Biomedical subjects

G D Abbott

Publications and source records attributed to G D Abbott.

At least 37 records · Page 2Linked to original sources

PubMed1992

Ondansetron antiemetic therapy for chemotherapy and radiotherapy induced vomiting in children.

AIM: To evaluate ondansetron as the sole antiemetic in children treated with emetogenic chemotherapy and irradiation. METHODS: Fifteen children aged 3-11 years were studied. Seven had acute lymphoblastic leukaemia, two acute myeloid leukaemia, two lymphoma and four had other tumours. Ondansetron 5 mg/m2 IV or 4 mg by mouth was given immediately before chemotherapy or radiation treatment and continued eight hourly for 24 hours. Nausea and vomiting was assessed during treatment and for the next 48 hours, and graded using WHO criteria. RESULTS: Thirty-eight courses of chemotherapy were assessed, 27 severely emetogenic and 11 moderately emetogenic. Two included total body irradiation. The most severe nausea and vomiting was grade 2 (transient vomiting) reported in six children. Nausea and vomiting was abolished on subsequent courses in four of these children by increasing the ondansetron dose frequency to six hourly. The remaining children experienced no nausea or vomiting (n = 7) or only nausea (n = 2). Nausea and vomiting were each completely controlled in 27 courses. CONCLUSIONS: Ondansetron is a cost effective and safe antiemetic in children receiving chemotherapy and total body irradiation, minimises weight loss on treatment and enables outpatient chemotherapy in some cases.

Child↗

PubMed1992

Neuroendocrine protein 7B2 in Prader-Willi syndrome.

7B2 is a neuroendocrine polypeptide of unknown function, the gene for which is sited near or within the chromosomal region deleted in Prader-Willi syndrome and Angelman's syndrome. Plasma immunoreactive 7B2 levels were measured in 26 individuals with Prader-Willi syndrome, and appropriate controls. Plasma 7B2 levels were within normal limits compared to the control groups, in adults with Prader-Willi syndrome. 7B2 levels in children with Prader-Willi syndrome were higher, this age-dependent variation having been previously reported in normal children.

Adolescent↗

PubMed1991

Aplastic anaemia in Christchurch Hospital 1979-89.

We have reviewed the records of all patients referred to our departments with aplastic anaemia during the 11 years from 1979 to 1989. Of the 22 patients identified, 19 fulfilled the standard criteria for severe aplastic anaemia. There were 11 females and 11 males. Their mean age was 35 (range 2-85 years). Five cases followed exposure to drugs known to cause aplastic anaemia and one had a recent history of viral hepatitis. A variety of treatments were used. Four patients received an allogeneic bone marrow transplant (BMT) from matched sibling donors and two of these were alive and well 65 and 120 months post BMT. Antithymocyte globulin (ATG) treatment has been followed by lasting complete remission in two of the six patients treated and a partial response was seen in one other patient. Cyclosporin therapy was associated with unmaintained complete remission in one of the three patients given this drug after ATG had failed. The remaining 13 patients received only supportive care with or without androgens and six (46%) had early recovery of bone marrow function with lasting complete remission. These patients illustrate some of the therapeutic options available for aplastic anaemia.

Adolescent↗

PubMed1991

A paediatric day ward: parental expectations, perceptions, and satisfaction.

OBJECT: to evaluate an acute paediatric day ward service from the parental perspective. METHODS: parental interview using structured questionnaire. RESULTS: overall satisfaction with the day ward concept and practice was high. Specific delays in the admission and management process were highlighted, as were concerns over practical issues such as parking facilities, pharmacy support, and perceived staff workload. CONCLUSIONS: the broad aims of the unit are being met. Areas for potential improvement are defined and discussed.

Consumer Behavior↗

PubMed1991

A paediatric day unit: the first year's experience.

In June 1989 a day unit was introduced into the paediatric department of Christchurch Hospital. Over the subsequent year, 1308 admissions occurred to the unit. Five hundred and thirty (40.6%) of the children were discharged home on the day of referral, only 22 (4%), were readmitted to the inpatient facility within a week of their first assessment. The common conditions dealt with were asthma and acute respiratory tract infection and the pattern generally reflected that normally seen in the inpatient wards. The average stay in the day unit was four hours thirty minutes. The day unit has proved to be effective in reducing overnight inpatient admissions but it requires a higher staff ratio than allocated to ensure rapid and efficient turnover. Utilisation on the weekends and wider use by other specialities dealing with children would increase the units effectiveness further.

Adolescent↗

PubMed1991

Evaluation of a principal-components tactile aid for the hearing-impaired.

Principal component analysis, a statistical data reduction technique which can be used to eliminate redundant information, has shown promising results as a speech coding strategy in auditory perceptual studies. The present study describes the development, modification, and evaluation of a principal components-based tactile aid for speech perception by the hearing-impaired. In this device, the first two principal components of an input speech signal were displayed on two-dimensional arrays of vibrators contacting either the fingertip or the forearm. Initial testing of the device with closed-set recorded speech tokens showed fair recognition performance, reaching 57% for three consonants and 56% for four vowels. Modifications to the processor algorithm designed to improve vowel recognizability resulted in higher levels of performance (66% for eight vowels). A real-time prototype was constructed implementing the revised algorithm. Live-voice testing was conducted with six normal-hearing subjects, three of whom had previous training with the Queen's University vocoder, a multichannel tactile vocoder that has shown promising results. Performance of these "trained" subjects for both single-item and connected speech tasks was excellent, equalling levels obtained with the Queen's vocoder. These results suggest that a principal components design may be a promising alternative to a vocoder strategy for a tactile aid. Results for the "naive" subjects did not reach the levels attained by the trained subjects, a finding partially attributed to the short training period available to the naive subjects. The higher level of performance for the trained subjects, together with the similarity of performance for the principal components aid and the Queen's vocoder for these subjects, suggests that they were able to transfer previous learning with the Queen's vocoder to the principal components device.

Adult↗

PubMed1988

Bacterial meningitis in childhood: a 13 year review.

One hundred and forty-five episodes of acute bacterial meningitis in children seen over a 13 year period are reviewed. The mortality rate was 1.4%. Over the study period H influenzae type b remained as the dominant causative organism, with 11% of the isolates being beta-lactamase positive. The difficulties in diagnosis in children, the sequelae of sensorineural deafness and continued morbidity in this disorder are stressed.

Anti-Bacterial Agents↗

PubMed1988

Single dose gentamicin treatment of urinary infections in children.

Sixty-nine children with urinary tract infections were randomly allocated to single dose gentamicin therapy (n = 39) or a seven day course of an appropriate antibiotic (n = 30). During the following six weeks the response to treatments did not differ and this was not altered by the child's clinical diagnosis, past history of infection or presence of radiological abnormalities. The poorest response was in those children with a history of recurrent infections (p less than 0.01) and/or radiological abnormality (p less than 0.02). Single dose therapy had significantly less suppression upon rectal (p less than 0.001) and periurethral (p less than 0.02) flora. There was a tendency for those not cured by single dose treatment to relapse whereas those treated by conventional therapy tended to be reinfected.

Acute Disease↗

PubMed1988

A protocol for the investigation of infants and children with urinary tract infection.

An investigation protocol, designed to reduce invasive procedures to a minimum, is described for the detection of reflux nephropathy in infants and children. Intravenous urography and voiding cysto-urethrography is necessary in patients up to the age of 2 years presenting with urinary tract infection, but in children over 2 years of age the protocol limits the investigation to an intravenous urogram unless this is abnormal. A review of this policy after 5 years has indicated that it is appropriate provided that children who continue to have infections have further evaluation including a voiding cysto-urethrogram.

Child↗

PubMed1988

A mesoblastic nephroma with hypercalcaemia.

A 14 week old female infant who presented with a mesoblastic nephroma was found to be hypercalcaemic. This was corrected prior to removal of the tumour and serum calcium concentrations remained within the normal range postoperatively. Hypercalcaemia is a life threatening complication of mesoblastic nephromas and should be investigated in all cases.

Calcitonin↗

PubMed1987

An evaluation of a structured case record in a paediatric department.

Two hundred and thirty-four paediatric medical records from August 1985 and 257 from August 1986, were evaluated and compared by criteria audit in order to assess the effects of the introduction of a structured admission form. The presence or absence of predetermined items of clinical relevance were recorded. A statistically significant improvement in the recording of 12 of 23 key items occurred following the introduction of a structured format. However, two of these items were recorded less frequently in the new notes. Changing working hours for house officers and an increase in overseas graduates had no significant influence on the results. Structured case records can improve information gathering, but careful design and reevaluation are important.

Child↗

PubMed1987

Co-trimoxazole red cell aplasia in leukaemia.

A 4 year old boy with acute lymphoblastic leukaemia developed a pure red cell aplasia 13 months after entering remission and while on maintenance chemotherapy. Co-trimoxazole was also being administered for prophylaxis against Pneumocystis carinii infection. When co-trimoxazole was stopped the red cell aplasia resolved.

Anti-Infective Agents↗

PubMed1986

Allogeneic bone marrow transplantation at Christchurch 1979-1985.

Twelve bone marrow transplants have been carried out at Christchurch since 1979 in five patients with aplastic anaemia and seven with acute leukaemia. Five patients are currently alive at 77, 69, 63, 45, and seven months post-transplant. Acute and chronic graft versus host disease have been major problems and its clinical features and management are described. Long term follow-up data is presented on the four patients currently alive at between three to six years post-transplant. The practical problems we have experienced by carrying out bone marrow transplants without special funding have been considerable and the implications of this are discussed.

Adolescent↗

PubMed1986

Should a lateral chest radiograph be routine in suspected pneumonia?

A study was undertaken on the chest X-rays of 414 children suspected clinically of having pneumonia, to ascertain whether the lateral film provided additional diagnostic information. In only nine cases the lateral film confirmed the diagnostic value of the frontal film and it is suggested that a routine lateral chest film should not be taken for children suspected of having pneumonia.

Child, Preschool↗

PubMed1985

Acute epiglottitis in childhood, Christchurch 1970-84.

The case records of 31 children presenting to Christchurch Hospital with acute epiglottitis over the last 15 years have been reviewed. There has been a significant increase in incidence over this period (p less than 0.05). Despite generally classical presenting features the disease was recognised in only 26% of children when seen by general practitioners prior to admission. The increasing problem of ampicillin resistance to Haemophilus influenzae type b locally has resulted in a change in first line antibiotic therapy in recent years. Changes have also occurred in methods of airway management with elective nasotracheal intubation now the usual procedure.

Acute Disease↗

PubMed1985

Acute respiratory tract infections of children in hospital: a viral and Mycoplasma pneumoniae profile.

Respiratory specimens and blood were collected from all infants and children admitted with acute respiratory illness to a paediatric unit in Christchurch from May to November (late autumn, winter and spring) 1983, to define the viral aetiological agents involved. A virus or Mycoplasma pneumoniae was identified in 160 (50%) of 317 children studied by the rapid indirect immunofluorescence, virus culture and/or serological techniques. Aetiological agents were detected in 71% of children with bronchiolitis, 57% with pneumonia, 53% with bronchitis, 40% with laryngotracheitis (croup), and 45% with upper respiratory tract illness. Respiratory syncytial virus was the most frequently identified virus, confirming the importance of this virus as a cause of respiratory illness requiring hospitalisation of young children in Christchurch. An epidemic due to influenza A/Dunedin/7/83 (HINI) and A/New Caledonia/4/83 (HINI) viruses occurred during the study period.

Bronchiolitis, Viral↗

PubMed1985

Vesicoureteric reflux: segregation analysis.

Complex segregation analysis was applied to data from 88 families containing at least one person with vesicoureteric reflux. Analysis showed that a single major locus was the most important causal factor in this condition, with the mutant allele being dominant to the normal allele and having a gene frequency of about 0.16%. Forty-five percent of gene carriers will have vesicoureteric reflux and/or reflux nephropathy as adults and 15% will develop renal failure, compared to 0.05% and 0.001%, respectively, for those not carrying the gene. This analysis confirms the importance of screening close relatives of persons with proven vesicoureteric reflux or reflux nephropathy.

Adolescent↗

PubMed1984

Radiological abnormalities in infants with urinary tract infections.

An intravenous urogram and micturating cystourethrogram were carried out in 100 infants presenting with documented urinary tract infections. Ninety three cases were identified by suprapubic aspiration and 7 by culture of two voided urine samples containing greater than 100 X 10(6) organisms per litre. The urinary tract abnormalities were analysed in respect of their clinical importance, patient's age, sex, and prematurity (in the 10 preterm infants). Radiological abnormalities were found in 47% of the infants (40% of boys; 63% of girls). Twenty nine per cent of the infants had a urinary tract abnormality regarded as clinically important--namely grade 3 or 4 vesicoureteric reflux, reflux nephropathy, or obstructive lesions requiring surgery. Six of the 10 preterm infants had radiological abnormalities. Spontaneous resolution or improvement occurred within 6 months of birth in three of the four preterm infants with severe vesicoureteric reflux.

Female↗