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Biomedical subjects

B M Sullivan

Publications and source records attributed to B M Sullivan.

5 recordsLinked to original sources
PubMed1990

A comparison of overall health between patients with rheumatoid arthritis and a population with and without rheumatoid arthritis.

Women with rheumatoid arthritis (RA) at a rheumatology outpatient clinic (PAT) were compared with women with RA in representative samples of the Gothenburg population (POP), and with non-arthritic women in this population (REF). Clinical routine measures disclosed substantial dysfunction in both RA groups. Their physical, psychosocial, and overall function, assessed by means of the Sickness Impact Profile (SIP), was more impaired than that of the REF. The PAT had a higher disease activity and worse overall health status than the POP. In definite and classical RA, a poorer SIP physical and overall function was noted in the PAT than in the POP group, despite similar mean age and mean disease duration. Women with probable RA in the POP group had worse SIP dysfunction than the REF, particularly regarding ambulation and personal care. The SIP was sensitive to variations in disease activity and comprehensively disclosed dysfunction better than routine clinical measures.

Activities of Daily Living↗
PubMed1985

Emphysema in the renal allograft.

Two diabetic patients in whom emphysematous pyelonephritis developed after renal transplantation are described. Clinical recognition of this unusual and serious infection is masked by the effects of immunosuppression. Abdominal radiographic, ultrasound, and computed tomography findings are discussed. The clinical presentation includes urinary tract infection, sepsis, and acute tubular malfunction of the allograft in insulin-dependent diabetics.

Adult↗
PubMedDate not supplied

The accuracy of tuberculin skin tests: self-assessment by adult outpatients.

Tuberculin skin testing is an accurate, inexpensive screening procedure for detecting tuberculosis infection. The return visit needed to interpret the reaction is inconvenient, costly, and may contribute to under-utilization of the test. Although some clinicians ask patients to read their own purified protein derivative (PPD) test results, patient accuracy and the degree of teaching needed to learn this skill are unclear. This study evaluated the accuracy with which 145 outpatients read their own Mantoux skin test (PPD) reactions and reported by postcard after brief training by nurse practitioners. A total of 89 instructed patients returned postcards and also returned for clinician readings; 46 submitted postcards without returning; 7 returned but did not complete postcards; and 3 neither returned postcards nor returned for readings. Ten of 135 postcards were uninterpretable. For 81 subjects with both interpretable tuberculin self-assessment postcards and clinician readings, overall PPD classification agreement was 88 percent; Kappaw = +0.905 (P less than .001). Compared to clinician readings, 1 of 53 patients falsely reported a positive reaction (greater than or equal to 10 mm) and 2 of 25 patients falsely reported negative PPD readings (0-4 mm). There was 100 percent agreement between postcard readings and clinician classifications in a subgroup of patients (N = 26), prospectively identified by nurse practitioners as capable of accurate tuberculin self-assessment. Inter-clinician reading agreement (N = 37) was 89 percent; Kappaw = +0.943 (P less than .001). The brief standardized teaching protocol described can enable most patients to measure and report their PPD results. Study results suggest thatpostcard reports, especially negative ones, from a subgroup of patients selected for their skill in measuring their initial PPD wheal and ability to paraphrase instructions, might be substituted for clinician readings.

Ambulatory Care↗