PubMed Health⌕ Search

Biomedical subjects

J Brebner

Publications and source records attributed to J Brebner.

At least 19 recordsLinked to original sources
PubMed2005

A comprehensive approach for evaluating telemedicine-delivered multidisciplinary breast cancer meetings in southern Scotland.

Multidisciplinary team (MDT) meetings for decisions on cancer management are a cornerstone of UK cancer policy. We have proposed a comprehensive methodology to assess the clinical and economic effectiveness of telemedicine in this setting, which is being tested in a randomized breast cancer trial. Pre- and post-telemedicine assessment includes attitudes to and expectations of telemedicine, based on semistructured interviews. The communication content of videotapes of the MDT meeting is being scored using Borgatta's revised Interaction Process Analysis System. The technical performance of the telemedicine equipment is reported on a standardized pro forma. A short questionnaire captures key elements of professional satisfaction for each patient discussion (consensus on future management, confidence in and sharing of decision), added value of linkage, group atmosphere, overall conduct of the meeting and compliance with SIGN guidelines. A cost-minimization analysis will be used for economic assessment.

Attitude of Health Personnel↗
PubMed2005

Attitudes of breast cancer professionals to conventional and telemedicine-delivered multidisciplinary breast meetings.

We surveyed the attitudes of breast cancer professionals to standard face-to-face and future telemedicine-delivered breast multidisciplinary team (MDT) meetings. Interviews, which included the Group Behaviour Inventory, were conducted face-to-face (n = 19) or by telephone (n = 26). The mean total score on the Group Behaviour Inventory was 96 (SD 19) for 33 respondents, which indicated satisfaction with standard MDT meetings, irrespective of role and base hospital. Positive attitudes to videoconferencing were more common among participants with previous experience of telemedicine (Spearman's rank correlation 0.26, P = 0.91). Common themes emerging from the interviews about telemedicine-delivered MDTs included group leadership, meeting efficiency, group interaction, group atmosphere and technical quality of communication. Most participants were satisfied with standard breast MDTs. Nurses and allied health professionals were least supportive of telemedicine.

Analysis of Variance↗
PubMed2003

Study of mortality risk factors for children under age 5 in Abu Dhabi.

We investigated the association of biological, sociocultural and economic risk factors with child mortality in Abu Dhabi from 1 January-31 December 1997. With McNemar chi-squared test, most selected biological risk factors were statistically associated with child mortality, although maternal age older than 40 years and history of fetal death were not positively correlated with neonate, infant or age under 5 mortality. Among sociocultural and economic risk factors, maternal lack of formal education and low monthly income were significantly associated with child death. Consanguinity was significantly associated with under 5 and infant but not neonatal mortality. Gestation <37 weeks was highly associated with mortality among all ages. Strengthening health care programmes and emphasizing the need to identify high risk groups should be priorities.

Age Distribution↗
PubMed2001

Asthma diagnosis and management in adults: is the risk of underdiagnosis and undertreatment related to patients' education levels?

To determine the relationship between patient education and the risk of underdiagnosis and undertreatment of asthma, a cross-sectional study of 500 (250 males and 250 females) adult attendees between 16 and 44 years of age was undertaken at five primary health care (PHC) centers in Al-Ain, United Arab Emirates. We used an Arabic translation of the European Community Respiratory Health Survey Screening Questionnaire. Asthmatics with higher levels of education had a significantly higher risk of underdiagnosis and undertreatment than asthmatics with less education. Doctors at PHC centers railed to diagnose 34.6% of the asthmatics with lower levels of education and 77.6% of the patients with higher levels of education. Eighty-five percent of the asthmatics with lower levels of education and 46.6% of the asthmatics with higher levels of education recognized that they had asthma. Thirty-eight percent of the asthmatics with lower levels of education and 83% of the asthmatics with higher levels of education were undertreated. It was found that 19% of the asthmatics with lower levels of education and 3% of the asthmatics with higher level of education were on prophylactic medication for asthma. We concluded that education level was related to underdiagnosis and undertreatment of asthma among adults between 16 and 44 years of age. People with higher levels of education have a higher risk of underdiagnosis and undertreatment than do those with lower levels of education. The factors that might be associated with these findings need to be explored in further studies.

Adolescent↗
PubMed2000

Asthma and respiratory symptoms among school children in United Arab Emirates.

OBJECTIVES: To determine the prevalence of asthma, wheezing, hay fever, and eczema among primary school children aged 6-13 years in United Arab Emirates (UAE). DESIGN: A cross-sectional study on school children was performed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires. SETTING: Government primary school children in seven Emirates, in UAE. SUBJECTS: Subjects were selected by a multi-stage stratified sampling design. 4200 children targeted for this study, but only 3200 children aged 6-13 years were agreed to participate and responded to the study. The overall response rate was 69.8%. RESULTS: The prevalence of physician diagnosed asthma was 13%, in addition, the wheeze by history was 15.6%. Furthermore, the prevalence of nocturnal cough was 21%. On the other hand, the prevalence of eczema was 11% and hay fever was 14.9%. Parental asthma but not parental atopy was associated with an increased risk of asthma and wheezing in children. CONCLUSIONS: The prevalence of asthma and wheezing in UAE is consistent with that in neighbouring Gulf countries.

Adolescent↗
PubMed1999

Efficacy of a single dose of oral antibiotic given within two hours of birth in preventing watery mouth disease and illthrift in colostrum-deficient lambs.

An antibiotic with a product licence limited to the treatment and control of infectious bacterial enteritis associated with Escherichia coli in piglets was tested for its ability to control watery mouth disease in neonatal lambs. Three groups of lambs were kept in conditions commonly encountered in intensive lambing systems, where high levels of environmental bacterial contamination may be expected. They were allocated at birth to: a control group (group 1) consisting of 18 colostrum-deprived lambs; group 2, consisting of 17 lambs given one feed of colostrum when they were two hours old; and group 3, consisting of 18 colostrum-deprived lambs given spectinomycin orally when they were two hours old. Nine group 1 lambs became diseased and were killed for humane reasons. Blood biochemical changes included hyperglycaemia followed by hypoglycaemia, lactacidaemia, hypoproteinaemia and metabolic acidosis, and postmortem examination of the diseased lambs showed signs consistent with endotoxaemia and a clinical diagnosis of watery mouth disease. Coliforms were isolated from the blood of all group 1 lambs and from half the lambs in groups 2 and 3, but endotoxaemia and watery mouth disease occurred only in group 1 lambs. The results for groups 2 and 3 showed that neither colostrum nor antibiotic at the rates and frequency used prevented bacteraemia, although consecutive samples were positive only on three occasions. Group 3 lambs consistently grew more rapidly than the surviving group 1 lambs and as rapidly as group 2 lambs. There was no evidence that male lambs were more prone to watery mouth disease than female lambs. The results indicated that the antibiotic spectinomycin did not induce endotoxaemia during low-grade bacteraemia and that a single oral dose given within two hours of birth protected colostrum-deprived lambs delivered into a contaminated indoor environment against watery mouth disease.

Administration, Oral↗
PubMed1996

Decoquinate and the control of experimental ovine toxoplasmosis.

Decoquinate was tested for its ability to reduce the effect of experimentally induced toxoplasmosis in pregnant ewes. Sheep were given decoquinate in their feed daily at either 2 mg or 1 mg/kg bodyweight from 10 days before an oral challenge with Toxoplasma gondii oocysts at 90 days of gestation, until lambing. Feeding decoquinate at the higher rate caused a delay in the onset of the febrile response to infection, reduced the overall severity of the fever and delayed the production of antibodies to the parasite. This treatment also reduced the placental damage caused by the parasite, lengthened the mean gestation period and increased the number and weight of live lambs, in comparison with ewes not fed decoquinate but challenged with T gondii oocysts. The treatment with 1 mg of decoquinate had smaller effects.

Abortion, Veterinary↗
PubMed1996

Tissue culture-propagated orf virus vaccine protects lambs from orf virus challenge.

Twenty, eight-day-old specific pathogen-free (SPF) lambs were vaccinated by a single scarification approximately 4 cm in length on the inner right thigh with a double-pronged applicator. The titre of live virus in the vaccine was 10(7.2) TCID50/ml and the estimated dose per lamb was 0.04 ml. Three months and six months later 10 of the vaccinated lambs and five age-matched unvaccinated control specific pathogen free lambs were challenged by a single scarification with virulent virus on the inner left thigh in the same way. After the vaccination all 20 lambs developed lesions characteristic of orf virus infection that had largely resolved four weeks later, when they all had reciprocal ELISA antibody titres > or = 3200 that persisted in all but one of them until they were challenged. After the challenge, the development of lesions in the vaccinated and unvaccinated sheep was compared daily for four weeks by means of a clinical scoring system. Both groups of vaccinated lambs had significantly lower (P < 0.01) total clinical scores after challenge at three months and six months than the unvaccinated lambs.

Animals↗
PubMed1995

A putative role for larval nematode infection in diarrhoeas of lambs which did not respond to anthelmintic drenches.

Attempts to control a summer diarrhoea in grazing Finnish landrace lambs which had been unresponsive to anthelmintics and coccidiostats were made by supplementing them with cupric oxide particles and withdrawing a magnesium-rich mineral, while maintaining parasite control measures. The diarrhoea persisted from July to September and plasma pepsinogen activities were raised, suggesting that the anthelmintic did not prevent abomasal damage; the jejunum of an affected lamb showed lesions of parasitic gastroenteritis. Small responses to cupric oxide particles and larger responses to the withdrawal of magnesium were deceptive, possibly being confounded by differences in parasite challenge. In another experiment Finnish landrace lambs were more susceptible to diarrhoea than Suffolk cross lambs in autumn. The susceptibility was then linked to a strong inhibition of worm egg output and may have been caused by a hypersensitive mucosal response to the larval challenge. Plasma pepsinogen concentrations were again raised in the Finnish landrace lambs and did not decline after treatment with anthelmintic, whereas the concentrations increased later in the Suffolk cross lambs, and were apparently responsive to anthelmintic. The cases of diarrhoea were similar to 'July disease' and may have been caused by continuous nematode infections which were only briefly controlled by drenches. Anthelmintic-unresponsive diarrhoea is the term proposed for the disorder, which may be controllable by devices releasing anthelmintic continuously or by a move to less infected pasture. Faecal egg counts remained low in the condition and were diagnostically misleading.

Animals↗
PubMed1995

Efficacy trials with tissue-culture grown, inactivated vaccines against chlamydial abortion in sheep.

Vaccines containing inactivated, semi-purified antigen of ovine abortifacient Chlamydia psittaci were prepared from tissue-culture grown harvests of two strains. These were evaluated for efficacy against experimentally reproduced enzootic abortion of ewes (EAE), the protection index (PI) of each vaccine being calculated from three variables. Trial 1 tested the adjuvants Marcol 52/Arlacel A, ISCOM matrix, Novasomes and Alhydrogel, each administered with a total antigen dose of 4 micrograms chlamydial protein (cp), against challenge with the two homologous vaccine strains. The first three formulations yielded PIs of 39-42%, while that of Alhydrogel was 23%. Marked granuloma and/or abscess formation occurred in the Marcol 52/Arlacel A group but in none of the others, and only this group seroconverted following vaccination. In Trial 2, ISCOM matrix containing 16 micrograms cp per dose was administered once or twice. Two challenges were used, one involving the two vaccine strains and the other these two strains plus five others, but no significant differences were seen between them. The double dose schedule, which was better than the single dose and also several Novasomes formulations tested concurrently, gave PIs of 64 and 77% against the two challenges (combined value 71.5%). Trial 3 studied duration of immunity over two lambing seasons using three different administration schedules of 16 micrograms cp in ISCOM matrix, namely single dose in year 1, single dose in year 2 (Group 1), double dose then booster (Group 2), and double dose without booster (Group 3). PIs against the homologous bivalent challenge were 79-80% for Groups 1 and 3 and 91% for Group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Veterinary↗
PubMed1988

An assessment of the efficacy and safety of selenium and cobalt included in an anthelmintic for sheep.

A trial was devised to assess whether the administration of selenium and cobalt together with the anthelmintic mebendazole (Ovitelmin S&C) was safe and could improve the supplies of selenium and cobalt for adult sheep fed a whole grain diet, low in both elements, which produced a steady decrease in blood glutathione peroxidase (GSHPx) and plasma vitamin B12 concentrations. Ovitelmin S&C, when given orally in a single dose as a suspension containing 0.34 mg selenium/ml, and 0.44 mg cobalt/ml (to provide 0.11 mg selenium and 0.15 mg cobalt/kg liveweight) significantly increased the GSHPx activity in blood. After a second dose given 28 days later the rate of change increased from 2.5 to 3.5 u/g haemoglobin/day. The responses in GSHPx were similar for a preparation which contained twice the concentration of selenium. Ovitelmin S&C increased the concentration of vitamin B12 in the plasma by about 1000 pg/ml for four to seven days after each dose and the increases were similar to those observed in sheep treated with an Ovitelmin preparation containing 45 times more cobalt (providing 6.7 mg cobalt/kg liveweight). After 63 days, liver vitamin B12 concentrations were 43 per cent higher in the cobalt treated than in the untreated groups (P less than 0.01) with no differences among the groups given cobalt. Neither adverse reactions nor signs of toxicity followed the administration of Ovitelmin S&C or Ovitelmin containing the higher concentrations of selenium and cobalt.

Administration, Oral↗
PubMed1986

Hydropneumothorax--an unusual complication of lung lavage.

Hydropneumothorax is an uncommon but potentially fatal complication for a patient undergoing positive pressure ventilation. The case of a 23-year-old woman with severe asthma requiring lung lavage is described. Twenty minutes after an uneventful left lung lavage, the patient experienced increased peak airway pressure, decreased oxygen saturation and hypercarbia, despite ventilation with 90 per cent oxygen. A chest x-ray revealed mediastinal shift and a left sided pneumothorax. Drainage was carried out, revealing air and clear fluid in the pleural space. The importance of technical problems such as patient and endotracheal tube positioning, elimination of cross-spilling and cardiopulmonary effects of lavage are discussed.

Adult↗
PubMed1984

Postthoracotomy pain and pulmonary function following epidural and systemic morphine.

Thirty patients undergoing thoracotomy for lung resection were entered in a randomized, double-blind trial comparing the effects of epidural (E) versus intravenous (iv) morphine on postoperative pain and pulmonary function. Postoperatively the patients were given repeated doses of either 5.0 mg of morphine epidurally or 0.05-0.07 mg/kg morphine intravenously until there were no further spontaneous complaints of pain. Two, 8, and 24 h postoperatively, the following indices were measured: linear analogue pain score, somnolence score, vital signs, arterial PaO2, PaCO2, and pH, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow rate (PEFR). Patients receiving epidural morphine had significantly less pain at 2 h (P less than 0.01) and 8 h (P less than 0.004) postoperatively. There was no difference in vital signs except for significantly slower respiratory rates at 2 h (P less than 0.04), 8 h (P less than 0.02) and 24 h (P less than 0.01) in the epidural group. No significant differences occurred in the somnolence scores or blood-gas measurements, which were within normal limits.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

A randomized evaluation of the reversal of ketamine by physostigmine.

One hundred and eleven patients undergoing ketamine anaesthesia for therapeutic abortion were studied in a double-blind trial of the reversal of ketamine by physostigmine administered postoperatively. The results demonstrate that physostigmine does not shorten recovery time or reduce the occurrence of ketamine emergence phenomena such as hallucinations, restlessness and dreams. In fact, the recovery course was prolonged in patients given physostigmine immediately upon termination of anaesthesia as compared with controls. By contrast, when physostigmine was given 30 minutes after the last dose of ketamine, the recovery was not prolonged as compared with that of the placebo-treated controls. These findings suggest some synergism between the effects of ketamine and physostigmine and should discourage the use of physostigmine as a ketamine antidote.

Abortion, Therapeutic↗