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Biomedical subjects

D West

Publications and source records attributed to D West.

123 records · Page 7Linked to original sources

Abortion.

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Abortion, Legal↗

Complete separation of lipid classes on a single thin-layer plate.

A double-development procedure employing first a polar and then a nonpolar solvent system is described for the complete separation by thin-layer chromatography of the main lipid classes encountered in natural lipids. For better quantification, long plates (34 cm) are employed. Diglycerides were separated from cholesterol, 1,2- from 1,3-diglycerides, and monoglycerides from phospholipids.

Acetates↗

Chronic constipation management for institutionalized older adults.

Bran's effectiveness in reducing the need for bowel medication for intermediate care patients was examined at a VA medical center in New York. Twelve older men with chronic constipation and bowel medication use were matched and randomized to receive either bran treatment or usual care (controls). After baseline assessment, six patients were given gradually increasing daily doses of a bran mixture. Results over a 4-month period showed that these patients completely discontinued oral laxative use and had an 80% reduction in total bowel medication use without adversely affecting bowel frequency. The six men who received usual care (controls) experienced no changes.

Aged↗

Inappropriate antibiotic therapy in febrile cancer patients with bacteremia.

OBJECTIVE: The aim of the study was to assess the outcome of inappropriately treated cancer patients with documented bacteremia. DESIGN/SETTING: 95 cases of inappropriately treated bacteremias in febrile cancer patients in a tertiary-care center were analyzed and compared with a group of appropriately treated bacteremias to assess risk factors for inappropriate therapy and outcome. RESULTS: Among 285 bacteremias, 95 (33.3%) were not treated appropriately, with 42 receiving the wrong antibiotics and 17 having too short a therapeutic course of appropriate antibiotics. In 13, therapy was delayed for more than 48 hours after the onset of fever. Twenty-three patients did not receive antibiotic therapy at all despite bacteremia. A group of 95 inappropriately treated bacteremias was compared to 190 appropriately treated bacteremias occurring in the same period. Microbiological cure after the initial course of therapy was achieved more often (76.8% vs 38.9%, P < .001) in the group of appropriately treated bacteremias in all cases and also in the subgroup of leukemic patients (P < .01). Overall and attributable mortality were significantly lower in patients who were treated appropriately. There was no difference in the number of antibiotics administered in appropriately versus inappropriately treated bacteremias. Cost of therapy between both groups was similar. CONCLUSIONS: Inappropriately treated bacteremic cancer patients had outcomes that were significantly worse than patients who were treated appropriately. The reasons for inappropriate therapy were selection of the wrong antimicrobials, too short a duration of therapy, delayed onset of therapy, or absence of antimicrobial therapy.

Anti-Bacterial Agents↗

Outcome in children under 5 years of age with constipation: a prospective follow-up study.

Constipation in the pre-school child is common and causes considerable distress to children and their parents. There is a lack of information regarding prognosis in this group of patients although some are clearly at risk of developing long-term difficulties with defaecation. We have previously reported characteristics of children under 5 years of age referred to hospital over a one-year period with idiopathic constipation. We now report outcome data after 18 months of follow-up in 41 of the original cohort of 42 children. We have also summarised what we regard as good practice in managing constipation in this age group. Eighteen months after initial outpatient assessment, the symptoms of constipation were reported to have resolved in 36 (88%), although seven of these were still needing regular laxative treatment. It was our subjective impression that the five children who apparently did not improve came from families that had a greater degree of psychosocial problems and where compliance with treatment was suspect. This study shows that with simple treatment measures and ongoing support, an optimistic prognosis can be given to families from the outset. The minority of pre-school children who do not improve may benefit from a more intensive psychological approach to management.

Child, Preschool↗

Characteristics of children under 5 referred to hospital with constipation: a one-year prospective study.

Constipation in the pre-school child can cause considerable distress to the individual and to the family. Most cases are idiopathic and with early diagnosis and effective treatment prognosis is good. In a teaching hospital paediatric unit, a year-long prospective study identified 42 new referrals for constipation in children under 5. Before referral for a specialist opinion there appeared to be considerable variation in both duration of symptoms and treatment given. Psychological factors in the family, as well as advice regarding simple behaviour modification and management of common secondary behavioural problems, seemed largely overlooked. Guidelines for for treating constipation in the community could help standardise and improve care. For children with refractory constipation referred to a specialist centre, we recommended a multidisciplinary assessment including paediatrician, paediatric surgeon and member of the child mental health team.

Child Behavior↗