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Biomedical subjects

G Carroll

Publications and source records attributed to G Carroll.

46 records · Page 3Linked to original sources

Comparison between fascicular and whole sural nerve biopsy.

Sural nerve regeneration and sensation were evaluated in 16 subjects five or more years after fascicular or whole nerve biopsy. Conduction studies demonstrated successful nerve regeneration in all subjects who had whole nerve biopsy. Postbiopsy interrogation revealed no long-term pain or paresthesias but a high incidence of tactile-induced dysesthesias. No significant difference was seen when areas of sural sensory loss were compared in fascicular and whole nerve biopsy groups. We conclude that whole nerve biopsy should be recommended in preference to fascicular biopsy since it is simpler, has greater diagnostic potential, and allows for a more complete morphological evaluation.

Action Potentials↗

Adolescents with chronic disease. Are they receiving comprehensive health care?

A survey of adolescents with a chronic disease attending six specialty clinics was conducted to determine the sources of their primary health care and to estimate the extent of unmet health needs. Sixty-one patients completed a self-administered questionnaire. Forty percent had no source of primary care other than the subspecialty clinic treating their chronic condition. Seventy-eight percent regarded the subspecialist as their "personal" physician, although only 27% actually spoke to this physician about their general health needs. For 44% general health needs were not being met. These findings suggest that these adolescents expect the subspecialty clinic to provide primary care; yet they receive, at best, fragmented health care. This situation could be improved by a decision on the part of the subspecialty to restrict its role to providing only specific specialty care or to coordinate overall care.

Adolescent↗

Recurrent urinary infections: causes and prevention.

Despite the development of effective antimicrobial agents very little progress has been made in preventing recurrence of urinary infections and especially in pyelonephritis. Obviously then there are other factors which cause recurrence. The high incidence has caused recently many studies to be focused on this trouble. Some of the results will be briefly discussed.

Anti-Bacterial Agents↗

Complications common to ventricular assist device support are rare with 90 days of DeBakey VAD support in calves.

The DeBakey VAD is a miniaturized, electromagnetically driven axial flow pump intended for long-term ventricular assist. Safety and performance data from six calves implanted with the complete DeBakey VAD system are reported elsewhere; here we describe complications and necropsy findings for these same six animals, all of which survived 90 days. The study was conducted according to a uniform protocol, which included anticoagulation and antibiotic prophylaxis. Clinical complications tracked included bleeding, cardiovascular abnormalities (e.g., arrhythmias, tachycardia unrelated to pain, bradycardia), hemolysis, hepatic dysfunction, renal dysfunction, thromboembolism (neurologic or peripheral), or infection. Each adverse event was retrospectively categorized with regard to severity (mild, moderate, severe) and relationship to device. Clinical findings were confirmed by necropsy. There was no evidence of systemic infection, thromboembolism, hemolysis, or renal or hepatic dysfunction in these six animals during the study period. A single adverse event was noted in each of two of the calves. Both events were considered mild according to the predefined criteria. Bleeding related to the surgical implantation procedure and requiring reoperation occurred in one animal. The other animal had evidence of a superficial infection at the exit site of the cables on the left lateral thoracic wall; the infection did not extend into the thoracic cavity. Chronic, healed small renal infarct scars were present in several animals. Mild valvular endocardiosis was observed in two calves and mild fibroelastosis was present in the endocardium at the site of the inflow cannula in three calves; however, these lesions were not considered clinically significant. No other gross or histologic abnormalities were noted at necropsy. In conclusion, calves implanted with the complete DeBakey VAD for 90 days demonstrated few complications and had no significant necropsy findings. Complications common to ventricular assist device (VAD) support (i.e., hemolysis, infection, bleeding, thromboembolism) were rare during long-term support (90 days) with the DeBakey VAD.

Animals↗

Priority setting in purchasing.

The NHS cannot deliver full comprehensive health care to all the population. In this article the need to define a range of basic health services is emphasized. Agreement on priorities requires ethical, economic and clinical debate.

Ethics, Medical↗

Beyond preceptorship and supervision: a third clinical teaching model emerges for Australian nursing education.

In Australia, there are two established models for teaching in the clinical setting, supervision and preceptorship. Both models are used in the final year unit at the University of Canberra. In 1995, seven clinical supervisors and 34 preceptors responded to a questionnaire about their perceptions of their respective roles. The most significant findings were that (1) clinical supervisors did not feel prepared for their role and felt that the supervision requirements were unreasonable and (2) although preceptors did feel adequately prepared for their role and able to supervise the students assigned, there were times when they felt that the demands of 'work' overtook the learning needs of the student. A review of the contemporary literature in the field of clinical education for undergraduate nursing students revealed a pattern of similar weaknesses in other programs. Compounded by the climate of economic restraint, these weaknesses could evolve into obstacles to effective student learning. A collaborative clinical education model, adapted from North America, is proposed as a third clinical teaching model to overcome the identified difficulties and capitalise on the combined benefits of supervision and preceptorship.

Australia↗