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Cheung VY, Bocking AD, Hollomby D, Gagnon R, Walton J. Waldenström hypergammaglobulinemic purpura and pregnancy. Obstet Gynecol 1993; 82:685-7. [PMID: 8378012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Waldenström hypergammaglobulinemic purpura is characterized by hypergammaglobulinemia, recurring purpura, and an elevated erythrocyte sedimentation rate. It is a rare disease and, to our knowledge, there have been no previous reports of its presence during pregnancy. We report a patient with this disease whose pregnancy was complicated by severe fetal growth restriction (FGR) and acute fetal distress. CASE A 24-year-old primigravid woman with a history of Waldenström hypergammaglobulinemic purpura and renal insufficiency developed FGR at 32 weeks' gestation. Cesarean delivery was performed at 33.5 weeks because of acute fetal distress, and a 1305-g male infant was delivered. Neonatal outcome was successful. No deterioration of the woman's medical condition occurred during or after her pregnancy. CONCLUSION Successful pregnancy outcome is possible in women with Waldenström hypergammaglobulinemic purpura. In view of the risk of FGR, close monitoring of fetal growth and well-being is recommended in women with this condition.
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Cheung VYT, Bocking AD, Hollomby D, Gagnon R, Walton J. Waldenström hypergammaglobulinemic purpura and pregnancy. Obstet Gynecol 1993. [DOI: 10.1097/00006250-199310020-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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128
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Walton J. [Changing face of neuroscience]. VESTNIK ROSSIISKOI AKADEMII MEDITSINSKIKH NAUK 1993:10-17. [PMID: 7694704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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129
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130
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Waldron G, Walton J, Helowicz R. Medical messages on television. Copycat overdoses coincidental. BMJ (CLINICAL RESEARCH ED.) 1993; 306:1416. [PMID: 8363657 PMCID: PMC1677823 DOI: 10.1136/bmj.306.6889.1416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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131
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Walton J. Lifting techniques for nurse-aiders. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1993; 2:385-6, 388. [PMID: 8508024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
When giving first aid, nurse-aiders must assess the working environment and make it safe or either remove the patient from it. If movement is necessary, nurses must keep in mind their own bodily capability.
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132
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Platt WD, Walton J. Nurse-aid management of neurological emergencies. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1993; 2:288-90. [PMID: 8485364 DOI: 10.12968/bjon.1993.2.5.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
People with altered levels of consciousness cannot be responsible for themselves. This article highlights the steps a nurse aider must take at the scene of an accident and discusses the importance of the environment in the neurological emergency.
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Platt WD, Walton J. Nurse-aid management of hypovolaemic shock. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1993; 2:189-92. [PMID: 8457755 DOI: 10.12968/bjon.1993.2.3.189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Shock is a potentially life-threatening situation and the nurse aider must therefore be able to recognize its development and take immediate action. This article describes the actions that a nurse aider must take at the scene of an accident.
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134
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Mitton DB, Walton J, Thompson GE. An XPS and AES study of the ageing of a Co-20%Ni metal-evaporated tape. SURF INTERFACE ANAL 1993. [DOI: 10.1002/sia.740200107] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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135
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Walton J. Neuroscience in the English-speaking world prior to 1500. JOURNAL OF THE HISTORY OF THE NEUROSCIENCES 1993; 2:17-20. [PMID: 11618441 DOI: 10.1080/09647049309525549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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136
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Duran O, Walton J. Treatment and care of pet pigs. Vet Rec 1992; 131:572-3. [PMID: 1287950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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137
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Walton J, Castledine G. First aid and emergencies in nursing. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1992; 2:37-40. [PMID: 1472857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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138
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Abstract
Emergency care is a broad term which usually refers to a wide range of situations, procedures and services administered in a wide variety of emergency situations. This series of articles will examine the nurse's role, both within and outside the hospital. This article will describe what the nurse's first and second responses should be in an emergency.
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Williams DI, White H, Moll J, Rains AJH, Casey T, Walton J. Royal Society of Medicine Services Limited. West J Med 1992. [DOI: 10.1136/bmj.305.6845.120-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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140
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Walton J. BOOK REVIEWS: Preserve Your Love for Science. (Life of Wm A. Hammond, American Neurologist). Journal of Neurology, Neurosurgery and Psychiatry 1992. [DOI: 10.1136/jnnp.55.5.426-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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141
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142
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Davies AH, Walton J, Stuart E, Morris PJ. Surgical management of the thoracic outlet compression syndrome. Br J Surg 1991; 78:1193-5. [PMID: 1958983 DOI: 10.1002/bjs.1800781015] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
There is some disagreement about whether the first rib should be excised in the presence of a cervical rib for the relief of the thoracic outlet compression syndrome (TOCS). Over a 14-year period (1975-1988) 58 patients have undergone surgery for TOCS. Forty-four patients (76 per cent) had vascular symptoms, 28 (48 per cent) with a neurological component; 11 (19 per cent) had only neurological symptoms. Thirty-six patients (62 per cent) had the first rib excised; 19 (33 per cent) had a cervical rib excised; two (3 per cent) had a division of fibrous bands; and one patient had a large transverse process resected. Follow-up details were available on 53 patients (91 per cent). Overall 38 (72 per cent) were cured of their symptoms, 11 (21 per cent) had a significant improvement, and four (8 per cent) showed no improvement. There was no significant difference between the results following excision of a cervical rib or of a first rib in terms of relief of symptoms. In patients with TOCS who have a cervical rib, excision of the cervical rib alone without excision of the first rib would appear to be an appropriate treatment.
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143
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Walton J. BOOK REVIEWS: Neurology in Clinical Practice Vols I and II. J Neurol Psychiatry 1991. [DOI: 10.1136/jnnp.54.7.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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144
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Collin J, Heather B, Walton J. Growth rates of subclinical abdominal aortic aneurysms--implications for review and rescreening programmes. EUROPEAN JOURNAL OF VASCULAR SURGERY 1991; 5:141-4. [PMID: 2037085 DOI: 10.1016/s0950-821x(05)80678-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
One hundred and six patients with abdominal aortic aneurysms (AAAs) of 2.5 to 3.9 cm in anteroposterior diameter were reexamined by ultrasound every 6 months for up to 3 years after diagnosis. Annual growth rates were 0.11 cm +/- 0.03 (mean +/- SE) for AAAs 2.5 to 2.9 cm and 0.29 cm +/- 0.08 for AAAs 3.5 to 3.9 cm (P = 0.002). In 73 patients (69%) the annual rate of increase in diameter was 0.2 cm or less and only 12 aneurysms (11%) grew at more than 0.5 cm per annum. We conclude that: (1) for AAAs less than 4.0 cm diameter remeasurement more often than every 6 months is unnecessary; (2) interval screening (rescreening) for AAAs more frequently than 5 yearly is unlikely to detect sufficient clinically significant aneurysms to be worthwhile.
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146
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Olson DM, Smieja Z, Zakar T, MacLeod EA, Walton J, Milne K. Regulation of prostaglandin synthesis in the human amnion. Reprod Fertil Dev 1991; 3:413-9. [PMID: 1957030 DOI: 10.1071/rd9910413] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
An increase in prostaglandin synthesis by intrauterine tissues may be responsible for labour initiation and/or maintenance in humans. In all studies to date, the amnion is the intrauterine tissue whose prostaglandin output consistently increases with the onset of labour. This may be due, in part, to acute activation of the phospholipases A2 and C and to an increase in the specific activity of prostaglandin H synthase (PGHS). A number of factors exist in amniotic fluid, the fetal membranes, the decidua and the placenta that can increase PGHS specific activity. Some of these factors may increase PGHS enzyme activity by gene expression and protein synthesis. Preliminary evidence is presented that suggests the hypothesis that PGHS specific activity increases before the onset of labour rather than as a consequence of labour initiation, and that idiopathic preterm labour may frequently be associated with increased PGHS activity. Hence, activation of PGHS gene expression and/or protein synthesis may be causal for term and preterm labour.
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Gerbier G, Lesquoy E, Rich J, Spiro M, Tao C, Yvon D, Zylberajch S, Delbourgo P, Haouat G, Humeau C, Goulding F, Landis D, Madden N, Smith A, Walton J, Caldwell DO, Magnusson B, Witherell M, Sadoulet B. Measurement of the ionization of slow silicon nuclei in silicon for the calibration of a silicon dark-matter detector. PHYSICAL REVIEW. D, PARTICLES AND FIELDS 1990; 42:3211-3214. [PMID: 10013204 DOI: 10.1103/physrevd.42.3211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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148
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Walton J, Greenhalgh RM. Brachial artery damage following cardiac catheterisation. When to re-explore. EUROPEAN JOURNAL OF VASCULAR SURGERY 1990; 4:219-22. [PMID: 2191874 DOI: 10.1016/s0950-821x(05)80198-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cardiac catheterisation is frequently performed in modern medical practice and the brachial artery is frequently used. The brachial and forearm systolic pressures were measured by Doppler ultrasound at rest and after hand exercise for 60 s in 75 patients undergoing catheterisation. These objective measurements, together with a history of forearm claudication during the one minute of exercise and clinical examination of the radial pulse were repeated again at 1 hour, 1 week and 3 months. Changes in the forearm/brachial pressure index (PI) at rest and a fall in forearm pressure after exercise were compared with the pre-catheterisation values. Sixteen per cent of patients suffered claudication of the forearm during the one minute hand exercise immediately after catheterisation. Of those seen at 3 months, 12% had persistent claudication and all had a markedly reduced PI measured following catheterisation. Conversely, at 1 [corrected] hour after catheterisation, the radial pulse was weak or absent in 20% and 33% were abnormal on Doppler studies and not all had symptoms. It emerges that to avoid claudicating forearms at 3 months, re-exploration, one hour after brachial catheterisation is indicated in some cases. We are inclined to base this upon the 16% who had forearm claudication after one minute of exercise and who also had absent or reduced radial [corrected] pulse and abnormal Doppler studies. Conversely to base the need for re-exploration upon a reduction or absence of the radial pulse [corrected] (20%) on Doppler studies (33%) would lead to an unnecessarily high rate of re-exploration just after the procedure.
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Abstract
This study aimed to discover the prevalence of undiagnosed abdominal aortic aneurysm in the community in men aged sixty-five to seventy-four. All 1,392 men in this age group registered with twenty general medical practitioners were invited for free health screening at hospital and 746 attended. The abdominal aorta was imaged by ultrasound and its anteroposterior diameter measured. An abdominal aortic aneurysm was present in 6.3% and the aneurysm was 4.0 cm or more in diameter in 2%.
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Walton J. Swanning in the steps of Hippocrates. BMJ (CLINICAL RESEARCH ED.) 1989; 299:1589-91. [PMID: 2514926 PMCID: PMC1838797 DOI: 10.1136/bmj.299.6715.1589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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