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Biomedical subjects

C Ashworth

Publications and source records attributed to C Ashworth.

10 recordsLinked to original sources
PubMed1993

Venous stasis complications of the use of the superficial femoral and popliteal veins for lower extremity bypass.

PURPOSE: The widely accepted durability of autogenous vein for infrainguinal arterial bypass has led the authors to use the superficial femoral and popliteal vein in selected cases. The results of this experience are presented. METHODS: From January through December 1991, during which 92 lower extremity bypass procedures were performed, deep vein bypass was attempted in seven patients (three femoral-popliteal grafts, two femoral-peroneal grafts, one femoral-deep femoral bypass, and one popliteal-posterior tibial bypass). In all cases the saphenous vein was absent or inadequate for use as a bypass conduit. The superficial femoral vein was harvested to below the knee in five patients. RESULTS: At last follow-up six of seven patients had patent grafts with relief of their original symptoms. All the procedures were complicated by venous stasis; acute postoperative phlegmasia developed in two cases. In one of these cases the limb was salvaged by below-knee fasciotomy and deep venous bypass (distal popliteal vein to common femoral vein with polytetrafluoroethylene). In the other case an above-knee amputation was required. Of the five remaining patients three had moderate venous stasis edema unresponsive to limb elevation and compression stockings after operation, and two have had resolution of minimal postoperative venous stasis with simple limb elevation. All cases of severe and moderate venous stasis occurred in patients with popliteal vein harvest to below the knee. CONCLUSIONS: The authors conclude that the use of the deep veins of the lower extremity for bypass is effective but is associated with a significant increase incidence of venous stasis edema. Two instances of phlegmasia were associated with popliteal vein harvest below the knee, and the authors caution against harvest of the popliteal vein to this level.

Aged↗
PubMed1990

Canada: perspectives in school health.

Because education is the individual responsibility of 10 provinces and two northern territories, the quality of school health varies greatly across Canada. However, planned major events in the past few years have served as catalysts to begin considering a comprehensive approach to school health. The value of coordinating instruction in health with school services and the community environment is beginning to be realized. These long "overdue" developments are reviewed and summarized.

Canada↗
PubMed1984

Life change and onset of cancer in identical twins.

The relationship of life change to the onset of cancer was studied in 22 pairs of HLA-identical siblings who were discordant for hematologic malignancies. The twin pairs were hospitalized for bone marrow transplantation. Life change was measured using a well-validated instrument, the Schedule of Recent Experiences (SRE). Contrary to our expectations, we were unable to document increased life changes in the sick twins. The timing of administration of the SRE with respect to the transplant did influence reporting of life events. However, regardless of timing of administration, in the period antedating the diagnosis of malignancy the healthy donor twins had increased or equivalent life changes when compared to their sick twins.

Adolescent↗
PubMed1984

Prediction of pregnancy complications: an application of the biopsychosocial model.

This paper describes a pilot study of biomedical and psychosocial risk and the outcome of pregnancy. Ninety-three pregnant women completed four instruments to identify three types of psychosocial risk: life events, family function and social support. Biomedical risk was identified through analysis of self-reported health histories and hospital records. Information on complications of pregnancy was obtained from hospital delivery records. Further complications data were obtained by a home interview at 6 weeks postpartum. In the sample studied, from an agricultural-university community in Eastern Washington, biomedical risk alone was not substantially related to complications. Psychosocial risk was related to both delivery and postpartum complications. Family function was the best single psychosocial predictor. The interaction between family function and biomedical risk also predicted complications reliability. A total of 11% of variance in postpartum complications could be explained jointly by biomedical and psychosocial risk. The results of the study suggest that psychosocial risk assessment alone and in interaction with biomedical risk assessment will offer significant improvement in the identification of women who may experience pregnancy complication.

Adult↗
PubMed1982

Validity and reliability of the family APGAR as a test of family function.

This paper offers evidence to support the use of the Family APGAR as a reliable, validated, utilitarian instrument to measure a subject's satisfaction with five components of family function. Mean total Family APGAR scores for several population groups are reported along with associated validity and reliability studies. A study from Taiwan supports the use of the Family APGAR in student populations 10 years of age and older. Studies are now under way to examine the use of the Family APGAR to correlate family function satisfaction with utilization of medical facilities, somatization, compliance, and the outcome of health problems.

Adolescent↗
PubMed1981

The family physician's knowledge of the cost of prescribed drugs.

In this study practicing physicians, residents and teaching faculty estimated cost to the patient of ten commonly prescribed drugs. Physician estimates were compared to averaage pharmacy prices. On the whole, physicians overestimated the costs of the drugs. Practicing physicians had the highest estimated while residents were the most accurate. Accuracy of price estimates differed greatly among the drugs. Physicians were also asked about their sources of drug price information and their prescribing policies in relation to cost. Residents and faculty relied heavily on pharmacists for the drug price information, whereas practicing physicians rellied on sales representatives and patients. Virtually all responders assign at least some importance to drug costs when prescribing. Residents and faculty reported prescribing generically more often than practicing physicians.

Costs and Cost Analysis↗
PubMed1977

Otitis media in children less than 12 weeks of age.

Cases of otitis media in infants under 12 weeks of age were reviewed to delineate the frequency, clinical features, and etiologic agents involved. Tympanocentesis was performed in 42 infants, 0 to 5 weeks of age, and in 17, from 6 to 11 weeks of age. The most common symptoms were irritability/lethargy (69%), fever (52%), cough (36%), vomiting (21%), diarrhea (20%), tachypnea (20%), and anorexia (18%). Associated illnesses were present in 33 (54%) of the patients, the most common being pneumonia (9), bronchiolitis (7), meningitis (6), conjunctivitis (4), and omphalitis (4). No peripartum infections or severe perinatal problems were found. Common respiratory pathogens were the predominant etiologic organisms, but coliform organisms were identified in 18% of the infants under 6 weeks of age. Cultures were sterile or grew organisms of questionable pathogenicity ("nonpathogens") in 39% of specimens. Since the signs and symptoms of otitis media in children less than 12 weeks of age are nonspecific and frequently associated with other major illnesses, the physician caring for these infants needs to be more aware of this disease and the therapeutic problems it presents.

Anti-Bacterial Agents↗