PubMed Health⌕ Search

Biomedical subjects

G Charlton

Publications and source records attributed to G Charlton.

At least 19 recordsLinked to original sources
PubMed2001

Primary pulmonary hypertension in pregnancy; a role for novel vasodilators.

We describe the case of a 28-week pregnant woman presenting with severe primary pulmonary hypertension (PPH). She had an elective Caesarean section under general anaesthesia at 32 weeks gestation. Pulmonary artery pressures (PAP) measured from a pulmonary artery catheter before anaesthesia were in excess of 100 mm Hg. Intraoperative nitric oxide was used to reduce PAP. After the delivery of a healthy infant PAP was controlled with nebulized iloprost and a prostacyclin infusion. Seven days later she was discharged from intensive care taking an oral calcium antagonist and warfarin. She developed intractable right heart failure and died 14 days after delivery. Despite increasing experience in the use of drugs to reduce PAP, the clinical course of pregnancy complicated by severe PPH is usually fatal.

Adult↗
PubMed1996

Metastatic carcinoma in the neck from an occult primary lesion.

Over an 11-year period, from January 1980 to December 1990, 23 patients with metastatic carcinoma of the neck were admitted to Addington Hospital with an unknown primary lesion. More than 50% of patients presented with disease in the N3 nodal stage. Sixteen patients had squamous cell carcinoma, 6 undifferentiated carcinoma and 1 adenocarcinoma. The diagnoses were made by means of fine-needle aspiration cytology and histological assessment of the neck nodes. Twenty-one patients were treated with radiotherapy and 2 with surgery. The primary tumour became apparent in only 4 (17%) patients, 7, 8, 9, and 12 months respectively after initial presentation. The sites were the base of tongue in 2, the pyriform fossa in 1 and the scalp in the remaining patient. The overall 3-year and 5-year survival rates were 26% and 17% respectively.

Adenocarcinoma↗
PubMed1993

A survey of patients seen in consultant clinics in conservative dentistry at Edinburgh Dental Hospital in 1990.

A baseline study of referrals by letter to a department of conservative dentistry staffed purely by honorary consultants was conducted for one year. Distinct differences were found between the majority of patients referred from general practice and those referred from other sources. Principal reasons for referral were problems of tooth replacement, appearance, endodontics and tooth wear. A predominance of female patients was seen in all groups except those complaining of tooth wear. 'Endodontic' patients featured the highest proportion of requests for hospital treatment. Complex restorative treatment was provided for the majority (70%) of referred patients, and about 10% received treatment from dental students. The rates of referral showed evidence of dependence on travelling distance to the referral centre but not on the availability of local GDPs. This emphasises the importance of maintaining existing specialist dental referral services in major population centres and the development of new services where appropriate.

Adult↗
PubMed1992

An evaluation of a nurse-run asthma clinic in general practice using an attitudes and morbidity questionnaire.

A before and after longitudinal study was conducted to evaluate a nurse-run asthma clinic in general practice. Sibbalds morbidity and attitudes questionnaire was used to monitor the changes in association with attendance at the clinic. One hundred and five patients aged 3-83 years attended the clinic. Over the 12 months of the study patients reported significant reductions in attacks of wheeze, nocturnal attacks, overall trouble (P eta 0.005) and GP home visits (P = 0.02). Patients also reported a significant improvement in feelings of stigma (P less than 0.001), and confidence in self-care (P less than 0.001). There was a significant association between morbidity criteria such as 'overall interference' and stigma at the outset of the clinic (R = -0.44; P less than 0.001; 95% confidence interval -0.58 to -0.26). A patient's feelings of stigma towards their asthma at the outset did not predict the eventual improvement in morbidity. As the patient's asthma improved the feelings of stigma became less apparent. This would suggest that improving a patient's morbidity should be one of the first priorities in asthma care. Confidence in the doctor was high at the outset and did not change throughout the study, despite the fact that a large proportion of patients wanted more information about their asthma but found it difficult to talk to their doctor. General practitioners are often restrained by how much time and resources they can devote to each patient. The nurse-run asthma clinic with its programme of structured care represents a possible solution to these problems.

Adolescent↗
PubMed1991

Presence of blood significantly decreases transmission of 630 nm laser light.

Application of 630 nm light in the presence of blood is often necessary during photodynamic therapy, particularly for proposed intravascular applications. The effect of blood on transmission of 630 nm light was studied using a three dimensional irradiation model and an integrating sphere for measuring light transmitted in any direction through blood layers of different hematocrit (25 to 75) and thickness (.15 to .98 mm). There was an inverse relationship between transmission and hematocrit and transmission and blood thickness, p = .000 for both. At a physiologic hematocrit of 46, transmission through blood layers of .98, .41, .28, and .15 mm were 21%, 33%, 29%, and 58% respectively. These blood thicknesses or more are likely in the clinical environment, and can be expected to result in significant transmission losses. The marked absorption of 630 nm light by blood indicates that removal of the blood or correction for power loss should be employed when 630 nm light is applied in a blood containing environment.

Absorption↗
PubMed1991

Audit of the effect of a nurse run asthma clinic on workload and patient morbidity in a general practice.

The aim of this study was to assess the effect of a nurse run asthma clinic on practice workload and the morbidity of patients in a four partner general practice. One hundred and fifteen asthmatic patients were studied and comparisons were made between the 12 months prior to the introduction of the clinic and the first 12 months after the clinic started. Morbidity was measured in terms of: the number of courses of oral steroids, the number of emergency salbutamol nebulizations, and the number of days lost from work or school. The number of consultations with the general practitioners were recorded. The repeat prescribing register was also monitored throughout the study to examine the effect of the clinic on prescribing in the practice. Consultations with general practitioners fell from a total of 818 to 414 during the study period (P less than 0.001). This was offset by 496 consultations with the nurse in the first 12 months of the clinic. As a result of attending the nurse clinic significant reductions (P less than 0.01) were found in the patients' requirements for courses of oral steroids, acute nebulizations and days lost from work or school. The results for the 46 children were similar to those for the 69 adults, confirming that the asthma clinic was effective for all ages. The clinic coincided with an increase in the number of patients receiving regular bronchodilator therapy and prophylactic medication. Eighty per cent of patients had their medication modified as a result of attending the clinic. The cost of prescribing remained remarkably stable.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1990

Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice.

OBJECTIVE: To compare a peak flow self management plan for asthma with a symptoms only plan. DESIGN: Randomisation to one of the self management plans and follow up for a year. SETTING: Four partner, rural training practice in Norfolk. SUBJECTS: 115 Patients (46 children and 69 adults) with asthma who were having prophylactic treatment for asthma and attending a nurse run asthma clinic. MAIN OUTCOME MEASURES: The number of doctor consultations, courses of oral steroids, and short term nebulised salbutamol treatments and the number of patients who required doctor consultations, courses of oral steroids, and short term nebulised salbutamol. RESULTS: Both self management plans produced significant reductions in the outcome measures but there were no significant differences in the degree of improvement between the groups. The results were similar for children and adults. The proportions of patients requiring a doctor consultation fell from 98% (50/51) to 66% (34/51) in the peak flow group and from 97% (62/64) to 53% (34/64) in the symptoms only group and the proportions requiring oral steroids from 73% (34/46) to 47% (21/46) and 52% (31/60) to 12% (7/60). The median number of doctor consultations was reduced from 8.0 to 2.0 in the peak flow group and from 4.5 to 1.0 in the symptoms only group. CONCLUSIONS: The peak flow meter was not the crucial ingredient in the improved illness of the two groups. Teaching patients the importance of their symptoms and the appropriate action to take when their asthma deteriorates is the key to effective management of asthma. Simply prescribing peak flow meters without a system of self management and regular review will be unlikely to improve patient care.

Administration, Oral↗
PubMed1990

Sinusitis and the acute orbit in children.

Acute orbital infection is an uncommon condition which is often secondary to acute sinusitis. Although it can present in any age group it is most prevalent in children and may cause impaired vision, blindness, intracranial complications and death. This paper documents the experience at the Royal Liverpool Childrens Hospital, Alder Hey, from 1973 to 1989. Clinical details were recorded retrospectively from the hospital case notes. Sixty-eight children had orbital sepsis of whom 30 had associated acute sinusitis. Of these 30 children, orbital sepsis was always unilateral with a preference for the left side; ten had diplopia of whom four had a sub-periosteal abscess which was subsequently drained. There were no serious complications although two children had diplopia for two to three months.

Acute Disease↗
PubMed1990

Survival of crowns and bridges related to luting cements.

The longevity of 782 items of crown and bridgework was investigated in a retrospective study. The effect of different cement lutes was assessed for periods varying from 70 to 89 months using a survival analysis technique. The analysis of all types of restoration showed slightly better survival figures for restorations cemented with polycarboxylate but were not statistically significant when compared with those cemented with glass-ionomer. However, those cemented with polycarboxylate were significantly more successful than zinc phosphate. The restorations cemented with glass-ionomer showed no statistically significant improvement in survival rate compared with those cemented with zinc phosphate. Restorations cemented with zinc/oxide eugenol reinforced EBA cement had the lowest survival rate of the four cement types. Analysis of the survival of crowns alone showed the same ranking of the cements compared with all restorations. Comparison of bridges, ranked those cemented with glass-ionomer above those cemented with polycarboxylate, but not statistically different. Posts cemented with phosphate were ranked first and lasted significantly longer than those cemented with glass-ionomer.

Crowns↗
PubMed1989

The retention of gold crowns on human dentine preparations--a comparison of eight cements.

Experiments were carried out to compare the retentive properties of eight dental luting cements, using gold crowns cemented onto human dentine. The order of retention of the cements was: 1 Composite (Panavia-Ex, J & S Davis); 2 Glass-ionomer. (AquaCem, DeTrey); Glass-ionomer (Ketac-Bond, Cottrell); and Polycarboxylate (Bondalcap, Vivadent); 3 Polycarboxylate (Poly F Plus, DeTrey); Zinc phosphate (DeTrey); and Zinc phosphate (Phosphacap, Vivadent); and 4 Zinc oxide/eugenol, alumina, EBA (Opotow, Teledyne Getz).

Crowns↗
PubMed1981

A technique for the production of standard test specimens of aluminous dental porcelain.

A technique has been developed for the preparation of test bars of the different types of aluminous porcelains using the standard laboratory procedures for the preparation of aluminous porcelain jacket crowns. Up to now the investigation of the properties of dental porcelain has been conducted using test specimens produced either by vibration of a slurry of porcelain powder without platinum foil or by grinding from the solid brock. These techniques are far removed from the methods used for the production of porcelain restorations in the laboratory. This might lead to a variation in the results achieved by testing porcelain jacket crowns on the one hand and test specimens on the other.

Aluminum↗
PubMed1978

Plaque minerals and caries experience: associations and interrelationships.

Inverse associations were demonstrated between DMFT and total calcium, phosphorus, magnesium, strontium, potassium, and fluoride concentrations in individual plaques. Lithium, strontium, fluoride, and zinc contents were inversely related to plaque mass. Consistent interdependence patterns between elements indicate the operation of a mineral level regulating mechanism, effective under diverse environmental conditions.

Adolescent↗