PubMed Health⌕ Search

Biomedical subjects

J H Tweedie

Publications and source records attributed to J H Tweedie.

16 recordsLinked to original sources
PubMed1998

Physical therapists' opinions and practices regarding direct access.

BACKGROUND AND PURPOSE: This study examined whether differences exist about physical therapists' opinions and practices regarding the use of direct access between therapists practicing in Massachusetts, a direct-access state, and therapists practicing in Connecticut, a state that allows only evaluation without referral. A second purpose was to examine direct-access practices of therapists in Massachusetts. SUBJECTS: A sample of 329 therapists in Massachusetts and 179 therapists in Connecticut were surveyed. METHODS: A cover letter, questionnaire, and return-reply envelope were mailed to each therapist. Independent group t tests and chi-square analyses were used to determine whether therapists' opinions about direct access differed between states. Frequencies were calculated to examine direct-access practices of therapists in Massachusetts. RESULTS: Adjusted response rates were 65.5% in Massachusetts and 57.9% in Connecticut. Therapists in both states were equally supportive of direct access (74.9%). Therapists in Connecticut were more supportive of three stipulations regulating direct access than therapists in Massachusetts were. In Massachusetts, 34.0% of the respondents stated that they practiced using direct access, and 8.8% of the patients seen by the therapists sampled were treated without physicians' referrals. The therapists indicated that the most common reasons for limited use of direct access were employer policies and lack of insurance reimbursement. CONCLUSION AND DISCUSSION: Therapists in Connecticut favored more stipulation regulating direct access than therapists in Massachusetts did. Although therapists in both states appear to be supportive of direct access, the number of patients in Massachusetts seen through this mode of care appears to be limited because of practice and financial restraints.

Adult↗
PubMed1989

Intercostal blockade and pulmonary function after cholecystectomy.

Sixty-six patients undergoing cholecystectomy were randomly allocated to receive either intercostal blockade with bupivacaine supplemented with papaveretum or papaveretum alone for postoperative analgesia. Both groups were similar regarding distribution of sex, age, and weight. These two groups were compared. Patients who did not have intercostal blockade required postoperative analgesia sooner. There was no significant difference, however, in the total consumption of papaveretum. Both groups experienced similar degrees of pain, and there were no differences in postoperative pulmonary function. We conclude that although single intercostal blockade is an effective analgesic, it does not improve pain relief and does not improve pulmonary function after cholecystectomy when compared with a regimen of on-demand, intramuscularly administered papaveretum.

Analgesia↗
PubMed1987

Management of acute biliary disease.

Acute biliary disease is the commonest general surgical reason for urgent admission to hospital in the over-65 age group. With an ever-increasing elderly population to treat, cholelithiasis and its complications will continue to present both surgeons and physicians with difficult decisions regarding its proper management.

Acute Disease↗
PubMed1986

Direct arterial pressure measurements during operation to assess adequacy of arterial reconstruction in lower limb ischaemia.

Over a 3-year period 164 patients undergoing arterial reconstruction for lower limb ischaemia had direct arterial pressure measurements during the operation. The arterial pressure was measured by direct puncture of the vessel with a No. 23 gauge needle connected, via a cannula, to a pressure transducer. The pressure was measured proximal and distal to anastomoses or endarterectomies, and note was made both of the absolute pressure and waveform. At 3 months 95 per cent were patent. In nine patients (5 per cent), there was a significant fall of pressure across the reconstructed artery and in eight of these procedures were carried out to correct the fault. The technique of direct arterial pressure measurement is quick and easy to perform, with equipment that is used routinely for monitoring by the anaesthetist. There has been no evidence of damage due to the arterial puncture itself. It provides a simple, objective assessment of adequacy of an arterial reconstruction and may lead to the early correction of otherwise unrecognized faults, and thus prevent early graft occlusion.

Adult↗
PubMed1985

A simple procedure with nail preservation for ingrowing toe-nails.

The numerous methods used for treating ingrowing toe-nails are testimony to the lack of a generally acceptable procedure with a low failure rate. A simple procedure with nail preservation is described, and the results of treatment assessed. The procedure consists of making a transposition flap of the nail wall after preliminary curettage of the granulation tissue in the nail groove. A total of 82 patients were treated by this method over a 3-year period, and the results in 63 patients were assessed between 18 months and 3 years after surgery. A total of 120 operations were carried out and 110 (92%) were successful. The treatment is effective, well tolerated, not technically difficult, and should be considered as an alternative to current methods of treatment.

Adolescent↗
PubMed1984

Peutz-Jeghers syndrome and metastasising colonic adenocarcinoma.

A case of metastasising colonic carcinoma associated with Peutz-Jeghers syndrome in a 39 year old man is described. The caecal adenocarcinoma had metastasised widely to regional lymph nodes and was associated with several other colonic Peutz-Jeghers polyps, showing no evidence of dysplasia or malignancy. It was not possible to determine whether the carcinoma had arisen from a Peutz-Jeghers polyp. The patient also had gastric and small intestinal polyps. The serum carcinoembryonic antigen (CEA) was normal at presentation in this patient and in one other reported case. The use of this determination as a screening test for so-called high risk groups is, therefore, not supported by this report. The risk of malignancy is not known. It will only be determined by careful follow up of a defined Peutz-Jeghers syndrome population and comparison of carcinoma incidence with a matched sample of the general population. A national registry of Peutz-Jeghers syndrome patients in the United Kingdom would help to resolve this question.

Adenocarcinoma↗
PubMed1984

Metastatic Crohn's disease of thigh and forearm.

Cutaneous involvement with Crohn's disease at a site separated from the gastrointestinal tract by normal skin is termed metastatic Crohn's disease. Such a complication is extremely rare and previous reports have emphasised the flexural distribution of the ulcerated lesions. We report a patient who developed Crohn's disease involving the skin of the thigh and forearm several months after a panproctocolectomy for colorectal Crohn's disease.

Aged↗
PubMed1981

Pancreatic secretions as a clue to the presence of pancreatic cancer.

Pancreatic secretory function is abnormal in at least 90% of patients with pancreatic cancer. These abnormalities may be due to direct involvement of the secretory cells by the malignant process and/or the effects of pancreatic duct obstruction. There is no specific stimulus (secretin and/or cholecystokinin, CCK, or CCK-like hormones) of pancreatic secretion that is clearly superior to any other as a test of pancreatic function. Pancreatic secretion is abnormal in animal models of pancreatic cancer and secretory abnormalities antedate the histologic appearance of the cancer. A decrease in protein secretion after CCK stimulation is the most significant finding in experimental partial pancreatic duct obstruction (the condition most commonly seen in pancreatic cancer). In the absence of any identifiable high-risk group within the population, it is unlikely that the testing of pancreatic function provides a means for the earlier diagnosis of pancreatic cancer.

Animals↗
PubMed1981

Effect of 16, 16 dimethyl prostaglandin E2 on aspirin-induced permeability changes in the pancreatic duct.

Perfusion of the pancreatic duct with acidified aspirin in cats increased the permeability of the duct to HCO3-. Intravenous administration of the synthetic prostaglandin analog 16,16 dimethyl prostaglandin E2 (PGE2) prevented this permeability change. The effect was dose-related and at the highest dose (50 microgram/kg/hour) was essentially complete. The beneficial effect of the PGE2 was apparent even when it was given after the duct had been exposed to aspirin. PGE2 had no effect on pancreatic water or electrolyte secretion in the unstimulated nonsecreting gland. No histologic changes in the pancreatic ducts were seen after exposure to aspirin, PGE2 or both. The effectiveness of PGE2 in restoring membrane permeability towards normal suggests the possibility of its therapeutic role in pancreatitis.

16,16-Dimethylprostaglandin E2↗
PubMed1981

Pancreatic cancer: diagnostic value of pancreatic function tests.

Pancreatic secretion is abnormal in at least 90% of patients with pancreatic cancer. Any of the standard tests of pancreatic function that employ an exogenous secretin or CCK-like stimulus effectively reveal those abnormalities. However, despite a high sensitivity, the tests lack the specificity necessary to distinguish reliably between pancreatic cancer and chronic pancreatitis. With the current practice of testing pancreatic function in symptomatic patients and in the absence of an identifiable high-risk group within the population, it is unlikely that the established pancreatic function tests will provide a means for the earlier detection of pancreatic cancer.

Animals↗