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Biomedical subjects

R Burwood

Publications and source records attributed to R Burwood.

7 recordsLinked to original sources

The development of regional nuclear medicine audit in south Thames.

A programme of audit, including clinical audit, organizational audit and patient/clinician satisfaction surveys, has been implemented in nuclear medicine departments throughout the South Thames Regional Health Authority (RHA). The clinical topics which have been audited include. ventilation-perfusion lung imaging, bone imaging, liver imaging, thyroid imaging and renal static DMSA imaging. Guidelines have been set for nuclear medicine practice in each of these areas against which further audit can be performed. Organizational audits have been performed in 10 nuclear medicine departments in the South Thames RHA and a confidential report supplied to the head of each department, consisting of findings and recommendations. A programme of re-audit has also commenced. The main findings have been a lack of facilities and space. Patient satisfaction surveys have been implemented in nine departments and a high level of patient satisfaction has been demonstrated. A clinical satisfaction survey has been implemented in 13 departments. It is hoped to continue this successful programme of audit to improve nuclear medicine practice by closing audit loops.

England↗

Changes in diurnal blood pressure variation and red cell and plasma volumes in patients with renal failure who develop erythropoietin-induced hypertension.

Hypertension is the most common side-effect of treatment with recombinant human erythropoietin (EPO) for the anemia of chronic renal failure. To elucidate why this occurs in some patients we measured changes in blood volumes and diurnal blood pressure (BP) variation during treatment. Isotope labelled measurements of red cell and plasma volume (RCV and PV) were carried out along with ambulatory BP monitoring before starting EPO and after target hemoglobin (Hb) was reached. RCV did not differ between the patient group developing EPO-induced hypertension (EpHT, n = 11) and the group with no change in BP (NC, n = 13) either before or after treatment. However PV was significantly lower in the EpHT group after treatment (2.97 vs 3.92 litres; p < 0.025). Mean BPs differed little between groups because antihypertensive medications were increased as necessary for clinical safety but after achieving target Hb, day-night difference in diastolic BP was greater in the EpHT than the NC group (11.5 vs 4.6 mmHg; p < 0.025) due to a greater rise in daytime BP. There were significant correlations between high day-night diastolic BP differences after EPO in all the studied patients and low plasma volumes either pre- or post-EPO. The study group was heterogeneous but the changes were in the same direction irrespective of type of renal replacement therapy. These results suggest that EPO-induced hypertension is associated with increased daytime vasoconstriction and greater hemoconcentration due to lower plasma volume.

Anemia↗

Duodenoscopy.

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Cholelithiasis↗