PubMed Health⌕ Search

Biomedical subjects

A Key

Publications and source records attributed to A Key.

18 recordsLinked to original sources
PubMed2002

Psychosocial benefits of sentinel lymph node biopsy in the management of cutaneous malignant melanoma.

Lymphoscintigraphy combined with sentinel lymph node biopsy has become a powerful and sensitive tool in establishing nodal spread in cutaneous melanoma, as well as in breast and other cancers. Although the technique is reliable and validated, there is, as yet, no proven clinical benefit. A suggested benefit of sentinel lymph node biopsy is that a negative biopsy may decrease the psychological morbidity associated with malignancy by reassuring the patient that he or she has localised disease. We studied a group of patients with cutaneous melanoma who underwent sentinel lymph node biopsy, and found that although they did gain some psychosocial benefit from the procedure, this was short term and they were still significantly concerned about their disease status.

Adolescent↗
PubMed2001

Clinical reasoning of an experienced physiotherapist: insight into clinician decision-making regarding low back pain.

BACKGROUND AND PURPOSE: Investigation of the clinical reasoning skills of experienced clinicians provides insight into decision-making in the practice of physiotherapy. The purpose of the present study was to analyse the clinical reasoning skills of an experienced physiotherapist during her assessment and treatment of clients with low back pain. METHOD: Deconstruction of the physiotherapist's reasoning process was accomplished through observation of encounters between her and each of six patient subjects. Reconstruction and analysis of the physiotherapist's decision-making process was performed through retrospective interviews and reflective analysis of her clinical reasoning during each encounter. RESULTS: A working model of the physiotherapist's clinical reasoning was created from an integration of theoretical elements in the literature and the data. Through analysis of this framework, two core dimensions of her clinical reasoning were revealed: the influence of clinical experience and the influence of advanced training in a specific philosophy of treating the spine. CONCLUSIONS: The construction of these themes has contributed to the growing understanding of clinical reasoning strategies and skills used in orthopaedic physical therapy practice. Detailed description of the physiotherapist's reasoning process provides more meaningful understanding of physiotherapy treatments. In this case the physiotherapist employed a pattern recognition strategy and forward reasoning process in making a diagnosis. Further research is necessary to expand knowledge on the development of clinical reasoning skills.

Adult↗
PubMed1999

Satisfaction with in-patient psychiatric services. Relationship to patient and treatment factors.

BACKGROUND: There is growing concern about patient satisfaction with psychiatric in-patient provision. This paper measures satisfaction in psychiatric in-patients and its relationships with patient characteristics and ward experiences. AIMS: To: (a) measure overall in-patient satisfaction; (b) examine its relationship to in-patient experiences; and (c) examine its relationship to patient factors. METHOD: Four hundred and thirty-three patients were interviewed. Satisfaction was assessed by a single quest on, the Client Satisfaction Questionnaire (CSQ) and by a semistructured interview. RESULTS: Over three-quarters of the patients were satisfied, but two-thirds reported adverse events. Females, younger patients and those detained were more dissatisfied. No significant relationship was found for ethnic group. Results were similar in the mental hospital and district general hospital. CONCLUSIONS: There remain problems with satisfaction scales. Qualitative approaches to examine patients' experiences in hospital and the causes of dissatisfaction are recommended.

England↗
PubMed1998

Gender issues in the management of multi-impulsive bulimia: a case-study.

We describe the management of multi-impulsive bulimia nervosa in a 27-year-old man. Inpatient treatment was attempted using a standardized focal-interpretative (psychodynamic) and cognitive-behavioral approach, with an emphasis on ward milieu. The value of this approach has been proved for female patients in the past. To our knowledge, this is the first report of its usage for a male with multi-impulsive bulimia, and the problems encountered highlight the impact of gender on behavioral symptoms, ward culture, and the predominantly female patient group.

Adult↗
PubMed1996

A perfusion system for in vitro measurement of human cilia beat frequency.

We have designed and built a perfusion system and perfusion chamber to allow investigation of the effects of anaesthetic agents on human cilia in vitro. Using this system, samples of human respiratory cilia can be maintained in a stable and controlled environment for several hours. We measured cilia beat frequency of nasal respiratory epithelium from 10 healthy volunteers; cilia beat frequency was constant over a 4-h period, and measurements were found to be in good agreement with previously published work [1]. In a separate study we investigated the effect of a sleep dose of propofol on cilia beat frequency in samples from six patients undergoing minor surgery; samples were obtained before and immediately after induction of anaesthesia with propofol 2-3 mg kg-1. There was no statistically significant difference in cilia beat frequency between data obtained before and after induction with propofol.

Adult↗
PubMed1993

Measurement of the sensitivity of upper airway reflexes.

We describe a method for measurement of the sensitivity of upper airway reflexes. The technique is based upon delivery of an irritant chemical stimulus (dilute concentrations of ammonia vapour) to the upper airway. The technique is non-invasive and uses equipment which is portable, allowing measurements to be made in the clinical environment.

Adult↗
PubMed1991

The effect of the Trendelenburg position on lower oesophageal sphincter tone.

Measurements were made of gastric, lower oesophageal and barrier pressures in the supine, moderate and steep Trendelenburg positions in 10 healthy female patients during balanced anaesthesia. Adoption of the Trendelenburg position resulted in no significant changes in any measurement, with the exception of a small increase (0.1 kPa) in intragastric pressure in the steep head-down position. We conclude that the steep Trendelenburg position should not predispose to regurgitation in healthy patients.

Anesthesia, General↗
PubMed1991

Comparison of the combined effects of atropine and neostigmine with atropine and edrophonium on the lower oesophageal sphincter.

In two groups (n = 11) of healthy patients, we have measured gastric, lower oesophageal and barrier pressures before and after antagonism of neuromuscular block during anaesthesia with nitrous oxide and isoflurane. In one group, atropine 1.2 mg and neostigmine 2.5 mg were given and in the second group atropine 0.6 mg with edrophonium 1 mg/kg. One minute after administration of the reversal agents, there was a significantly greater reduction in barrier pressures in the neostigmine and atropine group than in the edrophonium and atropine group, but subsequently, there was no significant difference between the two groups. We conclude that there is no clinical difference between the two reversal mixtures in terms of the risk of regurgitation in the immediate period after reversal.

Adult↗
PubMed1975

Cervical spine dislocations with unilateral facet interlocking.

From this series it would appear that 17-5 per cent (92 cases from a series of 525) of all cervical lesions associated with spinal cord trauma are dislocations with unilateral facet interlocking. This type of dislocation is often missed but nevertheless with suitable radiographs the very characteristic radiographic appearances are well demonstrated. Two-thirds of these cases are initially incomplete neurological lesions which carry a good neurological prognosis directly proportional to the degree of initial neurological escape. A significant percentage reduce easily on traction alone--51 per cent of the entire series. Taking the year 1973, with 17 cases on a standardised regime of treatment and disregarding the two cases reduced by immediate manipulation under general anaesthesia, ten out of 15 (66 per cent) reduced easily on skull traction alone-possibly a more realistic figure.

Accidents, Traffic↗