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Biomedical subjects

S Davies

Publications and source records attributed to S Davies.

At least 217 records · Page 12Linked to original sources
PubMed1996

Bone marrow transplantation. New strategies for treating malignant disease.

In the years since the world's first successful bone marrow transplant (BMT) was performed at the University of Minnesota in 1968, the field of bone marrow transplantation has evolved rapidly. Stem cells can be obtained from a variety of sources: bone marrow from a matched sibling or unrelated donor (allogeneic transplant), bone marrow or peripheral blood from the patient (autologous transplant), and umbilical cord blood that was collected and stored after delivery for later use by the infant, a matched sibling, or an unrelated patient. Bone marrow transplantation is a widely accepted and successful therapy for treating a variety of malignant and nonmalignant diseases. Continuing research should yield new methods to ensure successful engraftment and to prevent or reduce complications post-BMT. Many patients with cancer have been cured with BMT. However, much work remains to improve survival and to better manage complications. New approaches under investigation may expand the availability of transplantation and improve short- and long-term survival and quality of life.

Adult↗
PubMed1995

Urinary multiple marker screening for Down's syndrome.

We have examined the possibility of using multiple markers in maternal urine rather than serum in order to screen for Down's syndrome. Urine samples were available from 36 cases (24 Down's syndrome, five Edwards' syndrome, three Turner's syndrome, one Klinefelter's syndrome, one triploidy, one triple-X, one twin discordant for Down's syndrome) and 294 controls, including three twins. Three markers were tested: the beta-core fragment of human chorionic gonadotrophin (hCG), total oestrogen (tE) and the free alpha subunit of hCG. Levels were corrected for creatinine excretion and expressed as multiples of the gestation-specific median (MOM) level from the singleton controls. The median value for the singleton Down's syndrome cases was 6.02, 0.74, and 1.08 MOM for beta-core-hCG, tE, and alpha-hCG, respectively. The increases in beta-core-hCG and the reduction in tE levels were highly significant (P < 0.0001 and 0.005, respectively; Wilcoxon rank sum test) but the increase in free alpha-hCG was not (P = 0.40). On the basis of a mathematical model, the expected detection rate for a 5 per cent false-positive rate was 79.6 per cent for beta-core-hCG alone, which increased to 82.3 per cent when combined with tE. Aneuploidies other than Down's syndrome were characterized by low levels of tE and either low or high beta-core-hCG.

Adult↗
PubMed1995

A comparison of 'abruptly stopping' with 'tailing off' oral corticosteroids in acute asthma.

Systemic corticosteroids are almost universally used in the treatment of severe acute asthma but the optimum length of treatment with corticosteroids following recovery from an acute attack of asthma is not established. Thirty-five patients admitted with acute asthma and treated with oral prednisolone 40 mg daily in addition to bronchodilator therapy until full recovery, with stable peak expiratory flow recordings (PEF) within 15% of their previous best PEF or predicted PEF were studied. They were all discharged home on regular inhaled corticosteroids and regular or as required use of bronchodilators and randomized to receive either prednisolone 40 mg daily or placebo for the first 14 days. Median PEF values increased from 31% predicted on admission to hospital to 71% predicted on discharge from hospital in the active treatment group (19 patients) and from 32-73% in the placebo group (16 patients). There was no difference between the two groups in the median values of the forced expiratory volume in one second, forced vital capacity, total lung capacity or diurnal variation in PEF either at the time of discharge from hospital or at 14 and 28 days after discharge from hospital. This study suggests that there is no need to reduce prednisolone gradually following recovery from an exacerbation of asthma, provided systemic corticosteroid treatment is continued until a satisfactory and stable PEF is achieved.

Acute Disease↗
PubMed1995

A trauma centre in the UK: the Stoke experience.

This paper outlines the development of a pilot trauma centre in Stoke on Trent, UK, as part of the Department of Health Trauma Centre Evaluation Project. A historical background to the Evaluation Project is included along with details of the evolution of trauma services in North Staffordshire, UK. The authors draw upon their personal experiences of working in the pilot centre and provide an insight into how the Emergency Department, in particular, met the challenge.

Health Services Research↗
PubMed1995

Clinical support and the Project 2000 nursing student: factors influencing this process.

This paper reports on research commissioned by the English National Board for Nursing, Midwifery and Health Visiting into mentorship and clinical support arrangements for Project 2000 nursing students in the adult and mental health branches. Interviews and observation data were gathered from staff and students in three of the demonstration centres. Findings showed that the terms 'mentorship', 'assessor' and 'supervisor' were used interchangeably and covered diverse roles in both clinical and community settings. Generally there was an impression that staff were willing to help students learn from their experience but felt unprepared for the 'new nursing students'. Several factors emerged which seemed either to promote satisfactory experiences for students or inhibit their learning and enjoyment of the placement. These are discussed under the themes 'supernumerary status', 'team spirit', 'theory and practice', 'diploma level practice' and 'organization of nursing teams'.

Education, Nursing↗
PubMed1995

Aboriginal wellbeing and liquor licensing legislation in Western Australia.

This paper is based on the results of a project undertaken as the basis for a submission to the committee established to review the Western Australian Liquor Licensing Act 1988. It reports on key issues relating to liquor licensing, as identified by members of regional Aboriginal organisations. Among these issues are the promotion of alcohol consumption and misuse, discriminatory practices by licensees and the police and the need for greater community involvement in liquor licensing decisions. To address these issues, members of the participating organisations proposed: inclusion of a harm-minimisation objective in the Act, education and training programs for the public, licensees and the police, and industry funding for harm-minimisation programs.

Alcohol Drinking↗
PubMed1995

Care of schizophrenia in general practice: the general practitioner and the patient.

BACKGROUND: The transfer of patients with chronic schizophrenia from large mental hospitals into the community has had an impact on the role of the general practitioner in the effective delivery of primary care services to these patients. AIM: A study was undertaken to assess the care available in general practice for patients with schizophrenia, the attitudes of general practitioners and patients to the care provided and the factors influencing patients' use of services. METHOD: Eighty three patients with a diagnosis of schizophrenia and 26 doctors in 13 London practices registered on the VAMP research bank took part in a series of structured and semi-structured interviews. This was followed by a systematic examination of the patients' case notes. RESULTS: Only 14 patients (17%) had no active symptoms according to the present state examination interview and 52 (63%) were currently taking antipsychotic medication. Fifty three patients were in contact with a psychiatrist. Approximately one quarter of patients were visited by a community psychiatric nurse; in 18 of these 19 cases, the main reason for contact was reported to be for administration of medication by depot injection. In all but one case, patients seeing a community psychiatric nurse were also being seen by a psychiatrist. Sixteen doctors reported having had a consultation in the previous month with a patient's relative, friend or member of hostel staff. There were considerable differences between patients and their doctors in their attitudes to the use of services. Of the 26 general practitioners, 23 were enthusiastic about the possibility of introducing shared care records. Of the 54 patients in contact with a mental health professional, only 18 favoured the use of shared care records. Most of the doctors (19, 73%) reported they would welcome a psychiatric liaison service in their practice; 40% of 53 patients said they would not. Patients receiving antipsychotic drugs and patients registered with inner city practices attended their general practitioners more frequently than those not taking antipsychotic medication and those registered with suburban practices. Use of antipsychotic medication (adjusted odds ratio (OR) 8.2, 95% confidence interval (CI) 2.2 to 30.7, P < 0.01), male sex (OR 5.8, 95% CI 1.5 to 22.1, P < 0.01) and active symptoms on the present state examination (OR 4.1, 95% CI 1.0 to 17.5, P = 0.06) were all predictive of current contact with mental health professionals. CONCLUSION: Family doctors were closely involved with the care of patients with schizophrenia and their relatives and were eager for increased liaison with secondary care services. Although patients were more resistant than doctors to management innovations this may reflect lack of familiarity with changes in community services. Greater input is needed by mental health professionals, particularly community psychiatric nurses, and some consideration of the burden of care in inner city practices is necessary in health service planning.

Adult↗
PubMed1995

Acute leukemia and the transient myeloproliferative disorder associated with Down syndrome: morphologic, immunophenotypic and cytogenetic manifestations.

Individuals with Down syndrome have an increased incidence of leukemia compared to the general population. In addition, Down syndrome children may acquire a myeloproliferation that resembles acute leukemia that undergoes a spontaneous, durable remission. To clarify the relationship between these two disorders, the morphologic, immunophenotypic and cytogenetic characteristics of 28 patients with Down syndrome and the morphologic manifestations of acute leukemia were examined. Three cytomorphological groups were discerned. The first two groups consisted of five patients with acute lymphoblastic leukemia (group I) and three patients with acute myeloid leukemia (group II). These leukemias resembled those of non-Down individuals. The third and largest group (group III) consisted of 20 cases of acute myeloid leukemia that showed prominent megakaryocytic and/or erythroid differentiation and occurred in children under 6 years of age. The blasts in this group were non-reactive for myeloperoxidase or non-specific esterase and expressed CD7, CD34 and CD36 with variable expression of CD61, CD13 and CD33. Four patients in this group had an acquired trisomy 8. Four group III leukemias underwent a durable, spontaneous remission within 2 months of diagnosis. There were no morphologic differences between those leukemias in this group that progressed and those that remitted; however, all remissions occurred in newborns. It is concluded that Down syndrome children acquire a characteristic acute myeloid leukemia that has prominent megakaryocytic and/or erythroid differentiation and an unusual immunophenotype. This group of leukemias may undergo a durable, spontaneous remission in the newborn period.

Acute Disease↗
PubMed1995

Indicator-based audit of cataract surgery in four neighbouring hospitals in East Anglia.

To review and compare management and outcomes of patients undergoing cataract surgery in order to improve practice by identifying weaknesses and standardising best practice where appropriate, a concurrent and prospective audit from June to October 1993 was carried out in four neighbouring ophthalmic units in East Anglia. Six hundred and twenty-seven consecutive patients were undergoing cataract surgery in the audit period. The main measures and results were as follows: (1) Patients with visual acuity reduced to 6/60 or less should not wait longer than 3 months from consultation to surgery; 69.5% met standard. (2) Patients with visual acuity reduced to 6/18 or less should not wait longer than 12 months from consultation to surgery; 85.8% met standard. (3) Patients who have had cataract surgery should achieve 6/12 or better corrected visual acuity by 3 months post-operatively; 88.6% met standard. (4) There should be less than 2% sight-threatening complications of surgery; 4.2% suffered sight-threatening complications. (5) There should be no life-threatening complications of surgery; 100% met standard. The audit identified key areas of variation in practice, and analysis of reasons for differences in outcome has led to some changes in the management of patients with cataracts in the four units.

Adolescent↗
PubMed1994

Fluid velocity imaging of reservoir core samples.

Experimental definition of fluid flow in heterogeneous reservoir rock requires three dimensional imaging techniques. Fluid velocity mapping at a steady-state flow condition plus oil/water saturation mapping using MRI provides a high resolution view of the process.

Kerosene↗
PubMed1994

Quantification of oil and water in preserved reservoir rock by NMR spectroscopy and imaging.

Reservoir rock analysis by proton NMR requires separation of the response into brine and crude oil components. Tests on preserved core from a North Sea chalk reservoir show that spin-lattice relaxation time distributions can be used to distinguish the two fluids. NMR estimates of oil and water saturations for 1.5" diameter core examined in a 10 MHz Bruker Minispec spectrometer closely match fluid contents determined by distillation. The spin-lattice relaxation contrast mechanism developed for core samples can be applied in the quantitative analysis of NMR images. The relaxation data are compared with data from chemical shift imaging on the same core sample. The results indicate that it will be possible to monitor changes in fluid distributions, in this and similar systems, under dynamic conditions such as in a waterflood.

Calcium Carbonate↗
PubMed1994

Beyond the department's doors: pre-hospital emergency care.

This paper will define immediate care and outline its development in the UK. The training needs for Accident and Emergency (A & E) nurses involved in pre-hospital care will be discussed. The importance of personal safety will be emphasised as will the safety of the scene and that of the patient. Equipment used in the pre-hospital environment will be considered. Finally, the role of the A & E nurse will be examined.

Curriculum↗
PubMed1994

Face perception in children with autism and Asperger's syndrome.

Children with diagnoses of either autism or Asperger's syndrome were matched on measures of verbal mental age with nonautistic control children. They were tested on their abilities to process both facial and nonfacial stimuli. There were no significant differences between the low ability autistic and control groups, but the high ability autistic and Asperger's children performed significantly worse than controls across all tests. Group averages masked substantial individual variation. The results are seen as indicating a general perceptual deficit that is not specific to faces or emotions. This appears to be a common correlate of autism and Asperger's syndrome, rather than a core symptom.

Aptitude↗