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Biomedical subjects

L Burnett

Publications and source records attributed to L Burnett.

At least 37 records · Page 2Linked to original sources
PubMed1995

Application of CQI tools to the reduction in risk of needlestick injury.

OBJECTIVE: To reduce the risk of needlestick injuries to laboratory workers. DESIGN: Continuous Quality Improvement (CQI) tools were applied to data collected on the number of blood gas syringes that arrived in the laboratory with needles still attached and to the reasons for these occurrences. SETTING: A clinical chemistry department within a 900-bed tertiary referral university teaching hospital. PARTICIPANTS: Clinical chemistry laboratory staff and medical staff responsible for sending syringes with needles still attached. INTERVENTIONS: Changing to a preheparinized blood gas syringe that included a syringe cap within the packaging. RESULTS: Fivefold reduction in the number of syringes arriving in the laboratory with needles still attached. CONCLUSION: The risk of needlestick injury to laboratory workers can be reduced by provision to clinical staff of preheparinized blood gas syringes that include a syringe cap within the packaging. The techniques to CQI provide powerful tools for the identification, solving, and monitoring of safety-related issues within the healthcare environment.

Accidents, Occupational↗
PubMed1994

Decremental motor responses to repetitive nerve stimulation in ALS.

Repetitive nerve stimulation (RNS) of the trapezius muscle at slow rates was performed on 192 patients with amyotrophic lateral sclerosis (ALS). Fifty-six patients (29%) showed classical neuromuscular decrement of 10-43% (mean 16.8%) while 44 patients (23%) had a borderline decrement of 5-9%. The trapezius was significantly more sensitive in revealing the defect than the distal hypothenar muscles. In 30 patients followed serially, the decremental response remained constant or increased with time. However, 25% of patients continued to show no decrement in spite of progression of disease. No statistical correlation was found between decrement and clinical severity, disease staging, or disease progression. The finding that at least 50% of ALS patients show some degree of decrement on RNS of the trapezius muscle suggests that functional alterations of the neuromuscular junction accompany this disease.

Action Potentials↗
PubMed1994

The ovarian remnant syndrome and ureteral obstruction: medical management.

The ovarian remnant syndrome represents the development of symptoms due to residual ovarian tissue after bilateral salpingo-oophorectomy. Treatment generally consists of surgical resection but recurrence after resection is common. A case is reported in which a postoperative recurrent ovarian remnant was successfully managed by using a luteinizing hormone-releasing hormone agonist. In addition, this report includes a survey of gynecologists to determine the frequency of this syndrome and of ureteral involvement.

Adult↗
PubMed1994

Ageing and the pursuit of slimness: dietary restraint and weight satisfaction in elderly women.

Dieting and body dissatisfaction are highly prevalent amongst young women. In this study, dietary restraint, disinhibited eating, eating attitudes and body satisfaction were compared in elderly (ES) and young (YS) normal weight women. Dietary restraint and eating attitudes were similar across age groups. Differences between current body weight and desired body weight were equivalent for both age groups (ES, M = 10.8, SEM = 1.8 lb; YS, M = 11.3, SEM = 1.2 lb), although young women (Body Shape Questionnaire, BSQ, M = 78.5, SEM = 5.8) reported significantly greater dissatisfaction with their bodies than the elderly (BSQ, M = 61.7, SEM = 2.9). Of the elderly who had dieted, the majority had dieted five times or less, had started dieting between the ages of 40 and 50 years, and very few had dieted in their teens or twenties (< 8 per cent). Despite normal weight status, desire to lose weight and attempts to achieve this are experienced by young and old alike.

Adult↗
PubMed1994

Applying the Australian Quality Awards criteria to a clinical chemistry department.

National quality award schemes can provide a detailed self-assessment process enabling an organization to assess its current position and to highlight opportunities for further improvement along the road to implementing best practice. This article describes how the Australian Quality Awards were used to guide the intermediate stages of implementation and to integrate some advanced stages of implementation of total quality management within a clinical chemistry department.

Australia↗
PubMed1993

Familial hypobetalipoproteinaemia: a rare presentation to the lipid clinic.

OBJECTIVE: To report a case of familial hypobetalipoproteinaemia in a woman who presented after the incidental finding of marked hypocholesterolaemia during laboratory tests. CLINICAL FEATURES: An asymptomatic 37-year-old Lebanese woman presented to the lipid clinic with a serum total cholesterol concentration of 1.1 mmol/L, high density lipoprotein (HDL) cholesterol of 1.0 mmol/L, and triglycerides of 0.28 mmol/L. No secondary cause for the hypocholesterolaemia was established. INVESTIGATION AND OUTCOME: Her serum apolipoprotein B (apo B) levels were markedly reduced at 0.07 g/L. Except for one daughter (IV-4), all other family members including her husband (her first cousin) had apo B levels about 25% of normal. Daughter IV-4 had undetectable apo B levels. Family studies confirmed an autosomal dominant pattern of inheritance consistent with familial hypobetalipoproteinaemia. CONCLUSION: Familial hypobetalipoproteinaemia is a rare condition that should be considered in the differential diagnosis of hypocholesterolaemia. Absence of clinical features, autosomal dominant pattern of inheritance, and reduced apo B levels suggest the diagnosis.

Adolescent↗
PubMed1993

Introduction of total quality management into a clinical chemistry laboratory.

Total quality management (TQM) was introduced into a clinical chemistry laboratory department. During the first 9 months, 35 quality improvement projects were introduced, involving 87% of the Department's staff. As a result of these projects and with a capped budget, a range of new clinical services was introduced, significant improvements in the speed of Departmental services was documented, productivity improvements were achieved, and a 10-fold reduction in staff resignations occurred. The major hindrance encountered was the lack of interest from other non-quality orientated departments elsewhere in the hospital.

Chemistry, Clinical↗
PubMed1992

Randomised controlled trial of exercise in the elderly.

Eighty-seven healthy volunteers aged 60-81 years were randomly allocated to either an aerobic exercise class or a health education group. Only 6 subjects dropped out during the 32-week study, and the average compliance with the interventions was 83% for exercise (on average 83/100 individual exercise sessions were attended) and 71% for health education. The health education group showed improvements from the baseline in physical activity levels, pulse rate, blood pressure and self-rating of mood. The exercise group improved from baseline in knee and spine flexibility, leg and back strength, pulse rate, blood pressure, maximum physical exertion levels, self-rating of mood and perceived health status. Between group comparison at the end of the study showed the exercise group significantly better than the health education group in terms of spine flexion (p < 0.0001), perceived health status (p < 0.05), life satisfaction (p = 0.05) and maximal physical exertion (p = 0.01). This study has demonstrated the acceptability and effectiveness of an aerobic exercise class for the elderly, and the effectiveness of health education for this age group.

Aged↗
PubMed1992

Chorea and ballism.

Chorea and ballism are hyperkinetic movement disorders which can be caused by a variety of conditions including metabolic abnormalities, neurodegenerative and immunologic disorders, as well as structural lesions. In addition, paroxysmal dyskinesias may be associated with chorea. Chorea is increasingly recognized as a symptom of a variety of different conditions. The pathophysiologic mechanisms underlying choreic disorders, however, need further elucidation.

Athetosis↗
PubMed1991

Restrictions on 'multiple biochemical analyses' profiling decreases usage of biochemistry test requests.

One hundred and forty two thousand near-consecutive pathology episodes in a private practice laboratory were reviewed. During this period, a new government Medical Benefits Schedule (Pathology Services Table) was introduced which restricted the usage of the 'Multiple Biochemistry Analyses' (MBA) test profile. We found that requesting practitioners, when deprived of the use of the MBA profile, altered their biochemical requesting patterns and that usage of other permitted biochemical profiles increased. However, the overall use of biochemical tests decreased over the survey period, and the cost to the community of biochemical tests performed was lowered.

Australia↗
PubMed1991

A tree-structure model for analyzing laboratory test costs.

A method of costing clinical laboratory tests is described in which total laboratory costs are apportioned into 3 components: an 'organizational overhead cost' to describe the cost of running an organization; a 'cost per episode' to describe the costs incurred per request; and a 'cost per test' to describe the actual analytical costs of tests performed. A tree-like structural model is described which allows for distribution of this 'cost per test' component to the contributing tests and the calculation of the true 'cost per test'. The implementation of this model on a computer spreadsheet has been achieved. When combined with the other cost components, the true total costs of laboratory testing can be determined for any particular test. The model also allows calculation of the incremental and marginal costs of a test and permits optimization of laboratory test frequencies and work-load to minimize laboratory analytical costs.

Algorithms↗
PubMed1990

An audit of oral glucose tolerance test requests.

Requests for 1862 randomly selected oral glucose tolerance tests (OGTT) were reviewed in a general pathology practice. In non-pregnant patients, only 76% of OGTT requests were for the standard 2-hour OGTT. In pregnant patients, 21% of referrals were for the standard 2-hour OGTT, 75% were for a 1-hour screening test following a 50-g oral glucose load, 1% were for a 3-hour OGTT following a 100-g oral glucose load, and 3% were for other variants. Of 922 standardized 2-hour OGTTs performed, 70% may not have been medically necessary and a further 10% resulted in an uninterpretable outcome. Considerable misunderstanding appears to remain within the medical community as to when an OGTT is indicated. There also appears to be little standardization on the tests performed for the detection and diagnosis of gestational diabetes.

Australia↗
PubMed1990

Randomised controlled trial of recombinant human interferon -alpha A for chronic active hepatitis B.

The efficacy of interferon treatment for Australian patients with chronic active hepatitis B (CAH-B) was assessed by a three-centre randomised controlled trial in Sydney and Brisbane. Thirty patients (29 with histologically-proven CAH-B with and without cirrhosis and one with chronic persistent hepatitis) were allocated to receive either thrice weekly intramuscular injections of recombinant human leucocyte interferon -alpha A (either 2.5, 5.0 or 10.0 million units/m2) for six months followed by 12 months of observation, or to be observed for 18 months without active treatment. Three of 23 treated patients but none of seven controls underwent clinical, biochemical and histological resolution of their disease with loss of HBsAg, HBeAg and HBV-DNA from serum. An additional six treated and two control patients underwent a sustained partial remission of their disease. This was characterised by resolution of symptoms and serum aminotransferase abnormalities in association with seroconversion from HBeAg positive to negative, loss of HBV-DNA from serum but persistent hepatitis B surface antigenaemia. In such patients, there was significant improvement in histological appearances but some necroinflammatory activity remained and fibrosis was unchanged. Although total response rates were similar in treated and control subjects, they appeared to occur earlier after interferon treatment. Treatment with interferon was associated with predictable but minor side effects that usually did not necessitate dose reduction and rarely compromised the patient's life style. Interferon is thus a feasible treatment for CAH-B. Complete responses occurred only in treated patients and partial responses appeared to occur earlier in treated than in untreated patients. However, differences in the partial response rate at 18 months were not significant and seroconversion from HBeAg positive to negative was not associated with complete histological resolution of disease activity. Hence, while interferon is a promising agent for treatment of CAH-B, efforts must continue to define more optimal treatment regimes and to identify those patients most likely to respond to this agent.

Adult↗
PubMed1988

Survival of a dog with pneumonia caused by Mycobacterium fortuitum.

Pneumonia caused by Mycobacterium fortuitum was diagnosed in the left lung lobes of a 3-year-old male Samoyed. Unilateral pneumonectomy and antibiotic treatment (primarily amoxicillin trihydrate-clavulanate potassium and kanamycin) were associated with resolution of the pneumonia. In dogs, M fortuitum causes pulmonary disease that radiographically resembles bacterial pneumonia. Therefore, M fortuitum infection should be considered in dogs with radiographic signs of bronchopneumonia that worsen despite antibiotic treatment.

Animals↗