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Biomedical subjects

H Ward

Publications and source records attributed to H Ward.

143 records · Page 8Linked to original sources
PubMedDate not supplied

Reliability of drug histories in a specialized geriatric outpatient clinic.

To examine the reliability of drug histories of elderly outpatients, records of 122 frail elderly patients in a geriatric outpatient evaluation clinic were reviewed. Drug histories were taken by an internist during an initial clinical evaluation and by a nurse practitioner during a home visit. Home and office drug lists disagreed in 39 cases (32%). Roughly equal numbers of "extra" drugs were listed in the two settings. Number of medications (especially two or more), number of active medical problems (especially four or more), and depression were significant, independent predictors of an unreliable drug history. Neither dementia nor living situation was a significant predictor of an unreliable drug history. The only drugs associated with an unreliable history were megavitamins, beta-blockers, and centrally-acting antihypertensive agents. Using the home list as the reference, there were equal numbers of omission errors and commission errors in the office drug histories. Strategies to optimize the reliability of office drug histories need further investigation.

Aged↗
PubMedDate not supplied

Nonoxynol-9 in lubricated condoms. Results of a study in female prostitutes.

BACKGROUND AND OBJECTIVES: Debate continues on the efficacy and safety of intravaginal nonoxynol-9 for the prevention of horizontal transmission of human immunodeficiency and other sexually transmitted diseases. Little attention has been paid to the effects of nonoxynol-9 contained in the lubricant of many condoms. GOAL: To assess the tolerability of different levels of nonoxynol-9 in condom lubricants. STUDY DESIGN: Pilot, randomized, controlled trial in 70 female prostitutes. RESULTS: There was no association between dose of nonoxynol-9 and reported symptoms or signs of genital tract inflammation; an increased dose of nonoxynol-9 was associated with increased numbers of polymorphonuclear leukocytes on a vaginal wall smear. CONCLUSIONS: There is no recognized simple method of defining inflammation in the female genital tract. Future studies of the effects of low-dose nonoxynol-9 on the female genital tract require highly controlled exposures, plus colposcopy with or without vaginal biopsy to define inflammation.

Condoms↗
PubMedDate not supplied

Sexual partner networks in the transmission of sexually transmitted diseases. An analysis of gonorrhea cases in Sheffield, UK.

BACKGROUND AND OBJECTIVES: Routine contact tracing data on patients with gonorrhea are used to identify sexual partner networks. These are combined with gonococcal typing data to study patterns of transmission. The role of persons in transmission is discussed. STUDY DESIGN: Contact tracing data on patients with gonorrhea attending the Royal Hallamshire Hospital in Sheffield in 1988 and 1989 are analyzed. Gonococcal strains identified by auxotype/serovar (A/S) class are combined with these data to identify transmission paths. RESULTS: The network contained 1,272 persons, 724 (77%) of whom had gonorrhea during the study period. Four hundred two clusters of linked cases were identified. The largest cluster, containing 35 persons connected over 16 months, is discussed in greater detail to illustrate how these data may help identify patterns of transmission and the role of persons. CONCLUSION: Contact tracing data can be used to identify sexual partner networks and to study transmission patterns. Microbiologic data can aid interpretation. An person's risk of acquiring infection depends on indirect links as well as direct links. To understand patterns of transmission it may be important to distinguish between those involved in transmission and those only acquiring infection. Networks established through gonococcal transmission are also relevant to the transmission of other sexually transmitted diseases.

Adolescent↗
PubMedDate not supplied

Cutaneous hemangiosarcoma in 25 dogs: a retrospective study.

Hemangiosarcomas confined to the skin and underlying muscle were surgically excised in 25 dogs. Tumors were staged based on their histological location (ie, dermal, hypodermal, and deep). Dermal (stage I) hemangiosarcomas were small, most commonly ventral-abdominal or prepucial in location, and were associated with prolonged survival times (median survival, 780 days). Tumors with hypodermal (stage II) and underlying muscular involvement (stage III) were grouped together because of their larger size, bruise-like appearance, lack of anatomic predilection, biological behavior, and shorter survival times (median survival of 172 and 307 days for dogs with stages II and III, respectively). We conclude that dermal hemangiosarcomas may be effectively treated with surgery alone, whereas hemangiosarcomas located within the hypodermal tissues bear a poor prognosis and warrant wide surgical excision with adjuvant chemotherapy.

Animals↗
PubMedDate not supplied

Itraconazole for the treatment of histoplasmosis in cats.

Eight cats with histoplasmosis were treated with itraconazole at 5 mg/kg per dose PO bid. There were multiple sites of infection, and 2 of the cats had hypercalcemia that was attributed to the histoplasmosis. All 8 cats were eventually cured, but 2 cats experienced recurrences of disease after completion of therapy, requiring 2 to 3 additional months of itraconazole. There were no clinically relevant adverse effects during treatment. Although a limited number of cats were treated, the study suggests that itraconazole is a well-tolerated and effective drug for the treatment of histoplasmosis in the cat.

Administration, Oral↗
PubMedDate not supplied

Production of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor by carcinomas in a dog and a cat with paraneoplastic leukocytosis.

A dog with a pulmonary papillary carcinoma and a cat with a dermal tubular adenocarcinoma had profound paraneoplastic neutrophilic leukocytosis with no clinically detectable inflammatory foci. To investigate the mechanism of the leukocytosis, oligonucleotide primers were designed from the cDNA sequences of granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) of dogs. Reverse transcription polymerase chain reaction was performed on tumor tissues, and specific amplification of G-CSF and GM-CSF was obtained with the tumor RNA in the dog. The tumor RNA in the cat demonstrated specific amplification of G-CSF but not GM-CSF. These findings are consistent with the production of G-CSF and/or GM-CSF by neoplasms as a mechanism for paraneoplastic leukocytosis in small animals.

Adenoma↗
PubMedDate not supplied

Constrictive bronchiolitis and ulcerative colitis.

Pulmonary complications occur in an estimated 0.21% of patients with inflammatory bowel disease. The most common presentation of pulmonary manifestations is large airway disease, such as tracheobronchitis, chronic bronchitis or bronchiectasis. Small airway disease, such as constrictive bronchiolitis or bronchiolitis obliterans with organizing pneumonia, is less frequently reported, and is described as occurring in isolation from large airway disease. A case of a postcolectomy ulcerative colitis in a patient who has both large airway involvement, tracheobronchitis and bronchiectasis, and constrictive bronchiolitis is presented.

Adult↗
PubMedDate not supplied

Junctional care: the key to prevention of catheter sepsis in intravenous feeding.

Investigation of an outbreak of infection related to intravenous feeding catheters, predominantly with Staphylococcus epidermidis, suggested that the probable origin was the connections in the delivery system. Equipment and policy changes were then instituted: a catheter with integral hub was used, the connections were reduced from two to one, and improved antisepsis at the connection was devised. These actions resulted in a sustained, significant reduction in the catheter sepsis rate, supporting the hypothesis that junctional care is vital to the avoidance of catheter infection.

Catheters, Indwelling↗
PubMedDate not supplied

Clinical evaluation of methoximorpholino-doxorubicin (FCE 23762) in dogs with spontaneous malignancies.

We conducted a clinical evaluation of FCE 23762, a methoxymorpholino analog of doxorubicin, in 48 dogs with metastatic, nonresectable, or chemotherapy-resistant spontaneous malignancies at an initial dosage of 50-60 microg/kg IV every 3 weeks. Clinical evidence of toxicity was minimal; 6 dogs developed grades I, II, and III hematologic toxicities after the 1st treatment, and 1 dog developed grade II gastrointestinal toxicity. One dog became pancytopenic 4 months after discontinuation of FCE 23762. No other adverse effects were noted. Partial or complete remissions were observed in 32% of the dogs. Responses were observed both in previously untreated dogs and in those that had received prior chemotherapy, including doxorubicin. FCE 23762 is a promising new antineoplastic agent that can be used safely in dogs with cancer; doses higher than those used in this study may be used eventually in practice.

Animals↗
PubMedDate not supplied

Psychosocial predictors of accident/error rates in nursing studies: a prospective study.

A prospective study of accident/error rates was carried out on thirty-one nursing students. Recent life changes and stresses, social support available to cope with this stress, depression, illness rate, and coping skills were measured at baseline. Five weeks later students recorded accidents suffered and errors made over a week long period. The number of life changes in the previous two years made over a week long period. The number of life changes in the previous two years and the amount of adjustment required to cope with these changes, together with the social support available to help cope with these events were the most powerful predictors of accident/error rate. Together they accounted for 70 per cent of the variance. Multiple regression equations for the outcome variables were calculated to study the best linear predictor combination. Depression and coping skills had poor predictor power. The implications of the findings for health care personnel are discussed. Steps to lower the accident/error rate in those at risk are outlined.

Accident Proneness↗
PubMedDate not supplied

The relationship between response qualities of life change events and future illness rates.

A prospective study over three months explored whether measures of response "qualities" of life change events (e.g., whether the event was positive or negative in its subjective impact) enhance the ability of a simple counting of recent life change events to predict near future illness rates. Thirty-four nursing students were studied. Results confirm previous reports that future illness rates increase positively and significantly in direct relationship to the accumulation of recent past life change events. A simple count of the number of untimely or unexpected life stresses (31% of total life changes) or a simple count of the number of negative life events (53.8%) were as potent predictors as the total count of recent life changes. The total number of times each event occurred did not add to the predictive power of a count of the number of events experienced. Anticipated life events were poor predictors of future illness rates. The subjective life change unit scaling system (SLCU) did not add to the predictive power of a simple count of the number of events. Social support availability did not significantly lower illness rates.

Adaptation, Psychological↗
PubMedDate not supplied

Childhood lead exposure in Trail revisited.

We sought to identify modifiable determinants of elevated blood lead levels in preschool children; to compare the current situation with past information; to determine historical trends in environmental lead contamination in Trail; and to find a basis for identifying appropriate precautions and protection against future lead exposure. In Phase 1, blood samples were drawn from all children aged 2 to 5. In Phase 2, children in the highest and lowest quartile of blood leads were surveyed by questionnaire. Environmental samples of drinking water, paint, housedust, soil and vegetables were taken from their residences, and soil samples were collected from nearby parks. The average blood lead level was 13.8 micrograms/dl, range 4 to 30 micrograms/dl. This is approximately 40% lower than in 1975, when a previous survey was done, but is high compared to other places in Canada. The study of environmental determinants of lead revealed that soil lead levels and, secondarily, housedust lead levels are the principal determinants of high blood lead. Children with high blood leads also tended to concentrate in neighbourhoods near the lead-zinc smelter.

British Columbia↗