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Biomedical subjects

F Robinson

Publications and source records attributed to F Robinson.

At least 37 records · Page 2Linked to original sources
PubMed1997

Teacher's questionnaire for vision problems: is it a help or a hindrance for school health screening?

The importance of early detection of vision problems in children is widely accepted. Screening by nurses in the first year of school is important in such early detection. The feasibility of using a questionnaire for teachers in place of the traditional screen was examined. In addition, the effect of prior in-service training for teachers on the results of the questionnaire survey was assessed. The questionnaire had poor sensitivity and specificity. Used as the sole screen, it would have resulted in the unnecessary referral of healthy children, and more importantly, children with visual defects would have been missed. Further, there was no improvement in the outcome when prior in-service training on the questionnaire had been given. The questionnaire for teachers, as given, was an unsatisfactory alternative to the screening by health professionals and was not supported by this study.

Child↗
PubMed1997

Self-reporting Medicare and Medicaid overpayments.

Refunding a significant overpayment to the Medicare or Medicaid program can subject a healthcare organization to government scrutiny that can consume the time and energies of key staff members, risk potential litigation by shareholders, and possibly lead to severe sanctions. Delaying a refund, however, may precipitate even more costly consequences, such as triple damages and heavy monetary penalties. The government has stepped up its efforts to detect and punish fraud and abuse; therefore, providers should refund overpayments promptly. Failure to do so may constitute a crime, increase the likelihood of a whistleblower exposing the offense, or result in an increase in the amount of penalties imposed. Healthcare organizations can prevent overpayment abuses from occurring by following recommended procedures for making refunds, addressing underlying billing problems, and ensuring that senior management oversees the entire claims payment process.

Accounting↗
PubMed1997

What is a board's liability for not adopting a compliance program?

A key element of the 1991 United States Sentencing Commission's guidelines, used in sentencing corporations and business convicted of Federal crimes, is the provision of leniency for organizations that adopt effective corporate compliance programs. Given the increased scrutiny of healthcare organizations by Federal Investigators, the incentive to adopt corporate compliance programs has never been greater. Directors or trustees of healthcare organizations should be especially interested in adopting such programs, since recent case law suggests that they may be held personally liable for damages or losses resulting from a finding of fraud and abuse at their facilities.

Financial Audit↗
PubMed1996

Mobilization of Philadelphia-negative peripheral blood mononuclear cells in chronic myeloid leukaemia using hydroxyurea and G-CSF (filgrastim).

A relatively simple and non-toxic out-patient-based regimen for the mobilization of Philadelphia-negative (Ph-ve) mononuclear cells in chronic myeloid leukaemia (CML) was evaluated in 10 patients, nine in stable chronic phase and one in accelerated phase. They received oral hydroxyurea at a mean dose of 3.5 g/m2 daily for 7 d, followed by 300 micrograms of G-CSF daily until the last day of harvesting. In the nine chronic-phase patients the mean number of days from the end of hydroxyurea to the commencement of harvesting was 14.5 (range 10-18). The patient in accelerated phase recovered and was harvested after 6 d. The mean number of aphereses performed was 3.4. Adequate numbers of stem cells were obtained in 9/10 patients judged by our usual criteria. Side-effects were mild in comparison to published intravenous schedules. No patients lost their hair. Five (50%) patients required admission with neutropenic fever which responded to antibiotics in all cases. Four (40%) patients developed a transient rash and four (40%) experienced mild oral mucostis. This level of toxicity enabled half of the patients to be treated entirely on an out-patient basis. The harvest products were analysed for cells belonging to the leukaemic clone by conventional cytogenetics, FISH and PCR. All were PCR positive. The mean Ph positivities by cytogenetics and FISH were comparable at 18.1% and 15% respectively. Half the patients had > 98% normal metaphases. We conclude that this approach is comparable in efficacy to published intravenous regimens and significantly less toxic. It can be safely used at diagnosis before interferon therapy commences.

Administration, Oral↗
PubMed1996

Peripheral blood stem cell transplantation in myeloma using CD34 selected cells.

We have performed nine CD34 selection procedures on peripheral blood stem cells harvested from eight patients with myeloma using the Cellpro avidin-biotin immunoaffinity column (Ceprate). They all received CVAMP chemotherapy to maximum response prior to mobilisation. Six of the patients have been transplanted using these cells, one receiving successive autografts. Median absolute cell numbers processed and retrieved were: 31.1 x 10(9) pre-column, 2.07 x 10(8) in the final product and 30.4 x 10(9) in the column waste. Mean CD34 positivity in the product was 49% (range 18.4-98) with a median CD34+ yield of 31.4% (range 21-37.8). IgH PCR was performed and seven of the eight patients were amplifiable. Of these, two were positive in the pre-column product and both of these were successfully purged with a negative result in the final, post-column product. Patients were transplanted with a median of 2.0 x 10(6) CD34+ cells/kg (range 1.5-9.4) following conditioning with melphalan 200 mg/m2. The mean time to recovery of neutrophils to > 0.5 x 10(9)/l and platelets to > 20 x 10(9)/l was 16 and 17 days, respectively. At a mean follow-up of 9 months, four of the six patients transplanted are alive, three of them in complete remission and one in a clinically stable relapse. One has died of disease relapse and one of progressive neurological problems the aetiology of which was uncertain but there was no sign of progression of their myeloma. We conclude that PBSCT using CD34 selected cells is safe and practical in myeloma following remission induction with CVAMP chemotherapy.

Antigens, CD34↗
PubMed1995

Dorsal root ganglionectomy for intractable monoradicular sciatica. A series of 61 patients.

Dorsal root ganglionectomy was introduced in 1975 as a procedure with theoretical advantages over dorsal rhizotomy for the treatment of intractable radicular pain. Results of the few clinical reports have been generally favorable. The authors report the largest and most comprehensively studied series to date. 61 patients (33 men, 28 women) underwent dorsal root ganglionectomy for intractable sciatica, most often monoradicular. Patients were selected for surgery only if the clinical history, physical examination, radiologic studies, and diagnostic radicular block all predicted a favorable outcome. Sciatica was markedly reduced or eliminated in 36 patients (59%). Dysesthesia following ganglionectomy was observed frequently, but not invariably (approximately 60% of cases). Dysesthesia was generally of mild or moderate severity, self-limited, and responsive to treatment.

Adult↗
PubMed1994

Successful control of intractable nausea and vomiting requiring combined ondansetron and haloperidol in a patient with advanced cancer.

Chemically induced nausea and vomiting is a common symptom of advanced cancer effected through stimulation of dopamine (D2) or serotonin (5-HT3) receptors located in the chemoreceptor trigger zone (CTZ). These may be blocked by therapeutic doses of haloperidol and ondansetron, respectively. This case, reporting on a single patient acting as her own control, establishes that combined blockade of these receptors is sometimes required to relieve intractable nausea and vomiting. It also demonstrates the value of clinical review, audit of care, and quality assurance in the palliative care setting.

Analgesics↗
PubMed1994

Detection of fertilization in embryos with accelerated cleavage by fluorescent in-situ hybridization (FISH).

Embryos from a couple undergoing routine in-vitro fertilization for unexplained infertility had shown cleavage by day 1 in two consecutive cycles. The response of the woman to fertility drugs had been normal, and there were no known sperm abnormalities. In a subsequent cycle, accelerated cleavage occurred again and we used a modified method of spreading whole embryos and dual fluorescent in-situ hybridization (FISH) with directly labelled probes for chromosomes X and Y to determine if fertilization had occurred in these embryos. Nine oocytes were collected, five of which had cleaved when examined for pronuclei early on day 1 following late insemination. Pronuclei were observed in one of the remaining oocytes, but in this case, three were present. On day 2, all of the oocytes/embryos had cleaved and two were transferred to the patient. The remaining seven were spread for FISH analysis but nuclei were only obtained from five. In three, a Y signal was detected, indicating that fertilization had occurred. In all five embryos, a wide range of X chromosome signals were observed. These data suggest that the embryos had undergone abnormal fertilization and accelerated cleavage.

Adult↗
PubMed1992

The acute effect of topical epinephrine on macular blood flow in humans.

The acute effect of topical epinephrine HCl 2% on macular capillary blood flow was studied in 18 healthy human volunteers using the blue-field simulation technique. This technique provides a method for quantifying the velocity of leukocytes flowing in macular capillaries. Subjects adjusted the velocity of simulated leukocytes on a computer screen to match that of their own entoptically perceived leukocytes before instilling the drug and 2 hr thereafter. An artificial tear solution was instilled into the fellow eye for a control. Epinephrine instillation resulted in a 8% increase in macular leukocyte velocity and presumably blood flow (P less than 0.03, paired student t-test).

Administration, Topical↗
PubMed1989

Long-term follow-up of idiopathic central serous chorioretinopathy by fluorescein angiography.

Idiopathic central serous chorioretinopathy (ICSC) is typically described as a self-limited, unilateral disease that affects healthy, young adult males. The authors studied 13 patients (14 eyes) who had documented spontaneous resolution of symptomatic macular detachments. These patients were evaluated in a longitudinal fashion to determine the fate of the retinal pigment epithelium (RPE) as viewed angiographically, both in the initially affected eyes and the fellow eyes. At the time of follow-up examination of the initially affected eyes, nonleaking RPE defects had developed inside the areas of previous serous detachment in all cases. Nonleaking RPE defects had developed outside these areas in six (43%) eyes. Two (14%) eyes had new, asymptomatic macular detachments. Six (42%) fellow eyes had new RPE window defects; two (17%) of them also had active RPE dye leakage resulting in asymptomatic macular detachment at the final examination. Four (29%) originally involved eyes and one (8%) fellow eye lost more than two lines of Snellen visual acuity during the follow-up period. The authors' results suggest that ICSC may be a progressive bilateral disease that develops asymmetrically and causes diffuse RPE changes not localized to the area of serous detachment. Long-term follow-up of these patients may, therefore, be advisable.

Adult↗