PubMed Health⌕ Search

Biomedical subjects

R Allison

Publications and source records attributed to R Allison.

28 records · Page 2Linked to original sources
PubMed1992

Audit of oral examinations in psychiatry.

This study describes a simple set of statistical parameters for assessing the reliability and validity of oral examinations (OE). Traditional feedback to examiners tends to categorize them as 'hawks' or 'doves' on the basis of whether their personal mean mark is above or below the group mean. Our study shows that the mean OE mark on its own is not a good measure of examiner performance. We suggest that inter-rater reliability between examiner pairs is a more satisfactory indicator of reliability and face validity. The correlation between the OE marks given by an examiner and the student's subtotal from written parts of the exam (SUBTOT) is suggested as a useful indicator of OE validity. These measures, as applied to our own student exam results, suggest that our OE examiners are performing at an acceptable standard of agreement (Cohen's Kappa for pass/fail 0.74, p < 0.0001), and support the use of the OE as a method of student assessment.

Clinical Clerkship↗
PubMed1990

Regeneration of a functional RNA virus genome by recombination between deletion mutants and requirement for cowpea chlorotic mottle virus 3a and coat genes for systemic infection.

RNAs 1 and 2 of the tripartite cowpea chlorotic mottle virus (CCMV) genome are sufficient for RNA replication in protoplasts, whereas systemic infection of cowpea plants additionally requires RNA3, which encodes the 3a noncapsid protein and coat protein. By using biologically active CCMV cDNA clones, we find that deletions in either RNA3 gene block systemic infection. Thus, though some plant RNA viruses are able to spread systemically without encapsidation, both the coat and 3a genes are required for systemic infection of cowpeas by CCMV. When plants were coinoculated with CCMV RNAs 1 and 2 and both the 3a and coat deletion mutants of RNA3, 30-60% rapidly developed systemic infection. Progeny RNA recovered from systemically infected leaves in such infections contained neither of the starting deletion mutants but rather a single full-length RNA3 component with both genes intact. Nucleotide substitutions introduced into the coat protein deletion mutant as an artificial marker were recovered in the full-length progeny RNA, confirming its recombinant nature. Intermolecular RNA recombination in planta can, therefore, rescue a complete infectious genome from coinoculated mutants independently disabled for systemic spread. These results have implications for the repair of defective genomes produced by frequent natural replication errors, the possible emergence of newly adapted RNA viruses upon coinfection of new hosts, and further studies of RNA virus recombination.

Capsid↗
PubMed1975

Skin testing in genitourinary carcinoma: 2-year followup.

Compound 2,4 dinitrofluorobenzene was used to sensitize 115 patients with genitourinary cancer to test their ability to be immunized with a newly encountered antigen. In general, patients in whom a cutaneous hypersensitivity response did not develop were more likely to have advanced stage tumors than patients whose immunocompetence was intact. A 2 to 3-year followup showed that patients with impaired cell-mediated immunity were more likely to undergo disease advancement than patients of similar stage whose immunity was normal. Unfortunately, these results cannot be extrapolated for application to a given patient.

Adolescent↗
PubMedDate not supplied

Postoperative fever in pediatric orthopaedic patients.

Fever in hospitalized patients causes a great deal of concern. Its value in predicting complications, however, is questionable. For this reason, a retrospective analysis was performed on 200 records of children's orthopaedic admissions. Demographic data, would status, fever work-up, and daily peak temperatures were recorded. There were 174 patients who underwent surgical procedures and 26 patients who did not have surgery. Seventy-three percent (127/174) of the surgical patients had postoperative fever [temperature > 38 degrees C (100.4 degrees F)] Twenty-seven percent of the nonsurgical patients had fever. There were only three acute complications--one pneumonia and two wound infections. Complications were easily diagnosed by clinical means. In postoperative patients, the accuracy in predicting complications was 28%. Postoperative fever is a poor predictor of complications, and, therefore, should not delay discharge or indicate investigation for sepsis.

Child↗
PubMedDate not supplied

The extension of labour epidural analgesia for Caesarean section.

Seven hundred and twenty-two patients who received epidural analgesia during labour were delivered by Caesarean section. The block was extended in 554 patients to provide analgesia for surgery. In twenty-one cases incomplete analgesia necessitated general anaesthesia. The main complications were maternal hypotension (15.9%) and vomiting (17.1%). Almost all patients expressed enthusiasm for the technique.

Anesthesia, Epidural↗
PubMedDate not supplied

A phase II/III clinical study of tin ethyl etiopurpurin (Purlytin)-induced photodynamic therapy for the treatment of recurrent cutaneous metastatic breast cancer.

BACKGROUND: Chest wall recurrence of breast cancer after mastectomy, radiation therapy, and chemotherapy poses a therapeutic dilemma. Further intervention with any or all of these modalities is often futile and morbid. Left untreated, severe pain, infection, and suffering occur. OBJECTIVE: To ascertain whether photodynamic therapy may present a palliative option for these individuals. METHODS: A total of 86 lesions (2.4-cm mean diameter) were treated on eight patients who had biopsy-proven chest wall recurrence despite surgery, chemotherapy, and radiation therapy. Each patient underwent a single photodynamic therapy session in which 1.2 mg/kg of the drug tin ethyl etiopurpurin (Purlytin) was injected and followed 24 hours later by laser light treatment at 660 +/- 3 nm (at 150 mW/cm2 for a total light dose of 200 J/cm2). RESULTS: With a minimum 6-month follow-up, the objective response rates after photodynamic therapy were complete response, 92%; partial response, 8%; and no response, 0%. Lesions less than 0.5 cm had a 100% complete response. Morbidity was minimal with no systemic toxicity. One patient had a wound infection that responded to oral antibiotics. No photosensitivity reactions were reported in this set of patients. Posttreatment pain was reported and could be treated with medication and application of cold compresses. CONCLUSIONS: Photodynamic therapy offers an excellent local control rate of chest wall recurrence with minimal morbidity after multimodality treatment failure. The treatment is given in a single session and on an outpatient basis. In patients who may register a partial response or have recurrence or the incidence of further chest wall nodules after photodynamic therapy, the treatment is repeatable.

Adult↗