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Biomedical subjects

A L Collins

Publications and source records attributed to A L Collins.

29 records · Page 2Linked to original sources
PubMed1993

Bowel habit and dietary fibre intake before and during menstruation.

The stool frequency, faecal form and dietary fibre intakes of 25 menstruating women were recorded during the 4 days just before menstruation and the first 4 days of menstruation. At the time of the bleed there was a significant increase (P < 0.01) in stool frequency, a significant decrease (P < 0.001) in faecal form and a significant increase (P < 0.01) in dietary fibre intake. There are indications that cyclical changes in fibre intake may have some bearing on differences in bowel function between the luteal phase and menses although other factors would appear to play a dominant role.

Adult↗
PubMed1992

Hospital rightsizing: in line with long-term strategies and economic realities.

After two years of difficult financial times, the Kitchener-Waterloo Hospital was faced with another upcoming year of tight fiscal constraint. In February 1991, the hospital implemented a program review process to align its services with the hospital's long-term strategy and economic realities. The authors present a thorough review of the literature pertaining to downsizing decisions. From a practical perspective they demonstrate a downsizing process, its implications and lessons to be learned so that a "rightsizing" exercise can be implemented to minimize the effects of the program and staff reductions while focusing on the positive long-term benefits of strategic planning. Although downsizing is a difficult process, the Kitchener-Waterloo Hospital was able to develop and implement a plan that minimized the impact on the hospital services and its staff. A reduction in expenses of over $2 million was achieved without having to lay off any permanent hospital staff. This was achieved by streamlining programs, reducing management supervisory positions and eliminating 50 full-time equivalent positions through attrition. Ultimately, the hospital's board, senior management, medical staff and employees felt that a rightsizing decision had been made, one which minimized the negative impact of restructuring on service delivery, hospital employees and the community served.

Communication↗
PubMed1988

Skin rash associated with Candida guilliermondii.

We report a case in which the development of a skin rash in a neutropenic patient was associated with multiple blood culture isolates of Candida guilliermondii--an unusual isolate not previously documented to cause rashes.

Candida↗
PubMed1985

The clinical value of rapid C-reactive protein measurement in cerebro-spinal fluid.

C-Reactive protein (CRP) has been measured in 90 consecutive CSF specimens using both latex agglutination and an immunoradiometric assay (IRMA). In the 60 CSF specimens otherwise normal by standard biochemical and microbiological criteria, the median CRP level was 32 micrograms/l (95% confidence limits, 0-108 micrograms/l) and in the remaining abnormal specimens the median level was 176 micrograms/l (95% confidence limits, 110-325 micrograms/l, p = 0.001). C-Reactive protein was detected by a commercial latex agglutination kit at a level of approximately 120 micrograms/l and all significant CNS bacterial infections were positive (7 bacterial meningitis, 2 infected shunts). In addition, viral encephalitis, extensive intracranial malignancy and subarachnoid haemorrhage gave positive agglutinations, but not in every case. A further nine specimens with a minor elevation of CRP level were detected by IRMA (median 76 micrograms/l), but this was of little practical significance. We have shown that normal CSF C-reactive protein levels are very low and we conclude that latex agglutination set at a sensitivity of 120 micrograms/l, although only semi-quantitative, is a rapid and useful method to assess CSF C-reactive protein in routine clinical practice and, when positive, is strong supporting evidence for bacterial infection.

C-Reactive Protein↗
PubMed1985

Small bowel biopsy.

We describe our technique of small bowel biopsy, which has been used on 190 occasions over a four year period. In 77%, the examination was completed within 10 minutes, and fluoroscopy times were less than 10 seconds in 75% of the cases. The technique is easily taught, and it has made the examination a minor procedure.

Adolescent↗
PubMed1980

Coronary-artery surgery in patients with end-stage renal disease.

Between 1975 and 1979 we performed coronary arteriography on 15 patients with end-stage renal failure and clinical evidence of severe ischemic heart disease. One patient died after the procedure of severe pump failure. Ten patients subsequently received coronary-artery bypass grafts, and two of these patients also received mitral-valve replacement. One patient, a diabetic, died of sepsis after surgery. Eight of the nine surviving patients, including the two patients who had undergone mitral-valve replacement, are markedly improved as a result of surgery. Our experience indicates that these patients can undergo angiography and coronary-artery bypass surgery at an increased but acceptable risk, provided dialysis is done before and after cardiac catheterization and surgery to control extracellular volume overload and hyperkalemia. The operation benefits patients with end-stage renal failure and severe ischemic heart disease by relieving angina and improving their level of activity. It is unclear whether survival is improved for these patients.

Adult↗
PubMed1978

Effects of combined radiotherapy and immunotherapy with the use of pyran copolymer on murine fibrosarcoma.

A weakly immunogenic, 3-methylcholanthrene-induced, subcutaneous fibrosarcoma syngeneic to inbred C3H/HeJ mice was used. Pyran copolymer was injected either directly into the tumor, ip, or iv as soon as tumors appeared or when tumors were 8 mm in diameter. One, three, or five doses of pyran copolymer at 10 or 20 mg/kg/dose were injected, with multiple doses being given every other day. Pyran copolymer injected intratumorally once, three times, or five times significantly retarded tumor growth and prolonged the survival times of the hosts. Of the other routes and doses, only pyran copolymer given three times iv significantly retarded tumor growth, but none of these significantly prolonged the survival times of the hosts. Pyran copolymer alone did not induce any complete regression of tumor. Local tumor irradiation with a single exposure to 2,000 rads of X-ray induced complete regressions in some mice, but a higher percentage of tumor cure was observed when tumor irradiation was followed by pyran copolymer treatment.

Animals↗
PubMed1977

Combined radiotherapy and Corynebacterium parvum treatment of a murine fibrosarcoma.

A single dose of Corynebacterium parvum (Cp) at 70 microgram, 175 microgram or 350 microgram was effective in suppressing the growth of a subcutaneous fibrosarcoma and occasionally in inducing complete regression and in prolonging the survival time of C3H/HeJ tumor-bearing mice. A single exposure of x rays at 2,000 rads induced some complete regression, but a higher number of complete regressions was induced by combined x-ray and Cp treatment. In the combined x-ray and Cp treatment, Cp given on the same day immediately after x irradiation was best. When 70 microgram of Cp was given a few days before x rays, the intravenous and intraperitoneal routes were better than the intratumor route of injection.

Animals↗
PubMed1976

Salmonella typhimurium mutants generally defective in chemotaxis.

The mutations of eight chemotaxis-deficient strains of Salmonella typhimurium, including five new mutants in strain LT2, were mapped by P22 transduction in relation to various fla mot deletions in S. abortus-equi. Seven recessive che mutations mapped between motB and flaC: three, all nontumbling, the che region I, adjacent to motB, and four, including one ever-tumbling, in che region II, adjacent to flaC. Mutant che-107, never-tumbling and dominant to wild type, mapped at flaAII, other mutations of which cause either absence of flagella or lack of locomotor function. We surmise that gene flaAII specifies a protein that polymerizes to form an essential component of the basal apparatus (so that absence of gene product prevents formation of flagela); that a component built up from certain mutationally altered proteins cannot transmit (or generate) active rotation of the hook and flagellum, and so causes the Mot (paralysis) phenyotype; and that a component built up from protein with the che-107 alteration permits only counterclockwise rotation, so that the tumble, normally produced by transient clockwise rotation, cannot be effected.

Chemotaxis↗
PubMedDate not supplied

Outcome of calcaneal fractures treated operatively and non-operatively. the effect of litigation on outcomes.

BACKGROUND: The optimum management of calcaneal fractures is controversial. These injuries are frequently associated with compensation litigation, which effects the outcome. AIMS: To assess the outcome of operatively and conservatively managed intra-articular calcaneal fractures and to examine the effect of compensation litigation on outcome. METHODS: This was a retrospective study of calcaneal fractures from a single regional trauma unit, with management decided by the admitting consultant surgeon's preference. Fifty-four patients (33 operative, 21 conservative) with an average follow-up of 40 months (range 14-78 months) were reviewed. Sixteen patients (30%) were pursuing a compensation case resulting from the injury. RESULTS: Despite similar fractures, medical co-morbidity and trauma energy, significantly worse outcome scores were seen in litigants (p < 0.0001). Footwear fitting problems were greater in litigants. Time off work was more than twice that of non-litigants (14.5 vs 6 months, p < 0.01). Results were similar between the operative and non-operative groups in terms of functional score, footwear problems and time off work. CONCLUSIONS: Litigation was the major determinant of outcome following calcaneal fracture repair; highlighting the unreliability of subjective evaluation in determining outcome in the face of litigation. No subset of patients appeared to significantly benefit from internal fixation of their fracture.

Absenteeism↗