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Biomedical subjects

S Norman

Publications and source records attributed to S Norman.

At least 19 recordsLinked to original sources
PubMed2006

Efficacy of valganciclovir in the treatment of cytomegalovirus disease in kidney and pancreas transplant recipients.

Cytomegalovirus (CMV) disease is relatively common following solid organ transplant, particularly if a serologically negative recipient receives an organ from a serologically positive donor (D+/R-). Although valganciclovir is approved for the treatment of CMV retinitis in AIDS patients and is used for the prophylaxis against CMV infection in solid organ transplant patients, the current standard treatment for CMV disease in solid organ transplant recipients remains intravenous ganciclovir. We retrospectively reviewed our experience using valganciclovir as treatment for CMV disease in CMV D+/R- kidney and/or pancreas transplant recipients from March 2002 to June 2005. A total of 37 cases with primary CMV disease were diagnosed and treated with either intravenous ganciclovir as induction followed with valganciclovir or valganciclovir from the beginning. We compared clinical outcomes and viremia between the two groups. Our data suggest that valganciclovir is an effective treatment modality for primary CMV disease in kidney and/or pancreas transplant recipients. It led to the resolution of disease and undetectable viremia. Valganciclovir allowed for early initiation of treatment and for treatment to be given as an outpatient. These advantages of valganciclovir have both health and economic impact for patients with CMV disease.

Adult↗
PubMed2006

The use of telemedicine in psychiatry.

This paper examines the potential effects of using video-conferencing within the field of mental health in the UK. In order to assess the usefulness of telepsychiatric services, an electronic search was conducted for articles published between August 1998 and July 2006 using the MEDLINE, EMBASE, PsychINFO and Telemedicine and Information Exchange (TIE) databases. The search was carried out using the following terms: telepsychiatry, videoconferencing and telepsychology. A total of 178 articles were identified and based on review of the abstracts 72 were identified as being specific to efficacy, cost-effectiveness and satisfaction with psychiatric services delivered via videoconferencing. This paper concludes that the use of video conferencing can enhance psychiatric services within the UK especially for those patients who live in rural areas. Current advances in technology make this an increasingly more reliable and cost-effective method for assessing patients. The limitations of telemedicine are discussed and it is clear that this type of care is not suitable for all patients. Further research is required to assess the types of patients that telepsychiatry is most suitable for.

Cost-Benefit Analysis↗
PubMed2000

Professional regulation. Now and in the future.

The professional regulation of nursing, midwifery and health visiting is a partnership between the public which expects it, the practitioners who practise it and the UKCC and the four National Boards which co-ordinate and administer the system.

Community Health Nursing↗
PubMed2000

Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding.

BACKGROUND: This study is a trial to compare the effects and outcomes of three different bariatric procedures performed in two centers. Standard Roux-en-Y gastric bypass was performed by Dr. Norman Samuels in Fort Lauderdale (Florida); vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding were done in Hallein (Salzburg) by Dr. Emanuel Hell and Dr. Karl Miller. METHODS: In a prospective comparative study 30 matched patients from each group were followed to assess post-operative improvement in health status and quality of life, to compare the three different techniques. The Bariatric Analysis and Reporting Outcome System (BAROS) as described by Oria and Moorehead has been used for evaluation. RESULTS: The observation time was at least 3 years (3 to 8 years) in each individual case. A significant increase in quality of life and health status in 75% of the surgically-treated patients was observed when compared with a non-operated control group of morbidly obese patients. CONCLUSIONS: By utilizing BAROS it has been found possible to compare the results of different procedures done by different surgeons with different techniques, utilizing patients from different cultures and with different languages. The results of this comparative study favor the standard gastric bypass for the treatment of morbid obesity. This operation is superior to purely gastric restrictive procedures in weight loss and improvement of quality of life.

Adult↗
PubMed1999

Two-year follow-up after catheter-based radiotherapy to inhibit coronary restenosis.

BACKGROUND: Although early trials indicate the treatment of restenosis with radiation therapy is safe and effective, the long-term impact of this new technology has been questioned. The possibility of late untoward consequences, such as aneurysm formation, perforation, and accelerated vascular disease, is of significant concern. Furthermore, it is not known whether the beneficial effects of radiation therapy will be durable or whether radiation will only delay restenosis. METHODS AND RESULTS: A double-blind, randomized trial was undertaken to compare 192Ir with placebo sources in patients with previous restenosis after coronary angioplasty. Patients were randomly assigned to receive a 0.76-mm (0. 03-in) ribbon containing sealed sources of either 192Ir or placebo. All patients underwent repeat coronary angiography at 6 months. All living patients were contacted 24 months after their index study procedure. Patients were assessed with respect to the need for target-lesion revascularization or nontarget-lesion revascularization, occurrence of myocardial infarction, or death. Over a 9-month period, 55 patients were enrolled; 26 were randomized to 192Ir and 29 to placebo. Follow-up was obtained in 100% of living patients at a minimum of 24 months. Target-lesion revascularization was significantly lower in the 192Ir group (15.4% versus 44.8%; P<0. 01). Nontarget-lesion revascularization was similar in 192Ir and placebo patients (19.2% versus 20.7%; P=NS). There were 2 deaths in each group. The composite end point of death, myocardial infarction, or target-lesion revascularization was significantly lower in 192Ir-treated versus placebo-treated patients (23.1% versus 51.7%; P=0.03). No patient in the 192Ir group sustained a target-lesion revascularization later than 10 months. CONCLUSIONS: At 2-year clinical follow-up, treatment with 192Ir demonstrates significant clinical benefit. Although further follow-up (including late angiography) will be necessary, no clinical events have occurred to date in the 192Ir group to suggest major untoward effects of vascular radiotherapy. At the intermediate follow-up time point, vascular radiotherapy continues to be a promising new treatment for restenosis.

Angioplasty, Balloon, Coronary↗
PubMed1999

Studies of the behaviour and fate of the polymer-additives octadecyl-3-(3.5-di-t-butyl-4-hydroxyphenyl)propionate and tri-(2.4-di-t-butylphenyl)phosphite in the environment.

In order to evaluate the environmental risk potential of the polymer-additives octadecyl-3-(3.5-di-t-butyl-4-hydroxyphenyl)propionate (additive 1) and tri-(2.4-di-t-butylphenyl)phosphite (additive 2) we have studied the degradation of the 14C-labelled single components and their release from a polypropylene matrix in abiotic and biotic test systems as well as their transport behaviour in soil. The biotic degradation in waste compost, activated sludge and in soil was studied. In order to conduct release tests, waste disposal material were used as well. The abiotic degradation was effectuated by photooxidation at a catalytic surface. The highest mineralisation rates were obtained by photooxidative degradation of the two test substances. The maximum content of bounded residues was found for additive 1 in soil and for additive 2 in waste compost. In the extracts of soil and compost, the principal metabolites could be identified in the case of additive 1 as 7.9-di-t-butyl-1-oxaspiro[4.5]deca-6.9-dien-2.8-dion and in activated sludge as the methyl ester of 3-(3.5-di-t-butyl-4-hydroxyphenyl) propionic acid. Additive 2 metabolised in all degradation tests nearly completely under formation of two products. The main component was identified as tri-(2.4-di-t-butylphenyl)phosphate. Both polymer-additives were eluated from the chosen soil types. The transport behaviour of additive 1 was independent from the soil type. In all test matrices additive 1 as well as additive 2 were released from polypropylene. Because the amounts of additive 1 and 2 absorbed onto soil particles were taken into account, the highest liberation rates were found in the soil test.

Antioxidants↗
PubMed1998

Preparing for community violence: mood and behavioral correlates of the second Rodney King verdicts.

This prospective investigation applied the Experience Sampling Method to examine the mood and behavioral responses of individuals facing the risk of community violence (in anticipation of the second Rodney King verdicts). Threatened participants experienced more negative affect and were less stable in behavioral involvement than individuals not under threat. Threatened participants also avoided social contact except for well-known individuals, and were more likely to be traveling than nonthreatened participants. Social contact with family or close friends and being at home (one's own home or the home of familiar individuals) were associated with large reductions in negative affect for those at risk for urban violence. The findings are discussed in terms of risk factors for trauma following community-wide stressors.

Activities of Daily Living↗
PubMed1998

The elements of nursing ... all but unknown.

In summing up, I have explored briefly some notions on the elements of nursing through the theme of partnership with the public and with others involved in health care. These notions, which are by no means exclusive, have centred around five main areas; Firstly, the unique personal characteristics demanded by the closeness of sustained contact with patients and clients; Secondly, the primacy of the patient's and the public's needs in defining nursing or any other health care profession; Thirdly, the need for nursing both individually and organisationally to look outwards and engage with the wider public and their changing attitudes towards the professions; Fourthly, the unique skill of 'creating community', working with, co-ordinating and leading teams across disciplines in the interests of the patient and the challenge that true effectiveness of multi-disciplinary working presents for both education and practice; and Fifthly, the importance of reflective practice throughout the working life of nurses as a means of better meeting patients' needs. How nursing retains this focus whilst adapting to a constantly and rapidly shifting health and social care environment, will largely determine how nursing endures as a profession. If the example set by Florence Elliott and the many innovations and developments at the Royal Victoria Hospital are anything to go by, the people of Northern Ireland, nurses in Northern Ireland and health care generally in Northern Ireland, can look forward to another 200 years of healthy partnership.

Forecasting↗
PubMed1997

Maternal diagnosis and treatment of children's fever in an endemic malaria zone of Uganda: implications for the malaria control programme.

A mother's ability to suspect malaria in the presence of fever has important consequences for child survival in malaria-endemic areas. This paper presents results of a clinic-based study of mothers' abilities to suspect malaria in the event of recognizing fever and other physiological and behavioral changes associated with the disease. The study population consisted of all (439) women or mothers who had accompanied children 5 years and below to the Old Mulago Hospital, Kampala, Uganda over a 10 day period during the malaria season of 1992. The children were those who had fever as a major complaint at the time of the visit or those who had fever in the last 7 days and were visiting the clinic for the first time for the current illness. The children were physically examined and their blood tested for malaria parasites. Mothers' diagnosis was compared with clinical and laboratory diagnosis of malaria. Mothers associated the presence of fever with several types of illness and malaria was often not suspected. Only 40% of the mothers suspected malaria in their children. The mothers were poor at recognizing malaria when, in fact, it was present. The sensitivity of the mothers' diagnosis of malaria was found to be 37%; 63% of malaria cases were misclassified as other conditions. The doctors classified most (92%) of the cases presenting with fever as having malaria, but laboratory tests indicated that only 64% of the children really had malaria. The sensitivity of clinical diagnosis was 98%, but the specificity was only 18%. Ninety percent of the mothers gave some medicines before visiting the health centre; and, of these, 76% gave modern drugs exclusively, including antimalarials, antipyretics, antibiotics and other drugs. Among the modern drugs given to children suspected of having malaria, 50% were antimalarials. The most commonly used antimalarial was chloroquine tablets. Mothers indiscriminately administered antimalarials to children irrespective of the perceived cause of the fever. There is need to educate mothers to suspect malaria first in every case of febrile illness, just like the doctors do, and about the first line drugs for the treatment of malaria.

Adolescent↗
PubMed1997

An urban intergenerational program for cancer control education.

BACKGROUND: Recognizing the disparities in cancer morbidity and mortality that exist between African Americans and whites, an urban university and its neighborhood community undertook the development of an education program to transfer state-of-the-art cancer prevention, detection, and treatment information from an academic medical center to community residents, including school-age children. METHODS: An intergenerational, multilevel intervention was developed to: 1) assess the health beliefs of the community, 2) identify, develop, and train an intergenerational group of community residents who would serve as health educators, and 3) promote behavioral change among the target population. RESULTS: Ten community residents were trained as educators. Over the course of two years they conducted cancer education programs that reached 775 adults. During the same period, the school-based educational intervention reached 264 seventh-grade students. CONCLUSIONS: Implications for the design and implementation of community-based cancer education programs in this African American community are identified.

Academic Medical Centers↗
PubMed1997

Expression of the complement regulatory proteins decay accelerating factor (DAF, CD55), membrane cofactor protein (MCP, CD46) and CD59 in the normal human uterine cervix and in premalignant and malignant cervical disease.

The membrane-bound complement regulators decay-accelerating factor (DAF, CD55), membrane cofactor protein (MCP, CD46), and CD59 are broadly expressed proteins that act together to protect host tissues from autologous complement. Comparison of expression profiles of these proteins between normal and pathological tissues could reveal a mechanism by which tumor cells evade complement-mediated killing. Expression of the regulators was therefore examined in the normal human uterine cervix, in cervical intraepithelial neoplasia (CIN; n = 23), and in cervical squamous carcinomas (n = 6). DAF and MCP were reciprocally expressed in normal ectocervical epithelium. MCP was confined predominantly to the basal and parabasal layers with more extensive expression in metaplastic squamous epithelium. An apparent expansion in MCP expression was observed in more severe premalignant lesions whereas cervical carcinoma were uniformly MCP positive. By contrast, DAF expression appeared unaltered in premalignant lesions and variable in carcinomas. However, increased DAF was observed in stromal cells directly adjacent to infiltrating tumor cells. A low molecular weight DAF product was detected in tumors, and preliminary evidence suggests this may be derived from stromal cells. Overall, changes in expression of C3 convertase regulators in both the stromal and epithelial compartments may be important for evasion of immune surveillance in cervical cancer.

Antigens, CD↗
PubMed1996

Evaluation of 1-(9-anthracenylmethyl) piperazine for the analysis of isocyanates in spray-painting operations.

A new reagent, 1-(9-anthracenylmethyl)piperzine (MAP), was used for the derivatization of airborne 1,6-hexamethylene diisocyanate (HDI) and polyisocyanates generated during spray-painting operations. The new reagent, which offers enhanced sensitivity and uniformity of response to both the monomeric and oligomeric forms of HDI, was compared directly with 1-(2-methoxyphenyl)piperazine (MOP), the currently employed derivatizing reagent used in the National Institute for Occupational Safety and Health Method 5521. Both the validity of the side-by-side sampling protocol and the efficacy of two derivatizing reagents were evaluated in field studies. The analytical results indicate that there is no significant difference at the 95% confidence level in the concentration of polyisocyanate in the aerosol as determined by two impingers containing MAP and a third containing MOP when these are positioned in a side-by-side-by-side arrangement.

Air Pollutants, Occupational↗
PubMed1996

Woodsmoke exposure and risk for obstructive airways disease among women.

OBJECTIVE: To investigate if exposure to firewood smoke and other indoor pollutants is a potential risk factor for obstructive airways disease (OAD) among women in Bogota in whom cigarette smoking and other known risk factors may not be the most frequent. DESIGN AND SETTING: We conducted a hospital-based case-control study to identify risk factors for OAD among women in Bogota. An interview was conducted using a modified questionnaire recommended by the American Thoracic Society for epidemiologic studies. PATIENTS: We compared 104 OAD cases with 104 controls matched by hospital and frequency matched by age. ANALYSIS: The odds ratio (OR) was used as the basic statistic to evaluate risk. Multivariate analysis (MA) was conducted by the Mantel-Haenszel procedure and by logistic regression. MAIN RESULTS: Univariate analysis showed that tobacco use (OR = 2.22; p < 0.01), wood use for cooking (OR = 3.43; p < 0.001), passive smoking (OR = 2.05; p = 0.01), and gasoline use for cooking (OR = 0.52; p = 0.02) were associated with OAD. Trends for years of tobacco use and years of wood cooking were present (p < 0.05). After MA, variables remained significant except gasoline use. CONCLUSIONS: This study showed that among elderly women of low socioeconomic status in Bogota, woodsmoke exposure is associated with the development of OAD and may help explain around 50% of all OAD cases. The role of passive smoking remains to be clarified. This work may set the basis for interventional studies in similar settings.

Adult↗