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Biomedical subjects

R Belsey

Publications and source records attributed to R Belsey.

At least 19 recordsLinked to original sources

Long-term follow-up of children with colon and gastric tube interposition for esophageal atresia.

BACKGROUND: There are two major methods of esophageal substitution for children born with long-gap esophageal atresia. This study was undertaken to see whether one method of substitution emerged as clearly superior to the other. METHODS: Twenty-four UK children who received a colon transposition for esophageal atresia were compared with 15 US children with esophageal atresia who received a gastric tube. The charts of all patients were reviewed. Follow-up data were obtained by questionnaire, and more than 80% of patients were personally evaluated at follow-up clinics. RESULTS: At follow-up US children were 3 1/2 to 18 1/2 years of age; UK children were 7 1/2 to 19 years of age. Most of the children fell at or below the 10th percentile for height and weight, reflecting the tendency for prematurity in infants with esophageal atresia. One half of the children needed to eat slowly and to avoid certain meats. Dysphagia was rare. Older children ate socially with their friends without embarrassment. Early complications were technical; there were few late complications, and no difference was apparent between the two groups. CONCLUSIONS: In subjects who were growing, no difference was noted between the two methods of substitution as far as nutrition, growth, patient acceptability, or complications, early or late. Both groups functioned well and appeared to improve with the passage of time.

Anastomosis, Surgical↗

Managing bedside glucose testing in the hospital.

The scope and magnitude of bedside testing by personnel without formal laboratory training have recently increased. There has been some question about the reliability of bedside test results produced by nurses, physicians, and other ward staff that are used in clinical decisions. Glucose testing is currently the most widely performed bedside test. Because of the likelihood that the use of bedside testing will increase in the future, this article discusses various issues concerning bedside glucose analysis, including the scope of such testing, staff responsibilities, training and supervision, testing frequency, work flow and result reporting, and the reliability of bedside glucose results, in three institutions. We also suggest an approach to bedside testing quality management.

Blood Glucose↗

Evaluation of a laboratory system intended for use in physicians' offices. I. Reliability of results produced by trained laboratory technologists.

The accuracy and precision of the Kodak DT-60 tabletop chemistry analyzer were evaluated in the clinical laboratory at the Portland (Ore) Veterans Administration Medical Center, and its operational throughout and cost were estimated. All DT-60 tests that were studied exhibited clinically acceptable precision and, except for the glucose method, accuracy. The accuracy of the glucose method was indeterminate with the available data. Throughput under field conditions was found to be less than half of the manufacturer's claim. The estimated supply cost per test could vary from $1.20 to $5.49 per test, depending on the test type and the number of assays expected to be performed daily. The instrument seems to be accurate, precise, and generally reliable when operated by professional medical technologists.

Autoanalysis↗

Evaluation of a laboratory system intended for use in physicians' offices. II. Reliability of results produced by health care workers without formal or professional laboratory training.

The Kodak DT-60 tabletop chemistry analyzer was evaluated with standardized protocols to determine the system's precision and accuracy when operated by four volunteers (a secretary, a licensed practical nurse, and two family medicine residents) in a simulated office laboratory. The variability of the results was found to be significantly greater than the variability of results produced by medical technologists who analyzed the same samples during the same study period with another DT-60 placed in the hospital laboratory. The source(s) of increased variance needs to be identified so the system can be modified or new control procedures can be developed to ensure the reliability of results used in patient care. Prospective purchasers, manufacturers, and patients need this kind of objective information about the reliability of results produced by systems intended for use in physicians' office laboratories.

Autoanalysis↗