University of Wales

About: University of Wales is a education organization based out in Cardiff, United Kingdom. It is known for research contribution in the topics: Population & Poison control. The organization has 12462 authors who have published 16873 publications receiving 700173 citations. The organization is also known as: Prifysgol Cymru.

Defining and applying the concept of quality of life

Abstract: Quality of life has been increasingly used as a scientific concept in literature embracing a wide range of target groups and populations as a whole. Conceptualizations vary, but there is much common ground concerning the domain content embraced by the term. Commentators are also clear that account needs to be taken of both objective life conditions and subjective personal appraisals, and the fact that what is important to each person varies. A synthesis of these perspectives provides a model of quality of life which integrates objective and subjective indicators and individual values across a broad range of life domains. Life domain issues may be categorized within six areas: physical, material, social, productive, emotional and civic well-being. Whatever its precise specification, the model is put forward as a framework for organizing measurement relevant to the quality of life concept rather than as a blueprint for deriving the ultimate single instrument. There is still a need for methodological flexibility. The pre-eminent aim is to relate the fine grain of the experience of individuals with disability to that of the wider world.

British Association of Dermatologists guidelines for use of biological interventions in psoriasis 2005.

Abstract: Psoriasis is a common, persistent, relapsing inflammatory skin disease that can be associated with significant morbidity. Quality of life studies in psoriasis reveal a negative impact on patients comparable with that seen in cancer, arthritis and heart disease.1–5 Patients with severe disease constitute approximately 20–30% of all patients with psoriasis, often require systemic treatment, and represent a major economic burden to the Health Service. All standard systemic therapies for severe disease are associated with the potential for major long-term toxicity, many are expensive, and a proportion of patients has treatmentresistant disease.6 Biological therapies or ‘biologics’ describe agents designed to block specific molecular steps important in the pathogenesis of psoriasis and have emerged over the last 3–5 years as potentially valuable alternative therapeutic options. Currently, biological therapies for psoriasis comprise two main groups: (i) agents targeting the cytokine tumour necrosis factor (TNF)-a (e.g. etanercept, infliximab, adalimumab) and (ii) agents targeting T cells or antigen-presenting cells (e.g. efalizumab, alefacept). Two of these, etanercept (Enbrel) and efalizumab (Raptiva) were licensed in 2004 in the U.K. for patients with moderate to severe psoriasis.

Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane in man†

Abstract: Background The motivation for this study was the current difficulty in estimating the total age-related MAC for a patient in a clinical setting. Methods Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane were developed for the clinically useful MAC range (0.6–1.6), age range 5–95 yr, and put in a convenient form for use by practising anaesthetists. The charts are based on Mapleson's meta-analysis (1996) of the available MAC data and can be used to allow for the contribution of nitrous oxide to the total MAC. Results The charts indicate the influence of age on anaesthetic requirements, showing, for example, that a total MAC of 1.2 using isoflurane and nitrous oxide 67% in oxygen requires an end-expired isoflurane concentration of only 0.25% in a patient of 95 yr vs 1% in a 5-yr-old patient. Colleagues found the charts to be helpful and simple to use clinically. Conclusions The iso-MAC charts show clearly how patient age can be used to guide the choice of end-expired agent concentration. They also allow a consistent total MAC to be maintained when changing the inspired nitrous oxide concentration, thereby reducing the chance of inadvertent awareness, particularly at the extremes of age.

Subdural haemorrhages in infants: population based study

Abstract: Objectives: To identify the incidence, clinical outcome, and associated factors of subdural haemorrhage in children under 2 years of age, and to determine how such cases were investigated and how many were due to child abuse. Design: Population based case series. Setting: South Wales and south west England. Subjects: Children under 2 years of age who had a subdural haemorrhage. We excluded neonates who developed subdural haemorrhage during their stay on a neonatal unit and infants who developed a subdural haemorrhage after infection or neurosurgical intervention. Main outcome measures: Incidence and clinical outcome of subdural haemorrhage in infants, the number of cases caused by child abuse, the investigations such children received, and associated risk factors. Results: Thirty three children (23 boys and 10 girls) were identified with subdural haemorrhage. The incidence was 12.8/100 000 children/year (95% confidence interval 5.4 to 20.2). Twenty eight cases (85%) were under 1 year of age. The incidence of subdural haemorrhage in children under 1 year of age was 21.0/100 000 children/year and was therefore higher than in the older children. The clinical outcome was poor: nine infants died and 15 had profound disability. Only 22 infants had the basic investigations of a full blood count, coagulation screen, computed tomography or magnetic resonance imaging, skeletal survey or bone scan, and ophthalmological examination. In retrospect, 27 cases (82%) were highly suggestive of abuse. Conclusion: Subdural haemorrhage is common in infancy and carries a poor prognosis; three quarters of such infants die or have profound disability. Most cases are due to child abuse, but in a few the cause is unknown. Some children with subdural haemorrhage do not undergo appropriate investigations. We believe the clinical investigation of such children should include a full multidisciplinary social assessment, an ophthalmic examination, a skeletal survey supplemented with a bone scan or a skeletal survey repeated at around 10 days, a coagulation screen, and computed tomography or magentic resonance imaging. Previous physical abuse in an infant is a significant risk factor for subdural haemorrhage and must be taken seriously by child protection agencies.

Endothelial Control of Arterial Distensibility Is Impaired in Chronic Heart Failure

Abstract: Background Vascular tone is a determinant of conduit artery distensibility. The aim of this study was to establish whether endothelium-derived relaxing factor (EDRF) influences the distensibility of conduit arteries and whether endothelium-mediated increases in distensibility are impaired in chronic heart failure (CHF). Methods and Results Conduit artery distensibility was measured by two methods in healthy subjects and in nine patients with CHF caused by dilated cardiomyopathy. In the first method, pulse-wave velocity (PWV) was measured in the right common iliac artery at rest and during local infusions of acetylcholine (10 −7 to 10 −5 mol/L) or adenosine (2×10 −7 to 2×10 −5 mol/L), with correction for systemic effects. Acetylcholine induced concentration-dependent local reductions of PWV in healthy subjects (−5%, −15%, and −26%) but not in CHF patients (3%, 1% , −4%, P Conclusions These data indicate that conduit artery distensibility is increased by acetylcholine and increased blood flow in healthy subjects but not in CHF patients, whereas the effects of adenosine and GTN on distensibility are preserved in CHF patients. This implies that EDRF-mediated increases in distensibility are impaired in CHF patients, thus adding to cardiac work.