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Biomedical subjects

P Jennings

Publications and source records attributed to P Jennings.

At least 19 recordsLinked to original sources
PubMed2003

Haemodynamic and electrocardiographic consequences of severe nicorandil toxicity.

A 35 year old woman was admitted to the emergency department two hours after ingesting 60x20 mg tablets of nicorandil, total 1.2 g. The dominant feature of icorandil toxicity was profound peripheral vasodilatation associated with coronary hypoperfusion. Despite widespread electrocardiographic signs of myocardial ischaemia, there was no evidence of myocardial damage and no serious cardiac arrhythmia. Volume loading and pressor support proved to be an effective treatment strategy.

Adult↗
PubMed2002

Role of computerized tomography (CT) scan of the chest in patients with newly diagnosed head and neck cancers.

Chest metastases and second primaries are not uncommon in patients with head and neck cancer. Early detection of a second site of malignant disease may alter prognosis and management. This study assessed the diagnostic yield of chest radiographs compared with computerized tomography (CT) in a series of patients with head and neck cancer. Forty-four consecutive patients with a head and neck squamous cell carcinoma (SCC) attending the head and neck surgery department of Cumberland Infirmary, Carlisle, between January 2000 and December 2000 were included in this prospective study. Patients with lymphomas and localized cancers of the skin and lip were excluded. Thirty men and 14 women, with a mean age of 67 years, were assessed. All had chest radiographs and chest CT at the same time as the CT scan of the primary site. Only one patient had a true positive finding on chest radiograph. Five patients had an abnormal chest CT. Of these, two had multiple lung metastases, and another patient had biopsy-proved bronchogenic carcinoma and underwent surgical excision. The sensitivity and specificity of CT scan was 100% and 95%, as opposed to 33% and 97% for chest radiograph.

Aged↗
PubMed2002

Should paediatric units have bereavement support posts?

Eight bereavement support posts in paediatrics and maternity were established using the experience of the Child Bereavement Trust (CBT). Evaluation showed that staff welcomed the informal support and teaching for themselves, as well as support for families; 67% of staff who returned questionnaires felt care for bereaved families had improved as a result of the posts. Many felt that there had been a positive effect on staff retention and stress levels.

Attitude of Health Personnel↗
PubMed2001

Survival from out-of-hospital cardiac arrest in the Geelong region of Victoria, Australia.

OBJECTIVE: To study the outcome from prehospital cardiac arrest managed by ambulance personnel, and to examine overall survival rates from successful resuscitation. METHODS: A retrospective analysis was made of 115 patient care records of prehospital cardiac arrests with attempted resuscitation between July 1996 and September 1999. All cases had a presumed primary cardiac cause for their cardiac arrest. RESULTS: Overall survival, defined as admitted to hospital alive, was 22 subjects (19.1%), with five subjects (4.3%) being discharged from hospital neurologically intact. Of the patients who survived to the emergency department, six (5%) had initially presented in pulseless electrical activity and 16 (14%) presented with ventricular fibrillation. No patients presented with ventricular tachycardia and no survivors presented in asystole. Median response interval from time of call to arrival of initial crew at patient's side was 9 min. No patients survived when response interval was greater than 14 min. Bystander cardiopulmonary resuscitation was being performed on 55 patients (48%) on arrival of initial ambulance crew; 68.2% of patients surviving to hospital having had bystander cardiopulmonary resuscitation. CONCLUSION: Decreasing time delays in accessing the patient is crucial to improving outcome in out-of-hospital cardiac arrest.

Adolescent↗
PubMed2000

Guidelines for the management of women with abnormal cervical smears 1998.

Four important changes have been introduced in the revised guidelines for the management of women with abnormal cervical smears, 1998. 1. For the purposes of management, atypical squamous cells of undetermined significance (ASCUS) and atypical glandular cells of undetermined significance (AGUS) have been included with low grade squamous intraepithelial lesions (LSIL/CIN1/HPV) except where the smear raises the possibility of a high grade squamous intraepthelial lesion (HSIL) or favours glandular dysplasia. 2. Women with low grade cytological and histological intraepithelial abnormalities will, after initial follow-up, revert to three yearly screening. 3. Requirements for those practising colposcopy have been defined. 4. A formal review of all cases of invasive cervical cancer is advocated.

Adenocarcinoma↗
PubMed2000

Sarcoplasmic reticulum Ca(2+)-ATPase of sea cucumber smooth muscle: regulation by K(+) and ATP.

Although several Ca(2+)-ATPase isoforms have been described in vertebrates, little is known about Ca(2+)-transport in the muscle of invertebrates. In the microsomal fraction obtained from the sea cucumber (Ludwigothurea grisea) longitudinal body wall smooth muscle, we identified a Ca(2+)-transport ATPase that is able to transport Ca(2+) at the expense of ATP hydrolysis. This enzyme has a high affinity for both Ca(2+) and ATP, an optimum pH around 7.0, and - different from the vertebrate sarcoplasmic reticulum Ca(2+)-ATPases isoforms so far described - is activated 3- to 5-fold by K(+) but not by Li(+), at all temperatures, Ca(2+) and ATP concentrations tested. Calcium accumulation by the sea cucumber microsomes is inhibited by Mg/ATP concentrations >1 mM and the accumulated Ca(2+) is released to the medium when the ATP concentration is raised from 0.1 to 4.0 mM.

Adenosine Triphosphate↗
PubMed1995

Postnatal development of the calcium-dependency of glutamate release from rat cortical synaptosomes: comparison with 5-hydroxytryptamine release.

The ontogeny of the Ca(2+)-dependency of the depolarisation-induced release of preloaded [3H]glutamate and [3H]5-hydroxytryptamine [5-HT] from rat cortical synaptosomes was examined. 5-HT release was found to be exclusively Ca(2+)-dependent at all ages studied. In contrast, glutamate release only showed a significant Ca(2+)-dependent component from postnatal day 10 [PND 10] onwards. This correlated with the ontogeny of the glutamate accumulating activity of synaptic vesicles, a finding consistent with vesicles being the site of Ca(2+)-dependent release. The effectiveness of K(+)-depolarisation in inducing the Ca(2+)-dependent release of both transmitters increased during the early neonatal period, reaching near adult levels at PND20 for 5-HT and PND30 for glutamate.

Animals↗
PubMed1995

Epilepsy and children's social and psychological adjustment.

This research investigates the effects of epilepsy on the social and psychological adjustment of the children studied in the National Health Interview Survey of 1988. Analyses examine the effect of epilepsy on four measures of adjustment--home behavior problems, school behavior problems, depressed mood, and impulsiveness. For each outcome, we address five questions: (1) Do children with currently active epilepsy have poorer adjustment than children with inactive epilepsy? (2) Do children with epilepsy fare worse than other children? (3) Do demographic background and family structure moderate the apparent effects of epilepsy? (4) Do family processes mediate the apparent effects of epilepsy? and (5) Do cooccurring conditions produce the apparent effects of epilepsy? Generally, we find that: (1) Children with active and inactive epilepsy fare about equally; (2) Children with any history of epilepsy fare worse than children without epilepsy; (3) Demographic and family background moderate only a small part of epilepsy's effect; and (4) A combination of family processes and cooccurring conditions appears to produce epilepsy's apparent effects.

Adaptation, Psychological↗
PubMed1995

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Curriculum↗
PubMed1995

Oxidative stress is present in atherosclerotic peripheral arterial disease and further increased by diabetes mellitus.

OBJECTIVE: Atherosclerosis, which is associated with increased oxidative stress, may be widespread and more advanced in both complicated and uncomplicated diabetics than in healthy, age-matched non diabetic controls. The development of microangiopathy and the early development of microangiopathy and the early development of macroangiopathy which occurs in diabetes have unclear aetiology. We have previously shown an increase in the products of free radical activity in conventional atherosclerosis and this study has considered whether there us a further increase in this oxidative stress in diabetics. EXPERIMENTAL DESIGN: We measured oxidation by free radicals as lipid peroxides (malondialdehyde) and plasma thiols in 19 insulin dependent diabetic patients with retinopathy or microproteinuria but no clinical evidence of large vessel disease, 19 non diabetic patients with obstructive peripheral arterial disease confirmed by angiography and 19 asymptomatic matched healthy control subjects. PATIENTS: The patients were recruited from either the local diabetic or vascular surgery clinics. RESULTS: There were significant increases in oxidative stress in diabetic patients compared to control subjects with increased malondialdehyde 9.2 mumol/l (7.1-11.2) versus 7.65 mumol/l (5.4-9.6, p < 0.01 Mann Whitney test) and reduced plasma thiols 458 mumol/l (294-595) versus 506 mumol/l (433-589, p < 0.05). Those non-diabetic patients with obstructive peripheral arterial disease also had significantly increased malondialdehyde levels at 8.4 mumol/l (6.5-10.1, p < 0.05) and reduced plasma thiols 435 mumol/l (361-462, p < 0.05) compared to controls. The difference between patients with conventional atherosclerotic peripheral arterial disease and those with additional diabetes was significant for malondialdehyde (p < 0.05). CONCLUSIONS: These data confirm the oxidative stress that exists in atherosclerotic peripheral arterial disease and suggest that diabetic patients with microangiopathy have an increase in this oxidative stress which may contribute to their early development of atherosclerosis.

Adult↗
PubMed1994

Learning through experience: an evaluation of 'Hospital at Home'.

A Hospital at Home service for children was begun in April 1991 in a rural health authority in England. After 18 months a mainly qualitative evaluation has shown that the children and parents concerned have been very satisfied with the service and would choose the same type of care again. General practitioners and health visitors felt it was to the benefit of the whole family for the child to be at home while ill. They acknowledge a high standard of care received by the children but were critical of poor liaison between hospital and community and the loose arrangements for medical responsibility. These areas of strength and weakness are known to have been experienced in other districts establishing paediatric home care. Here, proposals have been made to improve the weaker aspects of the service as a direct response to the evaluation. These are now being put into practice, with one new appointee already in post. It is suggested that the proposals are applicable to other districts planning similar services and could help them to avoid the same pitfalls and establish a more credible service with good community integration from the start.

Child↗
PubMed1992

Phonological behavior in toddlers with slow expressive language development.

Toddlers with slow expressive language development were compared to normally speaking age-mates on three global measures of phonological behavior: the average level of complexity of their syllable structures, the number of different consonant phonemes produced, and the percentage of consonants correctly produced in intelligible utterances. The groups were found to differ significantly on all three variables. Further analyses were done, breaking the groups down into narrower age ranges. These comparisons also revealed differences between late-talking and normal youngsters. Detailed analyses of the range of phonemes and syllable structures produced, as well as the appearance of phoneme classes within syllable structures and positions, revealed that late talkers showed a delayed rather than a deviant pattern of phonological development. The implications of these findings for identifying and monitoring expressive delay in toddlers are discussed.

Articulation Disorders↗
PubMed1992

Portable chest radiography in intensive care: a comparison of computed and conventional radiography.

A prospective study was performed comparing computed and conventional radiography for the detection and visibility of cardiovascular devices in intensive care unit patients. Computed images were obtained using a commercially available 2K x 2K, 12-bit storage phosphor plate system. Image sets from 50 patients were assessed independently by three observers. A significant difference between the types of image was found for the detection of mediastinal drainage tubes and prosthetic valves. Computed images allowed greater confidence in the identification of courses and tips of lines. This advantage was most marked with edge-enhanced computed images.

Adult↗