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Biomedical subjects

P Yates

Publications and source records attributed to P Yates.

At least 55 records · Page 3Linked to original sources

Infection associated with the use of allograft bone from the north east Scotland Bone Bank.

To assess the rate of infection associated with use of banked allograft bone, the case records of patients receiving banked bone over one year were reviewed. The notes of patients undergoing autografting procedures during the same period were reviewed as controls. Eighty-two patients received 98 banked allograft femoral heads and there were 10 proven infections (12.2%). Fifty-seven patients had autograft procedures, with two cases of infection (3.5%). The results of bacteriological surveillance of grafts harvested during the same period were analysed; there was a discard rate due to bacterial contamination of 1.3%, and two patients received three contaminated grafts, one of these patients suffering a postoperative infection. The failure rate of procedures was 50% where there was postoperative infection and 4.2% where there was none. Procedures using banked allograft bone have a substantial infection risk, and this is associated with a much higher rate of failure of the procedure. Prospective audit of allograft use should be applied to reduce this risk.

Bone Banks↗

Peer mentorship in clinical education: outcomes of a pilot programme for first year students.

Identifying effective strategies for promoting learning in the clinical setting continues to pose challenges for nurse educators. The aim of the present paper is to examine the potential that peer mentorship may have in helping nursing students to improve clinical learning outcomes. An example of a peer mentorship programme for nursing students undertaking their first clinical practicum is described, and preliminary findings from an evaluation of this pilot programme are presented. The results suggest that peer mentorship may be of some benefit to students, particularly in relation to reducing anxiety and improving confidence with clinical practice experiences, and is therefore a strategy which is worthy of further investigation.

Clinical Competence↗

A comparison of surgery and radiotherapy in the management of post-cricoid carcinoma.

One hundred and forty-three patients with post-cricoid squamous cell carcinoma are described. Twenty-nine patients (20%) underwent pharyngolaryngoesophagectomy with gastric transposition. Forty-four patients (31%) were treated with radical radiotherapy and 70 (49%) had palliative therapy. Kaplan Meier 5-year survival following surgery was 45% and radiotherapy was 23%. The presence of nodal disease at presentation was the most significant prognostic factor. The 5-year survival of patients undergoing surgery with no palpable lymph node spread at presentation was 63% which compared with 25% following radiotherapy. This difference was statistically significant (P = 0.0153, Logrank test stratified by nodal status). Patients with palpable metastatic nodal spread at presentation had 5-year survivals of 10% and 0% in the surgical and radiotherapy groups respectively. This study demonstrates that patients with post-cricoid carcinoma who present without palpable lymph node spread have a significant improved 5-year survival following surgery when compared with radiotherapy.

Adult↗

Hypertensive effect of tissue kallikrein in rostral ventrolateral medulla is mediated by brain kinins.

Microinjections of kallikrein, 0.5-2.0 units, in the rostral ventrolateral medulla (RVLM) of brain increased arterial pressure in Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). This effect was significantly greater in SHR. The kinin B2 receptor antagonist icatibant (Hoe 140) blocked the hypertensive responses to kallikrein in both groups and caused greater hypotension and bradycardia in SHR. These results suggest that local kinins in the RVLM act to alter cardiovascular function and may be involved in the maintenance of blood pressure in the SHR.

Animals↗

Pain: the views of elderly people living in long-term residential care settings.

While an individual's beliefs and attitudes have long been considered important factors in how people respond to pain, few studies have attempted to provide in-depth descriptions of the nature of such pain beliefs and attitudes. The aim of this research was to investigate the views of pain and pain management practices held by elderly people living in long-term residential care settings. Ten 60-90 minute focus group interviews, each involving around five elderly people, were conducted in four large, long-term residential care settings in Brisbane, Australia. Categories of beliefs and attitudes regarding pain were identified following analysis of the verbatim transcripts of these interviews. Findings suggest that many elderly people living in long-term residential care settings may have become resigned to pain, that they are ambivalent about the benefit of any action for their pain and that they may be reluctant to express their pain. Implications of these beliefs and attitudes are discussed.

Aged↗

Genetic analysis in a female manifesting haemophilia B.

A 5 year old female child presented with a psoas haematoma as the first manifestation of haemophilia B. Molecular genetic studies were performed to investigate the inheritance of the disorder and the mechanisms by which females may express the haemophilia B phenotype are discussed.

Child, Preschool↗

Rostral ventrolateral medulla as a site for the central hypertensive action of kinins.

In the present study, we focused on the rostral ventrolateral medulla as a possible site of action for kinins because of its established importance in the central regulation of the cardiovascular system. Unilateral microinjections of 100 pmol to 4 nmol bradykinin into the rostral ventrolateral medulla produced dose-dependent increases in mean arterial pressure in Sprague-Dawley (SD) rats, Wistar-Kyoto (WKY) rats, and spontaneously hypertensive rats (SHR). The dose-response curves for the hypertensive responses to bradykinin in SD and WKY rats were essentially the same, whereas the hypertensive effect of bradykinin was significantly greater in SHR than in either SD or WKY rats. The kinin B2 receptor antagonists D-Arg0,Hyp3,Thi5,8,D-Phe7-bradykinin and Hoe 140 inhibited the hypertensive responses to bradykinin in both SHR and WKY rats. The hypertensive effect of 500 pmol bradykinin was reduced 65 +/- 5% after 4 nmol of D-Arg0, Hyp3,Thi5,8,D-Phe7-bradykinin in SHR and 50 +/- 16% in WKY rats, whereas 1 nmol Hoe 140 abolished the hypertensive effect of 500 pmol bradykinin injected into the rostral ventrolateral medulla. Microinjection of D-Arg0,Hyp3,Thi5,8,D-Phe7-bradykinin produced prolonged dose-dependent decreases in mean arterial pressure and heart rate. Blood pressure decreased 70 +/- 8 mm Hg and heart rate decreased 49 +/- 9 beats per minute in SHR, whereas in WKY rats mean arterial pressure decreased 12 +/- 4 mm Hg, with no change in heart rate. In a similar fashion, Hoe 140 caused a 51 +/- 7 and 17 +/- 3 mm Hg reduction in blood pressure in SHR and WKY rats, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The haemagglutinins of influenza A (H1N1) viruses in the 'O' or 'D' phases exhibit biological and antigenic differences.

Influenza A (H1N1) viruses when initially isolated in mammalian cell cultures (MDCK cells) had different agglutination reactions with chicken and guinea-pig erythrocytes compared to the same viruses after passage. On first isolation the virus HA resembled the 'O' phase viruses described originally by Burnet and Bull and agglutinated mammalian but not avian erythrocytes. After passage, the virus HA resembled a classical 'D' phase virus and agglutinated both avian and mammalian erythrocytes. Monoclonal and polyclonal antisera detected antigenic differences between the HAs of the viruses in the 'O' and 'D' phases. The 'O' phase virus HA reacted preferentially with antibodies in post infection human antisera. Viruses in the 'O' phase replicated poorly in the allantoic cavity of embryonated hens' eggs whilst 'D' phase virus replicated in both MDCK cells and in embryonated hens' eggs. At least three distinguishable subpopulations of influenza A (H1N1) viruses may co-exist in clinical throat swab material, including viruses possessing HAs in the 'O' and 'D' phases and other 'D' phase viruses cultivable in embryonated hens' eggs but antigenically distinguishable from the corresponding 'D' phase virus in MDCK cells.

Adult↗

Towards a reconceptualization of hope for patients with a diagnosis of cancer.

Recent years have seen increased attention given to examining the phenomenon of hope in patients with metastatic cancer. One of the results of this activity has been a greater appreciation of the significance of hope for the dying patient. However, there are many questions about the experience of hope and its impact on the lives of patients with cancer which remain to be answered. This paper discusses how hope is currently conceptualized in the nursing literature, and considers the implications that this conceptualization has for how we care for cancer patients. Some alternative ways of looking at the experience and the impact of hope are also discussed.

Attitude to Death↗

Evidence for Chlamydia pneumoniae of non-human origin.

This paper describes the characterization and taxonomic status of N16, a chlamydial isolate from the respiratory tract of a horse. N16 contains plasmid DNA, has normal elementary body morphology and its inclusions do not stain with iodine. Its major outer-membrane protein (MOMP) gene was completely sequenced and compared with the MOMP genes of Chlamydia pneumoniae, C. psittaci, C. trachomatis and C. pecorum. This analysis revealed that N16 is closely related to the TWAR strain of C. pneumoniae (94.5% and 94.4% DNA homology with TWAR isolates IOL-207 and AR-39 respectively). By comparison, N16 shows between 72.1% and 73.7% DNA homology with C. psittaci strains, 70.9% and 71.1% homology with C. pecorum strains LW613 and 1710S and 69.2% homology with C. trachomatis serotype E. The MOMP gene of N16 shares 93.8% DNA homology with the MOMP gene of a chlamydial isolate KC from the conjunctiva of a koala. Monoclonal antibodies raised to C. pneumoniae IOL-207 and shown to be C. pneumoniae-specific confirmed that N16 was more closely related to C. pneumoniae than to C. psittaci. Thus DNA homology and monoclonal antibody data both suggest that horse chlamydiae, as exemplified by N16, form a new second strain of C. pneumoniae. This species is probably more widespread and diverse than the current literature would suggest.

Amino Acid Sequence↗

Heparin skin necrosis--an important indicator of potentially fatal heparin hypersensitivity.

Skin necrosis at injection sites is a rare complication of heparin therapy. In this report, we describe only the second case of the even rarer complication of skin necrosis occurring at sites distant to those of subcutaneous heparin injections. The patient had also suffered systemic thrombotic events due to heparin-dependent platelet activation prior to the development of the skin necrosis, although these had not been recognized as such at the time. The development of heparin-induced skin necrosis should result in the immediate cessation of heparin therapy in order to prevent potentially fatal thrombotic events. This is in contrast to warfarin-induced skin necrosis, where therapy may be continued or restarted at a lower dose.

Aged↗

Treatment of haemophilic flexion deformities using the Flowtron intermittent compression system.

We have studied prospectively the use of the Flowtron intermittent compression system for the home treatment of fixed flexion deformities of elbows and knees, resulting from chronic haemophilic arthropathy. A total of 16 elbows (six unilateral and five bilateral), and 10 knees (six unilateral and two bilateral) in 11 patients were studied. Treatment caused a decrease in flexion contracture of the elbows from 41 +/- 3 degrees to 28 +/- 3 degrees (P < 0.001), an improvement of 32%. The knees showed a decrease in flexion contracture from 31 +/- 3 degrees to 20 +/- 2 degrees (P < 0.0001), an improvement of 35%. Prophylactic factor replacement was not used during the study and there were no bleeds attributable to the treatment. We conclude that the use of the Flowtron in home treatment of fixed flexion deformities in haemophiliac patients is safe, effective and cheap.

Chronic Disease↗

Red cell autoantibody production by colonic mononuclear cells from a patient with ulcerative colitis and autoimmune haemolytic anaemia.

We have studied the ability of mononuclear cells extracted from the colon (CMC), draining lymph nodes (LNMC), peripheral blood (PBMC) and spleen (SMC) of a patient with ulcerative colitis and severe autoimmune haemolytic anemia to produce red cell autoantibodies. The LNMC, PBMC and SMC secreted immunoglobulin in vitro in pokeweed mitogen culture but not spontaneously. They also produced immunoglobulin when transferred to severe combined immunodeficient (SCID) mice but no anti-red cell activity was demonstrable. In contrast, in vitro cultures of CMC produced immunoglobulin spontaneously, showing the presence of activated B-cells and plasma cells, but anti-red cell activity could not be demonstrated. However, CMC transferred to SCID mice were able to produce IgG with anti-red cell activity. These results concur with clinical observations suggesting that the colon is the source of red cell autoantibodies in these patients.

Adult↗

A mainframe interfacing computer management system for the control of oral anticoagulant therapy.

A unique computerized management system has been used to control the anticoagulation of over 400 patients at a large teaching hospital for the last eighteen months. The system is located on the main pathology computer which can be interfaced with the patient administration system (PAS). This enables files in the anticoagulant program to be linked with files in the PAS and files in the haematology database. This system has many advantages over a stand-alone microcomputer system and will form the basis for the next generation of computerized anticoagulant management systems.

Administration, Oral↗