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Biomedical subjects

J L Day

Publications and source records attributed to J L Day.

At least 19 recordsLinked to original sources
PubMed1992

Skin epidermal thickness and vascular density in type 1 diabetes.

Epidermal skin thickness and vascular density were assessed in skin biopsies obtained from the dorsum of the foot in 28 Type 1 diabetic patients and 17 normal control subjects, matched for age. Epidermal skin thickness did not differ significantly between control subjects (74 +/- 4 (+/- SE) microns) and diabetic patients (78 +/- 4 microns). It was not related to the duration of diabetes and presence of complications. Neither small (capillary) nor large (arteriole/venule) vessel densities differed significantly between control subjects (59 +/- 6 mm-2 and 19 +/- 2 mm-2) and diabetic patients (65 +/- 4 mm-2 and 22 +/- 3 mm-2). Vessel densities were unrelated to the duration of diabetes and presence of complications.

Adult↗
PubMed1992

Benefits provided by an integrated education and clinical diabetes centre: a follow-up study.

The effects of a new integrated system of diabetes care with an enhanced role of the diabetes specialist nurse based in a purposed design diabetes centre, on diabetes control, attendance and cancellation rates, and admission for diabetic emergencies have been reviewed. Glycaemic control was examined in: (a) a cohort of 163 insulin-treated and 47 non-insulin treated diabetic subjects (age < 65 years) studied prospectively before and 3 years following the introduction of a new system of care; (b) a second cohort of more elderly patients aged greater than 65 years studied for the 3 years after the change over; (c) a cross-sectional study of the clinic population (n = 700) the year before and 3 years after the changeover; (d) a group of patients attending standard unaltered clinics in the same district (n = 157). Significant and sustained falls in HbA1 were observed in all groups of subjects attending the centre, with the means for those aged less than 65 falling from 11.9 +/- 2.3% to 9.9 +/- 1.9% and for those aged over 65 from a mean of 11.7 +/- 2.0% to 10.3 +/- 2.3%, 3 years later. The cross-sectional study provided similar results with a mean HbA1 of 12.2 +/- 3.0% prior to changeover and 10.4 +/- 4.4%, 3 years later. Smaller but significant changes were observed in patients continuing to attend the routine clinic (from 12.2 +/- 2.3% to 11.3 +/- 2.6%) over a similar period. Yearly admission rates for ketoacidosis and hypoglycaemia fell from 44 and 23, to 33 and 5 per annum, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Patient experience with a jet injector.

The acceptability of a jet injector compared with disposable syringes for insulin injections was assessed in 10 people with Type 1 diabetes. The majority considered disposable syringes easier to use and either less painful or no more painful than jet injections. Given the choice only 1 of the 8 people completing the study would continue using the jet injector.

Adult↗
PubMed1988

New device to improve the accuracy of bedside blood glucose tests.

A new device to improve the accuracy of blood glucose measurements with glucose-oxidase reagent strips is described. The device ensures that an adequate amount of blood is applied onto the reagent pad when the strip is fully inserted. When the strip is withdrawn, the pad is automatically wiped, and so the reaction can be accurately timed. The device also reduces the risk of blood contamination of other surfaces. Use of a prototype of this device enabled more accurate measurement of blood glucose on general wards.

Blood Chemical Analysis↗
PubMed1988

The feasibility of a potentially 'ideal' system of integrated diabetes care and education based on a day centre.

A new system of clinical and educational care designed to replace traditional diabetic clinics is described. The overall aims were to provide adequate consultation time, patient access according to diabetic and social needs, minimal waiting time, continuity with experienced staff and objective based learning programmes in an environment suited to learning. This was achieved by changing the role of the diabetes nurse specialist from undertaking delegated tasks to providing primary consultative care, reorganization of existing staff and provision of a purpose designed unit. This gave sufficient flexibility to arrange daily early morning and weekly evening clinic sessions for routine diabetes counselling and medical audit with primary education scheduled at other times. A year's experience showed that our major targets had been met, with the provision of adequate consultation time, halving of waiting time, ease of patient access and continuity with either the doctor or nurse in consulting role. Default rates have fallen and patient and staff morale has improved substantially. Apart from an underestimate of receptionist and a small increase in technician hours, these changes have been achieved within the predicted small revenue cost.

Appointments and Schedules↗
PubMed1987

Problems of comprehensive shared diabetes care.

In its first year 747 diabetics were entered into a comprehensive shared care scheme in which general practitioners agreed to follow up their own patients. After two years patients were recalled to hospital for review through a computer based recall system. Analysis of the first 209 patients reviewed showed that the recall system worked well with failure to trace only eight patients. Six new cases of foot ulcer, 15 of retinopathy, 14 of macular degeneration, and 15 of raised blood pressure requiring treatment were detected at review. Sixty four patients appeared to have had no check on their diabetes during the two years. Of the 117 with written evidence in their cooperation books that they had received some diabetic supervision, many had had no measurement of weight (32), blood pressure (49), or urine (68) or blood glucose (70), and only 55 had had foot and 65 eye examination. This erratic and generally poor standard of supervision suggests that much tighter organisation is required within each practice, with time being set aside specifically for care of diabetics. Practice nurses could have an important role in the delivery and organisation of care.

Comprehensive Health Care↗
PubMed1987

Screen-film mammographic technique for breast cancer screening.

The values of dose and signal-to-noise ratio (SNR) for many techniques and breast thicknesses were computed and compared with a reference technique and breast thickness to provide a valid basis upon which to select a screening technique for screen-film mammography. The reference consisted of a Min-R/OM1 combination (or its equivalent) exposed through a 4.5-cm thick breast via 28 kV and a molybdenum target-beryllium window tube with a 0.03-mm Mo filter. Radiographs of an improved breast phantom were used to relate computed relative SNR values of techniques to diameters of the smallest calcific and soft-tissue objects demonstrated in mammograms. Without use of a grid, four Mo target/filtration combinations yielded similar computed dose and SNR levels, as did a tungsten target tube operated at 23 kV without a filter. Operation of the latter tube at 27.5 kV with a 0.051-mm rhodium filter should reduce dose by half but also SNR by 22%. However, such operation with a grid should greatly improve imaging moderate to large breasts without increasing dose over reference values.

Breast Neoplasms↗
PubMed1979

Metabolic consequences of atenolol and propranolol in treatment of essential hypertension.

A six-month study of triglyceride, cholesterol, free fatty acid (FFA), glucose, insulin, growth hormone, and glucagon concentrations was carried out in asymptomatic hypertensive normal-weight men randomly allocated to treatment with atenolol or propranolol. A highly significant increase in the basal plasma triglyceride concentration was observed in propranolol-treated patients after three and six months' treatment, with a smaller but significant increase in atenolol-treated subjects after six months' treatment. The changes in triglyceride concentration could not be ascribed to variations in plasma insulin, growth hormone, or glucagon concentrations. Basal FFA concentrations were reduced during the first three months of treatment in both groups but returned to pretreatment levels after six months. Plasma cholesterol concentrations were unchanged by either agent.

Adult↗
PubMed1979

Rapid computation of diagnostic X-ray bremsstrahlung spectra.

A method is described for rapid and accurate computation of diagnostic x-ray spectra. Accuracy limitations of Kramers' equation are overcome by providing intensity correction factors derived from published measured data. Use of a parameter based on the energy of the Kramers spectrum intensity peak permits deriving master factor curves which are remarkably independent of kVp, waveform and filtration. Computed and measured spectra generally agree to better than +/- 1 keV for beams generated at 100 kVp and below. Possible application of the method to higher energy diagnostic beams is discussed.

Mathematics↗
PubMed1979

A study of mammographic exposure and detail visibility using three systems: Xerox 125, Min-R, and Xonics XERG.

A breast phantom of novel design has been used to measure visibility of simulated calcific and soft-tissue fibrillar details in mammography, as well as to determine the roentgen exposure vs. depth. Exposure data were combined with a model of the breast as compressed during mammography to compute the mean exposure to the ductal parenchyma (MDE). Three different imaging systems were compared over a wide range of x-ray beam energies and breast characteristics. "Dosage" criteria other than the MDE are discussed.

Breast↗