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Biomedical subjects

C Paterson

Publications and source records attributed to C Paterson.

At least 55 records · Page 3Linked to original sources
PubMed1997

Use of contraception in women who present for termination of pregnancy in inner London.

OBJECTIVES: To describe the contraceptive usage of women undergoing termination of pregnancy in order to identify problems with contraception, and therefore suggest ways in which contraceptive services can be improved. DESIGN: Prospective study of attenders for NHS termination of pregnancy over a three month period. SETTING: Community based assessment clinics for NHS termination of pregnancy in inner London. SUBJECTS: Two hundred and sixty-nine women asking for assessment for NHS termination of pregnancy. MAIN OUTCOME MEASURES: Source of contraception, method used around time of conception, and problems experienced. RESULTS: Respondents tell into three groups: those using contraception around the time they became pregnant; those who had ceased to use contraception; and those that had never used contraception. The method of contraception used by the majority of the first group was the condom and the main source of the method was the chemist shop. The second group had most commonly used oral contraceptives in the past and had ceased use in many cases as a result of side effects. The majority of the third group did not speak English and had limited knowledge of methods of contraception. CONCLUSIONS: High usage of chemists means women avoid service providers who could offer help and advice. Women were prepared to put themselves at risk of unwanted pregnancy rather than return for further help and the lack of knowledge about emergency birth control was of some concern. The needs of black and ethnic minority women requires detailed work to improve access and acceptability of contraceptive services.

Adolescent↗
PubMed1996

Measuring outcomes in primary care: a patient generated measure, MYMOP, compared with the SF-36 health survey.

OBJECTIVE: To assess the sensitivity to within person change over time of an outcome measure for practitioners in primary care that is applicable to a wide range of illness. DESIGN: Comparison of a new patient generated instrument, the measure yourself medical outcome profile (MYMOP), with the SF-36 health profile and a five point change score; all scales were completed during the consultation with' practitioners and repeated after four weeks. 103 patients were followed up for 16 weeks and their results charted; seven practitioners were interviewed. SETTING: Established practice of the four NHS general practitioners and four of the private complementary practitioners working in one medical centre. SUBJECTS: Systematic sample of 218 patients from general practice and all 47 patients of complementary practitioners; patients had had symptoms for more than seven days. OUTCOME MEASURES: Standardised response mean and index of responsiveness; view of practitioners. RESULTS: The index of responsiveness, relating to the minimal clinically important difference, was high for MYMOP: 1.4 for the first symptom, 1.33 for activity, and 0.85 for the profile compared with < 0.45 for SF-36. MYMOP's validity was supported by significant correlation between the change score and the change in the MYMOP score and the ability of this instrument to detect more improvement in acute than in chronic conditions. Practitioners found that MYMOP was practical and applicable to all patients with symptoms and that its use increased their awareness of patients' priorities. CONCLUSION: MYMOP shows promise as an outcome measure for primary care and for complementary treatment. It is more sensitive to change than the SF-36 and has the added bonus of improving patient-practitioner communication.

Adolescent↗
PubMed1996

Identification of prostanoid receptors in rabbit non-pigmented ciliary epithelial cells.

Preliminary ligand binding studies demonstrated that the membrane preparations of the rabbit nonpigmented ciliary epithelial cell line have 3H-prostaglandin E2 binding sites. The binding sites were specific for 3H-prostaglandin E2 as demonstrated by competition with unlabeled prostaglandin E2. The IC50 of prostaglandin E2 for the inhibition of 3H-prostaglandin E2 binding was 435 nM. The stimulation of adenylyl cyclase and phospholipase C by prostanoid receptor agonists, in rabbit non-pigmented ciliary epithelial cells resulted in the formation of either cyclic AMP or inositol phosphates. Prostaglandin E2 and 16-16-dimethyl prostaglandin E2 (both are EP1, EP2, EP3 and EP4 receptor agonists). 11-deoxy prostaglandin E1 (EP2, EP3 and EP4 receptor agonist), butaprost (EP2 receptor agonist), and prostaglandin D2 (DP receptor agonist) stimulated the formation of cyclic AMP in a dose-dependent manner. Maximal stimulation occurred between 1.25 and 2.5 microM for prostaglandin E2 and 16,16-dimethyl prostaglandin E2 and between 10 and 20 microM for 11-deoxy prostaglandin E1 and prostaglandin D2. Prostaglandin E2 and 16,16-dimethyl prostaglandin E2 were more potent (EC50 of 0.25 microM and 0.42 microM respectively) than 11-deoxy prostaglandin E1, butaprost or prostaglandin D2. The formation of cyclic AMP by prostaglandin D2 was inhibited by BW868C, a highly selective DP receptor antagonist. 17-phenyl trinor prostaglandin E2, prostaglandin F2 alpha and U46619, the EP1, FP and TP receptor agonists, respectively stimulated phospholipase C (as measured by the formation of total inositol phosphates) in a dose-dependent manner. The agonists 11-deoxy prostaglandin E1 and butaprost coupled to adenylyl cyclase via guanine nucleotide binding protein, G8, did not increase the turnover of inositol phosphates. The results of the present study suggest that rabbit non-pigmented ciliary epithelial cells express EP1, EP2, DP, FP and TP receptors.

Adenylyl Cyclases↗
PubMed1996

Ultrasonographic examination of the femorotibial articulation in horses: imaging of the cranial and caudal aspects.

The aim of this study was to determine the normal ultrasonographic features of the cranial and caudal aspects of the femorotibial articulation and, in particular, to establish a method of examining the menisci, cruciate and meniscal ligaments ultrasonographically. Twenty hindlimbs isolated post mortem from 10 horses were used to study the normal ultrasonographic and gross anatomy of the femorotibial joint. Five stifles from 3 normal, live horses were also examined with B-mode, real-time ultrasound imaging. The results of the anatomical study are presented. The joint surfaces, menisci, cruciate and meniscal ligaments could be imaged adequately in all the specimens. No obvious variations in shape or echotexture, that might impair visualisation of potential lesions, were observed. The authors suggest that ultrasonography is a potential, noninvasive means of diagnosing soft tissue lesions in the femorotibial joint.

Animals↗
PubMed1995

Complementary practitioners as part of the primary health care team: evaluation of one model.

BACKGROUND: A four-partner, non-fundholding, urban practice with 6000 patients has since September 1991 worked closely with nine complementary practitioners working part time on a private, fee-paying basis. AIM: This study set out to describe and evaluate a model of integrating complementary practitioners into the primary health care team. METHOD: A description of the model operating in the practice was compiled. Qualitative analysis was carried out of semistructured interviews with all members of the primary health care team using the method of a cooperative enquiry. Retrospective quantitative data on patients attending complementary practitioners were also examined. RESULTS: The model allowed patients to refer themselves or be referred by a team member, encouraged communication between team members, and did not require any specific funding. After two years the model had been largely successful in preventing conflict over power, control and decision making; had maintained commitment to the idea of integrating complementary and allopathic medicine; and was self-funding. However, despite varied mechanisms set up to share knowledge and ideology, the rate of change in this area was slower than expected and referral rates were varied. The dilemma of charging patients for complementary medicine in an environment where health care is free emerged as a major concern among the doctors and practice staff. CONCLUSION: The method of cooperative inquiry allowed the whole team to gain an understanding of other viewpoints and to use the research to tackle the problems raised. This model could be adopted and used by any enthusiastic general practice.

Complementary Therapies↗
PubMed1995

Effect of poloxamer 407 on the adherence of Pseudomonas aeruginosa to corneal epithelial cells.

The effect of poloxamer 407 on Pseudomonas aeruginosa adherence to cultured epithelial cells from rabbit corneas was investigated. Three methods of bacterial quantification were used to assess P. aeruginosa adherence: scanning electron microscopy (SEM) counts, radioactivity counts, and viable bacteria counts. Confluent monolayers of rabbit corneal epithelial cells were incubated in agitation for 30 min at room temperature with H3-labeled or nonradiolabeled P. aeruginosa (10(10) bacteria/ml) in a solution of poloxamer 407 [2% or 4% in phosphate-buffered saline (PBS)] or PBS as control. Cell monolayers were washed to remove nonadherent bacteria and fixed with 2.5% glutaraldehyde and processed for SEM or processed for radioactivity counting or for culture on agar plates. The results showed that both solutions of poloxamer 407 inhibited approximately 75% of the bacterial adherence to epithelial cells (p < 0.05). Similar percentages of bacterial inhibition were obtained using the three methods of bacterial quantification. The use of an antiadherent agent such as poloxamer 407 in eye drops could possibly be a prophylactic approach to P. aeruginosa keratitis.

Animals↗
PubMed1994

Technical aspects of transvaginal ultrasound-guided follicular aspiration in cows.

A 7.5 MHz rectal transducer adapted for transvaginal use was compared with a human microcurvilinear 6 MHz transvaginal transducer for follicular aspiration in cows. Some of the problems encountered while developing an accurate and repeatable technique are discussed, including the preparation of the cow, and the selection of the needle and suction apparatus. Proficiency in the retrieval of oocytes was improved through practice. Four cows were aspirated on days 2 to 4, 9 to 12 and 15 to 16 after oestrus in two successive oestrous cycles. The initial recovery rates were poor (7 per cent) and the oocytes were of poor quality, being almost completely denuded. However, after five weeks' practice recovery rates of 41 per cent were achieved and the oocytes were suitable for in vitro maturation.

Animals↗
PubMed1994

What is the optimal caesarean section rate? An outcome based study of existing variation.

STUDY OBJECTIVE: To investigate the consequences of different levels of caesarean section (CS) rate in terms of fetal and maternal outcomes. DESIGN: Comparison of outcome variables between four categories of maternity units stratified according to CS rates. Data were collected concurrently. SETTINGS: All 17 maternity units in one health region. SUBJECTS: Data for the perinatal mortality analysis: all 221,867 deliveries in 1983-87 (excluding severe malformations) (1462 deaths); maternity information analysis system: all 36,727 women with singleton pregnancies who delivered in 1988. OUTCOME MEASURES: Perinatal mortality, Apgar scores at one and five minutes, onset of respiration after one minute, postnatal transfusion, postnatal infection, thromboembolism, low haemoglobin concentration at discharge, and puerperal psychosis were determined. RESULTS: Teaching hospitals with an increased proportion of high risk cases had the highest CS rate, but the other three categories were found to serve comparable populations. Perinatal mortality showed a birthweight specific pattern--for very low birthweight infants, but not for other deliveries, mortality rates were lower in units with higher CS rates. Apgar scores showed no trend, but the onset of respiration after one minute was significantly more frequent in units with a CS rate of less than 10%. Increased maternal postnatal blood transfusion was associated with higher CS rates but no trend was observed for the other maternal variables. CONCLUSIONS: CS rates in general maternity units should be 10 to 12% or lower in the singleton population as a whole, but a more interventionist approach is indicated for very low birthweight infants. If confirmed, these recommendations could easily be incorporated into clinical audit.

Apgar Score↗
PubMed1992

Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotrophin.

OBJECTIVE: To assess the effect of moderate obesity on the outcome of induction of ovulation with low dose gonadotrophin in women with polycystic ovary syndrome (PCOS). DESIGN: Retrospective analysis of women with PCOS treated consecutively. An analysis of the impact of obesity on outcome of pregnancy using data from the North West Thames Regional (NWTR) obstetric database was included for comparison. SETTING: Induction of ovulation clinic at the Samaritan Hospital for Women (St. Mary's Hospital Group). SUBJECTS: 100 women with clomiphene-resistant anovulation associated with PCOS. 75 were of normal weight (BMI 19-24.9 kg/m2, lean group) and 25 were moderately overweight (BMI 25-27.9 kg/m2, obese group). INTERVENTIONS: Induction of ovulation using low doses of gonadotrophins with small, stepwise increments in dosage as required. MAIN OUTCOME MEASURES: Rates of ovulation, pregnancy and miscarriage; daily and total doses of gonadotrophin required for induction of ovulation. RESULTS: The proportion of ovulatory cycles was significantly greater in the lean group (77%) compared with the obese group (57%) (chi 2 9.8, P less than 0.001). Obese women required larger doses of gonadotrophin to achieve ovulation (P less than 0.001). The proportion of women who achieved at least one pregnancy was similar in the two groups (39% vs 48%) but miscarriage was more frequent in the obese group (60% vs 27%; P less than 0.05). This difference was independent of the baseline and/or mid-follicular luteinizing hormone (LH) concentration either before or during treatment. Analysis of data from the North West Thames Health Region obstetric database confirmed an increased risk of miscarriage in moderately obese women which was independent of maternal age. CONCLUSIONS: Moderate obesity in women with PCOS, treated with low dose gonadotrophin, is associated with an increased risk of miscarriage. This is reflected in the results of analysis of the effect of obesity on outcome of pregnancy in the general population. It is therefore important to encourage weight reduction in obese women with PCOS before considering therapy to induce ovulation.

Abortion, Spontaneous↗
PubMed1991

Can we abandon Naegele's rule?

A pregnant woman may become anxious if she has not delivered by the date given to her by her physician. Much anxiety would be alleviated if a range of dates (38-42 weeks) was substituted for a specific date of delivery.

Anxiety↗
PubMed1991

How does the mode of delivery affect the cost of maternity care?

In this paper we present estimates of the difference in the cost of hospital care for women having different modes of singleton delivery. The estimates are based on observation of resources used in different procedures, and on data from the North West Thames Region Maternity Information System. For vaginal delivery the average cost is 363 pounds, but could fall between 189 pounds and 773 pounds, and for caesarean section the average cost is 1123 pounds, with a likely range from 837 pounds to 1560 pounds. The wide ranges in the costs of the two modes of delivery reflect variation in the length of stay and in the intensity of care required. The average cost for intrapartum care and postnatal stay is estimated to be 451 pounds for all singleton births. Variation in operative delivery rates between hospitals implies differences in the overall cost of care at different maternity units. This partly reflects differences in the needs of the population served by the units, but also differences in clinical practice. It is important for decision makers to consider the balance between the costs and outcomes of different policies of care.

Cesarean Section↗
PubMed1990

Detection of bacteria in histological sections of the dental pulp.

A series of deep cavities with and without traumatic pulpal exposures were prepared in the maxillary molars of albino rats. They were left untreated for various time intervals before killing. Demineralized sections were prepared in a mesiodistal plane and stained to demonstrate the presence of bacteria. In the cavities and coronal pulps that were grossly contaminated, bacteria were detected in the majority of sections. In the root canals and periapical tissues, bacteria were detected in only a minority of sections. It is considered that serial sections stained to demonstrate bacteria are necessary for the detection of bacteria that are present in only small numbers in the tissues. The demonstration of small numbers of micro-organisms in specific zones of the pulp remains problematic. Failure to detect stained bacteria in histological sections is not absolute proof of their absence.

Animals↗