Computer-based knowledge systems.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J Wyatt.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A patient is reported who presented with sterile hepatic abscesses which proved to be the first manifestation of Hodgkin's disease. He failed to improve with antibiotic treatment but responded to combined chemotherapy. Liver involvement as the first sign of Hodgkin's disease is rare. Liver abscesses due to Hodgkin's disease seem to be previously unreported.
Only clinical trials can assess the impact of prototype medical decision-aids, but they are seldom performed before dissemination. Many problems are encountered when designing such studies, including ensuring generality, deciding what to measure, feasible study designs, correcting for biases caused by the trial itself and by the decision-aid, resolving the "Evaluation Paradox", and potential legal and ethical doubts. These are discussed in this paper.
Explore the source record for details and available documents.
Women with abnormal cervical cytology and an unsatisfactory colposcopic examination were offered Lamicel in an attempt to expose the entire transformation zone. The sponge, which softens, dilates and effaces the cervix, was passed intracervically in 41 patients in whom the entire squamocolumnar junction could not be seen. After 3-4 h the sponge was removed and colposcopy repeated. In 29 of the 41 patients the lesion and the squamocolumnar junction were now fully visible. Twenty-five of these patients were spared a cone biopsy.
Explore the source record for details and available documents.
The content of sodium, potassium and calcium was determined in 15 regional dishes, by atomic absorption spectrophotometry. The Na:K ratio was high in most of the dishes due to the high sodium content and low content of potassium found. The higher sources of the studied minerals were "tortilla de harina" with 1,372.8 mg/100 g of sodium; "chorizo con papas" with 466 mg/100 g of potassium, and "calabacitas con queso" with 244.1 mg/100 g of calcium. Two of the dishes considered as desserts, "capirotada" and "arroz con leche" showed the lowest Na:K ratio (0.66 and 0.81, respectively).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In a series of 604 patients attending an accident and emergency department with chest pain, the decisions made by casualty officers about admission to the coronary care unit were compared with the retrospective opinions of experienced clinical assessors who knew the results of any subsequent investigations. Of the 119 patients whom the assessors judged should have been admitted to the coronary care unit, 14 (11.8 per cent) were judged to have been discharged in error. Of the 485 patients whom the assessors judged should not have been admitted to the coronary care unit, 32 (16 per cent) were judged to have been advised admission unnecessarily. Misinterpretation of the electrocardiographic results was apparently the reason for five of the 14 false negative errors and four of the 32 false positive errors. The median time that patients who were eventually admitted to the coronary care unit spent in the accident and emergency department was 78 min.
An altered state of cell hydration is a hallmark of a number of RBC disorders. The two parameters most often used to characterize the state of cell hydration are (a) the complete cell density distribution profile, and (b) the fraction of cells with densities greater than a defined value. Buoyant density cell fractionation with a variety of polymers has long been the preferred method for obtaining data on cell density distribution. Although this method provides accurate and quantitative information on the state of RBC hydration, its applicability has been limited due to the time-consuming experimental procedure involved in generating the data. A recently developed light-scattering method has been used in the present study to quantitate RBC density distribution. This new method accurately quantitates both the cell density distribution profile and the fraction of dense, dehydrated cells in various RBC disorders. The ability of the automated method to generate this information rapidly makes possible objective testing of different hypotheses concerning the contributions of cell hydration and dehydration to the pathophysiology of various RBC disorders.
To find out whether Pneumocystis carinii pneumonia (PCP) can be detected while still in an early phase by the degree of exercise-induced oxygen desaturation, arterial oxygen saturation was measured by continuous pulse oximetry in patients positive for antibody to the human immunodeficiency virus and clinically suspected of having PCP, in patients with other chest diseases, and in controls. Among patients with proven PCP 94% of those with low arterial oxygen pressures (PaO2) showed desaturation on exercise oximetry, as did 80% of those with a normal oxygen pressure at rest, whereas only 10% of patients with other chest disorders and HIV disease showed significant desaturation.
Explore the source record for details and available documents.
During the five year period December 1980 to November 1985, 106 infants with hypertrophic pyloric stenosis were treated. There were no operative deaths, but two late deaths occurred from associated abnormalities. The combination of preoperative rehydration, skilled anaesthesia, and the use of the Fredet-Ramstedt operation (pyloromyotomy) have virtually eliminated mortality from uncomplicated infantile hypertrophic pyloric stenosis. The most common complications were gastro-oesophageal reflux in 11 (11%), perforation of the duodenal fornix in nine (8%), and wound infection in five (5%); no wound dehisced.
Explore the source record for details and available documents.
Among all hospitalized patients, burned patients have been shown to have the greatest increase in metabolic demand. However, the temptation to overfeed those patients must be recognized, as that practice may lead to increased morbidity. Care must be taken to provide an appropriate nutritional regimen in order to minimize protein catabolism and to promote wound healing. Several formulas for calculating energy and protein needs for burned patients have been reviewed for this article, along with guidelines for estimating other nutrients for such patients. Methods for providing nutrition therapy depend on many factors, such as extent and degree of injury and gastrointestinal function. The feeding methods most commonly used are parenteral (peripheral and central venous alimentation) and enteral (oral and naso-gastric tube feeding). Guidelines for using both parenteral and enteral feedings are discussed, as well as reliable methods for evaluating the nutrition assessment of the burned patient. It must be noted that standard assessment parameters are often unreliable, and their limitations are also addressed. In addition, several new parameters are introduced, including compliance with caloric goal, corrected weight change, and prediction of total urinary nitrogen to be used to calculate nitrogen balance.
Explore the source record for details and available documents.