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Biomedical subjects

G George

Publications and source records attributed to G George.

At least 19 recordsLinked to original sources
PubMed2006

Effect of population ageing on emergency department speed and efficiency: a historical perspective from a district general hospital in the UK.

OBJECTIVE: To examine changes in the rate of seeing patients between 1990 and 2004 and to see whether performance might be related to patient age, using data held on the patient administration system. METHOD: Data collected in 1990 were compared with those collected in 2004. Age related data were examined for the following parameters: the number of patients arriving by ambulance; the time taken to process the attendance; the number of investigations; the number of emergency admissions; and the length of inpatient stay. RESULTS: Emergency department (ED) performance has fallen markedly since 1990. Between 1990 and 2004, there was a 54% increase in total patients with a disproportionate 198% increase in patients aged more than 70 years, including a 671% increase in those aged more than 90 years. The time taken to manage patients increased with age. In 2004, there was a marked rise in investigation rates, and the probability of having investigations increased with age. In 2004, older patients (aged more than 70 years) were 4.9 times more likely to require admission to hospital than younger patients (aged 30 years or less). Their average length of stay was 6.9 times longer. Younger patients were 3.3 times more numerous than older patients but older patients occupied 9.8 times more emergency bed days. CONCLUSIONS: Pressure on emergency care is associated with a disproportionate increase in the number of elderly patients and with an increased tendency to investigate them. Population ageing is of central importance in planning health services.

Adolescent↗
PubMed2005

Pitfalls in the clinical diagnosis of vertebral fractures: a case series in which posterior midline tenderness was absent.

OBJECTIVE: There is widespread belief among doctors that posterior midline tenderness is virtually a prerequisite for spinal fracture in alert, sober patients without any painful distracting injury or neurological deficit. This paper examines and challenges this belief. METHODS AND RESULTS: We present three patients in whom significant thoracic and lumbar vertebral fractures were missed, or were thought to be "old", because of lack of posterior midline tenderness. We also present two further patients, one with a lumbar spine fracture and one with a cervical spine fracture, in whom posterior midline tenderness was absent but in whom the correct diagnosis was made. All these patients were sober and fully alert and none had a neurological deficit or a painful distracting injury. CONCLUSION: The absence of posterior midline tenderness does not exclude significant spinal injury. We suggest that patients should satisfy both the Canadian and British guidelines before it is decided that imaging of the cervical spine is unnecessary.

Adult↗
PubMed2003

Perforation of the oesophagus and aorta after eating fish: an unusual cause of chest pain.

This report describes perforation of the oesophagus after eating fish complicated by perforation of the aorta six days later. The patient had not knowingly swallowed a fish bone. Aorto-oesophageal fistula is almost universally fatal. In the case described here, the fistula was demonstrated on contrast computed tomography before surgery, thus informing surgical management. The patient is the eighth reported survivor.

Animals↗
PubMed2002

Facilities for chemical decontamination in accident and emergency departments in the United Kingdom.

OBJECTIVE: To audit the facilities for chemical decontamination, with special reference to cyanide poisoning, in all major accident and emergency departments in the UK. METHOD: A simple postal questionnaire was used to audit planning, premises, equipment, protection for staff, and stocks of specific antidotes to cyanide poisoning. RESULTS: 227 questionnaires from 261 departments (87%) were returned and used in the survey. Of the 227 departments who responded, 151 (66%) had a written plan; 168 (74%) departments had premises for decontamination; 55 (24%) were judged to have satisfactory premises; 146 (64%) departments had a shower or hose for decontamination; 60 (26%) departments had a decontamination trolley suitable for "stretcher" patients; 203 (89%) had some protective equipment for staff but only 77 (34%) had complete protection--that is, goggles, chemical resistant clothing, and breathing apparatus. In the authors' opinion only seven (3%) departments had satisfactory premises and equipment to treat "stretcher" patients and full protection for staff. A further 11 (5%) departments were equipped to manage ambulant patients at a similar level. Some 205 (90%) departments stocked one or more antidotes to cyanide and 77 (34%) stocked all four antidotes. Thirty four (15%) departments held all four antidotes to cyanide and had full protection for staff. Only five (2%) departments had satisfactory premises and equipment to treat "stretcher" patients, full protection for staff, and at least three of four antidotes. CONCLUSIONS: Most departments had some equipment for chemical decontamination. However, there were major inconsistencies in the range of equipment held and these limited its usefulness. Only a small minority of departments was satisfactorily equipped to deal with a serious chemical incident.

Cyanides↗
PubMed2001

Kangaroo Mother Care in very low birth weight infants.

OBJECTIVE: This study was conducted (i) to study through a randomized control trial the effect of Kangaroo Mother Care (KMC) on breast feeding rates, weight gain and length of hospitalization of very low birth neonates and (ii) to assess the acceptability of Kangaroo Mother Care by nurses and mothers. METHODS: Babies whose birth weight was less than 1500 Grams were included in the study once they were stable. The effect of Kangaroo Mother Care on breast feeding rates, weight gain and length of hospitalization of very low birth weight neonates was studied through a randomized control trial in 28 neonates. The Kangaroo group (n = 14) was subjected to Kangaroo Mother Care of at least 4 hours per day in not more than 3 sittings. The babies received Kangaroo Care after shifting out from NICU and at home. The control group (n = 14) received only standard care (incubator or open care system). Attitude of mothers and nurses towards KMC was assessed on Day 3 +/- 1 and on day 7 +/- 1 after starting Kangaroo Care in a questionnaire using Likert's scale. RESULTS: The results of the clinical trial reveal that the neonates in the KMC group demonstrated better weight gain after the first week of life (15.9 +/- 4.5 gm/day vs. 10.6 +/- 4.5 gm/day in the KMC group and control group respectively p < 0.05) and earlier hospital discharge (27.2 +/- 7 vs. 34.6 +/- 7 days in KMC and control group respectively, p < 0.05). The number of mothers exclusively breastfeeding their babies at 6 week follow-up was double in the KMC group than in the control group (12/14 vs. 6/14) (p < 0.05). CONCLUSION: KMC managed babies had better weight gain, earlier hospital discharge and, more impressively, higher exclusive breast-feeding rates. KMC is an excellent adjunct to the routine preterm care in a nursery.

Adult↗
PubMed1998

Fourier transform infrared spectrometry: a versatile technique for real world samples.

The versatility of FTIR spectrometry was explored by considering a variety of samples drawn from industrial applications, materials science and biomedical research. These samples included polymeric insulators, bauxite ore, clay, human hair and human skin. A range of sampling techniques suitable for these samples is discussed, in particular FTIR microscopy, FTIR emission spectroscopy, attenuated total reflectance and photoacoustic FTIR spectrometry. The power of modern data processing techniques, particularly multivariate analysis, to extract useful information from spectral data is also illustrated.

Hair↗
PubMed1997

High-volume nonionic dimeric contrast medium: first experiences during complex coronary interventions.

Interventional cardiology is a rapidly developing field of medicine with annually increasing numbers of coronary interventions. Especially through the development of alternative techniques for coronary angioplasty, new indications have been found and more difficult lesions are tackled. Inevitably, such complex interventions are time-consuming and require high amounts of contrast medium. Newer, mostly nonionic agents have been developed with improved tolerability as well as fewer cardiac and renal side effects due to their nonionic, hydrophilic structure, and their osmolality isotonic to plasma. This study sought to investigate the effects of high-volume nonionic, dimeric contrast medium during coronary interventions with special emphasis on renal and hemodynamic side effects during routine hospital stays. Retrospectively, 25 consecutive patients (age 56 +/- 10 yr) with normal renal and cardiac function receiving > 500 ml of the nonionic dimeric contrast medium iodixanol during complex coronary interventions were analyzed. The analysis was based on serum creatinine levels 1 day before and 2 days after contrast medium administration for the monitoring of renal function. Additionally, heart rate and left ventricular pressures were evaluated before and after left ventricular angiography. Mean serum creatinine rose from 0.9 +/- 0.2 mg/dl to 1.1 +/- 0.2 mg/dl (P < 0.05) after 2 days of coronary intervention. Heart rate, left ventricular systolic pressure, and left ventricular end-diastolic pressure did not change significantly. No major side effects were encountered in the short follow-up period of 2 days. Based on this retrospective analysis, high-volume nonionic, dimeric contrast medium administration in patients without preexisting renal insufficiency is associated with little impairment of renal function, and has only minor hemodynamic and general side effects. Iodixanol 320 mg I/ml is well-tolerated and effective for the use of cardioangiography. Given the limitations of this retrospective analysis, future prospective studies should systematically address the effects of high-volume contrast medium administration in otherwise healthy patients as well as in high-risk patients undergoing coronary interventions.

Aged↗
PubMed1997

Neck pain as a presenting symptom in malignant hypertension.

Neck pain, unrelated to trauma, is relatively common and is usually presumed to be musculoskeletal in origin. A patient presented with an unusual and serious cause of neck pain-malignant hypertension. The mechanism of the neck pain may be incipient tonsillar herniation of the cerebellum caused by raised intracranial pressure.

Adult↗
PubMed1997

How to hire great employees.

The average dentist (as well as the average business person) tends to treat the hiring decision as a random event. However, it is relatively easy to update your hiring skills so that you can consistently select excellent employees. Hiring good employees is critical, because hiring poor ones can bring a practice to its knees. Many employers have a difficult time interviewing applicants, and many good employees have a difficult time being interviewed. The first step in successful hiring is to look carefully at the resumes you have on hand. After you've narrowed the field down to six or 10 potential candidates, you should consider the specific competencies required to do the job and develop relevant interview questions to ask the candidates. When you finally conduct interviews, your overall objective is to give the candidate an opportunity to tell you about their skills and experience, and how they apply to your operation. The interview is your time to get to know everything you can about the candidate, so use it wisely. Finally, you must make your decision.

Dental Staff↗
PubMed1994

Plasma aspirin esterase activity in elderly patients undergoing elective hip replacement and with fractured neck of femur.

Plasma aspirin esterase activity was measured in eight elderly patients undergoing elective hip replacement, and in 11 presenting with femoral-neck fracture. Elective hip surgery was associated with a marked and significant decline in esterase, from 330 +/- 35.9 (SE) (nmol salicylate/ml plasma/min) pre-operatively to 236 +/- 35.6 on the third post-operative day, and returning to normal (359 +/- 24.3) at recovery phase. Patients with fractured neck of femur showed a depressed esterase activity on admission (221 +/- 12.7), rising towards normal (290 +/- 15.4) on recovery. All of these changes were accompanied by a marked acute-phase response, both to injury and surgery. The data suggest that elderly patients experiencing injury or undergoing surgery may have significantly impaired drug metabolism, at least as far as this enzyme is concerned.

Aged↗
PubMed1994

Age, smoking and the activity of the mono-oxygenase aryl hydrocarbon hydroxylase in isolated human peripheral blood monocytes.

Age-associated changes in the microsomal mono-oxygenase enzyme, aryl hydrocarbon hydroxylase (AHH), were investigated in peripheral blood monocytes isolated from young and elderly subjects. Young subjects were selected from the age group < 35 years; elderly subjects were > 70 years. AHH activity, expressed as nM 3-hydroxy benzopyrene formed/10(6) cells/h of incubation, was similar in young and elderly non-smokers (elderly = 6.7 +/- 1.8; young = 9.1 +/- 0.9; p > 0.05). In smokers, contrary to some previous reports, AHH activity was not significantly higher than in non-smokers of similar age (elderly smokers = 8.6 +/- 1.0; young smokers = 10.5 +/- 2.4; p > 0.05). There was no significant difference between young and elderly smokers (p > 0.05). We conclude that: (a) AHH activity is similar in young and old non-smoking individuals; (b) no significant differences were detected in in vivo induction of this enzyme activity between smokers and non-smokers.

Adult↗
PubMed1993

[Attention deficit disorder and anxiety disorders: a co-occurrence study].

Recent epidemiological studies have evaluated the concomitant occurrence of several disorders in children. Over the last few years there have been reports from Anglo-Saxon investigators that many children with attention deficit disorder-hyperactivity also have anxiety disorders. This is the first French study addressing this issue. The prevalence and types of anxiety disorders were determined in 50 children with attention deficit disorder-hyperactivity using a questionnaire and a semi-structured interview. Over 40% of subjects had at least one concomitant anxiety disorder meeting DSM-III-R criteria. Hyperanxiety and separation anxiety were the most common anxiety disorders. Among patients with anxiety, over 40% had more than one anxiety disorder. These data are consistent with earlier Anglo-Saxon reports. Symptoms of anxiety which discriminated hyperactive children with and without anxiety disorders were identified.

Anxiety Disorders↗
PubMed1992

Dose dependent induction of the microsomal monooxygenase aryl hydrocarbon hydroxylase in isolated peripheral blood monocytes: the influence of age.

The induction of the microsomal monooxygenase benzo(alpha)pyrene hydroxylase was investigated in isolated peripheral blood monocytes from young and old donors, after exposure to different concentrations of benzanthracene as an inducing agent. The sensitivity of the cells to the inducing stimulus was not dependent on the age of the donor. The mechanisms underlying impaired monooxygenase induction in the elderly remain to be clarified.

Adult↗
PubMed1990

The association of age with the induction of drug-metabolizing enzymes in human monocytes.

In vivo studies in man suggest that the enzyme-inducing effect of environmental influences such as drugs or smoking may be reduced in elderly people. We have investigated the basal activity and response to induction of the oxidative enzyme, aryl hydrocarbon hydroxylase (AHH) in human monocytes. Three groups were studied: ten fit young, ten fit elderly and eight frail elderly subjects. Significant induction of AHH activity in response to the hydrocarbon benz(a)anthracene was achieved in all three groups. No impairment of basal AHH activity or in the synthesis of new enzyme protein was noted with age or frailty. There is still no direct evidence of an age-associated fall in drug metabolizing enzyme activities in man.

Adolescent↗