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Biomedical subjects

A Bliss

Publications and source records attributed to A Bliss.

10 recordsLinked to original sources
PubMed2000

Authors' reply

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Journal Article↗
PubMed2000

A pilot randomised controlled trial of medical versus nurse clerking for minor surgery.

BACKGROUND: Nurse led clerking is currently practiced in a growing number of UK centres, but there is a paucity of evidence to underpin the safety of this innovation. AIM: To assess the safety of nurse led clerking in paediatric day case and minor surgery. METHODS: Children aged 3 months to 15 years were randomly assigned to clerking by either a nurse or a senior house officer (SHO) (resident). All children were then independently reassessed by a specialist registrar anaesthetist to provide a "gold standard" against which practitioner performance could be judged. RESULTS: In 60 children studied, nurses identified a significantly greater proportion of the detectable abnormalities present in the sample (p = 0.16). This difference is attributable to nurses' greater accuracy in history taking (p = 0.04); no conclusions regarding the comparability of nurses' and SHOs' skills in physical examination can be derived from the current study. CONCLUSION: Evidence attests to the likelihood of nursing having superior skills in history taking to SHOs. Exploration of nursing safety in undertaking physical examination, however, requires the conduct of a large scale equivalence study. Only then can conclusions be drawn as to whether nurse led physical assessment offers children a standard of care equivalent to that which they currently receive from SHOs.

Adolescent↗
PubMed1991

Evaluation of a spring-loaded syringe driver for the subcutaneous administration of narcotics.

A simple spring-loaded syringe driver was tested for the subcutaneous administration of narcotic analgesics and antiemetics. With concentrations of 2 to 10 mg/mL of hydromorphone and 10 to 50 mg/mL of morphine, the infusion rate during preclinical testing was 1.01 +/- 0.1 mL/hr (range 0.70-1.2 mL/hr). The rate of infusion was not modified by the concentration of narcotic in solution. Clinical trials were performed with morphine in 17 patients, and with hydromorphone in 11 patients. The duration of the infusion was 21 +/- 11 days. The most frequent reason for discontinuation was death (22 cases). The average duration of the site of infusion was 6.3 +/- 4 days. When used subcutaneously, the rate of infusion of the device was 1 +/- 0.15 mL/hr (range 0.70-1.30 mL/hr). Patients and nurses were satisfied with the simplicity and safety of the device. Cost analysis shows that this device is significantly less expensive than currently available portable infusion devices. We conclude that the Medifuse Pump is an inexpensive, safe and effective device for the subcutaneous infusion of narcotics and antiemetics.

Adult↗
PubMed1987

Structural studies on bio-active compounds. Part 9. 2,4-Diamino-6-azidoquinazoline hydrochloride.

C8H7N7.HCl has a formula weight Mr237.7, and crystallizes in space group P21/n with a = 6.498(1), b = 10.333(8), c = 15.406(5) A, beta = 91.72(2) degrees. The final R factor was 0.049 for 1010 unique observed reflections. The azido substituent is almost linear, coplanar with the heterocycle, and parallel to the C(7)-C(6) ring bond. The heterocycle is protonated at N(1) and extensively hydrogen bonded. The 6-azido compound is at least a 100-fold better inhibitor of Escherichia coli dihydrofolate reductase than the analogue lacking the azido group, according to I50 values. Superimposing the quinazoline moiety upon the pteridine ring of the methotrexate-dihydrofolate reductase (E. coli) complex reveals two orientations of the N3 group in which it can fit the enzyme, making van der Waals contacts. Ab initio molecular orbital calculations suggest that one of these conformations, with torsion angle phi = C(5)-C(6)-N(61)-N(62) = -163.8 degrees, is low in energy.

Crystallography↗