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Biomedical subjects

P Sharpstone

Publications and source records attributed to P Sharpstone.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of the efficacy cost and complication rate of APD and CAPD as long-term outpatient treatments for renal failure.

We compared 10 patients treated with overnight APD in their homes with a parallel group of 30 patients having CAPD (Freeline II) over two years 1990 and 1991. Our aim was to discover if APD was an efficient and cost effective alternative to CAPD. The average amount of dialysate used per day in APD patients was 11 litres (range 9 to 14 litres) compared to 6.8 litres (range 6 to 10 litres) for CAPD. The average plasma creatinine was 920 umol/L, plasma urea of 21 mmol/L on APD and 825 umol/L and 24 mmol/L respectively on CAPD. In 1990 there were 2 incidences of peritonitis (2 in 1991) in the APD patients compared to 24 incidences (24 in 1991) in the CAPD patients with 6 recurrences (5 in 1991) and 19 exist site infections (24 in 1991). The average fluid costs plus disposables were comparable. However the cost of treating complications per patient for APD was for 1990 32 pounds (108 pounds in 1991) and for CAPD 832 pounds (1308 pounds in 1991). All the APD patients who had previously experienced CAPD preferred this treatment for its convenience and social acceptability. APD is a cost-effective alternative to CAPD and has advantages in some patients.

Adult↗
PubMed1984

A comparative study of dialysis techniques.

Comparative studies were performed on 19 patients who were dialysed initially for a mean of 25 h a week and then for a mean of 11.1 h a week over two 3-year periods. Clinical, biochemical, haematological and neurological valuations were performed, which showed no significant difference. As an adjunct to haemodialysis a perfusion system was added to 12 of these patients already stable on haemodialysis and estimations made of removal of middle molecular weight substances from plasma by a gel filtration method through a Sephadex column. The results of these various techniques are reported and the comparisons between haemodialysis, haemodialysis and ultrafiltration and haemodialysis, perfusion and ultrafiltration are given.

Blood↗
PubMed1979

Evaluation of ultra-short dialysis.

A study was carried out to compare the effects of three dialysis regimens of different durations. Nineteen patients dialysed over 1975--7 for an average of only 11.2 hours per week were compared with nine dialysed for 24 hours per week (1974--6) and 10 dialysed for 27 hours (1971--3). Clinical, biochemical, and haematological results showed that the short dialysis regimen was as effective as the longer regimens, except that patients had to take a phosphate binder regularly, and that it was considerably cheaper. Short dialysis has social and economic benefits, since patients have more free time and more patients can be treated with the same number of staff and dialysis stations. As in many areas there is a shortage of places for patients needing dialysis, a short regimen is recommended.

Evaluation Studies as Topic↗
PubMed1977

Haemoperfusion with R-004 Amberlite resin for treating acute poisoning.

Eleven patients who had taken overdoses of barbiturates, glutethimide, tricyclic antidepressants, and chloroquine were treated by resin haemoperfusion using an R-004 haemoperfusion cartridge containing XAD-4 resin. All but one patient showed rapid clinical recovery and the drugs were cleared rapidly from the plasma. There were few complications. Resin haemoperfusion is more effective than dialysis and other perfusion methods, especially in poisoning with tricyclic antidepressants. Although haemoperfusion is expensive, it greatly reduces the length of the patient's stay in an intensive care unit and hence is cost-effective.

Acute Disease↗
PubMed1976

Transplantation in mesangiocapillary glomerulonephritis with intramembranous dense "deposits": recurrence of disease.

Six patients with mesangiocapillary glomerulonephritis and intramembranous dense "deposits" developed terminal renal failure and were transplanted, three from living and three from cadaver donors. Eight renal biopsy specimens were obtained from five of the grafts, from 1 to 26 months following transplantation. All six biopsy specimens taken later than seven months following the graft showed recurrence of dense intramembranous "deposits" in the basement membranes of glomeruli, and of Bowman's capsule and tubular basement in five. Recurrence of "deposits" was associated with deposition of C3 on immunofluorescent study in all but one specimen; in addition, IgM was found in two specimens, but IgG and early complement components were absent. Only two patients, however, showed glomerular proliferation associated with profuse proteinuria. In the other subjects the recurrence of the "deposit" was not associated with clinical findings. Graft loss, which occurred in two patients, was predominantly from rejection.

Adult↗
PubMed1972

Screening for transmission of hepatitis within a liver unit.

Detailed screening of the patients and staff in a unit specializing in liver disease was carried out over a year to ascertain whether transmission of the serum hepatitis virus was occurring and whether the situation was comparable in any way to that found in a Renal Haemodialysis Unit. Of the 154 patients with liver disease tested on admission, 6% were found to have Australia antigen in the serum and throughout the year there were rarely less than two patients in the ward at any one time with positive serum. No instances of clinical hepatitis were detected in the other patients following their stay in the ward or in their attendant medical, nursing and lay staff. Six staff members were found to have Australia antigen in their serum. In four of these, all nurses, it was present in the first sample tested and so the infection may have been acquired earlier. Temporary elevations in both plasma bilirubin and serum aspartate aminotransferase levels were found in another five staff members whose serum was negative for Australia antigen and who clinically were well. In a further eight and apparently healthy staff members, an isolated but persistent elevation of the plasma bilirubin was noted. In both groups these changes could represent the spread of subclinical infectious hepatitis and it is recommended that in units dealing with ;liver patients' not only should considerable care be taken during diagnostic and therapeutic procedures but the medical and nursing staff should be screened at regular intervals.

Aspartate Aminotransferases↗
PubMed1971

Halothane hepatitis--a preventable disease?

Eleven patients with acute hepatitis following multiple anaesthetics with halothane have been seen at two hospitals during the last four years. Six had massive hepatic necrosis and died. Unexplained fever occurred in nine of the patients; two of these and one other had had previous episodes of jaundice after halothane anaesthesia. Thus, in ten patients the disease could have been avoided.

Acute Disease↗