Search PubMed⌕ Search

Biomedical subjects

P Lewis

Publications and source records attributed to P Lewis.

231 records · Page 13Linked to original sources
PubMedDate not supplied

FDG-PET analysis and findings in amnesia resulting from hypoxia.

The assumptions underlying neuroimaging, and problems in its analysis and interpretation, are commonly underestimated in neuropsychology. The ways in which fluoro-deoxy-glucose (FDG) positron emission tomography (PET) data can be analysed are discussed. PET findings from four patients who had suffered severe amnesia, following episodes of acute hypoxia, are presented. These patients had shown evidence of medial temporal (hippocampal and parahippocampal) atrophy on MRI brain scans. The PET data were analysed in several different ways. The converging findings were that the patients showed bilateral thalamic hypometabolism, and there was also evidence of retrosplenial hypometabolism bilaterally. Cognitively, these patients performed most like other patients with medial temporal lesions, but the results indicate that structural lesions can have distal metabolic effects on structures elsewhere. These findings are interpreted in the light of neuroanatomical observations concerning parallel projections between medial temporal lobe structures and the thalamus, some of which pass via the retrosplenium.

Adult↗
PubMedDate not supplied

Reducing delays in the CT scanning process at Bloomington Hospital.

UNLABELLED: Over a two-month period in 1992, a team in the Radiology Department at Bloomington Hospital recorded the number and types of delays that occurred in the computer tomography (CT) scanning process. Using the Pareto principle, the team identified two root causes for delays--equipment failure and insufficient information collected at scheduling. Appropriate interventions were identified, and the number of delays decreased dramatically. RESULTS: The number of delays in the CT scanning process decreased from a median of 19 per day to 2. Staff overtime hours decreased from a median of 87 per month to 46. The time patients spend waiting to receive a CT scan decreased from an average of 20 minutes to 30 minutes to 0 to 10 minutes. Patients are scheduled for a scan within one day's notice, as opposed to one week previously. Complaints from patients, physician offices, and other customers decreased dramatically. Morale and empowerment improved among staff.

Data Collection↗
PubMedDate not supplied

Hearing aid possession in the population: lessons from a small country.

The results of several studies on hearing aid use in the Welsh population were considered to investigate some general principles on determinants of such use within the general populations of developed countries. Overall hearing aid possession and use were not found to have changed significantly over the past 18 years, remaining at 4 per cent having obtained hearing aids and 3 per cent using them. The possession figures were consistent across all methodologies used. Higher hearing aid use in the post-industrial valleys (in which the traditional industries of coal mining and steel production had disappeared) was explained entirely by a higher level of reported hearing difficulties there. In all populations, less than 20 per cent of those reporting difficulties possessed hearing aids. Whether a hearing aid had been obtained free of charge from the National Health Service or purchased privately did not influence whether it was still used. It was concluded that an effort to improve the acceptability of hearing aids and reduce their stigma is required.

Aged↗
PubMedDate not supplied

Appendiceal mucocoele: a case report and review of the literature.

Mucocoele of the appendix denotes an obstructive dilatation of the appendiceal lumen due to abnormal accumulation of mucus, which may be related to a variety of pathological conditions. This may be the outcome of various processes. Most important for the surgeon, however, are the mucocoeles that are caused by mucinous cystadenomas and cystadenocarcinomas. In the latter case, a possible rupture of the mucocoele, either spontaneous or accidental, during surgery may result in the clinical condition of pseudomyxoma peritonei, a spread of malignant cells throughout the entire peritoneal cavity in the form of multiple mucinous deposits. It is therefore important both to identify the disease preoperatively and to plan a careful resection to remove the mass. We report one case and present the clinical and diagnostic aspects of this disease.

Aged↗
PubMedDate not supplied

Joint replacement for arthritis.

BACKGROUND: Joint replacement is most commonly performed at the hip and knee for osteoarthritis. It is also possible to replace joints such as: the shoulder, elbow, metacarpophalangeal joints and ankle, but usually only when the joint has been destroyed by rheumatoid arthritis. While the main benefit of joint replacement is the resolution of arthritic pain, range of movement and function can also be improved and the length of the limb or alignment of the joint may be restored. OBJECTIVE: In this article we address the indications for joint replacement, and how the patient is assessed. The results of joint replacements of varying joints are considered and we discuss some topical current concepts in joint replacement surgery.

Arthritis↗
PubMedDate not supplied

Identification of a high-risk clinically localized prostate cancer subgroup receiving maximum benefit from whole-pelvic irradiation.

PURPOSE: We recently identified a progression-free survival advantage for clinically localized high-risk prostate cancer patients receiving whole-pelvic irradiation. We now seek to identify a subgroup most likely to benefit from whole-pelvic irradiation. METHODS: Between October 1987 and December 1995, 506 clinically localized prostate cancer patients were treated with definitive radiotherapy consisting of whole-pelvic irradiation followed by a prostate-only boost, or prostate-only treatment (median follow-up, 35 months vs 30 months). Prostate-specific antigen (PSA) failure was defined as (1) a PSA value > or = 1 ng/mL or (2) a PSA value that rose > or = 0.5 ng/mL in < or = 1 year posttreatment on two consecutive measurements, with the first rise defined as the time of failure. The calculated risk of lymph node positivity (%rLN+) was defined as 2/3 (initial PSA) + 10(Gleason score - 6), with intermediate risk defined as 15% < or = %rLN+ < 35% and highest risk defined as %rLN+ > or = 35%. Univariate and multivariate analyses were performed. RESULTS: Intermediate-risk patients receiving whole-pelvic irradiation had significantly improved freedom from PSA failure compared with those receiving prostatic irradiation only (median progression-free survival 39.5 months vs 22.5 months; P < 0.0001); highest-risk patients did not (median progression-free survival 27.2 months vs 20.8 months, P = NS). Multivariate analysis revealed type of radiation treatment to be the most significant independent predictor of outcome (P < 0.0001). DISCUSSIONS: Whole-pelvic radiotherapy most significantly improves the PSA failure-free survival in patients with an intermediate calculated risk of lymph node positivity, suggesting that highest-risk patients may present with distant micrometastases.

Chi-Square Distribution↗