Psychiatry: observing the Italian job.
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Biomedical subjects
Publications and source records attributed to C Allen.
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The technique of heterotopically transplanting a rabbit heart into the abdominal position of a recipient rabbit is discussed. Myocardial preservation, vascular anatomy of the recipient, and general anesthetic considerations are described, as are techniques to avoid anesthetic death, hemorrhage, and paraplegia. Application of these techniques to experimental models of accelerated coronary atherosclerosis and reperfusion injury are suggested.
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Plasma exchange (PE) was used to treat 9 patients with rheumatoid vasculitis. The immediate development of new lesions was arrested in 7 patients. Two patients continued to develop new lesions. One responded to additional cyclophosphamide plus methyl prednisolone but the other died within days from severe systemic vasculitis. Prolonged PE alone, or PE followed by cyclophosphamide plus methyl prednisolone was associated with healing of existing lesions without relapse. Short term PE, alone or followed by azathioprine, failed to heal existing lesions and relapses occurred within 3 months. IgG rheumatoid factor and anticomplementary activity fell with PE and correlated best with clinical response.
A retrospective survey was undertaken of the participants in and the organisers of an exchange scheme for junior physicians which has operated since 1977 between leading hospitals in countries of the European Community and Switzerland. The exchange has clinical, research, educational and cultural objectives and the survey sought to record the experiences of participants and their chiefs of service and note the strengths and weaknesses of the scheme as well as problems encountered with it. Overall, the participants' reports of their experiences of the scheme were favourable. Chiefs of host departments were enthusiastic about the interaction between participants and the host institutions. The impact of the programme on the junior doctors' educational and career development was variable though generally positive; major career changes were rare, the common pattern being one of helpful focusing of career intentions. Problems were relatively infrequent, mostly related to poor briefing, finances and bureaucracy. Few general international differences of experience of the scheme emerged.
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A memory aid group was run for people with memory difficulties and their carers in a local health centre. It aimed to develop coping strategies that carers and clients felt they could put into practice in their own homes. While the numbers in the initial study were small, the group outcome suggested that providing a more localised service, linking mental health specialists and local nursing practitioners had advantages.