Biomedical subjects
J E Hammond
Publications and source records attributed to J E Hammond.
Making the transition from information systems of the 1970s to medical information systems of the 1990s: the role of the physician's workstation.
Many hospitals today have implemented widely disparate information systems on mainframe and mini-computer hardware. The advent of network technology in hospitals has made it possible to access information in these systems. Unfortunately, the user interfaces to applications on these systems are unique and difficult to learn, which makes them unsuitable for use by clinical services. In this paper we describe the development of a Physician's Workstation which integrates information from multiple existing information systems and discuss how the workstation makes it possible to move from the departmental systems of the present to the computer-based medical record system of the future.
The Physician's Workstation: an example of end user integration of information systems.
Many hospitals today have implemented widely disparate information systems on mainframe and mini-computer hardware. The advent of network technology in hospitals has made it possible to access information in these systems. Unfortunately, the user interfaces to applications on these system are unique and difficult to learn, which makes them unsuitable for use by clinical services. In this paper we describe the development using rapid prototyping object-oriented programming tools of a Physician's Workstation which integrates information from five different applications running on three separate computer systems.
Controlled ventilation and the laryngeal mask.
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Absorption of digoxin from tablets and capsules in subjects with malabsorption syndromes.
The relative steady-state bioavailability of two oral digoxin dosage forms was studied in 17 subjects with malabsorption syndromes. Male subjects received the following treatments in randomized crossover fashion for 14 days: three 0.125-mg digoxin tablets or three 0.1-mg digoxin capsules once daily. Female subjects received digoxin on the same schedule but at two-thirds the dose. Serum and urine samples were collected and analyzed for digoxin by radioimmunoassay, and treatments were compared by evaluating pharmacokinetic parameters. The mean area under the serum concentration versus time curve for tablets (28.1 h.nmol/L [21.9 h.ng/mL]) was smaller (p less than 0.03) than that for capsules (31.1 h.nmol/L [24.3 h.ng/mL]), and the mean maximum serum digoxin concentration for tablets (2.9 nmol/L [2.3 ng/mL]) was lower (p less than 0.02) than that for capsules (4.0 nmol/L [3.1 ng/mL]). There was no difference in cumulative urinary excretion of digoxin between the two treatments. In contrast to previous reports, we observed that digoxin from Lanoxin Tablets appears to be well absorbed in subjects with malabsorption. Nevertheless, these subjects absorbed digoxin from capsules better than from tablets, with the greatest differences occurring in subjects without a colon and in those subjects with the lowest serum carotene concentrations.
Androgen receptors detected by autoradiography in prostatic carcinoma and benign prostatic hyperplastic tissue.
Androgen receptor (AR) content in prostatic tissues from patients with either cancer or benign prostatic hyperplasia (BPH) is of interest from at least two standpoints: receptors may be a feature of the pathogenesis of these conditions, and they may be important to the management and prognosis of prostatic cancer patients. For these reasons, a quantitative autoradiographic assay for AR content in prostatic tissues has been developed. Application of autoradiography to rodent tissues yielded results that were highly correlated with those from biochemical assays. Thus, the autoradiographic analyses with human tissues reported in this paper were undertaken. Average AR content in 22 prostatic carcinomas was lower than that in tissues from 14 patients with BPH; the median values of the affinity index, the quantitative estimate of receptor content, were 7.0 and 12.0, respectively. For the cancer tissues, a trend of declining receptor content with advancing stage of disease appeared but was not statistically significant. No association between receptor content and degree of tumor aggressiveness as measured by Gleason score and MD Anderson score was evident. Patient age and race were not related to receptor content in either type of tissue.
Serum hormone levels among patients with prostatic carcinoma or benign prostatic hyperplasia and clinic controls.
This study sought to identify differences in serum hormone levels between prostatic cancer (CaP) patients, benign prostatic hyperplasia (BPH) patients, and clinic controls (CC). Serum testosterone, estradiol, and prolactin values were obtained from 35 CaP, 42 BPH, and 161 CC patients attending a single medical center between January 1984 and April 1985. Relative risk estimates adjusted for age and race were calculated to compare hormone values between each case group and the CC. The distributions of hormone values and the testosterone to estradiol (T/E) ratios were grouped into thirds with the lowest third forming the reference category. The relative risk estimates for BPH in the middle and high thirds of testosterone were greater than unity (1.26 and 2.10, respectively), whereas the relative risk estimates in the middle and high thirds of estradiol were less than unity (0.63 and 0.35, respectively). For the middle and high thirds of the T/E ratio, the relative risk estimates for BPH showed statistically significant three- to fourfold increases. Modest depression of serum testosterone and estradiol was noted for CaP patients compared to CC, although the differences were not statistically significant. This depression was interpreted to be a likely result of the malignant process rather than a cause of it, whereas the development of clinically evident BPH was felt to be a biologically plausible response to an elevated T/E ratio.
Anaesthesia and gastric carcinoid.
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Influence of tubocurarine, pancuronium and atracurium on bronchomotor tone.
Specific airways conductance (s.Gaw) was measured using the forced airflow oscillation method to study the effects of tubocurarine, pancuronium and atracurium. Twenty-seven patients undergoing elective surgery were randomly allocated to receive one of the three drugs. A statistically significant mean change in s.Gaw from the baseline values for each drug was apparent only after administration of atracurium (at 6 min) (P less than 005). Some individuals given atracurium or tubocurarine either showed large decreases in s.Gaw or cutaneous flushing, but only one patient showed both. Pharmacological release of histamine may be confined to individual tissues in these instances.
Reversal of opioid-associated late-onset respiratory depression by nalbuphine hydrochloride.
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Bioavailability of digoxin capsules and tablets: effect of coadministered fluid volume.
The effect of different coadministered fluid (water) volumes on the consistency of digoxin absorption was studied in 16 male volunteers. Each volunteer received four single-dose treatments (two 0.25-mg digoxin tablets with 30- and 240-mL of water and two 0.2-mg digoxin capsules with 30- and 240-mL of water). Digoxin present in serum and urine samples collected for 48 h after dosing was quantified by RIA. Treatments were compared by evaluating the following model-independent pharmacokinetic parameters: maximum serum concentration (Cmax); time of maximum serum concentration (tmax); area under the serum concentration-time curve for 0-12 h (AUC0-12); cumulative urinary excretion for 0-48 h (CUE48). No significant differences were found between dosage form (tablets versus capsules) and coadministered water volume (30 mL versus 240 mL) for any of the parameters. For both fluid volumes the AUC0-12 and Cmax were significantly larger (p less than 0.01) and the tmax significantly shorter (p less than 0.01) for the capsules than for the tablets. The volume of coadministered water had no effect on the amount of digoxin absorbed from either dosage form.
Burn injury: sunlight and a single dose of methoxsalen.
A patient is described in whom burn injury, caused by moderate exposure to sunlight in the U.K., was precipitated by undue sensitivity to a photosensitizing agent methoxsalen. This drug, although withdrawn in the UK, is freely available in the Republic of Ireland and many EEC countries for the treatment of psoriasis and acne vulgaris.
Transection of the cervical trachea resulting from closed trauma to the neck.
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Comparison of the resistances of double-lumen endobronchial tubes.
The resistance of commonly-used double-lumen endobronchial tubes were measured and a detailed comparison made. Robertshaw tubes were generally found to have a lower resistance than either the Carlens or the White tubes of equivalent size, but this was not so in every case. The White tubes had a disproportionately high resistance associated with the upper lobe orifice when compared with the resistance of the right main orifice. Theoretically this could lead to uneven ventilation of the right lung. This was not found to be the case in the right-sided Robertshaw tube.
Positive and expiratory pressure and one lung anaesthesia.
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Anaesthesia for laparoscopy: alfentanil and fentanyl compared.
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Resistance of Enderby tapered tracheal tubes.
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Hypotension following intravenous cimetidine.
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