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Biomedical subjects

R C Campbell

Publications and source records attributed to R C Campbell.

At least 19 recordsLinked to original sources
PubMed1996

Patient maintained alfentanil target-controlled infusion for analgesia during extracorporeal shock wave lithotripsy.

PURPOSE: The purpose of this study was to determine whether alfentanil given by a pharmacokinetic-based target controlled infusion (TCI) system under patient control is a suitable analgesic technique for extracorporeal shock wave lithotripsy (ESWL). METHODS: The design was an open, unblinded, noncomparative, prospective study. Forty outpatients undergoing ESWL were given patient maintained alfentanil TCI. Pain, nausea and sedation were assessed every 300 shocks. Vital signs were recorded every three minutes, pulse oximetry and electrocardiography being monitored continuously. Blood alfentanil concentration was measured for comparison with the predicted value. RESULTS: Alfentanil consumption (median 1.34 mg, range 0.8-3.6) and measured levels following treatment (median 60 ng.ml-1, range 15.6-134.3) varied widely. The precision of the TCI system and the median prediction error (bias) were both 49%. The median of pain scores recorded during treatment was 4 (range 0-8). The median respiration rate was 15 bpm (range 10-23), three patients required oxygen (SaO2 < 92%) cardiovascular measurements were stable and there was no excessive sedation. The incidence of nausea was 15%. All patients were ready for hospital discharge within one hour following treatment. CONCLUSIONS: Patient maintained alfentanil TCI provides good analgesia for ESWL in the majority of patients with little sedation. Respiratory depression is uncommon but supplementary oxygen should be given prophylactically. There is considerable interindividual variation in demand for alfentanil indicating the usefulness of the patient control method. The TCI system underestimated alfentanil blood concentrations but this did not affect its clinical usefulness.

Adult↗
PubMed1995

Analysis of tasks performed by certified ophthalmic medical personnel.

BACKGROUND: Proper delegation of routine tasks to trained personnel might increase cost efficiency by freeing the physician to concentrate on the medical and judgmental aspects of patient care. In ophthalmology, certified ophthalmic medical personnel (OMP) assist the physician by performing many tasks. The Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) selected 77 specific tasks performed by OMP and conducted a task analysis survey to determine the importance of these tasks to ophthalmic practice. Individual and practice demographics were surveyed simultaneously to compare the effect of individual and practice differences on task importance. METHODS: Certified OMP and their sponsoring ophthalmologists were surveyed independently. Each group was asked to rate the importance of the 77 selected tasks using a five-point scale of importance. Importance ratings from each survey group were used independently to generate a rank order listing of tasks. RESULTS: Only 3 of the 77 tasks differed significantly in importance between ophthalmologists and OMP. The same five tasks were rated as most important by both groups, whereas the second group of the five most important tasks varied only by +/-4. CONCLUSIONS: The similarity in task importance rankings indicates a common perception between ophthalmologists and OMP concerning the role played by OMP in ophthalmic eye care.

Allied Health Personnel↗
PubMed1995

Rotation fasciocutaneous flap repair of lower limb defects.

The rotation design was applied to fasciocutaneous flap repair of lower limb defects to produce a functional and aesthetic result superior to that obtained by the transposition design. A prospective, consecutive series of 21 patients is reported, 14 males and 7 females, ranging in age from 17 to 81 years (mean 43 years). The primary defects, 8 traumatic, 12 cutaneous malignancy excisions, and 1 radionecrotic ulcer, ranged in size from 3.5 x 3 cm to 10 x 8 cm (mean 6.6 x 5 cm). The rotation fasciocutaneous flap base ranged from 5 to 25 cm (mean 12 cm), and the radius ranged from 4.5 to 20 cm (mean 9 cm). The inclusion of a back-cut at the flap base permitted direct donor-site closure in all but one patient, obviating the need for a split-thickness skin graft and avoiding the otherwise inevitable significant contour defect. Postoperative bed rest ranged from 3 to 7 days (mean 5 days). Three minor and no major complications occurred, and there was complete survival of all flaps. The results in this series indicate a role for the rotation fasciocutaneous flap in the management of traumatic and excisional defects in the lower limb. It has proved reliable, gives good aesthetic results, and reduces treatment costs.

Adolescent↗
PubMed1994

Ondansetron for prevention of postoperative nausea and vomiting following minor oral surgery: a double-blind randomized study.

The efficacy and safety of ondansetron in preventing postoperative nausea and vomiting following minor oral surgery was evaluated in a prospective randomized double-blind study. Of a total of seventy-seven patients, randomly 38 had 4 mg of ondansetron and 39 had normal saline as placebo intravenously immediately prior to induction of anaesthesia. A standard general anaesthetic with thiopentone, suxamethonium, fentanyl, nitrous oxide and isoflurane was employed. Postoperatively nausea was assessed verbally and on a visual analog scale at 1, 4 and 24 hours from the time of awakening. Episodes of vomiting were recorded. Eight patients (21.1%) in the ondansetron group compared to 19 (48.7%) in the placebo group had nausea (P < 0.05) and 1 (2.6%) in the ondansetron group compared with 9 (23.1%) in the placebo group vomited (P < 0.05). Patients who vomited twice or more and the number who required a rescue antiemetic were significantly fewer in the ondansetron group (P < 0.05). Cardiovascular parameters were stable and showed no significant difference in the two groups. There were no significant adverse effects that could be directly attributable to ondansetron.

Adolescent↗
PubMed1989

A comparison of the speech results after early and delayed hard palate closure; a preliminary report.

An "early surgery" and a "delayed surgery" group of cleft palate cases' speech has been recorded and judged in two ways. Initially four different listener groups gave their "impressions" of the speech samples followed by the two speech therapist groups assessing specific aspects of speech. For analytical purposes the delayed surgery group was divided into "repaired" and "unrepaired" hard palate groups. The general conclusion was that delaying hard palate surgery may be responsible for the persistence of noticeable abnormal speech patterns until after hard palate repair. However, despite their higher frequency in the "delayed unrepaired" group, errors of tongue placement and airstream direction were common to all groups. The relative influence of maturation, surgery and speech therapy on speech progress has not been considered. It is suggested that a final review of oro-facial growth and speech as each subject reaches 17 years old would give more definitive results. Then the subjects might discuss the relative importance of facial appearance and speech results.

Child↗
PubMed1989

Emergency interhospital transport of the major trauma patient: air versus ground.

A prospective cohort study was undertaken to determine the effectiveness of air transport for major trauma patients when transferred to a trauma center from a rural Emergency Department. The null hypothesis evaluated was that there was no difference in outcome for patients transported by helicopter EMS (HEMS) when compared to patients transported by conventional ground EMS. The dependent variable of outcome was studied using the TRISS method in a group of 872 consecutive trauma patients admitted after long-distance transfer. Of this group, 110 patients transported by ground and 103 patients transported by air met the inclusion criteria. The ground EMS group had a mean TS of 14.4, a mean ISS of 25.2, and a mean Ps of 0.867. TRISS predicted 15 deaths and there were 15 actual deaths. The HEMS group had a mean TS of 11.4, a mean ISS of 34.9, and a mean Ps of 0.587. There were 46 predicted deaths and 33 actual deaths. This 25.4% reduction in predicted mortality was significant (Z = 3.95; p less than 0.001). Stratification of patients into Probability of Survival (Ps) bins allowed for outcome evaluation of groups with similar levels of injury severity. The benefit of HEMS transport was seen only in the patients with a probability of survival of less than 90%. We conclude that the major trauma patients transported by HEMS had a better outcome than those transported by ground EMS. The benefit seen with HEMS was directly related to injury severity and was demonstrated only in the patients with a Ps of less than 0.90.

Adult↗
PubMed1988

Quantitative rose bengal staining technique for external ocular diseases.

A new technique for quantitative assessment of rose bengal staining in ocular surface disorders is described. The globe is divided into 16 quadrants which represent clinically important regions of the eye. Each quadrant is graded numerically for intensity and area of rose bengal staining. This simple grading system facilitates mathematical study and computer analysis of ocular surface disease.

Diagnosis, Computer-Assisted↗
PubMed1988

Acanthamoeba-contaminated hydrogel contact lenses. Susceptibility to disinfection.

Acanthamoeba keratitis has frequently been associated with contact lens use. In this study, contaminated hydrogel contact lenses of patients were subjected to disinfection by thermal hydrogen peroxide and chemical (quaternary ammonium) systems. New hydrogel contact lenses contaminated by incubation on Acanthamoeba polyphaga plates were similarly subjected to the disinfection systems described above. Thermal disinfection was universally effective in eradicating acanthamoeba, whereas hydrogen peroxide and quaternary ammonium disinfection were ineffective. Scanning electron microscope photomicrographs suggest that acanthamoeba may adhere to surfaces of hydrogel contact lenses. These findings have significant implications for soft contact lens users.

Acanthamoeba↗
PubMed1987

Extended use of the Mustardé dancing man procedure.

Webs other than epicanthal folds can be corrected by the Mustardé "dancing man" procedure. A series of 20 patients is presented in whom this method has been used to correct either minor degrees of congenital syndactyly or burn scar contractures in fingers.

Adolescent↗
PubMed1986

Real-time acquisition and data analysis of skeletal muscle contraction in a multi-user environment.

A data acquisition system is described which acquires data from contracting skeletal muscle. The system is designed to run in a multi-user environment while acquiring contractile data in real-time. Time dedicated solely to laboratory experiments is thus eliminated. A menu-driver is included to allow users to enter experimental commands with or without command arguments. Error monitoring functions prevent operator errors from causing data loss. Data storage in both ASCII and binary formats maximizes file flexibility, readability and accessibility. Finally, an on-line tutorial and help facility is provided for user training. The system developed is applicable to any experimental environment involving data acquisition, storage and analysis.

Animals↗
PubMed1984

Brain stem death.

Explore the source record for details and available documents.

Brain Death↗
PubMed1984

Combined barium meal and cholecystogram--an analysis of 1,444 patients.

Since many dyspeptic patients are still investigated initially by radiology, a policy was initiated whereby all such patients were directly referred for combined simultaneous double-contrast barium meal and cholecystogram. This policy was aimed at reducing patient visits to hospital and increasing diagnostic yield. The results of 1,444 combined procedures are presented. Of these, 310 (25.5%) had a positive finding on barium meal only; 275 (19%) were positive for cholecystogram only; 117 (8.1%) were positive for both examinations; 742 (51.4%) were negative for both examinations. Of all the patients (427) who had a positive finding on barium meal, 27.4% (117) also had a positive finding on cholecystogram. Of all the patients (392) with a positive cholecystogram, 29.8% (117) also had a positive barium meal. Diagnostic yield rose considerably with patient age. It was found that simultaneous barium meal and cholecystogram presented no serious technical difficulties. It was concluded that in patients over 40 years old, this policy improved diagnostic yield as many patients had both gall bladder and upper gastrointestinal pathology. In all other patients this policy markedly reduced the number of hospital visits. Combined simultaneous double-contrast barium meal and cholecystogram is therefore recommended for hospitals which used radiology for the first line investigation of dyspepsia. Also, the general principle of examination of both gall bladder and upper gastrointestinal tract is pertinent where other first line investigations are used.

Barium↗