Abstract Introduction: Tuberculosis carries a high mortality in the days immediately after treatment. It is also the commonest cause of adrenal insufficiency in the developing world. Rifampicin is a potent hepatic enzyme inducer, and may contribute to adrenal insufficiency by accelerating cortisol breakdown. The aim of the study was to determine whether rifampicin induced accelerated catabolism of corticosteroids. Methods: A prospective, randomised study comparing adrenal function in 20 patients with pulmonary tuberculosis in the first five days treated with two different antituberculosis regimens, one containing rifampicin, and the other ciprofloxacin. Results: Demographic, clinical and laboratory results were similar in both groups. Both groups showed a statistically significant and similar decrease in morning cortisol, with similar responses to ACTH stimulation at both 30 and 60 minutes before and after four days of treatment. In the entire cohort, 40% demonstrated an incremental cortisol rise of <250nmol/l after ACTH stimulation on day 1. Mean basal cortisol concentrations were substantially elevated and DHEA-S levels were consistently subnormal, resulting in a high cortisol:DHEA-S ratio. No patient demonstrated overt adrenal insufficiency. There were no significant differences between the two groups before or during therapy for any electrolytes, hormones or calculated serum osmolality. Conclusions: Rifampicin did not additionally impair adrenocortical function during the initial period of therapy.

This grounded theory study investigates the experiences and perceptions of comfort and discomfort of hospital patients admitted for medical-surgical conditions, with a focus on the post-accute stage of hospitalisation. In-depth post-discharge interviews were conducted with seventeen English speaking adults who had been admitted to nine Australian hospitals. A substantive theory of finding comfort and of managing discomfort was generated. Processes of self-talk (anticipating, interpreting, accepting, making allowances and maintaining perspective) and self-care (self-help and seeking help, which involved accommodating to the level and type of help available through deferring, avoiding, persisting or desisting) were used to find comfort and to manage discomfort. The study has implications for nursign practice, management, research and education. Existing practice in the areas of assessment, communication, individualised care planning and the management of discomfort need to be strengthened if nursing care is to make a difference for this category of patient. The study revealed that integrated caring by nurses perceived by informants as 'experts', contributed most to the experience of finding comfort and managing discomfort in this group of informants / Doctor of Philosophy (PhD)

Thesis (Ph. D.)--New York University, 1972. / Includes bibliographical references (leaves [69]-81).

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In this study two methods of nutritional assessment were compared by evaluating the attitudes of health professionals concerning usefulness of the procedure and by determining the accuracy of diagnoses and time involved using the methods. The two procedures of assessment were the traditional "eye-ball" or observation method and a written method involving laboratory and anthropometric measurements. Thirty-eight persons, including physicians, nurses, dietitians, a medical school instructor, and students of related disciplines, were the subjects of this study.In addition to being more up to date, the subjects felt the written method was significantly more useful than the traditional method in terms of accuracy, organization, logical order, preciseness, value, understandability, use of form, and completeness. The traditional method was found to be more appealing to the subjects in terms of time saved, ease of use, and simplicity. The traditional method was found to be much quicker to complete but the written method was found to give significantly more correct diagnoses. In conclusion, the written method was found to be significantly more useful due to its logical approach to diagnosing the nutritional status of the hospitalized patients; however, its use would be curtailed due to the amount of time required to complete the procedure unless protocol were established whereby some other member of the health care team could take the responsibility for completing the procedure, thus relieving thephysician of the duty.

Thesis (MNurs)--University of South Australia, 1997

Thesis (M.S.)--University of North Carolina at Greensboro, 2007. / Title from PDF t.p. (viewed Feb. 28, 2008). Directed by Kenneth Gruber; submitted to the School of Human Environmental Sciences. Includes bibliographical references (p. 67-70).

Thesis PlanA (M.S.)--University of Wisconsin--Stout, 2007. / Includes bibliographical references.