly lower herpes antibody titer than did placebo-treated guinea pigs, suggesting that the drug can also reduce the viral antigen load. In this model, the drug appeared to be as effective as topical phosphonoformate or acyclovir.

Animals↗
PubMed1983

Aequorin measurements of free calcium in single mammalian cells.

The calcium-triggered photoprotein aequorin has been used as a sensitive indicator of cytoplasmic free calcium in cells of relatively large size. We describe here several novel modifications to the technique that make it possible to detect resting levels of free calcium in single mammalian oocytes, fibroblasts and granulosa cells. Concentrations of free calcium as low as 1 X 10(-7) M have been measured in single fibroblasts, corresponding to a detection limit of 10(-18)mol.

Aequorin↗