Biomedical subjects
Publications and source records attributed to T Potter.
The development of nurse-practitioners offers real scope for improvement in A&E services. However, if it is to be successful, the education must be properly established.
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It has been reported that activated charcoal reduces intestinal gas production after ingestion of beans as evidenced by decreased breath hydrogen excretion and decreased passage of flatus. In the present study we assessed the ability of activated charcoal to reduce intestinal gas production by in vitro and in vivo methods. In vitro studies were performed using human fecal homogenates incubated with or without additional carbohydrate. In all studies hydrogen and carbon dioxide production and consumption occurred at similar rates in the charcoal-treated homogenate as compared with the untreated control. The influence of activated charcoal on gas production, in vivo, was studied by double-blind assessment of breath hydrogen excretion and flatus excretion after ingestion of a baked bean meal. No significant difference was observed in breath hydrogen concentration or number of passages of flatus in subjects who ingested 16 capsules of activated charcoal (4 g) as opposed to the placebo. We conclude that activated charcoal does not influence gas formation in vitro or in vivo.
We reviewed the results of sixty-one McKeever unicompartmental arthroplasties performed by the senior one of us (T. P.) for osteoarthritis of the knee. The average follow-up was five years (range, two to thirteen years). Forty-four (72 per cent) of the arthroplasties were rated as good to excellent. The average postoperative range of motion in these knees was 110 degrees. Six knees were rated as fair and eleven knees, as poor. The poor results appeared to be caused by degenerative arthritis involving ipsilateral compartments that had not been resurfaced with an implant.
Detailed serologic and biochemical characterization of D region products of the wild-derived mouse strain B10.GAA37 (Dw16) were performed and compared with previous studies of the D region products of the H-2d,b, and q haplotypes. Serologic analysis revealed that the antigens encoded by the Dw16 region express a unique combination of specificities defined by monoclonal antibodies (mAb) with established activity for the Ld and Dd molecules. Two out of five anti-Ld-reactive mAb reacted with B10.GAA37 cells, whereas one of three anti-Dd mAb showed B10.GAA37 reactivity. Sequential immunoprecipitation of B10.GAA37 antigens demonstrated the existence of at least two antigenically distinct molecules (designated Dw16 and Lw16) encoded by genes associated with the Dw16 region. Peptide map comparisons of the Dw16 and Lw16 molecules defined multiple differences in their primary protein structure, suggesting they are products of separate genes. Structural comparisons of the Lw16 and Dw16 molecules with the Ld and Dd molecules implied a) that the Dw16 and Dd regions did not result from a recent evolutionary divergence of a common primordial haplotype, and b) that the Lw16 and Dw16 molecules are more structurally homologous to each other than the Ld and Dd molecules are. Comparison of these findings with our previous studies of antigens encoded by the D regions suggest that each of these haplotypes has unique properties in terms of the number of gene products expressed and/or the structural relatedness of products of the same region.
Ten patients were prospectively studied using 99mTc-PIPIDA imaging to evaluate the effects of fasting and parenteral alimentation on gallbladder function. Three of ten patients had initial nonvisualization of the gallbladder for up to 2 hr, yet had normal visualization on repeat imaging performed after resumption of oral intake or after parenteral alimentation was discontinued. 99mTc-PIPIDA imaging should be interpreted with caution in patients fitting into either of these groups.
The Kinematic rotating hinge offers a solution as a salvage procedure for severely deformed and unstable "end-stage" knees. Excellent short-term results in terms of pain relief can be achieved, and motion up to 130 degrees is possible, depending on the condition of the quadriceps mechanism and the extent of scarring from previous operations. Care must be taken to avoid cortical penetration, especially in cases of hinge revisions, osteoporosis, thin-walled bones, and the presence of old cement. As with any total knee arthroplasty, care must be taken to achieve optimal rotatory alignment of the tibia beneath the femur to guarantee good patellar tracking.
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The management of corticosteroid-induced osteoporosis in rheumatology outpatients in the West Midlands was audited in relation to the 2002 Royal College of Physicians (RCP) Guidelines and re-audited in relation to the 1998 National Osteoporosis Society (NOS) Guidance. Practice was assessed from prospective data on all follow-up patients over a 2-week period in 13 rheumatology units. Data were analysed on 2,609 patients. Of the 626 patients fulfilling criteria for assessment against the RCP Guidelines, 351 (56.1%) were treated appropriately. The results do not allow for availability of, or wait for, DEXA scanning. Of 197 patients fulfilling the criteria for assessment against the NOS Guidance, 137 (69.5%) were treated appropriately, compared to 63% in a similar audit undertaken in 2000. Regional audit may facilitate clinical governance. These audits will inform discussion on both improving local practice and strengthening cases for improved osteoporosis services.