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Biomedical subjects

R Davis

Publications and source records attributed to R Davis.

556 records · Page 31Linked to original sources
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Diagnostic concordance of telecytology and conventional cytology for evaluating breast aspirates.

OBJECTIVE: To evaluate the diagnostic concordance between static electronic images versus glass slides for breast fine needle aspiration (FNA) cytology. STUDY DESIGN: Nine malignant and 12 benign breast FNA cases were imaged using the Roche Image Manager, at a resolution of 1,024 x 768 pixels. A cytotechnologist or pathology resident selected five to nine representative images per case. Case histories and images were assembled into hypertext documents. Two pathologist blindly made diagnoses for each case based on the images and the clinical history and independently made diagnoses for the glass slides, also evaluating each set of images and glass slides for a list of cellular features. RESULTS: The two pathologist had concordance rates of 90.5% and 66.7% between their image and glass diagnoses. For each pathologist's discordant cases, 100.0% and 85.7%, respectively, were due chiefly to suspicious rather than definitive diagnoses. CONCLUSION: Evaluation of the electronic images indicated that almost all the cellular features were comparable to those viewed though a microscope.

Adult↗
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Minimizing hospitalization: children with newly diagnosed diabetes.

Children's recognized vulnerability to the adverse effects of hospitalization has resulted in the firm belief that minimization or avoidance of hospitalization is in children's best interests. For children with newly diagnosed diabetes, minimal hospitalization may be achieved through the flexibility of the paediatric diabetes specialist nurse role, which crosses the boundary between hospital and community. This study was undertaken to evaluate the effectiveness of a paediatric diabetes specialist nurse in reducing the length of hospitalization for newly diagnosed children. Using a quantitative approach, a quasi-experimental research design was chosen, measuring the length of hospitalization at diagnosis for 40 children diagnosed in the 2 years preceding, and 16 children diagnosed in the 9 months following, the commencement of the paediatric diabetes specialist nurse post. The study findings showed a significant reduction in the length of hospitalization, suggesting that paediatric diabetes specialist nurses, by minimizing or avoiding hospitalization for newly diagnosed children, can make a substantial contribution to their emotional wellbeing.

Adolescent↗
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Orthotopic hepatic transplantation in the dog.

Orthotopic hepatic transplantation has become a well-established treatment modality for end-stage liver disease, and research in this field is constantly evolving. Of the 34 canine liver transplants performed in this study, 17 (50%) survived more than 3 days (mean survival time 15 days). Causes of perioperative death included hemorrhage (4), anesthetic complications (3), systemic anaphylaxis (3), portal vein thrombosis (3), hepatic venous outflow block (2), and hepatic artery thrombosis (2). Gentle handling with minimal dissection of the donor liver in situ resulted in a decreased incidence of hepatic venous outflow block. The incidence of biliary leak was similar irrespective of the method of biliary reconstruction, although the incidence of acute cholangitis was 56% in the cholecystoduodenostomy group compared with 0% in the choledochocholedochostomy cohort. Using celiac to common hepatic end-to-side arterial anastomosis with preservation of the gastroduodenal artery, thrombosis of the hepatic artery was encountered in four instances, an incidence similar to previously reported studies where end-to-end hepaticohepatic arterial anastomosis or donor aortic conduit was utilized. The incidence of postoperative intestinal intussusception was reduced from 40 to 0% in those who underwent transmesenteric intestinal plication following implantation of the liver. Among short-term survivors, sepsis was the most frequent noted complication (10), followed by intestinal intussusception (6), rejection (6), and gastrointestinal bleeding (1). Among recipient dogs that survived more than 3 days, rejection was the most common cause of graft loss (5), followed by biliary leak (4) and hepatic artery thrombosis (2).

Animals↗
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Feasibility trial of postoperative radiotherapy and cisplatin followed by three courses of 5-FU and cisplatin in patients with resected head and neck cancer: a Southwest Oncology Group study.

BACKGROUND: Appropriate adjuvant chemotherapy for resected head and neck cancer patients has yet to be defined. Multiple trials have noted trends toward improved disease-free survival and local control. The Southwest Oncology Group undertook a feasibility trial of postoperative cisplatin and radiotherapy followed by three cycles of cisplatin and 5-fluorouracil. METHODS: Patients with resected stage III or IV head and neck cancer received cisplatin, 100 mg/m2, on days 1, 22, and 43 of radiotherapy. This therapy was followed by three cycles of cisplatin, 100 mg/m2 or last tolerated dose, and 5-fluorouracil, 1000 mg/m2, on days 1 to 4 every 21 days. RESULTS: Seventy-two patients from 22 institutions were registered; 68 were evaluable. Sixty-eight patients received radiotherapy. Only 25 of 68 patients (36.7%) were able to complete all six cycles of chemotherapy. Forty-three of 68 patients (63%) completed all three cycles with radiotherapy. Toxicities were tolerable. One toxic death occurred. CONCLUSIONS: It is not feasible to deliver six cycles of chemotherapy postoperatively in the sequence described. Compliance issues need further exploration to define effective adjuvant chemotherapy for head and neck patients.

Adult↗
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Home alone.

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Aged↗
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Three-dimensional CT imaging in postsurgical "failed back" syndrome.

One hundred consecutive patients with postsurgical "failed back" syndrome (PSFBS) without fusion and 100 patients with PSFBS with fusion were evaluated with direct CT, two-dimensional (2D) multiplanar, and three-dimensional (3D) imaging. In the patients with and without fusion, 3D images were found to best display the following: the surgical procedure and its extent, lateral neural foraminal narrowing, and fractures of the posterior elements. The 3D images enabled optimal demonstration of fusion: solidity, pseudarthrosis, incorporation of transverse processes and facet joints, and transitional syndrome. In the patients without fusion, 3D images provided improved appraisal of surgical results in 31%; it showed additional fracture(s) in 9%, better displayed lateral neural foraminal narrowing in 42%, and showed additional posterior element fractures in 11% as compared to axial and 2D multiplanar reconstructed (MPR) scans. Three-dimensional imaging uncovered incomplete fusion in 17%, transitional syndrome in 13%, and pseudarthrosis in 6%. Thus, the 3D imaging provided additional information over the direct axial and MPR images (2D images) in 56 of 100 patients without fusion and 76 of 100 patients with fusion. At our institution, this imaging modality is now routinely performed in this patient population.

Female↗
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Phase II study of continuous-infusion diaziquone in relapsed/refractory acute nonlymphocytic leukemia.

A total of 74 patients with relapsed/refractory acute nonlymphocytic leukemia were entered in a phase II trial of diaziquone (AZQ) administered by continuous infusion at a dose of 28 mg/m2 a day for 5 days. Complete remission (CR) was achieved in 12 of the 67 evaluable patients (18%), all occurring in relapsed patients (12 of 55, 22%). There were eight partial responders (one of whom was in the refractory group). Three of these had normal M-1 bone marrow but did not meet peripheral blood criteria for CR. The median duration of CR was 13.6 weeks (range, 4-40+). Nonhematologic toxicity was mild to moderate and easily manageable. Hematologic toxicity was severe or life threatening in all patients. This study confirms the activity of AZQ when given as a continuous infusion to patients with relapsed acute nonlymphocytic leukemia.

Acute Disease↗
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B.S. Education in Dental Laboratory Sciences at the University of Texas Health Science Center: an organizing framework.

This article describes the conceptual framework upon which the Bachelor's Degree program in Dental Laboratory Sciences at the University of Texas Health Science Center was constructed. Development of specific program objectives rested on the following four guiding principles: 1) combine professional laboratory training with management education; 2) focus on a problem-based pedagogy; 3) provide flexibility to accommodate today's "nontraditional" student population; and 4) utilize the close relationship with the University of Texas Dental School at San Antonio.

Curriculum↗