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Biomedical subjects

A MacDonald

Publications and source records attributed to A MacDonald.

At least 181 records · Page 10Linked to original sources
PubMed1975

Tumor localization of 131-I-labeled antibodies by radionuclide inaging.

Intravenous injections of 131-I-labeled anti-EL4 lymphoma antibodies showed progressive localization of radioactivity in EL4 transplants but not in B16 melanoma in mice carrying both tumors. Normal rabbit globulin labeled with 131-I did not localize in either tumor and cleared more slowly from the internal organs. Metastatic localization of intravenous 131-I-labeled anti-tumor antibodies was also observed in 2 cancer patients.

Animals↗
PubMedDate not supplied

Breast feeding in IMD.

Breast feeding has proven benefits for many infants with inherited metabolic disorders (IMDs) but, with the exception of phenylketonuria, there are few reports in other conditions. A questionnaire, completed by dietitians and clinicians from 27 IMD centres from 15 countries (caring for a total of over 8000 patients with IMDs on diet) identified breast feeding experience in IMD. Successful, demand breast feeding (in combination with an infant amino acid formula free of precursor amino acids) was reported in 17 infants with MSUD, 14 with tyrosinaemia type I, and 5 with homocystinuria. Eighty-nine per cent were still breast fed at 16 weeks. Fewer infants with organic acidaemias were demand breast fed (7 with propionic acidaemia; 6 with methylmalonic acidaemia and 13 with isovaleric acidaemia) (usually preceded by complementary feeds of a protein-free infant formula or infant amino acid formula free of precursor amino acids). Only 12 infants with urea cycle disorders were given demand breast feeds, but this was unsuccessful beyond 8 days in CPS deficiency. Further work is needed in developing guidelines for feeding and for clinical and biochemical monitoring for breast-fed infants with IMDs.

Amino Acid Metabolism, Inborn Errors↗
PubMedDate not supplied

Cerebrovascular accident clinical pathway.

The cerebrovascular accident (CVA) clinical pathway project was selected to complement the work already underway within the West Moreton Health Services District such as the development of a continuum of care model, revision of work practices to complement the new hospital redevelopment and encouraging team and evidence-based approaches to problem solving. Specific objectives were set for the project along with a detailed evaluation plan. A steering group was convened to run the project and a full time project officer was appointed. At the end of the 12 month period all the objectives were met. Specific achievements included a reduction in the overall average length of stay for those patients who experience CVA, improved clinical outcomes and a more effective use of resources. Quality of care has been improved through the preparation of specialized clinical pathway documentation, education packages, patient surveys, focus groups, independent reviews and benchmarking. Complementing these measures has been a series of process changes and environmental modifications. Furthermore, good working relationships have been established with private sector providers of health care and other external bodies. The development of the CVA clinical pathway at the Ipswich Hospital has meant timely referrals and a streamlined assessment and referral process to get patients into rehabilitation sooner. It has promoted good communication between, and recognition of, the professional roles of various team members and has put the patient back at the centre of the care process.

Critical Pathways↗
PubMedDate not supplied

Parkinson's disease and aided AAC: some evidence from practice.

Clinical observation that people with Parkinson's disease (PD) seem to have different training needs from other adult client-groups in developing effective use of aided augmentative and alternative communication (AAC) was the catalyst for this study. There is little good-quality research evidence available on the effectiveness (or lack of effectiveness) of aided AAC use by those with PD. One of the main aims of this preliminary study, therefore, was to elicit the experiences and attitudes of speech and language therapists in this specific area of their practice as the basis for future efficacy research and clinical practice. Thirty speech and language therapists were questioned about their experience of introducing low- and high-tech AAC devices to this client-group. Of particular interest was the discovery of the factors identified by the therapists as influencing their introduction of aided AAC to someone with PD and affecting implementation and successful use. The factors reported were both disease-specific (e.g. motor problems) and more general factors (e.g. carer support) relevant to the process of introducing aided AAC to other adult client-groups. Implications for future research and practice are discussed. Some research questions are posed and the inclusion of people with PD and their carers in practice development is promoted.

Attitude of Health Personnel↗
PubMedDate not supplied

Lemierre's syndrome: are we underdiagnosing this life-threatening infection?

Over a period of 12 months 3 patients presented with severe tonsillitis and subsequently grew Fusobacterium necrophorum (literally-spindle-shaped rod which brings death!) from blood cultures. Two patients responded well to antibiotics and were discharged within 4 days of admission. The third case had a longer history of symptoms and following investigations of a minor but unusual neck swelling was found to have thrombosis of the external and internal jugular vein. This is the first stage in the potentially fatal dissemination of this virulent organism which manifests clinically as Lemierre's syndrome. We describe the clinical histories and discuss whether cases are unrecognised because of the prompt clinical response to penicillin and metronidazole. We stress the importance of taking blood cultures and careful examination of the neck in all patients presenting with a severe tonsillitis.

Adult↗
PubMedDate not supplied

Psychological preparation for nasogastric feeding in children.

Psychological preparation of children undergoing enteral nutrition by nasogastric tube was evaluated in a prospective study of 48 children nursed at home. They were randomly allocated to receive either standard informal preparation or detailed psychological preparation and support. The children were divided into two groups according to age: group A comprised toddlers and younger children aged 2-6 years and group B comprised older children and adolescents aged 7-16 years. Detailed questionnaires were administered to all parents and older children by dietetic colleagues who were blinded to the type of preparation received by the children. The results emphasize that detailed psychological preparation of families takes time. Passage of a nasogastric tube was seen as very distressing to both parents and children. Having a nasogastric tube was perceived as a major problem by group A. There was no statistical difference in the effects of enteral nutrition between younger children who received routine preparation and those who received detailed preparation; however, parental assessment of their child's behaviour was the sole means of determining how the younger child felt and reacted. In group B, there were marked differences: scores suggested that those who received detailed preparation had been better prepared for enteral feeding in hospital and at home and that the passage of the nasogastric tube, although unpleasant, was less distressing to them (P < 0.05). Talking to a nurse and play therapist was seen by parents as essential (P < 0.05). The authors conclude that children should be prepared for painful procedures and followed up sensitively, according to their needs.

Adaptation, Psychological↗