Biomedical subjects

M Milburn

Publications and source records attributed to M Milburn.

8 recordsLinked to original sources

PubMed2000

Comparison of the laser and phenol chemical peel in facial skin resurfacing.

OBJECTIVE: To determine differences in postoperative outcomes, complications, and adverse effects between phenol chemical peel (CP) and the carbon dioxide laser peel, when used for facial skin resurfacing. DESIGN: Nonrandomized prospective comparison of 2 facial skin resurfacing techniques using a split-face paradigm. In this initial study, 18 months of follow-up data are available, including the patients' subjective evaluations, the surgeons' objective assessments, and a histological analysis of 1 patient by a blinded pathologist. SETTING: A facial plastic surgery clinic associated with a university medical center. PATIENTS: Four female patients with actinic-damaged facial skin and facial rhytids, aged 61 to 73 years. INTERVENTIONS: The left side of each face was treated with a phenol-based CP formula according to standard procedure. The right side was resurfaced using the Sharplan Silktouch Flashscanner carbon dioxide laser. Patients were photographed before treatment and at regular intervals postoperatively. One patient underwent rhytidectomy at 2 months posttreatment, and specimens were obtained for histological analysis. MAIN OUTCOME MEASURES: Evaluation of observable clinical improvement in skin quality, postoperative swelling, erythema, pigmentary alterations, healing time, and complications. RESULTS: All 4 patients experienced transient initial discomfort on the CP side that subsided within 24 hours after treatment. The laser side was noted to have slightly more prolonged stinging, erythema, and edema. Erythema was noted to be more uniform in the laser-treated areas. Final clinical improvement in rhytids was evaluated by 4 surgeons who reviewed color slide presentations of each patient 1 year or more postoperatively. Uniform wrinkle improvement was noted around the eyelid and lateral cheek areas on both the CP and laser-treated sides. A moderate advantage in the degree of wrinkle improvement was noted on the laser-treated sides of the upper lip and forehead. Thick-skinned, glandular skin areas, such as the nasolabial fold and chin, were found to be substantially smoother in the laser-treated areas. Histological studies indicate that the CP side was noted to have a deeper injury, extending into the reticular dermis. The skin treated with the laser was injured more superficially, down to the papillary dermis. CONCLUSIONS: Phenol CP is as effective as the laser in diminishing rhytids in the thin-skinned areas of the face. The laser produces improved results in the thick, glandular areas of the face, but also produces more intense hypopigmentation, longer periods of patient discomfort, and longer periods of postoperative erythema. Both phenol CP and laser resurfacing remain useful clinical tools.

Aged↗

PubMed2000

Taking practice forward in paediatric oncology: the impact of a newly developed education programme for nurses working in shared-care hospitals.

Fundamental to any change or development in health care is the quality of the service received by patients and their families. Practitioner-led initiatives that are designed to improve the quality of care are more likely to succeed if they are underpinned with appropriate educational input. A structured programme in paediatric oncology nursing was developed to meet the needs of nurses working in District General Hospitals. Nurses' perceptions of the consequences of undertaking the programme were explored using a focus group approach. Findings have shown that there have been significant changes to nurses' roles and this in turn has had an impact on the individual and the organization. It was perceived that there are positive outcomes for both the service and quality of care for children with cancer and their families. The shared-care nurses believe that this has been the result of improved knowledge, skill and expertise, better communication between care providers, and the collaborative frameworks which have evolved.

Journal Article↗

PubMed1999

Strial dysfunction in the MRL-Fas mouse.

The MRL-Fas(lpr) mouse, a model of multisystemic autoimmune disease, has been proposed as a potential model of autoimmune inner ear disease. Cochlear pathology, consisting of hydropic degeneration of the stria vascularis, has been documented to occur coincident with the establishment of systemic disease in this animal. Because the cochlear pathology is restricted to the stria, this study was designed to evaluate whether the endocochlear potential (EP) would be diminished in these animals because of a loss in strial Na, K-ATPase. Experimental (MRL-Fas(lpr)) mice, with established systemic disease, had auditory brain stem response thresholds and EPs recorded. MRL-+/+ mice served as controls. Animals were then euthanized, and their cochleas were processed for immunohistologic assay for the alpha1 and beta2 subunits of Na,K-ATPase. Density of staining was evaluated by use of quantitative means with densitometry image analysis of digitized images. MRL-Fas(lpr) mice revealed significant elevations in auditory brain stem response thresholds and reductions in EPs but no reductions in Na,K-ATPase levels, as evidenced by immunohistochemical assay. The reduction of EP likely occurs as a result of cellular degeneration within the stria vascularis and likely results from an abrogation of the strial perilymph/endolymph barrier and not from a reduction in strial Na, K-ATPase levels.

Animals↗

PubMed1997

Unusual neck masses secondary to jugular venous abnormalities: case report and discussion.

Thrombosis of the lateral sinus/proximal jugular vein and jugular venous ectasia are infrequent but not uncommon neck masses. Lateral sinus thrombosis was well described in the preantibiotic era, but modern-day surgeons may not be familiar with this entity. Failure to diagnose a neck mass due to jugular vein thrombosis may have deadly consequences. Jugular vein ectasia, which is innocuous, has been mistaken for laryngocele, cystic hygroma, as well as other vascular lesions. However, the management of jugular vein ectasia, which is thought to be caused by incompetence of the bicuspid jugular venous valve, is conservative. We present a case illustrating a neck mass arising from the internal jugular vein with a discussion of jugular venous pathology.

Adolescent↗

PubMedDate not supplied

Nursing care that patients value.

The delivery of nursing care should be based on meeting patients' individual needs. This article presents the findings of a small-scale study which explored the feelings that people express regarding the care they would like and receive from nurses.

Adult↗

PubMedDate not supplied

Compensation for elected hospital medical staff leadership.

As physicians' practices become more complex and their practice incomes more difficult to maintain, hospitals concurrently require more physician input into organizational, utilization, and strategic planning matters. Physicians and hospitals across the country are discussing the question of financial compensation to physicians for the time they spend performing these hospital administrative tasks. It is already common practice for hospitals to pay a salary for medical direction of hospital departments such as intensive care units or pulmonary laboratories. The question has become whether this practice should be extended to elected medical staff leadership.

Data Collection↗

PubMedDate not supplied

Correlates of first trimester care in a public health prenatal clinic.

Early access to prenatal care is a major issue in the prevention of low birth weight. Therefore, the authors studied 107 indigent women seen consecutively for their initial visits at a public health department's prenatal clinic to ascertain factors associated with first trimester care. The questionnaire included items on individual health behaviors, attitudes toward medical care, perceived social support, depression, and demographics. Data were collected over 12 weeks by a clinic nurse, and all patients agreed to participate. Using logit estimated odds ratios (OR), none of the independent variables examined were associated with first trimester care for married women. For unmarried women first trimester care was related to finding the clinic by word of mouth (OR = 5.5, 95% CI, 1.2-22.9) and maternal depression (OR = 4.0, 95% CI, 1.1-15.3). Finding the prenatal clinic by word of mouth and maternal depression were still associated with first trimester care after controlling for maternal education and health attitudes. These data suggest that subsequent explanatory research should explore the association between informal social support of unmarried women and first trimester prenatal care.

Attitude to Health↗

PubMedDate not supplied

Invisible visitors.

Explore the source record for details and available documents.

Communication↗