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Biomedical subjects

C Sanderson

Publications and source records attributed to C Sanderson.

At least 37 records · Page 2Linked to original sources
PubMed1995

Ethylenediaminetetraacetic acid in ammonium hydroxide for reducing decalcification time.

Ethylenediaminetetraacetic acid (EDTA) solution is used to decalcify bone specimens for histological examination. Sodium hydroxide (NaOH) has been used to dissolve EDTA and to bring EDTA solutions to neutral pH. This solution, however, requires several weeks to decalcify bone specimens. We investigated a new decalcification fluid using concentrated ammonium hydroxide (NH4OH) to dissolve EDTA and to adjust the pH to neutral. Decalcification was performed using a magnetic stirrer with and without vacuum, or with a sonic cleaner. Decalcification end point was confirmed using both the weight loss and X-ray methods. After decalcification, specimens were processed through paraffin and sections were stained with hematoxylin and eosin. Decalcification employing NH4OH required an average of six days. Light microscopy indicated good retention of cellular detail.

Ammonium Hydroxide↗
PubMed1993

Day surgery; development of a questionnaire for eliciting patients' experiences.

OBJECTIVE: To develop a single, short, acceptable, and validated postal questionnaire for assessing patients' experiences of the process and outcome of day surgery. DESIGN: Interviews and review of existing questionnaires; piloting and field testing of draft questionnaires; consistency and validity checks. SETTING: Four hospitals, in Coventry (two), Swindon, and Milton Keynes. PATIENTS: 373 patients undergoing day surgery in 1990. MAIN MEASURES: Postoperative symptoms, complications, health and functional status, general satisfaction, and satisfaction with specific aspects of care. RESULTS: Response rates of 50% were obtained on field testing draft questionnaires preoperatively and one week and one month after surgery. 28% of initial non-responders replied on receiving a postal reminder, regardless of whether or not a duplicate questionnaire was sent; a second reminder had little impact. Many patients who expressed overall satisfaction with their care were nevertheless dissatisfied with some specific aspects. Outcome and satisfaction were related to three aspects of case mix; patient's age, sex, and type of operative procedure. The final questionnaire produced as a result of this work included 28 questions with precoded answers plus opportunities to provide qualitative comments. Several factors (only one, shorter questionnaire to complete, fewer categories of nonresponders, and administration locally) suggested that a response rate of at least 65% (with one postal reminder) could be expected. CONCLUSION: A validated questionnaire for day surgery was developed, which will be used to establish a national comparative database.

Ambulatory Surgical Procedures↗
PubMed1993

Day surgery: development of a national comparative audit service.

OBJECTIVES: To develop software for hospitals to analyse their own survey data on patients' experiences of day surgery and to create and test the feasibility of a national comparative audit service. DESIGN: Software development and testing; database analysis. SETTING: Eleven general hospitals in England. PATIENTS: 1741 day surgery patients undergoing procedures during 1991-2. MAIN MEASURES: Postoperative symptoms, complications, health and functional status, general satisfaction, and satisfaction with specific aspects of care. RESULTS: Software for data entry and analysis by hospitals was successfully used at the pilot sites. The overall response rate for the 11 hospitals using the questionnaire was 60%, ranging from 33% to 90% depending on the way the survey was managed. Data from all 11 hospitals were included in the national comparative audit database. Hospitals showed little variation in measures of patients' overall satisfaction (around 85%), but significant differences were apparent for specific aspects such as receiving adequate written information before admission (range 50%-89%), provision of adequate parking facilities (14%-92%) and experiencing a significant amount of postoperative pain (8%-42%). The proportion of day case patients undergoing procedures that could have been performed in outpatient departments varied from 0 to 27% between hospitals. Further comparisons of outcome, in particular measures of effectiveness, must await the development of validated case mix adjustment methods. CONCLUSION: Establishing a comparative audit database is feasible but several methodological problems remain to be resolved.

Ambulatory Surgical Procedures↗
PubMed1993

Measuring hospital workload in general medicine.

The study described here used routine data sources to consider three aspects of hospital workload-volume and case-mix of inpatients; volume of outpatients; and volume of procedures.

Age Distribution↗
PubMed1993

Does labour substitution occur in district general hospitals?

A survey of 31 district general hospitals found a large variation in hours of medical and nursing time available per inpatient episode in general medicine and its associated specialties. These differences could not be attributed to case-mix variation or severity. The application of weightings to different grades of nursing and medical staff had little effect on either the rankings of hospitals by staff hours per episode, or the overall degree of variation in staffing levels. The results show no evidence to suggest that hospitals with relatively low levels for one category of staff are compensated by relatively high levels of another. It would appear that those hospitals with high levels for one category of staff are also well provided for the others. This evidence of inequality may reflect historic patterns of resource allocation that recent manpower policies might seek to redress. Studies of the relationship between staffing levels and quality of patient care should be undertaken before adopting a policy of labour redistribution.

Data Collection↗
PubMed1992

What makes outpatient attendance worthwhile for patients?

All patients attending 10 general medical and general surgical outpatient clinics at a provincial teaching hospital were surveyed during a 1-week period. Questionnaires administered and completed by the patients at the time of the visit were used to establish the factors most closely associated with patients feeling that their consultations had been "very worthwhile". These were: consultations lasting more than 10 min, having received advice from a specialist and having been reassured. The study may provide a basis for a process of medical audit in outpatient departments and, thus, more appropriate services.

Adult↗
PubMed1992

Infection of IL5 transgenic mice with Mesocestoides corti induces very high levels of IL5 but depressed production of eosinophils.

Transgenic mice expressing interleukin 5 (IL5) have been demonstrated to show a lifelong high level eosinophilia. These mice were produced using a construct in which the dominant control region (DCR) of the human CD2 gene was ligated to a 10-kb fragment containing the mouse IL5 gene. The construct allows the expression of the IL5 gene under the control of its own promoter, but the DCR ensures constitutive expression by all T cells. Infection of these transgenic mice with Mesocestoides corti, which is itself a potent inducer of eosinophilia, increases serum IL5 to very high levels. This demonstrates that the transgenes retain inducibility, which is a feature of the endogenous gene. However, despite the high levels of IL5, the numbers of eosinophils in the blood, marrow, and spleen decrease during the period 1-4 weeks after infection. Furthermore, there is a decrease in eosinophil precursors, as assessed by the capacity of bone marrow to produce eosinophils in culture. After this decrease eosinophils return to their previous high levels, although the levels of IL5 remain high. These results suggest that a control mechanism is operating to limit the numbers of eosinophils produced. This control appears to act at the level of the precursor production and may not be directly related to the high levels of IL5.

Animals↗
PubMed1992

What will happen to the quality of care with fewer junior doctors? A Delphi study of consultant physicians' views.

Hospital medical staffing: achieving a balance proposed a reduction in the number of junior doctors and an expansion in the number of consultant posts. This change was to be subject to the 'safety net'--that the number of staff should not fall below a minimum safe level for 24-hour emergency cover. However, no operational definition of 'safe' was offered. Consultant physicians in one NHS region were interviewed to find out how they thought safety would be affected by a reduction in junior doctor numbers. It emerged that consultants' concerns over reductions in staff covered a wider range of issues than just the clinical effectiveness of care. The interpretation of safety extended to cover general adverse effects on care. A survey, using the Delphi method, revealed that consultant physicians were most concerned over reductions in the humanity of care if numbers of junior staff were reduced. This included such factors as the time spent by patients waiting in outpatient and A&E departments, and the time doctors spend talking to patients. Consultants were less concerned over the effect of reduced staff numbers on the technical efficiency of provision, and least of all on the effectiveness of care. This last point was seen to be a reflection of consultant physicians' confidence in the basic medical knowledge and skill of their junior staff.

Attitude of Health Personnel↗
PubMed1990

Regulation of Ig H chain gene transcription by IL-5.

Stimulation of B lymphocytes to high rate Ig secretion is accompanied by increased RNA polymerase initiation on the mu-delta gene complex as well as alterations in the sites of polymerase termination. Stimulation of Ig secretion by in vivo preactivated B lymphocytes with IL-5 seems to operate via a mechanism that only affects polymerase termination so that newly synthesized transcripts are preferentially processed to microS mRNA. The absence of increased polymerase initiation may account for previous observations indicating that IL-5 acts primarily as a terminal differentiation factor.

Animals↗
PubMed1988

Central tarsal implant in a racing greyhound.

Although most type IV fractures in dogs can be treated with screw fixation, type V fractures usually lead to an unsuccessful clinical result. A central tarsal replacement composed of a titanium alloy was developed by our investigation team to treat type V fractures. The implant was used to successfully treat a greyhound and to allow it to return to racing. Continual development of this new surgical procedure hopefully will give the veterinarian predictable and reliable clinical results and return injured greyhounds to active racing.

Animals↗
PubMed1988

Contributions of social medicine and systems analysis to formulating objectives for a community-based cancer prevention programme.

In the part of Stockholm Cancer Prevention Programme, that is focussing on diet and cancer, the contribution of social medicine has been based on its concern for the relationships between individuals, populations, the environment and the socio-political structure. This has led to the choice of the community intervention approach, based on geographically defined populations, and involving the participation of organisations already active within the relevant areas. The contribution of systems analysis has been based on its concern for explicit models of the processes of cause and effect that lead from intervention to outcome, as a basis for debate and common understanding among the various participants. The combination of the two approaches has helped to clarify the objectives and has shaped the planned pattern of intervention.

Community Health Services↗
PubMed1987

Enzyme-linked immunosorbent assay for Campylobacter pyloridis: correlation with presence of C. pyloridis in the gastric mucosa.

Antibody to Campylobacter pyloridis was measured by ELISA in the sera of 160 patients from whom gastric biopsy specimens were also obtained. The antigen was an acid-glycine extract of C. pyloridis, and titers ranged from 80 to 22,000 ELISA units (EU). Of 117 patients in whom C. pyloridis was detected microbiologically or histologically, 87 (74%) had a titer greater than or equal to 300 EU, and only one had a titer less than 150 EU. Of 43 patients in whom C. pyloridis was not detected, only two (5%) had a titer greater than 300 EU. Thus, for a titer of 300 EU the ELISA test had a specificity of 97% and a sensitivity of 81%. At 150 EU the specificity was 78%, and the sensitivity was 99%. Histological diagnosis of active chronic gastritis was associated with a high median ELISA titer (485 E), chronic gastritis with a much lower titer (150 EU), and normal histology with a titer of 110 EU. Discriminating use of this serological test could be of assistance to detect C. pyloridis in the gastric mucosa.

Adult↗
PubMed1987

The convergent and discriminant validity of the MCMI as a measure of the DSM-III personality disorders.

The personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were constructed and validated to measure the typology developed by Millon (1981). The ability of the MCMI to measure the DSM-III personality disorders has not yet been empirically evaluated. The current study found better convergent validity for the DSM-III personality disorders that are consistent with Millon's typology (i.e., the avoidant and the dependent) than for the disorders that are inconsistent (i.e., the antisocial and the passive-aggressive). However, the results may reflect some advantages Millon's typology might have over the DSM-III. The discriminant validity of all four scales was limited, due in part to the overlap among the MCMI scales and the DSM-III personality disorders. We discuss implications of the results for the revision of the MCMI and the DSM-III.

Adult↗
PubMed1986

The MMPI, prototypal typology, and borderline personality disorder.

This study demonstrates inherent features in the DSM-III diagnostic criteria for personality disorders (i.e., overlapping diagnoses and heterogeneous symptomatology) that limit efforts to identify a sensitive and specific MMPI profile for the borderline personality disorder. A sample of 71 inpatients was administered an MMPI and a semistructured interview that systematically evaluated each of 81 symptoms for the 11 DSM-III personality disorders. Interrater reliability was substantially higher than has been obtained with unstructured interviews. The effect on the borderline MMPI profile of variation in the number of borderline symptoms and overlap with the schizotypal, histrionic, and antisocial diagnoses was demonstrated. We discuss implications with respect to a prototypal model of classification.

Adult↗
PubMed1983

Parallel growth of rectus sheath grafts and recipient aorta. Critical role of graft tissue preservation.

Previous experimental studies revealed striking similarities in mechanical properties of host aortic tissue and rectus sheath inserted as an aortic graft, as well as enlargement of some of the grafts. We have now evaluated the capacity of rectus sheath grafts to keep pace with aortic growth and investigated the role of tissue preservation in determining the ability of such grafts to maintain suitable dimensions. Autologous rectus sheath grafts were substituted for thoracic aortic segments in 15 puppies, 8 weeks of age. Nine grafts were inserted with careful attention to tissue preservation (live grafts), but in six experiments, cells were killed and tissues fixed by freezing and thawing in acetone before graft implantation (devitalized grafts). Grafts were fixed in situ by controlled pressure perfusion and examined 1, 2, and 3 months after implantation. Over the 3 month experimental interval, body weight increased from 2.0 +/- 1 pounds to 25.0 +/- 2.5 pounds, and as is characteristic for the period of maximum growth rate for the animals. Total thoracic aortic length increased 41.2% +/- 6.1% and aortic diameter, 30.0% +/- 3.1%, during this time. Growth rate of the total thoracic aortic length during the first month was greater for the devitalized graft group, but aortic length was the same for both groups at 3 months. The live grafts increased 42.3% +/- 12.0% in length and 27.3% +/- 3.0% in diameter, i.e., to the same degree as the aorta, whereas the devitalized grafts showed only slight increases in length and diameter (2.1% +/- 2% and 5.3% +/- 5%, respectively). The live rectus sheath grafts were augmented and largely replaced by a newly formed, layered fibrocellular structure, 45.8 +/- 25.8 mm3 in volume, whereas in the devitalized grafts more of the original rectus sheath persisted and only a minimal amount of organized connective tissue sheath was formed (volume 18.7 +/- 8.9 mm3). In addition, cellularity was much greater in live grafts than in devitalized specimens (990.9 +/- 186.8 cells/mm2 and 423.6 +/- 124.7 cells/mm2, respectively). All of the grafts were lined by endothelium. These findings indicate that autologous rectus sheath aortic grafts may be used to provide channels which keep pace with aortic dimensions during the period of maximum growth, provided that the graft tissue is viable on implantation. Long-term durability of such grafts may also depend on tissue preservation.

Abdominal Muscles↗