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Biomedical subjects

J Swallow

Publications and source records attributed to J Swallow.

8 recordsLinked to original sources
PubMed2002

An audit of post-operative analgesia in children following tonsillectomy.

Pain following tonsillectomy in children is a significant problem that tends to be underestimated. We audited post-operative pain in 33 children and found significant proportions of children in moderately severe to severe pain, particularly at, or soon after returning to the ward. These findings led to changes in practice that included the administration of pre-operative paracetamol and diclofenac as well as the uniform post-operative prescription of them, with printed instructions to reduce the scope for mistakes by medical staff. Other changes included a uniform policy, with which the nursing staff could become familiar, and the regular formal recording of pain to assist in the recognition of pain and analgesic requirements. On re-auditing two years later, in a group of 100 children, post-operative pain was significantly improved. The proportion experiencing moderately severe to severe pain on returning to the ward, as their maximum pain score and pain score at discharge fell from 70 per cent to 48 per cent, 85 per cent to 56 per cent, and six per cent to two per cent respectively.

Acetaminophen↗
PubMed2001

Audit of pain management at home following tonsillectomy in children.

The pain experienced at home and the burden this places on primary care resources is considerable following tonsillectomy in children. This was audited by postal questionnaire in 52 patients (36 responders). We found a significant proportion of patients experiencing moderately severe to severe pain and a high rate of consultation with general practitioners (50 per cent) for pain-related issues. These findings lead to changes in practice which included the provision of five days discharge medication (paracetamol/ibuprofen in non-asthmatics; paracetamol/dihydrocodeine in asthmatics) and improved written discharge advice. On re-auditing a year later in 100 patients (56 responders), we found reduced rates of consultation with general practitioners (27 per cent). However, the proportion of children experiencing moderately severe to severe pain was not reduced probably because most children were given the recommended analgesia during the first audit. We also found that paracetamol and ibuprofen was superior to paracetamol and dihydrocodeine for analgesia (p <0.05). Suggestions for further improvements are discussed.

Acetaminophen↗
PubMed2000

Pain at home: children's experience of tonsillectomy.

Earlier discharge following tonsillectomy increases the need for good pain management advice and effective analgesia. An audit determined the nature of children's pain experiences at home following tonsillectomy and identified pain management strategies used. Combined analgesia and formal pain assessment significantly reduced the number of children in moderate or severe pain on discharge. Pain could worsen following discharge, persist for three to ten days and be at times moderate to severe. 50% of parents contacted their GP and 75% of children required paracetamol and ibuprofen concurrently. Audit data was utilised to develop comprehensive written pain management advice and a discharge protocol for combined analgesia.

Adolescent↗
PubMed2000

Water systems to report drinking water quality to all customers: how can health professionals prepare for the questions that these reports will generate?

The ultimate safety of drinking water depends upon protection of source waters and construction and maintenance of reliable drinking water treatment and distribution systems. These objectives require public support. Physicians can encourage their patients to call their water suppliers and advocate for investment in effective treatment systems and support zoning that will protect water supply watersheds and wellheads. The Consumer Confidence Reports are meant to inform consumers about their drinking water supply. Consumers should use the reports to verify that their drinking water meets all health standards and to understand some of the potential threats to their drinking water quality. Physicians may use the reports as an opportunity to discuss the many types of environmental exposures and ways to reduce these exposures. As a crucial component of the public health community, this is your opportunity to encourage your patients to become more aware of their environment and its impact on their health.

Consumer Advocacy↗
PubMed1999

Experimental models of protein-RNA interaction: isolation and analyses of tRNA(Phe) and U1 snRNA-binding peptides from bacteriophage display libraries.

Peptides that bind either U1 small nuclear RNA (U1 snRNA) or the anticodon stem and loop of yeast tRNA(Phe) (tRNA(ACPhe)) were selected from a random-sequence, 15-amino acid bacteriophage display library. An experimental system, including an affinity selection method, was designed to identify primary RNA-binding peptide sequences without bias to known amino acid sequences and without incorporating nonspecific binding of the anionic RNA backbone. Nitrocellulose binding assays were used to evaluate the binding of RNA by peptide-displaying bacteriophage. Amino acid sequences of RNA-binding bacteriophage were determined from the foreign insert DNA sequences, and peptides corresponding to the RNA-binding bacteriophage inserts were chemically synthesized. Peptide affinities for the RNAs (Kd approximately 0.1-5.0 microM) were analyzed successfully using fluorescence and circular dichroism spectroscopies. These methodologies demonstrate the feasibility of rapidly identifying, isolating, and initiating the analyses of small peptides that bind to RNAs in an effort to define better the chemistry, structure, and function of protein-RNA complexes.

Amino Acid Sequence↗
PubMed1991

Fetal choroid plexus cysts: a prospective study and review of the literature.

To determine the incidence and significance of fetal choroid plexus cysts, a prospective study was carried out at Queen's Medical Centre, Nottingham. The incidence of cysts was found to be 0.42% and the size of cysts varied from 3 to 13 mm with a mean diameter of 6.2 mm. Choroid plexus cysts were associated with other fetal abnormalities in three cases, two of which were subsequently found to have a chromosomal abnormality, one Trisomy 18 and one Trisomy 21. A review of the reported cases of choroid plexus cysts reveals an overall incidence of 5.8% for Trisomy 18. We therefore recommend that in patients with choroid plexus cysts a detailed scan should be carried out to look for the ultrasound markers of Trisomy 18. If there is an associated abnormality or cysts are large (13 mm or greater in diameter) and bilateral then a karyotyping should be carried out.

Abnormalities, Multiple↗