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Biomedical subjects

M M Gregory

Publications and source records attributed to M M Gregory.

At least 19 recordsLinked to original sources
PubMed1993

On humanizing the critical care environment.

Critical care unit design should strive to provide physical and psychologic comfort for patients, families, and staff members. Thoughtful and creative analysis of the critical care unit milieu will result in both functional and environmental improvements. Clinicians, architects, engineers, interior designers, and equipment manufacturers should collectively focus their efforts on the integration of technology and comfort in this stressful setting.

Ergonomics↗
PubMed1993

If they don't ask these questions, give them the answers.

Clinicians must be active rather than passive participants in the design process. This article lists basic concepts that pertain to the model of care and are the foundation of the design. Clinicians must be in agreement on these concepts and discuss the rationale for them with the design team to establish the project goals.

Decision Making, Organizational↗
PubMed1993

Design considerations for heating, air conditioning, and exhaust systems in critical care units.

Air quality, temperature control, and air movement directly affect infection control, comfort, and safety in critical care units. This article explains basic concepts in the heating, ventilation, and air conditioning that affect patient care. Functional requirements must be determined early in the design process and discussed with clinicians, engineers, and architects to assure understanding and correct design.

Air Conditioning↗
PubMed1993

Concepts in headwall selection and design.

The headwall is the interface between the patient and critical care technology. This article lists headwall components, outlines various types of headwall systems, and discusses factors in selecting the type of headwall to support the desired model of care.

Humans↗
PubMed1989

Chronic colitis after Aeromonas infection.

Three patients with an acute colitis in which the only pathogen detected was either Aeromonas hydrophila or A sobria progressed to a chronic phase after the infection had been eliminated by antibiotic treatment in two and had resolved spontaneously in the third. The final diagnosis in each case was ulcerative colitis. Two of the patients have responded to anti-inflammatory medication but one has required panproctocolectomy. The sequence of symptoms and observations in these cases, as well as in others from the literature involving more familiar pathogens, suggests that bacterial infection may contribute to the development of chronic colitis. This supposition could be tested by extending the follow up of patients with acute infective colitis in a prospective multicentre trial.

Adult↗
PubMed1987

Surgical lights. Making a purchase decision.

Based on the preceding factors, a profile can be made for each light. The profile should include the following information: product literature with detailed information about the light, the average score from each of the six categories on the questionnaire, a summary of positive and negative comments from the questionnaire (recurring comments can identify significant factors), recommendations from other hospitals using the light, warranty and service information and any pertinent information about the vendor and manufacturer, information or comments from the clinical engineer, the purchasing agent, and the architect/engineer, and information about possible purchase agreements. Once the profiles of the lights are finished, present them to the OR committee or group charged with making the final decision. The information will enable the group to compare the lights and will serve as a basis for either the final purchase or a detailed bid specification. If cost is a major factor in the decision, the evaluation results can be used to justify purchasing lights that are more expensive but that the users believe are clearly superior. This constitutes the "professional justification" that some government institutions require to circumvent regulations that require buying the low-bid product. Although the result of this selection process is clearly a subjective decision, it is an informed subjective decision. Once the lights are installed, the staff members' satisfaction with the lights will not be based on objective criteria but on the same subjective opinions that were used to justify the selection.

Costs and Cost Analysis↗
PubMed1981

Pleomorphic salivary gland adenomas of the parapharyngeal space. Review of nine cases.

Nine cases of pleomorphic salivary gland adenomas of the parapharyngeal space are reviewed. In the discussion which follows we show that five of these tumours were situated medial to the superior constrictor muscle and arose within pharyngeal mucosa. We also outline our views on the management of pleomorphic salivary gland adenoma of the parapharyngeal space with particular reference to biopsy, surgical excision and post-operative radiotherapy.

Adenoma, Pleomorphic↗
PubMed1980

Etiology of carcinoma of the larynx.

Since 1973, evidence based on case-control and mortality studies has suggested that carcinoma of the larynx was an asbestos-related tumour. In this study, 305 male and 206 female patients were interviewed on admission to the Royal National Throat Nose and Ear Hospitals in London. Following endoscopy, biopsy material was reviewed and classified as either neoplastic, cysts and polyps or inflammatory; a fourth group consisted of patients for whom the surgeon recorded that the larynx appeared normal on inspection and from whom no biopsy was taken. Only 15 neoplastic conditions were detected among the women, and only two had asbestos exposure; thus, no further analysis was made. Among the males, the neoplastic group was significantly older than the other groups, and cigarette smoking was significantly more common. Alcohol consumption did not differ significantly; and asbestos exposure was not more common in the neoplastic group than in the three other groups.

Adult↗
PubMed1977

Pathology of 'non-healing (midline) granuloma'.

In a histological study of biopsy and postmortem material from 30 cases of nasal disease in which a clinical diagnosis of 'midline granuloma' or Wegener's granuloma had been given, we selected 10 cases on the basis of the presence of widespread coagulative necrosis and atypical cells. Evidence is provided that such changes represent a malignant neoplasm of histiocytic lymphoma type. Local invasion and spread to cervical and more distant lymph nodes, spleen, liver, and kidney were seen in some of the cases. Erythrophagocytic activity was marked in the spleen in three cases and histiocytic infiltration of the bone marrow in two cases, indicating a more generalised activity of histiocytic cells. Terms such as 'malignant granuloma' should be abandoned. In obstructive and ulcerating conditions of the nose efforts should be concentrated on making an accurate histological diagnosis.

Adult↗
PubMed1972

Methotrexate hepatotoxicity in psoriasis--comparison of different dose regimens.

Liver histological appearances were studied in 44 patients treated for psoriasis with methotrexate. Cirrhosis was found in six and hepatic fibrosis in another 11. Of these 17 patients 12 had received methotrexate by a regimen of frequent small dosage, two had been treated by a regimen of intermittent large dosage, while three had been treated at different times by both methods. The prevalence of cirrhosis and fibrosis was significantly greater in patients treated by frequent small dosage than in those treated by intermittent large dosage, though the dose level (mg/month) was similar in both groups. Hepatic fibrosis, sometimes preceding cirrhosis, seems to develop invariably if treatment with small frequent dosage is sufficiently prolonged. In the few circumstances in which this drug is indicated for psoriasis intermittent large dosage is the treatment regimen of choice.

Adolescent↗
PubMed1971

Liver damage due to methotrexate in patients with psoriasis.

Liver function and histological changes in liver biopsies were studied in 37 patients who had been treated for psoriasis with methotrexate. Cirrhosis was found in seven (19%) and hepatic fibrosis of varying severity in 10 (27%). Minor abnormalities in another 17 (46%) consisted of fatty change, round cell infiltration, and extensive vacuolation of liver cell nuclei. In only three (8%) was hepatic histology entirely normal. The severity of liver damage was related to the duration of methotrexate treatment. Minor abnormalities of liver function tests and liver histology were also found in eight control psoriatic patients. Standard liver function tests were of little value in predicting the degree of liver damage. It appears that methotrexate, in the doses normally used to control psoriasis, may cause cirrhosis if treatment is prolonged and that liver biopsy is necessary for evaluation of liver damage in these patients.

Adult↗