Public Health Commons^™

Palliative Care In The 1990s: Special Issues, Derek Doyle

Henry Ford Hospital Medical Journal

No abstract provided.

New Purine Analogues For The Treatment Of Chronic B-Cell Malignancies, Thomas E. Gribbin

Henry Ford Hospital Medical Journal

Adenosine deaminase (ADA). a purine salvage pathway enzyme, appears to play a key role in normal lymphocyte growth, development, and differentiation. Three new purine nucleoside analogues, deoxycoformycin, fludarahine, and 2-chlorodeoxyadenosine, affect the normal function of the purine salvage pathway by inhibiting ADA or by acting as analogs of the ADA substrates. These agents show significant activity in the treatment of chronic B-cell leukemias and low-grade lymphomas. The pharmacology, mechanism of action, and clinical usefulness of these agents are discussed.

Peripheral Blood Stem Cell Transplantation As An Alternative To Bone Marrow Transplantation: An Overview, Nalini Janakiraman

Henry Ford Hospital Medical Journal

Stem cells capable of restoring hematopoiesis following lethal bone marrow injury circulate in the blood of many animals, including humans. When collected through leukapheresis and reinfused following high-dose chemotherapy, stem cells offer a treatment option not currently open to some patients who are unable to undergo autologous bone marrow transplantation because of tumor involvement in the pelvis, prior pelvic radiation, or intolerance to general anesthesia. After stem cell infusion, hematologic and immunologic recovery are rapid in comparison to that after autologous hone marrow reinfusion: however, in some cases platelet engraftment is slower. There is some evidence that tumor contamination in …

Porcine Bioprosthetic Aortic Valve Endocarditis With Ring Abscess And Aortic Stenosis, Reda A. Girgis, Howard Rosman, Ramon Del Busto, Maryann Fitzmaurice, Norman A. Silverman

Henry Ford Hospital Medical Journal

Porcine bioprosthetic valve endocarditis is an infrequent but serious complication of valve replacement surgery. Ring (or annular) abscess is a frequent finding in mechanical valve endocarditis. In contrast, porcine valve endocarditis most often involves the cusps, and annular infection is uncommon. Porcine valvular dysfunction secondary to endocarditis usually takes the form of incompetence, whereas stenosis is less frequent. We report a case of a 76-year-old female who developed endocarditis wilh Staphylococcus epidermidis nine months after placement of a Carpenter-Edwards porcine aortic valve. Her initial presentation included complete heart block and moderate aortic stenosis. Transesophageal echocardiography aided the diagnosis by demonstrating …

The Department Of Surgery And The Halsted Tradition, Edward R. Munnell

Henry Ford Hospital Medical Journal

No abstract provided.

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Hospice Care: An Overview, Josefina B. Magno

Henry Ford Hospital Medical Journal

No abstract provided.

Crisis Intervention Services In Mental Health: A Review Of The Literature, Roger A. Lohmann, Ellen Neidermeyer

Faculty & Staff Scholarship

This paper is a review of the literature on mobile crisis services and other forms of modern crisis intervention services. It is the first part of a larger project, termed the North Central West Virginia Crisis Study. The purpose of this literature review is to identify recent published literature on crisis services, with particular attention to crisis response services. No attempt has been made to survey the voluminous literature on crisis intervention practice skills and techniques.

Commencement Program 1991, Loma Linda University

Commencement Programs

CONTENTS

2 | 1991 Events of Commencement

3 | Academic Procession

4 | The Speakers

8 | The Honorees

14 | The Zapara Awards

Order of Programs

• School of Medicine, 16
• Graduate School, 22
• School of Nursing, 27
• School of Public Health, 31
• School of Allied Health Professions, 38
• School of Dentistry, 43

A Descriptive Study Of Commitment Practices In A Selected Jurisdiction, Louis A. Pesnicak

Community & Environmental Health Theses & Dissertations

This study examines the application of commitment procedures in one urban community in Virginia. The study investigated: the concordance rates of clinical recommendation for treatment and the outcome of the commitment hearing. the time lapse between detention of an individual and the hearing outcome. the presenting symptomatology and outcome. and the pre-detention compliance to treatment and outcome. The study's findings showed a concordance rate of 64% between clinical recommendation and outcome. It provided no significant differences in symptomatology/outcome, compliance/outcome, and time lapse/outcome. The lack of any significant findings seems to suggest that application of commitment laws might benefit from institution …

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

Community & Environmental Health Theses & Dissertations

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 …

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.