PubMed Health⌕ Search

Biomedical subjects

I Bullock

Publications and source records attributed to I Bullock.

7 recordsLinked to original sources

Survival to discharge following open chest cardiac compression (OCCC). A 4-year retrospective audit in a cardiothoracic specialist centre--Royal Brompton and Harefield NHS Trust, United Kingdom.

OBJECTIVE: To review the use of Open Chest Cardiac Compression (OCCC) techniques in postcardiac surgical patients in one specialist cardiothoracic centre in the UK. METHODS: A 4-year retrospective audit (April 1995--March 1999) of all cardiac arrest victims and resuscitation practice across two specialist cardiothoracic hospitals. Audit outcomes related to initial survival and survival to discharge, arrest rhythm, reasons for resternotomy, surgical procedure prior to resternotomy and time elapsed from original surgery to resternotomy. RESULTS: Seventy-two patients (adult and paediatric) suffering cardiac arrest received OCCC following cardiac surgery. Thirty-three patients initially survived (46%) and 12 patients survived to discharge (17%). DISCUSSION AND RECOMMENDATIONS: In the absence of current European Resuscitation Council guidelines, we adopted recommendations for resternotomy to be performed after 5 min of unsuccessful conventional CPR and OCCC initiated. An adapted ERC algorithm incorporating these recommendations can provide much needed direction in postcardiac surgery cardiac arrest victims.

Adult↗

Establishing priorities for research in education within one college of nursing and midwifery.

The educational provision for nurses and midwives is currently undergoing immense change. These innovations encompass the organizational structure, the process of delivery and the projected outcomes for professional education within the UK. There is, however, a dearth of published research evidence designed to evaluate these educational changes. Nevertheless, anecdotal evidence suggests that within individual institutions small-scale, educationally-focused research is currently being conducted. These are usually 'one off' studies which address questions of personal interest to individual researchers rather than issues of importance to the organization or to the professions as a whole. the net result is a diverse research portfolio which, by its very nature, is wasteful in terms of lost opportunity to commission larger-scale research which might influence educational practice and in failing to direct effectively the energies and skills of researchers. In an attempt to address these issues and to set an agenda for research priorities within one college of nursing and midwifery, a four-round Delphi survey was conducted. This is the first of its kind to be reported in the UK literature. Fifty six of the teaching staff (77% of the total number of teaching staff) initially identified 213 issues which were grouped into 14 categories. The interrater reliability of the categorization process was checked on three separate occasions. In successive rounds, high response rates were maintained. To test for the manipulative effect of providing respondents with controlled feedback of their score in round 2, the third questionnaire was completed "blind' to previous scores. In the final round, participants were provided with feedback and invited to re-score and rank the items. The final round yielded 28 prioritized items. It was notable that the top ten issues primarily focused upon the pre-registration (Project 2000) provision encompassing both the preparation of students for professional practice and the changing role of the nurse/midwife teacher. This paper explores the implications of these findings for setting a research agenda within the organization.

Curriculum↗

Variation of SCE frequency in lymphocyte cultures from patients with Hodgkin's disease before, during, and after treatment.

Seven patients with newly-diagnosed Hodgkin's disease, having standard mustine-vinblastine-prednisolone-procarbazine therapy, had a large and regular pattern of rise in SCE frequency in their peripheral lymphocytes, which apparently started to fall before the end of the course (32 wk). In contrast, SCE frequency fell below normal in the lymphocytes of nine patients having mantle radiotherapy. Twenty-eight patients studied 2-13 yr after initial chemotherapy or radiotherapy for Hodgkin's disease had normal or near normal SCE frequencies.

Adult↗

Chromosome damage and sister chromatid exchanges in lymphocyte cultures from patients with two primary cancers.

Sister chromatid exchanges (SCEs) and chromosome damage were scored in lymphocyte cultures from 11 patients with two or more primary cancers and were compared with normal controls. None of the patients had a constitutional chromosome anomaly, but six showed evidence of chromosome instability, which could not be accounted for by treatment, expressed either as elevated SCE frequency or increased nonspecific chromosome damage and chromosome loss. Chromosome damage included major rearrangements as well as deletions and gaps. The possibility of common mechanisms in chromosome instability leading to susceptibility to a heterogeneous group of primary cancers is discussed.

Aged↗

Non-random chromosome loss in PHA-stimulated lymphocytes from normal individuals.

31773 lymphocyte metaphase cells from 280 karyotypically normal men aged 18-46 were examined for chromosome gain or loss. Chromosome loss was much more common than chromosome gain. Frequency of chromosome loss did not conform to a binomial distribution. There is a striking non-linear, inverse relationship between likelihood of loss and chromosome length. Chromosome gain shows a near binomial distribution between cells and no clear relationship to chromosome length. These facts indicate that the hypodiploid cells mostly arose as technical artefacts during slide preparation but that hyperdiploid cells were mainly due to non-disjunctional gain.

Adolescent↗

In vivo cytogenetic activity of sulphonylurea drugs in man.

A cytogenetic investigation of diabetic patients undergoing treatment with sulphonylurea drugs, particularly chlorpropamide, shows that significantly more chromatid aberrations and chromosome exchange aberrations are present in the lymphocytes of these patients compared with controls. This is taken as evidence of possible mutagenic activity by these drugs, although the possibility cannot be ruled out that the diabetic state itself is a contributory factor.

Adult↗