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Biomedical subjects

J Wales

Publications and source records attributed to J Wales.

34 records · Page 2Linked to original sources
PubMed1985

Hospice role in alleviating the emotional stress of terminal patients and their families.

Terminally ill cancer patients in a Veterans Administration hospital were randomly assigned to receive hospice care. Follow-up evaluation through the time of death revealed no significant differences in anxiety or depression between hospice or control patients, but hospice patients exhibited significantly greater improvement in two of three measures of satisfaction (interpersonal care and involvement in care decisions). Hospice patients' significant others (SOs) showed some decrease in anxiety and greater satisfaction with involvement in care than did control SOs. The differences were attributable in part to hospice staff better meeting SOs' perceived needs.

Anxiety↗
PubMed1985

Morphometry of blood monocytes in malignant lymphoma.

Morphometric methods were used to study the ultrastructure of blood monocytes in 23 patients with Hodgkin's disease, 12 patients with non-Hodgkin's lymphoma, and 20 normal subjects. The results were analysed using both univariate and multivariate methods. Both analyses supported the interpretation that the total mitochondrial contribution to the cellular ultrastructure was less in Hodgkin's disease than in the other two groups, with smaller mitochondrial volume fractions, volumes, and surface areas being found. In the patients with non-Hodgkin's lymphoma univariate analysis suggested that monocyte nuclei were larger, with more euchromatin and a relatively smaller heterochromatin-euchromatin interface; the cell profile area was larger and the surface to volume ratio was smaller compared with normal subjects. Morphological changes have not previously been described in blood monocytes in malignant lymphoma, but they may be the counterpart of the known mononuclear phagocyte dysfunction.

Adolescent↗
PubMed1985

Morphometry of monocytes of human blood.

Morphometric methods have been used to analyse the ultrastructural characteristics of human blood monocytes in 20 normal adults. Data were obtained relating to whole cell, nucleus and mitochondria and, using a method not previously applied to blood cells, for the distribution of heterochromatin and euchromatin. The results provide a normal baseline against which monocyte changes in disease can be assessed.

Adolescent↗
PubMed1985

Ultrastructure of skin window cells in malignant lymphoma.

The ultrastructure of cells in skin window preparations was analysed in 38 patients with malignant lymphoma and in 22 normal subjects. In the series as a whole, there were significant morphological changes in the macrophages between day 1 and day 2 consistent with cell maturation during the inflammatory response. At both intervals, lymphoma patients showed strikingly larger cell and nuclear profile areas as compared with normal subjects; there was a greater number of nucleoli per profile and proportionately more sections showed a Golgi complex. At day 1, a greater percentage of the patients' macrophages showed large numbers of phagocytic inclusions, but at day 2, significantly fewer profiles demonstrated this feature. These morphological findings could be a reflection of the known mononuclear phagocyte dysfunction in malignant lymphoma.

Adolescent↗
PubMed1984

A randomised controlled trial of hospice care.

Terminally ill cancer patients at a Veterans Administration hospital were randomly assigned to receive hospice or conventional care. The hospice care was provided both in a special inpatient unit and at home. 137 hospice patients and 110 control patients and their familial care givers (FCGs) were followed until the patient's death. No significant differences were noted between the patient groups in measures of pain, symptoms, activities of daily living, or affect. Hospice patients expressed more satisfaction with the care they received; and hospice patients' FCGs showed somewhat more satisfaction and less anxiety than did those of controls. Hospice care was not associated with a reduced use of hospital inpatient days or therapeutic procedures and was at least as expensive as conventional care.

Activities of Daily Living↗
PubMed1983

Aspiration following a cave-in.

Reported is a case of massive aspiration of particulate matter after a cave-in. A 14-year-old boy was buried beneath 18 inches of dirt while playing at a construction site. After extrication he was breathing spontaneously and was transported to the emergency department on supplemental oxygen. Physical examination revealed cough, tachypnea, and diminished breath sounds of the right lung field. Chest radiographs showed multiple radiopaque densities filling the right mainstem bronchus and a left-to-right shift of the mediastinum. The patient was treated with bronchodilators followed by postural drainage and percussion. Chest radiographs and physical examination both returned to normal within 24 hours. Reports of massive aspiration of sand are scarce, and have emphasized the need for bronchoscopic removal of particles to restore ventilation. This case was managed with bronchodilators and postural drainage alone, with complete resolution of pulmonary abnormalities.

Accidents↗
PubMed1983

UCLA hospice evaluation study. Methodology and instrumentation.

An unbiased evaluation of hospice effectiveness requires a randomized controlled trial (RCT), but the implementation of such a design is difficult. This paper describes the methods of the only RCT to date and reports on the validity and reliability of scales selected or developed to assess attainment of hospice goals. The patients involved are those in a VA hospital in Los Angeles who have cancer and a prognosis of about 6 months and who consent. They and their significant others are interviewed periodically until the patient's death to measure such hospice variables as pain, depression, anxiety, satisfaction with care and the environment, activities of daily living, and bereavement effects. Many of the scales, including McGill Pain, CES-D Depression, and Satisfaction with Care scales, have been validated in other studies with similar samples. The authors' test-retest reliability analyses show that these scales are reliable with advanced cancer patients and their significant others with coefficients ranging from 0.77 to 0.97.

California↗
PubMed1982

Ultrastructure of skin window cells in normal subjects.

Ultrastructural studies have been made of skin window inflammatory cells in 22 healthy human subjects at 24 hours and 48 hours after an initial abrasion. Large numbers of macrophages and neutrophil polymorphs were seen at both intervals. Compared with the 24 hours specimens, macrophages at 48 hours tended to have more eccentric and less irregular nuclei, as well as more voluminous cytoplasm; phagosomes and large vacuoles were much more prominent and cell diameters were larger. The differences are consistent with maturational changes in the macrophages during the inflammatory response. In the neutrophil polymorphs, the nuclei were frequently pycnotic and showed multiple profiles, and the complement of granules was small. Other cell types were only occasionally encountered. It is concluded that ultrastructural studies of skin window cells may have an application in investigating maturational defects of macrophages in malignant states.

Adolescent↗
PubMedDate not supplied

MRCP (Paeds) exam: the present and the possible future.

In this article I will give some general advice on how to prepare for the MRCP (Paeds) exam and outline the exam's present structure. I will also discuss the changes that may occur subsequent to the proposed establishment of a college of paediatricians.

Education, Medical, Graduate↗
PubMedDate not supplied

Slides in paediatrics 2.

Explore the source record for details and available documents.

Diagnosis, Differential↗