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Biomedical subjects

F A Campbell

Publications and source records attributed to F A Campbell.

At least 19 recordsLinked to original sources
PubMed2005

The management of non-melanoma skin cancer.

Non-melanoma skin cancer is an increasingly common problem with a diversity of aetiologies as well as treatments. This article describes the clinical sub-groups and discusses potential management strategies as determined by best clinical practice and patients' individual needs.

Administration, Topical↗
PubMed2003

Clinical governance and chronic pain: towards a practical solution.

There have been many studies into the effectiveness of single interventions in pain, however, little is known of performance or outcome of pain clinics where treatment often consists of multiple, complex interventions. Many pain clinicians currently experience considerable difficulty in fulfilling the requirements of clinical governance and completing a personal portfolio. There is a clear and urgent need for a viable method of monitoring performance. This study describes a well-developed computer-based system - Pain Audit Collection System (PACS). PACS has been designed by pain clinicians through consensus and its success in uptake suggests that it is a viable method for outcome evaluation. An analysis is provided of outcome data in typical pain clinics. Further work is needed to investigate the utility of this data.

Chronic Disease↗
PubMed2003

Scalp necrosis in temporal arteritis.

Giant cell arteritis is a systemic disease of the elderly which affects large and medium-sized arteries and which may occur in association with polymyalgia rheumatica. Scalp necrosis is a rare cutaneous complication of giant cell arteritis, and this dermatological presentation is not commonly reported.1-4 Giant cell arteritis should be considered in all elderly patients with scalp ulceration. We describe two patients who presented in this manner.

Aged↗
PubMed2001

Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review.

OBJECTIVE: To establish whether cannabis is an effective and safe treatment option in the management of pain. DESIGN: Systematic review of randomised controlled trials. DATA SOURCES: Electronic databases Medline, Embase, Oxford Pain Database, and Cochrane Library; references from identified papers; hand searches. STUDY SELECTION: Trials of cannabis given by any route of administration (experimental intervention) with any analgesic or placebo (control intervention) in patients with acute, chronic non-malignant, or cancer pain. Outcomes examined were pain intensity scores, pain relief scores, and adverse effects. Validity of trials was assessed independently with the Oxford score. DATA EXTRACTION: Independent data extraction; discrepancies resolved by consensus. DATA SYNTHESIS: 20 randomised controlled trials were identified, 11 of which were excluded. Of the 9 included trials (222 patients), 5 trials related to cancer pain, 2 to chronic non-malignant pain, and 2 to acute postoperative pain. No randomised controlled trials evaluated cannabis; all tested active substances were cannabinoids. Oral delta-9-tetrahydrocannabinol (THC) 5-20 mg, an oral synthetic nitrogen analogue of THC 1 mg, and intramuscular levonantradol 1.5-3 mg were about as effective as codeine 50-120 mg, and oral benzopyranoperidine 2-4 mg was less effective than codeine 60-120 mg and no better than placebo. Adverse effects, most often psychotropic, were common. CONCLUSION: Cannabinoids are no more effective than codeine in controlling pain and have depressant effects on the central nervous system that limit their use. Their widespread introduction into clinical practice for pain management is therefore undesirable. In acute postoperative pain they should not be used. Before cannabinoids can be considered for treating spasticity and neuropathic pain, further valid randomised controlled studies are needed.

Analgesics, Non-Narcotic↗
PubMed2001

Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review.

OBJECTIVE: To quantify the antiemetic efficacy and adverse effects of cannabis used for sickness induced by chemotherapy. DESIGN: Systematic review. DATA SOURCES: Systematic search (Medline, Embase, Cochrane library, bibliographies), any language, to August 2000. STUDIES: 30 randomised comparisons of cannabis with placebo or antiemetics from which dichotomous data on efficacy and harm were available (1366 patients). Oral nabilone, oral dronabinol (tetrahydrocannabinol), and intramuscular levonantradol were tested. No cannabis was smoked. Follow up lasted 24 hours. RESULTS: Cannabinoids were more effective antiemetics than prochlorperazine, metoclopramide, chlorpromazine, thiethylperazine, haloperidol, domperidone, or alizapride: relative risk 1.38 (95% confidence interval 1.18 to 1.62), number needed to treat 6 for complete control of nausea; 1.28 (1.08 to 1.51), NNT 8 for complete control of vomiting. Cannabinoids were not more effective in patients receiving very low or very high emetogenic chemotherapy. In crossover trials, patients preferred cannabinoids for future chemotherapy cycles: 2.39 (2.05 to 2.78), NNT 3. Some potentially beneficial side effects occurred more often with cannabinoids: "high" 10.6 (6.86 to 16.5), NNT 3; sedation or drowsiness 1.66 (1.46 to 1.89), NNT 5; euphoria 12.5 (3.00 to 52.1), NNT 7. Harmful side effects also occurred more often with cannabinoids: dizziness 2.97 (2.31 to 3.83), NNT 3; dysphoria or depression 8.06 (3.38 to 19.2), NNT 8; hallucinations 6.10 (2.41 to 15.4), NNT 17; paranoia 8.58 (6.38 to 11.5), NNT 20; and arterial hypotension 2.23 (1.75 to 2.83), NNT 7. Patients given cannabinoids were more likely to withdraw due to side effects 4.67 (3.07 to 7.09), NNT 11. CONCLUSIONS: In selected patients, the cannabinoids tested in these trials may be useful as mood enhancing adjuvants for controlling chemotherapy related sickness. Potentially serious adverse effects, even when taken short term orally or intramuscularly, are likely to limit their widespread use.

Antiemetics↗
PubMed2001

The development of cognitive and academic abilities: growth curves from an early childhood educational experiment.

In the Abecedarian Project, a prospective randomized trial, the effects of early educational intervention on patterns of cognitive and academic development among poor, minority children were examined. Participants in the follow-up were 104 of the original 111 participants in the study (98% African American). Early treatment was full-time, high-quality, educational child care from infancy to age 5. Cognitive test scores collected between the ages of 3 and 21 years and academic test scores from 8 to 21 years were analyzed. Treated children, on average, attained higher scores on both cognitive and academic tests, with moderate to large treatment effect sizes observed through age 21. Preschool cognitive gains accounted for a substantial portion of treatment differences in the development of reading and math skills. Intensive early childhood education can have long-lasting effects on cognitive and academic development.

Adolescent↗
PubMed1995

The role of tumor rejection antigens in host antitumor defense mechanisms.

BACKGROUND: Normal cells undergo contact inhibition of growth when their surface molecules interact. Tumor cells, however, have undergone a mutation that prevents this arrest of growth upon contact inhibition and allows constant growth. Thus, growth inhibition fails to occur despite the interaction of surface molecules. In recent years a subgroup of these surface molecules has been of interest to cancer investigators. This subgroup has been termed the tumor rejection antigens (TRAs). As the name implies, these are specific to the tumor of origin and may direct the immune system of the host to target the tumor cells and kill them. METHODS: A literature search was carried out on TRAs to ascertain the current thinking on the subject. RESULTS: Initial studies of TRAs have revealed that some of them may be heat shock proteins (HSPs). In particular, grp96, a number of the HSP90 family, has been implicated. More recent studies, however, have shown that HSPs alone may not be immunogenic but may act as carrier proteins for tumor specific peptides. CONCLUSION: Such findings have led to speculation that HSPs or their associated peptides may have a role in the diagnosis and/or treatment of specific cancers. Immunotherapy and bispecific antibodies in particular are areas in which HSPs may prove to be useful.

Antigens, Neoplasm↗
PubMed1994

End-tidal carbon dioxide measurement in infants and children during and after general anaesthesia.

We have examined the reliability of end-tidal carbon dioxide (PetCO2) monitoring as an estimate of arterial carbon dioxide tension (PaCO2) in spontaneously breathing infants and children. Forty patients were studied in the post-anaesthetic care unit; 20 < 12 kg and 20 > or = 12 kg. The PetCO2 was sampled via a 5 cm 16 gauge catheter taped below an external naris and this measurement was compared with the PaCO2 of a sample drawn from an indwelling arterial line. Twenty additional patients were studied during inhalational anaesthesia. The PetCO2 was measured both from the proximal end of the elbow connector and from a 5 cm cannula inserted through the elbow. An arterial blood gas sample was obtained simultaneously. The arterial to end-tidal (Pa-et) differences were compared between the two sites. Patients studied in the post-anaesthetic care unit showed good correlation between PetCO2 and PaCO2 regardless of weight: Pa-etCO2 of -0.6 +/- 3.6 (< 12 kg) and -1.1 +/- 2.8 mmHg (> or = 12 kg). Patients studied during mask anaesthesia showed better correlation between PetCO2 and PaCO2 when PetCO2 was sampled from the cannula: Pa-etCO2 of 3.5 +/- 4.8 mmHg (cannula), 8.6 +/- 4.5 (elbow) (P < 0.05). These results suggest that end-tidal CO2 monitoring is a useful and reliable method for assessing adequacy of ventilation in spontaneously breathing children weighing between 5.2 and 35 kg.

Anesthesia Recovery Period↗
PubMed1994

Effects of early intervention on intellectual and academic achievement: a follow-up study of children from low-income families.

Follow-up data, obtained 4-7 years after intervention ended, are presented for the Carolina Abecedarian Project, an experimental study of early childhood educational intervention for children from poverty families. Subjects were randomly assigned to 1 of 4 intervention conditions: educational treatment from infancy through 3 years in public school (up to age 8); preschool treatment only (infancy to age 5); primary school treatment only (age 5-8 years), or an untreated control group. Positive effects of preschool treatment on intellectual development and academic achievement were maintained through age 12. School-age treatment alone was less effective. Results generally supported an intensity hypothesis in that scores on cognitive and academic achievement measures increased as duration of treatment increased.

Child↗
PubMed1993

Publication of abstracts presented at anaesthesia meetings.

To determine the publication rate of abstracts as peer-reviewed manuscripts during the five years subsequent to their presentation, the rates of publication of abstracts that were presented at meetings of four anaesthesia societies (American Society of Anesthesiologists (ASA), International Anesthesia Research Society (IARS), Anaesthesia Research Society (ARS) and Canadian Anaesthetists' Society (CAS), in 1985 were determined. Abstracts (total = 215) from each of the four meetings were selected (ASA n = 114/573 total, IARS n = 39/119, ARS n = 33/99 and CAS n = 29/58) and their appearances in the literature as peer-reviewed manuscripts were determined using MEDLINE for the years 1985 to 1990 under the surname of the presenting author. The contents of the abstracts were compared with those of the resultant manuscripts. The proportions of abstracts from each of the four societies that were published as manuscripts were compared. We found that the mean proportion of abstracts from all four societies that were published as manuscripts within three years of presentation was 44% and within five years 50%. The proportions of abstracts that were published as manuscripts from the four societies were similar. Of the abstracts that were published as manuscripts, 13% from the ASA, 16% from the IARS, 16% from the ARS and 0% from the CAS were published four or five years after abstract presentation. Although the overall proportion of abstracts that was published within five years of presentation did not differ from the rate of publication within three years, we recommend that a uniform policy with respect to the time interval for citation of abstracts be adopted for all anaesthesia journals.

Abstracting and Indexing↗
PubMed1992

Analgesic efficacy and safety of a caudal bupivacaine-fentanyl mixture in children.

The analgesic efficacy and safety of a single caudal injection of a bupivacaine-fentanyl mixture was investigated in this prospective, controlled, triple-blinded study of 34 children, aged 1-11 yr and of ASA physical status I-II undergoing urological surgery. After induction of anaesthesia and before surgery, the children were randomly assigned to receive a caudal injection of 1.0 ml.kg-1 bupivacaine 0.125% with epinephrine 1:400,000 and either fentanyl 1.0 microgram.kg-1 in 1.0 ml of normal saline or 1.0 ml of normal saline. After completion of surgery, patients were assessed in the recovery room for six hours from the time of the caudal injection and for a further 18 hr on the ward. While in the recovery room arterial oxygen saturation and respiratory rate were monitored continuously and recorded hourly together with end-tidal carbon dioxide, pain and sedation scores. Other complications were also recorded. While on the ward, pain and sedation scores, respiratory rate and side effects were recorded every two hours. Postoperative analgesia was provided by intravenous morphine. Analgesic requirements were recorded for the 24-hr study period. Pain and sedation scores did not differ between groups. Respiratory depression or hypoxia did not occur. The incidences of other side effects did not differ. There were no differences in the numbers of patients requiring morphine within eight hours, the time to first morphine administration or the total morphine requirements. We conclude that a single caudal injection of a bupivacaine-fentanyl mixture with epinephrine administered prior to surgery, while safe, offers no advantage over an injection of bupivacaine 0.125% with epinephrine for paediatric urological surgery.

Anesthesia, Caudal↗
PubMed1984

Infants' home environments: a study of screening efficiency.

The predictive efficiency of Caldwell's Home Observation for Measurement of the Environment (HOME) with a sample of infants from low-income families at-risk for developmental retardation was assessed. The home environments of 51 infants were assessed with the HOME at 6 and 18 months. Multiple discriminant functions composed of the six HOME subscale scores predicted whether the child would be low IQ (below 75), low average (75 to 89), or average to superior (90 and above) at age 3. At both 6 and 18 months, the discriminant function of the HOME was found to be moderately sensitive in identifying children in the low-IQ group (62% correctly identified); 56% were false positives. Additional research is necessary to differentiate with precision among families at elevated risk levels.

Child Development↗
PubMed1984

Preventive education for high-risk children: cognitive consequences of the Carolina Abecedarian Project.

Longitudinal mental test scores for 54 educationally treated disadvantaged preschool children at high-risk for nonbiologically based mild mental retardation and 53 control children were compared. The educationally treated children were in a child-centered prevention-oriented intervention program delivered in a daycare setting from infancy to age 5. Language, cognitive, perceptual-motor, and social development were stressed. Children were examined with age-appropriate tests of development at 6, 12, 18, 24, 30, 42, 48, and 54 months of age. Beginning at 18 months, and on every test occasion thereafter, educationally treated children significantly outscored control group children on mental tests; treated children consistently scored at the national average whereas control children's scores declined from the average level at 12 months to below average at 18 months and thereafter. Implications of the results for early intervention were discussed.

Achievement↗