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Biomedical subjects

R J Taylor

Publications and source records attributed to R J Taylor.

At least 55 records · Page 3Linked to original sources
PubMed1999

Tumor localization and systemic absorption of intravesical instillation of radio-iodinated iododeoxyuridine in patients with bladder cancer.

PURPOSE: We evaluated tumor uptake and systemic distribution of intravesically instilled iododeoxyuridine (IUdR) in patients with superficial bladder cancer. MATERIALS AND METHODS: We performed 24 intravesical instillation studies in 11 patients with a mean age of 71 years. Radio-iodinated IUdR was administered through a Foley catheter. Gamma camera imaging was done after instillation and after 5 to 7 bladder irrigations. Tumor uptake was estimated by region of interest analysis. Bladder biopsy samples and surgical tumor specimens were tested for acid insoluble (deoxyribonucleic acid incorporated) radioactivity. Blood samples were obtained and analyzed for systemic absorption. RESULTS: Imaging was positive in all patients with bladder cancer. Average tumor uptake plus or minus standard deviation was 0.185+/-0.120% of the instilled dose. Preferential uptake of IUdR in the tumor was observed in all 6 patients undergoing tissue analysis. The tumor-to-normal bladder ratio ranged from 3.2 to 74,000 (median 202). Systemic absorption of IUdR was minimal. Blood sample analysis performed after intravesical instillation in all 11 cases revealed an average uptake of 3.2x10(-5)% instilled dose per ml. (range 0.69x10(-5) to 6.7x10(-5)) in the systemic circulation. Instillation within 24 hours after transurethral bladder tumor resection in 5 cases resulted in a higher but not dangerous average systemic uptake of 7.3x10(-4)% instilled dose per ml. (range 1.3x10(-5) to 2.6x10(-3)). Instillation 1 to 4 weeks after transurethral surgery in 8 cases resulted in no increased systemic absorption with an average blood level of 3.4+/-1.8x10(-5)% instilled dose per ml. There was no detectable distribution of radioactivity into other organs, including the thyroid. We noted no evidence of systemic toxicity in the study. CONCLUSIONS: Intravesical instillation of radio-iodinated IUdR achieves selective localization in the bladder tumor with minimal uptake by the normal bladder and minimal systemic absorption. The use of intravesical IUdR therapy for bladder cancer appears to be promising and requires further study.

Absorption↗
PubMed1999

A comparison of sub-bandage pressures produced with two multi-layer bandaging systems.

Fourteen nurses with experience in the use of high-compression bandaging were asked to bandage the same limb with two different bandaging systems: the 'Charing Cross' four-layer regimen (System A), and a modified system incorporating two new bandages (System B). A sub-bandage pressure monitor was used to quantify the efficacy of the resulting bandaging for the two systems. The results indicated that there was no significant difference between site sub-bandage pressures achieved using the two bandaging systems. Sub-bandage pressure profiles, however, fluctuated with patient posture, the best profiles being obtained with System B and the patient in the sitting position.

Bandages↗
PubMed1999

Dental service provision in private general practice for an insured population in New South Wales, Australia.

OBJECTIVE: To determine patterns of dental services provided to a cohort of the insured population 18 years and over, in private general practice in New South Wales, Australia. BASIC RESEARCH DESIGN: A cohort study using the person-years method and Poisson regression for analysis. SETTING: Data were derived from claims records submitted by members of a health insurance fund (Government Employees Health Fund-GEHF) for rebates during the study period 1 January 1992-31 December 1995. PARTICIPANTS: There were 133,467 members aged 18 years and over from New South Wales. MAIN OUTCOME MEASURES: To determine, by age group, for those members who used private general practice and made a claim (referred to as 'patients') the annual number of visits, total number of services received per year and number of services received at a visit. RESULTS: The mean number of visits per patient was 2.4 per year with patients under 45 years making fewer visits than the 45-54 age group reference category. Mean number of services utilised per patient-year was 5.9, with services provided increasing from 3.5 for the 18-24-year-old group, reaching a plateau of approximately 6.2 for those aged 45 years or more. The number of services received per visit was 2.4 and there were no differences by age. Service mix was dominated by restorative (35%), diagnostic (27%), and preventive services (18%); with age specific variations observed. CONCLUSIONS: Age was found to be an important determinant in the use of dental services, independent of membership duration and gender.

Adult↗
PubMed1998

Interval breast cancers in an Australian mammographic screening program.

OBJECTIVE: To determine the incidence of interval cancers which occurred in the first 12 months after mammographic screening at a mammographic screening service. DESIGN: Retrospective analysis of data obtained by crossmatching the screening Service and the New South Wales Central Cancer Registry databases. SETTING: The Central & Eastern Sydney Service of BreastScreen NSW. PARTICIPANTS: Women aged 40-69 years at first screen, who attended for their first or second screen between 1 March 1988 and 31 December 1992. MAIN OUTCOME MEASURES: Interval-cancer rates per 10000 screens and as a proportion of the underlying incidence of breast cancer (as estimated by the underlying rate in the total NSW population). RESULTS: The 12-month interval-cancer incidence per 10000 screens was 4.17 for the 40-49 years age group (95% confidence interval [CI], 1.35-9.73) and 4.64 for the 50-69 years age group (95% CI, 2.47-7.94). Proportional incidence rates were 30.1% for the 40-49 years age group (95% CI, 9.8-70.3) and 22% for the 50-69 years age group (95% CI, 11.7-37.7). There was no significant difference between the proportional incidence rate for the 50-69 years age group for the Central & Eastern Sydney Service and those of major successful overseas screening trials. CONCLUSION: Screening quality was acceptable and should result in a significant mortality reduction in the screened population. Given the small number of cancers involved, comparison of interval-cancer statistics of mammographic screening programs with trials requires age-specific or age-adjusted data, and consideration of confidence intervals of both program and trial data.

Adult↗
PubMed1998

Results of the double-blind, randomized, multicenter, phase III clinical trial of Thymoglobulin versus Atgam in the treatment of acute graft rejection episodes after renal transplantation.

BACKGROUND: Thymoglobulin, a rabbit anti-human thymocyte globulin, was compared with Atgam, a horse anti-human thymocyte globulin for the treatment of acute rejection after renal transplantation. METHODS: A multicenter, double-blind, randomized trial with enrollment stratification based on standardized histology (Banff grading) was conducted. Subjects received 7-14 days of Thymoglobulin (1.5 mg/kg/ day) or Atgam (15 mg/kg/day). The primary end point was rejection reversal (return of serum creatinine level to or below the day 0 baseline value). RESULTS: A total of 163 patients were enrolled at 25 transplant centers in the United States. No differences in demographics or transplant characteristics were noted. Intent-to-treat analysis demonstrated that Thymoglobulin had a higher rejection reversal rate than Atgam (88% versus 76%, P=0.027, primary end point). Day 30 graft survival rates (Thymoglobulin 94% and Atgam 90%, P=0.17), day 30 serum creatinine levels as a percentage of baseline (Thymoglobulin 72% and Atgam 80%; P=0.43), and improvement in posttreatment biopsy results (Thymoglobulin 65% and Atgam 50%; P=0.15) were not statistically different. T-cell depletion was maintained more effectively with Thymoglobulin than Atgam both at the end of therapy (P=0.001) and at day 30 (P=0.016). Recurrent rejection, at 90 days after therapy, occurred less frequently with Thymoglobulin (17%) versus Atgam (36%) (P=0.011). A similar incidence of adverse events, post-therapy infections, and 1-year patient and graft survival rates were observed with both treatments. CONCLUSIONS: Thymoglobulin was found to be superior to Atgam in reversing acute rejection and preventing recurrent rejection after therapy in renal transplant recipients.

Acute Disease↗
PubMed1998

Jobless. Unemployment and young people's health.

Morrell, Taylor and Kerr, from the University of Sydney's Department of Public Health, review the evidence of an association between unemployment and psychological and physical ill-health in young people aged 15-24 years. Aggregate data show youth unemployment and youth suicide to be strongly associated. Youth unemployment is also associated with psychological symptoms, such as depression and loss of confidence. Effects on physical health have been less extensively studies; however, there is some evidence for an association with raised blood pressure. Finally, the prevalence of lifestyle risk factors (cannabis use and, less consistently, tobacco and alcohol consumption) is higher in unemployed compared with employed young people.

Adolescent↗
PubMed1998

Pupil-sparing third nerve palsy associated with sildenafil citrate (Viagra).

PURPOSE: To report unilateral pupil-sparing third nerve palsy after use of sildenafil citrate (Viagra). METHOD: Case report. RESULTS: A 56-year-old man with a history of tobacco abuse was treated for erectile dysfunction. Viagra, 50 mg, was taken once without adverse effect. Three weeks later, the patient took a second dose of Viagra (50 mg); 36 hours later he experienced a complete pupil-sparing third nerve palsy. Erythrocyte sedimentation rate, blood glucose level, magnetic resonance imaging, and magnetic resonance angiography were normal. CONCLUSION: In a patient with microvascular disease, use of sildenafil may be associated with pupil-sparing third nerve palsy.

Blood Glucose↗
PubMed1998

Hemodynamic patterns of pharmacologically induced erection: evaluation by color Doppler sonography.

PURPOSE: Penile erection is achieved through hemodynamic mechanisms that can be assessed best with color flow imaging and Doppler waveform analysis. We performed dynamic studies using computer assisted analysis to assess the hemodynamic patterns of pharmacologically induced erection. MATERIALS AND METHODS: A total of 73 color Doppler ultrasound studies was performed in 66 patients with erectile dysfunction. Various blood flow parameters, including peak systolic velocity, end diastolic velocity, mean flow rate, resistive index and artery diameter, were observed continuously and recorded frequently for about 30 minutes after intracorporeal injection of papaverine/phentolamine/prostaglandin E1 mixture. A computerized Doppler waveform analysis of 3 curves or greater was performed for each recording to minimize error. A second injection was administered if the first injection failed to induce a rigid erection. Status of the erection was observed and recorded throughout the study. A computerized graph was generated for each corpus. RESULTS: After intracorporeal injection the time to reach normal or peak velocity varied from 1 to 24 minutes. Among 146 corpus units in 73 color Doppler ultrasound studies we observed the following hemodynamic patterns: I-normal maximal peak systolic velocity (35 cm. per second or greater), sustained; Ia-end diastolic velocity 0 or less with complete erection response (19 units); Ib-end diastolic velocity greater than 0 or incomplete erection response (14 units); II-normal maximal peak systolic velocity (35 cm. per second or greater), transient; IIa-end diastolic velocity 0 or less with complete erection response (21 units); IIb-end diastolic velocity greater than 0 or incomplete erection response (12 units); III-borderline maximal peak systolic velocity (30 to 35 cm. per second); IIIa-end diastolic velocity 0 or less with complete erection response (10 units); IIIb-end diastolic velocity greater than 0 or incomplete erection response (8 units); IV-low maximal peak systolic velocity (less than 30 cm. per second); IVa-end diastolic velocity 0 or less with complete erection response (24 units); and IVb-end diastolic velocity greater than 0 or incomplete erection response (38 units). CONCLUSIONS: Erection is a complex and dynamic process. A new classification of hemodynamic patterns is presented that aids in assessing and interpreting more thoroughly blood flow parameters to stratify more precisely the hemodynamic patterns of erectile dysfunction.

Adult↗
PubMed1998

A comparison of standard and a modified method of two resuscitator adult cardiopulmonary resuscitation: description of a new system for research into advanced life support skills.

The study compares two methods of Advanced Life Support by a pair of resuscitators using a bag-valve-mask (BVM) technique. Standard two resuscitator cardiopulmonary resuscitation (CPR) was compared with a modified method of two resuscitator CPR. During the modified CPR one resuscitator held the face mask while the other resuscitator alternates between squeezing the self inflating bag and performing simulated cardiac compressions. Standard CPR was performed at a ventilation:compression ratio of 1:5 while modified CPR was performed at a ventilation:compression ratio of 2:15. Comparisons were made during induction of anaesthesia in 30 ASA I and II patients. Modified CPR produced a greater tidal volume (TV) (P < 0.001), a slower respiratory rate (RR) (P < 0.001) and a faster compression rate (CR) (P < 0.01) (means with (S.D.): modified CPR: TV 990 (220) ml, RR 6 (1) min(-1), CR 82 (8) min(-1); standard CPR: TV 570 (190) ml, RR 10 (2) min(-1), CR 65 (11) min(-1)). A new method for the simultaneous computerised recording of simulated cardiac compressions together with mask pressure and expired gas composition in anaesthetised patients is described.

Adult↗
PubMed1998

Preoperative hyperbaric oxygen therapy for radiation induced injuries.

PURPOSE: We present our experience with preoperatively administered hyperbaric oxygen therapy to patients who have sustained significant therapeutic radiation induced soft tissue injuries and subsequently undergo planned abdominal intervention/surgery. MATERIALS AND METHODS: From February 1993 to May 1997, 5 patients with a history of complications following therapeutic radiation were prospectively treated with hyperbaric oxygen before a planned abdominal operation. RESULTS: All patients had uneventful hospital courses. An additional procedure was eventually necessary in 2 patients but with fewer radiation related problems following hyperbaric oxygenation. CONCLUSIONS: Hyperbaric oxygenation may improve postoperative outcomes when given before planned open operations in patients with previous therapeutic pelvic irradiation and a history of radiation related complications.

Adult↗
PubMed1998

Renal transplantation: surgical aspects, complications and results.

Despite the fact that kidney transplants have routinely been successfully performed for over 30 years there continues to be challenges for the transplant surgeon. These include a static donor pool, growing recipient list, declining number of ideal donors and greater reliance on marginal donors. Innovative methods to deal with these problems continue to be sought.

Journal Article↗
PubMed1998

Construction and calibration of a low-cost bandage pressure monitor.

This study describes the construction and calibration of a three-channel bandage pressure monitor and evaluates its in-service use. The monitor was constructed from a range of commercially available, relatively inexpensive components consisting of a pressure sensor, piezoresistive transducer, differential amplifier and liquid crystal display. The pressure sensors show a good ratio of thickness to surface area (< 10%) and are sufficiently robust and flexible to conform to most anatomical profiles. The transducers are internally calibrated and temperature-compensated to provide an accurate and stable measurement of gauge pressure relative to atmospheric pressure. During laboratory assessment and in-service use, the system has proved to be reliable, accurate (typically < +/- 0.5 mmHg) and reproducible over repeated calibration.

Bandages↗
PubMed1998

Using a bandage pressure monitor as an aid in improving bandaging skills.

This prospective study used a bandage pressure monitor to assess the bandaging skills of 16 nurses caring for patients with venous leg ulcers. Baseline measurements showed that only 50% of the nurses demonstrated bandaging skills that were adequate to good. However, by the end of the feedback/post-training session, 81% of those examined had reached this standard and this figure rose to 86% on recall. These data seem to support the view that the use of a pressure monitor is a useful adjunct in the teaching of bandaging skills.

Bandages↗