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Biomedical subjects

J MacDonald

Publications and source records attributed to J MacDonald.

At least 91 records · Page 5Linked to original sources
PubMed1991

Prospective evaluation of a totally implantable drug delivery system. Improved results at 4-year follow-up.

Totally implantable drug delivery systems have facilitated chemotherapy in cancer patients. The incidence of complications has been acceptable but not optimal. A series of 140 consecutive implants over a 4-year period is presented. The total follow-up was 41,185 days. Reversible obstruction was present in 12.8% of portals. The infection-erosion rate was 4.2%; only 6.3% of patients required removal of the system because of failure. In the last 111 patients only one device failed (0.9%). The reasons for these improved results are analysed, and recommendations are made to improve the current management of these devices.

Adult↗
PubMed1990

Functional capacity and mental status of elderly people in long-term care in west Glasgow.

Functional capacity and mental status were assessed in 821 patients in long-term care in West Glasgow. In geriatric medical long-term care only five (1.3%) out of 387 patients were independent in activities of daily living (walking, transfers from bed and chair, dressing, toileting, urinary and faecal continence) and were not severely mentally impaired (AMT score greater than 6/10); in psychogeriatric care n = 6/143 (4.2%) in private nursing homes n = 6/66 (9.1%) and in residential care n = 100/235 (42.6%). Patients in geriatric medical care had a greater prevalence of immobility and urinary incontinence but less mental impairment than those in psychogeriatric care. Nearly all patients placed in geriatric medical or psychogeriatric care had major functional disability or mental impairment. The level of disability was less in private nursing than in geriatric medical care. Although 57% of those in residential care required some assistance or supervision in activities of daily living or had severe mental impairment, 86% were independent in walking and 83% were continent of urine. The implications of these findings for the provision of care for physically and mentally frail elderly are discussed.

Activities of Daily Living↗
PubMed1989

To what extent should a hospital ethics committee be involved in hospital policy formation?

The extent to which a HEC becomes involved with policy formation depends in large measure on the credibility the committee has within the institution. Although on the basis of training, insight, or experience the HEC is in an ideal position to formulate policy, premature involvement in this area can jeopardize the effectiveness of the HEC in other areas which are equally if not more important. To the extent that the HEC does engage in policy formation it must do so with considerable political as well as ethical acumen.

Ethics↗
PubMed1988

Multiple sclerosis in the Shetland Islands: an update.

Annual incidence rates of multiple sclerosis (MS) in the Shetland Islands have been updated from 1938 to 1986. These reveal a significant decline in MS incidence beginning between 1951 and 1968. No significant change in prevalence, age-specific prevalence, duration of MS, or mean age of the MS population in Shetland has been found since the last survey in 1974, although a trend towards an older MS population was noted.

Adult↗
PubMed1988

Treatment of unresectable pancreatic carcinoma using irradiation with concurrent intravenous 5-FU infusion therapy.

Ten patients with unresectable carcinoma of the pancreas who had only bypass surgery to relieve biliary obstruction were treated with radiation therapy to the pancreas and liver with concurrent 5-fluorouracil (5-FU) intravenous infusion therapy. Treatment regimen was three cycles of chemoradiotherapy with a two week rest period between cycles. 5-FU (1,000 mg/m2 per day) was administered by continuous infusion for the first five days of each cycle. In the first cycle radiotherapy was given to the pancreas to 2,000 cGy/10 fractions using 6 to 10 mV x-rays. In the second cycle 2,400 cGy/160 rads/fraction radiation was delivered to the pancreas and whole liver. In the third cycle, 1,600 cGy/160 rads/fraction to a total dose of 6,000 rads, was administered to the pancreatic tumor. All ten patients completed the treatments without interruption. No major side effects were noticed during the course of treatment. Survival ranged from 9 to 16 months and median survival was 11 months. Symptomatic relief was obtained in all 10 patients. One patient who lived for 16 months developed duodenal stenosis and underwent gastrojejunostomy.

Adult↗
PubMed1987

Biochemical and biological activities of 2,3-dihydro-6-[3-(2-hydroxymethyl)phenyl-2-propenyl]-5-benzofuranol (L-651,896), a novel topical anti-inflammatory agent.

The biochemical and biological profile of a topical anti-inflammatory agent, 2,3-dihydro-6-[3-(2-hydroxymethyl)phenyl-2-propenyl]-5-benzofuranol (L-651,896 inhibited the 5-lipoxygenase of rat basophilic leukemia cells with an IC50 of 0.1 microM and leukotriene synthesis by human PMN and mouse macrophages with IC50 values of 0.4 and 0.1 microM respectively. L-651,896 also inhibited prostaglandin E2 synthesis by mouse peritoneal macrophages (IC50 = 1.1 microM). This compound inhibited ram seminal vesicle cyclooxygenase activity at considerably higher concentrations, and this effect was directly related to substrate concentration. When applied topically to the mouse ear, L-651,896 lowered elevated levels of leukotrienes associated with arachidonic acid-induced skin inflammation and delayed hypersensitivity induced by oxazolone. However, while L-651,896 inhibited the increased vascular permeability induced by arachidonic acid, it had no effect on the edema associated with the immune-based response to oxazolone in the same tissue. Thus, it is possible that leukotrienes may play a role in some but not all inflammatory responses.

Administration, Topical↗
PubMed1987

Treatment of liver metastases with a combination of chemotherapy and hyperfractionated external radiation therapy.

Twelve patients with liver metastases from colorectal cancer were treated with 5-FUdR hepatic artery, or 5-FU i.v. infusion therapy and hyperfractionated whole liver irradiation (2,100 rad in 14 fractions, two fractions/day over a period of 9 days). All 12 patients tolerated treatments well and no unusual toxicity was noted from this therapy. Response was assessed on completion of treatment and on follow-up examinations by physical examination, repeat liver function tests (LFTS), and CT scans. Symptomatic relief was achieved in all patients. Decreased liver size and improved LFTS were noted in 10/12 (83%) of patients. CT scans showed decrease in size of metastases. Survivals ranged from 16 to 120 weeks. Infusion therapy was given either by implanted infusion pump or continuous i.v. infusion therapy, 5-FUdR 0.3 mg/kg of body weight/day or 5-FU 1,000 mg/m2/day. Hyperfractionated external radiotherapy with concomitant 5-FUdR hepatic artery of 5-FU i.v. infusion therapy for liver metastases was well-tolerated, and both subjective and objective response and quality of survival were noted. Hyperfractionated external beam irradiation with concurrent chemotherapy can be effective in palliating patients with liver metastases.

Combined Modality Therapy↗