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Biomedical subjects

A Robinson

Publications and source records attributed to A Robinson.

At least 163 records · Page 9Linked to original sources
PubMed1996

Ocular manifestation of hairy cell leukemia with dramatic response to 2-chloro-deoxy-adenosine.

PURPOSE: To demonstrate that hairy cell leukemia may involve the eye. METHODS: We examined a patient who had a unique ocular manifestation of hairy cell leukemia with severe panuveitis in one eye and leukemic retinopathy in the fellow eye. RESULTS: Therapy with 2-chloro-deoxy-adenosine, a drug recently introduced for treatment of hairy cell leukemia, led to dramatic improvement of the ocular complications. CONCLUSIONS: Hairy cell leukemia may involve the eye and ocular symptoms may respond to systemic treatment with 2-chloro-deoxy-adenosine.

Aged↗
PubMed1996

Central sleep apnea.

A central sleep apnea is the absence of respiratory effect, and, thus, the absence of airflow during sleep. Central hypopnea, a related disorder, is also discussed. The sensory component of central sleep apnea; defects involving the integrative and executive neurons; non-neurologic causes of central sleep apneas, including chronic obstructive pulmonary disease and congestive heart failure; diagnosis; treatment; and other topics are reviewed in detail.

Airway Resistance↗
PubMed1996

Making information accessible: developing plain English discharge instructions.

Discharge education has always been an important role for nurses working in acute care contexts. With the advent of case mix funding and subsequent trends towards early discharge from hospital, this educational role is assuming increasing importance. This paper addresses one aspect of a participatory action research study where a group of nurses, working in a paediatric orthopaedic ward, explored their discharge education practices and resources. The seemingly large number of post-discharge telephone queries received from parents of children treated on the ward prompted these nurses to question whether their discharge teaching practices were effective. Data collected on these telephone queries identified parental concerns regarding the care of their child at home in a plaster. This finding prompted group members to explore the ways that written information relating to care of the plaster at home might be implicated in the situation. An analysis of an existing 'home cast care' discharge instruction sheet raised issues concerning the content and language used in such resources. The paper describes the subsequent development of a plain English 'plaster care' discharge instruction sheet and argues the importance of using plain English in such resources.

Child↗
PubMed1996

Quality evaluation of sputum specimens for mycobacterial culture.

The evaluation of sputum specimen quality before bacterial culture is an accepted practice. Traditionally, sputum received for mycobacterial culture has been processed regardless of specimen quality. In view of the increasing emphasis placed on the primary acid-fast smear, the effect of specimen quality and the contribution of the presence of neutrophils on subsequent smear and culture positivity for mycobacteria was assessed. A total of 873 sputa were evaluated and initially assigned a quality (Q) score of 1 (many squamous cells relative to neutrophils) to 3 (no squamous cells) based on criteria for specimen acceptability for routine bacterial culture. The percentage of specimens that were Q1, Q2, and Q3 were 46.8, 35.3, and 17.9, respectively. Most of the specimens received were Q1, and these specimens demonstrated the highest number of positive smears and cultures compared to Q2 or Q3 specimens. Thus, routine bacterial culture criteria were not helpful in assessing specimen quality for mycobacterial culture. The contribution of the presence of neutrophils to smear and culture positivity was assessed. A total of 724 sputa were evaluated for cellular composition: 665 (91.9%) specimens contained neutrophils, and 59 (8.1 %) did not contain neutrophils. A total of 51 (7.0%) primary smears and 121 (16.7%) cultures were positive for mycobacteria; 92.2% of the positive smears; and 90.1 % of the positive cultures were from specimens that contained neutrophils. Thus, screening sputum specimens for the presence of neutrophils provides an effective method to evaluate the acceptability of sputum for mycobacterial smear and culture, especially from patients in respiratory isolation.

Bacteriological Techniques↗
PubMed1996

Multivariate analyses of prognostic factors associated with hematopoietic recovery in autograft patients with different sources of progenitor cells. A GATMO experience. Argintine Group of Bone Marrow Transplant.

OBJECTIVE: To evaluate in a multivariate analysis the prognostic factors associated with hematopoietic recovery and the supportive care requirements after autotransplant of progenitor cells (PC) from various sources: bone marrow (BMPC), BMPC & peripheral blood (PBPC), and PBPC alone. PATIENTS AND METHODS: A total of 570 patients with hematological malignancies and solid tumors underwent high-dose therapy followed by autotransplant. PBPC were obtained after mobilization with chemotherapy and/or cytokines. One-hundred five patients received BMPC, 217 received BMPC & PBPC and 248 PBPC alone; all of the patients received G-CSF or GM-CSF after infusion. RESULTS: In a multivariate analysis the recovery of neutrophils was adversely associated with low numbers of nucleated cells infused (P < 0.13), bone marrow progenitor cell source, and diagnosis of multiple myeloma and acute leukemia (P < 0.001). The factors that adversely affected platelet recovery were low number of nucleated cells and diagnosis of multiple myeloma and acute leukemia (P < 0.001). CONCLUSIONS: We conclude that BMPC adversely affect neutrophil recovery while low numbers of nucleated cells and diagnosis of multiple myeloma and acute leukemia adversely affect both neutrophil and platelet recovery.

Adolescent↗
PubMed1996

Use of acute psychiatric beds: a point prevalence survey in North and South Thames regions.

BACKGROUND: Concerns have been expressed, particularly in inner cities, about the growing pressure on acute psychiatric beds, evidenced by increased occupancy rates, difficulties in accessing beds, and increasing use of private beds by health authorities. This study investigated these concerns by conducting a census of psychiatric patients occupying acute beds. The proportion of patients who no longer required acute care and their needs for alternative provision were determined, together with bed occupancy rates. METHODS: A point prevalence survey of acute psychiatric patients in all National Health Service acute psychiatric units and seven private psychiatric units in North and South Thames regions was conducted on 15 June 1994. Sociodemographic, diagnosis and admission characteristics data were collected. Patients who no longer required acute care were identified and the alternative service provision required for these patients was determined. Bed occupancy rates were calculated. RESULTS: A total of 3710 psychiatric patients (including those on leave) were ennumerated. More than one in five (23.2 per cent) were defined as inappropriately located. The main alternative services required for inappropriately located patients who could be discharged to the community were professional support in patient's home (71.5 per cent), and housing or more appropriate housing (61 per cent). For inappropriately located patients who could not be discharged into the community, the main alternative services required were group home (29.3 per cent) and in-patient rehabilitation (20.8 per cent). Bed occupancy rates were high on the day of the survey (95 per cent). CONCLUSION: Best use is not being made of acute psychiatric beds in the Thames regions. A high proportion of patients occupying beds are those who no longer require acute care, but for whom alternative services are unavailable.

Acute Disease↗
PubMed1996

The reproducibility of urinary growth hormone measurement in children undergoing adenotonsillectomy: a pilot study.

The reproducibility of urinary growth hormone levels in normal children and in children undergoing adenotonsillar surgery was investigated. Thirty normal children and 32 children pre- and post-adenotonsillectomy had overnight urinary growth hormone levels measured on two consecutive nights using the technique of immunoradiometric assay. There was no significant difference when levels in each of these groups were compared. Therefore, the results were pooled (n = 94) and the correlation coefficient comparing levels obtained on the first and the second consecutive nights sample was calculated, r = 0.644 (P < 0.001). This work suggests that studies of urinary growth hormone levels in children give reproducible results. Further investigation of this technique as a screening or diagnostic procedure in the clinical setting can now be more widely evaluated.

Adenoidectomy↗
PubMed1996

Snoring, apnoea and ENT symptoms in the paediatric community.

This study was designed to determine the prevalence of snoring and assess the extent of associated ENT symptoms in children up to 10 years of age. A questionnaire was presented to the parents of 245 children chosen at random from the General Practice list of the town of Frome, Somerset, UK. The prevalence of snoring was found to be 27%. This increased to 47% in the presence of an upper respiratory infection. Snoring was found to be significantly (P < 0.001) associated with a history of poor hearing, restless sleep, and having a cold. Less significant (P < 0.01) associations occurred with parental smoking, eczema, sleep talking, moving around the bed at night, sore throats, having a runny nose and mouth breathing. Snoring is a common symptom in children up to 10 years of age. Without evidence of other ENT disease the snoring child does not require referral to an ENT department for further investigation.

Child↗
PubMed1996

Orally administered microencapsulated Bordetella pertussis fimbriae protect mice from B. pertussis respiratory infection.

Fimbriae from Bordetella pertussis have been encapsulated in poly(lactide-co-glycolide) microparticles of a size appropriate for uptake by the immune inductive tissues of the gastrointestinal tract. Mice were immunized by oral gavage with a single dose of 10 micrograms of microencapsulated fimbriae. The resulting immune responses were compared with those resulting from intraperitoneal injection of mice with equivalent amounts of fimbriae absorbed onto alhydrogel. The examination of serum and mucosal secretions, collected over a 6-week period, for specific antifimbrial antibodies clearly demonstrated that only orally immunized animals mounted measurable immune responses in external secretions. Six weeks after immunization, all immunized animals were protected against intranasal challenge with live B. pertussis.

Administration, Oral↗
PubMed1996

Short communication: kilovoltage measurement with rhodium target and filters on mammography X-ray machines.

X-ray machines used for mammography have, until recently, almost exclusively employed molybdenum (Mo) as anode material and filtration. In the UK, the RMI model 232 kVp meter is used extensively for the measurement of kilovoltage on such equipment. This unit is provided with switchable internal calibration only for molybdenum and molybdenum, or tungsten and aluminium, as anode and filtration, respectively. However, rhodium (Rh) has recently been introduced for filtration with either a molybdenum or rhodium anode in mammography equipment but, as yet, calibration facilities are not available for rhodium spectra. In this work, appropriate corrections for readings obtained with the RMI 232 kVp meter are derived for use with rhodium as filtration material with either molybdenum or rhodium anode material. An intercomparison between measurements made with four RMI model 232 kVp meters and nine IGE DMR X-ray sets was undertaken. The reproducibility of the instruments was confirmed and measurements of tube potential made on each of the X-ray sets pooled. Measurements were made from a nominal 25-35 kVp using Mo/Mo, Mo/Rh and Rh/Rh target/filter combinations. Corrections for readings obtained with Mo/Rh and Rh/Rh were produced by comparison with readings obtained with Mo/Mo, assuming stability of tube potential between anodes. The results are compared with data recently produced by the manufacturer of the meter.

Calibration↗