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Biomedical subjects

D Simmons

Publications and source records attributed to D Simmons.

At least 199 records · Page 11Linked to original sources
PubMed1985

Stage II neuroblastoma--does adjuvant irradiation contribute to cure?

Twenty-one children with Stage II neuroblastoma diagnosed between 1973 and 1983 were analyzed retrospectively. Median age at diagnosis was eleven months (1 week to 153 months). Primary tumor was above the diaphragm in 67% and below the diaphragm in 33%. All patients underwent surgical resection and pathologic diagnosis was neuroblastoma in 76% and ganglioneuroblastoma in 24%. Regional lymph nodes were positive in three of eleven patients sampled. Sixty-seven percent had gross residual disease, and thirty-three percent had microscopic residual disease. Seventeen patients received postoperative irradiation and none has relapsed (median follow-up 57 months). Four patients received surgery alone (median follow-up 24 months); one local relapse occurred in this group and was subsequently treated with irradiation. All patients are alive and disease free, with a median length of follow-up of 55 months. Radiation dosage was 1000-1800 rad in patients less than 12 months of age, and 1800-3000 rad in those greater than 12 months of age at diagnosis. The high disease-free survival rate in both groups of patients, but especially in the group receiving adjuvant irradiation, emphasizes the need for a controlled, prospective study to determine which Stage II neuroblastoma patients, if any, would be benefitted by postoperative irradiation.

Age Factors↗
PubMed1985

Accidents in Malawi.

The frequency and types of children's accidents during a two month period in Malawi are described, showing that these are at least as numerous as in developed countries. It is suggested that preventive measures and an improvement in immediate treatment are required.

Accidents↗
PubMed1985

Computer charting: an evaluation of a respiratory care computer system.

A respiratory care computer-charting system was developed and implemented as an addition to our hospital's computerized information system. Medical personnel charted and reviewed respiratory care procedures at nursing station computer terminals instead of using the patient's traditional paper chart. The computer automatically performed billing and provided management as well as clinical information. In an attempt to isolate specific benefits or shortcomings, we evaluated charting systems both before and after computer implementation. Four assessments were made: (1) a survey of therapists' attitudes, (2) an observation of work patterns, (3) an audit of the content of charting, and (4) an analysis of productivity statistics. Computer charting was well accepted by therapists. Charge capture was reduced from a four-step manual process to a single-step computer documentation of the procedure. Computer charting was more complete and informative. Productivity increased 18%, although it remains unclear to what degree the computer was responsible. Computer charting streamlined the process of documentation and allowed more beneficial use of clinical information.

Computers↗
PubMed1983

Blood pressure, ethnic group, and salt intake in Belize.

A total of 1316 individuals were studied in seven villages in Belize, Central America. This represented 92% of the area population aged over 18. Generally, they were members of three ethnic groups--Maya, Spanish, and Creole. The systolic and diastolic IV and V blood pressures were recorded using standardised procedure. Significant differences in blood pressure, weight, and obesity were found between ethnic groups in both sexes, Creoles having higher means than the other groups. Significant relationships with blood pressure were found with obesity, age, and number of children. An early morning urine specimen was obtained from a random 50% of the men, and only in Creoles was there an association between raised blood pressure and sodium/potassium urinary excretion ratio.

Adult↗
PubMedDate not supplied

Electronic prescriptions.

Explore the source record for details and available documents.

Computer Communication Networks↗
PubMedDate not supplied

Diabetes in general practice: Tongans in Tonga and South Auckland.

The aim of this study was to compare the management and treatment outcomes of Tongan diabetic patients in Tonga and South Auckland, New Zealand. This was achieved by comparison of Tongan diabetic patients within clinical audits from a general practice in Tonga (n = 124) with those from participating general practices in South Auckland (n = 168). Our results indicate that some measures of diabetes care and outcomes were similar or even better in Tonga, while some interventions were not available in Tonga. Control of weight, glucose, blood pressure and cholesterol remained difficult in both areas. Severe diabetic foot damage was more common among Tongan patients in Tonga (6.5% vs 1.8%, P < 0.05). This international comparison shows that Tongans in both Tonga and New Zealand remain at high-risk of complications independent of the health system under which care is being delivered. While barriers to implementation may differ in the two settings, improvements in the co-ordination of care are likely to be of benefit in both settings.

Diabetes Complications↗
PubMedDate not supplied

Abnormal bone production associated with mutant mouse genes pa and we.

A syndrome including deficient linear, endochondral, and radial bone growth associated with severe cervico-thoracic lordosis, decreased intrathoracic volume, atelectasis, and early death has been noted in mice possessing the phenotypes of the recessive mutant genes pallid (pa) and wellhaarig (we) as the result of recombination of chromosome 2 between these genes. The syndrome is not seen in the parental strains, which are homozygous for the chromosomal segment containing one or the other gene (pa +/pa + or + we/+ we), nor in the intercross mice heterozygous for both genes in the trans configuration (pa+/+we). The abnormal offspring appeared randomly in the breeding colony with no F1 breeding pair producing more than one pa we mouse. These observations rule out the presence of a mutant gene, fixed or unfixed, as an explanation for this syndrome. We hypothesize that the syndrome is the result of the complementary action of the genes or the chromosomal segments containing the genes pa and we or weBkr. The posited synergism is further supported by the finding that we, which functions as a recessive gene in mice of the pa/+ genotype, appears to function as a dominant gene in mice possessing the pa/pa genotype.

Animals↗
PubMedDate not supplied

Prevalence and age of onset of type 1 diabetes in adult Asians in the Coventry Diabetes Study.

Although Asians are known to have an excess of Type 2 diabetes when compared with Europids, the relative prevalence of Type 1 diabetes in Asians remains controversial. The Coventry Diabetes Study enumerated all adult diabetic subjects in the electoral ward of Foleshill (population 10,304) by a house-to-house survey. Residents treated with insulin were classified as having either Type 1 or Type 2 diabetes on the basis of plasma C-peptide concentration and their diabetic history. Insulin treatment was received by 22% of Europids and 12% of Asians with previously diagnosed diabetes. Diabetic history was available for all and C-peptide for 69% of insulin-treated subjects. The age adjusted prevalence of Type 1 diabetes was 0.16 (95% CI 0.6-3.3)% in Europids and 0.12 (95% CI 0.4-2.7)% in Asians. Asians were found to have a significantly higher age at diagnosis (26 (range 19-34) vs 18 (6-29) years, p less than 0.05) than Europids, and all were born outside of the United Kingdom. No Type 1 diabetes was diagnosed under 19 years of age in Asians while 5 of the 8 Europid subjects with Type 1 diabetes were diagnosed under this age. Type 1 diabetes does occur in Asians born outside the UK but either commences later in life or, if of earlier onset, precludes migration to the UK.

Adult↗
PubMedDate not supplied

Knowledge of diabetes in Asians and Europeans with and without diabetes: the Coventry Diabetes Study.

Knowledge about the nature, symptoms, complications, and treatment of diabetes was assessed among United Kingdom Europeans and Asians with and without diabetes during the Coventry Diabetes Study. An open questionnaire was validated for use among Asians and Europeans and a 'Knowledge Index' constructed. The questions were answered by 3814 (87%) of 4395 Asians and 3783 (69%) of 5508 Europeans. Among those with known diabetes, 216 (96%) of 223 Asians and 98 (94%) of 104 Europeans answered the questions. The nature of diabetes was unknown in 30% of Europeans and 44% of Asians with diabetes, and 42% and 67%, respectively, could not name a single complication. Most of those without diabetes were unable to name either a complication (Europeans 66%, Asians 89%) or a single symptom (66% and 83%, respectively). The Knowledge Index was highest in Europeans, increased with increasing educational achievement, and was lowest in non-diabetic subjects without a family history of diabetes. Even those with diabetes had a low Knowledge Index.

Adult↗
PubMedDate not supplied

A community diabetes educator course for the unemployed in South Auckland, New Zealand.

PURPOSE: This paper describes an education program that targeted long-term unemployed people from the community and trained them to work as diabetes educators in their own communities in an attempt to address issues of cultural appropriateness. METHODS: Government funding was obtained to conduct two 22-week training courses for people who had been selected by their communities. These courses built on participants' existing cultural skills and provided appropriate diabetes training. RESULTS: The results indicate that the courses were successful both in creating a cadre of culturally acceptable diabetes educators and providing employment for course participants. CONCLUSIONS: Previously unemployed lay people are able to provide diabetes education in the primary prevention and group settings. Such individuals are able to incorporate extensive cultural skills in their work.

Communication↗
PubMedDate not supplied

A comparison of two intravenous insulin regimens among surgical patients with insulin-dependent diabetes mellitus.

We compared two intravenous insulin regimens among 58 consecutive surgical patients who required perioperative insulin infusions. Patients were randomized to either a standard glucose-insulin-potassium (GIK) infusion or a more complex, tailored two-pump protocol. Both methods provided similar overall glycemic control. However, the two-pump regimen resulted in a significantly greater proportion of finger-prick results in the target range both preoperatively (47.4% vs 60.1%) and postoperatively (52.0% vs 66.4%). The length of stay (15 vs 16 days), duration of infusion (15 vs 16 hours), and number of medical and nursing incidents (18% vs 20%) were similar. Although the two-pump protocol required more changes to the administration rate (2 vs 10), this method was preferred by the nursing staff over the GIK regimen, resulted in more stable glucose control, and is likely to be associated with fewer clinical errors.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Computer-assisted medical direction of respiratory care.

As medical technology and the increased demand for respiratory care make concurrent monitoring of all respiratory care services more difficult, computers are coming to the aid of medical directors and quality assurance committees. The respiratory care staff at LDS Hospital, Salt Lake City, has used computers to enhance patient care and quality assurance.

Hospital Bed Capacity, 500 and over↗