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Biomedical subjects

C C Evans

Publications and source records attributed to C C Evans.

At least 37 records · Page 2Linked to original sources
PubMed1990

Diaphragmatic plication for unilateral diaphragmatic paralysis: a 10-year experience.

Unilateral paralysis of the diaphragm due to nonmalignant disease is an uncommon disorder previously thought to have benign implications. Some patients, however, experience dyspnea and orthopnea with impairment of pulmonary function. Unilateral diaphragmatic plication was performed on 17 patients (16 men and 1 woman with a mean age of 53.7 years [range, 28 to 74 years]) during the last 10 years. Preoperatively each patient was shown to have paradoxical movement of the paralyzed diaphragm on sniffing and to have a reduction in forced vital capacity and lung volumes. These reductions were greater when the patient was in the supine position. All patients had moderate hypoxemia (mean arterial oxygen tension, 73.1 +/- 10.9 mm Hg). Plication was performed by imbricating the diaphragm in layers through a thoracotomy incision. After plication, all patients showed both subjective and objective improvement. Six patients were reassessed 5 or more years after plication (range, 5 to 7 years), and the improvement was maintained. Diaphragmatic plication is a safe and effective procedure for adult patients with dyspnea due to unilateral diaphragmatic paralysis; furthermore, the initial improvement is maintained.

Adult↗
PubMed1990

Nocturnal oxygen desaturation in patients using long-term oxygen therapy for chronic airflow limitation.

Nocturnal oxygen desaturation in patients receiving long-term oxygen therapy is described despite adequate daytime oxygenation (PaO2 greater than 8 kPa). Domiciliary oximetry overnight was performed on ten patients receiving long-term oxygen treatment for chronic airflow limitation: six patients were well saturated throughout the night with a fall in SaO2 to below 90% for only 1% of the monitoring time; four showed significant desaturation with a fall in SaO2 to below 90% for periods of 15-47% of the monitoring time.

Aged↗
PubMed1990

Factors influencing the compliance of patients using oxygen concentrators for long-term home oxygen therapy.

A previous study in the Liverpool district on patients receiving long term oxygen treatment using a domiciliary oxygen concentrator showed that only 55% were both using oxygen therapy correctly and had stopped smoking. To try and identify which factors influence patient behaviour, all 55 patients in this district receiving long-term oxygen therapy for hypoxaemic chronic airflow limitation were studied. We found that those with more symptoms were more likely to comply with this therapy. The prescription of a concentrator on the advice of a hospital physician did not improve on the compliance rates attained in those patients assessed by the general practitioner alone.

Adult↗
PubMed1989

Recent surgical experience for pulmonary tuberculosis.

Lung resection for pulmonary tuberculosis is unusual today. Over a 10-year-period 31 patients with pulmonary tuberculosis underwent thoracotomy at this Regional Centre. Five of these were for complications of known tuberculosis; two subsequently proved to be complications of pulmonary tuberculosis, and the remainder were for suspected malignancy. The clinical features, radiology, microbiology, and pathology are reviewed and the contemporary role of the surgeon in the management of pulmonary tuberculosis is examined.

Adult↗
PubMed1988

Prescription of oxygen concentrators for long term oxygen treatment: reassessment in one district.

When oxygen concentrators became available on form FP10 in 1985 the Department of Health and Social Security issued clear guidelines for their prescription for long term treatment. Reassessment of those patients prescribed a concentrator in one district showed that 29 out of 61 patients did not fulfil these criteria. Furthermore, in only 28 cases was the daily use of the machine appropriate, though this did not reflect poor patient cooperation but was a result of inadequate prescribing instructions. In addition, 12 out of 54 patients continued to smoke. Overall, in only 18 of the 61 cases was both the prescription appropriate and the concentrator properly used. These results suggest a need for better cooperation between general practitioner and hospital in the initial assessment of patients for long term oxygen treatment and better education of both doctor and patient in the use of oxygen concentrators.

Adult↗
PubMed1987

The effect of seasonal and domestic factors on the distribution of Euroglyphus maynei in the homes of Dermatophagoides pteronyssinus allergic patients.

A survey of the house dust mite population was carried out in the homes of fifty asthmatic Liverpool individuals with strongly positive skin tests to Dermatophagoides pteronyssinus. As expected, D. pteronyssinus was the commonest species found. However, Euroglyphus maynei made up 37% of the total adult mite count and was the predominant species in 48% of beds examined. There was a good correlation between increasing numbers of E. maynei and decreasing social class, but only a weak one with percentage relative humidity. Ionic sodium levels in bed dust were found to correlate with decreasing social class and increasing E. maynei levels. In nineteen beds, mites were sampled at 4-monthly intervals for 1 year--this showed a relative decrease in the proportion of E. maynei compared with other mites in the autumn, when relative humidity was high. A further twenty beds underwent intensive house dust eradication (including the use of plastic covers) for 1 year--these beds showed a progressive fall in the proportion of E. maynei recovered, suggesting that this mite is more vulnerable to anti-house dust mite measures. Euroglyphus maynei is a common house dust mite and further work needs to be done to assess its antigenic nature and clinical significance.

Animals↗
PubMed1986

The extrathoracic airway in acromegaly.

Pulmonary function tests and a radiological assessment of the larynx and cervical trachea were performed in 26 patients with acromegaly. Pulmonary function tests demonstrated six out of 26 patients to have upper-airways obstruction, while laryngeal tomography demonstrated 14 cases with marked narrowing of the true and false cords. The tracheal dimensions were normal. The thickness of both the true and the false cords showed a statistically significant increase, using the Mann-Whitney U-test, in both male and female patients compared with controls. The transverse tracheal diameter was significantly decreased in male but not female patients. These findings suggest that pulmonary function tests and radiological assessment are of value in indicating those patients with acromegaly who may be at increased risk when undergoing general anaesthesia.

Acromegaly↗
PubMed1986

Allergen avoidance in house dust mite sensitive adult asthma.

Fifty adult asthmatic patients with strongly positive skinprick tests to the house dust mite were admitted into a prospective randomised controlled trial of house dust mite avoidance in the community. Twenty-two of the experimental group completed one year of dust avoidance and 19 of these tolerated the use of plastic mattress and pillow covers. Twenty of the control group (who did not alter their housecleaning habits) also completed one year of study. A fall in mite and dust levels was noted in the homes of the experimental but not the control group. Fifteen of the experimental group who completed the study were strongly RAST positive (score 3 or more) to the house dust mite. These patients had a significant improvement in FEV1/FVC, PEFR, PC20, use of treatment, and symptom score at one year, whilst the seven experimental patients who were not strongly RAST positive (score 2 or less) did not, suggesting that the change noted in the former patients was not merely due to a placebo effect. Fifteen of the control group who completed the study were also strongly RAST positive for the house dust mite and these patients showed no change in any of the parameters. This study demonstrates that adult asthmatic patients can successfully carry out house dust eradication procedures in the community over a long period of time, and that those patients who are allergic to the house dust mite appear to have both subjective and objective improvement in their asthma.

Adult↗
PubMed1985

Prolonged gestation in sheep in western Scotland associated with diffuse neuronal necrosis of the fetal central nervous system.

A specific disorder of sheep resulting in gestation periods extending up to eight months is reported for the first time. The condition, which is of low prevalence, occurs on hill farms in coastal regions of western Scotland and affected ewes usually die unless relieved of their fetuses by surgery. The fetuses may weigh up to 12 kg and have long hairy coats, skeletal deformities, precocious gonadal development and extensive liquefaction of central nervous system tissue. The aetiology has not been determined but some mechanisms which may be involved in the pathogenesis are discussed.

Animals↗
PubMed1985

Sudden death due to isolated adrenal tuberculosis.

A 65 year old man admitted to hospital for investigation of pleural thickening was found to have carcinoma of the prostate with metastases. Before investigations were completed the patient collapsed unexpectedly with hypotension. A post mortem examination revealed tuberculosis of both adrenal glands without evidence of tuberculosis in any other organ.

Adrenal Gland Diseases↗
PubMed1985

Behavioral rehabilitation for chronic mental patients.

A three-component program drawn from the vulnerability-stress paradigm of major mental disorders has shown promise in rehabilitating patients with chronic schizophrenia. In the first part of the program, patients are prepared for independent living by training in social skills. Ten "modules" have been devised, each addressing a category of social skills that falls within a given life area (for example, conversational skills or vocational rehabilitation). Each module consists of a set of sequential exercises and videotaped demonstrations. Intensive training with the modules is followed by "booster" exercises and maintenance services for an indefinite period. The second technique is medication self-management, because it is now recognized that neuroleptic drug therapy offers the stabilization of symptoms requisite for effecting behavioral change with psychosocial interventions. Compliance with a medication program must be learned; in this rehabilitation program, both patient and family are educated about drug actions and side effects, and negative attitudes toward taking drugs are examined. The last part of the program is behavioral family management. Numerous reports in the literature indicate that relapse rates are higher in patients who return to families with high expressed emotion. Training procedures are therefore aimed at creating a more congenial family milieu. Patients and family are educated about the nature and management of schizophrenia, trained in effective communication, and taught problem-solving skills. The modern treatment of schizophrenia is overriding the earlier dichotomy between drugs and psychotherapy. The combination of three treatment modalities--skills training, medication self-management, and behavioral family management--offers new hope in rehabilitating the chronically mentally ill.

Adaptation, Psychological↗