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Biomedical subjects

J Temple

Publications and source records attributed to J Temple.

At least 19 recordsLinked to original sources
PubMed2004

Pin site care for preventing infections associated with external bone fixators and pins.

BACKGROUND: Metal pins are used to apply skeletal traction or external fixation devices in the management of orthopaedic fractures. These pins protrude through the skin and are therefore described as 'percutaneous' and much has been written on the management of the associated skin wound. The way in which percutaneous pins are treated may affect the incidence of pin site infection. Recommendations for care are not necessarily evidence based. This review set out to summarise the research evidence on the effect of pin site care on infection rates. OBJECTIVES: To assess the effect on infection rates of different methods of cleansing and dressing orthopaedic percutaneous pin sites. SEARCH STRATEGY: The following electronic databases were searched: Medline (from 1966), the Cochrane Central Register of Controlled Trials (2003 issue 1) and the Wounds Group Specialised Trials Register (March 2003). In addition reference lists of review articles and relevant trials were also searched and some handsearching undertaken. SELECTION CRITERIA: All randomised controlled trials (RCTs) in people comparing the effect on infection rates of different methods of cleansing or dressing orthopaedic percutaneous pin sites were evaluated. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the citations retrieved by the search strategies for reports of relevant RCTs. MAIN RESULTS: Only one trial was eligible for inclusion in the review. Henry (1996) compared cleansing with 0.9% saline, cleansing with 70% alcohol and no cleansing and found significantly fewer infections in pin sites which had not been cleansed. REVIEWER'S CONCLUSIONS: There is very little evidence as to which pin site care regimen best reduces infection rates. Clearly there is a need for large RCTs to determine the best method of pin site management.

Bandages↗
PubMed2004

Injury to preflowering and flowering cotton by brown stink bug and southern green stink bug.

The impact of brown stink bug, Euschistus servus (Say), and southern green stink bug, Nezara viridula (L.), injury was evaluated on preflowering and flowering cotton, Gossypium hirsutum L., plants in no-choice tests. Vegetative stage cotton seedlings and reproductive structures, including flower buds (square) and bolls, were infested with adults and/or nymphs of both species. There were no significant differences in height, height to node ratio, square retention, and flower initiation for cotton seedlings or plants with a match-head square between southern green stink bug adult- or brown stink bug adult-infested and noninfested treatments. Abscission for individual large squares (precandle) and multiple squares (medium and small square on the same sympodial branch) was not significantly different among infested and noninfested treatments for the following species and developmental stages: brown stink bug adults, southern green stink bug adults, and third and fourth to fifth instar southern green stink bug nymphs. In boll infestation studies, the relationship between boll maturity, expressed as heat units beyond anthesis, and boll growth, abscission, hard locked carpels, seedcotton yield, and seed germination was measured. Brown stink bug induced abscission in bolls that had accumulated > 0-350 heat units beyond anthesis. Boll growth and seedcotton yield was significantly lower for bolls infested with brown stink bug through 266.5 and 550 heat units beyond anthesis, respectively. The proportion of hard locked carpels per boll was significantly greater for the infested treatment in a cohort of bolls that accumulated from 51 to 400 heat units beyond anthesis. Seed germination in bolls infested with brown stink bug was significantly lower in bolls aged 101-600 heat units beyond anthesis.

Animals↗
PubMed1995

The influence of gonadal hormones on periodicity of obsessive-compulsive disorder.

OBJECTIVE: This paper reviews the evidence linking gonadal hormones and obsessive-compulsive disorder (OCD) symptoms. METHOD: Four case reports of the relationship between obsessive-compulsive disorder symptoms and exogenous sex hormone changes are presented. These cases are reviewed within the context of other case reports and the literature on the relationship between serotonin, gonadal hormones and OCD. RESULTS: The authors suggest that there is a relationship between onset or exacerbation of OCD and changes in gonadal hormones. CONCLUSION: Clinicians should carefully evaluate patients for exogenous and endogenous changes in gonadal hormones when evaluating onset or exacerbation of OCD.

Adult↗
PubMed1995

Job satisfaction and health of house officers in the West Midlands.

A postal questionnaire survey was conducted in 1993 to determine the job satisfaction and current state of health of British-trained pre-registration house officers (PRHOs) working in the West Midlands Regional Health Authority. The questionnaire included parts of the Occupational Stress Indicator looking at job satisfaction, and mental and physical ill-health (as manifestations of stress). Out of 234 eligible PRHOs 182 (78%) returned questionnaires: female PRHOs had significantly higher scores for physical and mental ill-health than male PRHOs; 14.2% of PRHOs had scores for mental ill-health, and 17.6% scores for physical ill-health that were higher than the average reported for patients with psycho-neurotic disorders. The PRHOs had significantly lower scores for all individual aspects of job satisfaction and total job satisfaction, and significantly higher scores for mental and physical ill-health than a comparative group of junior hospital doctors (all grades), and a large group of non-health-care white-collar workers. These results indicate that there is a need to raise awareness of stress and stress-related problems faced by junior doctors, and to provide adequate support.

Adult↗
PubMed1993

Reorganization of craniofacial/cleft care delivery: the Massachusetts experience.

Until 1989, the Commonwealth of Massachusetts operated a mandated care program known as Services for Handicapped Children (SHC) for children with cleft lip/palate or craniofacial anomalies. During the mid 1980s, the federal government reduced its block grant funds and encouraged the Commonwealth of Massachusetts to develop Project SERVE to address this changing fiscal reality. The principal outcome of Project SERVE was the recommendation that the SHC direct care programs, including all craniofacial and cleft palate clinics, should be dismantled over a number of years. However, due to the economic recession, all government funding was suddenly withdrawn from cleft palate teams and the state-run SHC clinics were abruptly dissolved. To treat patients left without coordinated care, former team members reassembled and began a new craniofacial team based at the University of Massachusetts Medical Center. Difficulties with the transition of the clinic included recruiting and retaining team members; remuneration procedures for team members; maintenance of patient records previously kept by the state; coordination of clinical/clerical responsibilities; identifying a physical locale to hold the clinics; and solicitation of referring health care provider referrals and follow-up. All these issues required specific interventions that are presented in this paper. Project SERVE, begun under federal auspices, in the Commonwealth of Massachusetts, has recently been promoted as a model for a new and improved approach to the management of cleft palate and craniofacial care delivery nationwide. Awareness of the potential for abrupt, radical change in funding for federally mandated cleft/craniofacial care is essential, and a successful transition to a medical center-based model is possible using the procedures established at our center.

Child↗
PubMed1986

Ultrasound differentiation of the competent from the incompetent cervix: prevention of preterm delivery.

To evaluate the feasibility of the use of serial ultrasound measurements of cervical length, membrane protrusion, and dilatation to discriminate between the competent and the incompetent cervix, 107 at-risk patients and 30 control subjects were examined prospectively. Patients were divided into five groups based on treatment and method of diagnosis. Epidemiologic, ultrasound, and outcome data were analyzed. Means and standard deviations for ultrasound measurements were established. Highly significant differences between all prediagnostic and postdiagnostic-pretreatment measurements were found (p less than 0.001). Highly significant differences were also found between all postdiagnostic-pretreatment and postdiagnostic-posttreatment measurements (p less than 0.001). No significant differences between prediagnostic and postdiagnostic-posttreatment measurements were noted. The incidence of preterm delivery was significantly higher among untreated diagnosed patients (p less than 0.01). By combined clinical and ultrasound criteria 51 patients (47.7%) were identified as not having cervical incompetency. Fifty-six patients (52.3%) were diagnosed.

Adolescent↗
PubMed1985

A controlled trial of fixed versus tailored calorie intake in patients receiving intravenous feeding after abdominal surgery.

Excessive intravenous calorie intakes have been shown to increase fat deposition and CO2 production with deleterious results. A controlled trial has therefore been performed to determine whether there is clinical benefit from tailoring calorie intake of intravenously fed patients to the patient's metabolic expenditure. Twenty patients requiring intravenous feeding after abdominal surgery were randomly allocated to receive either (i) a constant regimen containing 2 600 calories and 15.55 g nitrogen or (ii) a varied regimen with a fixed calorie: N2 ratio of 167:1 but with the calorie intake adjusted according to the previous day's metabolic expenditure. Only one patient had a requirement of greater than 2 600 calories; there was no difference in mean RQ during intravenous feeding between the constant regimen (0.90 +/- 0.10 s.d.) and the varied regimen (0.90 +/- 0.09 s.d.) and no significant difference in peak CO2 production. Excess calorie intake over expenditure did not correlate with increased positive nitrogen balance but on the varied regimen patients receiving a higher nitrogen intake tended to be in more positive nitrogen balance. This study suggests that a fixed calorie intake of 2 600 calories per day is suitable for adult patients requiring intravenous feeding after abdominal surgery but currently prescribed nitrogen intakes may be suboptimal.

Journal Article↗
PubMed1985

Venous access using the Hickman catheter.

Fifty silastic (Hickman) right atrial catheters were implanted in 43 patients receiving cytotoxic chemotherapy or parenteral nutrition. The mean catheter survival was 72 days (range 2-316 days), but 17 catheters were removed before treatment was complete. Thirteen catheters were removed for septic complications. It is concluded that the Hickman catheter will provide venous access for prolonged periods, but its benefits must be weighed against the risks of septic complications which may occur frequently in the absence of uniform care and maintenance of the catheter.

Adolescent↗
PubMed1982

Cefoperazone therapy of serious infections.

Cefoperazone was evaluated as the therapeutic agent in 64 adults with serious infections. Included were pneumonias, urinary tract infections, septicemia, osteomyelitis, joint infections, and superficial infections. A total of 84 organisms, including many multiantibiotic-resistant strains, were designated as the etiological agents. In most patients therapy was initiated before information on cefoperazone sensitivity of the infecting organism was available. This proved suitable in most instances. Clinical response to therapy was excellent in these individuals. Bacteriological responses coincided with the problems of the patient but did not reflect inadequacy of the antibacterial effect of cefoperazone. Adverse effects on renal function, including already impaired function, were not observed.

Adolescent↗
PubMed1976

Surgical audit: one year's experience in a teaching hospital.

For 12 months the surgical staff at Hope Hospital have operated a form of audit. The monitored information included work load, methods of treatment, complications, misdiagnoses, and deaths. The method described is suitable for any district general or teaching hospital provided adequate secretarial help is available. In addition to helping to maintain standards, an audit of this type has a positive educational role.

England↗