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Biomedical subjects

D Denny

Publications and source records attributed to D Denny.

11 recordsLinked to original sources

Development of a holistic admission assessment: an integrated care pathway for the hospice setting.

This article describes the development of a holistic admission assessment for all inpatients admitted to a 66-bedded hospice, structured in the form of an integrated care pathway (ICP). The need for an improved assessment process was identified by clinical staff, who recognized that the existing assessment was not truly holistic and was dependent on the skills of the assessors. The assessment also lacked appropriate goals and actions. The recently published National Institute for Clinical Excellence (NICE) guidance on Improving Supportive and Palliative Care for Adults with Cancer, has also highlighted key areas for the improvement of patient assessment in specialist palliative care (NICE, 2004). Implementation of the ICP has resulted in a systematic and timely holistic assessment process for patients. The ICP addresses effectively the NICE recommendations for the assessment of specialist palliative care patients.

Critical Pathways↗

Cross-linked bispecific monoclonal antibody heteropolymers facilitate the clearance of human IgM from the circulation of squirrel monkeys.

We have previously demonstrated that cross-linked bispecific monoclonal antibodies (mAb) heteropolymers (HP), specific for primate erythrocyte (E) complement receptor type 1 (CR1) and target antigen (Ag), facilitate the binding of these target Ag to human and non-human primate E. Once bound in vitro to rhesus monkey E, upon re-infusion these HP/Ag complexes are recognized in vivo by cells of the reticuloendothelial system (RES) and removed from the circulation without loss of the E. We now show, in squirrel monkeys, that an HP specific for E CR1 and human IgM (anti-CR1 x anti-IgM) can be used to facilitate in vivo E binding and clearance from the circulation of a previously injected and circulating model protein pathogen, human IgM. Approximately 70-80% of 125I-labeled human IgM is cleared from the circulation of each of five squirrel monkeys via the HP system. We observe, in experiments analogous to previous studies on immune complex (IC) clearance, that subsequent to HP/Ag clearance there is a decrease in the number of CR1 epitopes per E which is manifested when we use both monoclonal and polyclonal anti-CR1 probes. Our results indicate that the primary organs responsible for uptake of the complexes are the liver and spleen. This work strongly suggests that the HP/Ag complexes, bound to E, function as IC prototypes and are recognized and processed as such in vivo. Thus, the HP-E system may eventually serve as a viable immunotherapy for the clearance of blood-borne pathogens from the circulation.

Animals↗

Comparison of platelet scintigraphy, impedance plethysmography gray scale and color flow duplex ultrasound and venography for the diagnosis of venous thrombosis.

The several techniques available for the diagnosis of venous thrombosis have not been directly compared in the same patient population. Thus color and gray scale duplex ultrasound (U), impedance plethysmography (IPG), 3-4 hr platelet imaging (PS) were compared to venography (V), in 104 consecutive patients (in hospital and out). PS and V were read by two, and IPG and U by one, blinded reader. Comparisons were made for the calf (CA), popliteal (Pop) and femoral (Fem) vessels. Reproducibility of V and PS was 84 and 87%. (table; see text) We conclude that PS, while having a very high specificity, has an unacceptably low sensitivity. However, while both impedance plethysmography and color flow ultrasound have excellent and similar diagnostic accuracy in the femoral, these techniques have either a low sensitivity or low technical success rate in the calf or popliteal veins.

Blood Platelets↗

Results from a single kidney procurement center.

During a 16-month interval 235 kidneys were recovered from 120 consecutive donors, 15 of which were not transplanted for a variety of reasons. The factors believed to be important in producing a low wastage rate of procured kidneys included careful management of the donor during the brain death period, en bloc resection to avoid damage to vascular structures and the ureter, and avoidance of cold ischemia.

Adolescent↗

Deanol in the treatment of tardive dyskinesia.

A patient who developed severe tardive dyskinesia after the termination of long-term phenothiazine therapy was successfully treated with deanol, a possible precursor of acetylcholine. Physiological measurements were obtained to quantify the clinical course. The authors discuss the practical and heuristic implications of these observations and suggest further consideration of therapy directed toward enhancement of cholinergic activity in the central nervous system.

Chlorpromazine↗

Liver procurement for orthotopic transplantation: an analysis of the Pittsburgh experience.

The incidence of prospective organ donors in the United States and the techniques which are to used to guarantee their optimal use after identification are analyzed. Attitudes of the public and health professionals toward organ donation are discussed. The organization of the Pittsburgh Organ Procurement Agency and its relationship to other such agencies is described. Finally, the presently used techniques of liver salvaging and preservation are outlined.

Adolescent↗

Retrospective analysis of operative ankle fractures.

Closed-ankle fractures presenting to the podiatric service between 1978 and 1991 are reviewed. Patients able to return for follow-up were tested through Cybex isokinetic testing, proprioception, and radiographic studies. All patients reviewed had equal or greater strength and endurance on the involved side when compared to the uninvolved side. Proprioceptive deficits were noted in all patients with lateral malleolar involvement regardless of time of follow-up.

Ankle Injuries↗