Description of nurse practitioner functioning as most responsible provider in an intravenous therapy clinic.

Background: IV antibiotic patients at the Strathcona Community Hospital were previously seen through the Strathcona emergency department (ED). This led to decreased patient satisfaction and increased wait times for these patients.

Purpose: The purpose of this study was to describe a nurse practitioner (NP) functioning as the most responsible provider (MRP) in an intravenous therapy (IVT) clinic and to describe the benefits and services the clinic provides within a suburban community hospital setting.

The influence of peer relationships on young people's sexual health in Sub-Saharan African street contexts.

This paper explores the interaction between peer relationships and sexual health among street youth in three Sub-Saharan African cities: Accra (Ghana), Bukavu (Democratic Republic of Congo), and Harare (Zimbabwe). It begins by conceptualising peer relationships for youth globally and considers why these are pivotal for young people living in street settings. The paper reconceptualizes street peer relationships not as replacement families, but as sharing 'social anchorage' in the street space.

The accuracy of parathyroid gland localization in primary hyperparathyroidism using sestamibi radionuclide imaging.

Primary hyperparathyroidism is a common condition due to either a parathyroid adenoma or, less commonly, parathyroid hyperplasia, whose treatment is essentially surgical. We have, therefore, assessed the accuracy of Tc-99m pertechnetate/Tc-99m sestamibi (methoxy-isobutyl isonitrile) imaging in the localization of adenomas and hyperplastic parathyroids. The clinical records of all patients who had Tc-99m pertechnetate/Tc-99m sestamibi imaging and parathyroid surgery at this hospital were reviewed.

Linear growth after colectomy for ulcerative colitis in childhood.

Eighteen children and adolescents, of a total of 90 treated in our unit between 1982 and 1992, underwent colectomy for ulceractive colitis. Six (6.7%) of the 90 patients had short stature, i.

The long-term outcome after adrenalectomy and prophylactic pituitary radiotherapy in adrenocorticotropin-dependent Cushing's syndrome.

We have reviewed our experience of adrenalectomy performed as part of the management of 56 patients with ACTH-dependent Cushing's syndrome between 1946 and 1993. Forty-three patients were operated on at our institution. Surgery-related mortality did not occur, but complications developed in 14 (33%); these were minor in 12.

Surgical therapy of chronic inflammatory bowel disease in childhood.

The overall impression gained from the experience of the Departments of Paediatric Gastroenterology and Surgery attached to St Bartholomew's Hospital are the enormous benefits that surgery has to confer on the large percentage of children with both Crohn's disease and idiopathic proctocolitis who require it. The surgical procedures described in this chapter have been accompanied by a remarkably low complication rate, dispelling the impression that morbidity in such cases would be high. This must in large measure be due to the fact that the children who come to surgery are in as good a state of nutrition as can be achieved by means of the various forms of enteral and parenteral feeding now available.

Bilateral phaeochromocytomas in von Hippel-Lindau disease: diagnosis by adrenal vein sampling and catecholamine assay.

Three unrelated patients with von Hippel-Lindau disease had phaeochromocytomas diagnosed as a result of screening in their third decade. All had raised 24-h urinary noradrenaline levels and obvious unilateral adrenal tumours on ultrasound scanning and computed tomography. The contralateral adrenal appeared either normal or equivocally abnormal using the same imaging techniques.

The effect of feed intake and body weight on purine derivative excretion and microbial protein supply in sheep.

Urinary excretion of purine derivatives (PD) was used to estimate the microbial N (MN) supply to sheep in three experiments designed to examine the effects of DMI and BW on the efficiency of microbial N supply (EMNS) to the host animal. In Exp. 1, four sheep of about 45 kg BW were given 328, 656, 984, and 1313 g of DM/d of a hay/concentrate diet in a Latin square design.

Management of stage II Hodgkin's disease: 15 years experience at St. Bartholomew's Hospital.

One hundred seventy-seven consecutive patients with newly diagnosed stage II Hodgkin's disease (HD) (supradragmatic 157; infra diaphragmatic 20) were treated at St. Bartholomew's Hospital on the basis of pathologic stage (PS) in 84 (IIA 69; IIB 15) and clinical stage (CS) in 93 (IIA 33, IIB 60) between January 1968 and December 1984. The median follow up is 13 years.

Surgery for Crohn's disease in childhood: influence of site of disease and operative procedure on outcome.

Factors influencing outcome after surgery have been studied in 67 children requiring bowel resection or diversion of the faecal stream for Crohn's disease. Patients were divided into four groups on the basis of disease location at time of surgery, and mean follow-up was 4.5 years.

Radiotherapy for stage I Hodgkin's disease: 20 years experience at St Bartholomew's Hospital.

One hundred and one consecutive patients with newly diagnosed stage I Hodgkin's disease (HD) received treatment at St Bartholomew's Hospital, between 1968 and 1987, with a median follow-up of 12 years. Eleven patients have been excluded from detailed analysis because they either received involved field radiotherapy (RT) or radiotherapy with chemotherapy or were lost to follow-up. Actuarial analysis predicts 78% to be alive and without relapse of Hodgkin's disease at 15 years.

Acceleration of linear growth following intestinal resection for Crohn disease.

Twelve patients with Crohn disease aged from 11.3 to 17.1 years, underwent intestinal resection.

Female pseudohermaphroditism due to a maternal adrenocortical tumor.

A 15-yr-old, apparently male, patient presented with a 2-yr history of gynecomastia and poor genital development. A normally formed, but small, penis with a phallic urethra was present, and testes were impalpable. The karyotype was 46,XX, and at laparotomy a uterus, Fallopian tubes, and ovaries were found, but there was no testicular tissue.

Stab injury--the experience of an East London Hospital 1978-1983.

A retrospective review of 201 patients with stab wounds admitted to an East London Hospital over a period of six years was performed. There was no striking increase in the annual incidence of these injuries over the period reviewed. The majority of patients were young males who arrived at the Accident and Emergency Department after 1800 h on a Friday, Saturday, or Sunday and had consumed alcohol prior to admission.

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.

The management of localized, infradiaphragmatic Hodgkin's disease: experience of a rare clinical presentation at St Bartholomew's Hospital.

Between 1969 and 1982, 23 previously untreated patients with Hodgkin's disease (HD) confined to infradiaphragmatic sites were treated at St Bartholomew's Hospital. The distinguishing clinical characteristics of the patient population were a male: female ratio of 20:3. The mean age was 39 years, which was significantly older (P less than 0.

Methane formation in faunated and ciliate-free cattle and its relationship with rumen volatile fatty acid proportions.

Twelve steers fitted with rumen cannulas were used in three separate experiments to investigate the effects of the presence or absence of rumen ciliate protozoa on methane production. The diet consisted of 850 g barley and 150 g protein supplement/kg, and was given in three feeds daily at a restricted level of 61 g/kg live weight 0.75.

Microbial protein synthesis in cattle given roughage-concentrate and all-concentrate diets: the use of 2,6-diaminopimelic acid, 2-aminoethylphosphonic acid and 35S as markers.

Three steers, each fitted with a rumen cannula and a re-entrant cannula in the proximal duodenum, were offered diets consisting of a barley-based concentrate and chopped hay at a daily intake of 61 g/kg live weight0.75 given in three equal meals. The ratio, concentrate: hay was changed from 50:50 to 90:10 and then to 100:0 in successive periods of 12-18 weeks and the flow and composition of digesta at the duodenum was measured over 48-h periods on each dietary treatment.

Use of absorbable mesh to displace bowel and avoid radiation enteropathy, during therapy of pelvic Ewing's sarcoma.

The use of absorbable polyglactin 910 mesh (Vicryl) is described in a case of Ewing's sarcoma of the pelvis. An operation was performed to hold the small bowel and colon out of the pelvis for a temporary period during which radical radiotherapy was delivered. The mesh allowed the temporary displacement of bowel and obviated bowel radiation morbidity.

2-Aminoethylphosphonic acid concentrations in some rumen ciliate protozoa.

The concentration of 2-aminoethylphosphonic acid has been measured in seven genera of rumen ciliate protozoa. Expressed as milligrams per gram of total nitrogen, 2-aminoethylphosphonic acid concentrations ranged from 17.2 in Ophryoscolex spp.