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Biomedical subjects

S George

Publications and source records attributed to S George.

At least 181 records · Page 10Linked to original sources
PubMed1995

Characterization of systemic lupus erythematosus in patients in U.A.E.

Twenty-eight SLE patients (Arabs and Asians) in the UAE were studied in this report. The F:M ratio was markedly high; 27:1 in the group as a whole and 21:1 among Arabs. Local patients (Emirians) developed the disease at an earlier age compared to their expatriate Arab compatriots. Arthropathy occurred in 86% and nephropathy in 43% of cases. Next in frequency were leucopenia, mucocutaneous manifestations and serositis. Apart from lupus headache, the other neuro-psychiatric LE were uncommon or not encountered. Anti-cardiolipin syndrome, Sneddon's syndrome, shrunken lung syndrome, sicca complex, thyrotoxicosis and myasthenia gravis were also present in this small group of patients. Their presence reflects the marked heterogeneity displayed by the disease irrespective of the number of cases involved. An unusually high prevalence of anti ds (DNA) antibodies (92.5%) as compared to ANF (82.5%) was detected (P = NS). Anti-Sm antibody occurred in 30% of cases particularly in those patients with lymphadenopathy and fever. There was a relative paucity in the prevalence of anti RNP, Ro and La antibodies in this group. Differences with and similarities to previous reports concerning other populations are also presented.

Adolescent↗
PubMed1995

Impact of culture on pain management: an Australian nursing perspective.

Pain assessment and pain management are complex tasks. Knowledge and beliefs of patients, physicians, and nurses about pain are key determinants of clinical decision making. Despite new theoretical insights, routine approaches to pain assessment and management persist in practice. Culture is a potent force in shaping beliefs, behavior, and meaning about pain. In health care contexts, there may be conflict between care and cure and differing perceptions about the role and status of nurses that impinge on the provision of pain relief. The article explores aspects of culture, knowledge, and belief and their influence on pain management from an Australian perspective.

Attitude of Health Personnel↗
PubMed1995

Routine therapeutic monitoring of lamotrigine in epileptic patients using a simple and rapid high performance liquid chromatographic technique.

We have developed a simple and rapid high performance liquid chromatographic technique to determine lamotrigine concentrations in epileptic patients and validated it using external quality control material. The method has been used to monitor the lamotrigine concentration in 70 specimens from 61 patients. Only 50% of the specimens had concentrations within the proposed target range of 1 mg/L to 4 mg/L, and there was no relationship between lamotrigine concentration and age, sex, other anti-epileptic treatments, or dose, although this could in part be explained by concomitant anti-epileptic therapy. We suggest that lamotrigine should be monitored therapeutically in order to assess its efficacy and audit its use as an anti-epileptic treatment, especially with the introduction of this relatively new drug as monotherapy.

Adolescent↗
PubMed1995

An investigation into the extent of possible dilution of specimens received for urinary drugs of abuse screening.

Recent American and Swedish studies have shown an increase in "false" negative results when analysing dilute urine specimens for drugs of abuse. In the light of these studies, it was decided to perform a pilot study to determine the extent of possible specimen adulteration and dilution in a random batch of 50 urine specimens presented to this laboratory, using creatinine, osmolality, pH and relative density. It was found that 20% of the specimens were outside the pH range associated with the optimum working of Syva EMIT Drugs of Abuse in Urine (DAU) immunoassay screening techniques, and that if the National Institute on Drug Abuse (NIDA) recognized dilution cut-off of 1.8 mmol/L for urine creatinine concentration is applied, 84% of the specimens surveyed here would need to be repeated to ensure accurate results. Because of these findings, it is recommended that routine creatinine and pH estimations should be performed on all specimens submitted for urinary drugs of abuse screening, or at least when unexpectedly negative results are obtained.

Creatinine↗
PubMed1995

A preliminary evaluation of five rapid detection kits for on site drugs of abuse screening.

There are now several rapid drugs of abuse testing kits that have been designed for near-patient testing and on-site clinic screening for drug abuse. These kits are sold on the basis of their cost and rapid generation of accurate results. Five such kits have been evaluated by comparison with recognized and established methodologies. All of the kits evaluated were found to lack both sensitivity and specificity. An unacceptable proportion of false negative and false positive results were observed for most kits. This raises the question of their usefulness in the near-patient and clinic situation.

Cost-Benefit Analysis↗
PubMed1995

Increasing prevalence of human immunodeficiency virus infection among patients attending a clinic for sexually transmitted diseases.

Of 5883 patients screened during 1986 to 1993 in the sexually transmitted diseases (STD) clinic at a hospital in Vellore, south India, 105 (1.79%) were positive for human immunodeficiency virus (HIV) antibody. The prevalence of HIV infection increased from 0.26 per cent in 1986 to 2.64 per cent in 1993. In 1992 the prevalence was even higher, namely 3.94 per cent. The overall prevalence in these 8 yr was 1.98 per cent among men (n = 4392) and 1.21 per cent among women (n = 1491), the difference being statistically significant (P < 0.05). The prevalence in men rose from 0.36 per cent in 1986 to 4.24 per cent in 1992, and in women from 0 to 3.04 per cent during the same period. The major source of infection in men was female commercial sex workers, but among women it was mostly their husbands. The increase in prevalence of HIV infection is alarming, and indicates that the massive educational campaigns and other preventive measures have not resulted in decreased transmission.

Ambulatory Care Facilities↗
PubMed1994

Intravenous pamidronate disodium treatment of bone metastases in patients with breast cancer. A dose-seeking study.

BACKGROUND: Treatment of the symptoms of bone metastases currently involves the use of narcotic medication, radiation therapy, or hormonal therapy. Pamidronate disodium, a bisphosphonate, may prove helpful in the palliative treatment of bone metastases in patients with breast cancer as demonstrated in this multicenter, dose-ranging trial. METHODS: Ambulatory female patients age 18 years or older with breast cancer metastatic to bone and a life expectancy of at least 3 months were eligible for the study. Bone metastases were confirmed by bone scan or bone survey within 6 months of enrollment. Sixty-one patients were treated as outpatients and were randomized to receive one of four intravenous pamidronate regimens for 12 weeks: 30 mg administered every 2 weeks, 60 mg every 4 weeks, 60 mg every 2 weeks, or 90 mg every 4 weeks. The primary efficacy parameter for this study was pain score. The change from baseline in pain score was determined for each patient at each study visit and at endpoint, defined as the last postbaseline evaluation for each patient before or at week 12. Secondary efficacy variables included narcotic scores, urinary calcium/creatinine and hydroxyproline/creatinine ratios, serum osteocalcin and bone alkaline phosphatase concentrations, and bone lesion (radiologic) response. RESULTS: At 3 months, the regimens of 60 mg every 4 weeks, 60 mg every 2 weeks, and 90 mg every 4 weeks resulted in significant reduction in bone pain beginning by week 6 of treatment. The regimen of 30 mg every 2 weeks was not effective. Narcotic use, as reflected by narcotic scores, did not parallel the pain scores, because there was little evidence of any effect for any of the treatment groups. Reduction in bone pain was accompanied by decreases in urinary calcium/creatinine and hydroxyproline/creatinine ratios, and bone alkaline phosphatase concentrations. Side effects of pamidronate were mild and transient. Radiographic changes consistent with healing of lytic lesions were observed in 15 patients (25%). CONCLUSION: Intravenous pamidronate is a well tolerated treatment that produced significant relief of bone pain in the majority of patients with metastatic breast cancer at the three highest doses tested.

Adolescent↗
PubMed1994

Carbohydrate metabolism studies after one year of using an oral contraceptive containing gestodene and ethinyl estradiol.

UNLABELLED: The objective of the study is to evaluate the effects of a gestodene-containing oral contraceptive on carbohydrate metabolism. The design of the study is prospective. The setting is at University of South Florida Outpatient Unit. The patients consisted of twenty-three normal women desiring contraception. Serum glucose and insulin levels were measured during a three-hour glucose tolerance test at control time and after one year of drug use. RESULTS: All of the one-year glucose values were significantly elevated as well as the fasting and three-hour insulin values. These changes were mostly confined to women over 26 years of age and not in the younger 18 to 23 year olds. An oral contraceptive containing 75 micrograms of gestodene and 30 micrograms of ethinylestradiol can significantly alter carbohydrate metabolism in older women.

Adolescent↗
PubMed1994

A comparative study of the safety and efficacy of dysprosium-165 hydroxide macro-aggregate and yttrium-90 silicate colloid in radiation synovectomy--a multicentre double blind clinical trial. Australian Dysprosium Trial Group.

The aim of our study was to compare the safety and efficacy of a new preparation, Dysprosium-165 Hydroxide Macroaggregate (165Dy) with Yttrium-90 Silicate (90Y) for radiation synovectomy of the knee in patients with RA and OA. A multicentre double blind clinical trial with subjects randomized to receive 165Dy or 90Y was undertaken in Sydney, Melbourne and Perth. Seventy knees of 59 patients were studied, using as clinical end point measurements, pain in the knee on walking, pain in the knee at rest and stiffness in the knee after rest. Cytogenetic damage, knee retention and extra-articular spread of the radionuclide to regional lymph nodes, liver, urine and blood were evaluated. There was no significant difference in clinical response in the two treatment groups for either RA or OA. Chromosomal changes occurred with equal frequency and the knee retention and extra-articular leakage of radiocolloids to regional lymph nodes and liver were comparable in the two groups. For radiation synovectomy of the knee, 165Dy is at least as safe and as effective as 90Y and has the advantage of a short half-life (2.334 h) and hence requires a shorter period of post-injection immobilization and hospitalization.

Aged↗
PubMed1994

Nurse practitioners in accident and emergency departments: reflections on a pilot study.

This paper reflects on the conduct of a pilot study which was intended to prepare the ground for a randomized, controlled clinical trial of the assessment and treatment of patients with minor injuries by nurse practitioners or senior house officers (junior doctors) in an accident and emergency department. The authors believe that such reflection makes a useful contribution to the growing debate about methodology in health services research. Following a brief literature review on nurse practitioners, the intended research design is explained. The authors then describe how observation in the chosen department led to a change in design, involving trial use of patient-kept diaries as a means of assessing outcome. Despite promising results from the third diary exercise, doubts remained about the validity of the relationship between process and outcome. The small number of patients managed by nurse practitioners compared to the greater number managed by junior doctors posed difficulties for randomization; similarities in pathways of care for patients managed by the two staff groups made it unlikely that differences in outcome could be demonstrated. These problems led to abandonment of the plan for a clinical trial at that point, but the authors believe that further exploration of the idea is desirable.

Data Collection↗
PubMed1994

Screening for coronary heart disease risk factors in retail pharmacies in Sheffield, 1992.

OBJECTIVE: To investigate the current and likely future provision of screening services for risk factors for coronary heart disease in retail pharmacies in Sheffield. DESIGN: This was a questionnaire survey asking about screening tests currently offered, price charged per test, likely future provision of screening tests, the action respondents would take upon finding an abnormal test result, whether the pharmacy was owner-run, franchised, or part of a commercial chain, and inviting open comments from respondents. SETTING: All retail pharmacy premises on the Sheffield Family Health Services Authority list. RESULTS: Seventy seven responses were obtained to 102 questionnaires distributed. Only nine of these currently offered any screening test other than pregnancy testing, although 37 indicated that they might offer tests in the future. Thirty nine were not offering screening and had no plans to do so. Pharmacies offering or likely to offer screening tests were mainly owner-run. All pharmacists who replied to the question asking about their action upon finding abnormal result (33) reported that they would advise the patient to see a doctor. The most frequent comments made by pharmacists were about the commercial viability of screening in pharmacies and the lack of space available to ensure patient privacy and confidentiality during screening. CONCLUSIONS: Screening in retail pharmacies would probably be a commercial failure unless doctors were able to contract for screening services from pharmacies. Evidence from this study and others, however, leads us to question the desirability of this option.

Attitude of Health Personnel↗
PubMed1994

Drugs of abuse screening in the West Midlands: a 6 year retrospective survey of results.

We describe the results of urinary drugs of abuse screening performed by the West Midlands Regional Laboratory for Toxicology, Birmingham, UK, on more than 27,800 urine specimens received between January 1988 and December 1993. The number of specimens positive for amphetamine declined from 1988 to 1990, but this was followed by a doubling of specimens testing positive from 5.7% in 1990 to 12.0% in 1993. There is very little evidence of methamphetamine or Ecstasy abuse in the West Midlands. Morphine (assumed to be from heroin abuse) is the most common opiate detected, with 11.7% of all specimens received proving to be positive in 1993. The incidence of cocaine abuse is low, less than 5% when requests are based on clinical judgement, and less than 3% in the overall population monitored.

Amphetamine↗