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Biomedical subjects

D Wright

Publications and source records attributed to D Wright.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

A pilot study of ChlOPhEPP-B--a weekly regimen for patients with untreated advanced or recurrent Hodgkin's disease.

Twenty-five patients with either previously untreated advanced Hodgkin's disease (HD) or with relapsed disease were treated with an intensive weekly chemotherapy regimen (ChlOPhEPP-B) in which the myelosuppressive combinations of epirubicin and chlorambucil, and procarbazine and etoposide alternated at two-week intervals, interspersed with vincristine and prednisolone and then vincristine, prednisolone and bleomycin in a four-week cycle. Of the previously untreated patients (n = 14), 12 (86 per cent) showed a complete response (CR); in the previously treated patients (n = 11), CR was achieved in five (46 per cent). Toxicity was predictable and not evidently more severe than with more standard regimens. Neutropenia leading to treatment delay and/or dose reduction was seen in 11 patients (44 per cent) but severe neutropenia (WHO grade 4) was documented in only six patients (24 per cent) for a cumulative total of nine treatment weeks (1.8 per cent of the total treatment time). Dose reductions for neutropenia were applied in relation to 11 of the 379 weekly treatment points (2.9 per cent). Delays in treatment, for any reason, averaged 3.65 weeks per patient. The study demonstrated the feasibility of a more intensive weekly multidrug schedule. This approach may be applicable in the treatment of advanced HD and represents a further option in the strategy of treating relapsed disease.

Adult↗
PubMedDate not supplied

Comparison of two methods of transporting paramedics to cardiac arrests outside hospital.

OBJECTIVE: To compare the deployment of paramedics in a separate rapid response unit with their deployment in a standard emergency ambulance. DESIGN: A one year period of each deployment. SETTING: Throughout the community in some parts of West Yorkshire. PARTICIPANTS: All patients receiving resuscitation for cardiac arrest by paramedics. INTERVENTIONS: Using the same group of paramedics and central control, 12 months with the paramedics deployed in separate cars in addition to the standard ambulances (period 1) were followed by another 12 months when they were deployed as one crew member of a standard emergency ambulance (period 2). MAIN OUTCOME MEASURES: Number of arrests attended, number of patients in ventricular fibrillation at paramedic arrival, response times, survival to leave hospital. RESULTS: In period 1, 580 arrests were attended with 31 survivors. In period 2, 462 arrests resulted in 25 survivors. The mean response time was shorter in period 1 (6.24 versus 6.60 min, Cl--0.01-0.73 min). In period 1, 217 patients were found in ventricular fibrillation (23 survivors): In period 2, 141 patients were found in ventricular fibrillation (11 survivors). CONCLUSION: Separating paramedics from the standard emergency ambulances increases the number of survivors of cardiac arrest but the difference may not be sufficiently large to justify the additional expenditure.

Ambulances↗
PubMedDate not supplied

A characterization of the acute cardiopulmonary toxicity of fenfluramine in the rat.

Fenfluramine (FN) is a potent serotonin-releasing drug used primarily as an anorectic agent. The symptomatology of its acute lethality has been well documented in animal models such as the rat. A very prominent feature of this lethality profile is hypoxia, as demonstrated by the onset of severe cyanosis just prior to death. It is not clear in the literature whether this hypoxia is the result of a direct pulmonary effect or is secondary to cardiac injury. To further characterize this aspect of FN's toxicity, respiratory and electrocardiographic measurements were taken in anaesthetized rats subjected to high doses of FN (129.6 mg/kg, i.p.). Death occurred in these animals within 15 min of drug administration, apparently as the result of abrupt respiratory cessation, followed by cardiac ischaemia. No significant gross or histopathological lesions were evident in these animals. In other trials, prior treatment with diethylcarbamazine (DEC) was found to potentiate the lethality of FN, while cyproheptadine (CHP) pretreatment attenuated FN's toxic effects. Necropsies, conducted 24 h after FN administration, revealed widespread alveolar and pulmonary interstitial haemorrhage in the CHP-pretreated animals. The data suggest that high doses of FN directly result in pulmonary hypertension, which secondarily induces ischaemic cardiac injury.

Animals↗
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Hickman catheter dislodgement due to pendulous breasts.

Dislodgement of Hickman, Broviac, and Mediport catheters is a rare but recognized complication. To date, no specific etiology for this has been cited. We present five cases of dislodgement due to positional changes in large-breasted women and one man with gynecomastia. Apparently, motion in the subcutaneous tissue secondary to gravitational forces on large breasts causes downward and outward traction on the subcutaneous portion of the catheter. Variations in placement technique to help avoid this complication are described.

Adult↗
PubMedDate not supplied

Beyond health promotion: reducing need and demand for medical care.

A population's medical need represents its illness burden. Medical demand represents the service level requested for a particular need. Medical care costs are, in large part, a function of need and demand. Our review of health education programs designed to reduce health risks and reduce costs identified thirty-two programs with documented effectiveness, generally achieving claims reductions of 20 percent. Specific program features including chronic disease self-management, risk reduction, and increased self-efficacy appear important. A broadened definition of health promotion focused on increased personal responsibility for health-related actions and directed at improvement of long-term health outcomes also could reduce health care costs.

Cost of Illness↗
PubMedDate not supplied

Carry on matron?

Explore the source record for details and available documents.

Female↗
PubMedDate not supplied

Educational support for nursing and midwifery students with dyslexia.

AIM: This article sets out to begin the process of discussing and investigating the support of nursing students and midwives with dyslexia. METHOD: The method is informed by grounded theory using a survey of universities through email contact with members of the Council of Deans (CoD). RESULTS: Twenty eight universities responded to the survey, representing 46 per cent of the CoD membership and 40 per cent of the universities offering nursing and midwifery courses. The results show a wide variation of support available to students within financial constraints. Many universities offer support funded by top-slicing or goodwill gestures. CONCLUSION: Although concentrating on academic support, there are implications for practitioners who support students on clinical placements.

Disability Evaluation↗
PubMedDate not supplied

New method for the determination of 1,1-dimethylhydrazine residues in apples and peaches.

A new method for determining 1,1-dimethylhydrazine (UDMH) in peaches and apples is presented. The method consists of extraction with L-ascorbic acid, derivatization with 2-nitrobenzaldehyde to the corresponding hydrazone, and cleanup on an alumina column. The hydrazone derivative is determined by gas chromatography using an electron-capture detector. Recoveries were determined from 10 to 100 ppb. Stability of the UDMH residues on frozen peaches was investigated, and results indicate that the residues degrade even while frozen.

Chromatography, Gas↗