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Biomedical subjects

C Taylor

Publications and source records attributed to C Taylor.

At least 289 records · Page 16Linked to original sources

The straw men of primary health care.

The following paper discusses the progress made in providing primary health care (PHC) to the developing world in the 10 years following the joint WHO/UNICEF International Conference on Primary Health Care held at Alma Ata, U.S.S.R., in 1978. UNICEF is now 12 years from the goal to provide Health for All by the Year 2000. In this context, the authors describe UNICEF's 'country programming approach' to PHC as part of the child survival and development revolution (CSDR), articulated by the agency in 1982. A polarization between the two concepts of 'selective' and 'comprehensive' PHC is examined in the light of quotations from the original conference document which set forth strategies and priorities. The authors, a consultant and a staff member of UNICEF, respond to criticism of the agency in this regard by drawing directly on UNICEF's own work in the field and its record of success, even at a time when developing countries are battling severe economic constraints and health budgets are being slashed--a contingency not foreseen at Alma Ata. WHO evaluations of both the Expanded Program on Immunization (EPI) and oral rehydration therapy (ORT) show that accelerated programs develop best when underpinned by a good health infrastructure. The challenge is to develop priority programs in such a way as to build on or strengthen this infrastructure. Flexibility is the key in adapting national priorities to local programs. The point is made that international agencies should be careful to limit themselves to advocacy and support.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

Long-term bony and soft tissue stability following advancement genioplasty.

Twenty-three patients who had undergone advancement genioplasty were evaluated an average of over 3 years postsurgically for bone and soft tissue stability. Traced serial cephalometric radiographs revealed no discernible bony remodeling from gnathion to the menton region. Six cases showed minor posterior shifting of the inferior border segment. Although good correlation existed between hard and soft tissue movement, minor soft tissue variation occurred without obvious correlation to bony remodeling.

Adolescent↗

Effects of vasoactive intestinal polypeptide infusions on renal function in patients with liver disease.

1. The effect of intravenous vasoactive intestinal peptide (VIP, 6 pmol/kg per min) on renal function in six patients with cirrhosis of the liver was examined. 2. VIP caused generalized vasodilation and increased plasma renin activity, but diminished the glomerular filtration rate by about one third. 3. The excretion of water, sodium, potassium and calcium also fell significantly. 4. These results differ from our findings in normal man in whom VIP diminished water and electrolyte secretion largely by increasing tubular reabsorption. 5. It is concluded that the elevated VIP levels present in patients with severe liver disease may affect renal function, but that the presence of liver disease may affect renal responses to VIP.

Blood Cell Count↗

Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, US, and CT.

A prospective blinded study of 201 patients was performed to determine the relative sensitivities and specificities of excretory urography/linear tomography (EU/LT) and ultrasound (US) for the diagnosis of renal parenchymal masses. Computed tomography (CT) was used as a standard. EU/LT permitted detection of 10% of CT-confirmed masses (cystic or solid) less than 1 cm, 21% of lesions greater than or equal to 1 cm but less than 2 cm, 52% of lesions greater than or equal to 2 cm but less than 3 cm, and 85% of lesions 3 cm or more in diameter. US permitted detection of 26% of CT-confirmed lesions less than 1 cm, 60% of lesions greater than or equal to 1 cm but less than 2 cm, 82% of lesions greater than or equal to 2 cm but less than 3 cm, and 85% of lesions 3 cm or more in size. The results confirm the relative insensitivity of EU/LT for masses less than 3 cm in diameter and of US for masses less than 2 cm. Further, they suggest that CT may have a role not only in evaluation of cases in which the urographic or sonographic results are questionable or positive, but also in confirmation of apparently negative urographic findings when clinical suspicion of a lesion is high.

Carcinoma, Renal Cell↗

Mammary immunity in mothers of infants with respiratory syncytial virus infection.

Seven of 230 breast fed infants followed prospectively from birth through their first winter contracted RS virus infections. The colostral from five of the mothers of these infants contained antiviral IgA antibodies. In each case antibody levels were above the mean for a group of 36 mothers whose infants were age matched to infected infants but for whom there was no evidence of RS virus infection in their first winter. Four colostral samples from mothers of infected infants also contained antiviral IgG antibody. Colostral lymphocyte reactivity to RS virus antigen was tested in three mothers of infected infants and two showed significant proliferation. There was, therefore, no evidence that mothers of infected infants lacked mammary immunity to the virus. Maternal mammary IgA and IgG responses following diagnosis of RS virus infection in the infant were followed for the seven cases identified prospectively and for a further 23 infants admitted to hospital with RS virus infections of varying severity. There was no evidence that the mothers of more severely affected infants were deficient in IgA or IgG milk antibody.

Animals↗

The relationship between the QT interval and plasma amiodarone concentration in patients on long-term therapy.

We have studied 27 patients on long-term treatment (6-60 months) with amiodarone (dose range 350 mg per week to 2800 mg per week) to ascertain whether the corrected QT interval could predict plasma amiodarone or plasma desethylamiodarone concentration. The patients were assessed on three or four occasions one month apart. There were positive correlations for delta % QTc and plasma amiodarone and delta % QTc and plasma desethylamiodarone. There was approximately a four-fold variation for delta % QTc and plasma amiodarone. This variation was not accounted for by between-occasion variation in the QTc interval, as the coefficient of variation was 2.1%. In six of the patients delta % QTc either decreased or did not change. delta % QTc is not a reliable predictor of plasma amiodarone concentration in the individual patient over time.

Adult↗

The effect of surface finish on the reflection of CO2 laser beams from specula.

A potential source of hazard during gynaecological surgery with a CO2 laser is the reflection of the laser beam from the surfaces of the metal speculum. An experimental method of measuring the levels of radiation reflected from a variety of surfaces is described. Results which compare the effectiveness of different surface treatments in reducing reflections and show how this varies over a range of angles of incidence are presented. The significance of the results in terms of hazards to patients and staff is discussed.

Carbon Dioxide↗