PubMed Health⌕ Search

Biomedical subjects

W A Nelson

Publications and source records attributed to W A Nelson.

At least 19 recordsLinked to original sources
PubMed1992

Fine-needle aspiration biopsy of small round blue cell tumors of childhood.

One hundred twenty-eight palpable and deep-seated fine-needle aspiration biopsies (FNAB) were done on pediatric patients at James Whitcomb Riley Hospital for Children and Indiana University Hospital between 1985 and 1988. During that 4-year period, 71 (56%) benign and 49 (38%) malignant diagnoses were made. Only eight (6%) of the FNAB were considered inadequate. Thirty-nine (80%) of the malignant aspirates were small round blue cell tumors of childhood (SRBCT). The SRBCT consisted of 21 (54%) lymphomas, 7 (18%) Ewing's sarcomas, 3 (8.5%) neuroblastomas, 3 (8.5%) rhabdomyosarcomas, 2 (5.0%) medulloblastomas, 2 (5.0%) Wilms' tumors, 1 (3.0%) retinoblastoma, and 1 (3%) granulocytic sarcoma. Fifteen (38%) of the SRBCT aspirates were obtained to render a primary diagnosis and 24 (62%) documented recurrence. Various combinations of electron microscopy, immunocytochemistry, and other special stains were used to confirm the diagnosis in 11 (28%) cases. These cases consisted of five lymphomas, two rhabdomyosarcomas, two Ewing's sarcomas, one neuroblastoma, and one granulocytic sarcoma. The technique of FNAB is a successful diagnostic tool for documenting primary and recurrent SRBCT in a pediatric population.

Biopsy, Needle↗
PubMed1990

A study of the dying process in elderly hospitalized males.

The dying process was studied by questioning nurses and next of kin of 40 consecutive patients who died in an acute care Veterans Hospital. Information regarding problems commonly thought important in the dying process was elicited and attempts were made to relate this information to global assessments of quality of life during the preterminal week and quality of the moments surrounding death. Despite long-standing awareness of many of these problems, important pain, respiratory difficulty, mood problems, blunted alertness, stooling problems, urination problems, and oral intake problems each was present in at least 50% of patients. Multivariate analysis did not define a convincing relationship between these problems and global assessments of quality. Responses of nurses and next of kin were similar most of the time, but nurses systematically rated pain as less severe than next of kin and next of kin systematically demonstrated less awareness of urinary and stooling problems than nurses.

Adult↗
PubMed1989

Moral theory and neurology.

This article presents an outline of a general moral theory and shows its relationship to the concepts of paternalism and that of valid consent and refusal. The authors then show how this theory and these concepts can be usefully applied to the moral problems that neurologists often face in determining how to act when they have distressing information for their patients. Finally, a procedure is provided for determining when it is morally justified to deceive patients by withholding information about their diagnoses, prognoses, or about their prospective treatments.

Comprehension↗
PubMed1989

Decisions to withhold or terminate treatment.

Decisions to withhold or terminate treatment are common clinical dilemmas in patients dying from diseases of the nervous system. Decision making for such patients must be based upon ethical principles. Under the doctrine of valid consent and refusal, competent patients have the right to refuse life-sustaining therapies. For incompetent patients, this right may be exercised through their previously executed advanced directives or through appointed proxy decision makers. Physicians have the duty to assess the potential benefits and harms of various treatment options and to clearly communicate this information to patients and their proxies in a supportive manner. The authors illustrate the application of ethical principles in neurologists' management of patients in persistent vegetative states, dementia, and end-stage neuromuscular disease.

Beneficence↗
PubMed1988

Fine-needle aspiration of metastatic atrial myxoma.

Atrial myxoma is the most common primary neoplasm of the heart, but "metastatic" or embolic phenomena are rare. The first reported case of "metastatic" atrial myxoma diagnosed by fine-needle aspiration biopsy is presented. It occurred in a 54-yr-old woman with multiple metastatic lesions. The cytologic and histologic findings of the fine-needle aspiration biopsy and subsequent surgical excision are presented as is a discussion of the incidence, origin, and clinical findings of atrial myxoma and the characteristics of its emboli.

Biopsy, Needle↗