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Biomedical subjects

A M Porter

Publications and source records attributed to A M Porter.

At least 37 records · Page 2Linked to original sources
PubMed1989

Quality and the use of time in general practice: widening the discussion.

To examine the association between different consulting styles in general practice (defined according to the average length of doctor-patient contact time in surgery consultations) and the process of care for those patients presenting with new episodes of respiratory illness, 1787 consultations conducted by 85 general practitioner principals in Lothian from November 1987 to May 1988 were analysed. Short as against long consultations resulted in less attention being given to psychosocial issues that the doctor recognised as relevant. When psychosocial problems were dealt with prescribing of antibiotics decreased. In this volunteer sample of doctors the process of care seemed to reflect decisions as to how time was allocated rather than inherently different patterns of clinical behavior. Organisational and contractual changes will shift the mix of financial and professional incentives for general practitioners in ways that could lead to doctors reallocating their time toward shorter consultations; such a reallocation could have important implications for patient care.

Anti-Bacterial Agents↗
PubMed1988

Effects of lactic acid infusions and pH on cerebral blood flow and metabolism.

To determine the effects of lactic acidemia versus lactate on CBF, we infused lactic acid, either buffered with NaOH (L + NaOH) or with added NaCl (L + NaCl), to attain similar osmolalities in 18 piglets. CBF (microsphere technique), pH, blood gases, plasma osmolality, and cerebral arteriovenous differences of O2 content and lactic acid concentrations were measured prior to, at 30 min of a lactic acid infusion, and 15 and 90 min after completion of the infusion. Control arterial pH was comparable between groups (7.50 +/- 0.02 vs. 7.49 +/- 0.02, X +/- SE); during and following L + NaCl and L + NaOH, values were (p less than 0.05) 7.09 +/- 0.03, 7.35 +/- 0.02, and 7.46 +/- 0.02 vs. 7.58 +/- 0.03, 7.61 +/- 0.01, and 7.57 +/- 0.03, respectively. PaCO2 remained unchanged and osmolality rose by 15% in both groups during infusions and persisted throughout the study period. For L + NaCl piglets, CBF (ml/min.100 g) rose from 136 +/- 15 to 198 +/- 26 (p less than 0.05) at 30 min of infusion and remained elevated at 201 +/- 25 and 207 +/- 28 at 15 and 90 min following the infusion, respectively. Similarly, for L + NaOH piglets, CBF rose from 130 +/- 25 to 196 +/- 31 (p less than 0.05) with the infusion and was 174 +/- 17 and 166 +/- 21 at 15 and 90 min afterward, respectively. Although lactic acid infusion increases CBF, the associated metabolic acidemia is not responsible for changes in CBF.

Animals↗
PubMed1987

Cerebral lactic acid delivery and uptake during and after ischemia in the piglet.

To determine whether lactic acid is a cerebral substrate during and after partial ischemia in piglets, cerebral blood flow and arteriovenous differences of O2 and substrates were measured during control, after hemorrhagic hypotension, and 10 and 90 minutes after reperfusion with blood. During and following ischemia, alterations in cerebral O2 and glucose uptake indicated disturbed oxidative metabolism. Cerebral lactic acid uptake was similar at control, hypotension, and 90 minutes postreperfusion, but rose 10 minutes postreperfusion. Absent cerebral production of lactic acid during and net uptake following ischemia do not support lactic acid as a substrate since insufficient O2 was available for oxidation.

Animals↗
PubMed1986

Summarizing and coding case records: can the task be delegated?

After several preliminary joint sessions a doctor and a nurse independently constructed summary cards for 100 alphabetically consecutive case records and coded them according to the classification of the Royal College of General Practitioners. The searches and codings were repeated after an interval of at least one month. The error rates of the doctor and the nurse were similar. The interobserver concordance for the ratings was acceptable for broad diagnostic categories, but was less good when strict criteria were applied. It is concluded that the task may be delegated.

Abstracting and Indexing↗
PubMed1985

Measurement of stress as it affects the work of the general practitioner.

This paper describes a preliminary study which collected information on the work of 18 general practitioners during a total of 52 days, and also recorded their feelings of pressure and stress from hour to hour throughout each day. The instruments used to record information on day-to-day activities and to measure self-perceived pressure, stress and arousal are described. The reliability and validity of the methods used are discussed, and some suggestions made for future development. A few preliminary findings are presented.

Appointments and Schedules↗
PubMed1984

Marathon running and adverse weather conditions: a miscellany.

This paper considers various predisposing and corrective factors for hypothermia and hyperthermia in marathon runners. It is concluded that a race should be cancelled or deferred if the forecast suggests that certain climatic thresholds are likely to be met or crossed.

Fever↗