PubMed Health⌕ Search

Biomedical subjects

M Barringer

Publications and source records attributed to M Barringer.

12 recordsLinked to original sources
PubMed1998

Elderly care. Early warning system.

In one area in Merseyside, primary care teams were only identifying elderly people with dementia in times of crisis, resulting in earlier than necessary residential or nursing home placements. Employing a social worker to work with primary care teams as a specialist care manager for this group has resulted in earlier and more appropriate care in the view of both carers and care workers. Following the appointment, interviews with 10 carers revealed that eight out of 10 patients were now receiving health and social care when nine out of 10 had previously received none.

Aged↗
PubMed1992

Assessing Alzheimer severity with a global clinical scale.

Diagnosis of dementia needs to be complemented by precise determination of disease severity across the broad spectrum of disease progression. The Mini-Mental State Exam (MMS), the Activities-of-Daily-Living assessment (ADL) and the Clinical Dementia Rating scale (CDR) were modified for direct comparability and administered to 112 outpatients and 45 nursing home residents with a range of dementia severity from mild to profound. The scales showed the highest correlations for the probable Alzheimer's disease patient group (62) (Global Assessment of Dementia; GAD vs. ADL: r = 0.91; Extended Mini-Mental Assessment; EMA vs. GAD: r = 0.91; ADL vs. EMA: r = 0.86). For these patients, scores on the individual scales tended to be similar. Disparity among the three scores for individual cases was associated with the presence of comorbidities. The high correlations and correspondence among these scales demonstrate their reliability, validity, and utility in the assessment of dementia severity. The use of an average of these measures, with their increased precision, may give a more accurate indication of dementia severity over a broader range of impairment.

Activities of Daily Living↗
PubMed1984

Increased tissue factor activity of monocytes/macrophages isolated from canine renal allografts.

Kidney allografting was performed in a group of ten beagles, and viable leukocytes infiltrating the transplanted organs were isolated during episodes of acute rejection 5 or 6 days postoperatively. These infiltrate populations, consisting predominantly of lymphocytes and monocytes/macrophages, were found to have significantly increased amounts of procoagulant activity relative to control leukocytes isolated from circulating blood and lymph. Using nonspecific esterase staining in an agar microclot assay, procoagulant activity in the infiltrate leukocytes was found to reside in monocytes/macrophages rather than other coisolated cell types. By contrast, control monocytes from blood had no activity in this microclot assay. Procoagulant activity in the infiltrate cells was characterized as tissue factor. Increased amounts of this activator of the extrinsic pathway, as found in infiltrate monocytes/macrophages, may initiate clotting reactions and fibrin deposition within allografts.

Animals↗
PubMed1983

The diagnosis of aortoiliac disease. A noninvasive femoral cuff technique.

An inexpensive femoral "cuff" developed in this noninvasive vascular laboratory allows pulse volume recordings and systolic pressure measurements of the femoral arteries. Using the parameters 1) femoral/brachial systolic pressure ratio, 2) wave amplitude, and 3) status of the dicrotic notch for assessment of results, it was found that the cuff correctly identified 59 of 62 limbs with at least 50% aortoiliac stenosis, with only two false-positive results, for an accuracy of 97%. The high, wide thigh cuff identified 57 of the 62 limbs, but had 45 false-positive results (77% accuracy). Use of the femoral "cuff" has refined the ability to identify the anatomic location of significant arterial stenoses in the lower extremities.

Adult↗
PubMed1983

A method of securing the arterial catheter for hepatic artery infusion.

The infusion of chemotherapeutic agents through the liver is an important part of the non-surgical treatment of metastatic carcinoma of the liver. A stable catheter position is essential to the maintenance of good hepatic infusion. This technique assures that stable position.

Catheterization↗
PubMed1982

Multiple primary carcinomas of the colon and associated extracolonic primary malignant tumors.

A review of 308 cases of colorectal carcinoma showed 12 cases (3.9%) of colorectal multiple primary malignant tumors and 14 cases (4.5%) of colorectal primary malignant tumor associated with extracolonic primary malignant tumor. A total of 60 tumors was involved: 14 each in the sigmoid and transverse colon; eight in the cecum; six in the rectum; one each in the ascending and descending colons; three each in the bladder and prostate; two each in the breast, cervix, and lung; and one each in the skin, nasopharynx, kidney, and endometrium. Three of the four patients with multifocal cancer were found to have in situ cancer, and 12.7% of concomitant adenomas had malignant changes. Seven patients had regional lymph node metastases. Of the six patients with rectocolonic multiple tumors who had adequate follow-up data, survival in three ranged from 19.5 to 60 months; three were alive and well 15 to 51 months after resection. Survival of patients with primary rectocolonic and extracolonic tumors was similar. From these data and the pathologic study of the resected specimens, we recommend for any patient with cancer of the rectocolon that the entire colon be searched for multiple primary malignant tumors, that extracolonic tumors be considered second primary tumors unless proved to be metastases, and that follow-up be long and include frequent rectocolonic examinations for a second primary tumor.

Adenocarcinoma↗
PubMed1982

Effectiveness of high-frequency jet ventilation in management of an experimental bronchopleural fistula.

An animal model was prepared to compare the effectiveness of high-frequency jet ventilation (HFJV) with that of conventional intermittent positive pressure ventilation (IPPV) in managing bronchopleural fistula. In ten adult beagles, the left upper pulmonary lobe was resected and the left upper lobe bronchus was cannulated to establish a permanent bronchopleural fistula. Apposition of the middle lobe to the chest wall was examined via an open thoracotomy. Fistula leakage was measured with the thoracotomy closed, and chest tube drainage was set at 20 cm H2O. With HFJV, lung apposition was attained at lower peak (8.9 cm H2O) and expiratory (5.7 cm H2O) pressures than with IPPV (21.2 cm H2O Peak pressure and 10.7 cm H2O expiratory pressure). With equivalent arterial blood gases, fistula leakage was 47 per cent higher with IPPV than with HFJV (P less than .001). Each 5 cm of positive end expiratory pressure (PEEP) added increased fistula leakage similarly to both systems. Varying the frequency of HFJV did not alter leakage significantly, but increasing the driving pressure markedly increased leakage. Thus, experimentally, HFJV proved superior to IPPV in the management of bronchopleural fistula. When HFJV is used clinically to manage a bronchopleural fistula, the driving pressure should be kept as low as possible and PEEP should be limited. The ventilatory rate may be varied to achieve the desired PaCO2 without significantly affecting leakage through the fistula.

Animals↗
PubMed1982

Effect of anesthesia and splenectomy on antibody response to pneumococcal polysaccharide immunization.

Whether anesthesia-induced immunosuppression and postsplenectomy decreased antibody response are important in the timing of postsplenectomy pneumococcal vaccination was tested in 57 inbred 150 to 175 gm Fischer 344 rats immunized three weeks preoperatively (Group 1), immediately after anesthesia (Group II), and three weeks postoperatively (Group III). Groups IV and V were not immunized. All rats had splenectomy and one hour of 1 per cent halothane anesthesia. After intraperitoneal immunization of the rats with 5 mu g of Type III pneumococcal polysaccharide, weekly serum antibody levels were determined by radioimmunoassay. Six weeks postoperatively, Groups I through IV received an intravenous LD50 dose of Type III pneumococcus; Group V was challenged one week after operation. Survival was assessed every 12 hours for one week. Antibody responses among the groups were statistically equal, except on day 4 and day 26 postimmunization. On day 4, Group I had higher levels than Groups II and III (P less than .05), showing the spleen's role in early antibody production, and on day 26, Group I had much lower levels than Group II (P less than .05), indicating a short-term depressive effect of anesthesia and operation on ongoing antibody formation. Survival was equal among Groups I through IV. Survival in Group V was poorer than in Group IV (P less than 0.5), probably indicating that nonsplenic sites had acquired an enhanced ability to clear pneumococcus. The study shows, therefore, that anesthesia and splenectomy do not affect the timing of pneumococcal vaccination postsplenectomy.

Anesthesia, Inhalation↗
PubMed1977

Impact of medical training on ambulance dispatching.

This study was designed to assess the ability of trained individuals to screen calls for emergency medical services to allow for safer or more appropriate responses. The degree of urgency of calls, as judged by dispatchers and a panel of physicians, was compared to estimates of the severity of the patient's illness or injury. Physicians were more likely to designate calls as emergencies than were dispatchers. Neither physicians nor dispatchers were able to discriminate between the severely ill or injured and those without severe problems. The emergency medical technicians were better able to assess severity and degree of urgency than were physicians or dispatchers. A tentative conclusion is that rapid response by an emergency medical services system will be based upon the caller's description of the situation rather than medical assessment of patient condition.

Allied Health Personnel↗
PubMed1977

Fatal poisoning with propoxyphene: report from 100 consecutive cases.

The first 100 deaths caused by propoxyphene and recorded by the Chief Medical Examiner of North Carolina were studied. Victims ranged evenly in age from the second to the seventh decade. Over 65% were suicides with a female to male ratio of 2:1. Blood propoxyphene concentrations of 0.2 mg/dl were fatal, representing rapid ingestion of approximately ten capsules. In North Carolina, deaths due to propoxyphene have increased from five in 1969 to 49 in 1975. Raising physician-awareness of propoxyphene's toxicity and placing the drug in Schedule II are two of the author's recommendations for reducing the number of propoxyphene deaths.

Adolescent↗