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Biomedical subjects

G Cunningham

Publications and source records attributed to G Cunningham.

At least 55 records · Page 3Linked to original sources
PubMed1989

The diagnosis of immature teratoma by maternal serum alpha-fetoprotein screening.

We report a case in which maternal serum alpha-fetoprotein (MSAFP) screening of a low-risk patient led to the antepartum detection of an asymptomatic and previously undetected stage Ia immature teratoma of the ovary. It is widely accepted that MSAFP screening is valuable in the antepartum diagnosis of neural tube defects, ventral wall defects, and aneuploid fetuses. Similarly, such screening may lead to the diagnosis of AFP-producing neoplasms not appreciated on physical or ultrasonic examinations. This benefit, though extremely rare, is significant when a potentially aggressive malignancy is detected in the earliest stages, prior to extraovarian spread.

Adult↗
PubMed1989

Sexuality and the older woman.

The nurse has a responsibility to be informed of the sexual needs of older patients and the physiological changes due to aging. Through education of the patient, family and other health care personnel, the nurse can do much to change their knowledge about sexuality in the older woman (Steinke, 1988), and encourage a healthy perspective and sexuality.

Aged↗
PubMed1988

California's experience with low MS-AFP results.

The California AFP Screening Program was developed to offer pregnant women the opportunity to have their pregnancies screened for open neural tube defects (NTD). Because it is unwise to withhold potentially important clinical information about low MS-AFP results from the screened women and their physicians, follow-up diagnostic evaluations and counseling were offered to women with low MS-AFP results in addition to those with high results or positive family histories of NTD. Between April 7, 1986 and September 30, 1987, over 275,000 women voluntarily participated in the screening program. During the first year of the program 3,939 women were seen for follow-up evaluations due to low MS-AFP results. These evaluations occurred at state-approved AFP follow-up centers where ultrasonographic dating led to reinterpretation of 35% of the results. Of the remaining 2,552 (65%), 1,940 women (76%) had an amniocentesis. Sixteen Down syndrome fetuses were detected for a yield of 1/121 amniocenteses. Additional chromosome abnormalities included trisomies 18 and 13, Ullrich-Turner syndrome, (45,X), Klinefelter syndrome (47,XXY) and triploidy. The total yield of significant chromosome abnormalities was 1/78 amniocenteses.

Adult↗
PubMed1988

Risk of alloimmunization and delayed hemolytic transfusion reactions in patients with sickle cell disease.

Blood transfusion is an integral part of the supportive care of patients with sickle cell diseases. The hazards of red blood cell alloimmunization and delayed hemolytic transfusion reactions (DHTRs) complicate the treatment of patients with sickle cell diseases, particularly since such reactions may be misinterpreted as a pain crisis, and, as a result, specific transfusion serologic studies may not be performed. The frequency of alloimmunization in this population has been the subject of several reports; however, the frequency of DHTRs is unknown. To determine the frequency of this event, we retrospectively reviewed the medical and transfusion service records of all adult patients with sickle cell diseases transfused during the six-year period from January 1980 to December 1985. Seventy-three adult patients with sickle cell diseases received transfusions. The prevalence of recognized DHTR was three (4%) of 73. Red blood cell alloimmunization was seen in 22 (30%) of 73 of the patients. The calculated risk of alloimmunization was 3.1% per unit of blood. These observations suggest that alloimmunization and clinically apparent DHTRs occur more frequently in patients with sickle cell diseases and support pretransfusion testing for at least Rh and Kell red blood cell antigens in patients who are at high risk of such events (patients who have formed an alloantibody or who are being enrolled in a transfusion program).

Adolescent↗
PubMed1988

Randomized double-blind comparison of mezlocillin versus cefoxitin prophylaxis for vaginal hysterectomy.

One hundred patients undergoing vaginal hysterectomy were enrolled in a randomized double-blind comparative antibiotic prophylaxis study. Forty-six patients received mezlocillin and 54 patients received cefoxitin. No significant difference was found among patients who developed febrile morbidity. Failure rate for mezlocillin was 17 per cent and for cefoxitin, 15 per cent. There was an increase in colonization of Streptococcus faecalis and Enterobacter species in patients receiving three doses of cefoxitin prophylaxis.

Adult↗
PubMed1987

Morphological changes of an inflammatory myopathy in rhesus monkeys with simian acquired immunodeficiency syndrome.

Eleven of 25 rhesus monkeys which died of simian acquired immunodeficiency syndrome (SAIDS) caused by infection with a type D retrovirus related to Mason-Pfizer monkey virus showed evidence of muscle weakness and atrophy and had elevated levels of muscle enzymes. Biopsies of affected muscle studied with enzyme histochemistry showed the characteristic features of polymyositis. Inflammatory cells consisting of lymphocytes, macrophages, and large vacuolated bizarre-shaped cells of undetermined type were surrounding or invading muscle fibers and were present in the perivascular spaces and endomysia septa. Within the perivascular infiltrates, lymphocytes were abundant but very few macrophages were present. Other myopathic features including profound proliferation of fibrous tissue, necrosis, and phagocytosis of muscle fibers were noted to a variable degree. The retrovirus was isolated from affected muscles. The clinical and historical features of polymyositis in rhesus monkeys with SAIDS are very similar to those of human polymyositis. The polymyositis in SAIDS induced by a type D retrovirus related to Mason-Pfizer monkey virus is an excellent primate model to study the mechanism and morphological changes of viral-induced muscle damage.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Characterization of amyloid deposits in biopsies of 15 with "sporadic" (non-familial or plasma cell dyscrasia amyloid polyneuropathy.

Review of the clinical and laboratory findings of 39 patients with amyloid polyneuropathy (AP) showed 12 cases to be hereditary and 12 to be associated with plasma cell dyscrasia (PCD). The remaining 15, termed "sporadic" AP, had neuropathy clinically indistinguishable from the other two groups but without a clinicopathologically identified PCD or positive family history. In an attempt to identify the type of amyloid in "sporadic" AP, the immunoreactivity of amyloid deposits was investigated using specific antisera raised against the following different chemical types of amyloid fibril proteins: variable regions of amyloid light chains kappa (A kappa) and lambda (A lambda), amyloid protein AA, and prealbumin. It was found that the amyloid in "sporadic" AP had A lambda antigenic determinants in ten cases, A kappa in one and prealbumin in three; in one case, the A lambda nature of amyloid was confirmed biochemically on the extracted amyloid fibrills. Thus, the most common type of AP in our population appears to be the "sporadic" form. In "sporadic" AP, the amyloid is most commonly of immunoglobulin light chain origin, even in the absence of overt PCD, and it can be rapidly categorized immunocytochemically to determine therapeutic directions or provide genetic guidance.

Amyloid↗
PubMed1981

Computed tomography in the evaluation of chest lesions in the pediatric patient.

The role of computed tomography (CT) in the management of chest masses in the pediatric patient is emphasized and illustrated. Thirty-seven patients with various chest lesions who had both CT and conventional radiologic evaluations are reviewed. CT was the most consistently accurate examination, especially in the evaluation of disease extent and relationship with other organs. CT was the only modality to provide clinically useful information in 27% of the cases, and it provided significant additional information in another 24% of the group.

Adolescent↗
PubMedDate not supplied

Ward leadership.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMedDate not supplied

Management control systems in the NHS.

Non-profit organisations like the NHS require mechanisms for evaluating their performance and judging how effectively or efficiently they are achieving their objectives. Management control systems (MCS) can provide a major input to this type of evaluation and, in addition, can assist in planning, motivating staff, and securing co-ordination at various levels in the organisation. This article examines the use of management control systems in the NHS.

Humans↗
PubMedDate not supplied

An evaluation of the RCN Clinical Leadership Development Programme: Part 1.

AIM: The RCN Clinical Leadership Development Programme was set up in 1995 and sought to identify how clinical nurses in recognised leadership positions could improve the quality of patient care. METHOD: The programme was tested on four senior nurses and 24 ward sisters in four acute hospital trusts in England over an 18-month period. The primary research question was whether the intervention improved the clinical leadership skills of participants. A pre-test/post-test design incorporating action research was deployed. RESULTS: On a number of leadership dimensions, ward sisters' and senior nurses' performance had significantly improved. Five key themes emerged from the process data documenting the journey towards more effective clinical leadership: managing self; managing the team; patient-centred care; networking; and becoming more politically aware. There was evidence to show that patient care had also improved as measured by the way nursing care was organised; by patients' accounts of care they received and by documented improvements nurses carried out as a result of direct observation of care. CONCLUSION: From the results of the study, it appears that there is a need for more effective clinical leadership development programmes for nurses to achieve better patient-centred care.

Education, Nursing, Continuing↗
PubMedDate not supplied

An evaluation of the RCN Clinical Leadership Development Programme: Part 2.

AIM: The RCN Clinical Leadership Development Programme was set up in 1995 and sought to identify how clinical nurses in recognised leadership positions could improve the quality of patient care. METHOD: The programme was tested on four senior nurses and 24 ward sisters in four acute hospital trusts in England over an 18-month period. The primary research question was whether the intervention improved the clinical leadership skills of participants. A pre-test/post-test design incorporating action research was deployed. RESULTS: On a number of leadership dimensions, ward sisters' and senior nurses' performance had significantly improved. Five key themes emerged from the process data documenting the journey towards more effective clinical leadership: managing self; managing the team; patient-centred care; networking; and becoming more politically aware. There was evidence to show that patient care had also improved as measured by the way nursing care was organised; by patients' accounts of care they received and by documented improvements nurses carried out as a result of direct observation of care. CONCLUSION: From the results of the study, it appears that there is a need for more effective clinical leadership development programmes for nurses to achieve better patient-centred care.

Education, Nursing, Continuing↗