Search PubMed⌕ Search

Biomedical subjects

J May

Publications and source records attributed to J May.

317 records · Page 18Linked to original sources
PubMedDate not supplied

Impact of subpatent multi-species and multi-clonal plasmodial infections on anaemia in children from Nigeria.

Childhood anaemia in sub-Saharan Africa is often caused by Plasmodium falciparum malaria. The influence of subpatent, multi-species and polyclonal infections with malaria parasites on haematological parameters was assessed in 1996/97 in clinically healthy children in Nigeria. Of the 228 children studied, 64% were anaemic by the WHO age-dependent criteria. A univariate analysis of risk factors indicated that the prevalence of anaemia was dependent on the number of Plasmodium species detected by species-specific PCR (P < 0.0001). Furthermore, the prevalence of anaemia increased gradually with the complexity (P < 0.003) as well as with the extent of P. falciparum parasitaemia (P < 0.0001). A logistic regression analysis revealed that individuals with an enlarged spleen tended to be anaemic. The number of Plasmodium species by which an individual was infected was independently associated with anaemia (P < 0.03). ANOVA revealed that the age-corrected values for haemoglobin (Hb) and red blood cells (RBCs) were mainly influenced by the occurrence of mixed infections. Haematological parameters were also influenced by the number of different P. falciparum clones by which an individual was infected. Hb levels and RBC counts were further diminished by additional infections with P. malariae and/or P. ovale. However, the effect of multi-species infections on haematological parameters exceeded that of multi-clonal infections.

Age Distribution↗
PubMedDate not supplied

When the central executive lets us down: schemas, attention, and load in a generative working memory task.

Participants were asked to generate a single sequence of numbers in between two bounds. By varying the requested sequence length and way in which the question is posed, this paradigm enables assessment of the contributions to central executive functioning of schema, focus of attention, and load. With sequences of three or four numbers, a quarter of the sample failed fully to comply with the instructions. They generated an incorrect number of numbers or went outside the specified bounds. With sequences of six numbers, more than half of the sample infringed one or more of the constraints. Participants consistently generated sequences with particular generic properties. The overall frequency and patterns of infringements suggest that a substantial proportion of participants focused their conceptual attention on sequence content and often neglected the problem of how thelength and boundary constraints were going to be evaluated either before or during response delivery.

Attention↗
PubMedDate not supplied

Populus candicans and the Balm of Gilead.

Bud exudates of some poplars are compared using GC-MS. P. candicans resembles P. balsamifera. A sample of "Balm of Gilead" purchased in Oxford proved not to resemble its supposed source, P. candicans. Instead it was similar to P. nigra, from which it was presumably collected in Europe.

Medicine, Traditional↗
PubMedDate not supplied

Peripheral and central parenteral nutrition: a cost-comparison analysis.

The concept that total parenteral nutrition (TPN) has to be administered centrally is increasingly recognised to be mistaken: for most patients, peripheral parenteral nutrition provides satisfactory nutritional support. Use of the peripheral route avoids the risks of central venous cannulation--but is it more cost-effective? In a randomized clinical study we examined the costs of TPN in 51 patients who underwent a mean of 8 days of intravenous feeding and conclude that the use of peripheral parenteral nutrition may lead to cost savings.

Catheterization↗
PubMedDate not supplied

Medical student evaluation of family nurse practitioners as teachers.

BACKGROUND: Demands on family medicine faculty to generate clinical revenue may negatively impact the undergraduate medical education program. To minimize this possibility and better model interprofessional education, family nurse practitioners (FNPs) were hired as clinicians and teachers as part of a longitudinal family medicine clerkship. This paper reports the results of a pilot study of student evaluations of nurse practitioner teaching. METHODS: All M3 and M4 students were asked to evaluate one of three FNPs who had precepted them multiple times during their previous year of ambulatory care practice. Two previously studied closed-ended questionnaires were used to assess quality of teaching by the FNPs. Students also responded to a series of open-ended questions. RESULTS: Ninety-one percent of 97 students responded to the survey. Responses to the closed-ended questions as well as comments by the students and physicians were positive regarding the teaching by FNPs. The teaching skills most highly regarded by the students tended to be different than those most highly regarded in physicians. CONCLUSIONS: This pilot study suggests FNPs can be successfully integrated into undergraduate medical education settings, offering teaching strengths that complement those of physicians. Integrating the two professions in a family medicine clerkship may prove beneficial to students and expand departmental teaching resources without further straining finances. Efforts at evaluating the teaching contributions of FNPs at other institutions are needed to substantiate the present study results.

Ambulatory Care↗
PubMedDate not supplied

Is the outlook for the vascular amputee improved by striving to preserve the knee?

A trend to amputate below knee (BK) began in the late 1960's when the disadvantages of above knee (AK) amputation were recognised. In this study, the outcome of 189 consecutive patients who had major lower extremity amputations between 1978-1982 was compared to earlier reports from the same institution. Their cumulative survival of 52% at three years, was similar to the cumulative survival of 116 amputees whose surgery was done in 1966-1971. The risk of losing the second limb, almost 10% per year, was also similar to the earlier experience of 1966-1971. In 1964 one BK amputation was performed for every six above the knee. By 1980 this ratio had reversed to three BK for each AK amputation. When a ratio of BK:AK amputation greater than 2:1 was achieved in our patient population, using clinical criteria as the sole guide to amputation levels, one in four failed. The eventual ratio of healed BK to AK amputation achieved was little better than unity. A trend to below knee amputation was not associated with improvement of long term survival after lower extremity amputation for advanced arterial disease. These results indicate a need for better care of the vascular amputee and for a test to compliment clinical selection of amputation levels.

Actuarial Analysis↗
PubMedDate not supplied

Failure of patent aorto-renal grafts to cure hypertension in renin positive patients.

Correction of renal artery stenosis in a hypertensive patient does not always result in cure of the hypertension. In a follow-up on 127 patients operated on for renovascular hypertension over a 24-year period 32 patients with favourable preoperative factors, unilateral disease, normal renal parenchyma and a positive renal vein renin ratio were studied. 20/32 were regarded as cured with a BP of less than 140/90 and 12/32 were regarded as unsuccessful with a BP, although lessened, higher than 140/90. Hypotensive medication was required in 10/12 in the latter group and was still required in 8/20 of the former. The cure rate of less than 2/3rd is lower than most reports in the literature. The possible causes of the discrepancy are discussed.

Adult↗
PubMedDate not supplied

Lessons learnt in the management of aortoenteric fistulae.

Secondary aortoenteric fistula may be treated directly by local repair or by excision of all prosthetic material with extra-anatomic revascularisation. We have reviewed our experience with 14 aorto-enteric fistulae encountered between 1960 and 1984. Two patients who were not treated surgically died. Direct repair was attempted in seven patients, two of whom had no prosthetic material present and survived. Five patients had prosthetic grafts which were not removed and four died from recurrent aortic haemorrhage. There were five other patients who had prosthetic grafts which were removed prior to extra-anatomic reconstruction. Three of these died in the peri-operative period, two from sepsis but only one from aortic stump bleeding. The operative mortality was 58%. The overall survival was only 36% (5 of 14 patients) but there was less chance of recurrent aortic haemorrhage when all prosthetic graft material was removed and direct repair avoided.

Adult↗
PubMedDate not supplied

Fathers: the forgotten parent.

Fathers today face a confusing set of values and role choices. The challenges are particularly great for fathers of children with chronic illness or disability. Fathers must reexamine priorities, come to terms with losses, and develop and strengthen caretaking capabilities. The isolation commonly felt by fathers of children with special needs places the entire family at risk. Conversely, paternal involvement has many benefits. Professionals can take many steps to engage men in becoming supportive and important figures in the lives of their children.

Chronic Disease↗