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Biomedical subjects

S E Jewell

Publications and source records attributed to S E Jewell.

15 recordsLinked to original sources
PubMed1995

Increasing trends in plural births in the United States.

OBJECTIVE: To determine the nature and possible reasons for the increasing trend in plural births in the United States during the 1980s. METHODS: We performed a descriptive analysis of births in the United States for five racial and ethnic groups from 1980-1989, using the United States vital records natality files. RESULTS: The rates of twin and triplet births rose 19 and 100%, respectively, during the 1980s. Approximately one-fourth of the observed increases can be attributed to rising maternal age. The increases in twin and triplet births occurred mainly among more educated and older white women. CONCLUSION: The association of high education status with rising rates of plural births, independent of maternal age, suggests that the observed increase is the result of increasing use of fertility-stimulating therapy among a subset of the childbearing population.

Adult↗
PubMed1994

Patient participation: what does it mean to nurses?

Patient participation as a nursing philosophy and practice has grown in popularity. Research studies have reported the possible positive effects of involving patients in their health and care, while investigations interested in the meaning of participation have tended to concentrate upon the patient's perspective. However, little research has focused upon the practitioner's understanding of the concept or its execution. The aim of this ethnographic study was to uncover the perceptions of primary nurses towards the notion of patient participation, and represents early explorative work within a larger project devoted to discharge decision making. A group discussion was led by the author with four primary nurses working within a rehabilitation unit for elderly people. The data were subjected to a content analysis and two central themes or principles emerged. First, participation was regarded as having both a formal and informal meaning as well as a formal and informal method or practice, and secondly, it was seen to involve mutual informing or negotiation between patient and nurse. Both these principles were regarded as closely linked to the concepts of nurse-patient closeness and patient individuality.

Aged↗
PubMed1993

Discovery of the discharge process: a study of patient discharge from a care unit for elderly people.

Patient discharge is not a new research topic. Numerous studies have shown patients do not always receive the services they need on leaving hospital. The purpose of this study was to examine the process of discharge and move away from the snapshot study of discharge outcomes. Interviews were undertaken with elderly patients, their carers and the hospital and community staff involved in their care. A content analysis of the data revealed a distinctive discharge process which started with admission and ended with the patient leaving hospital. Discharge planning was highlighted as a separate component of this process. A number of examples are examined of how vulnerable to breakdown patient discharge can be.

Aged↗
PubMed1989

Sources of imprecision in laboratories screening for congenital hypothyroidism: analysis of nine years of performance data.

We evaluated sources of imprecision in screening assays for congenital hypothyroidism performed between 1979 and 1987 by more than 45 laboratories participating in the national Neonatal Screening Standardization Program offered by the Centers for Disease Control. Reported concentrations were available from approximately 70,000 enriched dried-blood spot samples for thyroxin and thyrotropin, the primary and secondary screening assays, respectively. The most important sources of variation in assayed concentrations are within-laboratory imprecision and the methods or kits used. The importance of each of these sources depends on the analyte and its concentration. In most cases, the greatest source of measurement variation is attributable to within-laboratory imprecision (coefficient of variation 13% to 26%); however, kits are the largest source of variation at the lower concentrations of thyroxin. For both analytes, the greatest relative imprecision occurred at the low concentration, which was within the critical range of the cutoff values for detection of presumptive positive specimens. Imprecision in this range increases the risk of misclassifications. Minimizing within-laboratory imprecision and differences among kits seems to be the best way to improve overall efficiency of screening laboratories.

Congenital Hypothyroidism↗
PubMed1988

Low field strength magnetic resonance imaging of the spleen: results from volunteers and patients with lymphoma.

Low field strength (0.08 Tesla) magnetic resonance imaging (MRI) of the spleen with spin lattice relaxation time (T1) measurement was performed on a total of 79 healthy volunteers and 62 patients with lymphoma. Inhomogeneity was observed on the T1 images of the spleen from 25 volunteers. This was therefore considered a normal variant. The normal range of spleen T1 at 0.08 Tesla was established (362-420 msec). No influence of age on spleen T1 was detected. The range of T1 values observed in males and females was similar, although the mean spleen T1 for females was significantly longer than that for males. The sensitivity of T1 measurement for the detection of lymphoma in the spleen was poor, particularly for patients with Hodgkin's disease. In a minority of untreated patients, however, a spleen T1 value outside the normal range may indicate the presence of lymphoma in the spleen. A significant decrease in spleen T1 following treatment was observed in 9 patients who underwent serial scanning.

Adolescent↗
PubMed1988

Low field strength magnetic resonance imaging of bone marrow in patients with malignant lymphoma.

Detection of bone marrow infiltration by lymphoma with low field strength magnetic resonance imaging (MRI) has been assessed. Measurements of spin lattice relaxation time (T1) were made in 31 patients with lymphoma and compared with the results of bone marrow biopsy and with T1 measurements made on 90 healthy volunteers. The sensitivity of MRI was excellent in patients for whom the microscopic pattern of marrow infiltration was diffuse, but poor in those with microscopically focal infiltration.

Adult↗
PubMed1988

In-vivo measurement of spin lattice relaxation time (T1) of bone marrow in healthy volunteers: the effects of age and sex.

Magnetic resonance images of the spine, sternum, femoral heads and upper femoral shafts were obtained from 90 healthy volunteers to determine the normal ranges of spin lattice relaxation time (T1) for different regions of the bone marrow. The influence of age, sex and oral contraceptive usage on bone marrow T1 was assessed. Differences observed between the T1 of the various regions of the bone marrow examined were consistent with the expected distribution of erythropoietic cells and fatty marrow. Bone marrow T1 was found to decrease with age, significantly lower mean T1 values being observed in subjects over 40 years of age than for those in the 20-40 years age group. The mean bone marrow T1 of females in the 20-40 years age group was significantly higher than that for males of comparable age. For subjects over 40 years of age, the difference in bone marrow T1 observed between males and females was not significant. Oral contraceptive usage had no effect on bone marrow T1.

Adult↗
PubMed1988

In-vivo measurement of spin lattice relaxation time (T1) of liver in healthy volunteers: the effects of age, sex and oral contraceptive usage.

Magnetic resonance imaging of 81 healthy adult volunteers has been undertaken to establish the normal range of liver spin lattice relaxation time (T1) at 0.08 tesla. The influence of age, sex and oral contraceptive usage has been assessed. Liver T1 decreased with age. The mean liver T1 of subjects under 40 years of age was significantly longer than that of older subjects. A wider range of T1 values was observed in the younger age group. No difference in T1 was found between males and females who were not oral contraceptive users. The mean liver T1 of females who were taking the pill was significantly longer than that of females of similar age who were not oral contraceptive users. Serial examinations of eight oral contraceptive users showed that mean liver T1 values were significantly longer in the 3 weeks during which they were taking the pill than during the week off the pill.

Adult↗
PubMed1987

Reproducibility of spin lattice relaxation time (T1) measurement using an 0.08 tesla MD 800 magnetic resonance imager.

The reproducibility of T1 measurements using an MD 800 magnetic resonance imager operating at 0.08 T (3.4 MHz) has been assessed by repeated imaging over a 15-week period of a phantom containing six copper-sulphate solutions of different dilutions. The standard pulse sequence of this scanner with an inversion time of 200 ms and a repetition time of 1 s was used. Reproducibility was excellent for the lower T1 range (less than 350 ms), but greater variability was observed at higher T1 values (greater than 490 ms). A linear relationship between T1 and temperature has been demonstrated and a method for standardising T1 values obtained at different temperatures is described.

Magnetic Resonance Spectroscopy↗
PubMed1986

Detection of spread of malignant lymphoma to the liver by low field strength magnetic resonance imaging.

The accuracy of spin lattice relaxation time (T1) measurement obtained with a low field strength magnetic resonance imager for the detection of spread of malignant lymphoma to the liver was assessed. The results of histological examination obtained at open liver biopsy were compared with liver T1 values in 27 patients with lymphoma. The normal range for T1 was established by scanning 61 healthy volunteers. Magnetic resonance imaging was highly sensitive in detecting hepatic lymphoma, all seven patients with liver lymphoma proved by biopsy having considerably higher T1 values. Specificity was less good. Five out of 20 patients with no histological evidence of hepatic lymphoma had abnormal T1 values. this level of sensitivity is considerably better than that reported for other imaging methods and contrasts with the results of one previous study using a different magnetic resonance system. Low field strength magnetic resonance imaging may prove to be a useful screening test in patients with lymphoma. The presence of a normal liver T1 seems to be a reliable guide to the absence of hepatic disease.

Adolescent↗
PubMed1978

Students in CME.

Explore the source record for details and available documents.

California↗
PubMed1978

The effect of osmotic diuresis on urinary iodine concentration using contrast media of differing osmolality.

The urinary iodine concentrations of a monomer (sodium iothalamate), a dimer (sodium iocarmate) and a non-ionic compound (metrizamide) have been compared in dogs with varying levels of solute excretion. All the animals were undergoing maximal antidiuresis. In dogs with normal solute excretion, metrizamide and iocarmate produced higher urinary iodine concentrations than iothalamate. There was no significant difference between metrizamide and iocarmate. With increasing levels of solute excretion, the differences between the compounds were reduced. These findings suggest that contrast media of reduced osmolality are unlikely to have a special place in advanced renal failure.

Animals↗
PubMedDate not supplied

Low field strength magnetic resonance imaging of bone marrow in acute leukaemia.

The accuracy of low field strength (0.08 Tesla) magnetic resonance imaging (MRI) of bone marrow for the detection of acute leukaemia in adults has been assessed by comparison with bone marrow biopsy results. Spin lattice relaxation time (T1) measurements from patients were compared with those from 90 volunteers. Eighteen patients were studied at the time of diagnosis of leukaemia. Bone marrow T1 was prolonged in all cases. One of two patients with refractory anaemia with excess of blasts in transformation (RAEBt) had prolonged bone marrow T1, the other had normal T1. T1 at the time of diagnosis for patients with acute leukaemia or RAEBt correlated with the cellularity and blast cell count in the marrow. None of the 17 patients who were studied when in long-term remission of leukaemia had prolonged marrow T1. Serial studies were undertaken in five of the newly diagnosed patients. An increase in bone marrow T1 was observed in each of four patients studied seven days after the start of treatment, at a time when they showed a decrease in leukaemic cells on peripheral blood examination. T1 measurements made 3 weeks after the commencement of chemotherapy were similar to pretreatment values and did not reflect the reduction in leukaemic infiltration observed on bone marrow needle aspirate. The implications and possible explanations for these findings are discussed.

Acute Disease↗