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Biomedical subjects

J Turner

Publications and source records attributed to J Turner.

At least 289 records · Page 16Linked to original sources
PubMed1987

Aerosolised pentamidine as sole therapy for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome.

15 patients with first episodes of Pneumocystis carinii pneumonia and the acquired immunodeficiency syndrome were treated with only aerosolised pentamidine, which they inhaled for 20 minutes every day for 21 days. 13 of the 15 responded to therapy. Mean PaO2 (mm Hg) and vital capacity (% predicted) were 67.9 and 50.8 before therapy and 80.1 and 67.9 after therapy in patients successfully treated. No systemic side-effects occurred and serum pentamidine concentrations were low in all patients. The only local adverse reaction was cough in 12 patients. Aerosolised pentamidine may be an effective non-toxic treatment for P carinii pneumonia.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The occurrence of cardiac lipidosis and necrotic lesions in the hearts of rats following long-term feeding of different lipid supplemented diets.

The effects of "long-term" feeding of different lipid supplemented diets (12% added fat, w/w) on the incidence of lipidosis or the severity of necrosis was examined in the cardiac muscle of male Hooded Wistar rats, after at least 12 months on the diets. The effects of supplementation with either n-6 polyunsaturated fatty acids (PUFA's) added as sunflower seed oil (the SSO diet), or one enriched with n-3 PUFA's added as a low cholesterol, low vitamin (A & D) fish oil preparation obtained from eviscerated Southern Bluefin Tuna (the TFO diet) were compared to those found in the hearts of rats fed either a relatively low fat commercially available stock diet (REF) which contained 4% (w/w) of mixed fats of animal, vegetable and marine origin, or after this stock diet had been supplemented to the same extent by the addition of 12% (i.e. 12:88 g) sheep kidney (perirenal) fat, the SF diet. Extensive cardiac lipidosis was seen after feeding either the TFO or the SF diets, but was not observed in the hearts of experimental rats from either the SSO or REF fed groups. Conversely, in these mature animals, grade 1 necrotic lesions were uniformally found in the cardiac muscles of all rats examined, but neither their incidence nor severity could be attributed to any dietary effect. These necrotic lesions are therefore more probably a reflection of the age of the animals at the time of sacrifice, rather than to any of the dietary supplements employed. Some evidence of "Yellow Fat" disease was found by the presence of lipofuscin pigmentation in the storage fat of rats receiving n-3 PUFA's (the TFO diet) but was not observed in any other dietary group nor in the livers or kidneys of any animals. This extent of storage fat pigmentation was not associated with any retardation of growth in this dietary group.

Adipose Tissue↗
PubMed1987

A revised objective rating system for patient selection for chymopapain chemonucleolysis.

A revised objective rating system, previously found useful for patient selection for lumbar laminectomy and discectomy, was evaluated in patient selection for chemonucleolysis by intradiscal chymopapain. Based on the severity of findings within each of four categories (neurologic signs, root tension signs, myelogram or computed tomography (CT) findings, and psychosocial environment), numerical scores are derived. A maximum score of 25 points is available in each of four categories for a total of 100 points. The objective rating score was determined in a series of 101 patients prior to treatment of lumbar disc herniation by chemonucleolysis. The patients were evaluated at least one year after injection. The objective rating score was predictive of the result of chemonucleolysis, and was even more strongly predictive of the ultimate surgical outcome, which included the results in 22 patients who were treated by laminectomy after chemonucleolysis failure.

Adolescent↗
PubMed1986

Acute, severe hepatitis due to Coxiella burneti infection.

An unusual case of Coxiella burneti infection is described in which the patient presented with an "acute abdomen" and marked clinical icterus. This case emphasizes that Q-fever may appear as acute hepatitis and illustrates its "characteristic" histopathological lesions which have been recognized only recently.

Biopsy↗
PubMed1986

Phenacetin and papillary necrosis: independent risk factors for renal pelvic cancer.

A case-control study was undertaken to determine whether renal papillary necrosis (RPN) is an essential step in the genesis of analgesic-associated cancer of the renal pelvis (CaP). Kidneys of 66 patients (and 86 cases of renal parenchymal cancer (CaK), for comparison) were examined for evidence of RPN. Information concerning past consumption of phenacetin-containing analgesics (PhA) was obtained from all cases and 751 population controls by means of a questionnaire. Separately, RPN and regular consumption of PhA each conferred a relative risk for CaP of 3-1/2 to 7, while together they increased the risk some 20 times that for non-consumers without RPN. This suggests that each factor has independent, and when they coexist sequential, effects. The risk for CaK was doubled by regular PhA consumption but was not increased by RPN.

Aged↗
PubMed1986

Low-dose subcutaneous heparin in the prevention of deep-vein thrombosis and pulmonary emboli following acute stroke.

Venous thrombo-embolism is a major and often unrecognized cause of morbidity and mortality in patients after acute strokes. Three hundred and five elderly patients were randomly allocated to either control (161) or treatment (144) with 5000 units calcium heparin subcutaneously 8-hourly for two weeks. A reduction in deep-vein thrombosis rate from 72.7% in the control group to 22.2% in treatment patients was achieved. In patients who died (84), post-mortem examination to look for pulmonary emboli was performed in 71. Comparison between treated and untreated patients showed significantly fewer deaths and pulmonary emboli in the treated group. Most of the beneficial effect on mortality was seen in patients with lighter strokes. When patients with pulmonary emboli at post-mortem were excluded, there was no significant difference in the death rate in treatment (17) and control (14) groups. At post-mortem, 9.9% of the strokes were haemorrhagic (4 in the treatment and 3 in the control group). Low-dose calcium heparin given subcutaneously following acute stroke reduced the number of deep-vein thromboses, pulmonary emboli and deaths without increasing the number of haemorrhagic strokes in this study.

Aged↗
PubMed1986

Immediate trauma resuscitation with type O uncrossmatched blood: a two-year prospective experience.

From January 1982 through December 1983, 83 severely injured and hypovolemic patients were immediately resuscitated with uncrossmatched packed red cells. Seventy-four patients received 250 units (3.3 units/pt) of Group O red blood cells (TOB), and nine patients received 27 units of type-specific blood (TSB) (3.0 units/pt). Additionally, 53 units of TSB were transfused to the TOB group in the interval between TOB immediate transfusion and the availability of fully crossmatched blood. A total of 880 units (10.6 units/pt) were transfused without instance of transfusion reaction or subsequent crossmatching difficulty. The protocol called for two units of TOB (Rh positive for males, Rh negative for females) to be delivered to the resuscitation area before patient arrival. The decision to transfuse TOB was left to the surgeon in charge and was based on the clinical impression of severe shock. Thirty-eight per cent (31 patients) met the criteria of requiring a 'massive transfusion' (greater than 10 units within 24 hours). Overall, 28 patients (31%) died, 22 within hours of arrival. No death was attributable to transfusion reaction or blood incompatibility. Complications included one dysrhythmia, six patients developed ARDS (7.2%), and ten patients (12%) had 'DIC'. Two patients developed positive hepatitis screens, and there was one clinical case of hepatitis observed. None of the 'DIC' cases were related to incompatible blood transfusion. We conclude that for immediate trauma resuscitation, TOB is safe and TOB has additional advantages over TSB or Type O whole blood transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

ABO Blood-Group System↗
PubMed1986

The differential utility of the Minnesota Multiphasic Personality Inventory. A predictor of outcome in lumbar laminectomy for disc herniation versus spinal stenosis.

One hundred six patients with disc herniation who underwent lumbar laminectomy and discectomy and 51 patients with spinal stenosis who underwent decompressive lumbar laminectomy were evaluated for surgical outcome at least 1 year postoperatively (mean: 18 months). All had completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of the preoperative evaluation. The Hypochondriasis (Hs), Depression (D), Hysteria (Hy), Psychopathic Deviate (Pd), Psychasthenia (Pt), and Schizophrenia (Sc) scales were found to be predictive of surgical outcome in the herniation group. However, no MMPI scale was related to outcome in the stenosis group. Analysis of covariance showed this fact to be related to the differences in age between the two groups of patients, rather than a result of the differing diagnoses. The MMPI appears to be more useful in predicting surgical outcome in the young and middle-aged adult patient population with disc herniation and is not of predictive utility in the older stenosis population.

Adolescent↗
PubMed1986

The human needs model of nursing.

Nurses in the United Kingdom spend much time attempting to fit British nursing practice into the theoretical framework of American nursing models. This is often a manipulative process in that it seeks to establish positive links with a care delivery system totally unlike our own. In the present paper the authors detail the process of establishing a new nursing model which integrates nursing curricula, education and practice to meet the needs of patients, staff and students within their own health district. An over-emphasis on lower levels of human need is common within nursing practice, which, although often blamed upon lack of human and financial resources, is also due to practitioners' misconceptions. The latter are invariably the result of a lack of an adequate or overt, practice orientated, conceptual framework. The Human Needs Model of Nursing adapts Maslow's concept of human needs to create such a conceptual framework for practice. It places equal emphasis on those patient problems which arise as the result of unmet needs at higher levels as well as those at lower levels, thereby acknowledging the holistic and dynamic nature of man.

Holistic Health↗
PubMed1986

The effect of inspiratory resistive training on exercise capacity in optimally treated patients with severe chronic airflow limitation.

This study was designed to determine whether inspiratory resistive training could improve the exercise performance of patients with severe chronic airflow limitation who had already received optimum conventional therapy with bronchodilators and physiotherapy. Eighteen patients were studied. Ten patients were trained with an inspiratory resistance device for six weeks and eight patients used a placebo device. Psychological factors, likely to influence exercise capacity, were taken into account. Although there was no significant increase in maximum inspiratory pressure in the ten trained subjects, inspiratory muscle endurance was improved. Exercise performance, as assessed by progressive cycle exercise, stair climbing, 12 minute walking distance and treadmill walking did not change significantly in either group. It was concluded that inspiratory muscle training, using a currently available technique, produced no additional improvement in exercise capacity beyond that achieved by conventional bronchodilator and rehabilitation therapy.

Aged↗
PubMed1986

Intensive care of patients with the acquired immunodeficiency syndrome. Outcome and changing patterns of utilization.

Eighty-two patients with the acquired immunodeficiency syndrome (AIDS) were admitted to the intensive care units (ICUs) at San Francisco General Hospital (SFGH) between March 1981 and December 1985. Of these patients, 69% died in the hospital, as did 87% of patients who required mechanical ventilation because of Pneumocystis carinii pneumonia and respiratory failure. Although the number of hospital admissions of patients with AIDS has increased steadily since the fourth quarter of 1982 (12 admissions) through the fourth quarter of 1985 (158 admissions), the number of admissions to the ICUs peaked at 17 in the second quarter of 1984 and decreased steadily, averaging 5 per quarter in 1985. This decrease was not explained by a reduction in the number of patients with P. carinii pneumonia or an improvement in their treatment. A survey of physicians at SFGH indicated that physicians are aware of the poor prognosis of patients with AIDS with P. carinii pneumonia and respiratory failure, believe that mechanical ventilation is infrequently indicated for this condition, and have become increasingly likely to discuss issues of resuscitation with their patients with AIDS. Therefore, possible explanations for this trend in ICU utilization include changing physician attitudes, in addition to more effective patient counseling and increased availability of hospital and community-based support services that provide alternatives to terminal intensive care.

Acquired Immunodeficiency Syndrome↗
PubMed1986

A comparison of the Millon Clinical Multiaxial Inventory and the Minnesota Multiphasic Personality Inventory as predictors of successful treatment by lumbar laminectomy.

One hundred twenty-nine patients who were treated by lumbar laminectomy for discogenic disease were evaluated preoperation by means of the Millon Clinical Multiaxial Inventory (MCMI) and the Minnesota Multiphasic Personality Inventory (MMPI). At follow-up evaluation, there were 71% good, 18% fair, and 11% poor surgical results. Patients with fair or poor outcomes scored significantly higher in the hypochondriasis, depression, hysteria, and psychasthenia scales in preoperative MMPI testing. These patients also showed significant differences on the MCMI asocial, gregarious, and neurotic depression scales. The MMPI profiles had a higher correlation with successful treatment than did those of the MCMI. The MMPI can help identify patients whose pain syndrome has a significant psychosocial component, and it can easily be used by orthopedic surgeons to facilitate referral and treatment planning.

Adolescent↗
PubMed1986

Nursing intervention in patients with peripheral vascular disease.

Peripheral vascular disease is a chronic progressive disease. Nursing intervention will be aimed at primary prevention through risk factor modification. Quality patient care will be facilitated through the development of an individualized plan of care. An essential element to consider in promoting successful nursing intervention is collaboration of the nurse and patient when developing the plan of care. Overall goals of care for a patient with PVD include promotion of circulation, relief of pain, and prevention of tissue damage or infection.

Behavior Therapy↗