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Biomedical subjects

D Allen

Publications and source records attributed to D Allen.

At least 325 records · Page 18Linked to original sources
PubMedDate not supplied

Changing care staff approaches to the prevention and management of aggressive behaviour in a residential treatment unit for persons with mental retardation and challenging behaviour.

The impact of a new training procedure aimed at improving staff skills in the preventative and reactive management of severely challenging behaviours was investigated within a six-place residential treatment unit. The results showed that there was some evidence to support the notion that the training reduced the number of behavioural incidents for most residents. The rates of major reactive strategy use (restraint and emergency medication) also declined over time, as did rates of staff and resident injury. Although only a limited number of these changes showed statistically significant correlations with time, it is argued that they were clinically significant when viewed against the complexity of the client group under study.

Activities of Daily Living↗
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Does the density of lymphatic vascular space invasion affect the prognosis of stage Ib and IIA node negative carcinoma of the cervix?

Lymphatic vascular space invasion (LVSI) has been noted as a poor prognostic factor in many tumors. In some studies of carcinoma of the cervix, LVSI has been demonstrated to be independent of other prognostic factors. The aim of this study is to evaluate if, by a simple quantitative technique, the density of lymphatic invasion could be correlated with the risk of recurrence in node negative early stage carcinoma of the cervix. We analyzed the pathology and clinical course of 71 consecutive patients with stage IB and IIA carcinoma of the cervix treated primarily by radical hysterectomy and pelvic lymphadenectomy. All cases had negative nodes and adequate surgical margins. There were 67 patients suitable for evaluation. Tumour type, grade, stage and the dimensions of the tumor were recorded. The density of LVSI was categorized as absent (45%), mild (15%), moderate (33%) or severe (7%) depending on the number of lymphatic vascular spaces involved per high power field in the worst affected slide. The patients were followed for 2-8(1/2) years with a mean follow up of 4 years and 2 months. There were 13 recurrences and 7 deaths. All recurrences occurred in less than 2 years after surgery. The risk of recurrence was 40% for patients with extensive LVSI, 32% for moderate, 30% for mild and 3% if LVSI was absent. Only the presence of LVSI was associated with an increased risk of recurrence. The density of lymphatic invasion as represented by the number of lymphatic spaces occupied on the worst histological slide offered no further clinically useful information.

Adult↗
PubMedDate not supplied

Social, biological and reproductive characteristics of mothers of twins: implications for breast cancer risk.

The biological, social and reproductive characteristics of women who have had twins were compared with those of other parous women using questionnaire data gathered for a prospective cohort study of women aged 35 and over on the island of Guernsey. Data for 97 mothers of twins and 4026 other parous women were available for analysis. The two groups were similar in height, first degree family history of breast cancer, use of hormone replacement therapy or other hormones, age at menarche, length of menstrual cycle and age at first and last birth. The mothers of twins were slightly heavier, more likely to smoke and consume more caffeine, less likely to have used oral contraceptives in the past, slightly younger when reaching the menopause and had a larger number of pregnancies. Adjustment for age did not alter these results. This study does not provide evidence that mothers of twins differ markedly from other parous women across a range of characteristics that might be associated with twinning or associated with breast cancer risk.

Adult↗
PubMedDate not supplied

Proton MR spectroscopy of experimental radiation-induced white matter injury.

We studied the spectroscopic appearance of radiation-induced myelinolysis in cats to understand the characteristics of proton MR spectroscopy of demyelinating disorders. Eight cats received 5,000 rads to a 1.5 x 1.5 cm area of the right cerebral hemisphere. Eight to 9 months after irradiation, a gross area of abnormal postcontrast enhancement and/or high MR signal intensity was detected in the irradiated hemisphere of six of the eight cats. Proton spectra of a 1.0 cm3 voxel in the affected region demonstrated depressed N-acetyl aspartate/creatine-phosphocreatine and N-acetyl aspartate/choline-containing compound peak ratios compared with the contralateral non-irradiated brain in all cats. Elevated amino acid resonances in the 2.0-2.5 ppm range were not consistently seen in irradiated zones of the brain with pathologic findings of demyelination. In vivo proton MR spectroscopy may show differences between irradiated brain and nonirradiated brain even when histopathologic lesions are not apparent yet.

Amino Acids↗
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Morphologic effects of experimental distention of equine small intestine.

The morphologic effects of induced intraluminal hydrostatic pressures (IHPs) of 0, 9, and 18 cm H2O were evaluated in 33 isolated equine jejunal segments. Fifteen segments were distended with Tyrode's solution for 1 hour and nine segments for 4 hours. Tyrode's solution was added as needed to maintain the prescribed pressures. Nine other segments were left undisturbed for 4 hours after the initial distention period. On decompression of the intestinal segments, progressive peristaltic contractions resumed in all segments. Evaluation of intestinal sections by light microscopy and transmission electron microscopy showed edema of the villi and submucosa and separation of the epithelial cells adjacent to the basement membrane in all segments. The epithelial cell necrosis found in ischemic intestine was not seen. This study indicates that the necrosis found at the villous tips in distended sections of small intestine remote from the site of obstruction cannot be reproduced by IHP increases of 4 hours duration.

Animals↗
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Mid-metacarpal deep digital flexor tenotomy in the management of refractory laminitis in horses.

Deep digital flexor tendon transection at the mid-metacarpus was performed in 20 horses with severe acute or chronic laminitis that was not responsive to conventional treatment. Sixteen horses improved within 72 hours, one horse worsened, and two horses were unaffected by the surgery. Eleven horses survived less than 1 month after surgery and six horses survived longer than 6 months. Three horses surviving longer than 6 months have remained lame and no horse has returned to athletic performance. Transection of the deep digital flexor tendon at the mid-metacarpus may decrease the pain associated with the acute refractory stage of laminitis and may be useful as an immediate salvage procedure; however, despite the early clinical improvement observed after tenotomy, the survival rate of affected horses may not be altered.

Acute Disease↗
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Complete excision of a fractured fourth metatarsal bone in eight horses.

Proximal open comminuted fractures of the fourth metatarsal bone (Mt IV) in eight horses were treated by complete removal of the affected bone and antimicrobial therapy. Two horses had concurrent septic arthritis of the tarsocrural or distal tarsal articulations, and five horses had radiographic evidence of osteomyelitis and sequestration of the affected bone. Five horses became athletically sound for their intended use, two horses with septic arthritis had residual lameness but were pasture sound, and one horse was lost to follow-up. Excision of the entire bone appears to be an acceptable treatment of open comminuted fractures of the proximal one-third of Mt IV that do not respond to more conservative modes of therapy.

Animals↗
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Palmar digital neurectomy in horses. 57 cases (1984-1990).

The medical records of 57 horses that had palmar digital neurectomy performed between 1984 and 1990 were reviewed. Neurectomies were performed either by transection and electrocoagulation (47 horses) or by the guillotine technique (10 horses). Middle-aged geldings, Quarter Horses, and Thoroughbreds were significantly over-represented when compared with the hospital population. Horses used as hunter/jumpers also appeared to be over-represented. Complications occurred in 17 (34%) of the 50 horses for which follow-up information was obtained. Recurrence of heel pain was the most common complication (14 horses). Palpable painful neuromas were detected in three horses. One year after neurectomy, 74% of the horses were sound; this decreased to 63% after 2 years.

Animals↗
PubMedDate not supplied

Repair of fractures of the distal aspect of the radius in two horses.

Fractures of the distal radius in two horses were repaired by open reduction and interfragmentary compression using screws placed in a lag fashion. One horse had a complete oblique fracture of the medial aspect of the epiphysis of the distal radius and was sound for riding 32 months after surgery. The other horse had an open spiral comminuted fracture with medial displacement of the distal radial fragment. Laminitis developed in the contralateral limb and this horse was euthanatized 5 weeks after surgery.

Animals↗
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Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy.

The effect of intraperitoneal sodium carboxymethylcellulose (SCMC) administration on clinical outcome and survival was evaluated in horses undergoing exploratory celiotomy for acute gastrointestinal disease. Comparison of variables was made retrospectively between 44 horses that had SCMC and 92 horses (controls) not treated with SCMC. Mean age, body weight, heart rate, packed cell volume and plasma total protein of horses at admission, and convalescent period were not significantly different between control and SCMC groups. No significant differences were noted between control horses and SCMC horses with respect to incisional infection, hernia formation, recurrent episodes of colic, clinical outcome, and long-term survival (> 6 months). Seventy-six (83%) control horses and 34 (77%) SCMC horses survived long-term. Seventy (76%) control horses and 30 (68%) SCMC horses survived without complications and returned to their previous use. These results suggest that intraperitoneal use of SCMC does not adversely affect abdominal incisional wound healing, clinical outcome or long-term survival, however, the efficacy of SCMC in prevention of postoperative intestinal adhesions in horses requires further investigation.

Abdomen↗
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Quassinoids exhibit greater selectivity against Plasmodium falciparum than against Entamoeba histolytica, Giardia intestinalis or Toxoplasma gondii in vitro.

The in vitro activities of a series of quassinoids against Plasmodium falciparum, Entamoeba histolytica, Giardia intestinalis and Toxoplasma gondii have been compared with their in vitro cytotoxic effects against KB cells (human epidermoid carcinoma of the nasopharynx). All of the compounds tested were more toxic to KB cells than to G. intestinalis, but four (ailanthinone, bruceine D, brusatol and glaucarubinone) were slightly less toxic to KB cells than to E. histolytica. Glaucarubinone was similarly more toxic to intracellular T. gondii than to KB cells but ailanthinone was more selective (36 times more toxic to T. gondii than to KB cells). All of the compounds were more toxic to P. falciparum than to KB cells; the most selective quassinoids--glaucarubinone, bruceine D, ailanthinone and brusatol--were found to have toxicity/activity ratios of 285, 76, 48 and 32 respectively. These results suggest that quassinoids have a selective action on P. falciparum. Further studies to elucidate the basis for this are in progress.

Animals↗
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Hepatic parenchymal cells in cystic fibrosis: ultrastructural evidence for abnormal intracellular transport.

Few ultrastructural observations of hepatic parenchymal cells in cystic fibrosis (CF) have appeared in the literature. Utilizing a unique opportunity to examine freshly fixed hepatic tissue by transmission electron microscopy, we studied 12 patients dying with CF at Duke Hospital from 1979 to 1981 in order to identify possible abnormalities of intracellular architecture. The major findings include (1) intracellular fatty vacuoles, (2) distended bile ductules and bile ducts containing increased cellular debris, (3) profiles of distended rough endoplasmic reticulum containing material of medium electron density, and (4) membrane-bound deposits of electron-lucent material containing electron-dense cores resembling mucus. We suggest that the material seen within the cytocavitary network reflects a derangement of intracellular transport.

Adolescent↗
PubMedDate not supplied

A dressing down.

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Clothing↗