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Biomedical subjects

M Coleman

Publications and source records attributed to M Coleman.

At least 379 records · Page 21Linked to original sources
PubMedDate not supplied

Patients' knowledge of perioperative care.

BACKGROUND: Patient knowledge of perioperative care, particularly the role of the anaesthetist, appears limited. AIM: This study investigated patients' knowledge of common medical terms, of their surgical care, of the role of the anaesthetist, and their preoperative fears and concerns about postoperative pain. We examined the changes in their knowledge base as a result of the pre-anaesthetic visit and their inpatient stay. METHODS: Three hundred patients were surveyed on three separate occasions, before a routine pre-anaesthetic visit, two to three hours after this visit and on the day of discharge from hospital. RESULTS: Patients' knowledge of medical terms, their surgical procedure, and the role of the anaesthetist in their perioperative care were limited. There was little change following either the pre-anaesthetic visit or postoperative convalescence. Misconceptions, about such issues as postoperative pain, appeared to increase by the end of their hospital stay. Male patients, older patients and patients in lower socio-economic groups had poorer knowledge. A significant proportion of patients remained unaware that the anaesthetist was medically qualified. CONCLUSIONS: Patients' knowledge of perioperative care is limited, with very little change during hospital stay. Novel educational approaches may be required to increase basic medical knowledge.

Anesthesia↗
PubMedDate not supplied

Site-directed isotope labeling and FTIR spectroscopy: assignment of tyrosine bands in the bR-->M difference spectrum of bacteriorhodopsin.

Fourier transform infrared difference spectroscopy has been used extensively to probe structural changes in bacteriorthodopsin and other retinal proteins. However, the absence of a general method to assign bands to individual chemical groups in a protein has limited the application of this technique. While site-directed mutagenesis has been successful in special cases for such assignments, in general, this approach induces perturbations in the structure and function of the protein, thereby preventing unambiguous band assignments. A new approach has recently been reported (Sonar et al., Nature Struct. Biol. 1 (1994) 512-517) which involves cell-free expression of bacteriorhodopsin and site-directed isotope labeling (SDIL). We have now used this method to re-examine bands assigned in the bR-->M difference spectrum to tyrosine residues. Our results show that out of 11 tyrosines in bR, only Tyr 185 is structurally active. This work further demonstrates the power of SDIL and FTIR to probe conformational changes at the level of individual amino acid residues in proteins.

Amino Acid Sequence↗
PubMedDate not supplied

Scleroderma renal crisis: poor outcome despite aggressive antihypertensive treatment.

BACKGROUND: Scleroderma renal crisis (SRC) is a rare but feared complication of scleroderma. Angiotensin--converting enzyme (ACE) inhibition has significantly improved survival, but it is unknown whether prophylactic ACE inhibitors will prevent this complication. AIMS: To determine: (i) the frequency of SRC in our cohort of well-characterized scleroderma patients resident in South Australia, (ii) any predisposing clinical and serological features, (iii) median disease duration at which SRC occurs, (iv) possible precipitants, (v) disease outcome, and (vi) whether patients were taking ACE inhibitors prior to onset of SRC. METHODS: Systematic review of the clinical course of all patients registered on the South Australian Scleroderma Register. RESULTS: SRC occurred in 16 patients. This constituted 2.8% of a total scleroderma cohort and 15% of the diffuse scleroderma cohort identified in South Australia. All 16 patients had diffuse cutaneous scleroderma. SRC occurred at a median disease duration of 15 months (range 1 week-11 years). Disease outcome was poor (five deaths, three requiring long-term dialysis and only two patients regaining a normal creatinine) despite aggressive antihypertensive treatment (including ACE inhibitors) in an intensive care or specialized renal unit. Two patients were later able to discontinue dialysis. Only two patients were taking small doses of ACE inhibitors prior to the onset of their SRC. The frequency of Scl-70 was decreased in the SRC group (P = 0.003). CONCLUSION: SRC is a rare event occurring in a small proportion of patients with diffuse scleroderma. The outcome of SRC was poor despite aggressive antihypertensive treatment. It is hypothesized that prophylactic ACE inhibition in susceptible patients might prevent or ameliorate this complication.

Adult↗
PubMedDate not supplied

Case report: splenectomy in patients with Hodgkin's disease and marrow hypoplasia.

Two patients with Hodgkin's disease and hypoplastic bone marrow underwent splenectomy in an attempt to reverse pancytopenia and to improve chemotherapeutic tolerance. Although the peripheral blood counts were improved, the clinical course was not significantly affected. Infectious complications occurred. This suggests that the peripheral hematologic improvement following splenectomy may not reflect a true improvement in marrow tolerance.

Adult↗