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Biomedical subjects

D Jeffrey

Publications and source records attributed to D Jeffrey.

At least 19 recordsLinked to original sources
PubMed2005

Managing diabetes mellitus in patients with advanced cancer: a case note audit and guidelines.

Patients with advanced cancer and diabetes mellitus present a challenge to healthcare professionals. To establish how diabetes is currently being managed in these patients, we audited the care of patients who died in Cheltenham General Hospital over the previous 12 months with diagnoses of both diabetes mellitus and cancer. Management and monitoring of the diabetes was variable and there was little record of discussion between healthcare professionals and the patient or family regarding the diabetes. Thirty-two out of 42 patients continued to have blood sugar monitoring up to and including the day they died. We review the literature on this topic and suggest guidelines to help professionals to appropriately manage diabetes in the palliative setting at the end of life.

Blood Glucose↗
PubMed2002

Do not attempt resuscitation decisions in a cancer centre: addressing difficult ethical and communication issues.

Talking to patients about 'Do Not Attempt Resuscitation' decisions is difficult for many doctors. Communication about 'Do Not Attempt Resuscitation' decisions should occur as part of a wider discussion of treatment goals at an earlier stage in the patient's illness. A doctor should not initiate any treatment, including cardio-pulmonary resuscitation if he/she does not believe it will benefit the patient. An ethical framework is offered which may be of practical help in clarifying decision-making.

Cancer Care Facilities↗
PubMed1999

The Palliative Care Education Group for Gloucestershire (PEGG): an integrated model of multidisciplinary education in palliative care.

Multidisciplinary teamwork is an essential part of palliative care. Traditionally, in the UK, education of health care professionals has been carried out within single professional disciplines. The Palliative Care Education Group (PEGG) for Gloucestershire, a county in the south-west region of England, UK, is a multidisciplinary group, which promotes and integrates palliative care education across the county. This report describes the evolution of the group, its aims and objectives and the methods used to evaluate its impact on clinical practice. PEGG is a practical model of multidisciplinary education, which could be adopted in other areas.

Attitude of Health Personnel↗
PubMed1995

Appropriate palliative care: when does it begin?

The transition between a curative and a palliative approach to the care of a patient with cancer may be filled with uncertainty for patients, their families and health care professionals. A conventional model of treating the patient with cancer through curative, palliative and terminal phases is examined. The boundaries between the phases of care are blurred. A model of care based on respect for patient autonomy ensures that the timing of the switch from curative to palliative care is appropriate.

Humans↗
PubMed1994

Education in palliative care: a qualitative evaluation of the present state and the needs of general practitioners and community nurses.

A questionnaire survey was carried out of all general practitioners, community hospital nurses and community nurses working in Worcester Health District in the west of England, to assess the present state and future needs of their education in palliative care. The overall response rate of the survey was 72%. The respondents were an experienced group of doctors and nurses. They felt that their undergraduate or basic training did not prepare them to care for dying patients in the community. Educational needs were identified: control of symptoms other than pain and bereavement care were priorities for doctors. Community hospital nurses rated pain control education as a major need. Alternative medicine and caring for dying children were additional areas for further education for the general practitioner and community nurses. Ninety per cent of general practitioners, 84% of community hospital nurses and 95% of community nurses felt that multi-disciplinary teaching sessions would be helpful. Analysis of their responses revealed that these would be most likely to succeed it they were arranged in the middle of the day during lunch or in the evenings. The doctors felt that they lacked protected learning time. Nurses also felt this, but in addition, identified lack of finance as a limiting factor in their post-basic education. There was evidence that existing educational resources in the district are under-utilized.

Community Health Nursing↗
PubMed1994

Active euthanasia--time for a decision.

There has been renewed interest in the moral arguments surrounding euthanasia. Some patients are now apprehensive of advanced medical technology which they fear may result in a prolonged and undignified death. In the current situation of scarce resources for health care, both patients and doctors could be coerced into considering active euthanasia if it was legally available. In this paper it is argued that doctors now need to make a clear statement rejecting active euthanasia but affirming that in certain cases passive euthanasia, or letting die, may be morally justifiable.

Decision Making↗
PubMed1983

Experimental and clinical study of a new permanent myocardial atrial sutureless pacing lead.

A new permanent lead has been developed for atrial epicardial use. Early clinical evaluation (26 human implants) following thorough canine studies indicates that the new lead is safe, effective, and reliable. Canine thresholds and P-wave amplitudes as a function of implant time are similar to those of transvenous atrial "J" leads. Human thresholds at implant are higher than canine, but change less with time. Implant and acute repositioning were found to be easy. There have been no lead-related operations.

Animals↗
PubMed1978

Stimulation of cyclic AMP secretion in Vero cells by enterotoxins of Escherichia coli and Vibrio cholerae.

The morphological response of Vero cells to Escherichia coli heat-labile enterotoxin was similar to that of cholera toxin and was accompanied by increases in the intracellular level of cyclic AMP. The effects of both enterotoxins were enhanced by the presence of phosphodiesterase inhibitor and inhibited by heat or specific antisera. Accumulation of cyclic AMP preceded the morphological response.

1-Methyl-3-isobutylxanthine↗
PubMed1978

Pregnancy specific beta1 glycoprotein in fetal and maternal compartments.

Pregnancy specific beta glycoprotein is produced by the syncytiotrophoblast and secreted into the maternal peripheral circulation reaching levels of approximately 200 m/liter in normal pregnancy at term. In the present study the distribution of this newly defined placental protein was examined in maternal and fetal compartments in 12 patients at delivery.

Amniotic Fluid↗
PubMed1977

Concentrations of pregnancy-specific beta 1-glycoprotein in maternal blood in normal pregnancy and in intrauterine growth retardation.

A radioimmunoassay has been developed for pregnancy-specific beta 1-glycoprotein (S.P.1), a product of the human placenta. Circulating concentrations of S.P.1 were measured in 153 women in the third trimester of normal pregnancy and in 27 women who delivered children with birth-weight below the 10th centile of the normal range--i.e., with intrauterine growth regardation (I.U.G.R.). Concentrations of S.P.1 showed a skewed distribution and rose progressively to reach a plateau in the last four weeks of pregnancy. In over 70% of women with I.U.G.R. of the fetus, concentrations of S.P.1 were low. Measurement of serum-S.P.1 may provide a new index of fetal wellbeing.

Birth Weight↗
PubMed1977

Specific and sensitive determination of pregnancy-specific beta 1-glycoprotein by radioimmunoassay. A new pregnancy test.

A specific and highly sensitive radioimmunoassay (R.I.A.) for determination of pregnancy-specific beta 1-glycoprotein (S.P.1) in human plasma, urine, amniotic fluid, and breast milk has been developed. The minimum detection limit of S.P.1 was 8 mug/1 of sample. The assay was applied to plasma and/or urine samples from 8 women in early pregnancy. S.P. 1 was detected in the plasma of all three women obtained within 14 days of ovulation, the earliest positive result being at 7 days. In another woman plasma was negative at day 18 and positive by day 22. In the three remaining women plasma S.P.1 was detected when measured within 24 to 36 days of ovulation. S.P.1 was detected in four urine samples obtained between 20 and 28 days after ovulation. S.P.1 was also measured in breast milk, amniotic fluid, cord blood, and plasma of women with ectopic gestation and trophoblastic disease. It is suggested that the assay of S.P.1 may have important advantages over existing systems for detection and monitoring of early pregnancy.

Amniotic Fluid↗