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Biomedical subjects

T English

Publications and source records attributed to T English.

At least 19 recordsLinked to original sources
PubMed1997

Personal paper: medicine in the 1990s needs a team approach.

Health care increasingly emphasises the team approach in which doctors, nurses, and other health workers adapt and develop new skills. Before changes of this kind are widely accepted, however, there must be clarity about the training, status, authority, working relationships, career structure, and remuneration of those who undertake responsibilities well beyond their traditional roles.

Critical Care↗
PubMed1997

The use of upper extremity anthropometrics in the clinical assessment of patients with amyotrophic lateral sclerosis.

We evaluated the feasibility of using upper extremity anthropometrics to monitor the clinical status of 18 patients with amyotrophic lateral sclerosis (ALS). The bone-free arm muscle area (AMA) was computed using measurement of triceps skinfold thickness and the mid-upper arm circumference according to published formulae. The AMA correlated significantly with body mass, isokinetic muscle force generation, cross-sectional muscle area on computerized tomography scanning, and pulmonary functions including forced vital capacity and maximal voluntary ventilation. Serial determinations of AMA demonstrated a decline in 10 of 13 patients over 6 months. We pilot tested the use of AMA in a clinical trial of ciliary neurotrophic factor (CNTF) in the treatment of ALS. The AMA progressively decreased by 13%, 15%, and 30% in ALS patients treated with 0 microg CNTF/kg, 15 microg CNTF/kg, and 30/microg CNTF/kg, respectively, over a 9-month treatment period. We conclude that measurement of AMA provides a simple, inexpensive method to monitor the progression of muscle atrophy in ALS patients. The technique does not require effort on the part of the patient and as such, appears to have potential utility as an outcome measure in clinical drug trials.

Adult↗
PubMed1996

Risk management.

Explore the source record for details and available documents.

Maintenance and Engineering, Hospital↗
PubMed1991

The coronary arteries of the transplanted human heart: studies of the development of disease based on serial angiography.

291 coronary angiograms were performed routinely 1 to 8 years after cardiac transplantation in 116 patients operated on at Papworth Hospital between January 1979 and September 1986. In this setting, as in others, angiography tends to underestimate the amount of disease present, and the patterns of angiographic abnormality are various. The actuarial probability of freedom from angiographic evidence of coronary occlusion is 79% at 2 years, 76% at 3 years, 60% at 4 years, 57% at 5 years. We have defined two disparate groups designated 'fast disease' and 'slow disease', being respectively those who have angiographic and/or pathologic evidence of disease at two years, and those who have normal coronary angiograms at 5 years. In comparing features of these two groups, donor age, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride level differ, though significantly only for the high density fraction.

Adult↗
PubMed1988

Cyclosporin A in cardiac transplantation: medium-term results in 62 patients.

Between March, 1982, and October, 1984, 62 patients underwent orthotopic cardiac transplantation in our institution. Immunosuppression was based on cyclosporin A (Cy A) and low-dose steroids with an initial 10-day course of antithymocyte globulin. Follow-up ranged between 39 and 71 months (mean, 51.7 months). Actuarial survival at 1 year through 5 years was 80.6%, 77.4%, 74.2%, 71.4%, and 63.5%, respectively. Graft atheroma led to graft failure in 6 patients, 4 of whom died between 23 and 55 months after transplantation and 2 of whom had a repeat transplantation at 32 and 53 months. Diastolic hypertension (90 mm Hg or higher) developed in 88% of patients at 1 year. Chronic renal impairment was evident in all patients who survived for 2 years. Mean serum creatinine preoperatively and at 1 year through 4 years was 1.49 +/- 0.08 mg/100 ml (+/- the standard error), 2.01 +/- 0.09 mg/100 2.07 +/- 0.09 mg/100 ml, 2.26 +/- 0.19 mg/100 ml, and 2.32 +/- 0.33 mg/100 ml, respectively. End-stage renal failure requiring regular hemodialysis developed in 3 patients, 2 of whom died. We conclude that in addition to graft atheroma, Cy A-related nephrotoxicity is emerging as a major cause of medium-term and long-term morbidity and mortality. The use of lower doses of Cy A in a triple-therapy protocol, that is, Cy A, azathioprine, and low-dose steroids, could help reduce the extent of renal impairment.

Adolescent↗
PubMed1980

Possession, prayer, and testimony: therapeutic aspects of the Wednesday night meeting in a Black church.

The value of the church as a psychological support system in the daily lives of many people is taken for granted. Yet, assiduous attention has not been paid to the specific mechanisms which churches may use to achieve this end. Even less attention has been given to black churches, particularly those which are independent institutions, with a loose regional or national affiliation to the well-known major denominations that allows the maintenance of the church's own autonomy. In this paper, we describe the Wednesday night prayer-meeting in an independent black church and outline the structure of the service which facilitates its use as a vehicle for mutual aid. We also discuss the ways in which members of the group experience the service as therapeutic. The utility of this exercise for some black people is explored, and the manner in which it may serve as a coping device is delineated. This special church service is presented as a model of a therapeutic group experience which functions to help some black underprivileged people adapt to the stresses of urban living.

Adult↗