Biomedical subjects

D S Duncan

Publications and source records attributed to D S Duncan.

5 recordsLinked to original sources

PubMed2000

Efficacy and safety of radiologically placed gastrostomy tubes in paediatric haematology/oncology patients.

BACKGROUND: The treatment of malnutrition, which is of great concern in paediatric haematology/oncology patients, is fraught with problems. The goals of our study were to document the complications and assess the weight gain with gastrostomy tubes (G-tubes) in this population. PROCEDURE: Patient data were acquired by retrospective review of all haematology, oncology, and bone marrow transplant (BMT) patients (n = 44) who received radiologically placed G-tubes at our institution over a 4-year period. RESULTS: Forty-four G-tubes were placed (59% peri-BMT). At tube placement, 55% of patients were malnourished and 45% were nourished. Seventy-five percent of patients had the procedure without general anaesthetic. Localized G-tube-site infection was the most common complication (41%). Major complications occurred in 3 patients; 2 patients experienced localized peritonitis, and 1 patient developed a localized collection of pus in the abdominal wall. There were no G-tube-related deaths. At 1 month after the tube insertion, 39% of patients had gained, 54% maintained, and 7% lost weight. At 3 months, 69% had gained, 28% maintained, and 3% lost weight. There was a statistically significant weight gain from the time of the G-tube placement to both 1 month (P < 0.018) and 3 months (P < 0.0001) after G-tube placement. Patients in all diagnosis categories showed improvement from 1 to 3 months. CONCLUSIONS: We conclude that retrograde tube placement is safe and can frequently be done without general anaesthetic and that G-tube feeding effectively reverses malnutrition and prevents weight loss in this patient population.

Adolescent↗

PubMed1999

CT-guided percutaneous needle biopsy of small lung nodules in children.

Malignant pulmonary nodules in a patient with neoplasia alters clinical staging and therapy. Although it may be difficult, it is imperative to obtain a tissue diagnosis of such nodules. We describe a coaxial technique using controlled respirations, which we have found useful for biopsy of small pulmonary nodules in children. Clinical records, imaging and pathology (histology and cytology) were reviewed for 17 children who had 18 nodules biopsied in the method described. A diagnosis of malignant or benign tissue was made in 15 nodules. One biopsy was inadequate and there was one false-negative. Adequate cores were obtained in 15 nodules, cytology in 2 and inadequate material in 1. There was no significant morbidity.

Adolescent↗

PubMed1996

The quality information management program database in South Carolina.

BACKGROUND: The Quality Information Management (QIM) Program was initiated in 1987 on the basis of the decision of the South Carolina Hospital Association's Subcommittee on Quality Assurance to develop a statewide database that could provide member hospitals with comparative quality indicator data. There are ten indicators for acute care and seven for psychiatry and substance abuse. Thirty-seven acute care hospitals participate in the QIM program, as do 7 specialty hospitals. For each three-month period, participant hospitals complete a computerized software report from their data sources specifying summary-level and patient-level data elements. REPORTING OF DATA: Participating hospitals are provided detailed, quantitative statistical reports to help them identify variations for further investigation. Risk adjustment is accomplished by peer grouping. Each hospital receives summary data for the peer groups to which it is assigned. During the quarterly users group meetings, participants discuss their successes and failures in collecting, reporting, and presenting indicator data. DISCUSSION: Involvement in the QIM program has educated participants in the use of comparative databases for quality improvement activities. It is a challenge to help providers and practitioners, in the face of increasing demands for dissemination, become more comfortable with the release of data to the public, while still preserving some degree of confidentiality.

Computer Communication Networks↗

PubMed1985

Clinical fracture of the carpal scaphoid--an illusionary diagnosis.

The management of patients with clinical evidence of a fracture of the carpal scaphoid bone but without radiological evidence of a fracture is based on dogma emphasizing the need to immobilize the wrist in all cases. Because of the apparently high proportion of patients who spend up to six weeks in a plaster cast and in whom no fracture is ever demonstrated radiologically, a study was undertaken to determine the fate of those wrist injuries diagnosed as clinical fractures of the scaphoid. All patients who presented with clinical or radiological evidence of fractures of the scaphoid over a one year period were reviewed. Of the 108 patients in whom the diagnosis of clinical fracture of the scaphoid was made at the time of presentation none was proved radiologically to have a fracture of the scaphoid subsequently after a period of mobilization. These patients spent an average time of 21.9 days in a plaster cast which represents a significant loss of productivity to the community and inconvenience to the patient.

Adolescent↗

PubMed1979

Evaluation of negative staining technique for determination of CN--insensitive superoxide dismutase activity.

The different forms of superoxide dismutase (superoxide-superoxide oxidoreductase, EC 1.15.11) have been studied, in tissues of rat, mouse and chicken, by the ectrophoresis-nitro blue tetrazolium technique proposed by Beauchamp. Similar enzyme patterns were evident in every tissue. A fast migrating CN--sensitive form of dismutase activity was present in isolated liver mitochondria of each species. Chicken and mouse liver mitochondria, as well as whole homogenate of every tissue of these two species, showed two additional slow-migrating bands of CN--insensitive activity. In contrast, such bands were not detectable in mitochondria isolated from rat liver or in any of the rat tissues analyzed by this technique. Prior to their electrophoretic separation, the samples were analyzed for CN--insensitive superoxide dismutase activity by a spectrophotometric assay; by this assay it was possible to demonstrate and quantitate a CN--insensitive superoxide dismutase activity in every preparation. Two units of CN--insensitive activity were applied to the gels for each sample. These results indicate that the electrophoresis-nitro blue tetrazolium technique is unsuitable for the detection of the rat CN--insensitive form of superoxide dismutase in crude preparations such as whole tissue homogenates or isolated mitochondria.

Animals↗