Estimating Plasmodium vivax parasitaemia.
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Animals↗
Biomedical subjects
J Simpson
Publications and source records attributed to J Simpson.
Artesunate and mefloquine in the treatment of uncomplicated multidrug-resistant hyperparasitaemic falciparum malaria.
Oral artesunate is the most effective treatment for uncomplicated hyperparasitaemia in falciparum malaria. To assess the contribution of mefloquine to therapeutic efficacy in an area endemic for mefloquine-resistant Plasmodium falciparum, an open randomized comparison of a 5 d course of oral artesunate (total dose 12 mg/kg) with and without a single dose of mefloquine (25 base mg/kg) was conducted in 100 adults and children with uncomplicated hyperparasitaemia (> 4% parasitized red blood cells). Both regimens were well tolerated and gave equally rapid clinical responses (84% of patients were aparasitaemic and 96% were afebrile within 48 h), but the recrudescence rate assessed at day 42 was 6% in those receiving artesunate with mefloquine compared to 36% in those receiving artesunate alone (adjusted hazard ratio 7, 95% confidence interval [95% CI] 2-32; P < 0.01). In addition, the efficacy of a 7 d course of artesunate, with and without the addition of mefloquine, was monitored in 178 patients who were not part of the randomized comparison. The failure rate was again lower in those receiving artesunate and mefloquine--7% (95% CI 2-13) compared with 26% (95% CI 8-44) in patients treated with artesunate alone. An oral regimen of 5 d or more of artesunate, together with mefloquine (25 mg/kg) given on day 2, is an effective treatment for uncomplicated hyperparasitaemic falciparum malaria in this area of high level multidrug resistance.
Administration, Oral↗
HIV RNA quantitation: marker of HIV infection.
Assessment of the status and prognosis of an HIV-infected individual traditionally has been difficult for the clinician. The use of markers of disease progression such as CD4+ has been found to not be a complete indicator of the status of an HIV-infected individual. As a result, determining appropriate therapy for the treatment of this viral infection has been both unpredictable and challenging. Recent development of a laboratory assay has brought a new tool in the management of HIV. The assay is a quantitation of the amount of detectable HIV RNA and estimates the amount of HIV viral load or HIV viral burden present in the blood. Since the development of this assay, HIV RNA quantitation has rapidly become an important surrogate marker of HIV infection. In addition, this quantitation is used to determine the effectiveness of anti-HIV therapies. Understanding the differences and results of quantitative assays is imperative in the management of HIV-infected patients. This article summarizes the events leading to the creation of quantitative assays, explanations and comparisons of the current quantitative assays, and nursing considerations for the implications and uses of viral load markers.
Biomarkers↗
Congo red birefringent structures in the hypothalamus in senile dementia of the Alzheimer type.
Serial cryostat sections of hypothalamus from four cases of Alzheimer-type dementia and four controls were stained with Congo red and examined for birefringence. Green birefringence and dichroism was associated with (a) neurofibrillary tangles, which were most numerous at the level of the tuberomammillary nucleus where they were found in large acetylcholinesterase-positive neurons; (b) neuropil processes within tangle fields; (c) a few plaque cores in the mammillary body; (d) spicules at the ependyma of the third ventricle, and (e) blood vessels. Birefringence (e) had different properties from (a) to (d) and was considered to be due to collagen. The ependymal spicules did not react with an antibody which recognized the tangles and neuropil processes. Each Alzheimer case had many more tangles than the control cases. Birefringence in (b)-(d) tended to be greater in the Alzheimer than in the control cases. This study confirms previous reports of large numbers of tangles in circumscribed areas of caudal hypothalamus in Alzheimer-type dementia and demonstrates that Congo red staining reveals abnormalities in hypothalamic structures (neuropil processes and ependyma) not demonstrated by other staining techniques.
Aged↗
Locally determined performance related pay.
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Employee Performance Appraisal↗
Sex- and age-related differences in colour vocabulary.
Data were collected on the colour names used by 26 females and 24 males in naming 200 colour samples. Women used more elaborate colour names than men but, contrary to other findings, older subjects of both sexes used more elaborate names than younger subjects. Older men in our sample had a more elaborate vocabulary than younger women, showing that although sex differences were well established, vocabulary continued to increase with age. Colour related hobbies were significantly correlated with enhanced vocabulary for the male group, but not for the female group.
Adult↗
Androgen effects on bioactive and immunoreactive gonadotrophin levels during puberty in male baboons.
The effect of androgens on changes in circulating LH and FSH during pubertal development was examined longitudinally in a 3 year study in male hamadryas baboons. Baboon LH and FSH were measured by a species-specific radioimmunoassay and bioactive LH (B-LH) was measured by the mouse in vitro Leydig cell bioassay. Control baboons (n = 5) progressed normally through puberty. Eight baboons were castrated prepubertally; of these four received testosterone implants at the chronological age (CA) of clinical puberty (4.0 +/- 0.1 yr, mean +/- SEM). The timing of the postcastration rise in B-LH levels ranged between 1 and 15 months later (median 3.5 months) (CA 3.5 +/- 0.2 yr) thus supporting the hypothesis that central activation of gonadotrophins occurs at the time of puberty, independent of gonadal influences. Similar results were seen for immunoreactive-LH (IR-LH) and IR-FSH levels. IR- and B-LH levels continued to rise with age (P < 0.0003) in the untreated castrated baboons, associated with an increased LH B/I ratio. Administration of testosterone resulted in temporary suppression of B-LH, IR-LH and IR-FSH levels; however gonadotrophin levels subsequently rose with age despite increased testosterone levels. Thus the mechanisms initiating puberty involve both gonad-independent events as well as alterations in negative androgenic feedback sensitivity on gonadotrophin secretion.
Animals↗
Health care experiences of Vietnamese families in Nottingham.
There is a dearth of information on the health needs of Vietnamese refugees in Britain. In May 1993, a structured interview survey was undertaken to determine the health care experiences and health-related behaviour of Vietnamese adults living in Nottingham Health District. One hundred and thirty-five adults (66 women) were successfully interviewed in Vietnamese or Cantonese, from 71 to 77 eligible households. Levels of English usage were extremely low, and between 27% and 69% of respondents reported considerable difficulty during the various stages of a consultation with their general practitioner. Data on breast screening services suggested a pattern of low uptake, and the prevalence of male smoking was estimated to be 47%. These results suggest that Vietnamese communities suffer high levels of disadvantage in their use of primary care services; remedial action is required.
Adolescent↗
Conditions: a tool for effective certificate-of-need regulation.
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Certificate of Need↗
Depression in black women of low socioeconomic status: psychosocial factors and nursing diagnosis.
This study examines the relationship between depressive symptomatology and selected psychosocial variables in a sample of low socioeconomic status of Black women. The purpose of the investigation was to determine if a study of attribution style, interpersonal style, and racial identity within this sample of Black women might yield results that would lead to the development of treatment strategies with specific applicability to this population of people. Findings indicated a significant disproportionate prevalence of depressive symptomatology in sample of 101 Black women.
Adolescent↗
The use of monoclonal antibody B72.3 in the management of gynecologic malignancies.
Monoclonal antibodies are currently used in the diagnosis of gynecologic malignancies by way of immunohistochemical assays, serum assays, and in situ radiolocalization of carcinoma lesions. Among them is MAb B72.3, generated against a human tumor-associated antigen (TAG-72). Using immunohistochemical techniques, MAb B72.3 has shown reactivity with 100 percent of common epithelial ovarian carcinomas and endometrial carcinomas and non-reactivity with normal adult tissues, with the exception of normal secretory endometrium. B72.3 appears to be a valuable immunocytologic adjunct, with greater than 90 percent of effusions and fine-needle aspiration biopsies from gynecologic carcinomas showing reactivity. Using a serum assay developed to detect the presence of the TAG-72 antigen, 48 percent of patients with ovarian carcinoma demonstrated TAG-72-positive sera versus 1 percent of control sera. 131I-labeled MAb B72.3 IgG and gamma scanning have been used for the in situ detection of metastatic carcinoma. Twelve of 15 patients with ovarian carcinoma showed positive gamma scans, and approximately 80 percent of the lesions demonstrated specific localization of the antibody. These studies indicate the potential utility of MAb B72.3 in the diagnosis of gynecologic carcinoma.
Antibodies, Monoclonal↗
Protracted dying: a challenge to the caring team.
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Adenocarcinoma↗
Doctors as managers: juniors and seniors.
Doctors have been encouraged to take an active part in management for a numbers of years. So, where are we now? What about the doctors/managers of the future? What happens next?
Chief Executive Officers, Hospital↗
Implementation of unit-based continuous quality improvement approach to quality management: applying concepts to practice.
This article describes the implementation of unit-based continuous quality improvement approach to quality management and the resultant fostering of autonomy and decision-making among clinical nurses. Restructuring, education and evaluation activities during implementation are described. Nurses in the post-implementation evaluation survey stated that quality of care was improved by unit-based continuous quality improvement. Unit-based continuous quality improvement promotes a high level of clinical nurse involvement as evidenced by quality improvement initiatives and projects completed. Accompanying this involvement, is a system of continuous quality improvement which facilitates patient care improvement.
Decision Making, Organizational↗