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Biomedical subjects

A Grant

Publications and source records attributed to A Grant.

At least 253 records · Page 14Linked to original sources
PubMed1984

West Berkshire perineal management trial.

One thousand women were allocated at random to one of two perineal management policies, both intended to minimise trauma during spontaneous vaginal delivery. In one the aim was to restrict episiotomy to fetal indications; in the other the operation was to be used more liberally to prevent perineal tears. The resultant episiotomy rates were 10% and 51% respectively. An intact perineum was more common among those allocated to the restrictive policy. This group experienced more perineal and labial tears, however, and included four of the five cases of severe trauma. There were no significant differences between the two groups either in neonatal state or in maternal pain and urinary symptoms 10 days and three months post partum. Women allocated to the restrictive policy were more likely to have resumed sexual intercourse within a month after delivery. These findings provide little support either for liberal use of episiotomy or for claims that reduced use of the operation decreases postpartum morbidity.

Adult↗
PubMed1984

The problem of evaluating in situ pinning of slipped capital femoral epiphysis: an experimental model and a review of 63 consecutive cases.

Over a 3-year follow-up period, 63 hips (in 49 patients) that were pinned as treatment for slipped capital femoral epiphysis were examined and evaluated. A 36.8% incidence of unsuspected pin penetration was discovered. Four types of experimental models representing different degrees of severity of slipped capital femoral epiphysis were designed and manufactured in the bioengineering laboratory. In situ pinning was performed on each model. An extensive series of controlled test films on the models indicated the difficulty of accurately determining the true position of the pins with conventional roentgenographic views. Subsequent fluoroscopic analysis revealed a verifiable correlation between the limited visualization of conventional X-ray analysis following the pinning of a slipped capital femoral epiphysis and unrecognized pin penetration.

Bone Nails↗
PubMed1984

A randomized controlled trial of cervical cerclage in women at high risk of spontaneous preterm delivery.

The effect of cervical suture on pregnancy outcome was studied in 194 women with a high risk (approximately 30%) of having a late abortion or a preterm delivery. The women were randomly allocated either to have a cervical suture inserted (n = 96) or to be managed without a suture (n = 98). There was no evidence that cervical cerclage either prolonged gestation or improved survival. Patients allocated to receive cerclage spent significantly longer in hospital, even when the period of admission for insertion was excluded. The patients in the cerclage group were more likely to receive tocolytic drugs, and more of them experienced puerperal pyrexia, although these differences between the groups were not statistically significant.

Adolescent↗
PubMed1984

Merits of an individualized approach to fetal movement counting compared with fixed-time and fixed-number methods.

The most commonly employed methods for maternal counting of fetal movements take no account of variation in the level of activity between fetuses. This may result in false alarms or prolonged counting in pregnancies in which perceived movements are infrequent. A new counting method is described in which an individualized hourly rate of perceived movements is first calculated for each patient; then, the time taken to feel this number is recorded each day for the remainder of the pregnancy. The new system is associated with a substantially lower false alarm rate than a system of counting for an hour and continuing for a second hour if the level is low. In comparison with the Cardiff 'count-to-10' method, the amount of time spent counting each day was more uniform and was halved overall. Although this system is more complicated to initiate these clear advantages suggest that it should be subjected to large-scale feasibility trials.

Female↗
PubMed1984

A method for isolation of islets of Langerhans from the human pancreas.

A method has been developed for the isolation of islets of Langerhans from the human pancreas. The average number of islets isolated was 1011 islets per gram of pancreas (SD 475, range 752-2111), and the purity of the preparation as defined by histologic examination and specific staining for insulin varied from 10% to 40%. Islet structure was well preserved and the islets were shown to be viable by supravital staining, demonstration of insulin response to glucose, and by transplantation of isolated islets beneath the renal capsule of nude mice. The essential features of this technique for isolation of human islets include injection of a high concentration of collagenase (6 mg/ml) into the pancreatic duct under pressure, followed by a short incubation (23 min) at 39 degrees C. The gland is then dispersed by a process of teasing and shaking, and the islets are separated by a two-stage process of filtration on a nylon mesh to remove the larger islets and centrifugation on a preformed Ficoll density gradient to separate the small islets.

Animals↗
PubMed1984

A method of evaluating possible pin penetration in slipped capital femoral epiphysis using a cannulated internal fixation device.

A technique that utilizes a newly designed cannulated screw with injection of radiographic dye through the screw cannula provides a reliable and practical method for detection and avoidance of pin penetration when operating on slipped capital femoral epiphyses. Adoption of this method minimizes the possibility of poor results occurring as a consequence of internal fixation.

Bone Nails↗
PubMed1983

Informed consent.

Explore the source record for details and available documents.

Attitude to Health↗
PubMed1983

[Intramuscular injections in rheumatology: risks and opportunities].

The parenteral use of non-steroidal antiinflammatory drugs has been shown, in pharmacokinetic studies, to have two advantages: more rapid action relative to oral or rectal routes due to a more prompt achievement of maximum serum concentrations; greater efficacy due to the achievement, with the same dosage, of higher serum concentrations than after rectal or oral administration. Among the side-effects, general disorders do not seem more prevalent than after oral or rectal doses. Local side-effects should be prevented by a careful technique and the use of non-irritating compounds.

Anti-Inflammatory Agents↗
PubMed1983

Portsmouth operative delivery trial: a comparison vacuum extraction and forceps delivery.

A total of 304 women, for whom operative delivery was considered necessary in the second stage of labour, were randomly assigned to delivery by vacuum extraction or forceps. Of those allocated to forceps a higher proportion of babies were actually delivered with the allocated instrument; however, the caesarean section rate was also higher in this group. Maternal trauma, use of analgesia and blood loss at delivery were significantly less in the group allocated to vacuum extraction. Vacuum extraction did, however, appear to predispose to an increase in mild neonatal jaundice. More serious neonatal morbidity was rare in both groups and the trial was of insufficient size to rule out a clinically important differential effect of the two instruments on these measures of outcome. Another trial is now needed to address this still open question more rigorously.

Adult↗
PubMed1983

Assessment of fat malabsorption.

For the assessment of fat malabsorption, the standard method of measuring faecal fat excretion using a 5 day stool collection has been compared with the alternative methods: stool microscopy, a lipid tolerance test and a continuous marker technique for the estimation of fat content on a single stool sample. The lipid test, using an emulsion of arachis oil (Prosparol), was less reliable than had been expected with a sensitivity of 33% and a specificity of 45.4%. Stool microscopy using Oil Red O to stain fat globules had a sensitivity of 72.2% and a specificity of 95.4%. Fat estimation of a single stool sample using copper (1) thiocyanate showed a high correlation with that determined on a 5 day stool collection (p less than 0.001). It is concluded that lipid tolerance tests have little place in the estimation of fat absorption. In laboratories where faecal fats are not measured, microscopic examination of stool for fat globules provides a specific and relatively sensitive method for detecting steatorrhoea. The use of a continuous marker provides a method for assessing the degree of steatorrhoea on a single stool sample without the disadvantages of the conventional method of faecal fat analysis.

Celiac Disease↗
PubMed1983

[Eosinophilic arthritis and general review of the significance of articular eosinophilia].

The authors report two cases of eosinophilic arthritis in allergic patients, which constitute the 9th and 10th reported cases. This condition consists of episodes of mildly painful, mildly incapacitating monoarthritis, essentially involving the knee, which last 2 to 15 days. These monoarthritis occur in young allergic patients; there are no allergic manifestations during the episode of arthritis and there is apparently no provoking allergen, but examination reveals intense dermographism. Apart from the presence of eosinophil polymorphonuclear cells in the synovial fluid, one can also find Charcot-Leyden crystals (one of the two cases in this study). The histological examination of the synovial membrane in one of these patients revealed an infiltration of eosinophil polymorphs. A raised serum IgE is always found. Including these two cases, the authors have found 11 out of 4277 specimens of joint fluid which show articular eosinophilia. The nine other cases consisted of one haemarthrosis, two post-arthrographic effusions, one filarial arthritis, one psoriatic rheumatism, one Gougerot-Sjögren syndrome and three cases of unclassifiable arthritis. Data from the literature show that articular eosinophilia is a rare phenomenon, that it does not constitute a simple local reflection of a blood hypereosinophilia and that it can consist of the cases found in this study.

Adolescent↗
PubMed1982

Differential anticoagulant activity of heparin fragments prepared using microbial heparinase.

Heparin of an average molecular weight of 13,000 with known polydispersity was degraded using microbial heparinase. The kinetics of this degradation were followed by four assays which measured the anticoagulant activity of the heparin digestion products. Both clotting and amidolytic chromogenic assays were used to measure heparin-potentiated inhibition of both thrombin and Factor Xa. These assays showed different profiles throughout the digestion and were related to the average molecular weight of the digestion products.l The final products of this enzymatic digestion were fractionated on the basis of size and their anticoagulant activities were measured. Fragments causing Factor Xa inhibition but not thrombin inhibition were isolated. Anticoagulant activity was found in a fragment as small as a tetrasaccharide.

Animals↗