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V Shaw

Publications and source records attributed to V Shaw.

At least 19 recordsLinked to original sources
PubMed2001

The role of blinded interviews in the assessment of surgical residency candidates.

BACKGROUND: Interview assessments of surgical residency candidates may be biased by prior knowledge of objective data. METHODS: Each candidate (site 1: n = 88; site 2: n = 44) underwent two interviews, one by faculty members informed only of a candidate's medical school, the second with prior knowledge of the complete application. Interviewers (site 1: n = 28; site 2: n = 14) independently rated candidates overall and on nine qualitative characteristics. RESULTS: At site 1 only, overall ratings were significantly more favorable for unblinded than blinded interviews (23.0 +/- 17.7 versus 32.6 +/- 23.1, P < 0.01). Blinded and unblinded overall ratings correlated -0.01 (P = 0.90) and 0.31 (P = 0.05) at sites 1 and 2, respectively. At site 1 only, overall ratings correlated significantly with USMLE scores, but in opposite directions for blinded (r = 0.32, P = 0.003) versus unblinded interviews (r = -0.32, P = 0.003). CONCLUSION: Interview assessments may be influenced by objective data, and faculty and program variables. The value of blinded interviewing may vary as a function of individual program characteristics.

Educational Measurement↗
PubMed2000

Outcome and growth of infants with severe chronic renal failure.

BACKGROUND: We aimed to assess the outcome and growth of infants with severe chronic renal failure (CRF). One hundred and one children presented between January 1, 1986, and December 12, 1998, with a glomerular filtration rate (GFR) of <20 mL/min/1.73 m2. The median (range) age at presentation was 0.3 (0 to 1.5) years, and follow-up was 7.6 (1.5 to 13) years. One- and five-year survival rates were 87 and 78%, respectively. The growth of the 81 children who survived over two years was evaluated. Eighty-one percent were enterally fed from age 0.7 (0 to 4.5) years for 1.9 (0.1 to 6.8) years. Forty-six percent had a gastrostomy, and 22% a Nissen fundoplication. Twenty-five were managed conservatively. Twenty were transplanted without dialysis at age 4 (1.7 to 8.5) years, and 36 were dialyzed at age 1.1 (0 to 9.8) before transplantation at age 2. 4 (1.3 to 10) years. RESULTS: The mean (SD) height standard deviation score increased from -2.16 (1.34) at 6 months (N = 63) to -1.97 (1.37) at 1 year (N = 75), -1.79 (1.29) at 2 years (N = 75), -1.33 (1.29) at 3 years (N = 68, P = 0.0006), -1.27 (1.04) at 5 years (N = 47, P = 0.0001), and -0.85 (0.82) at 10 years (N = 18, P = 0.001). The body mass index was in the normal range in the majority of patients. CONCLUSION: Mortality in infants with CRF occurs mainly in the first year of life. With early enteral feeding, the mean height standard deviation score is within the normal range from one year of age.

Body Height↗
PubMed2000

Watching brief.

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Aged↗
PubMed2000

Ending the splits.

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Health Services Administration↗
PubMed1999

Long-term enteral nutrition in infants and young children with chronic renal failure.

An inadequate nutritional intake is common in infants and young children with chronic and end-stage renal failure (CRF/ESRF), causing poor weight gain and growth retardation. In a programme of enteral feeding (EF), growth, nutritional intake and outcome for oral feeding were evaluated in 35 children with CRF/ESRF, mean (range) age 1.6 (0-4.9) years at start of EF for 30 (12-60) months. Twenty-nine had a glomerular filtration rate of 12.1 (6-26) ml/min per 1.73 m(2) and 6 were on peritoneal dialysis. Mean (SD) weight standard deviation scores (SDSs) in the 0 to 2-year age group (n=26) were -3.3 (1.0) 6 months before EF, -3.1 (1.3) at the start, -1.7 (1. 4) at 1 year, (P=0.0003) and -1.4 (1.8) at 2 years, (P=0.0008). Height SDSs were -2.9 (0.7), -2.9 (1.2), -2.2 (1.2) (P=0.008) and -2. 1 (1.3) (P=0.004). Weight SDSs in the 2 to 5-year age group (n=9) were -2.3 (1.2), -2.0 (1.1), -1.1 (1.3) (P=0.002) and -0.9 (1.0) (P=0.04). Height SDSs were -2.8 (0.6), -2.3 (0.7), -2.0 (0.7) and -2. 0 (0.8). There was no change in energy intake as a percentage of the estimated average requirement, nor was this exceeded. Percentage energy from the EF in the 0 to 2 year age group remained unchanged despite an absolute increase in energy intake with age. Twenty-one have had renal transplants, of whom 86% eat and drink normally. Long-term EF prevents or reverses weight loss and growth retardation in children with CRF/ESRF, with the achievement of significant catch-up growth if started before age 2 years.

Age Factors↗
PubMed1999

Nutritional management of renal disease.

This article discusses the nutritional management of children with chronic renal failure and renal replacement therapy. It is important to remember that there is no set diet for the treatment of renal disease. Diets are prescribed for each individual child and must be reviewed regularly.

Child↗
PubMed1998

Effect of enteral feeding on lipid subfractions in children with chronic renal failure.

The anorexia of chronic renal failure (CRF) is frequently managed with enteral feeds using combinations of commercial preparations, glucose polymers and fat emulsions. Such feeds might predispose to atherogenic blood lipid profiles. Our aim, therefore, was to compare the blood lipid profiles of enterally fed and non-enterally fed children. Plasma lipid subfractions were measured in 37 children with CRF managed conservatively and 10 managed with peritoneal dialysis (PD); 10 of the children were tube fed, 5 of whom were on PD. Results were compared between these groups. Overall, triglycerides (TGs, mean +/- SD) were high (2.3 +/- 1.4 mmol/l) and total cholesterol (TC) was at the upper limit of normal (5.2 +/- 1.5 mmol/l). Low-density lipoprotein (LDL), high-density lipoprotein (HDL), apoprotein A1 (apo A1), A2 (apo A2) and B (apo B), and lipoprotein (a) [Lp(a)] were within the normal range. There was an inverse correlation between TGs and glomerular filtration rate (P = 0.0001). There were no differences in the levels of TC, TG, LDL, HDL, apo A1, apo A2 or Lp(a) between tube-fed and non-tube-fed children. We conclude that enteral feeding does not enhance hyperlipidaemia.

Adolescent↗
PubMed1993

Serum melatonin and 6-sulfatoxymelatonin in end-stage renal disease: effect of hemodialysis.

The pineal hormone melatonin plays a role in the regulation of hypothalamic-pituitary axis, target gland function, sleep pattern, mood changes, cellular immunity, antibody response, and skin pigmentation, nearly all of which are also affected by renal insufficiency. We measured serum melatonin and its main urinary metabolite, 6-sulfatoxymelatonin (6-SM), by radioimmunoassay in 11 patients with end-stage renal disease (ESRD) between the hours of 6 and 9 a.m. during hemodialysis and again on an off-dialysis day. The results were compared with those obtained in a group of normal control subjects. Predialysis serum melatonin and 6-SM levels obtained at 6 a.m. in the ESRD patients were comparable with those obtained in the normal control group. Serum melatonin concentration in the ESRD group fell approximately 25% during dialysis while 6-SM remained virtually unchanged. The changes observed on the off-dialysis day during the same time period were of nearly the same magnitude as those seen during dialysis (-32% and 1.4%, respectively). No significant difference was found in the concentration of either analyte in the blood entering and leaving the dialyzer. These observations suggest a lack of discernible removal of either compound by hemodialysis. In contrast to the ESRD patients, who showed a slow fall in serum melatonin and no significant change in serum 6-SM on both on- and off-dialysis days, the normal control subjects showed an expected reduction in serum melatonin (-43%) and a sharp fall in serum 6-SM (-53%) between 6 and 9 a.m.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Treatment of advanced Kaposi's sarcoma using a combination of bleomycin and vincristine.

Eighteen patients with disseminated AIDS-related Kaposi's sarcoma (KS) and compromised bone marrow function were treated with a relatively non-myelosuppressive regimen of bleomycin and vincristine (BV). At study entry, the patients presented with the following median laboratory values: hemoglobin of 9.5 g/dl, granulocyte counts of 1,173/mm3, platelet counts of 218,000/mm3, and CD4 lymphocyte counts of 58/mm3. All patients had extensive Kaposi's sarcoma. Nine patients had visceral involvement: four with pulmonary involvement, two with gastrointestinal involvement, and three with both. Following a median number of seven cycles of biweekly chemotherapy, complete or partial tumor responses were achieved in 13 patients (72%). Two patients experienced bleomycin-induced skin toxicities, whereas 10 others (55%) experienced peripheral sensory neuropathy requiring vincristine dose reductions. Opportunistic infections had occurred in 11 patients prior to initiation of chemotherapy and in 16 after initiation of chemotherapy. Despite the frequent development of opportunistic infections, BV chemotherapy was relatively well tolerated and resulted in a high response rate in this patient population that presented with suboptimal marrow function and extremely low CD4 lymphocyte counts.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Dietary practices and pregnancy discomforts among urban blacks.

In this prospective study, we investigated the relationship between dietary practices and pregnancy discomforts among 50 urban black American women during their first and third trimesters of pregnancy. Subjects were interviewed during their regular prenatal clinic visits for information about their previous 24-hour dietary intake, the presence and severity of pregnancy discomforts occurring in the previous month, and pertinent demographic data. Findings indicated that high intake of meat products but low or no intake of vegetables was correlated with nausea, little or no intake of milk products was correlated with heartburn, and low or no intake of citrus fruit but intake of vitamin and iron supplements was correlated with heartburn, constipation, and sleeping difficulty. Replication of the study with a larger sample is warranted so as to provide further validity to the findings.

Black or African American↗
PubMedDate not supplied

Nursing management of patients with brain injury requiring one-on-one care.

Patients with traumatic brain injury currently constitute a major portion of the rehabilitation population. Although agitated, restless, and wandering behavior is an expected stage in the recovery process of these patients, issues involving the patient's and the staff's safety can arise when these behaviors are excessive and hard to control. In addition, patients may have difficulty achieving their rehabilitation goals because of these behaviors. One-on-one supervision, specialized interventions, and a structured approach often are necessary and beneficial if patients are to achieve rehabilitation goals. The facility described in this article has a large population of patients with head injury who require one-on-one supervision. Guidelines for the nursing management of two different patient populations that required two different interdisciplinary approaches were developed and established.

Brain Injuries↗
PubMedDate not supplied

Understanding lesbians' mammography utilization.

Lesbians face unique barriers to health care, and may be at higher risk for breast cancer than are other women. Yet, no research on lesbians and mammography utilization exists. We conducted telephone interviews of 107 lesbians aged 51-80, of whom 68 had had mammograms in the last year and 39 had not. Responses to open-ended questions identified the barriers lesbians face in obtaining mammography, lesbians, reasons for obtaining mammograms, and factors that would help lesbians obtain mammograms. Some issues identified were particular to lesbians; many issues were common to those identified by general samples of women (which include lesbians).

Aged↗