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Biomedical subjects

J Fielding

Publications and source records attributed to J Fielding.

At least 37 records · Page 2Linked to original sources
PubMed1991

Haemoccult testing as an indicator of recurrent colorectal cancer: a 5-year prospective study.

A prospective study was conducted to assess the value of routine haemoccult testing as an indicator of early luminal recurrence of colorectal cancer. One hundred patients (mean age 72 years) undergoing radical resection (70% Dukes' B and 30% Dukes' C) for colorectal carcinoma were asked to provide 3-monthly haemoccult tests to a special follow-up clinic for a minimum of 5 years. Positive tests underwent further investigation with barium enema and colonoscopy. Patient compliance was 84%. Positive tests were obtained in 14 asymptomatic individuals, five of whom proved to have anastomotic recurrence. Recurrence was also identified in a further patient despite a negative haemoccult test. Three patients with anastomotic recurrence were able to undergo further radical surgery; two were still alive over 5 years after detection of recurrent disease. Haemoccult screening appears to detect increased numbers of patients with luminal recurrence (7.2%) when compared to historical controls (2.1%). Larger studies will be needed to determine if this increased detection rate results in improved long-term survival.

Aged↗
PubMed1990

Worksite health promotion: its evolution and the Johnson & Johnson experience.

Worksite health promotion, a rapidly growing form of preventive health service, may include health risk appraisal with communication of findings to the individuals tested. It may also assist in achieving and maintaining physical and mental fitness, controlling alcohol use, avoiding or quitting tobacco and other drugs, and otherwise maintaining health protective habits, while providing opportunities to control high blood pressure, and reduce elevated blood cholesterol, obesity, and other health hazards. This article presents a synopsis of the evolution of that movement and reviews the experience of one industrial firm that has endeavored to document and evaluate its effort. Such a review may be helpful in consolidating the various findings to date and in indicating the complexity of assessing the health and economic consequences of such an endeavor in private companies.

Health Education↗
PubMed1990

Exploratory project for development of nursing outcome criteria in long term care.

This exploratory project in developing outcome criteria for long term care was conducted with the view that the individual professional nursing practitioner has a unique, valuable contribution to make to the overall nursing quality assurance effort. Twenty-seven nurses volunteered to design and conduct individual systematic nursing diagnosis/intervention/outcome measurement projects. They were employees of five long term care facilities in New York state. Their contribution to this project was an embodiment of their professional judgement and practice with 107 selected clients under their care. They were prepared for participation through instruction repeated in all five facilities. The North American Nursing Diagnosis Association's Taxonomy of Nursing Diagnoses was used in the instruction, by the practitioners in their practice and data collection, and in the data analysis. Data analysis also included use of Campbell's nursing intervention category scheme. This work demonstrated that professional nurses are able to specify appropriate outcome criteria and to measure these outcomes of their planned nursing interventions. Eighty-seven percent of the expected outcomes were achieved as anticipated or in the anticipated direction. Results provided many leads for future study of nursing diagnosis/intervention/outcome measurement among residents of long term care institutions.

Humans↗
PubMed1988

Failure of second-look laparotomy to influence survival in epithelial ovarian cancer.

The survival benefit of second-look laparotomy after completion of primary chemotherapy in patients with epithelial ovarian cancer has been assessed in a prospective randomised trial of 166 patients. Patients were randomised into three groups. All were initially treated with cisplatin (100 mg/m2 x 5) after primary laparotomy. Group A (n = 53) was scheduled to have a second-look laparotomy, followed by cyclical oral chlorambucil. Group B (n = 56) was scheduled to have a second-look laparotomy, followed by total abdominal and pelvic irradiation, and group C (n = 57) received oral chlorambucil as for group A but had no second-look operation. With a median follow up of 46 months (range 21-64), no differences in survival were noted between the three groups. The median survival for group A was 21 months (95% CI 11-31 months), for group B 15 months (11-19), and for group C 17 months (8-26). Thus second-look laparotomy after completion of first-line single-agent cisplatin chemotherapy did not confer any survival benefit on patients with epithelial ovarian cancer.

Actuarial Analysis↗
PubMed1985

Size of spleen rather than amount of platelet sequestration may determine long term responses to splenectomy in adult idiopathic thrombocytopenic purpura.

Fourteen adults with idiopathic thrombocytopenic purpura suffered a relapse after treatment with steroids, vinca alkaloids, or intravenous gammaglobulin. Splenic sequestration of platelets labelled with 111In-oxine was assessed, and the patients then underwent splenectomy. During follow up of four to 47 months (mean 20.7) none of the patients required further treatment, including three of 14 who showed partial relapses. Splenic sequestration patterns did not predict relapses, but an unexpected finding was that patients who relapsed had significantly smaller spleens. It is concluded that splenectomy is beneficial in most adult patients with idiopathic thrombocytopenic purpura and that radiological techniques to measure the size of the spleen may be useful in predicting which patients may relapse.

Adolescent↗
PubMed1984

Streptococcus salivarius strains carry either fibrils or fimbriae on the cell surface.

Strains of Streptococcus salivarius were screened by negative staining for the presence of surface structures. Two structural subgroups were found, carrying either fibrils or fimbriae, projecting from the cell surface. Eight strains carried a very dense peritrichous array of fibrils of two distinct lengths. Long fibrils had an average length of 175 nm, and short fibrils had an average length of 95 nm. Two strains carried only long fibrils, one strain carried only short fibrils, and another strain carried a lateral tuft of very prominent fibrils of two lengths, with a fibrillar fuzz covering the remainder of the cell surface. In all the strains in which they were present, the long fibrils were unaffected by protease or trypsin treatment. In contrast, the short fibrils were completely digested by protease and partially removed by trypsin. Neither long nor short fibrils were affected structurally by mild pepsin digestion or by lipase. The Lancefield extraction procedure removed both long and short fibrils. These twelve fibrillar strains were therefore divisible into four structural subgroups. Extracts of all the fibrillar strains reacted with group K antiserum. The second main structural subgroup consisted of nine strains of S. salivarius, all of which carried morphologically identical, flexible fimbriae arranged peritrichously over the cell surface. The fimbriae were structurally distinct from fibrils and measured 0.5 to 1.0 micron long and 3 to 4 nm wide, with an irregular outline and no obvious substructure. There was no obvious reduction in the number of fimbriae after protease or trypsin treatment. Extracts of the fimbriated strains did not react with the group K antiserum. The two serological and structural subgroups could also be distinguished by colony morphology.

Fimbriae, Bacterial↗
PubMed1979

Ferritin as a cytosol iron transport intermediate in human reticulocytes.

The major iron-bearing cytosol components of human reticulocytes identified after incubation with 59 Fe-125I-transferrin have been studied further. Component C previously found to behave consistently as an intermediate in the iron transport pathway to haem is shown to consist entirely of ferritin. After a short pulse of labelled transferrin incubation, chase experiments showed a fall of ferritin label with time and a corresponding increase in haemoglobin-iron incorporation. There was no loss of ferritin to the culture medium. Restriction of iron uptake by reticulocytes using both p-hydroxymercuribenzoate inhibition of uptake and incubation with progressively lower saturations of iron-transferrin gave linearly related incorporation of 59Fe into ferritin and haemoglobin at all levels of iron uptake, thus negating the concept of ferritin as an 'overspill' form of reticulocyte iron. The results suggest that cytosol ferritin is an obligatory intermediate in reticulocyte iron transport.

Biological Transport, Active↗
PubMed1978

The pregnant drinker.

Explore the source record for details and available documents.

Abnormalities, Drug-Induced↗
PubMed1977

Does sarcoma occur in man after intramuscular iron?

Several factors influence the induction of sarcomas at the site of iron carbohydrate complex injection in high dosage, in animals. 1. Species specificity: tumours have been induced in rats, mice and hamsters but not in guinea pigs or dogs; 2. dose-response: a threshold dose may be defined and the yield of tumours increases with the dose; 3. the amount of residual iron at the injection site: the effect is a local oncogenesis; 4. the latent period relative to life span in the species: the probable latent period in man has been estimated to be 15-20 years. Since iron-dextran was introduced 22 years ago, nine malignancies in man allegedly related to iron-complex injection have been described in five reports during the period 1960-1977. A critical review of the information available on these cases suggests that in one case only is the data sufficiencyl strong to support the probability of iron-dextran induced sarcoma in man. Soft tissue tumours of the buttock are not rare: on the basis of this single case a causal relationship in man cannot yet be made.

Adolescent↗