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Biomedical subjects

M Chambers

Publications and source records attributed to M Chambers.

At least 55 records · Page 3Linked to original sources
PubMed1991

Effect of contact on nursing students' attitudes to patients.

Shortly before and shortly after they went on district nurse and mental handicap placements the attitudes of university nursing students to elderly people, people who are disabled and people with a mental handicap were assessed. Before the placements the students had a more favourable attitude towards elderly people and towards those who are disabled than towards those with a mental handicap. After the placements their attitudes towards those with a disability had improved. These findings are discussed with reference to the character of the placements.

Adult↗
PubMed1991

Endopyelotomy: review of results and complications.

Percutaneous endopyelotomy augmented by balloon dilation was performed on 27 of 40 patients for the treatment of symptomatic, primary ureteropelvic junction obstruction. Percutaneous ultrasonic lithotripsy was performed simultaneously on 12 of 27 patients (44%) for associated calculi. After endopyelotomy 24 of 27 patients became asymptomatic (clinical success rate 89%). Three clinically improved patients demonstrated only radiographic stability, while radiographic improvement was documented in 21 of 27 (radiographic success rate 78%). Adjuvant percutaneous ultrasonic lithotripsy was successful from the standpoint of stone removal in all patients and no increased morbidity could be identified. Of 27 patients 3 (11%) suffered major complications and are considered failures. Reasons for failure varied and are discussed. Included is a patient who at nephrostography and stent capping became septic and subsequently died. To decrease the risk of sepsis perioperative antibiotics to include at the time of nephrostomy tube capping are recommended. Angiography was performed in 19 of 40 patients to rule out an accessory crossing vessel at the ureteropelvic junction, and such a vessel was found in 6. From analysis of presenting excretory urograms (IVPs) we conclude that a crossing vessel cannot predictably be identified on an IVP.

Catheterization↗
PubMed1990

Measuring readmission rates.

OBJECTIVE: To assess the feasibility of extracting data on readmissions and readmission rates from Körner data for use as health service indicators. DESIGN: Retrospective analysis of inpatient Körner data for January 1988 to April 1989. SETTING: Three districts in North East Thames region. MAIN OUTCOME MEASURES: Number of readmissions after index discharge for all acute specialties combined and by specialty (general medicine, general surgery, gynaecology, trauma and orthopaedics, and geriatrics); readmission rates at 28 days after index discharge; and rates standardised for age group and sex by specialty and by consultant. RESULTS: All specialties showed an early peak in number of admissions, which levelled off by 28 days. Readmission rates at 28 days were appreciably lower in surgical specialties than in medical specialties (for example, general surgery 4.1% v geriatric medicine 15.1%). They were related to age and sex of the patient. Rates standardised for these variables did not significantly differ by district. Likewise, significant differences in standardised rates were not obtained for consultants within a specialty in one district. CONCLUSIONS: Readmission rates may be measured with Körner data. The pattern of readmissions with time means that readmission rates should be measured at not more than 28 days after the index discharge; the rates require standardisation for age and sex. Annual comparisons of standardised rates may be made among districts for combinations of specialties; those among individual consultants or specialties are unlikely to be statistically valid.

Adolescent↗
PubMed1990

Computer training in nurse education: a bird's eye view across the UK.

This paper is borne of the increasing interest and relevance of computers in nursing. It describes the method, and results obtained from a postal questionnaire survey distributed across the United Kingdom to gain information about the developments in computing in nursing education. The results indicate that considerable developments have been made, but that they are more piecemeal than co-ordinated. A selection of the results are presented and discussed, and one or two points concerning future proceedings are raised.

Computer Systems↗
PubMed1990

Characteristics of students entering different forms of nurse training.

Developments in nurse training need to be based upon an understanding of the characteristics and aspirations of students. In this study, characteristics of a sample of registered nurses (n = 27) and students (n = 41) entering an undergraduate degree programme in nursing were compared with those of student nurses (n = 46) beginning training in a college of nursing. It was found that the three groups differed in terms of their social background, their reasons for becoming a nurse, their views on nursing, their perceived social competence and their views on the role of the nurse vis-à-vis the doctor. Certain sex and social class differences were also apparent. The findings are discussed with reference to the selection of students for different forms of training and the content of current nurse training programmes.

Adult↗
PubMed1989

Analgesia after hip replacement surgery: comparison of nalbuphine with morphine.

Two groups of 40 patients undergoing hip replacement received either nalbuphine 0.3 mg kg-1 or morphine 0.15 mg kg-1 i.m. on up to three occasions: 1 h before operation, as soon as requested after operation, and 3 h subsequently if required. Pain intensity was assessed by the patient as severe, moderate or none, and pain relief by a "blind" nurse observer as slight, moderate or complete. Assessments of pain and sedation were carried out at 30-min intervals for 2 h and at 1-h intervals thereafter for up to 6 h. Six patients who received nalbuphine and eight who received morphine before operation required no postoperative analgesia. Ten patients in the nalbuphine group and two in the morphine group failed to obtain adequate pain relief (P less than 0.05) and were given i.v. morphine.

Analgesia↗
PubMed1989

Teaching microcomputing to student nurses: an evaluation.

This paper describes an introductory computer course designed for student nurses facing a career in nursing in which computers will play a major part. Questionnaires were given before and after the course. The purpose of the questionnaires were (a) initially to gain information about the students' previous computing experience, motivation and expectations of the course, and (b) to enable an evaluation to be undertaken. The course content, structure and results of the questionnaires are presented; modifications made to the course following the evaluation are mentioned and finally some of the issues which need to be considered when developing a computer course for nurses are raised.

Computer User Training↗
PubMed1988

Curriculum evaluation: an approach towards appraising a post-basic psychiatric nursing course.

Recently, considerable interest has been generated in the area of curriculum evaluation, most of which has concentrated on basic nurse education. This paper describes how an illuminative evaluation approach was used to examine the curriculum for a post-basic psychiatric nursing course. Following a brief introduction to curriculum evaluation it outlines the various methods of data collection and analysis, adds a word of caution and concludes by saying: the study revealed that psychiatric nurses were being trained to a high standard in a pleasant, relaxed environment where the standard of nursing care and the commitment of all involved was excellent.

Curriculum↗
PubMed1987

Basolateral membrane Cl/HCO3 exchange in the rat proximal convoluted tubule. Na-dependent and -independent modes.

To examine whether Cl-coupled HCO3 transport mechanisms were present on the basolateral membrane of the mammalian proximal tubule, cell pH was measured in the microperfused rat proximal convoluted tubule using the pH-sensitive, intracellularly trapped fluorescent dye (2',7')-bis(carboxyethyl)-(5,6)-carboxyfluorescein. Increasing the peritubular Cl concentration from 0 to 128.6 meq/liter caused cell pH to decrease from 7.34 +/- 0.04 to 7.21 +/- 0.04 (p less than 0.001). With more acid extracellular fluid (pH 6.62), a similar increase in the peritubular Cl concentration caused cell pH to decrease by a similar amount from 6.97 +/- 0.04 to 6.84 +/- 0.05 (p less than 0.001). This effect was blocked by 1 mM SITS. To examine the Na dependence of Cl/HCO3 exchange, the above studies were repeated in the absence of luminal and peritubular Na. In alkaline Na-free solutions, peritubular Cl addition caused cell pH to decrease from 7.57 +/- 0.06 to 7.53 +/- 0.06 (p less than 0.025); in acid Na-free solutions, peritubular Cl addition caused cell pH to decrease from 7.21 +/- 0.04 to 7.19 +/- 0.04 (p less than 0.05). The effect of Cl on cell pH was smaller in the absence of luminal and peritubular Na than in its presence. To examine whether the previously described Na/(HCO3)n greater than 1 cotransporter was coupled to or dependent on Cl, the effect of lowering the peritubular Na concentration from 147 to 25 meq/liter was examined in the absence of ambient Cl. Cell pH decreased from 7.28 +/- 0.03 to 7.08 +/- 0.03, a response similar to that observed previously in the presence of Cl. The results demonstrate that Cl/HCO3 (or Cl/OH) exchange is present on the basolateral membrane. Most of Cl/HCO3 exchange is dependent on the presence of Na and may be coupled to it. The previously described Na/(HCO3)n greater than 1 cotransporter is the major basolateral membrane pathway for the coupling of Na and HCO3 and is not coupled to Cl.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗
PubMed1987

Reactions to blindness: a four-year follow-up study.

A previously studied group of newly blind adults was followed up after four years. There was only a slight increase in the acquisition of blind skills, while there was a surprising continuing pervasiveness of depression and poor health. A number of variables from the original study and from the follow-up data predicted outcome measures. Significant predictors of depression and distress were poor health, being married, being nonProtestant in this predominantly Protestant London population, and lacking ability to be more independent. Higher social class and an absence of a family history of blindness predicted greater distress. Earlier acceptance of blindness, early learning of blind skills, and better preillness adjustment predicted better coping and greater use of blind skills at follow-up. The extent of the depression and poor health are discussed, and recommendations are made for caregivers.

Adaptation, Psychological↗
PubMed1986

Cell pH in the rat proximal convoluted tubule. Regulation by luminal and peritubular pH and sodium concentration.

To examine the relative roles of apical and basolateral membrane transport mechanisms in the regulation of cell pH in the proximal convoluted tubule, cell pH was measured in the in vivo microperfused rat tubule using fluorescence. Decreasing luminal pH by 0.7 pH units caused cell pH to decrease by 0.08 pH units, whereas a similar decrease in peritubular pH caused cell pH to decrease by 0.32 pH units. Inhibition of basolateral membrane bicarbonate transport with peritubular 4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonate (SITS) enhanced the response to luminal fluid acidification. Removal of luminal sodium caused a small transient acidification which was followed by a late alkalinization. Peritubular SITS increased the magnitude of the transient acidification, and eliminated the late alkalinization. The acidification was partially inhibited by luminal amiloride. The results demonstrate sodium-coupled processes on both the apical (Na/H antiport) and basolateral (Na/HCO3 symport) membranes. Basolateral membrane transporters are more important determinants of cell pH.

Amiloride↗
PubMed1985

Experimental wound healing: increased breaking strength and collagen synthetic activity in abdominal fascial wounds healing with secondary closure of the skin.

Delayed primary closure or secondary closure of skin and subcutaneous fat in contaminated laparotomy incisions virtually eliminates the risk of wound abscess in clinical practice. Incisional hernias rarely develop in these wounds. This experimental study offers a possible explanation. Longitudinal incisions in the linea alba of female Wistar rats healed under skin incisions which were either sutured ('closed' subgroup) or left to close by secondary intention ('open' subgroup). Postoperative breaking strengths and collagen contents (measured as hydroxyproline) were studied at intervals of 3-120 days. Measurable strength developed by 5 days, at which time 'open' subgroup wounds were found to be weaker and to have less collagen. At all other times, however, 'open' subgroup wounds were stronger, a property which could be ascribed at earlier, but not at later, periods (42 or 120 days), to a higher content and concentration of collagen. At 3 days the rate of collagen production was significantly (P less than 0.025) lower in 'open' than in 'closed' subgroup wounds but the converse was true at 6 and 9 days (P less than 0.025), thus accounting for the changes in biomechanical properties. It is suggested that initially the stimulus for collagen synthesis is greater in the 'open' wounds and this leads to the development of a collagenous structure which is better adapted to resist tensile forces.

Abdominal Muscles↗
PubMed1985

Abnormal regulation of in vitro IgE synthesis by T cells obtained from patients with atopic dermatitis.

The regulatory influence of atopic eczema and non-atopic T cells on spontaneous IgE synthesis by eczema B cells was examined. Eczema B cells were cocultured with either autologous or allogeneic T cells in RPMI 1640 with 10% fetal calf serum at 0.75 X 10(6) cells/ml (B/T = 0.5) and supernatant IgE was measured by a modified PRIST assay. Net IgE synthesis was obtained by subtracting preformed IgE (+ cycloheximide at Day 0) from total IgE in 7-day supernatants. T cells were either untreated, heat-killed, exposed to 2000 rad, or depleted of helper/suppressor T cells by "panning" with monoclonal antibodies (Leu 3a and Leu 2a). Atopic eczema B cells spontaneously synthesized IgE when cultured alone. No significant suppression of net IgE synthesis occurred when atopic eczema T cells were cocultured with autologous B cells. In allogeneic recombinations, non-atopic T cells significantly suppressed net IgE synthesis by atopic eczema B cells (mean suppression = 59%; P less than 0.05). This suppression was abrogated if allogeneic control T cells were heat-killed, irradiated, or depleted of Leu 2a+ suppressor cells. In order to exclude an "allogeneic effect" as the sole mechanism to explain the suppression of IgE synthesis observed by coculturing non-atopic T cells with eczema B cells, the latter were recombined with either T cells from HLA-DR and mixed lymphocyte culture-matched sibling or autologous T cells. Greater suppression of net IgE synthesis was seen in the presence of histoidentical non-atopic T cells than in the presence of autologous eczema T cells, indicating that the latter have a partial defect in their suppressor function. This apparent "defect" in immunoregulatory function may be overcome by in vitro activation of atopic eczema T cells by concanavalin A.

Adolescent↗
PubMed1985

Effect of dexamethasone on de novo IgE synthesis by human blood lymphocytes.

The effect of dexamethasone (DM) on de novo in vitro total IgE synthesis by blood mononuclear cells (MNC) was studied in atopic patients with eczema and in nonatopic control subjects. Unfractionated blood MNC were cultured at 1 X 10(6) cells per milliliter for 7 days in RPMI 1640 with 10% fetal calf serum with or without decreasing concentrations of DM (10(-7) to 10(-11). Net IgE synthesis was calculated by subtracting preformed (+ cycloheximide at day 0) from total IgE in 7-day supernatants. Supernatant IgE was measured by use of a modified PRIST assay. A significant increase in net IgE synthesis occurred in the presence of DM in 11 of 11 atopic patients with eczema (mean percent increase = 68%; p less than 0.05) and five of five atopic patients without eczema (mean percent increase = 53%; p 0.05) but not in seven of seven nonatopic controls. This increase in de novo IgE synthesis could not be explained by a significant change in cell viability. In five of five experiments, a mean increase of 78% was still noted when DM was added to atopic blood MNCs depleted of T cells by sheep red blood cell rosetting. The addition of 10(-9)M of DM to eczema B+ T cell recombinations enriched for suppressor cells (depleted of Leu 3a+ helper T cells) resulted in a loss of suppressor-T cell activity and maximal augmentation of IgE synthesis. Enhancement of IgE synthesis was also noted when DM was added to eczema B+ T cell recombinations enriched for helper T cells (depleted of suppressor Leu 2a+ T cells).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

The immortalization of human lymphocytes by spheroplast fusion.

A method for immortalizing animal cells based on the spheroplast fusion technique of Schaffner is being developed. Human lymphocytes have been fused with E. coli spheroplasts containing the plasmid pTSV3, which represents the entire SV40 genome cloned into the EcoRI restriction enzyme site of the plasmid pAT153. The efficiency of transformation was examined using pTSV3 and derivatives which have deletions in parts of the late gene sequences. Although there was a marked increase in the survival time of the lymphocyte cultures after fusion compared with cells which had been mitogen-stimulated but not fused, the cells did not continue to proliferate indefinitely. Attempts are now being made to extend the survival time by culturing the transformed lymphocytes in the presence of feeder cells.

Cell Division↗
PubMed1982

Antipyrine elimination in saliva after low-dose combined or progestogen-only oral contraceptive steroids.

1 A 'low-dose' combined oral contraceptive steroid (OCS) preparation containing 30 microgram ethinylo-estradiol and 150 microgram levonorgestrel was found to reduce significantly antipyrine clearance in a group of women acting as their own controls. 2 An OCS preparation containing only a progestogen (75 microgram norgestrel) did not reduce antipyrine clearance in a second group of women. 3 The evidence suggesting that the oestrogen component of combined OCS preparations could be responsible for the reduction in antipyrine clearance is discussed.

Adolescent↗