You're the flight surgeon. Intervertebral disk protrusion.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J Campbell.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Radiotherapy can cause a number of dermatological reactions. Treatment for these reactions needs to be research-based and standardised. A clear protocol helps health-care professionals select the appropriate treatments.
Prospective baseline MRI was obtained on 31 patients who had "total" removal of acoustic schwannoma 6 months to 9 years previously. Follow-up MRI was performed after 1-2 years on patients with questionable abnormalities. We found four patterns (1) internal auditory canals (IAC) with nonenhancing soft-tissue strands, possibly scars or distorted residual nerves (8); (2) IAC with marginal enhancement-reactive dura mater (16); (3) IAC with contrast-enhancing globular tissues suggesting residual or recurrent tumour (5); (4) high-signal intensity in the IAC before contrast medium administration, probably related to graft with fat/fascia/muscle (2). Prospective 1-to 2-year follow-up studies were available in 8, 5, and 1 patients in groups 2, 3, and 4 respectively. In group 2, dural enhancement remained unchanged in 5 patients and decreased in 3. In group 3 follow-up showed 1 tumour recurrence (surgically confirmed) and 4 stable abnormalities. In group 4, follow-up in 1 of the 2 patients was stable. In groups 1 and 2, the MRI features correlate well with complete tumor removal. Whether follow-up in these groups is indicated needs to be determined. In group 3 residual or recurrent tumor cannot be excluded. In group 4, grafts may prevent adequate visualization of the IAC.
Research methods are not paradigm specific but should be selected on the basis of whether they fit with the purposes of an investigation. In the postpositivist, interpretive, and critical paradigms, both qualitative and quantitative data or a combination of these may be used without violating paradigm assumptions. Attention to the four basic issues of quality of the data, investigator bias, quality of the research process, and usefulness of the finding is necessary to produce valid research. Although researchers in each paradigm deal with these differently, combining strategies across paradigms may enhance the scientific value of a study and result in new methodologies to address the health needs of all people.
Explore the source record for details and available documents.
Helicobacter pylori has been cultured from the inflamed gastric mucosae of naturally infected cats; the lesions in H. pylori-infected cat stomachs mimic many of the features seen in H. pylori-infected human stomachs. To determine whether H. pylori-negative specific-pathogen-free cats with normal gastric mucosae were susceptible to colonization by this bacterium and whether gastritis developed after infections, four H. pylori-negative cats treated with cimetidine were orally dosed three times with 3 ml (1.5 x 10(8) CFU/ml) of H. pylori every 4 days. All four cats became persistently colonized as determined by gastric cultures and PCRs from serial gastric biopsy samples and necropsy samples at 7 months postinfection. H. pylori was not isolated from the two control cats, nor were their gastric tissues positive by PCR; one of the two cats had a few focal lymphocytic aggregates in the body submucosa, whereas the second cat had a normal gastric mucosa. All four H. pylori-infected cats had multifocal gastritis consisting of lymphoid aggregates plus multiple large lymphoid nodules, which were most noticeable in the antral mucosa. In addition, one H. pylori-infected cat had a moderate diffuse infiltration of polymorphonuclear leukocytes in the subglandular region of the antrum. H. pylori-like organisms were focally distributed in glandular crypts of the antrum. Two of the H. pylori-infected cats had significant (eightfold) increases over baseline in levels of immunoglobulin G H. pylori serum antibody. The H. pylori isolates from the four experimentally infected cats had restriction fragment length polymorphism patterns specific for the flaA gene that were identical to those of the inoculating strain. H. pylori readily colonizes the cat stomach and produces persistent gastritis.
OBJECTIVE: This study assessed the value of the CAGE questionnaire in detecting alcohol dependence in the walk-in (triage) clinic of an acute care Veterans Affairs hospital. METHOD: Male veterans (N = 1,667) attending the walk-in clinic were asked several questions relating to whether they were current drinkers, were seeking alcohol treatment, and whether they had been hospitalized for treatment of alcoholism. Those who were current drinkers, were not seeking alcohol treatment and had not been hospitalized for alcohol treatment were given the CAGE questionnaire followed by a diagnostic interview utilizing DSM III-R criteria to determine the presence or absence of a lifetime diagnosis of alcohol dependence. RESULTS: The diagnostic interview revealed a prevalence rate for alcoholism of 22% in this clinic population. The CAGE scale, when used with one or more yes responses indicating a positive response, achieved a sensitivity of 86% and specificity of 93% when using the diagnostic interview as the criterion standard. CONCLUSIONS: This study adds to the evidence that the CAGE questionnaire is an effective, efficient, easily used screening instrument for the detection of alcohol dependence in a clinical setting.
OBJECTIVE: The drug and alcohol related knowledge and attitudes of trainee psychiatrists were examined to obtain a baseline measure of these factors in order to determine whether current training is appropriate and adequate. METHOD: A questionnaire was distributed to trainees enrolled in the training program of the Royal Australian and New Zealand College of Psychiatrists in New South Wales, Victoria, Queensland and South Australia (N = 425). Questions were asked relating to theoretical knowledge, diagnostic and problem solving skills for a number of drug groups; further questions concerned the respondents' attitudes and opinions on aspects of management. RESULTS: Sixty per cent of recipients returned the questionnaire. Theoretical and applied knowledge levels were of an adequate standard overall, but highly variable. Notable areas of weakness included knowledge of opiates, barbiturates and stimulants. Trainees' views regarding treatment options were also variable. Alcoholics Anonymous was considered the best supported form of treatment from evidence from controlled trials. Low levels of self efficacy and little support were recognised for early intervention strategies. CONCLUSIONS: While positive views were generally expressed towards involvement with patients with alcohol and drug problems, specific strategies to enhance training and performance are needed. Findings are discussed in terms of continuing education. It is recommended that if sufficient training in this area is not provided then psychiatrists will have little confidence in appropriate therapeutic approaches in treating substance misusers.
OBJECTIVE: To determine the variability of several clinical outcome measurements commonly used in scleroderma clinical trials. METHODS: Ten researchers, members of a multicenter placebo controlled trial of methotrexate in early diffuse scleroderma, studied the intraobserver and interobserver variability of variables used to assess efficacy in scleroderma trials. RESULTS: For most measures, the variability within an observer was less than that found between observers, and therefore the intraobserver reliability was better than the interobserver reliability. The reliability of the modified Rodnan skin score exceeded the Rodnan skin score. Measures with inherent interpretation such as global assessments and skin scores had more variability than easily performed measurements such as grip strength and oral opening. CONCLUSION: Some of our variability was higher than variability previously reported; this could be due to the large number of examiners and patients in our study.
An update on injection techniques, with a review of their indications, choice of routes and ideal sites. A discussion of potential complications for the patient and practitioner is also provided.
We examined the inhibitory effect of heparin on vascular smooth muscle cell (VSMC) outgrowth from cultured coronary artery explants of primary atherosclerotic lesions and of undiseased regions from the same patients, compared with explant outgrowth from control patients (idiopathic cardiomyopathy) with no evidence of atherosclerosis. For undiseased tissue regardless of origin, heparin significantly delayed half-maximum percentage explant outgrowth time (mean difference from control treatment 2.1 [SE 0.8] days for atherosclerosis patients and 2.3 [1.0] days for control patients). For plaque tissue, heparin had no such effect. Thus the proliferative state of the cells involved in outgrowth may influence the activity of heparin.
Explore the source record for details and available documents.
Second trimester amniotic fluid placental alkaline phosphatase (PLAP) immunoreactivity was measured in 756 normal pregnancies, 63 Down's syndrome pregnancies and 42 pregnancies associated with other chromosomal abnormalities. PLAP levels were significantly reduced in cases of Down's syndrome (MoM = 0.72, U = 17,565, P = 0.0002, 95% Cl = 0.63-0.88). However, there was no significant difference between other aneuploid conditions and the normals (MoM = 0.88, U = 13,289, P = 0.35, 95% CI = 0.77-1.08). PLAP is the carrier protein for immunoglobulin G. Neonates with Downs syndrome but not other chromosomal abnormalities are associated with a deficiency of IgG. These data therefore support the theory that the low IgG levels in Downs syndrome are a result of a defect in PLAP transport.
Explore the source record for details and available documents.
The aim of this study was to measure the levels of erythropoietin in amniotic fluid from normal and trisomy 21 pregnancies at 10 to 20 weeks gestation. Samples of amniotic fluid were collected from 142 women with singleton pregnancies after genetic amniocentesis; 110 had a normal fetal karyotype and 32 had trisomy 21. Erythropoietin was measured using a double antibody radioimmunoassay. Amniotic fluid erythropoietin levels in normal pregnancies increased from 10 weeks (mean 3.2 mU/ml; range < 2.0-6.3 mU/ml) to 20 weeks gestation (mean 7.9 mU/ml; range 2.0-11.5 mU/ml). There was a significant linear correlation between gestational age and erythropoietin levels (r = 0.543; P < 0.0001). For the 32 patients with trisomy 21 pregnancies the median multiple of the median (MoM) was 1.11 (range 0.42-2.1). There was no difference between erythropoietin levels in amniotic fluid from normal and Down's syndrome pregnancies (U = 2352, P = 0.75, 95% CI = -0.11, 0.18); (Mann-Whitney U-test).
First trimester maternal serum levels of pregnancy-associated plasma protein A(PAPP-P) are reduced in women with a Down's syndrome pregnancy. We have examined the concentration of this molecule in the amniotic (AF) and extra-embryonic coelomic (EECF) fluids surrounding the developing fetus. Maternal serum levels of PAPP-A were elevated in all samples and steadily rose from a median of 480 mIU/1 at 8 weeks to a median of 6375 mIU/1 at 14 weeks gestation. Levels of PAPP-A were low in EECF and undetectable in the AF until 14 weeks gestation. This pattern of distribution is in contrast to that of most other trophoblast-associated antigens. This may reflect PAPP-A physiology and its specific production by the syncytiotrophoblast.