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Biomedical subjects

M Parry

Publications and source records attributed to M Parry.

At least 19 recordsLinked to original sources
PubMed2005

Pitfalls in the clinical diagnosis of vertebral fractures: a case series in which posterior midline tenderness was absent.

OBJECTIVE: There is widespread belief among doctors that posterior midline tenderness is virtually a prerequisite for spinal fracture in alert, sober patients without any painful distracting injury or neurological deficit. This paper examines and challenges this belief. METHODS AND RESULTS: We present three patients in whom significant thoracic and lumbar vertebral fractures were missed, or were thought to be "old", because of lack of posterior midline tenderness. We also present two further patients, one with a lumbar spine fracture and one with a cervical spine fracture, in whom posterior midline tenderness was absent but in whom the correct diagnosis was made. All these patients were sober and fully alert and none had a neurological deficit or a painful distracting injury. CONCLUSION: The absence of posterior midline tenderness does not exclude significant spinal injury. We suggest that patients should satisfy both the Canadian and British guidelines before it is decided that imaging of the cervical spine is unnecessary.

Adult↗
PubMed2000

Patient compliance to a new enteric-coated weekly formulation of fluoxetine during continuation treatment of major depressive disorder.

BACKGROUND: A new formulation of enteric-coated fluoxetine given once weekly could be a useful option for the long-term treatment of depression, but compliance to once-weekly fluoxetine treatment has not been assessed. METHOD: Patients were adults from the United Kingdom who had responded to fluoxetine treatment for a current episode of depression (DSM-IV criteria). In the baseline assessment phase, all patients (N = 117) were continued on 20 mg of open-label fluoxetine once daily for 4 weeks. In the follow-up phase, patients (N = 109) were randomly assigned to once-weekly or once-daily fluoxetine for 3 months. Patient compliance was monitored by electronic devices during both phases of the study. RESULTS: Compliance to once-weekly fluoxetine treatment was higher than compliance to once-daily fluoxetine (85.9% vs. 79.4%, respectively). CONCLUSION: Once-weekly fluoxetine treatment allows for new flexibility for both the clinician and the patient, and this study alleviates the concern that patients will forget weekly doses.

Adult↗
PubMed1999

Irinotecan therapy in adults with recurrent or progressive malignant glioma.

PURPOSE: To determine the activity, toxicity, and pharmacokinetics of irinotecan (CPT-11, Camptosar; Pharmacia & Upjohn, Kalamazoo, MI) in the treatment of adults with progressive, persistent, or recurrent malignant glioma. PATIENTS AND METHODS: Patients with progressive or recurrent malignant gliomas were enrolled onto this study between October 1996 and August 1997. CPT-11 was given as a 90-minute intravenous (i.v.) infusion at a dose of 125 mg/m2 once weekly for 4 weeks followed by a 2-week rest, which comprised one course. Plasma concentrations of CPT-11 and its metabolites, SN-38 and SN-38 glucuronide (SN-38G), were determined in a subset of patients. RESULTS: All 60 patients who enrolled (36 males and 24 females) were treated with CPT-11 and all were assessable for toxicity, response, and survival. Pharmacokinetic data were available in 32 patients. Nine patients (15%; 95% confidence interval, 6% to 24%) had a confirmed partial response, and 33 patients (55%) achieved stable disease lasting more than two courses (12 weeks). Toxicity observed during the study was limited to infrequent neutropenia, nausea, vomiting, and diarrhea. CPT-11, SN-38, and SN-38G area under the plasma concentration-time curves through infinite time values in these patients were approximately 40%, 25%, and 25%, respectively, of those determined previously in patients with metastatic colorectal cancer not receiving antiepileptics or chronic dexamethasone treatment. CONCLUSION: Response results document that CPT-11, given with a standard starting dose and treatment schedule, has activity in patients with recurrent malignant glioma. However, the low incidence of severe toxicity and low plasma concentrations of CPT-11 and SN-38 achieved in this patient population suggest that concurrent treatment with anticonvulsants and dexamethasone enhances drug clearance.

Adult↗
PubMed1997

Total arterial revascularization of the heart: intentional or inevitable.

The impact of left internal mammary to left anterior descending coronary bypass grafting in enhancing long-term patient survival has led to a widespread interest in arterial grafting over the past decade. It is now accepted that the internal mammary artery is a biologically superior coronary bypass graft compared with the traditional saphenous vein. Experience with other arterial grafts--the right gastro-epiploic artery, the inferior epigastric artery and the radial artery--has shown compelling evidence that they share the same biologic advantage. With the judicious use of some or all of these conduits, all regions of the heart can be reached, and total arterial revascularization is a feasible and desirable objective on a routine basis. As long-term results become available, it is inevitable that it will become the operation of choice.

Critical Care↗
PubMed1995

Eosinophilic enteritis in northeastern Australia. Pathology, association with Ancylostoma caninum, and implications.

While eosinophilic gastroenteritis is considered a rare condition, eosinophilic enteritis without gastric involvement is quite common in northeastern Australia. We present 79 patients with biopsy-proven eosinophilic enteritis, 70 seen since 1987. In 10 patients, eosinophilic enteritis was associated with infection by single, sexually immature, adult hookworms, most positively identified as the common dog hookworm Ancylostoma caninum. An additional 22 patients (of 34 tested) had serological evidence of A. caninum exposure. The essential pathology, i.e., edema and eosinophilic infiltration of the gut wall, ascites, and regional lymphadenopathy, was identical to that seen in eosinophilic gastroenteritis. Additional, more specific features included pathological reactions centered on attached worms, mucosal alterations and ulcers considered to be hookworm bite sites, and submucosal and lymph node granulomas with central eosinophil degranulation and degradation products. Since A. caninum has an almost worldwide distribution, it is probable that A. caninum-induced eosinophilic enteritis occurs outside Australia. We show that the worm is easily overlooked in pathological specimens and that care is required to preserve worms intact for specific parasitological identification. The clinical and pathological features were similar to those seen in another human enteric helminthic zoonosis, anisakiasis. The possibility that there are yet other undiscovered intestinal zoonoses remains.

Adolescent↗
PubMed1992

Strategy and marketing tactics in nonprofit hospitals.

Through the analysis of questionnaire data, this study examines the strategic management styles of 114 nonprofit hospitals and the relationship between each of these styles and hospital marketing tactics. The analysis has important implications for nonprofit hospitals and other health care organizations.

Financial Management, Hospital↗
PubMed1991

Marketing budgeting in nonprofit hospitals.

The authors summarize the results of an investigation of the marketing budgeting practices of nonprofit hospitals. They examine various dimensions of budgeting behavior, including (1) the prevalence of budgeting methods that are widely used in the marketing of consumer and industrial goods, (2) the relationship between budgeting practices and the budgeting process, and (3) the relationship between budgeting practices and hospital strategy and performance. The authors also discuss implications for marketing executives and directions for future research.

Budgets↗
PubMed1989

Use of the Femurett adjustable prosthesis in the assessment and walking training of new above-knee amputees.

The Lic Femurett adjustable training prosthesis was evaluated on 51 above-knee amputees attending the Oxford Disablement Services Centre. In the elderly it proved superior to the Pneumatic Post-Amputation Mobility Aid (P.P.A.M.-Aid) in the assessment of their ability to use a prosthesis, and is useful for walking training once the stump is fully healed; it does not replace the P.P.A.M-Aid at the early post-operative stage.

Adult↗
PubMed1982

A comparison of the effects of pirenzepine and atropine on gastric acid secretion, salivary secretion and pupil diameter in the rat.

The ability of pirenzepine and atropine, given i.v., to inhibit gastric acid and salivary secretion and increase pupil diameter has been assessed in the rat. Pirenzepine had a similar potency against acid secretion, ED 50 0.71 (0.41 to 1.1) mg.kg-1, and salivary secretion, ED 50 (0.43 to .59) mg.kg-1, whilst its potency was less in the eye, ED 50 1.8 (1.6 to 2.1) mg.kg-1. Atropine however, was more potent in reducing salivary secretion, ED 50 0.012 (0.010 to 0.016) mg.kg-1 and increasing pupil diameter, ED 50 0.028 (0.025 to 0.031) mg.kg-1 than in inhibiting gastric acid secretion, ED 50 0.056 (0.037 to 0.083) mg.kg-1. Therefore, that quantity of pirenzepine which inhibits gastric acid secretion by 50% will have only a slight effect on the eye and will inhibit salivary secretion by a similar magnitude. In contrast, the amount of atropine required to inhibit acid secretion by 50% will significantly increase pupil diameter and abolish salivary secretion.

Animals↗