Biomedical subjects
Publications and source records attributed to A Edwards.
SH profiles Fowler Healthcare Affiliates, Inc., an Atlanta-based consulting firm which has developed a unique niche in specialty services consulting. Frances J. Fowler, president, and Harriet S. Gill, managing partner, explore why specialty services diversity presents growth opportunities for hospitals today, especially in the South. They also present guidelines for selecting consultants and ensuring the best results from them.
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An increased frequency of bacterial pneumonia occurs in HIV-infected individuals: however the development of bronchiectasis is not well recognized. We describe seven patients with HIV infection who developed chronic symptomatic lung disease, six with troublesome recurrent infective exacerbations. Bronchiectasis was demonstrated by computed tomography in five patients, and bronchial wall thickening was shown in a further two patients. The characteristics of the patients are described, and possible aetiological factors are discussed. As measures become available which prolong the later stages of HIV disease, bronchiectasis may become an increasing problem in this patient population. Early recognition and appropriate management may significantly alter morbidity in advanced HIV disease.
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By means of two dimensional echocardiogram we diagnosed a trans-septal migration of a pacemaker wire. The septal perforation was corroborated by EKG and radiographic studies.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This report is part of a feasibility study focused upon developing a valid and reliable method of screening for tardive dyskinesia. The research questions concerned establishing the validity and reliability of the procedure, the acceptability of the procedure to the subjects, and the characteristics of the subjects with scores that exceeded more than a minimal level. Sixty patients were screened in four randomly selected psychiatric aftercare homes. A 12-hour training program was developed to prepare the raters. The interrater reliability achieved for total score using the Abnormal Involuntary Movement Scale (AIMS) was .90, p less than .01, and the validity of the examination was achieved and maintained at an 80-percent agreement level between the nurse raters and a study expert. Thirty percent of the population had scores exceeding minimal symptoms for tardive dyskinesia. The screening program was acceptable to the subjects. A program of training for professional-level raters is described, which is applicable to many settings.
Natural killer cell (NK) activity against allogeneic melanoma and Chang liver target cells were measured in a group of 212 patients with primary (stage I) melanoma and 85 patients with metastases in regional lymph nodes (stage II) 2-4 weeks after surgical removal of their tumor. No significant correlation was established between NK activity measured at this time and the recurrence-free period or death from melanoma in prospective studies ranging from 3 to 5 years. Trends for an association between these factors appeared to mainly reflect the influence of tumor growth on NK activity. These studies do not prove that NK activity is not important in host defences against melanoma but do suggest that such measurements in tumor-bearing patients are not related to subsequent prognosis of the patient.
The routes of airborne contamination, during Blow-Fill-Seal (BFS) production, were studied using tracer gas, particles and bacteria. The prevention of airborne contamination, by the air shower at the point of fill, was effective (> 99.2% efficient). However, microbe-carrying particles could gain access, by deposition or air exchange, when the containers were cut open and before they shuttled under the protection of the air shower. The use of SF6 tracer gas demonstrated that when the air shower was not on, 50% of the air within the containers came from the area round the machine. When the air shower was switched on, only about 5% of the air came from the surroundings. Airborne microbial contamination of containers is in proportion to: the number of airborne microbes around the machine, the time the container is open, the neck area and the amount of air left within the container. The likely microbial contamination rate can be calculated from a model incorporating these variables. Microbial contamination of containers during BFS manufacturing is normally very low, but by increasing the naturally occurring bacteria in the air of the production rooms by about 100-fold, it was possible to verify the accuracy of this model. The contamination model agrees well with the observation that microbial contamination levels of between 1 in 10(5) and in 10(7) will be found when small containers (< 10 ml) are filled in conventionally ventilated rooms. To achieve similar contamination rates when filling of larger bottles, it is likely that unidirectional flow, or barrier technology will be required.