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Biomedical subjects

S Thomas

Publications and source records attributed to S Thomas.

At least 451 records · Page 25Linked to original sources
PubMed1995

Children and bicycles: what is really happening? Studies of fatal and non-fatal bicycle injury.

OBJECTIVES: The objectives of the study were to ascertain the causes of accidents, injuries, and deaths in children who ride bicycles. Fatality and injury rates were also studied in order to compare with other studies. METHODS: Two studies of children were undertaken in children aged less than 15 years. In the first (retrospective fatality study), children who died as a result of a bicycle incident during the period 1981-92 were reviewed. In the second (prospective injury study) data were obtained prospectively between April 1991 and June 1992 about children who were injured while riding a bicycle and treated at a public hospital in Brisbane. RESULTS: Study 1: fatality rates for boys were twice those for girls. The rate was highest for boys of 14 years in the metropolitan area at 6.23/100,000. All deaths involved vehicles, and the majority involved head injury or multiple injuries including head injury. Study 2: similar numbers of children were injured at onroad and off-road locations. Faculty riding was described by the rider or caregiver as the cause in 62.5% of cases. The most common time of injury was between 3 and 6 pm on both school and non-school days. Only 5.5% of all incidents involved a moving vehicle. CONCLUSIONS: Bicycle riding by children is a common cause of injury, particularly for boys. Equal numbers of injuries occurred on the road as at other locations. Faulty riding caused most accidents. Injury prevention for bicycle riders should involve not only compulsory wearing of helmets, but should also include education and training about safe riding habits, separation of motorised vehicles from bicycles, modified helmet design to incorporate facial protection, and improved handlebar design.

Accident Prevention↗
PubMed1995

Haplotype analysis in autosomal dominant polycystic kidney disease.

Haplotype analysis was performed in 35 autosomal dominant polycystic kidney disease (ADPKD) families typed with 13 markers close to the PKD1 locus. The identification of recombinants close to the PKD1 gene on chromosome 16p indicates that PKD1 lies between CMM65 distally and 26-6 proximally. In addition, three unlinked (PKD2) families and two families with potential new mutation were identified.

Adult↗
PubMed1995

Rapid troponin T measurement in whole blood for detection of myocardial damage.

A dry chemistry system for rapid qualitative measurement of cardiac troponin T in whole blood, serum, EDTA and lithium heparin plasma was studied in 197 admissions to the coronary care unit and general wards of a typical district general hospital for whom troponin T was requested. This included patients with unexplained collapse, acute dysrythmia or elevated creatine kinase of unknown origin. EDTA whole blood and plasma proved the most satisfactory sample matrices. Lithium heparin whole blood was equally appropriate but lithium heparin plasma gave a false negative result. Serum was an unsatisfactory sample material. Comparison with the conventional wet chemistry quantitative enzyme-linked immunosorbent assay showed a positive bias for EDTA plasma, particularly in the range 0-1 microgram/L and a significant negative bias for lithium heparin plasma. There was no difference between serum from plain or gel separator tubes. The whole blood method allows troponin T measurement to be performed rapidly and simply in the laboratory, either as an emergency test to alter patient management, or for those laboratories that wish to offer troponin T for selected cases but do not have the ability to measure troponin T quantitatively.

Adult↗
PubMed1995

A research agenda for health education among underserved populations.

This article summarizes the outcome of health education efforts among populations that, due to their cultural heritage, have received limited services. The literature reviewed shows that programs found to be effective in one population cannot be assumed to be equally effective with a different population. An argument is made for the design of culturally appropriate and group-specific interventions which would properly serve the various underserved populations. Research needs to be conducted to identify appropriate approaches and intervention strategies, as well as the group-specific sociopsychological characteristics (attitudes, norms, values, expectancies) that are related to health-damaging and protective behaviors.

Attitude to Health↗
PubMed1995

The cost of wound care in the community.

As part of a project examining expenditure on all wound management materials currently prescribed by general practitioners in Wales, the cost of bandages and surgical tapes was analysed. Changes to prescribing patterns are suggested which could result in significant financial savings and improvements in patient care.

Adhesives↗
PubMed1995

The cost of wound care in the community.

Prescriptions issued between July 1993 and June 1994 for wound management materials cost the NHS in Wales a total of 5.5 million pounds. A detailed analysis of Welsh PACT (prescribing analysis and cost) data suggests that this expenditure could be reduced by up to 140,000 pounds by the introduction of minor changes in prescribing patterns. These savings would be achieved with no reduction in the quality of care provided to patients, and in some instances the changes proposed would lead to the use of products which are superior in performance terms to those items that are currently being prescribed. More fundamental changes, involving the exclusion of some products of questionable efficacy, would result in additional savings up to a maximum of 527,000 pounds. As expenditure in Wales is generally considered to represent approximately 10% that of the UK as a whole, this figure could approach 5 million pounds on a national basis.

Bandages↗
PubMed1995

Collagen metabolism in two types of autosomal dominant osteopetrosis during stimulation with thyroid hormones.

In order to investigate collagen metabolism in two different types of autosomal dominant osteopetrosis (ADO), eight patients with type I (aged 23-61 years, mean 40.4 years) and nine patients with type II ADO (aged 20-49 years, mean 32.8 years) were compared with ten normal controls (aged 22-54 years, mean 35.4 years). The subjects were treated with 100 micrograms of triiodothyronine (T3) daily for 7 days and followed for a total of 4 weeks. Serum T3 increased in all subjects and a corresponding suppression of thyroid-stimulating hormone (TSH) was observed. Serum carboxy-terminal propeptide of type I collagen (S-PICP) in the control and type I groups showed no difference at baseline, whereas type II was lower than controls (p < 0.01). No significant alterations following stimulation were observed in any of the groups. Serum BGP (osteocalcin) values in the two patient groups were insignificantly lower than controls both at baseline and throughout the study. Following stimulation, a significant response was seen in the three groups (p < 0.001). The increases during the treatment period (delta values) for controls, type I and type II were 47.6% (p < 0.01), 51.7% (p = 0.05) and 34.8% (NS), respectively, with no difference between the groups. Serum bone-specific alkaline phosphatase (S-ALP) was not different between the groups and no alterations were observed in relation to treatment. The serum N-terminal propeptide of type III collagen (S-PIIINP) showed no difference at baseline between type I and controls but was significantly higher (p < 0.003) in type II than in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Haemolytic properties of pluronic surfactants and effects of purification.

The effects of incubating blood from mice, rats, rabbits or hamsters with either a commercial grade or a silica-purified fraction of Pluronic F-68 or Pluronic F-38 have been studied. Incubation of blood with up to 4.0% (w/v) of commercial or purified Pluronic F-68 produced no detectable haemolysis (< 0.1%). Haemolysis did occur with concentrations of commercial Pluronic F-68 above 4.0% (w/v). This was maximal with rat blood incubated with 10.0% (w/v) Pluronic F-68, where the mean haemolysis was 4.7 +/- 1.5%; the mean haemolysis in rat blood was reduced to 0.5 +/- 0.3% (P < 0.05) following incubation with the purified Pluronic F-68 fraction. Neither commercial grade or purified Pluronic F-38 produced any significant haemolysis when incubated with rat or hamster blood. Incubation of rabbit blood with 10.0% (w/v) commercial Pluronic F-38 produced only 0.5% haemolysis.

Animals↗
PubMed1995

Factors associated with perceived competency levels of graduating seniors in a baccalaureate nursing program.

Factors hypothesized to affect perceived competency levels of graduating seniors were examined in three classes from a BSN program in a large southeastern university (N = 204). Although externship participation was unrelated to perceived competency, employment in a health care setting during the nursing program was positively related. Trait anxiety and social support were also significantly related to competency. A pervasive theme in both quantitative and qualitative data was students' desire for more practice of technical skills. Students also expressed the desire for more positive feedback from faculty. There are a number of implications of these findings, including curricular modifications, identification and intervention with highly anxious students, and increased faculty caring and support. Given the rigor of the professional nursing role, we owe it to our graduates to send them into the work arena with a healthy sense of self-confidence.

Adaptation, Psychological↗
PubMed1995

Recanalization of coronary occlusions using the Magnarail system: technique and procedural outcome.

Angioplasty for occluded coronary arteries is less successful than for sub-total stenoses. The Magnarail system (Schneider) has been designed to improve success rates. We used the system in 112 patients with coronary occlusions (TIMI flow < or = 1) which the operator felt suitable for angioplasty. It was successful (defined as < 50% stenosis) in 75.9% overall, 65.9% in occlusions > 3 months and 83.3% < 3 months. Intimal dissection occurred in 26 instances, more commonly after right coronary angioplasties. One patient died and one procedure was complicated by coronary perforation treated surgically. The procedure was less successful in the right coronary artery (p = 0.02). Coronary calcification (p = 0.03), the absence of a tapered occlusion (p = 0.04) and the absence of collaterals from another vascular territory (p = 0.04) were all associated with angiographic failure. The mean fluoroscopy time for the procedures was 22.8 +/- 16.9 minutes. The Magnarail system seems highly effective in recanalization of coronary occlusions.

Adult↗
PubMed1995

Measurement of activated factor IX in factor IX concentrates: correlation with in vivo thrombogenicity.

Current in vitro tests for thrombogenicity of FIX concentrates used for prothrombin complex concentrates (PCCs), are of little value when applied to high purity FIX (HP FIXs). In the present study, we have developed a chromogenic assay for activated FIX (FIXa) and evaluated its ability to predict in vivo thrombogenic potential of HP FIXs in a modified Wessler stasis model. Among the HP FIXs, only 1 out of 7 products had no detectable FIXa; this product also showed no in vivo thrombogenicity. In the other 6 products, FIXa content ranged from 0.15-1.2 U/1000 in FIX, and all showed some evidence of in vivo thrombogenicity, with mean thrombus scores ranging from 0.25-4. There was a significant positive correlation (r = 0.55, p < 0.02) between FIXa levels and in vivo thrombogenicity of HP FIXs. NAPTT data were not significantly correlated with the in vivo results and the TFCT also showed no direct correlation with the mean thrombus score. These results indicate that HP FIXs may still carry a small residual thrombotic risk and measurement of FIXa content of these products may be a better predictor of thrombogenicity than the current in vitro tests.

Animals↗
PubMed1995

Fluid handling properties of hydrogel dressings.

The fluid handling properties of four hydrogel dressings were examined in a laboratory-based study to determine their ability to absorb liquid from or donate liquid to a range of standard test substrates simulating wound tissue in various states of hydration. The tests suggest that three of the dressings are likely to be effective fluid-donating agents, and one of the dressings has a dual ability to donate or absorb liquid depending upon moisture content and nature of the substrate to which it is applied. These observations are discussed in the context of the clinical use of hydrogel dressings.

Absorption↗
PubMed1995

The cost of wound care in the community. Part two in a series of three articles discusses the expenditure on wound management materials.

As part of a project examining expenditure on all wound management materials currently prescribed by general practitioners in Wales, the cost of dressing packs, pharmaceutical preparations and surgical absorbents was analysed. The findings suggest that by replacing non-woven swabs for woven swabs and by discontinuing the use of topical antibiotic powders and multiple dressing packs, considerable savings can be made.

Bandages↗
PubMed1995

Clinical decision-making in critical care.

A survey of 230 practising critical care nurses was conducted to examine the frequencies with which the nurses made decisions to perform 10 critical care tasks drawn from cardiac, respiratory and gastrointestinal management. The relationship between the nurses' levels of appointment and the frequencies with which they made their decisions was also studied. Substantial intra-respondent and inter-respondent variations were found in the frequencies with which nurses reported that they made the decisions. Chi-square analysis showed that there was a positive association (p < 0.05) between nurses' appointment levels and the frequency with which decisions were made to perform five of the tasks. Notwithstanding these associations, it is of concern that the professional preparation of some nurses had not been at a level that equipped them to routinely make these decisions. The findings of the study have implications for the development of standards of practice guidelines and critical care education.

Adult↗
PubMed1995

[Ureterorenoscopy in children].

Ureterolithiasis is rare in children. Although ureterorenoscopy is needed only in few cases, because of the small number of children who suffer from ureteral stones, the development of small-calibre semi-flexible instruments for the treatment of any ureteral stones can be seen as a useful extension of the range of therapeutic options. The established technique used in adults can also be applied in children. It is recommended that endoscopic stone treatment should be carried out in children only by operators who can draw on a wide experience of such procedures in adults. The small-calibre instruments must be used and extreme caution is still required. We report on our experience with ureterorenoscopy in 12 children.

Adolescent↗
PubMed1994

Control of glucose utilization in working perfused rat heart.

Metabolic control analyses of glucose utilization were performed for four groups of working rat hearts perfused with Krebs-Henseleit buffer containing 10 mM glucose only, or with the addition of 4 mM D-beta-hydroxybutyrate/1 mM acetoacetate, 100 nM insulin (0.05 unit/ml), or both. Net glycogen breakdown occurred in the glucose group only and was converted to net glycogen synthesis in the presence of all additions. The flux of [2-3H]glucose through P-glucoisomerase (EC 5.3.1.9) was reduced with ketones, elevated with insulin, and unchanged with the combination. Net glycolytic flux was reduced in the presence of ketones and the combination. The flux control coefficients were determined for the portion of the pathway involving glucose transport to the branches of glycogen synthesis and glycolysis. Major control was divided between the glucose transporter and hexokinase (EC 2.7.1.1) in the glucose group. The distribution of the control was slightly shifted to hexokinase with ketones, and control at the glucose transport step was abolished in the presence of insulin. Analysis of the pathway from 3-P-glycerate to pyruvate determined that the major control was shared by enolase (EC 4.2.1.1) and pyruvate kinase (EC 2.7.1.40) in the glucose group. Addition of ketones, insulin, or the combination shifted the control to P-glycerate mutase (EC 5.4.2.1) and pyruvate kinase. These results illustrate that the control of the metabolic flux in glucose metabolism of rat heart is not exerted by a single enzyme but variably distributed among enzymes depending upon substrate availability, hormonal stimulation, or other changes of conditions.

3-Hydroxybutyric Acid↗