Biomedical subjects

K Fitzpatrick

Publications and source records attributed to K Fitzpatrick.

16 recordsLinked to original sources

PubMed1992

Automated acuity scoring within a computer based medical record.

This paper describes the initial development of a completely automated acuity scoring system that resides within the TMR bedside computing system at the Duke University Medical Center, Surgical Intensive Unit. The scoring system is based upon the APACHE II acuity scoring system and provides for the recalculation of acuity scoring at 12 hour intervals through the patient's ICU course. When comparing hand calculated versus computer generated acuity scores for 19 patients, discrepancies fell into three broad categories: 1) data available to the application differed from that available to the human scorer. 2) apparent transcription errors 3) data items lost or absent from the paper record. It remains to be determined if computer generated acuity scoring provides for a more accurate representation of the patient's acuity.

Creatinine↗

PubMed1991

Studies of the pharmacokinetics and metabolism of 4-amino-propiophenone (PAPP) in rats, dogs and cynomolgus monkeys.

The pharmacokinetics and metabolism of 4-aminopropiophenone (PAPP), a cyanide antidote, have been studied in rats, dogs and cynomolgus monkeys using 14C-PAPP. Radiolabelled material was rapidly excreted in all three species, mainly in urine. In rats, PAPP was metabolized by N-acetylation, while in dogs, ring and aliphatic hydroxylation occurred. In monkeys, both N-acetylation and oxidation took place. In the latter pathway, PAPP was oxidized to p-aminobenzoic acid which underwent amino acid-conjugation to p-aminohippuric acid. In rat blood in vitro, the PAPP metabolites, p-aminobenzoic, p-aminohippuric and N-acetyl-p-aminobenzoic acid were only weak methaemoglobin producers.

Animals↗

PubMed1991

Bedside computerization of the ICU, design issues: benefits of computerization versus ease of paper & pen.

This paper describes the design considerations for the implementation of a bedside computer system in an intensive care environment. Specific issues discussed include application design, implementation problems, design revisions, and design solutions. Specific examples of the above issues include passive data acquisition from bedside devices and computer systems, automated nursing assessments, respiratory therapy assessments and integrated reports.

Consumer Behavior↗

PubMed1990

Trimetrexate in prostatic cancer: preliminary observations on the use of prostate-specific antigen and acid phosphatase as a marker in measurable hormone-refractory disease.

Thirty-one patients with bidimensionally measurable hormone-refractory prostatic cancer received trimetrexate (TMTX). Serial values of prostate-specific antigen (PSA) and acid phosphatase (SAP) were correlated with response. Five patients (17%; 95% confidence interval, 3% to 30%) achieved a partial remission for a median of 3 months (range, 3 to 7.5 months). Marker levels showed large variations with no discernible patterns. Serial PSA and SAP in 19 patients with abnormal baseline values showed a correlation with measurable disease response in only 68% (13 of 19) and 47% (nine of 19) of patients, respectively. Values were then smoothed using an exploratory data analysis technique of running medians and averages. Trends in marker changes were much more apparent. Several "decision rules" were evaluated for use of markers as indices of disease progression. A 50% increase from the patient's minimum value in either PSA or SAP on two successive determinations correlated with progression in 90% of cases in this trial. TMTX has modest activity in prostatic cancer, and further trials are not warranted. Biochemical markers do not uniformly reflect disease activity in hormone-refractory disease, and changes in biochemical markers must be interpreted cautiously when used as the sole end point to assess efficacy in clinical trials.

Acid Phosphatase↗

PubMed1988

Rapid detection of herpes simplex virus (HSV) antigen in human ocular infections.

The new HERPCHEK (Dupont, No. Billerica, MA) enzyme immunosorbent assay (EIA) was used in a double-blind clinical study for rapid and specific detection of ocular herpes simplex virus (HSV) infection. This 4-hour assay can be used to demonstrate conclusively the presence of HSV antigen without culture and thereby rapidly differentiate between HSV and other clinically similar ocular infectious diseases. Ocular samples were collected from 180 individuals including 30 patients with acute HSV, 90 with latent HSV (ie, currently asymptomatic but with a positive history), 11 with acute or latent varicella zoster virus, 30 with nonherpetic infections (due to adenovirus, Acanthamoeba or bacteria), and 19 normal controls. A clinical diagnosis was made by one of us (DPL) and duplicate tear-film samples obtained by swabbing the conjunctival cul-de-sac and cornea. Coded samples were tested by routine viral culture on Vero cell monolayers and also were run independently in the HERPCHEK test. During active HSV infection, the HERPCHEK correlated 100% with clinical diagnosis, and virus culture correlated 90% with clinical diagnosis. In all latent HSV ocular infections, other nonherpetic ocular infections and normal samples, both the HERPCHEK and culture assays were negative.

Antigens, Viral↗

PubMed1987

Midazolam sedation following open heart surgery.

Midazolam given as hourly intermittent injections was compared with the same dose given by infusion for postoperative sedation in patients after cardiopulmonary bypass. A stable concentration was rapidly attained with the infusion whereas 6-8 h was required to attain stable plasma (trough) concentrations in the intermittent injection group. Plasma concentrations decreased rapidly to low values within 6 h of discontinuation of therapy. High plasma concentrations and a long (16 h) half-life were noted in one patient who may be a slow metabolizer of the drug.

Adult↗

PubMed1986

Schmorl's nodes (intravertebral herniations of intervertebral disc tissue) in two historic British populations.

The herniation of the nucleus pulposus into the vertebral body produces ectopic deposit of disc material which are known as Schmorl's nodes. This prolapsed disc tissue leaves characteristic deformations on the surface of the vertebral body and hence the incidence of this lesion can be studied in skeletal remains. This report describes the occurrence of Schmorl's nodes in TV8-SV1 in two historic adult British populations, one from Aberdeen and the other from London. In the Aberdeen group, both males and females showed a high incidence rate and severity of Schmorl's nodes. In the London group, the males had a similarly high affliction whereas the females were nearly free of the condition. The lesion had no significant predilection for any one particular vertebral surface. However, in males in both localities, the frequency of Schmorl's nodes was significantly higher in the thoracic region than in the lumbosacral region. In contrast, both groups of females showed similar node frequency in these two zones. The majority of Schmorl's nodes were localised in the central and central-posterior regions of the vertebral surface. When nodes occurred on successive vertebral surfaces, they often formed sequences showing similar shape and position. The aetiology of Schmorl's nodes is unclear. Various hypothetical causal factors were appraised in relation to the findings of this study. It was suggested that anomalies in vascular and/or notochordal regression may be related to the development of the lesion.

England↗

PubMed1984

Cross-national reliability study of a schedule for assessing personality disorders.

The inter-rater reliability of a schedule used to assess personality disorders was examined. The Personality Assessment Schedule (PAS) involves an interview with both the patient and a close informant and the ratings for the informant are given most weight in the final scoring. Videotaped interviews with 23 psychiatric patients, most of whom had a clinical diagnosis of personality disorder, and a close informant were scored by seven raters, four in the United Kingdom and three in the United States. Overall inter-rater reliabilities (using the intraclass correlation coefficient, RI) were generally good to excellent for each of the 24 personality variables tested, ranging between .66 and .94 for informants and between .51 and .91 for subjects. Corresponding reliability coefficients for overall mean PAS scores were .82 and .75, respectively. Consistent with these findings, there was little bias between the scores of American and British raters, although there was some tendency for American raters to score higher for the trait of eccentricity and lower for the trait of conscientiousness than was true for British raters. There was less bias for informants' ratings than for those of subjects. In a second set of analyses, it was shown that inter-rater reliability levels (using the Kappa statistic) were also good to excellent (.6 to .8) for the categorical diagnosis of personality disorder. These results, taken together, demonstrate that abnormal personality can be reliably assessed by both British and American raters.

Adolescent↗

PubMed1976

Magnesium depletion and hypocalcaemia after removal of parathyroid carcinoma.

A case of parathyroid carcinoma is described which presented with severe bone disease, complicated after parathyroidectomy by symptomatic hypocalcaemia and magnesium deficiency, both of which responded dramatically to the administration of magnesium. Urinary cyclic AMP assays were used to monitor parathyroid activity.

Adult↗

PubMed1975

Treatment of Paget's disease of bone with porcine calcitonin: clinical and metabolic responses.

The clinical and metabolic responses of 12 patients with painful Paget's disease have been assessed before, during and after an 18-day course of treatment with purified porcine calcitonin, 160 MRC units i.m. daily. The indices of response included relief from pain, changes in concentration of serum alkaline phosphatase, calcium, magnesium, electrolytes and plasma inorganic phosphate; balance studies of calcium, phosphate, magnesium and in some cases sodium and potassium were undertaken. Urinary excretion of hydroxyproline was also measured. Remission of pain was complete in 11 of 15 courses of treatment. Coexistent osteoarthrosis was considered to be responsible where remission was incomplete. The mean duration of remission of pain was 12 months. Three patients who received a second course of treatment achieved further remission of pain. Side effects were not troublesome. Serum levels of alkaline phosphatase decreased to 67 per cent of the initial reading and the degree of suppression depended on the initial alkaline phosphatase activity. Urinary hydroxyproline correlated closely with the activity of serum alkaline phosphatase before, during and after treatment. The ratio of serum alkaline phosphatase:hydroxyproline excretion rose at the start and at the termination of treatment. Retention of calcium and inorganic phosphate occurred during the early phase of treatment only. Withdrawal of treatment resulted in a rebound retention of calcium and inorganic phosphate. The degree of calcium retention after treatment correlated with the level of plasma inorganic phosphate prevailing before treatment. The efficacy of these short courses of calcitonin are discussed and the metabolic observations related to theories of bone remodelling at a cellular and hormonal level.

Aged↗

PubMed1974