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Les Accidents Aux Mains Dans Le Secteur De La Fabrication De Produits En Métal, Danièle Champoux, Madeleine Bourdouxhe

Rapports de recherche scientifique

No abstract provided.

An Analysis Of Quality Assessment Efforts In Health Care, Margaret M. Curran

Community & Environmental Health Theses & Dissertations

The purpose of this research was to determine whether consensus could be reached by experts in the field of quality assurance on the most important indicators of health care quality and to determine whether cause and effect relationship could be attributed to the process and outcome indicators suggested in our survey. We invited participation by a representative sample of experts in a Delphi Panel to address these issues. There were 49 respondants to our Round One Questionnaire and they evaluated the relative importance of 50 process and 50 outcome indicators. Panelists were asked to establish cause and effect relationships between …

Evaluation Of Four Aerobiological Sampling Methods For The Retrieval Of Aerosolized Pseudomonas Syringae, Mark P. Buttner, Linda Stetzenbach

Environmental & Global Health Faculty Research

The Andersen six-stage impactor, the SAS (Surface Air System) impactor, the AGI-30 impinger, and gravity plates were evaluated for the retrieval of aerosol-releasedPseudomonas syringae. The upper limits of the impactor samplers were exceeded at a spray concentration of 10^7 CFU/ml, indicating that these samplers are not appropriate for monitoring high airborne concentrations. Decreased cell concentrations were retrieved with increased sampling time for the Andersen and AGI samplers, indicating that a minimum sampling time is preferable for monitoring aerosolized vegetative cells.

The Aids Project Newsletter, Vol.4, No.1 (Spring 1991), Jeffrey Levensaler, The Aids Project

AIDS Project Newsletter (1987-1991)

No abstract provided.

Identification Of Health Promotion Behaviors, Perceived Health Status And Perceived Health Education Needs Of Older Women, Susan Carol Fellinger Reynolds

Ellmer School of Nursing Theses & Dissertations

The health-promoting behaviors, perceived health status, and perceived health education needs of older women were identified in this non-experimental, descriptive, correlational study. Fifty women over 60 years of age, living in three housing complexes for the elderly, disabled and handicapped in two southeastern United States cities were asked to complete The Health-Promoting Lifestyle Profile, The Perceived Health Status Questionnaire, The Health Education Needs Questionnaire, and Demographic Data Sheet. It was concluded that the women engaged in a high level of health-promoting behaviors. The participants rated their health as good and rated their health as good compared to that of other …

Identification And Ranking Of Stressors Specific To The Acute Head Care Nurse, Joan A. Breen

Community & Environmental Health Theses & Dissertations

No abstract provided.

Ua12/2/1 Magazine, Wku Student Affairs

WKU Administration Documents

Special magazine edition of the College Heights Herald:

• Poore, Chris. Silent Escape – Amy Deputy, Bulimia

Nutrition Support Of Hiv+ Patients, Johanna T. Dwyer

Henry Ford Hospital Medical Journal

Case management strategies for the nutritional support of patients infected with the human immunodeficiency virus (HIV) are evolving as the disease becomes less rapidly fatal and more chronic. Nutritional status changes in advanced HIV infection are similar in many respects to protein-calorie malnutrition. Current clinical effort and research focuses on the beneficial effects of preserving lean body mass and keeping asymptomatic patients in good nutritional status by preventing micronutrient deficiencies and by treating preexisting nutritional problems rather than attempting to intervene late in the disease's course, after secondary malnutrition has already developed. Nutrition support and intervention trials only late in …

Human Growth Hormone Treatment: Henry Ford Hospital Experience 1964-1990, David C. Leach

Henry Ford Hospital Medical Journal

Treatment with human growth hormone (GH) at Henry Ford Hospital began in 1964 and has included 145 patients. A total of 68 patients were treated with extracted hormone and 77 with recombinant GH. The appearance of Creutzfeldt-Jakob disease, now five cases worldwide, in patients treated with extracted hormone abruptly stopped its use in the United States. The development of recombinant GH in 1985 has resulted in greater availability of treatment. Diagnostic criteria are now more liberal and certain patients without GH deficiency, i.e., those with the Turner syndrome, are now being successfully treated with GH. GH is expensive and its …

Chronic Pancreatitis Progressing To Duodenal Obstruction In The Absence Of Classic Symptoms, John R. Condit Jr., Dominic K. H. Wong

Henry Ford Hospital Medical Journal

We report the case of a 34-year-old alcoholic who was initially seen in March 1985 because of acute pancreatitis. A mass was demonstrated in the head of the pancreas. Serial sonogram and computed tomography scans over 4 1/2 years revealed progressive encroachment of the duodenum without symptoms attributable to obstruction. In 1989, three separate endoscopies with multiple biopsies showed chronic inflammation and strictures. Hypotonic duodenography confirmed stricture and obstructed duodenum. Surgical intervention is being considered. Duodenal obstruction secondary to chronic pancreatitis is rare. It may proceed subclinically for several years independent of continued alcohol use. Only when obstruction became severe …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

A Thyroid Testing Algorithm: Results Of A Pilot Study, Hossam Ibrahim, Malachi J. Mckenna, Carolyn S. Feldkamp

Henry Ford Hospital Medical Journal

We conducted a pilot study to evaluate an algorithm for thyroid function testing consisting of initial serum thyrotropin values, measured by a sensitive immunoradiometric assay (TSH-IRMA) followed by a computer-directed decision to order further studies. We divided 216 outpatients according to their serum TSH-IRMA values as follows: suppressed (< 0.1 mU/L, group I); low (0.1 to 0.4 mU/L, group II); normal (0.5 to 5.0 mU/L, group III); and high (> 5.0 mU/L, group IV). Thyroxine (T4), resin uptake (RU). and free thyroxine index (FTI) tests on groups I, Il, and IV revealed that T4 and RU were normal for most patients in all groups and FTI was normal in 80% of group 1, 93.4 % of group ll, and 93.3% of …

Measurement Of Left Ventricular Ejection Fraction Using Gated 99mtc-Sestamibi Myocardial Planar Images: Comparison To Contrast Ventriculography, David A. Parker, Ramon L. Lloret, Francesco Barilla, Lori Douthat, Mihai Gheorghiade

Henry Ford Hospital Medical Journal

Using the new myocardial perfusion agent 99mTc-sestamibi and multigated acquisition on a nuclear medicine gamma camera, the left ventricular ejection fraction (LVEF) was derived in 13 patients with coronary artery disease (CAD). Cross-sectional activity profiles were used to measure the left ventricle from end-diastolic and end-.systolic images. Several different geometric methods were then utilized to derive ejection fractions from the nuclear data. Comparison of the resultant ejection fractions to those obtained from contrast ventriculography showed significant correlation for all geometric methods (P < 0.01,S y X x = 6.2 to 9.6). We conclude that in patients with CAD one or more of these simple geometric methods can provide a useful estimate of the LVEF when performing 99mTc-sestamibi multigated myocardial perfusion imaging.

Disturbances In Lipid Metabolism Associated With Chylothorax And Its Management, Malachi J. Mckenna, Jau-Wen Chu, Dorothy M. Kahkonen

Henry Ford Hospital Medical Journal

Changes in circulating lipid status were studied in a 70-year-old woman during management of chylothorax that included chest drainage, pleuroperitoneal shunting, and a successful thoracic duct ligation. Hypolipidemia with a relative decline in high-density lipoprotein (HDL) cholesterol was apparent at presentation. Following recovery, serum HDL cholesterol rose to the upper limit of normal. Apolipoprotein A-l (Apo A-l) was discordantly raised during the period of pleuroperitoneal shunting. We speculate that diversion of chylomicrons to the liver with subsequent hydrolysis accounted for a release of Apo A-l particles into the circulation at a time when the formation of HDL was compromised by …

Suzanne Falgout's Review Of Martha C. Ward's Nest In The Wind: Adventures In Anthropology On A Tropical Island, Suzanne Falgout

Pacific Studies

No abstract provided.

The Phenomenology Of Cushing's Syndrome: One Patient's Account, Andrew Armstrong, J. David Fachnie

Henry Ford Hospital Medical Journal

Cushing's syndrome caused by ectopic secretion of adrenocorticotropic hormone (ACTH) is often a serious disease and a diagnostic dilemma. In the reported patient, the source of ACTH proved to he a benign pulmonary carcinoid tumor. The patient describes his trying experiences through the six months from initial diagnosis to definitive therapy.

Cushing's Disease: Dilemmas Of Diagnosis And Management, M. Saeed-Uz-Zafar, Raymond C. Mellinger, Max Wisgerhof

Henry Ford Hospital Medical Journal

Determining the cause of Cushing's disease and correcting the abnormality presents a continuing challenge to the clinician despite remarkable advances in diagnostic and therapeutic techniques. We present seven cases to illustrate 1) the classic disorder cured by pituitary adenomectomy: 2) persistence of the disease after adenomectomy: 3) Cushing's disease manifesting in the puerperium and remitting with dopamine agonist therapy: 4) a patient whose disease relapsed at least five times during 20 years of treatment by adrenalectomy, pituitary radiation, mitotane, and pituitary adenomectomy; 5) the Nelson syndrome; 6) the ectopic adrenocorticotropic hormone (ACTH) syndrome in a patient with dexamethasone suppressible urinary …

Hyperandrogenemia And Virilization With Simultaneous Pituitary And Adrenal Adenomas, Jeffrey A. Jackson, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

We describe a postmenopausal woman who presented with virilizing hyperandrogenemia and was found to have an intrasellar tumor and a large left adrenal mass. Pathologic studies showed an undifferentiated hypophyseal adenoma with immunostaining for chromogranin only and a benign adrenocortical adenoma. In light of current understanding of the regulation of adrenal androgen secretion and adrenocortical mitogenesis, we postulate that this case may be explained by secretion of adrenal androgen-stimulating and mitogenic factors by the pituitary tumor.

Contemporary Approach To Thyroid Disease Emphasizing Use Of High-Sensitivity Thyrotropin Assays, Carolyn S. Feldkamp, Malachi J. Mckenna

Henry Ford Hospital Medical Journal

Capabilities of new high-sensitivity immunoradiometric assays for thyroid-stimulating hormone (TSH-IRMA) to distinguish among hypothyroid, euthyroid, and hyperthyroid subjects and patient groups with low TSH for nonthyroidal causes suggested an algorithmic approach (directed TSH) to the evaluation of patients with suspected thyroid disease. Utilizing the algorithm, a TSH-IRMA result outside normal limits (0.5 to 5.0 mUlL) generates follow-up tests on the same sample. The interpretation of thyroid function tests (TSH-IRMA, thyroxine, resin uptake, free thyroxine index) and associated studies in the context of different clinical settings is reviewed. The approach is a cost-effective and efficient utilization of laboratory services.

An Ambulatory Approach To Self-Care Of Diabetes, Fred W. Whitehouse, Iris J. Whitehouse, Mary Sue Cox, Dorothy M. Kahkonen

Henry Ford Hospital Medical Journal

Managing the insulin-requiring diabetic patient in an ambulatory selling includes metabolic regulation of the diabetes and education in its self-care. Means of achieving these goals include structured group or one-on-one individualized sessions. Third party policies relating to ambulatory care are challenged and their need for fiscal support emphasized. During the coming decade, diabetic patients should 1) have access to ambulatory care programs for metabolic regulation and education in self-care. 2) expect third party support of these programs, and 3) heighten their own priorities on diabetes care to ensure quality management of their diabetes.

Vertebral Compression Fractures At The Onset Of Acute Lymphoblastic Leukemia In A Child, M. Beatriz Oliveri, Carlos A. Mautalen, Carlos A. Rodriguez Fuchs, M. Del Carmen Romanelli

Henry Ford Hospital Medical Journal

A child with acute lymphoblastic leukemia, spinal osteoporosis with vertebral compression fractures, and hypercalcemia appearing early in the course of the hematologic disease was followed for two and a half years. Bone mineral density (BMD). measured by single photon absorptiometry at the radial shaft. was within normal limits for age and sex. However, x-rays of vertebrae and vertebral BMD. measured by dual photon absorptiometiy, showed marked demineralization. Despite leukemic remission, the spinal osteoporosis became worse and the patient required aggressive treatment for eight months. Treatment included 50 units of calcitonin subcutaneously every other day. 1.000 mg/day of oral calcium, and …

Primary Hyperparathyroidism And Monoclonal Gammopathy, D. Sudhaker Rao, Rosella Antonelli, Kevin R. Kane, John E. Kuhn, Celina Hetnal

Henry Ford Hospital Medical Journal

Coexistent primary hyperparathyroidism and monoclonal gammopathy, although rare, has been reported previously by a number of investigators. We report four patients with such an occurrence who were seen between 1976 and 1988. Another patient with primary hyperparathyroidism also had multiple myeloma and was in remission for 12 years. These patients represent approximately 1% of the 386 patients with primary hyperparathyroidism seen during the same 12-year period. Although several mechanisms have been proposed to explain this concurrence, we believe it is the result of a chance occurrence. A review of the literature, an estimate of the chance occurrence of coincidental monoclonal …

The Right To Die: An Old Woman's Formula, Mary Guinan

School of Public Health Faculty Research

On December 26, 1990, Nancy Cruzan died, 12 days after her feeding tube was removed. She had been in an irreversible coma for seven years and her parents had sued for the right to remove the feeding tube that was keeping her alive. The pain and suffering of her family in coming to this decision was certainly compounded by those who disagreed with them and tried to prevent the extubation. Whether one agrees with this particular decision or not, most of us will not be faced with such clear alternatives, ie, leave the tube in or take it out in …

Suicide In Micronesia: The 1920s And 1930s, David C. Purcell Jr.

Pacific Studies

No abstract provided.

Maine Aids Alliance Newsletter (February 1991), Maine Aids Allaince

Newsletter / Maine AIDS Alliance (1990-1991)

No abstract provided.

Chloramphenicol Therapy Of Typhoid Fever, Z A. Bhutta, S H. Naqvi, S Durrani, A Suria

Department of Paediatrics and Child Health

In a prospective study we compared two different dosage regimens of IV chloramphenicol succinate (100 mg/kg/day and 75 mg/kg/day) in children with culture proven typhoid. Trough and peak blood samples, obtained at 48 hrs, were analysed for free chloramphenicol by high pressure liquid chromatography (HPLC). Although the mean trough (8.8 +/- 7.7 versus 5.4 +/- 2.6 mcg/ml) and peak (19.9 +/- 12.2 versus 15.4 +/- 6.1 mcg/ml) chloramphenicol concentrations were comparable in both groups, a significantly wider range was found in the group receiving 100 mg/kg/day. Potentially toxic levels (greater than 30 mcg/ml) developed in two patients with liver dysfunction. …

Using Joint Fact-Finding To Resolve Disputes Over Cleanup Of Hazardous Waste Sites, R. Steven Konkel

Environmental Health Science Faculty and Staff Research

This research demonstrates how and why joint fact-finding works to break impasses in negotiations and overcome obstacles to the cleanup of hazardous waste sites. Superfund cleanup negotiations often involve multiple-party, multi-issue disputes. Disputes often arise over identification of the responsible parties, allocation of cost and liability, definition and interpretation of cleanup standards, and development of a viable settlement structure. In 1988, Marks and Susskind identified disagreements over the accuracy and validity of data as critical barriers to cleanup of Superfund and other hazardous waste sites. Disputes over data have led to delays, costly supplemental studies, and site fragmentation into multiple …

Review Of John V. Schappi, Improving Job Attendance (Bna Books), W. J. Hankins

RISK: Health, Safety & Environment (1990-2002)

Review of JOHN V. SCHAPPI, IMPROVING JOB ATTENDANCE. (BNA Books 1988.) [187 pp.] Appendices, bibliography, index. LC 87-27638; ISBN 0-87179-535-3

Evaluation Of Particulate Air Filters For Indoor Air Cleaning, Murray R. Clark, Kevin Tennal, Thomas Rimmer, Malay K. Mazumder

Journal of the Arkansas Academy of Science

No abstract provided.