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Biomedical subjects

A Griffin

Publications and source records attributed to A Griffin.

At least 55 records · Page 3Linked to original sources
PubMed1995

Writing to referring doctors after a new patient consultation. What is wanted and what was contained in letters from one medical oncologist?

BACKGROUND: There are no Australasian data on the preferred information content of letters from consultant physicians to referring doctors. AIMS: To survey referring general practitioners (GPs) and specialists concerning their preferences for letters from a consultant physician after a new patient consultation to include different categories of information. To investigate the information content of letters written by one medical oncologist to referring doctors after a new patient consultation and contrast with that of individualised letters written to patients. METHODS: Fifty-five referring GPs and 53 specialists were sent a questionnaire seeking their views on the information content of letters from consultant physicians. Ninety-four letters after a new patient consultation were selected at random and analysed for their information content, and compared with 182 individualised letters sent to patients. RESULTS: Referring doctors wanted letters to contain details of diagnosis, clinical findings, test results and recommended future tests, treatment options, side effects and prognosis. Letters to referring doctors contained 19 items of information (range 8-33), while letters to patients contained a mean of 5.6 'salient' points (range 5-7). Both letters almost always stated the diagnosis, the presenting history and recommended treatment. Letters to patients more commonly presented information about prognosis, further tests, and explanation of symptoms than letters to doctors. In contrast, letters to referring doctors contained more information concerning the past medical, family, and drug history, clinical findings and test results. CONCLUSIONS: Letters sent by a consultant oncologist are not well tailored to the information needs of the referring clinician. Summary letters sent to patients may be modified to include information required by referring doctors.

Cross-Over Studies↗
PubMed1995

Cephalad sacral resection with a combined extended ilioinguinal and posterior approach.

A combined anterior and posterior approach was used for the resection of a large tumor (a chordoma, a giant-cell tumor, an osteosarcoma, or a chondrosarcoma) of the cephalad part of the sacrum in twelve patients. The anterior aspect of the sacrum was exposed through an extended ilioinguinal approach, and the posterior aspect, through a midline approach. This widely extensile procedure permitted simultaneous visualization of the anterior, posterior, and circumferential aspects of the sacrum at the time of the osteotomy and facilitated the resection of these difficult lesions. At the time of follow-up (average duration for the eleven surviving patients, thirty-seven months; median, thirty months; range, twenty to sixty-nine months), ten patients were able to walk independently (four with the use of a cane) and one was confined to a wheelchair. One patient had died immediately postoperatively. The results of the present study indicate that a combined extended ilioinguinal and posterior approach can be used effectively for the wide resection of a tumor arising in the cephalad part of the sacrum.

Adult↗
PubMed1994

Properties of K+ currents recorded from cultured ovine trachea submucosal gland cells.

We have used the whole cell recording technique to investigate voltage-activated outward currents in cultured ovine trachea submucosal gland cells. The cultured gland cells secreted lysozyme in response to secretagogues, methacholine (20 microM), phenylephrine (100 microM) and substance P (10 microM). Most cells in culture for 7-21 days expressed a voltage-activated outward current at potentials positive to -30 mV. This outward current inactivated slowly, by 44 +/- 6% during a 3 sec depolarization to +30 mV. The voltage-activated outward current was sensitive to the potassium channel inhibitors tetraethylammonium bromide (5 mM), 4-aminopyridine (500 microM) and glibenclamide (1 microM). These data suggest that the outward voltage-activated currents observed are due to K+ channel activity. In cells with little or no outward current present the potassium channel opener Ro 31-6930 produced an additional voltage-activated net outward current. This effect of Ro 31-6930 was sensitive to glibenclamide (1 microM). Our results suggest that some cultured submucosal gland cells express voltage-activated K+ currents with a mixed pharmacology to antagonists and that a portion of this current is sensitive to modulation by Ro 31-6930.

Adenosine Triphosphate↗
PubMed1993

Treatment of intraductal breast cancer--noncomedo type.

The treatment of intraductal breast carcinoma, ranging from local incision alone to modified radical mastectomy, remains controversial. Seventy-nine patients were treated for intraductal breast carcinoma, noncomedo type at our institution from 1975 to 1991. There were 78 females and one male with a mean age of 58 years and a range from 32 to 90 years. Clinical presentation included a palpable mass in 25 patients, abnormal mammogram in 60 patients, and nipple discharge in 12 patients. Treatment consisted of local excision in 19 patients, simple mastectomy in 25 patients, and modified radical mastectomy in 35 patients. Twenty-five patients underwent simultaneous prophylactic contralateral mastectomy. Choice of treatment was determined by physician preference and no differences were seen in family history, parity, nipple discharge, history of fibrocystic disease, presence of palpable lymph nodes, tumor size, tumor location, patient age, or mammographic findings. Forty-five patients had multicentric tumors on final pathology. One patient demonstrated an axillary lymph node metastasis following modified radical mastectomy raising the question of undetected invasive carcinoma. All patients were free of disease at last evaluation and no differences in survival were noted between different treatment groups with a mean follow up of 5 years. We conclude that local excision is an appropriate option for treatment of intraductal breast carcinoma noncomedo type.

Breast Neoplasms↗
PubMed1992

The pharmacokinetics of 125I-atrial natriuretic factor in anaesthetized rats. Effects of neutral endopeptidase inhibition with candoxatrilat and of ANF-C receptor blockade.

The effects of candoxatrilat (cis-4-([2-carboxy-3-(2-methoxyethoxy)propyl]-1-cyclopentanecarbonyla mino)- 1-cyclohexane carboxylic acid) and the ring-deleted atrial natriuretic factor (ANF) analogue C-ANF4-23 (des[Gln18, Ser19, Gly20, Leu21, Gly22]ANF4-23-NH2) on the clearance of (3-[125I]iodotyrosyl28)ANF (125I-ANF) were studied in both intact and nephrectomized anaesthetized rats. HPLC analysis was used to verify that the 125I-labelled material isolated by solid phase extraction of rat plasma was intact ANF. In intact animals, clearance of 125I-ANF was biphasic with a T1/2 alpha of 17 sec and T1/2 beta of 95 sec. Volume of distribution (Vd) was 564 mL/kg and plasma clearance (Clp) 248 mL/min/kg. Candoxatrilat, over the dose range 0.01-10 mg/kg i.v., increased T1/2 beta (by a maximum of 56%) and decreased Clp (by up to 52%) with no effect on T1/2 alpha or Vd. C-ANF4-23 (10 micrograms/kg+1 microgram/kg/min i.v.) reduced Vd (by 57%) and Clp (by 54%) with no effect on T1/2 beta, whilst abolishing the T1/2 alpha phase in over 50% of animals. Increasing the dose of C-ANF4-23 did not increase the effect on any of these parameters, apart from a small increase in T1/2 beta. Combining the two agents resulted in a substantial decrease in Clp (76%) whilst the reduction in Vd and increase in T1/2 beta were comparable to those seen with C-ANF4-23 and candoxatrilat alone, respectively. In nephrectomized rats, the pharmacokinetics of 125I-ANF and the changes induced by candoxatrilat were similar to those observed in intact animals, whilst the effects of C-ANF4-23 alone were greater than in intact animals. The combination of C-ANF4-23 and candoxatrilat again produced a substantial increase in T1/2 beta (153%) and decreases in Vd (55%) and Clp (78%) in nephrectomized animals, although these changes could not be distinguished from those seen in intact animals treated with the same combination. Our studies indicate that neutral endopeptidase and ANF-C receptors are both major, and approximately equal, clearance mechanisms for 125I-ANF, together accounting for at least 75% of the total clearance of this peptide in the rat.

Amino Acid Sequence↗
PubMed1991

Adjuvant effects of beta-adrenergic drugs on indomethacin treatment of newborn canine endotoxic shock.

Newborns are susceptible to gram-negative sepsis/septic shock, but there is no established method of its treatment. This study was performed to evaluate the adjuvant effects of dopamine and dobutamine in the indomethacin treatment of newborn endotoxic shock. Endotoxic shock was induced in newborn dogs (2 to 10 days old; 300 to 800 g) by Escherichia coli lipopolysaccharide (LPS; 1.5 mg/kg, intravenously [IV]). Indomethacin (1.5 mg/kg, IV) was injected 5 minutes after LPS injection. Dopamine (5 micrograms/kg/min) or dobutamine (5 micrograms/mg/min) infusion started 5 minutes after LPS injection immediately following indomethacin injection. Hemodynamic parameters were monitored serially for 120 minutes. LPS induced bradycardia and hypotension, decreased the cardiac output and cardiac performance, and increased the total vascular resistance. When dopamine, dobutamine, or indomethacin were used alone, they attenuated the hemodynamic deterioration by LPS. Dopamine infusion following indomethacin administration improved the hemodynamics further, although dobutamine infusion did not. Therefore, we conclude that the adjuvant therapy of dopamine in the indomethacin treatment of newborn endotoxic shock is beneficial.

Adjuvants, Pharmaceutic↗
PubMed1991

Prediction of treatment response in bipolar, manic disorder.

We examined the records of 53 patients with a diagnosis of bipolar affective disorder, manic. Thirteen patients were refractory to lithium carbonate treatment. Clinical variables hypothesized to have value in predicting response including the presence of elation, grandiosity, paranoia, irritability, delusions and hallucinations did not predict treatment response.

Activities of Daily Living↗