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C Whittle

Publications and source records attributed to C Whittle.

12 recordsLinked to original sources
PubMed2001

A pilot study to assess the viability of a randomised controlled trial of methods of supplementary feeding of breast-fed pre-term babies.

OBJECTIVES: to compare the impact of two methods of supplementary feeding of pre-term babies (bottle vs cup) on subsequent breast feeding and to assess the feasibility of using a randomised controlled trial (RCT) to investigate the topic. DESIGN AND METHOD: small scale prospective RCT. Data on breast feeding, as defined as the exclusive method of feeding, were collected. A range of relevant bio-data was also collected and their impact on breast feeding assessed. SETTING: a special care baby unit in a District General Hospital in the UK. PARTICIPANTS: over a three-month period, all pre-term babies (32-37 weeks' gestation) who fulfilled the inclusion criteria and has been born to mothers who had expressed a pre-partum desire to breast feed, who had consented to take part, were included (n=14). PROCEDURE: the eligible babies were randomly allocated to supplementary feeding of breast milk, via either a cup or a bottle. Whether or not the baby was being breast fed at discharge was noted. FINDINGS: the study suggested that this RCT framework is a viable method of investigating baby feeding. Because of the small-scale nature of the project, the actual database must be treated with extreme caution. No significant differences were found between the two groups in terms of breast feeding. However, the mothers reported high levels of support and also the breast-feeding rates were above the national averages. These two findings could have contributed to the non-significant results observed in this analysis. CONCLUSIONS: if the present findings could be supported by further research, then the non-significant results relating method of supplementary feeds to subsequent breast feeding could be explained by reference to three factors. Firstly, there is, in fact, no real effect of method of supplementary feeding and subsequent breast feeding; secondly, the method adopted differed from existing research and thus may be expected to produce non-corroborative results; and finally, the overall levels of breast feeding within the Unit generally were higher than the national average. The relevance of the RCT for investigating this subject is also discussed with reference to the present data set. Further experimental work to develop these ideas and to identify causal links is required.

Bottle Feeding↗
PubMed2001

[Hemorrhage caused by the rupture of a pancreatic pseudoaneurysm. Case report].

We report a 52 year old man with a pancreatic pseudocyst, that was admitted with severe abdominal pain, severe vomiting, fever and malaise. The clinical picture was considered secondary to a pseudocyst infection and the patient was operated, draining the infected cyst performing a necrosis surgery and pancreatojejunostomy. Forty eight hours after the operation, an ostomy bleeding was detected. A upper mesenteric artery angiography showed two pseudoaneurysms in the gastroduodenal artery, that were embolized. Bleeding stopped initially, but seven days later, it reappeared. The patient was subjected to an emergency pancreatoduodenectomy. Postoperative evolution was uneventful and the patient was discharged two weeks later. Spontaneous bleeding of pseudoaneurysms secondary to chronic pancreatitis is a complication with a 15 to 40% mortality that must be bore in mind.

Aneurysm, False↗
PubMed2001

Expression of neuropilin-1 by human glomerular epithelial cells in vitro and in vivo.

Vascular endothelial growth factor (VEGF) is a potent promoter of endothelial mitogenesis and of endothelial permeability. Within the kidney it is synthesized primarily in the visceral glomerular epithelial cells (vGECs); however, the role of VEGF in the glomerulus remains unknown, as does the target cell upon which it acts. Although the target cells may be those of the glomerular endothelium, there are micro-anatomical reasons why this might not be the case. This, therefore, led us to consider the possibility that glomerular VEGF may bind to the vGECs themselves. Since it has been shown that vGECs do not express the main tyrosine kinase VEGF receptors, we chose to study vGEC expression of the more recently described VEGF isoform-specific receptors, the neuropilins. The expression of mRNAs for neuropilin-1, neuropilin-2 and soluble neuropilin was studied in whole kidney, sieved glomeruli and cultured podocytes by reverse transcription-PCR, and neuropilin-1 mRNA expression in isolated single glomeruli was analysed by nested reverse transcription-PCR. The expression of neuropilin-1 protein was investigated in cultured vGECs by Western blotting and immunocytochemistry, and in normal kidney sections by immunohistochemistry. Neuropilin-1 mRNA was detected in whole kidney, single and sieved glomeruli and cultured vGECs. Neuropilin-1 protein was detected in cultured vGECs and in vGECs in normal kidney sections by immunohistochemistry. Thus the present study suggests that vGECs may have the potential to bind the VEGF that they secrete. Functional studies will be required to address the potential significance of this finding in terms of an autocrine loop or VEGF sequestration.

Adult↗
PubMed2000

[Detection and characterization by ultrasonography of soft tissue foreign bodies].

BACKGROUND: Soft tissue foreign bodies are a frequent cause of consultation in emergency rooms. It is difficult to verify their existence since conventional radiology only detects radio opaque objects. Ultrasound can be a useful diagnostic procedure. AIM: To report our experience in the detection of soft tissue foreign bodies by ultrasound examination. PATIENTS AND METHODS: The ultrasonographic appearance of vegetables, glass and plastic, metal, bone and stones was studied in gelatin preparations. In a second stage, 52 patients (27 male, aged 3 to 88 years old) were studied, in whom the presence of a soft tissue foreign body was confirmed surgically. RESULTS: The mean error of the procedure for the assessment of foreign body size was 0.2 mm in vitro and 0.5 mm in vivo. The deepness and involved planes were correctly diagnosed in 96%, the number of fragments were diagnosed correctly in 94% of cases. The type of foreign body was identified correctly in 77% of cases and complications were detected in 100% of cases. CONCLUSIONS: Ultrasound is a sensitive and accurate method for the detection of soft tissue foreign bodies.

Adolescent↗
PubMed2000

[Primary epiploic appendicitis: clinical and radiological diagnosis].

BACKGROUND: Torsion of appendices epiplocae leads to an ischemic infarct of surrounding adipose tissue, causing a syndrome, called "primary epiploic appendagitis" characterized by acute abdominal pain that can simulate a surgical clinical picture. AIM: To describe the clinical picture, ultrasonographic and computed tomographic features of primary epiploic appendagitis. MATERIAL AND METHODS: A report of patients with acute abdominal pain whose diagnosis was a primary epiploic appendagitis, diagnosed and treated in a period of 48 months. RESULTS: Fifty five patients (45 males) aged 16 to 76 years old are reported. Their clinical presentation was acute abdominal pain in the left abdominal quadrant in 48, pain in the right lower quadrant in 4 and epigastric pain in two. Two had mild fever and 12 had nausea. Ten perform physical activities prior to the onset of pain. Imaging examinations showed a 1.5 to 5 cm diameter, uncompressible small mass of adipose origin, located anteriorly and anterolaterally, between the colon and the abdominal wall. There were inflammatory phenomena surrounding the lesion and thickening of the neighboring parietal peritoneum. In all cases, the mass gradually subsided with medical treatment. CONCLUSIONS: Primary epiploic appendagitis is a relatively frequent cause of spontaneously resolving abdominal pain. It is diagnosed by ultrasound or CT scanning.

Abdomen, Acute↗
PubMed1999

Heterogeneous vascular endothelial growth factor (VEGF) isoform mRNA and receptor mRNA expression in human glomeruli, and the identification of VEGF148 mRNA, a novel truncated splice variant.

Vascular endothelial growth factor (VEGF) mediates increased vascular permeability and endothelial mitogenesis, and may orchestrate normal glomerular permselectivity and proteinuria. Distinct isoforms result from differential gene splicing. VEGF binds to two cell surface tyrosine-kinase receptors, KDR (kinase domain region) and Flt-1 (fms-like tyrosine kinase-1). The latter also exists in a soluble form (sFlt), which is inhibitory. We have studied patterns of VEGF-isoform and VEGF-receptor expression in isolated single normal human glomeruli. mRNA from 190 glomeruli (from 20 individuals) was harvested on to magnetic beads, and nested reverse transcription-PCR was performed using primers for the VEGF isoforms and VEGF receptors. Simultaneous nested reverse transcription-PCR for CD45 was conducted in order to exclude leucocyte contamination. Unexpected products were isolated, cloned and sequenced. Multiple patterns of glomerular VEGF mRNA isoform expression were identified. Most frequently (58%), all three common forms were expressed. VEGF(189) (i.e. 189-amino-acid form of VEGF) was expressed in 63%, VEGF(165) in 85% and VEGF(121) in 84% of glomeruli. Two unexpected PCR products were also identified: 18% of glomeruli expressed VEGF(145), and 27% of glomeruli expressed a new truncated VEGF splice variant, VEGF(148), lacking exon 6, the terminal part of exon 7 and exon 8. Multiple patterns of VEGF-receptor expression were also identified, the most common being expression of all three isoforms (28%). Overall, KDR was seen in 59% of glomeruli, Flt-1 in 45% and sFlt in 57%. Thus the expression of VEGF within normal glomeruli is complex and variable, with inter- and intra-individual variation. Furthermore, sFlt appears to be the co-dominant form of VEGF receptor expressed within glomeruli, suggesting that, in healthy individuals, a degree of VEGF autoregulation is the norm. The physiological importance of VEGF(148) remains to be confirmed.

Aged↗
PubMed1999

[Obstructive jaundice in prostate neoplasm. Case report].

We report a 58 years old male, presenting with malaise, weight loss and jaundice. An abdominal ultrasound showed multiple lymphadenopathies in the hepatic bilus and around the pancreas. Fine needle aspiration of these nodes demonstrated an undifferentiated carcinoma. Prostate specific antigen was over 100 ng/ml and a prostate biopsy demonstrated a high grade carcinoma. The patient was subjected to an orchiectomy and hormone therapy (flutamide). Jaundice subsided and he is well after 3 years of follow up and maintained hormone therapy.

Adenocarcinoma↗
PubMed1997

An analysis of professional, specialist and advanced nursing practice in critical care.

A recent document, The Future of Professional Practice--Standards for Education and Practice Following Registration (United Kingdom Central Council (UKCC) 1994a), has laid down a structure for clinical practice, providing a pathway for nurses to progress from the professional level, through to specialist and advanced levels, according to clinical expertise and educational preparation. The purpose of this article thus sets out to analyse critically these distinct levels in relation to critical care nursing. In particular, the paper discusses the development of advanced practice and how the proposed levels may be integrated within critical care.

Career Mobility↗
PubMed1994

[Gallbladder polyps. 2d Consensus Workshop of the Chilean Hepatology Association].

During a workshop, hepatologists analyzed and gave recommendations about gallbladder polyps. They arrived to the following agreements: gallbladder polyps of less than 10 mm should be followed with ultrasonography at 3, 6 and 12 months if there is no enlargement. If there is enlargement, a cholecystectomy should be performed. Polyps larger than 10 mm should be subjected to cholecystectomy.

Female↗
PubMed1994

[Papillary cystic tumor of the pancreas: an infrequent carcinoma of good prognosis].

Papillary cystic tumor of the pancreas is a rare low grade carcinoma, with only 130 cases reported in the English literature. We report a 22 years old female presenting with a palpable mass and abdominal pain. Abdominal ultrasound and CAT scan showed a solid-cystic lesion in the head of the pancreas. The patient was subjected to a partial pancreatoduodenectomy and the histological study of the surgical specimen disclosed a papillary cystic carcinoma. Post op course was uneventful and the patient is well at 8 months follow up.

Adult↗
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Clinical Competence↗