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Biomedical subjects

L Price

Publications and source records attributed to L Price.

At least 91 records · Page 5Linked to original sources
PubMed1990

Nephrotoxicity after ifosfamide.

Eleven children and adolescents with previously normal renal function who received ifosfamide for the treatment of extrarenal solid tumours underwent detailed investigation of glomerular and renal tubular function to assess the incidence and extent of renal damage. None had received cisplatin. Glomerular filtration rate (measured by plasma clearance of 51Cr labelled edetic acid) was reduced in six children. All 11 patients had evidence of proximal, and six of distal, tubular damage. Proximal tubular toxicity was indicated by phosphaturia and hypophosphataemia (n = 4), glycosuria (n = 5), increased urine beta 2 microglobulin excretion (n = 11), and generalised aminoaciduria (n = 10); distal tubular damage caused a reduction of the osmolality of the urine in an early morning sample. Two children developed clinical hypophosphataemic rickets, and one of these also had severe nephrogenic diabetes insipidus. Glomerular and tubular nephrotoxicity are common and potentially serious complications of ifosfamide treatment in children.

Adolescent↗
PubMed1990

A model of cooperation between complementary and allopathic medicine in a primary care setting.

This paper describes an acupuncture and osteopathy service offered free of charge to patients at a National Health Service general practice. The background to the setting up of this service, its organization, funding, aims and philosophy, and the ethical and legal implications for the general practitioners whose patients are treated by complementary therapists are discussed. This service provides a model of cooperation between allopathic and complementary medicine in a primary care setting and could be copied elsewhere.

Acupuncture Therapy↗
PubMed1989

Topographic mapping of quantitative EEG variables in chronic heavy marihuana users: empirical findings with psychiatric patients.

EEG studies of marihuana use dating back to 1945 were reviewed. The earlier studies depended upon visual analysis of the tracing, and while some minor frequency and amplitude variations occurred in some subjects, there was no consistent THC induced change noticeable across subjects. Quantitative EEG studies of acute exposure to THC came later and produced reliable findings of a placebo controlled dose dependent THC induced increase in relative power of alpha, combined with decreased alpha frequency and a reduction of beta activity. These findings were reported for data collected from central-occipital derivations only. In our present investigation, we report that chronic heavy THC users have EEGs characterized by (1) increased absolute power of all frequencies over all cortical areas (2) hyperfrontality of elevated relative and absolute power and coherence values of alpha activity, and (3) a decrease in relative power of all non-alpha frequencies. Methodological issues were discussed and some suggestions were made for continuing research in this area.

Adult↗
PubMed1989

Midazolam in upper gastrointestinal endoscopy: a single-blind dose-finding study.

Midazolam is a water soluble benzodiazepine with potent sedative and amnestic properties. Sixty unpremedicated patients who were to undergo upper endoscopy for diagnostic purposes were enrolled in an open, non-randomized study to assess the efficacy of 4 increasing dosages of midazolam (0.05, 0.10, 0.15 and 0.20 mg/kg). Efficacy measures included Trieger test (psychomotor drawing), presence of anterograde amnesia, patient rating (PR) of the sedation, evidence of inflammation at the site of the injection and physician's global assessment (PGA). The 4 patient groups were similar in age, sex and ASA class. Eight of the 15 patients who received the 0.05 mg/kg and 1 patient each in the 0.10 mg/kg and 0.15 mg/kg group were considered to be treatment failures and required supplemental diazepam. PR (excellent-good) was constant for all doses throughout. Nearly all patients had anterograde amnesia. Deterioration in the Trieger test results was associated with increasing dose (ANOVA, p less than 0.05). There were no significant changes in vital signs. Signs of phlebitis were noted in two patients who received both diazepam and midazolam. PGA rating rose from 26.7% (0.05 mg/kg) to 80.0% (0.20 mg/kg) (p less than 0.01). Few adverse effects (unrelated to dosage) were noted. Midazolam is a well tolerated benzodiazepine which provides satisfactory sedation for endoscopy. If no premedication is given, there are no benefits to be gained from using a dose greater than 0.10 mg/kg.

Adult↗
PubMed1985

False negative angiogram in pulmonary embolism.

A 19-year-old woman presented with symptoms of pulmonary infarction and an abnormal perfusion scan compatible with pulmonary embolism. Pulmonary angiogram performed utilizing two bolus injections in the frontal plane and recorded on multiple cut films was reported as normal. This false negative angiogram points out the need for modifications in conventional pulmonary angiographic technique.

Adult↗
PubMed1982

DSM III and consultation-liaison psychiatry: toward a comprehensive medical model of the patient.

The descriptive and multiaxial approaches in DSM III encourage comprehensive conceptualization of the patient. The use of explicit criteria for diagnosing syndromes facilitates communication between psychiatry and general medicine. The DSM III category Psychological Factors Affecting Physical Condition should be further elaborated into (a) Psychiatric Factors Affecting Physical Condition, and (b) Physical Condition Affecting Psychiatric Disorder. In addition, the phase of the illness these factors affect should be specified, i.e., the precipitation, course, and recovery. Somatoform Disorder should not be a diagnosis of exclusion, and the diagnostic criteria should clearly specify that conversion symptoms may be superimposed on a pre-existing physical disorder. The DSM III axes are not coherent: they include diagnostic categories, statements concerning possible relationships, and factors that might affect outcome. We propose an alternative to the DSM III Axes based on the Patient Evaluation Grid (PEG), a system comprised of four axes, including Biological Dimension, Personal Dimension, Environmental Dimension, and Assessment of Interaction Among Dimensions. Developing a comprehensive diagnostic model for both medical and psychiatric patients that can be shared by all physicians may be an important function of the liaison psychiatrist.

Depressive Disorder↗
PubMed1982

Sydney Eye Hospital.

This year, 1982, marks the centenary of the Sydney Eye Hospital, originally the ophthalmic department of the old Sydney Infirmary, which was founded with the settlement of the Colony in 1788. Established in 1882, the hospital was transferred to its present site 60 years ago, and it still provides ward accommodation. After alternating periods of stagnation and progress the new hospital (stage 1) was completed in 1974, with modern clinic and research facilities. It is now the largest eye hospital in the southern hemisphere and is a first-class referral centre with an annual attendance of 75,000. The Department of Ophthalmology, University of Sydney, is based at the hospital, providing undergraduate instruction and a comprehensive postgraduate training programme for Australian ophthalmologists and others in more distant continents.

Australia↗
PubMed1982

A self-supporting library service in a rural region: a new look at hospital consortia.

To meet the informational needs of health care practitioners and trainees in a four-county rural area of northwestern North Carolina, the eleven-member UNIFOUR Consortium was founded as a two-year experimental project from 1978 to 1980. The consortium has several unique features: (1) it is an organization of institutions, not libraries; (2) it employs its own professional librarian who manages a central library, coordinates consortium programs, and makes regular circuit visits to all affiliated institutions; (3) the central library, where the circuit is based, is a developing community hospital library, not an established academic medical center library; and (4) it is ultimately tied to the Northwest Area Health Education Center and that organization's emerging learning resources network, which includes the Bowman Gray School of Medicine, Library, two other subregional libraries, and the libraries of all member institutions. At the end of the experimental period in 1980, member institutions voted unanimously to continue the program and assume their share of the costs.

Libraries, Hospital↗