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Biomedical subjects

M Riley

Publications and source records attributed to M Riley.

144 records · Page 8Linked to original sources
PubMedDate not supplied

Cardiopulmonary exercise testing in the pre-operative assessment of patients for repair of abdominal aortic aneurysm.

We have investigated the value of cardiopulmonary exercise testing in the pre-operative assessment to patients for abdominal aortic aneurysm repair. Thirty-six patients were entered into the study. All had a pre-operative clinical assessment and investigations including chest radiograph, electrocardiograph, spirometry and echocardiogram with measurement of left ventricular ejection fraction. Each patient performed a symptom limited treadmill exercise test using a STEEP protocol with on-line measurement of respiratory gas exchange. Patients were followed up for 12 months post-operatively by review of casenotes. Thirty out of 36 patients had surgical repair of abdominal aortic aneurysm. There was 1 death in the perioperative period and 2 deaths in the following 12 months. Seven other patients suffered post-operative complications. There were no significant differences in left ventricular ejection fraction, spirometry and peak achieved oxygen consumption (PVO2) between those patients who died or who had post-operative complications and those who had not. However, PVO2 < 20 ml/min/kg was found in 70 per cent of patients who had complications compared with 50 per cent of those who had not. Also 4 patients considered medically unfit for surgery all had PVO2 < 20 ml/min/kg. Cardiopulmonary exercise testing with measurement of PVO2 may be helpful in identifying patients more at risk of post-operative complications but should not be used in isolation without through clinical assessment.

Aged↗
PubMedDate not supplied

Validation of the Victorian Perinatal Morbidity Statistics form: new items, pre-coded text and free text.

This study assessed the quality of information on the form used by the Victorian Perinatal Data Collection Unit. Information relating to four new and one modified data items, and to pre-coded and free text regions relating to maternal morbidity, was compared with that in the medical record. The new data items were documented correctly on 95.5% of forms, as were 67% of pre-coded conditions. Between 53% and 75% of free text items were correctly recorded. The results highlight the need for information and education sessions for midwives and other staff in order to collect and maintain high quality data.

Congenital Abnormalities↗
PubMedDate not supplied

Validating a statewide data collection: differences in information technology resources between hospitals.

The Victorian Perinatal Data Collection Unit (VPDCU) is a statewide data collection established to collect information on the health of mothers and their babies. A Perinatal Morbidity Statistics Form is required to be completed for every birth, then forwarded to the VPDCU. Many medical record departments are responsible for both forwarding the forms to the VPDCU and responding to queries on data accuracy. In 1996 we undertook to determine if we were receiving a perinatal form for every birth occurring at every hospital in the State with obstetric beds. Health information managers were requested to supply a listing of all babies born at their hospitals in 1995-129 hospitals responded. Overall 62,759 births were validated. The VPDCU had received a perinatal form for 99.6 per cent of these births, with 251 missing forms. Reasons why the VPDCU had not received the forms were investigated.

Adolescent↗
PubMedDate not supplied

The accuracy of eclampsia cases reported to the Victorian Inpatient Minimum Database and the Perinatal Data Collection Unit.

The aim of this study was to compare the quality of the reporting and coding of eclampsia in two routine data collections: the Victorian Inpatient Minimum Database (VIMD) and the Perinatal Data Collection Unit (PDCU). The validity of cases in the two data sets was confirmed by reference to the original medical record data. Only 12 cases were the same in both data sets (i.e., 35.3% agreement). There were an additional 51 cases that were reported to either one or the other of the data sets and, of these, only 15 (i.e., 29%) were confirmed as eclampsia. The overall number of cases confirmed for both systems in 1995 was 27, or 0.4 per 1000 confinements. Reasons for these discrepancies were investigated and three basic problems identified: quality of documentation in the medical record, coding errors, and use of data from computer-generated forms. Neither the VIMD nor the PDCU was regarded as having sufficiently accurate data for adequate reporting of maternal morbidity. By combining the information from both databases a better estimate of incidence can be obtained, but improved reporting and coding is essential for accurate assessment of this condition.

Adult↗
PubMedDate not supplied

Art in hospitals.

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England↗
PubMedDate not supplied

Cell-type-specific transcription factor interactions with cis-elements present in the mouse LDH/C proximal promoter region.

The major aim of this study was to identify cell-type-specific transcription factors present in somatic and germ cells that interact at cis-elements within the lactate dehydrogenase C (LDH/C) proximal promoter region. Electrophoretic mobility shift assays (EMSAs) were performed using wild-type and mutagenized GC-box LDH/C double-stranded (ds) oligonucleotides to probe nuclear extracts from primary germ cell populations, and an LDH/C nonexpressing cell line (Hela cells). Significant differences were observed in the composition of nuclear transcription factors bound to cis-elements within the LDH/C proximal promoter region in somatic versus germ cells. Using the wild-type LDH/C ds oligonucleotide to probe germ cell nuclear extracts, we consistently observed two DNA-protein complexes, one formed by Sp1 proteins and one formed by another uncharacterized germ cell nuclear transcription factor. Methylation interference analysis identified a unique 5'G residue within the GC-box motif as an integral part of the cis-element recognized by this germ cell nuclear transcription factor. In contrast, at least six major DNA-protein complexes were observed in EMSA studies using Hela cell nuclear extracts probed with the LDH/C wild-type oligonucleotide. In these EMSA studies, supershift analyses with antibodies recognizing the somatic Sp1 protein and the GC-box mutated LDH/C ds oligonucleotide demonstrated that only one of the six complexes formed was due to binding of Sp1 proteins. These in vitro EMSA studies have identified several somatic nuclear factors and at least one other germ cell nuclear transcription factor, which in addition to members of the Sp1 protein family, recognized cis-elements within the LDH/C proximal promoter region. Observations presented in this report strongly suggest that these somatic and germ cell nuclear transcription factors play central roles in modulating transactivation or suppression of the mouse LDH/C subunit gene in the respective cell types.

Amino Acid Sequence↗
PubMedDate not supplied

Understanding depression.

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Attitude of Health Personnel↗