PubMed HealthSearch

Biomedical subjects

N Morgan

Publications and source records attributed to N Morgan.

9 recordsLinked to original sources

Box Hill Hospital Intensive Care Unit.

The Unit Profile of the Intensive Care Unit at Box Hill Hospital describes the Unit's history and the progression it has made through the past 26 years. Details are given on the type of patients received and the catchment areas this Unit services. The organisational structure and the educational services available are discussed. The breakdown of staff including the nursing and medical staff and the available ancillary services as stated. The critical care course is described in detail to give an outline of and to promote this tertiary based course. It is also hoped this will encourage other hospitals and tertiary institutions to structure such similar courses to provide a more professional education for nurses.

Diagnosis-Related Groups

Cognitive deficits in delirium: assessment over time.

Delirium is commonly defined as a transient organic brain syndrome characterized by concurrent disorders of attention, perception, thinking, memory, psychomotor behavior, and the sleep-wake cycle. One of the difficulties in studying delirium is that symptoms tend to fluctuate over the course of the day. Pre-existing organic brain disease appears to be a significant risk factor for the development of delirium, and numerous studies have shown a high rate of delirium in patients with cerebrovascular disease, Parkinson's disease, and Alzheimer's disease. The cognitive deficits associated with delirium have not been widely studied in a systematic, quantitative fashion. Following resolution of the frank delirium, documented cognitive deficits can be observed, and may persist in a diluted form for a period of months. Residual cognitive deficits may be due to a minimal and persistent confusion or to an underlying brain disorder.

Cognition Disorders

[Concepts about AIDS among the adult population of Managua].

Nicaragua has the lowest prevalence of AIDS in Central America. In other countries where AIDS is more prevalent, the first epidemic of asymptomatic infections with human immunodeficiency virus (HIV) and the second of clinical cases of AIDS have been followed by a third epidemic of fear and discrimination. In December 1989 a study was conducted to investigate knowledge and attitudes about AIDS in a sample of 287 adults in Managua. Most of the interviewees had heard of the disease from newspapers and television, and more than 90% understood how HIV was principally transmitted. However, between one-third and one-half the interviewees believed that HIV could be transmitted by causal contact such as kissing (53%) or by mosquito bites (49%). In addition, the majority considered that isolation of HIV-infected persons and control of immigration into the country would be effective measures for preventing the spread of the disease. These results are similar to findings from studies carried out in other countries of Latin America where the HIV and AIDS epidemics started much earlier. This would suggest that the so-called "third epidemic" of discrimination and fear is affecting Nicaragua in advance of the other two.

Acquired Immunodeficiency Syndrome

Oral almitrine in treatment of acute respiratory failure and cor pulmonale in patients with an exacerbation of chronic obstructive airways disease.

The effects of oral almitrine bismesylate, a respiratory stimulant that acts on peripheral arterial chemoreceptors, was studied in patients with chronic obstructive airways disease and hypoxaemic cor pulmonale. Twenty three patients admitted to hospital with an acute exacerbation of ventilatory failure were randomised to receive either almitrine 100 mg twice a day reducing to 50 mg twice a day over 48 hours or placebo in addition to conventional treatment. On admission the mean (SE) values for blood gas tensions were PaO2 4.8 (0.3) and PaCO2 7.7 (0.3) kPa in the 12 patients who received almitrine and PaO2 4.9 (0.1) and PaCO2 7.6 (0.3) kPa in the 11 who received placebo. After three hours of oxygen therapy at 1 1/min there was a similar rise in PaO2 in both groups, 6.4 (0.2) kPa in those receiving almitrine and 6.6 (0.4) kPa in those receiving placebo. After 24 hours of oxygen therapy values of PaO2 were again similar at 6.3 (0.8) kPa and 6.7 (2.2) kPa respectively. Arterial blood gas tensions improved during the study in those who survived but no significant differences were apparent between the two groups. There were six deaths, five in the almitrine group and one in the placebo group. There were no differences between the groups in respiratory rate, results of spirometry, oxygen requirement, or degree of dyspnoea (on visual analogue scale). The results did not show any benefit from oral almitrine in patients with acute respiratory failure secondary to chronic obstructive airways disease. Plasma almitrine concentrations, however, were often below the optimum therapeutic range, suggesting impaired drug absorption.

Administration, Oral

Multichannel cochlear implantation in a patient with bilateral Mondini deformities.

A 31-year-old man with bilateral Mondini dysplasia was successfully implanted with a Nucleus multichannel 22-electrode cochlear prosthesis. To our knowledge, this is the first report of multichannel cochlear implantation in a patient with Mondini dysplasia. The surgical procedure used to insert the device was uncomplicated. Although objective measurements demonstrated only slight improvement in most categories of the Iowa test battery, he has the ability to discriminate pure-tone frequency differences and environmental sounds. Subjectively, he was a satisfied implant user. The surgical feasibility of multichannel implantation in patients with Mondini dysplasia should open the door for improved speech recognition and tonal discrimination in this subset of patients.

Adult

Acquired chronic candidiasis treated with transfer factor.

A patient with acquired chronic oral and vaginal candidiasis resistant to topical and parenteral therapy was found to have impaired cell mediated immunity to Candida antigen and loss of skin test response to tuberculin (Mantoux). Treatment with Candida-active transfer factor produced clinical remission lasting 1 year and restitution of in vitro and in vivo immune parameters. Relapse occurred while receiving a second lot of transfer factor from the same donor. Subsequent treatment with levamisole was associated with onset of agranulocytosis.

Adult

Development of a non-viable particulate monitoring system for drugs manufactured in an aseptic environment.

Automated non-viable particulate monitoring systems can significantly reduce sampling costs while providing increased assurance that pharmaceutical products are free of microbial contamination. The need for consistently reliable data in the batch release process requires incorporating adequate fail-safes to detect operator error and hardware malfunction. Use of the "Life Cycle Approach" in system design and validation is also needed to provide assurance that the system will continue to meet its specifications. The author has collaborated with an instrument vendor to design, install and validate a data gathering and reporting system. Test function design is also discussed.

Asepsis