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Biomedical subjects

A D Noble

Publications and source records attributed to A D Noble.

At least 19 recordsLinked to original sources

Resource-conserving agriculture increases yields in developing countries.

Despite great recent progress, hunger and poverty remain widespread and agriculturally driven environmental damage is widely prevalent. The idea of agricultural sustainability centers on the need to develop technologies and practices that do not have adverse effects on environmental goods and services, and that lead to improvements in food productivity. Here we show the extent to which 286 recent interventions in 57 poor countries covering 37 M ha (3% of the cultivated area in developing countries) have increased productivity on 12.6 M farms while improving the supply of critical environmental services. The average crop yield increase was 79% (geometric mean 64%). All crops showed water use efficiency gains, with the highest improvement in rainfed crops. Potential carbon sequestered amounted to an average of 0.35 t C ha(-1) y(-1). If a quarter of the total area under these farming systems adopted sustainability enhancing practices, we estimate global sequestration could be 0.1 Gt C y(-1). Of projects with pesticide data, 77% resulted in a decline in pesticide use by 71% while yields grew by 42%. Although it is uncertain whether these approaches can meet future food needs, there are grounds for cautious optimism, particularly as poor farm households benefit more from their adoption.

Agriculture↗

Changing trends in gynaecological surgical workload.

A reduction has been recorded in National Health Service gynaecological bed occupancy in Winchester and Wessex. At least part of this change may be explained by an increase in private hospital practice. NHS managers should plan for similar changes elsewhere in the United Kingdom.

Bed Occupancy↗

Effect of introduction of colposcopy into a district general hospital.

Management of cervical intra-epithelial neoplasia, in a district general hospital, was examined for two 22-month periods before and after the introduction of colposcopy. This technique enables the clinician to evaluate the extent and severity of pre-malignant change, and makes treatment, using less radical destructive techniques, possible. The method of conservative treatment in this hospital was diathermy, and the cure rate of cases so treated was 97%. The use of diathermy treatment resulted in a 75% reduction in the incidence of cone biopsy in women below the age of 40 years. A further advantage of colposcopy has been recognized, which is that some women with "mild or moderate changes" are discovered to have more severe lesions, and receive appropriate treatment without delay. It follows that all patients with an abnormal smear should be referred for colposcopy, unless there is an obvious local cause of the abnormality, such as easily treatable infection, and that the post-treatment smear reverts to normal. In this hospital the cost of establishing a colposcopic service was low, and the cost benefits, as well as the improved management of cervical intraepithelial neoplasia suggests that the service should be introduced in all district general hospitals.

Adolescent↗

Reversal of female sterilization.

Reversal of sterilization was attempted in 22 women without the use of an operating microscope. Fifty per cent became pregnant. Success was influenced by the site and extent of the tubal damage resulting from the sterilization procedure, mechanical occlusive sterilization techniques offering the best change of a successful reversal.

Female↗

Treatment of endometriosis: a study of medical management.

Fifty patients with endometriosis were treated with hormones: 27 with danazol and 23 with Enavid (mestranol 75 micrograms and norethynodrel 5 mg). Side effects were more common and potentially more serious in the group treated with Enavid. Fewer women completed treatment with Enavid and their physical signs showed little improvement. Danazol was better tolerated and the results of treatment, as judged by improvement of symptoms or signs and in future fertility rates, were superior to those recorded in the Enavid treated group. Patients with large endometriotic cysts or severe fibrosis did not benefit from medical treatment. Danazol treatment appeared helpful for women who had mild or moderate endometriotic disease. It may be used alone or as a complimentary treatment after conservative surgical operations.

Adult↗

Comparative trial of extra-amniotic and vaginal prostaglandin E2 in tylose gel for induction of labor.

Two hundred and sixty-one patients of varying parity and cervical "ripeness" were given Prostaglandin E2 (PCE2) in tylose gel either vaginally (2.0 mgm) or extraamniotically (0.3 mgm) prior to planned surgical induction. Surgical inductions was avoided in 52 per cent of the vaginal group and 40 per cent of the extra-amniotic group. When subdivided according to parity and cervical ripeness, both groups were comparable except in the multigravid patients with high cervical 'scores', when the vaginal route was significantly more likely to establish labor. Both groups were without significant ill-effects to the mother or fetus.

Amniotic Fluid↗

Laparoscopy or minilaparotomy for sterilization of women.

A prospective randomly controlled study was conducted on 200 women undergoing sterilization by application of clips to the fallopian tubes. Laparotomy or laparoscopy was used, and the patients' response to the procedure was evaluated. There were few surgical complications. Postoperative pain and discomfort were experienced for a mean of 2.7 and 2.4 days in the those undergoing minilaparotomy and laparoscopy, respectively. The patients' response indicates a marginal benefit from the laparoscopic approach to application of clips to the fallopian tubes.

Female↗

Abortion associated with intrauterine infection by candida albicans. Case report.

A 27-year-old patient who became pregnant whilst fitted with an intrauterine contraceptive device developed an intrauterine Candida albicans infection and aborted. The diagnostic (and other inconspicuous) features of C. Albicans infection in the fetus are described. The presence of the intrauterine contraceptive device may have predisposed to the establishment of the infection.

Abortion, Spontaneous↗

Medical treatment of endometriosis: a comparative trial.

In a comparison of danazol, and mestranol with norethynodrel (Enavid, Searle) in the treatment of endometriosis danazol was shown to be superior. Danazol is however relatively ineffective when large tumours or extensive adhesions are present and such patients will usually need a surgical operation. Women who have completed their families and who have severe symptoms will be better treated by hysterectomy. Treatment with danazol is indicated for young women with mild or moderate endometriosis. Danazol treatment may also be given postoperatively after conservative operations.

Body Weight↗