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Biomedical subjects

D M Thomas

Publications and source records attributed to D M Thomas.

117 records · Page 7Linked to original sources
PubMedDate not supplied

Retrospective survey of unselected hospital patients with and without cancer comparing outcomes following venous thromboembolism.

BACKGROUND: Cancer patients are at risk of venous thromboembolism (VTE). Currently, management of these patients is based on studies performed in the general population. AIMS: To determine whether the natural history of VTE in cancer patients differs sufficiently from patients in general such that a specific management approach is required. METHODS: A retrospective survey was conducted using case records from three tertiary referral hospitals (1993-2001). One hundred and forty-seven VTE patients with cancer and 82 control patients matched for age and gender were followed for a median of 24 months (0-104 months). RESULTS: The overall prevalence of cancer among patients with VTE was 19.3% (vs 4% in patients with arterial thromboembolic events). In the follow-up groups, cancer conferred a significantly worse functional status, although other risk factors for VTE were similar. Proximal sites of VTE were twice as common in cancer as in non-cancer patients. The majority of patients in both groups were treated with oral anticoagulants. Complications were more common in cancer patients (40% vs 23%) and occurred more frequently despite apparently adequate anticoagulation. Following VTE, cancer patient survival (median 4.1 months, 127 deaths) was markedly worse than non-cancer patients (median not reached, eight deaths). Thirty-five cancer deaths occurred within 5 weeks of VTE. Eleven deaths in cancer patients were directly related to VTE compared to three in patients without cancer. CONCLUSIONS: Cancer patients with VTE fare extremely poorly compared to the general hospital population. Prospective treatment studies, specifically in cancer patients with VTE, are needed.

Aged↗
PubMedDate not supplied

Age differences in feature search as a function of exposure duration.

Older and younger observers searched for two targets embedded in response-compatible or -incompatible distractors. Display duration was varied across trial blocks from 26 to 1,664 ms. For both age groups, response-incompatible displays led to relatively poorer accuracy, particularly at brief durations. Age differences in accuracy were larger for response-incompatible displays and diminished at longer durations, an effect that was also revealed in the latency data. Results are interpreted within a continuous-flow conceptualization of visual processing and are consistent with the hypothesis that older adults are slowed in the feature extraction process that underlies visual search.

Adolescent↗
PubMedDate not supplied

Dopamine does not mediate protein-induced hyperfiltration.

Dopamine and a meat meal have both been used to stimulated hyperfiltration. Urinary dopamine has been said to rise after a meal. It has been suggested that the responses are the same. In order to clarify this relationship, the DOPA decarboxylase inhibitor carbidopa was used to abolish dopamine synthesis during a meat meal. Eight normal individuals were studied twice. On each occasion they ate a meat meal and resting and post-prandial haemodynamics were measured. On 1 of the 2 study days they received carbidopa which abolished renal dopamine synthesis. Despite this there was no change in resting haemodynamics and the meat meal response was preserved. We conclude that urinary dopamine does not rise after a meal and that dopamine does not mediate the meat meal response.

Carbidopa↗
PubMedDate not supplied

Audit of patient acceptance of nasal surgery as a day case procedure.

A greater emphasis on day case surgery within the health service is seen as a method of improving efficiency and reducing expenditure. We interviewed 90 consecutive patients undergoing nasal surgery who had been preoperatively assessed as being fit for day case surgery. They were randomised into three groups regarding the duration of postoperative nasal packing. All patients stayed overnight following surgery and were interviewed prior to discharge. Some 52% of the overall sample would be happy to have nasal surgery performed as a day case. If the nasal pack was removed after two hours, this figure rose to 67%. This difference in patient acceptance did not attain statistical significance overall, but there was a significant difference in those undergoing submucosal resection. There was no difference in the age, sex distribution or type of surgery performed between each group. The audit commission quotes patient satisfaction with day case surgery at 80%. Nasal surgery was not examined in their report, but was included as one of a set of procedures suitable for consideration. Although day case nasal surgery may be safe, further research regarding patient acceptance is required.

Ambulatory Surgical Procedures↗