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Biomedical subjects

R P Craig

Publications and source records attributed to R P Craig.

14 recordsLinked to original sources
PubMed1990

Recombinant interleukin-2 (rIL-2) with flavone acetic acid (FAA) in advanced malignant melanoma: a phase II study.

Recombinant interleukin 2 (rIL-2) and flavone acetic acid (FAA) were used to treat 34 patients with progressing metastatic melanoma. Five patients had solely non-visceral disease and the median number of organ sites involved was two. Five doses of rIL-2 were given, the first dose intrasplenically via a femoral artery catheter with a further dose 4 h later i.v. and the other doses i.v. on alternate days. The rIL-2 dose was 11 x 10(6) Cetus units m-2; the day before rIL-2, FAA (4.8 G m-2) was given as a 6 h i.v. infusion, in order to enhance further killer cell activity. A total of three courses at 21-day intervals was planned and 74 courses in all were given. Despite the high dose of rIL-2 and the potential overlapping toxicity affecting blood pressure with the addition of FAA, side-effects were generally mild. There were only five episodes of grade 4 toxicity: one of ventricular tachycardia and four other episodes of transient biochemical or haematological disturbance. Grade 3 hypotension or hypertension occurred on 22 courses but again was transient. No patient required intensive care facilities. Five patients had tumour response, one being complete. Responses occurred in pulmonary and hepatic metastases, but mainly in non-visceral sites. Eleven patients remain alive at 6-17 months and in five there is no relapse or progression of disease. Despite the impressive results in animal tumour models, the addition of FAA to rIL-2 in the present study has not markedly improved results over rIL-2 alone.

Adjuvants, Immunologic↗
PubMed1987

Integrating values in job descriptions.

The Mission Services Division of the Sisters of Charity of the Incarnate Word Health Care Corporation, Houston, has established training sessions to help various facilities develop criteria-based job descriptions that integrate values. A major problem with traditional job descriptions is that they do not contain enough information for value integration to occur. Each facet of the job description--the responsibility statement, the task statement, and the standard--can integrate the facilities' values in explicit and implicit ways. Such integration reduces the possibility of a supervisor arbitrarily defining the qualitative aspects of how an employee performs the job and provides a better method for evaluating the quality of the employee's performance. The first step in value integration is to identify the organization's values. Next, illustrative behaviors are identified to emphasize value integration in both activity-based task statements and results-based standards. The final step is to integrate the values in the job description, which makes the value operational and bridges the gap between commitment to values and behavior that exemplifies those values. Although values cannot be measured as objectively as the successful accomplishment of a procedure with a specified method of measurement, evaluation of values is not fruitless. When the employee and supervisor agree on specific qualitative aspects of patient care or other tasks, the consistency of the qualitative aspects of the job can be evaluated.

Attitude of Health Personnel↗
PubMed1986

Occlusion of a traumatic false aneurysm of the vertebral artery.

A case of false aneurysm of the second part of the vertebral artery due to stabbing with a pair of scissors is described. Successful occlusion of the aneurysm with preservation of vertebral blood flow was achieved by the percutaneous insertion of a silicone-filled detachable balloon.

Adult↗
PubMed1986

Five key players shape institution's ethical character.

Various individuals or groups play important roles in achieving moral insight and direction in a health care facility. The administration, medical and nursing staffs, the professional theologian, and the bishop all contribute unique perspectives to the complex process of developing an institution's ethical character. An institutional ethics committee's (IEC's) effectiveness depends largely on the administrator's ability to support educational programming in ethics for the entire staff, coordinate ethical reflection throughout the organization, and shape ethically informed policy based on an IEC's practical experience. The medical staff brings its scientific background and practical experience to ethical issues under a committee's consideration, and nurses offer valuable insights based on their close contact with patients and family. The theologian provides resources and background on Catholic tradition as well as information on current theological developments. The IEC also should maintain a relationship with the local bishop whose duty is to articulate the Church's positions in health care ethics. Forthright dialogue among all parties is central to the IEC's task.

Catholicism↗
PubMed1984

Military cold injury during the war in the Falkland Islands 1982: an evaluation of possible risk factors.

Throughout the history of war, there have been many instances when the cold has ravaged armies more effectively than their enemies. Delineated risk factors are restricted to negro origins, previous cod injury, moderate but not heavy cigarette smoking and the possession of blood group O. No attention has been directed to the possibility that abnormal blood constituents could feasibly predispose to the development of local cold injury. This study considers this possibility and investigates the potential contribution of certain components of the circulating blood which might do so. Three groups of soldiers from two of the battalions who served during the war in the Falkland Islands in 1982 were investigated. The risk factors which were sought included the presence or absence of asymptomatic cryoglobulinaemia, abnormal total protein, albumin, individual gamma globulin or complement C3 or C4 levels, plasma hyperviscosity or evidence of chronic alcoholism manifesting as high haemoglobin, PCV, RBC, MCV or gamma glutamyl transpeptidase (GGT). No cases of cryoglobulinaemia were isolated and there was no haematological evidence to suggest that any of those men who had developed cold injury, one year before this study was performed, had abnormal circulating proteins, plasma hyperviscosity or indicators of alcohol abuse. Individual blood groups were not incriminated as a predisposing factor although the small numbers of negroes in this series fared badly. Although this investigation has excluded a range of potential risk factors which could contribute to the development of cold injury, the problem persists.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

Intravenous glucose, aminoacids, and fat in the postoperative period. A controlled evaluation of each substrate.

The metabolic effects of hypocaloric (2-51 MJ), equicalorific quantities of intravenous glucose, crystalline aminoacids, and soyabean emulsion were comapred with those of fasting in 4 groups of male patients (closely matched for age, weight, and fat-free mass) on the day of vagotomy and pylorplasty and on the fast 3 postoperative day. Patients given glucose alone excreted less nitrogen than the fasting patients but nitrogen sparing was greatest in the group given aminoacids alone. There was no evidence of any nitrogen sparing when intravenous fat was the source of energy. There was no difference in blood glucose, free fatty acids, and insulin concentrations among the groups. Ketone-body concentrations rose in the fasting and fat-fed groups but remained low in the groups who received glucose or aminoacids. This study indicates that, in the short term, the increased preservation of protein achieved by the infusion of aminoacids compared with that produced by the traditional infusion of glucose does not warrant the extra cost involved.

Adult↗
PubMed1977

Some surgical aspects of homozygous beta-thalassaemia.

The surgical aspects of the management of patients with homozygous beta-thalassaemia are reviewed, and the operative findings in 10 patients with the disease who underwent splenectomy are described. Postoperatively, blood consumption was reduced and there was a longer time interval between transfusions needed to maintain the haemoglobin level. Hyperplastic lymph nodes containing erythropoietic elements are always present, and the first reported case of extrabiliary obstructive jaundice caused by this tissue is included. All the patients survived for 2-3 years after treatment and there were no serious infections. All received prophylactic oral penicillin after surgery. Cholelithiasis was not found. Two malleolar ulcers were successfully grafted with split skin after preparation of the craters with silver sulphadiazine cream.

Adolescent↗
PubMed1977

Factitious subcutaneous emphysema: a case report.

A case is described of a young man who produced surgical emphysema of his left forearm using a 2-ml syringe with a modified needle. It is believed that this is the second reported example of this type of artefact. Other cases may occur with the present high incidence of drug abuse and increasing general access to syringes.

Adult↗
PubMed1975

The quantitative evaluation of the use of oral proteolytic enzymes in the treatment of sprained ankles.

A double-blind trial was carried out on 50 patients with soft-tissue ankle injuries. The treated group was given proteolytic enzymes (Chymoral) by mouth while the untreated group was given enteric-coated lactose tablets. Both groups received identical supportive therapy for their injuries. No statistically significant difference in swelling, bruising and function between the 2 groups in the measurements of volume and allied parameters was found. No side effects were noted. The results suggest that the use of Chymoral in this type of injury is not indicated.

Adolescent↗
PubMedDate not supplied

Tailoring pattern of pastoral care. Five models for achieving quality.

Facilities can restructure pastoral care delivery in a number of ways without sacrificing quality. Five models for pastoral care services attempt to define and evaluate what "quality" in pastoral services means: The departmental model offers a formal pattern of defined relationships within the pastoral care department and requires a certified director and properly trained and certified staff. The shared services model provides for one pastoral care director serving several facilities in close proximity. A pastoral services advisory council, consisting of community members, identifies and recruits pastoral care staff, participates in program development and implementation, and creates appropriate models of evaluation. In the contractual services model, members of local churches or organizations with trained ministers contract to provide pastoral care. The pedagogical model employs either a certified clinical pastoral education supervisor or a trained pastoral professional who educates and supervises pastoral care staff and students. The model of pastoral care delivery must fit a particular facility or community's needs and finances, with an honest, fair, and qualitative assessment of a facility's pastoral care strengths and weaknesses together with an acknowledgement and realization of pastoral care trends.

Chaplaincy Service, Hospital↗