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Biomedical subjects

R Browne

Publications and source records attributed to R Browne.

60 records · Page 4Linked to original sources
PubMedDate not supplied

The effect of an educational program upon hospital antibiotic use.

The effect of an educational program on the use of antibiotics was studied in a university-affiliated Veterans Administration Hospital. Following an initial survey of antibiotic usage, educational presentations of the collected data were made to the hospital staff which included specific prescribing errors and alternative recommendations. Then, another survey was conducted. Measurable changes following the educational presentations were limited to decreasing costs of unjustified antibiotic use. An effect was noted in decreasing unjustified use of antibiotics in prophylactic situations, but this remained the most common misuse. Thus, an educational program directed at specific prescribing errors produced little noticeable effect on the use of antibiotics in a university-affiliated hospital. The study indicates that more direct measures, such as control of use of particular antibiotics, may be required to produce a meaningful change in prescribing practices.

Anti-Bacterial Agents↗
PubMedDate not supplied

Open fractures of the tibia in children.

We treated 38 patients from 4 to 15 years old and with open growth plates for open fractures of the tibia. The average follow-up was 33 months (range, 9-122). All patients had repeated operative debridement, parenteral antibiotics, and immobilization by cast or fixation. Outcomes were analyzed with respect to age at the time of injury, grade of injury, and type of immobilization. The time to union was prolonged and averaged 21 weeks (range, 6-82). No patients younger than 11 years required bone grafting for union. The deep infection and nonunion rate was 8%, with all of these occurring in patients older than 11 years. Clinically significant leg-length discrepancy or functional limitation was encountered only in patients with an ipsilateral femur fracture or with deep infection requiring osseous debridement. Our data suggest that open tibia fractures in children older than 11 years have nonunion and infection rates that parallel those of adult patients, but that younger children have a more benign course. With aggressive wound care and adequate stabilization, few complications or sequelae should occur in open tibial shaft fractures in younger patients.

Adolescent↗
PubMedDate not supplied

Accepting the challenges of pain management.

Despite advances in the treatment of pain, studies reveal that hospitalized patients continue to suffer under-recognised and unrelieved pain. Several factors contribute to this problem including health-care professionals' lack of knowledge about pain and analgesia, the inadequate use of pain assessment techniques and incomplete charting of patients' reports of pain. This article describes these challenges which must be overcome if the situation is to improve. It outlines the potential value of systematic assessment and documentation of pain so that the patient's pain is acknowledged as a unique experience. This should enable the health professional to individualize his/her approach to pain management.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

Syringomyelia and scoliosis in children.

We reviewed 28 patients < 18 years of age with scoliosis and syringomyelia. Children with scoliosis and syringomyelia had an equal incidence of left- and right-sided curves with a normal sagittal alignment. Most were first seen at Risser 0 with significant curves, and curve progression occurred in half of the patients. Bracing was not effective in preventing curve progression. Neurologic signs, present in most children, stabilized after syrinx drainage. Neither the sex or age of the child, nor the type of curve, nor the drainage of the syrinx was predictive of curve progression.

Adolescent↗
PubMedDate not supplied

Detection of benzodiazepine abuse in opiate addicts.

There is an increasing problem with benzodiazepine co-abuse in the opiate dependent population of Dublin. The importance of early detection of this co-abuse is essential as there is an increased risk of dangerous injecting practices such as sharing of needles and criminality in those who co-abuse benzodiazepines and opiates. This study was carried out in the National Drug Treatment Centre, Dublin. It aims to describe the current difficulties in identifying the co-abuse of short acting benzodiazepines including flunitrazepam in a cohort of opiate dependent patients. Using a sample of those attending the clinic it was discovered that standard methods of urinalysis failed to identify 10% of co-abuse. For those patients whose abuse of flunitrazepam is undetected on screening, clinical interventions which aim to minimise the consequence of the co-abuse and reverse the chaotic drug using patterns fail to be put in place at the earliest possible time.

Ambulatory Care Facilities↗