Long-term monitoring for epilepsy. Report of an IFCN committee.
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Electroencephalography↗
Biomedical subjects
D King
Publications and source records attributed to D King.
Serum progesterone and estradiol concentrations in the early diagnosis of ectopic pregnancy after in vitro fertilization-embryo transfer.
To determine if discriminatory P or E2 concentrations can be established for early diagnosis of EP after IVF, 282 pregnancies were studied 11, 13, 15, and 17 days after ET. Receiver-operator characteristic analysis of P and E2 indicated no clinically useful threshold value for EP. No significant differences in P or E2 was seen when intrauterine and extrauterine pregnancies or viable and nonviable pregnancies were compared. All EPs had P < 50 ng/mL and E2 < 500 pg/mL at 11 days after ET. Serum P and E2 cannot differentiate EPs from intrauterine pregnancies nor viable from nonviable pregnancies resulting from IVF.
Embryo Transfer↗
The role of ultrasound to detect aortic aneurysms in "urological" patients.
The adoption of ultrasound as a means of imaging the urinary tract instead of the intravenous urogram (IVU) has resulted in an interesting observation. Men undergoing ultrasound examination of the urinary tract are often noted to have an incidental abdominal aortic aneurysm. Screening programmes for such aneurysms are being investigated around the country. We have looked at the prevalence of abdominal aortic aneurysm in male urological patients aged 65-80 years as they pass through the radiology department, in order to have an ultrasound scan of the urinary tract. When the IVU was the standard rate of imaging, few aneurysms were noted. On changing to ultrasound, 3.1% of patients were found to have an aneurysm. This rose to 9.5% when a deliberate policy of imaging the abdominal aorta was included. We suggest it is well worth the minimal extra time and effort to examine the aorta of "urological" patients, as more serious pathology may be detected than that for which the scan was originally ordered.
Aged↗
Nutritional care of the terminally ill adult.
Nutrition and hydration options are based on many considerations that arise during the various phases of the dying process. This paper includes discussion of the psychological issues affecting intake, assessment techniques to determine whether nutrient intake is adequate, feeding suggestions for the caregiving family, and some guidelines for routine and complex care of the terminally ill adult. The ultimate goal is to improve quality of life for each terminally ill individual through a focus on patient benefit and patient care.
Energy Intake↗
A phaeohyphomycotic cyst and peritonitis caused by Phialemonium species and a reevaluation of its taxonomy.
Two cases of human fungal infections caused by members of the genus Phialemonium, a genus proposed by Gams and McGinnis (1983) for fungi intermediate between the genera Acremonium and Phialophora, are presented. The first case was a phaeohyphomycotic cyst on the foot of a renal transplant recipient. The fungus was detected by direct examination and histopathology and was recovered by several procedures over 4 months. It was flat, glabrous, and white becoming yellow with the production of a diffusible yellow pigment; it had conidiophores that were mostly solitary and lateral and terminal phialides and adelophialides with distinct collarettes producing cylindrical to curved conidia. The isolate resembled both Phialemonium dimorphosporum and Phialemonium curvatum, although its characteristics were more consistent with those of the latter. The second case was peritonitis in a renal transplant recipient. The fungus was white-to-cream colored and yeast like, but later became black with a green diffusible pigment, and produced obovoid conidia; it was easily identified as Phialemonium obovatum. Difficulties encountered in the identification and taxonomy of members of this genus highlight the need for standardized conditions, e.g., potato dextrose agar culture incubated at 24 to 25 degrees C for morphologic comparisons, to control significant variations due to culture conditions.
Child, Preschool↗
Follow-up of a cohort of men with untreated benign prostatic hyperplasia.
A cohort of 266 men with untreated benign prostatic hyperplasia (BPH) identified in a community-based survey were followed for a period of 1 year. Although the overall prevalence of urinary symptoms increased during the year, substantial within-subject variation in urinary symptomatology occurred, with up to a quarter of men reporting urgency and dribbling to have improved whilst one third of men reported other urinary symptoms to have deteriorated. Levels of bothersomeness caused by urinary symptoms did not show much change during the period of follow-up. An overall increase of 19% in urinary peak flow which was also consistent across all age groups was present at 1 year compared with baseline, even after adjusting for increased urinary void volume. A slow progression in the extent to which interference with selected activities of daily living by urinary dysfunction occurred. This was greater in men of working age (40-64 years), compared with men of retirement age (65-79 years). A longer period of observation is required in order to determine the extent to which a consistent pattern of urinary symptomatology exists in untreated BPH, as well as whether interference with daily living activities continues to progress over time.
Activities of Daily Living↗
A national study of housing affordability for recipients of supplemental security income.
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Activities of Daily Living↗
Magnetic resonance imaging in childhood intractable partial epilepsies: pathologic correlations.
We conducted a retrospective single-blind study assessing the value of MRI in 44 children surgically treated for partial epilepsy, and correlated the MRI findings with the pathology in all cases. MRI revealed abnormalities in concordance with the clinical and electroencephalographic data in 84% of patients. Developmental neuronal migration pathology was present in 25% of patients and was relatively more common in the sensorimotor cortex. There was hippocampal sclerosis in 50% of patients with temporal lobe resection; however, only two of the 10 children with hippocampal sclerosis were below the age of 12 years. Similarly, ganglio-glial tumors were more common than astrocytomas in children below age 12. These results indicate that MRI is sensitive in the detection of pathologic abnormalities in most pediatric candidates for epilepsy surgery, and that the distribution and type of pathology appear to be age related in this population.
Adolescent↗
The use of cortical allograft struts for fixation of fractures associated with well-fixed total joint prostheses.
Nineteen patients with 19 fractures around or below a well-fixed femoral stem, were treated by open reduction and internal fixation using massive cortical allograft struts and cerclage wires or cables. The first procedure was performed in 1982 and the last in 1990. Follow-up averaged 28 months. Seventeen patients united their fractures and returned to their preoperative functional status at an average time of 41/2 months. Sixteen healed anatomically. There was one mild malunion and there were two nonunions, both requiring further surgery.
Aged↗
Professional attitudes to cardiopulmonary resuscitation in departments of geriatric and general medicine.
Cardiopulmonary resuscitation for the elderly has long been a contentious issue. We have established by means of a postal survey the attitudes of 300 consultant geriatricians, 300 consultant physicians and 249 registered nurses to cardiopulmonary resuscitation. We also audited 400 case notes to document current practice in departments of general medicine and medicine for the elderly. No formal resuscitation policies were in operation. Geriatricians were more likely than physicians to make a positive resuscitation decision (p < 0.001), and involve nursing staff in the decision-making (p < 0.001). All professional groups felt age was unimportant in deciding on resuscitation, while the patients' prognoses and their wishes were most important. Case note audit revealed that geriatricians were better at documenting resuscitation decisions. Inappropriate resuscitation of patients is unacceptable. Each department or hospital ought to have agreed guidelines for cardiopulmonary resuscitation.
Aged↗
Antigen-specific activity of carcinoma-reactive BR64-doxorubicin conjugates evaluated in vitro and in human tumor xenograft models.
The anticarcinoma antibody BR64 was conjugated to a doxorubicin derivative, doxorubicin 13-[3-(2-pyridyldithio)propionyl]hydrazone, and the resulting conjugates (BR64-DOX) were evaluated for activity and immunological specificity in vitro and in human tumor xenograft models. The BR64-DOX immunoconjugates retained immunoreactivity and cytotoxicity and demonstrated antigen-specific cytotoxicity in vitro. The potency of BR64-DOX immunoconjugates in vitro was related to the drug:monoclonal antibody mole ratio of the conjugates. The antitumor activity of BR64-DOX conjugates was consistently superior to the maximal activity obtained with the parent drug, doxorubicin (DOX), in established human lung and human breast carcinoma xenograft models. The superior antitumor activity of BR64-DOX conjugates was reflected both in tumor growth inhibition and in regressions and cures of established tumors following the administration of tolerated doses of BR64-DOX. The antitumor activity of BR64-DOX conjugates was not the result of synergism between monoclonal antibody BR64 and DOX, because mixtures consisting of monoclonal antibody and optimized DOX were not more active than an equivalent dose of DOX administered alone. The antitumor activity of BR64-DOX conjugates was antigen specific; equivalent doses of nonbinding isotype-matched conjugates were not active against established tumor xenografts.
Adenocarcinoma↗
The neuroretinal rim in descending optic atrophy.
We studied seven human eyes in which the changes of the neuroretinal rim areas following complete loss of all axons could be measured planimetrically. The mean diminution of the neuroretinal rim area was 40% (range from 26-72%). The optic nerve pathology causing the loss of axons was in the posterior portion of the nerve and the optic disc was therefore not directly disturbed by the injuries. It appears that less than half of the neuroretinal rim is occupied by nerve fibers.
Axons↗
Using strategic planning to drive strategic change.
This article describes a case history of strategic planning, learning and change within a major division of Dowty plc. At Dowty CASE, a telecommunications company, the management team used strategic planning as a structured learning process to generate strategic change. There are many lessons which academics and practitioners alike can learn from this case of strategic planning and change in action.
Administrative Personnel↗
High-level expression of a recombinant antibody from myeloma cells using a glutamine synthetase gene as an amplifiable selectable marker.
We report a method for introducing a glutamine synthetase (GS) selectable marker into myeloma cells in which transfectants are selected by growth in a glutamine-free medium. Vector amplification can subsequently be selected using the specific inhibitor of GS, methionine sulphoximine (MSX). Using this system, DNA sequences encoding a chimeric B72.3 IgG4 antibody were expressed from hCMV-MIE promoters in NSO myeloma cells. A cell line was isolated after a single round of selection for vector amplification which contains approximately 4 copies of the vector, secretes 10-15 pg/cell/day cB72.3 antibody during exponential growth and can accumulate 560 mg/l antibody in a fed-batch air-lift fermentation system. Productivity is stable in the absence of MSX selection.
Animals↗
Mentorship in nursing management...
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Humans↗
Attitudes of elderly patients to medical students.
The attitudes of elderly patients towards clinical teaching of medical students was assessed by a structured interview carried out by a doctor unknown to the patient immediately prior to discharge. One hundred and thirty alert patients were approached on three acute geriatric medicine wards in the Royal Liverpool (Teaching) Hospital. A total of 106 (81.5%) patients were suitable for inclusion in the study (mean age, 80.2 years). Twenty-nine per cent did not know what a medical student was despite having been interviewed and examined by one. Fifty-nine per cent of patients had no prior knowledge that clinical teaching occurred. Fourteen patients (13 women, 1 man, P < 0.05) objected to being examined. Nineteen women patients were examined by a man student without a chaperone. Students usually (95%) asked permission to interview and examine the patients whereas doctors only asked patients in the context of bedside teaching (33%). Elderly patients were sympathetic towards ('They have to learn') and positive about ('It's good to have them') medical students. However, 29% of patients were not aware that a medical student was going to be a doctor despite being interviewed and examined. We suggest that the term should be used either with explanation or abandoned in favour of 'student doctor'. The level of awareness of clinical teaching was poor and examination of women patients without a chaperone caused distress and should be rectified.
Aged↗
The law and medical fitness to drive--a study of doctors' knowledge.
We assessed doctors' knowledge on laws and recommendations regarding fitness to drive in certain medical conditions by a questionnaire survey. A total of 646 doctors consisting of 400 general practitioners and 246 hospital doctors of all grades were circulated with the questionnaire. The survey was anonymous so non-responders could not be re-circulated. The response rate was 26% general practitioners and 32% (hospital doctors). The results show the poor knowledge of doctors on several aspects of fitness to drive. It is necessary for all doctors to have a basic knowledge on the laws and recommendations on fitness to drive so that they can advise their patients correctly. Our survey clearly shows that doctors' knowledge is poor. Many drivers may therefore be placing themselves and others at risk. It is mandatory that this subject receives more attention in undergraduate and postgraduate education and that doctors should be regularly updated on new recommendations from the Driver and Vehicle Licensing Agency.
Automobile Driving↗
Concentrations of vitamins A, C and E in elderly patients with Parkinson's disease.
Concentrations of the naturally occurring antioxidant vitamins A, C and E were measured in 27 patients with Parkinson's disease and 16 age-matched control subjects, from a similarly disabled patient group. There was no significant difference in the serum concentrations of vitamins A and E in the two groups. Vitamin C was significantly higher (P < 0.05) in the Parkinson's disease group, however, the mean leucocyte vitamin C concentration in the control group was low (101 nmol/10(8) WBCS) compared to established data in healthy young individuals (119-301 nmol/10(8) WBCS). There was no correlation between the severity or duration of Parkinson's disease and concentrations of vitamins A, C and E. There is therefore no evidence from this study that a deficiency of these antioxidants contributes to the onset or progress of Parkinson's disease.
Aged↗