PubMed Health⌕ Search

Biomedical subjects

D Wyatt

Publications and source records attributed to D Wyatt.

At least 19 recordsLinked to original sources
PubMed2002

A review of a multiprofessional cancer course.

The report of the Expert Advisory Group on Cancer (the Calman-Hine Report) (Department of Health 1995) set out a clear framework of services for people with cancer in England and Wales. Subsequent developments, such as The NHS Cancer Plan (Department of Health 2000a), have built on this framework. What emerges clearly from these documents is the importance of a skilled and knowledgeable workforce in delivering high-quality cancer services. Although appropriate educational courses exist for some professional groups, such as nurses, cancer care has traditionally received scant attention in curricula for the allied health professionals (AHPs), either before or after qualification. This article describes the development and successful implementation of a course in cancer care aimed specifically at AHPs. Using Skilbeck's (1984) curriculum model as a framework, the development and design of the course, and aspects of its delivery, are examined. Evaluation of the first 2 years of the course reveals that it is popular and perceived as interesting and relevant to AHPs involved with patients with cancer in general and specialist settings.

Curriculum↗
PubMed2001

Nested multiplex polymerase chain reaction for the diagnosis of cutaneous herpes simplex and herpes zoster infections and a comparison with electronmicroscopy.

Herpes simplex virus (HSV) and varicella zoster virus (VZV) are common causes of cutaneous and mucocutaneous vesicular eruptions. Laboratory diagnostic techniques include Tzanck smears, electronmicroscopy, antigen detection and viral culture. This paper describes a nested multiplex polymerase chain reaction with respective sensitivities of 0.0001, 0.01 and 0.1 TCID50 for VZV, HSV-1 and HSV-2. The assay was used in (a) a salvage capacity for slides already processed for electronmicroscopy, and (b) as a front-line assay for prospectively processed specimens. Sixty-two glass slides with vesicle lymph/scrapings from 58 patients with suspected cutaneous herpetic lesions were examined. The clinical presentations were described as atypical/not specified (24), VZV (20) or HSV (18), and involved eruptions from diverse anatomical sites, including the genitalia. Of the 62 specimens, 6 and 38 were positive by electronmicroscopy and multiplex PCR respectively, giving a comparative sensitivity of 16% for electronmicroscopy. Nested multiplex PCR identified 15 VZV and 20 HSV-1 infections. Where the clinical details indicated either HSV or VZV (38/62), nested multiplex PCR was statistically likely to be reactive (26/38 vs. 9/24) (chi2 P = 0.000004) whereas electronmicroscopy was not (4/38 vs. 2/24) (chi2 P= 0.77). Where the clinical details indicated VZV (20/62) or HSV (18/62), nested multiplex PCR was statistically more likely to confirm VZV (10/20 vs. 5/42) (chi2 P= 0.001) or HSV (9/18 vs. 11/44) (chi2 P = 0.05) respectively. Two suspected HSV and 6 suspected VZV infections were shown to be VZV and HSV respectively by nested multiplex PCR.

Adolescent↗
PubMed1999

A comparison of virus isolation, indirect immunofluorescence and nested multiplex polymerase chain reaction for the diagnosis of primary and recurrent herpes simplex type 1 and type 2 infections.

134 swabs in viral transport medium were received from 126 patients with suspected clinical HSV-1 and HSV-2 infections. They were tested by (i) nested multiplex polymerase chain reaction NMPCR (strongly positive specimens had visible bands on both rounds of PCR) without prior extraction, (ii) culture in primary rhesus monkey kidney, E6-Vero, RD and HEp-2 cells and (iii) antigen detection by immunofluorescence (IF). Antigen detection employed four novel pools (A-D) of monoclonal antibodies (Mab): A was HSV-1 specific, B was HSV-2 specific while C and D were generic. In comparison to NMPCR the sensitivity and specificity of (i) culture was 59% (22/37) and 100% (134/134), (ii) IF by Pool A was 59% (16/27) and 100% (117/117), (iii) IF by Pool B was 40% (4/10) and 100% (130/130) and (iv) IF by Pools C and D were 60% (18/30) and 100% (96/96). Specimens positive by culture were more likely to be strongly positive by NMPCR (chi2 P = 0.004). Typing by each method concurred on all occasions. NMPCR was cost effective, easier to perform and was the most sensitive method for HSV detection. It should become the method of choice for HSV diagnosis.

Base Sequence↗
PubMed1999

Negotiation strategies for men and women.

The ability to negotiate plays a key role in one's professional and personal life. If men and women want to negotiate successfully, they must know the steps of negotiation plus the sex differences when approaching the negotiation process.

Female↗
PubMed1999

Melanocytic nevi in children treated with growth hormone.

There is concern that growth hormone (GH) therapy may influence the growth of melanocytic nevi. In a review of the experience of the National Cooperative Growth Study, we found no excess of skin cancer in children who were treated with GH. We also reviewed our experience in 90 children with GH deficiency and 24 with Turner syndrome. We found no difference in the nevi count between control subjects and children with GH deficiency, even after many years of GH therapy. Nor was there any relation between the duration of therapy and the nevi count. Children with Turner syndrome had more nevi, but there was no relation to the duration of GH therapy. These findings and the absence of a greater frequency of skin cancer in acromegaly are reassuring. It is unlikely that GH therapy has a significant influence on nevi count or the risk of skin cancer.

Child↗
PubMed1998

Use of PCR in resolving diagnostic difficulties potentially caused by genetic variation of hepatitis B virus.

AIMS: To assess the relevance of genetic variants of hepatitis B virus (HBV) and to demonstrate the usefulness of the polymerase chain reaction (PCR) in cases of HBV diagnostic difficulty. METHODS: Five serum samples from patients that presented diagnostic difficulty in routine laboratories were sent to a research laboratory for PCR, and if appropriate, S gene sequencing, in vitro expression, and antigenic analysis. RESULTS: The demonstration of HBV in serum by PCR allowed a definitive diagnosis of current infection. One serum sample with poor reactivity in a diagnostic assay had a minor hepatitis B surface antigen (HBsAg) variant and another with very poor reactivity had multiple variants of HBsAg. Transient HBsAg reactivity was observed in a recently vaccinated patient. A hepatitis Be antigen (HBeAg) false positive reaction was noted in a patient from a well defined risk group for HBV. One patient who was strongly HBsAg/HBeAg positive, but anti-hepatitis B core antibody negative, was viraemic. CONCLUSIONS: PCR may become the gold standard for the diagnosis of current HBV infection. HBV variants are responsible for a proportion of diagnostically difficult cases. Modification of commercial assays is necessary to increase the sensitivity of detection of such variants.

Adult↗
PubMed1998

Research productivity and activities of clinical laboratory science faculty: a follow-up study.

A national study was conducted in 1996 to compare clinical laboratory science faculty demographics, scholarly activities, and perceptions of the research environment with corresponding data reported in 1988. Faculty have made progress in earning doctorates (46%), achieving higher ranks (49%), and getting tenured (50%). Relatively few faculty are conducting much of the research, with the greater majority serving as teachers. Research productivity, as evaluated via research publications and presentations, showed that in 1996, full professors and those with doctorates published the most articles and abstracts in refereed journals; they also made more presentations than junior faculty. Faculty in research universities were more productive than those in four-year colleges and universities. The faculty surveyed in 1985 and those surveyed in 1996 perceived their research skills and environments to be almost identical. In both 1985 and 1996, the importance of research for promotion and tenure decisions ranked highest as a characteristic of the environment. Financial resources and time available for research ranked lowest.

Attitude of Health Personnel↗
PubMed1997

Magnitude estimation scaling of the loudness of a wide range of auditory stimuli.

The study of the perception of loudness lends itself well to the psychophysical scaling technique of magnitude estimation. This study was designed to extend the range of auditory stimuli used to study the magnitude estimation scaling of loudness. The five stimuli chosen were a 1000-Hz pure tone, narrow band noise (700-1300 Hz band width), broad band noise (100-10,000 Hz band width), rock music, and babble speech, i.e., speech in which meaning is not discernible because several individuals are talking at once. Subjects were 30 normal young women (M = 19 yr.). During the auditory magnitude-estimation task for each of the five stimuli, a subject was instructed to assign numbers to stimulus presented in a randomly ordered series of nine sensation levels (10, 20, 30, 40, 50, 60, 70, 80, and 90 dB SL). Multivariate analysis of variance for repeated measures indicated there were no significant differences in the numerical responses of the subjects for the five stimuli. A possible explanation for these results is the presence of an underlying stabilizing factor (internal scaling mechanism) that allows adults to scale loudness consistently irrespective of the type of auditory stimulus.

Acoustic Stimulation↗
PubMed1995

The influence of regional deposition on the pharmacokinetics of pulmonary-delivered human growth hormone in rabbits.

The pulmonary deposition and pharmacokinetics of human growth hormone (hGH), administered by aerosol and instillate, in formulations containing 99mTc-DTPA (for gamma scintigraphic imaging) have been studied in five male New Zealand White rabbits. Gamma scintigraphy indicated that the peripheral:central deposition tended to be greater for aerosol (1.54) than for instillate (0.8). Two gamma scintigraphic methods were used to quantify dose deposited by aerosol, which permitted bioavailabilities to be determined. The bioavailable fraction for aerosolized hGH (45%) was greater than for instilled hGH (16%). This was attributed to the differential effects of mucociliary clearance. Absorption rate limited pharmacokinetics prevailed for both hGH formulations with post-peak half-lives approximately 10-fold greater than the intravenous elimination half-life of 40 min. Apparent absorption rate constants resulting from instillation and aerosolization were equivalent (0.0012 min-1 and 0.0020 min-1 respectively), however lung-to-blood transfer rate constants for aerosol delivery (0.00071 min-1) were greater than for instillation (0.00018 min-1).

Administration, Inhalation↗
PubMed1994

Effect of abrupt discontinuation of high glucose infusion rates during parenteral nutrition.

We measured serum glucose and insulin levels in 15 children older than 2 years of age for 30 minutes after abrupt discontinuation of total parenteral nutrition. Initially high insulin levels rapidly became normal, and glucose levels were stable after 15 minutes. No patient had biochemical or symptomatic hypoglycemia. Glucose infusion rate, age, or use of steroid therapy had no apparent influence. Abrupt discontinuation of total parenteral nutrition is safe in most children older than 2 years of age.

Adolescent↗
PubMed1992

A simple standardised protocol for the production of monoclonal antibodies against viral and bacterial antigens.

A simple standardised protocol for making monoclonal antibodies against a range of human bacteria and viruses is described. The protocol was designed to reduce the number of steps to a minimum. A one step footpad immunisation was followed by the fusion schedule 10-15 days later. A vital step in the technique was the use of the immunised mouse's spleen to provide a feeder layer post fusion. This simplified the protocol and more importantly greatly accelerated the growth of the hybridomas produced. Immunisation, fusion and clonal expansion of specific antibody secreting hybridomas was complete within 5 weeks. The percentage of hybridomas secreting specific antibody ranged from 6% to 28%, the majority of which were of the IgG isotypes. The method was economical in the use of tissue culture medium and simple to perform.

Animals↗
PubMed1992

The pharmacokinetics of pulmonary-delivered insulin: a comparison of intratracheal and aerosol administration to the rabbit.

The pulmonary deposition and pharmacokinetics of insulin, administered via an endotracheal tube as an aerosol and instillate, in formulations containing either 113mIn-DTPA or 99mTc-DTPA (for gamma scintigraphic imaging) have been studied in four male New Zealand White rabbits. Using a randomized crossover design, the pharmacokinetics of intravenous insulin were also characterized. Recovery of immunoreactive insulin after nebulization was greater than 90%, indicating that the aerosolisation procedure did not cause appreciable insulin degradation. Gamma scintigraphy demonstrated that the penetration index (peripheral:central deposition) for the aerosolized formulation (1.52) was much greater than that for the instillate (0.32). Gamma scintigraphy also allowed exact quantification of the dose deposited after aerosol administration and thus permitted accurate determination of bioavailabilities. The bioavailable fraction for aerosolized insulin was 10-fold greater than for instilled insulin (57.2 vs 5.6%). Mucociliary clearance was likely to be greater for the instillate since it showed a preferential central deposition; this may account for the lower bioavailability. Insulin pharmacokinetics from both pulmonary formulations were absorption rate limited, resulting in postpeak half-lives which were approximately 20-fold greater than the intravenous elimination half-life (3 min). The apparent absorption rate constants resulting from instillation and aerosolisation were statistically equivalent (0.015 and 0.011 min-1, respectively). Mucociliary clearance of insulin would result in an overestimation of the true absorption rate constant; hence if mucociliary transport were greater for the instillate, then the true airways to blood transfer rate constant will be higher for the aerosolized formulation.

Aerosols↗
PubMed1991

Improved speed and accuracy of calculations with a programmable calculator in pediatric emergency scenarios.

Both mathematical and selection errors may occur when ordering drug or fluid therapy in a busy emergency department. In an attempt to improve the speed and accuracy of such calculations, we programmed a hand-held calculator to assist in drug and intravenous fluid therapy dosages and rates for three emergency situations: diabetic ketoacidosis, asthma, and asystole. Performance by 58 subjects at various levels of training was compared when using either the programmable calculator or standard materials and methods. When standard methods were used, an average of 30.6 minutes was needed to complete the three scenarios, with an accuracy of 73%; by contrast, use of programmable calculator resulted in a significant decline in time needed to calculate doses (an average of only 8.5 minutes), with an improved accuracy of 98%. The use of a programmable calculator can result in a significant improvement in both speed and accuracy of drug and fluid selection and dosage and rate calculations, regardless of the level of the subject's medical training.

Age Factors↗