PubMed Health⌕ Search

Biomedical subjects

R Mullins

Publications and source records attributed to R Mullins.

At least 19 recordsLinked to original sources
PubMed1997

Prevalence of workplace smoking bans in Victoria.

Restrictions on smoking in the Victorian workplace have been measured since 1988. This paper investigates whether the trend of increasing prevalence of total bans found between 1988 and 1992 has continued. Estimates are based on workers' reports of the restrictions on smoking that apply at their workplaces. For indoor workers a total ban on smoking restrictions in the workplace has increased from 58% in 1992 to 66% in 1995. White collar workers continue to enjoy a higher rate of protection than blue collar workers. Factories, warehouses, hotels and restaurants are the worksites least likely to have restrictions. Bans result in considerable exiled smoking: half the smokers reported going out to smoke during working hours on their last work day.

Data Collection↗
PubMed1997

Laparoscopic pericardial window.

The creation of a drainage orifice in the pericardium for the release of an accumulated effusion has been proven to be an effective means to eliminate the physiologic effects of a cardiac tamponade. Numerous surgical approaches have been used to create an opening in the pericardium for this purpose. Thoracic and thoracoscopic approaches have been found to produce a fair amount of morbidity by further compromising an already compromised cardiopulmonary system by necessitating an invasion into the hemithorax and the requirement of a thoracostomy tube. This report identifies a laparoscopic technique for the creation of a pericardial window with low morbidity that has been successfully used in 14 patients who presented to the Department of Surgery of the Rapid City Medical Center with clinical evidence of pericardial effusion and tamponade.

Adult↗
PubMed1996

Do smokers want to quit?

In any year, about 40 per cent of smokers will have tried to stop smoking in the previous 12 months, and about the same proportion will intend to stop in the next three months. These figures do not indicate what proportion of smokers would rather not smoke. In 1993, 601 Victorian smokers were asked 'If you could quit painlessly would you quit smoking or would you continue to smoke?' The study found that 75 per cent of smokers said they would give up under those circumstances, and 13 per cent gave some other indication of interest in giving up. Only 12 per cent were not interested in stopping at present. The results suggest that most smokers are receptive to the idea of giving up, although they may be inhibited from taking action by the perceived difficulty of the task. Only a small proportion of smokers reject cessation messages outright.

Adolescent↗
PubMed1995

Preference and requests for smoke-free dining.

This study looked at whether people prefer to sit in smoking or smoke-free areas when they go to cafés and restaurants. It also considered whether those who said they would prefer smoke-free dining made this known when booking or going to a restaurant. The sample was 2387 Victorians, randomly selected and interviewed in their own homes. Overall, 68 per cent of respondents said they would prefer a nonsmoking area, and only 11 per cent preferred a smoking area. Even among smokers, less than half (42 per cent) wanted to sit in a smoking area. Of those people who wanted smoke-free dining, only 45 per cent said they always made this known. The results demonstrate strong community desire for smoke-free dining, but also point to the need for restaurant managers or the dining public to take the initiative, or for legislative action to ensure the provision of smoke-free areas.

Adult↗
PubMed1994

Attitudes and smoking habits of dentists in Victoria: 16 years on.

In 1977 a survey of Victorian dentists measured their smoking prevalence, and their attitudes to dealing with patients who smoked. In 1993 these questions were repeated as part of a telephone survey of Victorian dentists. From 1977 to 1993 their prevalence of daily smoking had dropped from 30 per cent to 6 per cent, and this was not attributable simply to an influx of younger dentists who had never smoked. Many of those who had graduated in 1977 or more recently had never smoked, but many of the earlier graduates had quit, and there was no difference in the current smoking prevalence of the two groups. There had also been a change in dentists' attitudes towards smoking patients, with more of the 1993 sample (55 per cent) than the 1977 sample (43 per cent) agreeing with the statement 'I encourage all my patients to give up smoking wherever possible'. Again, the more experienced dentists were adopting the new behaviours, not just the more recent graduates. Even so, in 1993 nearly half the dentists waited until the patient either was affected by smoking, or asked for advice before raising the issue.

Age Factors↗
PubMed1994

Proliferative activity and aneuploidy in pleomorphic adenomas of the salivary glands.

We used flow cytometry in a retrospective study of pleomorphic adenoma and carcinoma arising in pleomorphic adenoma, using paraffin-embedded tissue, to assess the relationship among proliferative activity, ploidy, and recurrence or malignant transformation. Twenty-four specimens obtained from 22 tumors were acceptable for analysis (co-efficient of variation, < or = 7.0), including multiple samples from two tumors. Fourteen tumors (13 benign and one malignant) were diploid. Six tumors were aneuploid: four benign pleomorphic adenomas and two carcinomas arising in pleomorphic adenoma. Two tetraploid tumors were malignant recurrences from the same patient. Of the recurrent tumors (nine benign and four malignant), 54% were aneuploid. The highest S-phase fractions were observed in recurrent and malignant pleomorphic adenomas. Immunostaining with p105, a nuclear proliferation antigen, revealed increased proliferative activity in a majority of pleomorphic adenomas. Increased proliferative activity and aneuploidy occurred in benign pleomorphic adenomas.

Adenoma, Pleomorphic↗
PubMed1993

Doctors' advice to their patients about smoking.

OBJECTIVE: To examine people's perceptions of doctors' views on smoking, smokers' recall of doctors' advice about smoking, and the relationship between doctors' warnings about smoking and attempts to quit. DESIGN AND METHOD: Face-to-face interviews with a representative sample of Victorians in their own homes in September and October 1990. SAMPLE: 2357 Victorians aged 16 years and over. RESULTS: 1. 83 per cent of people perceive doctors in general to be against smoking, but only 55 per cent think their own doctor is. 2. 55 per cent of smokers reported their doctor had never advised them to quit smoking, and for 22 per cent this was despite recalling that the doctor had asked if they smoked. 3. Patients who had been advised to stop smoking were more likely to have attempted to quit (81%) than those to whom the doctor had said nothing (61%). 4. Patients who had been advised to cut down on their smoking, rather than to quit, were less likely to be planning a quit attempt (27%) than any others. CONCLUSION: Either doctors are failing to warn many of their patients about smoking or the advice is not being given in a manner that makes it memorable.

Adolescent↗
PubMed1990

Plasma albumin repletion after transfusion with polymerized hemoglobin.

Pyridoxalated polymerized hemoglobin (PPHG) has promise as a blood substitute for transfusing patients with hemorrhage. Exchange transfusion with PPHG depletes plasma proteins. The purpose of this study was to determine if, during the early repletion of intravascular proteins, albumin was transported from the interstitium of skin or skeletal muscle into the vascular compartment. PPHG was prepared from stroma-free human hemoglobin (100-120 mg/ml). The Hct of anesthetized rats dropped from 42 +/- 4% to 10 +/- 1% after exchange transfusion. Immediately postexchange plasma albumin declined from 24 +/- 2 to 6 +/- 3 mg/ml. Five hours postexchange transfusion plasma albumin had doubled and the skin and skeletal muscle albumin content was 80% of control. These data indicate that a shift of interstitial albumin from skin and skeletal muscle can rapidly replace plasma protein deficits after massive transfusion with PPHG.

Animals↗
PubMed1989

Gentamicin solution for mediastinal irrigation: systemic absorption, bactericidal activity, and toxicity.

Local irrigation with gentamicin sulfate represents a possible substitute for neomycin sulfate, used for many years but now no longer available for use as an irrigation fluid. In this investigation, mediastinal irrigation with gentamicin was used in 12 patients who had experienced problems after a heart operation. The regimen employed for mediastinal irrigation with gentamicin was equipotent with that using neomycin. We sought to determine the degree of absorption and risk of either inadequate or toxic blood levels that might follow gentamicin absorption. Irrigation periods were short, ranging from one to four days and determined by measurements of plasma gentamicin concentration using radioimmunoassay evaluation. Systemic gentamicin absorption occurred in all patients. Toxic levels of higher than 8.0 micrograms/mL occurred and were size related, ie, correlated with smaller body weight and surface area, and sex related, ie, female sex. Larger-sized patients often had inadequate levels. Despite the potential risk from toxic blood levels, major increases in serum creatinine levels were not seen. These findings suggest that monitoring of plasma gentamicin levels during mediastinal irrigation with gentamicin is mandatory to avoid both inadequate treatment and toxicity.

Absorption↗
PubMed1989

Comparison of whole-blood cyclosporine levels measured by radioimmunoassay and fluorescence polarization in patients post orthotopic liver transplant.

This study compared the analysis of whole blood cyclosporine concentrations measured by fluorescence polarization immunoassay (FPIA) and radioimmunoassay (RIA) polyclonal and monoclonal procedures. Fifteen orthotopic liver transplant patients with a mean age of 39 +/- 11.06 years were included in the study. One hundred thirteen levels were analyzed using FPIA, RIA polyclonal, and RIA monoclonal procedures. There was no difference statistically in comparing FPIA and RIA polyclonal results (p greater than 0.05). There was a statistical difference between FPIA and RIA monoclonal results p = 0.0001). With use of least squares simple linear regression analysis, FPIA results showed good correlation with RIA polyclonal results (R2 = 0.87). Poor correlation was shown between FPIA and RIA monoclonal results (R2 = 0.51). In this study population, FPIA produced results 2.5% higher than the RIA polyclonal procedure.

Adult↗
PubMed1987

Exchange-transfusion with pyridoxalated polymerized hemoglobin: effects on liver PO2.

To examine the efficacy of modified stroma-free hemoglobin in maintaining liver PO2, rats were exchange-transfused to hematocrit 10% using pyridoxalated polymerized hemoglobin (plp-polyHb, 10-12 g/dl) prepared from crystalline Hb. Following hemodilution, plasma Hb was 7.4 g/dl, and rats were normotensive. Mean liver PO2 was 3.4 vs 23.3 mm Hg in sham-exchanged controls. Other rats, hemodiluted similarly with 6% albumin or hydroxyethylstarch, were hypotensive and died. At 24 hours plasma Hb was 2.0 g/dl, indicating an intravascular half-life of approximately 16 hours. Hepatic PO2 was 12.4 vs 26.8 mm Hg in nonhemodiluted controls. Data provided by clearance of low-dose indocyanine green suggested reduced plasma volume and depressed liver blood flow. Scattered foci of midzonal hypoxic damage were observed in liver lobules. The basis for hypoxic injury is considered to be due in part to the acute restriction of oxygen supply induced by exchange-transfusion with plp-polyHb. The rate of loss of intravascular hemoglobin and diminished plasma volume could have contributed to oxygen insufficiency as well. Endotoxin present in the plp-polyHb was not a factor.

Animals↗
PubMed1986

Colonoscopy after curative resection of colorectal cancer.

Colonoscopy is generally considered to be an important part of the follow-up program for patients who have undergone curative resection of colorectal cancer. However, there are few data available concerning the frequency with which colonoscopy should be performed and for what length of time after operation. Since 1978, our policy has been to examine the colon annually in these patients using colonoscopy alternating with barium enema. We have evaluated the results in 100 patients over a four-year period. Based on size and histology, the significant colonoscopic findings were new colon cancers in three patients and 11 polyps demonstrating increased risk for malignancy in nine patients. This represents an interval yield of 3% per year. From these results and other reports, we recommend that these patients undergo total colonoscopy in the perioperative period to identify and remove synchronous lesions of the colon, and that examination of the remaining colon should be performed annually, preferably with colonoscopy, for at least the first four years after curative resection.

Barium Sulfate↗
PubMed1985

Increases in serum sphingomyelin by 17 beta-estradiol.

The effects of estrogens on plasma sphingomyelin and the hepatic activity of the initial enzyme of sphingomyelin synthesis were examined using immature chicks. After three days of 17 beta-estradiol administration, serum sphingomyelin, total phospholipids, and cholesterol doubled, and triacylglycerol levels increased 7.5 fold. The sphingomyelin content and percentage of total phospholipids of liver were unaffected by estrogen treatment. The specific activity of serine palmitoyltransferase (EC 2.3.1.50) was unchanged, but the total activity appeared slightly higher due to increased liver weights. The higher sphingomyelin may, therefore, be due less to increased levels of biosynthetic enzymes than to factors such as the substrate (i.e., fatty acid) supply or decreased clearance of plasma sphingomyelin. These results are similar to earlier findings with key enzymes of cholesterol and glycerolipid biosynthesis and suggest that the three lipid pathways may be coordinated during estrogen treatment and enhanced very-low density lipoprotein (VLDL) synthesis.

Acyltransferases↗
PubMed1985

Essential hypernatremia: disordered thirst and blood pressure control.

A 24 year old man developed partial central diabetes insipidus with impaired thirst and an elevated osmotic threshold to the release of arginine vasopressin (AVP). Plasma AVP was present in inappropriately small concentrations despite severe hyperosmolality. In addition, marked hypertension accompanied this disorder and all abnormalities, including the hypertension, responded to 1-desamino-8-D-arginine vasopressin therapy. Several lines of evidence suggest this disorder may be a disturbance of hypothalamic function.

Adult↗