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K Dean

Publications and source records attributed to K Dean.

14 recordsLinked to original sources
PubMed1992

Splenic abscess. Imaging and intervention.

We reviewed the imaging findings of 14 splenic abscesses in 13 patients. All patients underwent chest radiography, 12 ultrasonography (US), 9 CT, 4 plain abdominal radiography, 2 99mTc-HMPAO leukocyte scan and 2 99mTc-HIG scan. Three patients were treated with percutaneous catheter drainage, and 5 with diagnostic or therapeutic fine-needle aspiration (FNA). At US the abscess was hypoechoic (n = 9), anechoic (n = 2), or anechoic with gas-bubbles (n = 1), or the entire spleen was inhomogeneous with gas-bubbles (n = 1). At CT the abscesses appeared as low density (18-30 HU) lesions with (n = 2) or without (n = 7) gas. In 2 cases 99mTc-HMPAO leukocyte scan, and in one case 99mTc-HIG scan showed an intrasplenic defect, and in one case 99mTc-HIG scan was considered normal. At plain abdominal radiography extraintestinal gas was suggested in 2 patients, and the findings were normal in 2. US-guided FNA confirmed infectious etiology of the lesion in 4 patients, and a necrotic specimen suggested infection in one. One patient was cured with repeated aspirations. Catheter drainage was successful in all 3 patients who underwent the procedure. We conclude that US and CT are accurate in detecting splenic abscesses. Our results in splenic interventions advocate wider use of the procedures.

Abscess↗
PubMed1989

Self-care components of lifestyles: the importance of gender, attitudes and the social situation.

Self-care practices of individuals are health related elements of lifestyles. In order to understand the influences that shape and maintain the self-care patterns of behaviour that determine health and functional ability, research frameworks for study of the social situations in which people live and the levels of influence among variables are needed. This paper reports on findings from an investigation of self-care practices in a population sample of persons over 45 yr of age in an attempt to study self-care in a lifestyle framework. The findings show the importance of examining patterns of behaviour rather than exclusive focus on the magnitude of differences in discrete behaviours. Gender was the major independent influence on patterns of health maintenance behaviour while social network variables assumed major importance for self-care responses to illness.

Aged↗
PubMed1988

A preliminary study of the pharmacodynamics and pharmacokinetics of a novel enkephalin analogue [Tyr-D.Arg-Gly-Phe (4NO2).Pro.NH2 (BW443C)] in healthy volunteers.

We have studied 16 healthy men to evaluate preliminary pharmacodynamics and kinetics of BW443C given by i.v. infusions. Four volunteers received escalating doses at weekly intervals, starting at 0.1 microgram.kg-1 for 60 min and increasing to a maximum of 2.0 micrograms.kg-1.min-1 for 180 min. Subsequently 12 different subjects received single i.v. infusions of 10 micrograms.kg-1.min-1 for 20 min. Subjective effects were reported and objective measurements made of central nervous and cardiovascular effects. Blood was sampled at intervals on all occasions, plasma concentrations were determined by radioimmunoassay and pharmacokinetic profiles were analysed using NONLIN. Dry mouth and some nasal stuffiness were reported and postural hypotension occurred in 5/16 subjects at plasma concentrations greater than 0.8 microgram.ml-1. Supine blood pressure was well maintained in all subjects and hypotension resolved within 60-90 min of discontinuing the infusion. There was no evidence of sedation, mood change, nausea, vomiting, miosis, change in accommodation or respiratory depression. Rapid infusions produced transient feelings of warmth, heavy eyelids, heavy legs, and increased bowel sounds, which resolved despite increasing plasma concentrations. The disposition of the peptide was adequately described by a 2-compartment model with a mean +/- SD plasma clearance of 123 +/- 18 ml.min-1 and a half-life of 2.0 +/- 0.4 h.

Adult↗
PubMed1987

Mucosal proctectomy and ileoanal pull-through technique and functional results in 23 consecutive patients.

Mucosal proctectomy with ileoanal pull-through in the treatment of ulcerative colitis and familial polyposis provides a technique for the preservation of the anal sphincters and relatively normal mechanisms of continence. Five patients had straight ileoanal anastomosis while 18 had the construction of a J-pouch. A two-team approach was used for simultaneous abdominal and perineal procedures to facilitate a shortened operating time. A loop ileostomy was routinely used in the postoperative period and was closed an average of 4.5 months (range: 2-16 months) later without complication. Prolonged preoperative hospitalization was rarely necessary and outpatient steroid enema preparation was routinely used. There were no deaths. Nineteen patients with functioning pull-through procedures have been followed an average of 23 months (range: 3-42 months). Two other patients have not had ileostomy closure because of complications. The two remaining patients had intractable diarrhea and have since undergone conversion to a permanent ileostomy. The 19 patients are continent, having three to nine bowel movements each day. Nearly all wear a perineal sanitary pad because of rare, unpredictable leakage of small amounts of fluid, especially at night. Complications were significant in this group of patients. Intestinal obstruction was a frequent problem, occurring in 52 per cent of the entire series and necessitating reoperation in 22 per cent. Anal stricture was a problem in another five patients. A variety of other minor problems occurred and most were treated nonoperatively. In spite of moderate diarrhea and occasional leakage of stool, all patients with functioning pull-through procedures prefer their current status to life with an ileostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenomatous Polyposis Coli↗
PubMed1986

Lay care in illness.

This paper discusses lay care in illness with special reference to research and development in Northern Europe. The discussion concentrates on two components of lay care: individual self-care in illness and self-help groups. Individual self-care in illness is shaped in social environments, and in turn is a major determinant of the type and amount of health care services used. Self-help groups of all kinds have increased in recent years. Groups 'next' to the system and groups opposed to the system increased rapidly during the seventies. A form of self-help group that interfaces more directly with services is now being encouraged by physicians. Major issues concerned with these developments are considered.

Adaptation, Psychological↗
PubMedDate not supplied

Trusting to technology.

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Hospital Information Systems↗