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Biomedical subjects

E Burns

Publications and source records attributed to E Burns.

At least 19 recordsLinked to original sources
PubMed1992

Vitamin C depletion and pressure sores in elderly patients with femoral neck fracture.

OBJECTIVE: To evaluate the contribution of specific nutritional deficiencies (as indicated by zinc; vitamin A, C, and E; albumin; and haemoglobin concentrations) to the risk of pressure sores. DESIGN: Observational cohort study. SETTING: St James's University Hospital, Leeds. SUBJECTS: 21 elderly patients presenting consecutively to the orthopaedic unit with femoral neck fracture. MAIN OUTCOME MEASURE: Full thickness epidermal break over a pressure bearing surface. RESULTS: 10 patients (48%) developed a pressure sore during their hospital stay. Indices of zinc status and concentrations of albumin, haemoglobin, and vitamins A and E were similar in patients who developed a pressure sore and those who did not. Mean leucocyte vitamin C concentration, however, was 6.3 (SD 2.2) micrograms/10(8) cells in patients who developed a pressure sore as compared with 12.8 (4.6) micrograms/10(8) cells in patients who did not. CONCLUSIONS: Low concentrations of leucocyte vitamin C appear to be associated with subsequent development of pressure sores in elderly patients with femoral neck fractures.

Aged↗
PubMed1992

A survey of hospital toilet facilities.

OBJECTIVE: To assess the quality of toilet facilities available for disabled people in a large provincial teaching hospital. DESIGN: Survey of toilet facilities for patients on the wards and in the outpatient department. SETTING: Teaching hospital in Leeds. RESULTS: Although the quality of toilet facilities varied, none met the standards recommended by the British Standards Institution. The worst facilities were found on a ward accommodating elderly patients, where the toilets were unsuitable for use by disabled people and bedside commodes had to be used instead. CONCLUSION: Toilet provision within a major hospital failed to meet standards required for disabled people. Admission to hospital may therefore result in loss of independence and dignity. If hospitals are to be centres of excellence, greater consideration must be given to the requirements of disabled people in the design of new wards, and current inadequate facilities should be upgraded.

Architectural Accessibility↗
PubMed1992

Lymphadenectomy in gastric carcinoma. A prospective and prognostic study.

In 193 gastric resections for adenocarcinoma, lymphadenectomy was prospectively evaluated to quantify the number of lymph nodes and to identify prognostic factors. Overall, 7112 nodes (median, 36.8 per patient) were resected with 27.2% showing metastases. Most nodes were found in the perigastric region. The histologic type and site of the tumor did not influence the number of invaded nodes, but tumor stage and quality of the resection (curative/palliative) did. By multivariate analysis the tumor stage, curative vs palliative resections, and the number of metastatic lymph nodes in curative resections were independent prognostic factors. Patients with less than six metastatic nodes showed a survival not significantly different from that of patients with normal nodes. These patients may be well treated by surgery alone, but the other patients may require multimodal therapy to improve their prognosis.

Adenocarcinoma↗
PubMed1992

The influence of age on policies for admission and thrombolysis in coronary care units in the United Kingdom.

Age is an important factor influencing survival following an acute myocardial infarction. In clinical practice many elderly patients are neither admitted to coronary care nor receive thrombolytic therapy. A postal questionnaire was sent to all 175 consultants in charge of coronary care units in the United Kingdom to determine whether age-related policies are being operated which are limiting the access of elderly patients to life-saving interventions. One hundred and thirty-four questionnaires (77%) were returned. One-fifth of coronary care units operate an age-related admission policy, and two-fifths operate an age-related thrombolysis policy. The age limits used by many of these units are likely to exclude large numbers of patients who could benefit from cardiac monitoring and resuscitation as well as thrombolytic treatment. The abolition of age-related policies would help to ensure that thrombolysis is readily available to the group of patients most likely to benefit from it.

Aged↗
PubMed1992

Practical problems with eye-drops among elderly ophthalmology outpatients.

Many elderly patients have eye-drops prescribed. We have examined the abilities in eye drop application of 43 consecutive outpatients aged 75 years or more who completed a questionnaire and demonstrated their technique in eye-drop application. Less than one-third of patients applied drops themselves, the rest relying on others; one-third of this group lived alone. The majority of patients experienced some difficulty with the application of their drops and it was estimated that half of those who usually applied their own treatment were unlikely to succeed in instilling a drop into the conjunctival sac. Few patients had been prescribed aids or appliances to improve their eye-drop application technique.

Aged↗
PubMed1991

Indocyanine green elimination in patients with liver disease and in normal subjects.

1. The validity of a two-compartment pharmacokinetic model for the estimation of the hepatic extraction ratio of Indocyanine Green was tested in six patients with cirrhosis of the liver. 2. No agreement was found between the value of the hepatic extraction ratio measured directly and that calculated using the two-compartment model. 3. To investigate the reasons for the failure of the model, an extended sampling period was used to define the time course of Indocyanine Green in plasma in six healthy subjects and in six patients with cirrhosis of the liver after a bolus injection of the dye. 4. Indocyanine Green was measurable in the plasma for up to 10 h after injection in healthy subjects, and up to 48 h after injection in the patients. The plasma elimination curve in both groups was best described by a triexponential function. 5. The clearance of Indocyanine Green calculated using data collected in the first 20 min after injection overestimated that calculated using data collected for as long as Indocyanine Green was measurable in the plasma. In the patients with cirrhosis the mean overestimate was 87%. 6. Thus, a two-compartment pharmacokinetic model was inappropriate for the description of the disposition of Indocyanine Green and estimates of the hepatic extraction ratio obtained using this model in patients with cirrhosis were inaccurate.

Female↗
PubMed1990

Trusses.

Explore the source record for details and available documents.

Equipment Design↗
PubMed1990

Leukoaraiosis in asymptomatic adult offspring of individuals with Alzheimer's disease.

The presence of white matter changes on magnetic resonance imaging (MRI), which has been referred to by Hachinski (1987) as leukoaraiosis, is frequently noted in elderly individuals in conditions ranging from health to frank dementia. This study involved the use of MRI to document cerebral structure if 41 healthy 50-60-year-old individuals, 28 of whom were offspring of Alzheimer's disease victims. On visual inspection of spin-echo images, 13 of the 28 offspring showed white matter lesions whereas all of the controls were free of leukoaraiosis. This statistically significant difference suggests that the presence of leukoaraiosis might be of importance in understanding changes in the white matter among populations at increased risk for Alzheimer's disease.

Alzheimer Disease↗
PubMed1990

IgG anti-tetanus toxoid antibody synthesis by human bone marrow. I. Two distinct populations of marrow B cells and functional differences between marrow and peripheral blood B cells.

This investigation uses a system for inducing and detecting anti-tetanus toxoid antibody (anti-TT) synthesis to study specific antibody (Ab) synthesis by bone marrow mononuclear cells (MC). We measured the amounts of anti-TT secreted and the number of B cells secreting antibody (Ab). The ELISA plaque detects single B cells secreting specific Ab. The results show that (1) spontaneous anti-TT secretion by MC is higher than spontaneous anti-TT secretion by peripheral blood lymphocytes (PBL) using an ELISA plaque (P less than 0.01); (2) spontaneous anti-TT production by MC correlated with the serum anti-TT titers as measured by an ELISA (r = 0.75, P = 0.005); (3) two types of marrow B cells were identified--one that spontaneously secretes anti-TT and another that produces anti-TT after TT-stimulation; (4) the frequency of anti-TT-secreting B cells is higher in MC than in PBL; (5) the amount of Ab secreted per marrow B cell is not different from that secreted by a peripheral B cell; and (6) marrow B cells could be induced to produce anti-TT in vitro up to 10 months without added cytokines. These results show that bone marrow is a major repository for differentiated B cells that spontaneously produce Abs to maintain circulating Abs titers and for memory B cells that can be induced to produce specific Ab.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1990

Elderly patients' understanding of their drug therapy: the effect of cognitive function.

The relationship between cognitive function and knowledge about drug therapy and its risks was examined in 207 elderly patients attending a geriatric outpatient clinic. The patients' reports of their therapy were compared with those of their clinic doctor. Patient-doctor agreement on the number of drugs taken per patient fell with increasing age independently of change in cognitive function. However, knowledge about drugs was related to cognitive function. Many patients taking some of the potentially more dangerous drugs were ignorant of possible side-effects of their treatment. Doctors need to be trained more effectively in communicating with elderly patients about their treatment and its risks.

Aged↗
PubMed1989

Direct and indirect measurement of the hepatic extraction ratio of indocyanine green in the rat.

1. In order to estimate liver blood flow in the rat, the extraction ratio of Indocyanine Green was determined using a two-compartment model fitted to the plasma concentration time data after a single intravenous bolus dose and compared with values obtained directly by transhepatic sampling, both in the intact rat and in an isolated perfused rat liver preparation. 2. There was no agreement between estimates of the extraction ratio obtained by using the kinetic model and the directly measured values. 3. Elimination curves for Indocyanine Green were simulated to yield varied clearance values. Despite a 250% variation in clearance, extraction ratios derived using the two-compartment model were all greater than 0.9 and varied by less than 6%. 4. Estimates of liver blood flow obtained by deriving a value of the extraction ratio of Indocyanine Green using the two-compartment model are inaccurate.

Animals↗
PubMed1987

Plasma ultrafiltrable magnesium in insulin dependent diabetics.

Plasma ultrafiltrable (MgUF) and total magnesium concentrations were measured in 60 insulin dependent diabetics and compared with values in an age matched control group. Although the diabetic patients had lower plasma albumin concentrations (p less than 0.05), both ultrafiltrable and total magnesium concentrations were significantly decreased by 6.8% and 7.6%, respectively, compared with those of the controls (p less than 0.001). In the diabetic group MgUF varied inversely with fasting plasma glucose (r = -0.269, p less than 0.05). In 14 patients with significant hypomagnesaemia, fasting plasma glucose concentration was higher (p less than 0.01) and the diabetes was of shorter duration (p less than 0.05) than in 46 patients with an MgUF in the control range. The fasting urinary magnesium creatinine ratio was greater in the diabetic patients (p less than 0.05). Patients with retinopathy did not have lower plasma magnesium values than those without retinopathy.

Diabetes Mellitus, Type 1↗
PubMed1985

The unwarranted use of replicate analysis in routine coagulation studies.

The need to assure the validity of semiautomated coagulation procedures by performing replicate determinations is assessed. Prothrombin times (PT) and activated partial thromboplastin times (aPTT) were run as duplicate assays using two different photo-optical detection systems. Sixty specimens with a broad range of PT and aPTT results were studied as aliquots of 80, 100, and 140 microL of plasma. A total of 1,440 studies were performed. No statistically significant differences were found among the data for complementary groups of assays. It is concluded that replicate analyses do not enhance the precision nor the accuracy of these coagulation studies. These factors are more controlled adequately by quality assurance procedures, including frequent calibration checks, the use of internal standards, and multilevel commercial controls.

Blood Coagulation Tests↗