Biomedical subjects

A John

Publications and source records attributed to A John.

98 records · Page 6Linked to original sources

PubMedDate not supplied

Reliability of speech and language therapists using therapy outcome measures.

The Therapy Outcome Measure (TOM) aims to provide Speech and Language Therapists (SLT) with a practical tool to measure outcomes of care by providing a quick and simple measure which can be used over time with patients and clients in a routine clinical setting. The TOM allows therapists to reflect their clinical judgement on the dimensions of impairment, disability/activity, handicap/participation and well-being on an 11-point ordinal scale. The purpose of this paper is to examine the reliability and the influences on reliability of SLT using this measure. Three studies are presented and give information on 73 SLT using the measure with different client groups. Study one assesses the degree of reliability of six SLT using the TOM following training and practice. Reliability was studied on three occasions and the results demonstrate the influence of training and practice. Study two included 56 SLT to examine reliability over a broader range of client groups and to investigate the effect of the SLT specializing on rating patients from within or -out that specialism. Eleven therapists were included in the study, which examined the influence of a specific training approach. The participating SLT achieved a substantial-moderate level of reliability; this was established in all domains. The degree of reliability achieved on the TOM was affected by some, but not extensive, training and experience.

Clinical Protocols↗

PubMedDate not supplied

Therapy outcome measures in speech and language therapy: comparing performance between different providers.

BACKGROUND: The use of outcome measures to monitor improved quality of care has been advocated for 20 years but has only achieved prominence with the increasing resource pressures and related changed in health service provision in the past 6 years. OBJECTIVE: This paper describes the development of an approach to outcome measurement suitable for all patients receiving speech and language therapy. The measure, which is based on rating the dimensions of impairment, disability, handicap and well-being, is tested to assess whether it can usefully be used to compare the services of different providers. METHOD: Five trusts volunteered for the study. Service descriptions suggest that these services are typical for the purposes of providing speech and language therapy. Twenty-five therapists were trained to use the Therapy Outcome Measure (TOM); their reliability was assessed and they provided prospective data on clients with speech and language impairments related to dysphasia, stammering and dysphonia. RESULTS: The study provides evidence indicating the differences in the types of patients being referred to different providers of speech and language therapy. Different services have different impacts on the number and type of domains and that services discharge patients at different points in their recovery. DISCUSSION: Different outcomes by different providers may be associated with different referral policies, base populations, skills and work policies of therapists. Differences in outcomes associated with certain therapy services can initiate the task of analysing attributions and progress endeavours to provide equitable quality of care which is the philosophy underpinning the move towards benchmarking in health service delivery.

Adolescent↗

PubMedDate not supplied

The renal response to acute hypervolemia is caused by atrial natriuretic peptides.

In anesthetized rats, synthetic rat atriopeptin II produced an increase in urinary volume and sodium excretion as well as a decrease in arterial blood pressure. Both the natriuretic and hypotensive effects were blocked by monoclonal antibodies directed against atriopeptin II. The diuresis and natriuresis caused by furosemide was not inhibited by these antibodies. Thus, the monoclonal antibodies provide a specific inhibitor for atriopeptin-mediated responses in vivo and can be used to investigate the role of atriopeptin in volume regulation. Volume expansion with 20 ml/kg i.v. homologous blood induced strong diuresis and natriuresis in the anaesthetized rat. This response was also blocked by the described monoclonal antibodies. A radioimmunoassay for the determination of atriopeptin-like immunoreactivity (ANP-IR) is described. The plasma levels of ANP-IR 8 min after blood injection were 3-4 times higher than in control rats. Thus, the strong diuresis observed after volume expansion is due to an increase in circulating atrial natriuretic peptides that obviously exert a regulative function in fluid volume control.

Animals↗

PubMedDate not supplied

Lymphangioma circumscriptum.

Lymphangioma circumscriptum (LC) of the vulva is a rare complication of radiotherapy to pelvis. We report two cases of LC of the vulva occurring after radiotherapy to pelvis for carcinoma cervix. Patients were managed conservatively.

Adult↗

PubMedDate not supplied

A basic guide to the principles of drug therapy.

Why must glyceryl trinitrate tablets be given sublingually? Why can you crush some tablets but not others? Can drug therapy cause red urine? How can suppositories stop vomiting? This article discusses why certain drugs are given by specific routes of administration and examines issues related to drug therapy, giving examples of drugs used in practice. Clinical tutors may wish to use this and subsequent articles for teaching purposes.

Drug Interactions↗

PubMedDate not supplied

Cloning, characterisation and bacterial expression of full length cDNA for the mouse liver microsomal glutathione S-transferase.

We have isolated a cDNA encoding full length microsomal glutathione S-transferase (MGST) from mouse liver. The cDNA was isolated by RT-PCR using primers designed from published cDNA sequence of rat MGST with the addition of 5' Nde-1 and 3' HindIII sites, and cloned into bacterial expression vector pSP19T7LT. Deduced amino acid sequence (155 amino acids, calculated mol.mass 17512 Dalton) confirmed the identity of microsomal GST from mouse liver which has sequence homology with that of rat and human liver MGST1. Recombinant GST cDNA (Genbank accession # 159050) was expressed in BL21(DE3) in the presence of 1 mM IPTG at 30 degrees C. The expressed GST protein was found to be localised in the bacterial membrane as determined by measuring catalytic activity using CDNB and cumene hydroperoxide substrates, SDS-PAGE and Western blot analysis. We have demonstrated the cloning and expression of full length cDNA for MGST from mouse liver and have characterised the functionally active product as MGST protein. These results should facilitate studies on the role of MGST in the regulation of chemical carcinogenesis and in the prevention of oxidative stress caused by endogenous and exogenous chemicals.

Amino Acid Sequence↗

PubMedDate not supplied

Carcinoma gall bladder presenting as hemobilia.

A 60-year-old man presented with recurrent bouts of melena, requiring multiple transfusions. Upper GI endoscopic evaluation demonstrated fresh bleeding from the ampulla of Vater. Ultrasonography and CT scan suggested a gall bladder mass without evidence of metastases. Laparotomy confirmed a mass confined to the lumen of the gall bladder. The patient underwent cholecystectomy. Histological examination showed papillary adenocarcinoma of the gall bladder extending up to the muscularis propria.

Adenocarcinoma, Papillary↗

PubMedDate not supplied

Hemoperitoneum following rupture of ectopic varix along splenorenal ligament in extrahepatic portal vein obstruction.

A 29-year-old man with extrahepatic portal vein obstruction who underwent variceal eradication by sclerotherapy six years ago, was admitted with hypotension and abdominal pain. Abdominal paracentesis yielded frank blood. Laparotomy showed bleeding from a large ectopic vessel along the splenorenal ligament. The vessel was ligated and the patient recovered.

Adult↗