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Biomedical subjects

P Trotter

Publications and source records attributed to P Trotter.

9 recordsLinked to original sources

Deep venous thrombosis: gradient-recalled-echo MR imaging changes over time--experience in 10 patients.

PURPOSE: To determine the gradient-recalled-echo (GRE) magnetic resonance (MR) imaging changes caused by intraluminal thrombus of the lower extremities over time and to establish GRE MR imaging criteria to help distinguish acute from previous deep venous thrombosis. MATERIALS AND METHODS: Four women and six men, aged 38-76 years, underwent GRE MR imaging two to four time after the original diagnosis of deep venous thrombosis; eight also underwent confirmatory ultrasonography at that time. Follow-up was 3 months to 1 1/2 years. All patients were treated with anticoagulants. Evidence of thrombus, signal intensity characteristics, and MR imaging appearance were evaluated. RESULTS: Acute thrombosis was identified as an occlusion or prominent filling defect within the vessel. The luminal diameter of thrombosed veins was equal to or larger than that of a corresponding, unaffected vessel in each case. Acute thrombus signal intensity tended to be decreased initially and increase over time. Residual changes due to thrombosis included the web formation (n = 3), luminal narrowing (n = 4), and wall thickening and/or slow flow (n = 5). Vessels in three patients reverted to normal. CONCLUSION: GRE MR imaging demonstrated progressive changes of venous thrombus over time. These criteria may help distinguish acute deep venous thrombosis from the residual changes of previous thrombosis.

Adult↗

Building blocks. Roundtable discussion.

Former Hospitals & Health Networks executive editor Mark Hagland and Health Facilities Management editor Kurt Luchs and associate editor Catherine Quayle recently hosted a roundtable discussion on design and construction issues in health care. They wanted to know what health care senior executives and experts in the design and construction field thought about today's most pressing issues and biggest trends. Hagland and Luchs assembled a group or experts and executives in Chicago and set the tape rolling. Here are excerpts from the discussion.

Decision Making, Organizational↗

How well are we protecting our children? An immunisation coverage survey in Hawke's Bay.

AIMS: In July 1991, an immunisation coverage survey was conducted to assess the proportion of two year old children who have been vaccinated in the Hawke's Bay. METHODS: Parents from a representative sample of 100 households with children between the ages of two and four years of age were interviewed regarding household characteristics and parental attitudes towards immunisation. Immunisation histories were abstracted from each child's Health and Development Record Book or, if this was not available or was incomplete, from records retained by the general practitioner(s) responsible for administering immunisations to the child. RESULTS: Coverage levels among two year olds exceeded 85% for all postneonatal vaccinations scheduled for the first year of life; however, levels among two year olds were lower than 85% for all vaccinations scheduled to be received after the first birthday. Overall, only 61% (95% confidence interval (CI) = 50.7, 70.6) of the children were fully vaccinated by the age of two years. Children living in a household where the principal source of income was from benefits were almost 60% less likely to have been fully immunised at two years of age (odds ratio (OR) = 0.42, 95% CI = 0.18, 0.97), as were Maori children (OR = 0.43, 95% CI = 0.18, 1.06). CONCLUSIONS: These results emphasise the need for enhanced education about the importance of completing the full series of recommended vaccinations and of on-time vaccination, as well as for checking childrens' vaccination histories at every contact with the healthcare system and, where necessary, administering past-due immunisations.

Adult↗

Phase III clinical evaluation of gadoteridol injection: experience in pediatric neuro-oncologic MR imaging.

Twenty-two pediatric patients with known CNS neoplasms underwent magnetic resonance (MR) imaging before and after intravenous injection of 0.1 mmol/kg gadoteridol injection as part of a Phase IIIB open label multicenter clinical trial. Intravenous administration of this neutral, nonionic contrast agent was found to be safe in children. No clinically relevant changes in vital signs or laboratory values (including complete blood count, blood chemistry, serum electrolytes, thyroid and metabolic panel and clotting function) were attributed to the administration of gadoteridol injection. There were no systemic complaints. The imaging characteristics of gadoteridol in pediatric CNS disease appeared similar to those of gadopentetate dimeglumine. Contrast enhancement was present in 17 of 22 patients (77%). The administration of gadoteridol injection provided additional clinically relevant information including improved visualization and delineation of the primary lesion, detection of additional lesions, determination of tumor recurrence and narrowing the list of differential considerations in all 17 enhancing studies as well as in 2 of 5 studies without signal intensity enhancement. The very low toxicity, inherent to this nonionic low osmolal paramagnetic contrast formulation may allow administration of increased doses at increased infusion rates for an increased number of indications with improved sensitivity.

Adolescent↗

Catalysis of the reduction of vanadate by psychotropic drugs.

It has been suggested that vanadium may be of aetiological importance in manic depressive psychosis. Therefore, the ability of psychotropic drugs to catalyze the reduction of vanadate ion by reduced nicotinamide adenine dinucleotide (NADH) was investigated. The most active drug was methylene blue but all the phenothiazines and all the monoamine oxidase inhibitors tested showed catalytic activity. A large number of drugs showed no catalytic activity, eg. tricyclic antidepressants and benzodiazepines.

Catalysis↗

Prospective comparison of helical CT and MR imaging in clinically suspected acute pulmonary embolism.

The purpose of this study is to compare sensitivity and specificity of helical CT and MR imaging for detecting acute pulmonary embolism(PE). Patients who were suspected clinically of having PE were randomly assigned to undergo either helical contrast-enhanced CT or gradient-echo MR (if one modality was contraindicated, the patient was assigned to the other.) Patients were considered to have PE if they had: 1) high-probability V-Q scan and low clinical probability of PE; 2) pulmonary angiogram positive for PE. Patients were considered not to have PE if they had either:1)normal V-Q scan; 2) low probability V-Q scan and low clinical probability of PE; or 3) pulmonary angiogram negative for PE. The CT and MR images were read randomly and independently by five radiologists with varying levels of CT and MR experience. Twenty eight patients underwent CT and 25 MR. A total of 21 patients underwent pulmonary angiography (6 had PE, 15 did not have PE). Of the other 32 patients, 15 had high probability scan/high clinical probability and 17 had low probability scan/low clinical probability. For the five observers, the average sensitivity of CT was 75% and of MR 46%; the average specificity of CT was 89% and of MR 90%. Experience with vascular MR and enhanced CT influenced diagnostic accuracy. For the two vascular MR experts, average sensitivity and specificity of MR were 71% and 97%, and of CT 73% and 97%. In this pilot study, when CT and MR were interpreted with comparable expertise, they had similar accuracy for detecting pulmonary embolism.

Adult↗