Search PubMed⌕ Search

Biomedical subjects

S Bailey

Publications and source records attributed to S Bailey.

At least 109 records · Page 6Linked to original sources
PubMed1998

A prospective, randomized controlled trial of sedation vs. no sedation in outpatient diagnostic upper gastrointestinal endoscopy.

BACKGROUND AND STUDY AIMS: The majority of gastrointestinal endoscopists in the United Kingdom routinely use intravenous sedation prior to diagnostic upper gastrointestinal endoscopy. We conducted a prospective, randomized controlled clinical trial to help determine whether the use of sedation influences the duration, safety, and tolerance of diagnostic upper gastrointestinal endoscopy. PATIENTS AND METHODS: Adults referred for outpatient diagnostic upper gastrointestinal endoscopy were invited to participate in the study. Patients with a history of previous upper gastrointestinal endoscopy or dysphagia were excluded. Patients were prospectively randomized to sedation with intravenous midazolam (5 mg for those under 65 years or 3 mg for those aged 65 or more), or no sedation. All patients were given topical oropharyngeal anaesthesia with 100 mg lignocaine spray. Outcome measures included duration of procedure, ease of procedure (as assessed by medical and nursing staff), tolerance of procedure (as assessed by patients), and incidence of complications. RESULTS: 100 patients were randomized to receive sedation or no sedation. The two groups were well matched for age, sex, and number of biopsies taken during the procedure. In the non-sedated group, the duration of endoscopy tended to be reduced and the procedure tended to be easier according to the endoscopists' assessment (neither of these observations was significant). The sedated group reported greater comfort for the procedure (P < 0.001), although both groups tolerated the procedure well, and the majority in both groups preferred to have any future procedure repeated in the same manner. There were no serious adverse events in either group. CONCLUSIONS: In patients who are willing to contemplate upper gastrointestinal endoscopy without sedation, the avoidance of sedation may lead to faster and easier endoscopies, without any increased risk of procedural difficulties or adverse events.

Adult↗
PubMed1997

Vascular loops of the internal auditory canal: a diagnostic dilemma.

OBJECTIVE: To describe clinical and radiographic characteristics of vascular loops occupying the internal auditory canal. STUDY DESIGN AND SETTING: A retrospective review of patients with lesions initially suggestive of neoplasm, such as acoustic neuroma, who were subsequently found to have vascular compression of the facial and/or cochleovestibular nerves. The symptoms suggestive of this retrocochlear pathology, including vertigo, tinnitus, hearing loss, hemifacial spasm, and facial paralysis, were assessed. Subsequent evaluation with MRI revealed findings suggestive of intracannalicular neoplasm in three patients. MAIN OUTCOME MEASURES: Vascular loops with the cerebellopontine angle have been reported to approach the facial and cochleovestibular nerves at the level of the porus acousticus or within the internal auditory canal in approximately 65% of postmortem specimens. Although presumably the majority of individuals are asymptomatic, several cases are presented where vascular loop compression created symptoms and radiographic findings suggestive of neoplasm. RESULTS: Within this study, two patients underwent surgical exploration for expected neoplasm and were subsequently found to have pathology secondary to vascular loop compression. A third patient avoided surgical exploration due to radiographic confirmation with angiography. CONCLUSIONS: Although skepticism exists regarding true pathology occurring secondary to vascular loop compression, histologic confirmation of neural compression injury secondary to a vascular loop is presented. Further, diagnostic parameters and treatment are presented as well.

Aged↗
PubMed1996

Crystallization and preliminary X-ray crystallographic analysis of the putative [6Fe-6S] prismane protein from Desulfovibrio vulgaris (Hildenborough).

Crystals of the prismane protein from Desulfovibrio vulgaris (Hildenborough) containing a putative [6Fe-6S] cluster have been obtained and X-ray data collected to a resolution of 1.7 A using synchrotron radiation. The unit cell is orthorhombic with a = 64.1, b = 65.1 and c = 154.1 A, space group P2(1)2(1)2(1) (No. 19). The unit cell will readily accommodate four molecules of molecular weight 60 kDa with a corresponding solvent content of approximately 48%.

Journal Article↗
PubMed1996

Acute lymphoblastic leukaemia: the Wellington experience 1980-92.

AIMS: The study was designed to compare two populations of children with acute lymphoblastic leukaemia treated in the Wellington regional oncology unit over two six year periods, 1980-6 and 1986-92 when two different treatment protocols were used. METHODS: Fifty-eight cases were identified from the children's cancer registry and the relevant data collected from the hospital records. Overall survival and disease free survival in the two populations were compared. RESULTS: There was a significant difference for both outcomes between the two study populations, those treated prior to August 1986 having an actuarial survival of 53% and a disease free survival of 47% compared with 93% and 88% in those children treated after August 1986 (p=0.01 and 0.001 respectively). This was not explained by differences in sex, age, area of residence at diagnosis or disease risk. CONCLUSIONS: Increased intensity and duration of the induction and consolidation phase of treatment has significantly improved outcome for standard and high risk disease in children who have received the intensive phases of this treatment at a regional paediatric oncology centre. Outcome is not compromised if children receive the less intensive maintenance therapy close to their homes at the district or base hospital and close links are maintained with the regional unit.

Adolescent↗
PubMed1996

Preliminary crystallographic studies of dimethylsulfoxide reductase from Rhodobacter capsulatus.

Dimethylsulfoxide reductase from the photosynthetic bacterium Rhodobacter capsulatus has been crystallized in two similar forms which are suitable for X-ray structure determination. Both crystals forms belong to space group P4(1)22 or P4(3)22, with cell dimensions a = b = 80.81, c = 229.75 A (type I crystals) or a = b = 89.30, c = 230.05 A (type II crystals) and one molecule in the asymmetric unit. Diffraction has been observed to at least 2.0 A in type I crystals and to 2.6 A in type II crystals. Dimethylsulfoxide reductase from Rhodobacter is the simplest molybdenum oxotransferase known and this makes it an ideal model to study the structure and function of this class of enzymes.

Journal Article↗
PubMed1996

The crystal structure of trypanothione reductase from the human pathogen Trypanosoma cruzi at 2.3 A resolution.

Trypanothione reductase (TR) is an NADPH-dependent flavoprotein unique to protozoan parasites from the genera Trypanosoma and Leishmania and is an important target for the design of improved trypanocidal drugs. We present details of the structure of TR from the human pathogen Trypanosoma cruzi, the agent responsible for Chagas' disease or South American trypanosomiasis. The structure has been solved by molecular replacement, using as the starting model the structure of the enzyme from the nonpathogenic Crithidia fasciculata, and refined to an R-factor of 18.9% for 53,868 reflections with F > or = sigma F between 8.0 and 2.3 A resolution. The model comprises two subunits (968 residues), two FAD prosthetic groups, two maleate ions, and 419 water molecules. The accuracy and geometry of the enzyme model is improved with respect to the C. fasciculata enzyme model. The new structure is described and specific features of the enzyme involved in substrate interactions are compared with previous models of TR and related glutathione reductases from human and Escherichia coli. Structural differences at the edge of the active sites suggest an explanation for the differing specificities toward glutathionylspermidine disulfide.

Amino Acid Sequence↗
PubMed1996

Adolescents who murder

Although few in number, children and adolescents who murder attract much public attention. Following a review of the literature on aetiology, assessment, treatment programmes and outcomes, descriptive data on a 5-year cohort of 20 adolescent murderers from England and Wales are presented. An outline is made of their pathway through the care and criminal justice system together with a framework for ongoing individual therapy. Suggestions are made about refinement of categories of juvenile homicide, and increased information sharing between child and adolescent and adult forensic specialists and the relevance of this group to the mainstream adolescent offenders.Crimes of violence of children differ little from place to place and from epoch to epoch. In Britain approximately the same number of juvenile murderers and future privy councillors are born each week. Anger, shock, grief and self righteousness often demand certain punishments but sanctions thus motivated cannot be said to have the efficacy of curative measures (Wilson, 1973).

Journal Article↗
PubMed1996

Even More Precisely Assessing Children's Understanding of the Order-Irrelevance Principle

There are conflicting views of when children understand that the cardinality of a set is independent of the order in which the objects are counted. Some discrepancies between studies using similar tests may be due to children interpreting the experimenter as questioning the accuracy of their counting. Three studies are reported of children between 3 and 6 years old. In Experiments 1 and 2, more expected a count in a different order to yield the same number when they did not have to do any counting than when they had to count or monitor a puppet's counting. However, some also expected subtraction not to affect cardinality. In Experiment 3 substantially more children predicted correctly whether a recount would yield the same number than what the number would be. These variations may reflect the power of forms of questioning to orient the child toward principles or practice.

Journal Article↗
PubMed1996

Acquisition of a morris water maze task is impaired during early but not late withdrawal from morphine.

Behavioral changes in male Sprague-Dawley rats during early and late withdrawal from morphine were investigated. Morphine-treated subjects (M) were implanted (SC) with osmotic pumps containing 2.0 ml of a 159 mg/ml morphine sulfate solution while control subjects (C) received sham implants. Implants were removed after 7 days. M subjects exhibited a significant decrease in body weight during withdrawal that recovered by 21 days after pump removal. Beginning 1 or 21 days following pump removal, subjects were tested for 8 days in a Morris water maze (MWM) task. M subjects trained in the MWM during early withdrawal exhibited significantly longer escape latencies than C subjects. However, during sequential probe trials, the same subjects exhibited a significant preference for the target quadrant of the maze and executed accurate searches for the escape platform. Though these subjects failed to locate the platform as efficiently as controls during training trials, they learned the location of the escape platform. M rats trained during late withdrawal exhibited no deficits in any measure of MWM performance relative to C subjects. The data suggest that a variety of processes involved in the acquisition and performance of the MWM task are differentially affected during early withdrawal from morphine.

Animals↗
PubMed1996

Levels of empathy of critical care nurses.

Empathy represents an essential element for effective caring and therefore enhances the goals and rationale of nursing care. The focus of this study was the level of empathy possessed by critical care nurses, in relation to their gender, years of experience in critical care nursing, level of formal education and their current position. This descriptive correlational study utilised the Empathy Construct Rating Scale (ECRS) in order to measure empathy. The study revealed that critical care nurses possess moderately well-developed levels of empathy. No statistically significant relationships were found between gender, years of experience in critical care, level of formal education and current position and levels of empathy. The conclusion of the study was that further research is required to explore the concept of empathy within the context of critical care nursing, and in particular the meaning and significance of empathy to critical care nurses.

Critical Care↗
PubMed1996

Cancer detection activities coordinated by nursing students in community health.

This article describes ongoing cancer screening in a low-income and ethnically diverse community (primarily Southeast Asian and Hispanic). These services are part of the comprehensive care provided in a district nursing community health clinical. Screening services occur within the refugee community and include mammograms, individualized breast self-exam (BSE) teaching, home follow-up on the BSE teaching, and assistance obtaining any additional screening or treatment, if necessary. Except for technician activities, students plan, implement, and evaluate all services. The first event was in spring 1995, the second in summer 1995, and the third in fall 1995. Thus far, 85 women have received services. Cambodian and Laotian women show the lowest level of knowledge and experience related to breast cancer detection. This article provides some of the first data on cancer screening for low-income Cambodian and Laotian women in the United States. The article also shows how ongoing cancer screening and prevention services can be provided to populations that have not been successfully reached through usual means, e.g., referral by nurse practitioner, physician, and electronic or print media. Specific means of overcoming barriers to screening, prevention, and learning are described in detail.

Breast Neoplasms↗
PubMed1996

Pineal tumours in the north of England 1968-93.

The records of 38 patients under 25 years of age presenting with pineal tumours between 1968 and 1993, identified from the Northern Region Children's and Young Adults' Malignant Disease Registry, were analysed retrospectively with regards to clinical presentation, diagnostic approach, treatment strategy, and outcome. The overall five year survival was 45%. Fifteen patients had a histological diagnosis: six with germinomas, three with teratomas, three with astrocytomas, and three with pinealoblastomas. One patient had a definitive diagnosis of teratoma made on the basis of raised tumour markers (alpha fetoprotein). Treatment consisted of surgery (87%) (ventriculoperitoneal or atrial shunt and/or biopsy), and/or radiotherapy (82%), and/or chemotherapy (26%). Those patients with a tissue diagnosis appeared to have a more favourable outcome, especially after 1976 when treatment was determined by tumour type (five year survival for those with a tissue diagnosis was 91% v 51% for those without, 95% confidence intervals 74 to 100% and 26 to 75%). This study suggests that tissue diagnosis allows more appropriate treatment to be delivered for children with pineal tumours resulting in improved survival. Referral to a centre with neurosurgery, radiotherapy, neuropathology, and paediatric oncology collaboration is essential.

Adolescent↗
PubMed1996

The psychosocial characteristics of juvenile sexual offenders referred to an adolescent forensic service in the UK.

Criminal statistics indicate that a high percentage of sexual offences are committed by perpetrators under the age of 18 years. Descriptive data based on a retrospective case note study of 121 juvenile sexual offender referrals to an adolescent forensic unit are presented. The results suggest that adolescents commit an array of offences and present with generalized adjustment difficulties. Conduct disorder was the most common diagnosis, while rates of mental illness were lower than in earlier studies. Abused as opposed to non-abused offenders experienced more dysfunctional upbringings and demonstrated higher rates of personal disturbance. Theoretical and treatment implications are discussed in relation to the available literature on adolescent sexual offending.

Adolescent↗