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Biomedical subjects

J Grant

Publications and source records attributed to J Grant.

At least 19 recordsLinked to original sources
PubMed1992

Underutilization of Rh prophylaxis in the emergency department: a retrospective survey.

STUDY OBJECTIVE: To determine the practice of emergency physicians with regard to the issue of Rh isoimmunization. DESIGN: A retrospective chart review. SETTING: A university-affiliated tertiary care hospital emergency department. TYPE OF PARTICIPANTS: Pregnant women presenting with a risk factor for Rh sensitization. MEASUREMENTS AND MAIN RESULTS: One hundred thirty-eight patient encounters were analyzed descriptively as to whether they were candidates for Rh immune prophylaxis, and if so, whether it was given. Most (68%) were hospitalized. Of those, all were Rh typed, but two patients were not given Rh immune globulin (RhIG) when indicated. Of those discharged from the ED, most (86%) were not Rh typed, and none was administered RhIG. CONCLUSION: This study demonstrates a need for increased attention to the potential for Rh isoimmunization in patients presenting to the ED.

Abortion, Spontaneous↗
PubMed1992

Lethal olivopontoneocerebellar hypoplasia with dysmorphic features in sibs.

This report describes the clinical and neuropathological features in male and female sibs who died shortly after birth as a result of frequent convulsions and lack of spontaneous respiratory effect. Both sibs had a prominent occiput with mild contractures and the female also had overlapping fingers and rockerbottom feet. The genetic and neuropathological findings were consistent with a diagnosis of an autosomal recessive form of olivopontoneocerebellar hypoplasia/atrophy.

Abnormalities, Multiple↗
PubMed1992

Multiple primary cutaneous plasmacytomas.

BACKGROUND: Cutaneous plasmacytoma is an uncommon tumor and is mostly seen in the context of end-stage multiple myeloma. Only 20 cases of primary cutaneous plasmacytoma have been documented. A significant proportion of these patients went on to develop systemic disease with a poor prognosis. In a number of patients, however, the abnormal clone of plasma cells may arise in the skin and never progress to multiple myeloma involving the bone marrow. OBSERVATIONS: We describe a patient who developed multiple primary cutaneous plasmacytomas after a possible insect bite reaction. The monoclonality of the tumor cells is demonstrated using immunohistochemical techniques. He has been treated vigorously with chemotherapy and local radiotherapy and remains well 3 years after diagnosis. Bone marrow has been harvested for use as an autologous bone marrow transplant in the event of systemic relapse. CONCLUSIONS: Unlike previous reports of this rare entity, this case documents the monoclonality of tissue plasma cells with immunohistochemical techniques. As cutaneous plasmacytomas have been reported with an early significant mortality, unlike extramedullary plasmacytomas elsewhere, we have advocated combination chemotherapy and cryopreservation of uninvolved bone marrow for future autologous bone marrow transplantation should systemic myelomatosis develop in the patient.

Adult↗
PubMed1991

Distance learning in a local setting: a structured learning course for the introduction of general practice to undergraduate students.

This paper describes the development and evaluation of a structured introductory course in general practice. Following some of the principles developed in distance education, the Department provides everything the student needs for the formal learning requirement as well as detailed assistance in how best to tackle the selected topics. The course was reported to be demanding, relevant and enjoyable. The major areas requiring attention were in reducing the amount of reading required, more help in learning to work in small student-run groups and more one-to-one supervision of physical examination skills. With further refinement the course should be applicable to other medical schools in developed countries.

Curriculum↗
PubMed1978

Hepatitis B in hemodialysis patients: significance of HBeAg.

Twenty-four HBsAg-positive (HBsAg+) hemodialysis patients were prospectively studied to assess (1) the prognostic value of HBeAg and its HBe1Ag and HBe2Ag components and (2) whether a difference in cellular immune status between HBeAg+ and HBeAg-negative (HBeAg-) patients could be defined. Sixteen patients were HBeAg+ and 8 were HBeAg- initially. After a mean follow-up period of 23.7 months, it was concluded that the initial presence of HBeAg correlated with the persistence of HBsAg because 15 of the 16 HBeAg+ patients were still HBsAg+ at death or last follow-up, whereas 7 of the 8 HBeAg- patients had become HBsAg- at a mean period of 3.8 months. HBe1Ag was consistently present in 15 of the 16 patients when HBeAg was detectable, whereas HBe2Ag fluctuated widely in individual patients over time. No difference in cellular immune status between HBeAg+ and HBeAg- patients could be defined; although both HBeAg+ and HBeAg- patients had a similar decrease in peripheral blood T cells and poor responsiveness to purified HBsAg, both groups of patients had stimulation indices to nonspecific mitogens within the normal range.

Adult↗
PubMed1978

Bacterial contamination of telephones in an intensive care unit.

Pathogenic and potentially pathogenic bacteria were found on telephones of an intensive care unit. Direct contamination by microorganisms from throats, hands, and noses of the staff members is real although airborne contamination would also play a role. The awareness of environmental risk in intensive care units is underlined.

Asepsis↗
PubMed1977

Neonates at risk. Screening for deafness--practical or not?

Over a six-year period, 3,507 neonates in King George V Memorial Hospital, classified as being at risk for deafness, were screened for hearing. Although 144 failed to respond in the nurseries, 88 of them were cleared at a later test. The remainder, whether suspect, untraceable or still to return, would all be outside the neonatal period by now. No sensorineural impairment of hearing was detected in all neonates in the programme.

Australia↗
PubMed1977

Raised serum transaminase levels in patients with rheumatic fever treated with salicylates.

Of 11 patients with acute rheumatic fever, 9 were treated with a total daily salicylate dosage of 3,6 g or less, 1 patient required a total daily dosage of 5,4 g and another required 9,0 g daily. Six of the 11 patients had elevated serum transaminase levels, and all were asymptomatic. The elevated transaminase levels appear to bear a direct relationship to the serum salicylate level, and a serum salicylate level of 19,2 mg/100 ml appears to be the critical point. In 5 out of the 6 patients with elevated transaminases, the serum salicylate level exceeded 19,2 mg/100 ml, while in the 5 patients with normal transaminases the serum salicylate level did not exceed 19,2 mg/100 ml. Also, in 10 of the 11 patients eosinophilia was noted, but this decreased despite continued or increased salicylate administration. A narrow margin thus appears to exist between therapeutic serum salicylate levels and hepatotoxic levels, and serial serum transaminase estimations are advocated in patients on long-term salicylate therapy.

Acute Disease↗
PubMed1977

An inactive renin in human plasma.

Normal human plasma contains an active form of renin that is activated by acidification to pH 3.0 and comprises 56% of the total renin. In our study, inactive renin was also present in plasma from five anephric persons, and the proportion of active to inactive renin in these subjects was similar to normal. Plasma from normal pregnant women contained increased concentrations of inactive renin and the proportion of inactive renin was raised to around 66%. Plasma from persons with renal hypertension contained varying amounts of inactive renin but the mean percentage (35%) was lower than normal. An infusion of saralasin sufficient to lower the blood pressure in five subjects with renal hypertension resulted in a rise in active renin concentration but no change in the concentration of inactive renin. Plasma angiotensin II correlated with active renin but not with inactive renin, suggesting that the inactive renin does not produce angiotensin II in vivo.

Angiotensin II↗