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Biomedical subjects

B W Taylor

Publications and source records attributed to B W Taylor.

At least 19 recordsLinked to original sources
PubMed2005

The emergency department as an asthma surveillance tool at the community level: a decline in the burden of pediatric asthma in halifax, Canada.

We report pediatric emergency department (PED) asthma visit and inpatient asthma (AS) admission data in our area over a 5-year period. AS visits decreased by 33.9%, AS admissions by 24.6%, both significant compared with the decline in elementary school enrollment. The decrease in asthma visits was due to a decrease in the number of asthmatic patients, not a decline in repeat visits, or use of alternate venues of care. Explanations include a decrease in the burden of disease or an improvement in ambulatory care, but not alternate treatment venues or improvement in acute (PED) care. Readily available, emergency department data are useful in the community surveillance of asthma.

Asthma↗
PubMed2003

The recent expansion of Pluto's atmosphere.

Stellar occultations--the passing of a relatively nearby body in front of a background star--can be used to probe the atmosphere of the closer body with a spatial resolution of a few kilometres (ref. 1). Such observations can yield the scale height, temperature profile, and other information about the structure of the occulting atmosphere. Occultation data acquired for Pluto's atmosphere in 1988 revealed a nearly isothermal atmosphere above a radius of approximately 1,215 km. Below this level, the data could be interpreted as indicating either an extinction layer or the onset of a large thermal gradient, calling into question the fundamental structure of this atmosphere. Another question is to what extent Pluto's atmosphere might be collapsing as it recedes from the Sun (passing perihelion in 1989 in its 248-year orbital period), owing to the extreme sensitivity of the equilibrium surface pressure to the surface temperature. Here we report observations at a variety of visible and infrared wavelengths of an occultation of a star by Pluto in August 2002. These data reveal evidence for extinction in Pluto's atmosphere and show that it has indeed changed, having expanded rather than collapsed, since 1988.

Journal Article↗
PubMed2001

E-mail amplification of a mock code teaching round.

To determine whether e-mail could be used to supplement a teaching round, we implemented the following educational intervention: each Monday, a mock code was presented. Two e-mails were then sent the same day to all residents. One summarized the main teaching points whereas the second solicited discussion. Each Friday, a third e-mail was sent that summarized the discussion. We collected all e-mails and surveyed the residents. Fifteen of 18 residents completed the questionnaire; two were not participants in the e-round. Forty percent (7/15) of the residents attended fewer than half of the mock codes but most participants (10/13) reported reading >95% of the e-mails. A majority reported storing (11/13), printing (7/13), and reading e-mails a second time (12/13). Seven of 13 reported learning as much or more from the e-mails as from the mock code itself. We conclude that e-mail can increase learning from a traditional mock code teaching round.

Computer Communication Networks↗
PubMed1999

Trauma recurrence in the pediatric emergency population.

BACKGROUND: A link between ambulatory trauma and trauma recurrence may be hypothesized: (a) children who present for trauma may be those with characteristics that place them at particular risk; (b) children who frequently present for trauma may be those who present because of parental anxiety; and (c) children may learn from traumatic episodes and therefore decrease their trauma risk. METHODS: A retrospective chart review of billing data was conducted to determine the value of the emergency department trauma visit count as a predictor of future trauma visits and to validate one of the models described above. RESULTS: Records for 16,994 patients were obtained for the period January 1 through December 31, 1997, and these patients were followed as a cohort through the first 6 months of 1998. There were 9,236 males and 7,757 females. Of these, 5,413 patients had a trauma visit count in 1997 (TC97) of at least 1; 120 patients had a TC97 of 3 or more. The relationship between TC97 and trauma visit count in 1998 was linear, present in both males and females and across all age categories, with odds ratios for the group with TC97 > or =3 ranging from 3.8 to 6.4. Conversely, the risk of presentation with respiratory tract infection during the study period in 1998 was not increased with higher TC97 values. CONCLUSION: Our data support the theory that children who present with trauma tend to be those with extrinsic or intrinsic factors that increase trauma risk. We have demonstrated a direct relationship between emergency department visit counts for trauma with future trauma occurrence risk. This relationship is present at all ages and in both males and females. The emergency trauma visit count is an easily obtained measure that has merit as an index to identify higher-risk children for possible intervention strategies. Further work is needed.

Adolescent↗
PubMed1996

Psychological and clinical effects of renal biopsy performed using sedation.

A sedation regimen using sequential oral trinepazine, intravenous Pethco (pethidine, chlorpromazine and promethazine) and diazemuls was evaluated in children having native kidney (n = 17) and transplant kidney (n = 17) biopsies. Biopsy was successful in all cases, with no serious side effects. A self-reported scale of memory recall and pain perception showed the optimal time for biopsy to be between 30 and 90 min after the intravenous Pethco. The child's level of distress was measured by a self-reported scale, a parent-reported scale and an observational scale for doctors and nurses; 45% of children rated themselves highly distressed prior to the procedure, their parents being the best assessors of this distress. Younger children and those undergoing native kidney biopsy had less understanding of the procedure. Children's worries could be clearly categorised into procedural and outcome issues: those undergoing transplant biopsy were more worried about outcome, whereas those undergoing native kidney biopsy were more worried about the procedure.

Adolescent↗
PubMed1993

Pseudodisaster: a case of mass hysteria involving 19 schoolchildren.

A case of mass hysteria involving 19 children has been presented. Our case demonstrated many of the common symptoms and vectors identified in the literature. No children were harmed, but significant health care dollars were spent ensuring their safety. Better education of child care personnel and preplanning by schools may reduce the frequency of this condition.

Child↗
PubMed1991

Results of the 1989 Association of Residents in Radiation Oncology survey.

To assess a variety of issues concerning physician-trainees in radiation oncology, a survey was conducted by the Association of Residents in Radiation Oncology (ARRO). Ultimately, 70% of residents responded to the survey. The survey identified perceived strengths as well as shortcomings in training programs. We conclude that residents are generally satisfied with their training. Future surveys are planned to expand this important database.

Adult↗
PubMed1991

The impact of pelvic recurrence and elective pelvic irradiation on survival and treatment morbidity in early-stage Hodgkin's disease.

A retrospective analysis of patients with supradiaphragmatic Stage I-II Hodgkin's disease was performed to assess the impact of pelvic recurrence and elective pelvic irradiation on survival and treatment morbidity. One hundred twenty patients were treated with radiotherapy (RT) alone; 38 received total nodal (including pelvic) irradiation (TNI), 63 received modified total nodal (excluding pelvic) irradiation (MTNI), and 19 received involved-field or mantle irradiation only (less than MTNI). Thirty-three patients received combined-modality therapy. In laparotomy-staged (PS) patients treated with RT alone, the overall treatment failure rate was 13% after TNI, 24% after MTNI, and 43% after less than MTNI. The pelvic failure rate in PS patients was 0% after TNI, 9% after MTNI, and 29% after less than MTNI. Cause-specific deaths in patients treated with RT alone occurred in 10% following less than MTNI, 13% following MTNI, and 10% following TNI. Cause-specific deaths due to pelvic failure in patients treated with RT alone occurred in 5% following IF and 6% following MTNI, and also occurred in 7% of patients receiving combined-modality therapy. The potential disadvantages of elective pelvic irradiation in early-stage Hodgkin's disease include compromise of future tolerance of chemotherapy in the event of treatment failure, and infertility. Gonadal function was assessed in 67 patients less than 35 years old at the time of treatment. Compromise of gonadal function was correlated with the lack of special testicular shielding during pelvic irradiation and chemotherapy in the male, and with no oophoropexy before pelvic irradiation in the female. Twelve of 26 patients with recurrence after either less than MTNI or MTNI, with or without chemotherapy, were alive and without evidence of disease at greater than 2 years after completing salvage therapy, compared with 7 of 11 patients with recurrence after TNI.

Adolescent↗
PubMed1990

Reproducibility of mantle irradiation with daily imaging films.

Daily mantle imaging films were reviewed to evaluate the accuracy of daily treatments for 28 de novo patients with Hodgkin's disease treated with curative intent between September 1978 and September 1983. Each film was compared with the original simulation film by three independent observers. Each observer graded each film for accuracy in the superior mediastinal, axillary, and inferior mediastinal areas and for overall conformity to the treatment plan. Grades ranged from 1 to 3: grade 1 denoted accuracy within +/- 0.5 cm of the treatment plan, grade 2 denoted minor deviations greater than 0.5 cm but with no tumor or prophylactic treatment areas shielded, and grade 3 denoted an unacceptable setup. The results in 28 patients (1,186 films) showed that 84% of the films were within 0.5 cm of original plan, 15% had minor deviations, and 1% were considered unacceptable. Three patients in the study developed recurrence of Hodgkin's disease in the chest. In one of these patients, 4 of 40 films were unacceptable, but recurrence was in lung parenchyma in an area not designated for treatment. Errors in treatment setup in this small sample were not a factor in the likelihood of disease recurrence in the chest. Daily imaging films have helped decrease the number of minor deviations and unacceptable setups, compared with previous experiences.

Diagnostic Imaging↗
PubMed1989

A non-linear multi-criteria programming approach for determining county emergency medical service ambulance allocations.

In this paper an integer, non-linear mathematical programming model is developed to allocate emergency medical service (EMS) ambulances to sectors within a county in order to meet a government-mandated response-time criterion. However, in addition to the response-time criterion, the model also reflects criteria for budget and work-load, and, since ambulance response is best described within the context of a queueing system, several of the model system constraints are based on queueing formulations adapted to a mathematical programming format. The model is developed and demonstrated within the context of an example of a county encompassing rural, urban and mixed sectors which exhibit different demand and geographic characteristics. The example model is solved using an integer, non-linear goal-programming technique. The solution results provide ambulance allocations to sectors within the county, the probability of an ambulance exceeding a prespecified response time, and the utilization factor for ambulances per sector.

Ambulances↗
PubMed1988

The meningioma controversy: postoperative radiation therapy.

Total surgical excision is the main goal of therapy for intracranial meningiomas. The controversy today involves the efficacy of postoperative radiation therapy. To evaluate this question, 132 patients with benign intracranial meningiomas, treated between October 1964 and April 1985, were evaluated. All patients had a minimum 2-year follow-up. The actuarial local control rates at 10 years for the three treatment groups were as follows: subtotal excision alone, 18%; subtotal excision plus postoperative radiation therapy, 82%; and total excision alone, 77%. The actuarial determinate survival rates at 10 years were 49%, 81%, and 93%, respectively. Postoperative radiation therapy was also effective for patients treated at the time of the first recurrence, with an actuarial local control rate at 10 years after salvage treatment of 30% for patients treated with surgery alone and 89% for patients receiving postoperative radiation therapy at the time of salvage. This analysis suggests that radiation therapy has a significant role in the treatment of subtotally excised and recurrent intracranial meningiomas.

Brain Neoplasms↗
PubMed1982

Critical assessment of jacket plethysmographs for use in young children.

In infants and very young children changes in thoracic gas volume (Vtg) during tidal breathing and during intermittent positive-pressure lung inflations have been estimated from pressure changes within double-layered rubber jackets covering the thorax and abdomen. In vitro and in vivo assessments demonstrated the linearity of these jackets over the range of volume changes found in these young subjects during respiratory function tests, and the small intrajacket background pressure (2.5 cmH2O) had minimal effects on resting lung volume and lung mechanics. These jackets can be used to monitor tidal volume in quiet subjects, and if an intermittent positive-pressure inflation technique is used static compliance can be accurately measured. The hysteresis of natural rubber and the direct contact of the recording system with the subject renders it unsuitable for the measurement of lung mechanics during tidal breathing and for the estimation of Vtg during airway occlusions.

Child, Preschool↗
PubMed1976

Thoracic gas volume in early childhood.

A total body plethysmograph is descirbed which was used to study thoracic gas volume (TGV) in infants and young children from birth to 2 1/2 years, and was suitable for use even in very sick babies. Normal TGV values were obtained in 42 studies of 35 healthy infants and young children, and 16 children with abnormal lung volume are described. TGV correlated well with length, weight, chest circumference, and age in the healthy infants. A low TGV was found in children with respiratory difficulties after cardiac and thoracic surgery, in respiratory distress syndrome of the newborn, and in association with pulmonary infection and chest cage abnormalities. Abnormally high TGV was most frequently seen in infants with small airways disease.

Asthma↗
PubMed1976

Association of cystic fibrosis with allergy.

Immediate skin hypersensitivity to various inhalant allergens was present in 59% of 123 children with cystic fibrosis (CF), a much higher percentage than in the general population. This is consistent with the idea that atopy arises as a result of impaired handling of antigen at mucosal surfaces. The allergic CF children had more chest infections, a worse chest x-ray appearance, and lower peak expiratory flow rates. Allergic diseases were also frequent in the CF obligate heterozygotes (32% of mothers and 26% of fathers). It is suggested that the heterozygotes may also have a mucosal abnormality resulting in defective antigen handling.

Adolescent↗