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Biomedical subjects

J Reid

Publications and source records attributed to J Reid.

At least 289 records · Page 16Linked to original sources
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Blanket bans on treatment: conflict in healthcare resourcing.

Blanket bans of specific treatments have been controversially introduced by some NHS trusts as a means of rationing health care and prioritizing funding for services. This article examines the perceived value conflicts that emerge in relation to blanket bans on specific treatments. Following an initial overview of rationing in contemporary society the needs and wants of given individuals are compared with those of a wider society. Ethical values and philosophical considerations are explored as an analysis of the continuing debate is attempted.

Attitude to Health↗
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Children's self-reports of psychologic adjustment and coping strategies during first year of insulin-dependent diabetes mellitus.

Psychologic adjustment, assessed by self-ratings of anxiety, self-esteem, and depression, and cognitive as well as behavioral coping strategies, elicited by interview, were monitored longitudinally among school-age children with recent-onset insulin-dependent diabetes mellitus (IDDM). Our article documents the findings over the 1st yr of illness. From the start, the children viewed themselves as self-confident and emotionally comfortable. The diagnosis of IDDM created minimal emotional upheaval (which faded within 6 mo), despite this cohort's consistent report that the diet, insulin injections, and urine tests were difficult. The most prevalent cognitive strategies for coping with IDDM included wishful thinking, thoughts of forbidden foods, and resentful thoughts. Behavioral coping strategies, including information seeking, were evident from the beginning. The frequency of socially oriented coping behaviors (e.g., showing IDDM management to peers) indicated that the young patients actively tried to adapt to the illness and were more comfortable with aspects of home care than previously thought. Self-rated psychologic adjustment, psychiatric diagnosis, and illness-related coping behaviors were unrelated to one another; psychologic variables were similarly unrelated to the use of socially oriented coping strategies. Therefore, in juvenile cohorts, the presumed association between psychologic status and coping behaviors requires further examination.

Adaptation, Psychological↗
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Nice 'n' easy.

Explore the source record for details and available documents.

Complementary Therapies↗
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Fast-tracking older people through A&E.

This article explores the concept and feasibility of fast-tracking older people through A&E services to enable appropriate admission and quality responsive patient care. It illustrates how an academic assignment undertaken as part of a pre-registration programme could be adapted for publication to challenge thinking and encourage examination of potential new ways of working.

Aged↗
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Pharmacokinetics and cerebrospinal fluid penetration of daunorubicin, idarubicin, and their metabolites in the nonhuman primate model.

PURPOSE: Idarubicin (4-demethoxy-daunorubicin) is more potent and less cardiotoxic than the commonly used anthracyclines, doxorubicin and daunorubicin. In addition, idarubicin is metabolized to an active metabolite, idarubicinol, in contrast to other anthracyclines whose alcohol metabolites are much less active than the parent drug. The current study was performed in nonhuman primates to determine the plasma and cerebrospinal fluid (CSF) pharmacokinetics of idarubicin and idarubicinol and to compare them to the pharmacokinetics of daunorubicin and daunorubicinol. METHODS: A dose of 30 mg/m2 of daunorubicin or 8 mg/m2 of idarubicin was administered intravenously over 15 minutes. Plasma and CSF were sampled frequently from the end of the infusion to 72 to 96 hours after infusion. Drug and metabolite concentrations were measured using high-pressure liquid chromatography (HPLC). RESULTS: Daunorubicin elimination from plasma was triphasic with a terminal half-life of 5.9 +/- 1.8 hours, area under the concentration-time curve (AUC) 22.5 +/- 9.2 mumol/L.min, and clearance 2790 +/- 960 mL/min/m2. Daunorubicinol elimination was biphasic with a terminal half-life 10.2 +/- 2.3 hours and an AUC 74.5 +/- 5.3 mumol/L.min. Idarubicin elimination was triphasic with terminal half-life of 12.3 +/- 11.4 hours, a AUC 10.8 +/- 3.7 mumol/L.min, and clearance 1650 +/- 610 mL/min/m2. Idarubicinol elimination was biphasic with a terminal half-life 28.7 +/- 4.2 hours and AUC 67 +/- 9.8 mumol/L.min. CSF penetration was low for both parent drugs and their metabolites. CSF idarubicin was measurable at a single time point (1 hour after administration) for 2 animals, and was not measurable for the third. The CSF to plasma concentration ratio at that time point was 8% in 1 animal and 15% in the other. Idarubicinol was detected in 2 to 4 samples at various times, appearing as early as 1 hour in 1 animal and persisting as late as 48 hours in another. The CSF to plasma concentration ratio at corresponding time points was 1.9 +/- 0.6%. Daunorubicin was measurable for < 6 hours after intravenous administration. For individual animals, the mean CSF to plasma concentration ranged from 4% to 12%. Daunorubicinol was detectable by 1 hour in 2 of 3 animals and by 3 hours in the other, and remained detectable at 24 hours in 2 of 3. The terminal half-life of daunorubicinol in CSF was 8.8 +/- 1.3 hours, the AUC was 1.8 +/- 1.5 mumol/L.min, and the AUCCSF to AUCplasma ratio was 2.4 +/- 1.9%. CONCLUSION: Idarubicin, idarubicinol, daunorubicin, and daunorubicinol penetrate poorly into the CSF after intravenous administration.

Animals↗
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1999 in review.

ARRT completed the 20th century with a strong tradition of advancing certification in the radiologic sciences and is poised to address the challenges of the next century.

Certification↗
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Women's knowledge of Pap smears, risk factors for cervical cancer, and cervical cancer.

OBJECTIVE: To review the literature on women's knowledge of Pap smears, risk factors for cervical cancer, and cervical cancer. DATA SOURCES: The review was based on a search of the relevant literature over a 10-year period using MEDLINE and CINAHL. DATA EXTRACTION: Articles from relevant, indexed journals and textbooks published within the past decade were included. Seminal articles were included as appropriate. DATA SYNTHESIS: Risk factors for the development of cervical cancer have been reevaluated. The case for human papillomavirus as the cause of cervical neoplasms has been strengthened. CONCLUSIONS: Cervical cancer is associated with early sexual debut, number of lifetime sexual partners, nonuse of condoms, and infection with human papillomavirus. Cigarette smoking facilitates development of cervical cancer.

Condoms↗
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Didactic and clinical competency.

Because the ARRT's mission is to recognize individuals "qualified" in the use of ionizing and nonionizing radiation for medical imaging and radiation therapy, it falls upon the ARRT to define what "qualified" means. The goal of the competency project was to further refine our definition of what qualified means as it relates to educational preparation and to incorporate that refined definition into existing eligibility requirements. Certification requirements should be both specific and public. The competency requirements accomplish this for ARRT's educational eligibility requirements and will help advance certification as well as education in the profession.

Clinical Competence↗
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Reduced incidence of severe infection after heart transplantation with low-intensity immunosuppression.

Despite advances in immunosuppressive therapy and prolonged graft and patient survival, infection after heart transplantation remains problematic. From January 1987 through June 1989, 104 heart transplantations were performed in 100 patients. Immunosuppression induction was by antilymphocyte globulin for 7 days, with oral cyclosporine introduced on stabilization of kidney function (day 3). Steroid therapy was rapidly tapered, and azathioprine was added only in cases of positive donor crossmatch or steroid-resistant rejection. No reverse isolation was used. Twenty-two deaths occurred, one from sepsis. Actuarial survival at 6 months, at 1 year, and at 2 years was 85% +/- 4%, 81% +/- 3%, and 75% +/- 4%, respectively. Fifty-four patients had 81 infections, of which 21 were bacterial; 83% of these episodes were treated. Sixty infections were opportunistic (85% viral), and only 23% necessitated treatment. Actuarial infection-free rates (all types necessitating treatment) at 1 month, at 6 months, and at 2 years were 83% +/- 4%, 75% +/- 5%, and 75% +/- 5%, respectively. Of the 100 transplant recipients, 66% were treated with azathioprine; 47 patients (69%) had an infection, whereas only seven (19%) of the patients not receiving azathioprine became infected (p less than 0.00001). Rejection was noted in 66% of patients, with a median time to the first episode of 4 weeks. A low-intensity immunosuppressive regimen has resulted in fewer serious infections, with acceptable graft loss from rejection. Increased infection surveillance is required for the first 30 days postoperatively and after treatment of rejection episodes.

Actuarial Analysis↗