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Biomedical subjects

D Hall

Publications and source records attributed to D Hall.

At least 181 records · Page 10Linked to original sources
PubMed1987

Social and psychological care before and during hospitalization.

Hospitalisation is a stressful experience, especially for children. While maternal separation has been seen as a major cause of distress among younger children, a broader perspective is required to understand the links between the individual, familial, professional, institutional and structural levels of hospital care affecting children. This can be seen in the changing attitudes in hospitals to parents as visitors, and the gradual introduction of open visiting. A model of discontinuity is proposed to analyse the experiences of children, parents, and professional staff in the ward. A variety of ameliorative techniques are discussed, in terms of their implications for change to hospitalised children or to hospital organisation. Studies in the development of children's concepts of illness show the need for providing information relevant to their developmental level. It is suggested that more should be done to involve parents in the care of their children in hospital, and to offer them support during this time. The effects on nursing and other staff are considered. The introduction of play schemes has benefits for children, but may lead to organisational complications if the priorities between therapy and welfare are not reassessed. More attention should be given to the psychological risks of treatment in assessing effects of medical intervention. A move towards more child centred care should in particular involve a change in the role assigned to the family within the medical sphere, and a reduction in the insularity of hospitals and fragmentation of treatment derived from existing medical and nursing practices.

Affective Symptoms↗
PubMed1987

Neurobehavioral sequelae of minor head injuries in children.

The incidence of neurobehavioral sequelae in children who have sustained minor head injury is controversial. Following an emergency room visit, behavioral symptoms in 247 children with mild head injuries were compared to those in 280 children with trauma to other regions of the body. Serial telephone interviews showed that complaints of irritability, clinging behavior and sleep disturbances were common in both groups, though headaches were a more frequent problem in the head-trauma patients. Virtually all symptoms were transient. Our results demonstrate a high incidence of behavioral sequelae in children after minor head injury and suggest that physicians should counsel parents about this brief functional morbidity.

Adolescent↗
PubMed1987

Respiratory symptoms and pulmonary function in farmers.

A questionnaire was given to 1,824 farmers and 556 control subjects in Saskatchewan to assess respiratory health and pulmonary function tests. With data corrected for age and smoking, farmers were found to have increased prevalences of the respiratory symptoms of phlegm, wheeze, shortness of breath, and the condition of chronic bronchitis. In addition, farmers had significantly lower values for the pulmonary function test variables forced vital capacity (FVC), forced expired volume in one second (FEV1) and maximum midexpiratory flow rate. However, the FEV1/FVC ratio was slightly but significantly greater in farmers than in control subjects. These findings suggest an increase in respiratory symptoms in farmers compared with rural control subjects who are not farmers and a decrease in lung volume and expired flow rates. The slightly high FEV1/FVC ratio may indicate a mixed obstructive and restrictive picture.

Adult↗
PubMed1986

Comparison of guanfacine versus clonidine for efficacy, safety and occurrence of withdrawal syndrome in step-2 treatment of mild to moderate essential hypertension.

Guanfacine, an alpha 2-adrenoceptor agonist, was compared with clonidine as step-2 therapy of mild to moderate essential hypertension in a 24-week, double-blind, randomized, parallel evaluation to determine efficacy, safety and occurrence of withdrawal syndrome. During a 5-week period, patients were weaned from current antihypertensives, if any, and stabilized on step-1 therapy with 25 mg of chlorthalidone once a day. Those with a diastolic blood pressure (BP) from 95 to 114 mm Hg while taking chlorthalidone were randomized to treatment. The 2 agents had equal efficacy; 149 of 270 patients treated with guanfacine (55%) and 164 of 276 treated with clonidine (59%) achieved goal diastolic BP of less than or equal to 90 mm Hg. Terminations because of adverse effects were relatively low. Dry mouth (30% of guanfacine and 37% of clonidine groups) and somnolence (21% of guanfacine and 35% of clonidine groups, p less than 0.05) were reported most frequently. Nonsyncopal dizziness was reported in 11% of guanfacine-treated and 8% of clonidine-treated patients. This difference was not statistically significant. To evaluate the occurrence of a withdrawal syndrome in 316 outpatients and 156 inpatients, vital signs were monitored at least twice a day for up to 7 days after the end of therapy. Segmented 24-hour urine studies were performed on inpatients. Abrupt withdrawal of clonidine produced a rapid increase in diastolic and, especially, systolic BP, whereas guanfacine withdrawal produced more gradual increases. The differences were significant over the first 3 withdrawal days. It is concluded that guanfacine is a safe, effective, second-generation alpha 2-adrenoceptor agonist.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Hematotoxic effects of 3,5-dinitro-4-chloro-alpha,alpha,alpha-trifluorotoluene, a water contaminant.

Three short-term studies of 7, 14, and 21 days, respectively, were made to investigate the nature of the anemia induced in rats by 3,5-dinitro-4-chloro-alpha,alpha,alpha-trifluorotoluene (DNCTT). This compound is an intermediate in the synthesis of dinitroaniline herbicides and was detected as a contaminant of a water-bearing stratum in northern Italy. DNCTT was mixed in a powdered rodent diet at a level of 2000 ppm and administered to Wistar-derived rats. DNCTT was shown to produce a hemolytic anemia of rapid onset; packed cell volume and hemoglobin concentration were decreased at all three treatment periods. Methemoglobin and reticulocyte count were increased in all the treated groups. The relative organ weights of the spleen and the liver were increased compared to those of the control groups. Spleen enlargement was also evident at the macroscopic examination, whereas the liver appearance was normal. Pearl's Prussian blue staining performed on the spleen and liver was highly positive in the spleen of treated rats, but no iron deposition was detected in the liver of treated rats.

Animals↗
PubMed1986

An animal model for fungal peritonitis: evaluation of therapeutic options.

An animal model for fungal peritonitis was developed and is described. This model was used to compare various therapeutic options for Candida albicans peritonitis. Twenty-four rabbits were treated on three different protocols. Results from these protocols confirm the clinical observation that removal of the catheter is necessary for successful treatment of fungal peritonitis. Further, the combination of catheter replacement and imidazole anti-fungal therapy appears to be curative in this animal model, and suggests that by using this protocol, discontinuation of peritoneal dialysis may not be necessary.

Administration, Oral↗
PubMed1985

Protein catabolism during the postoperative course after renal transplantation.

Protein catabolic rate (PCR) was measured daily by computerized mass balance studies in 50 subjects during hospitalization after renal transplant. All subjects received 60 mg prednisone per day. PCR rose over the first 3 to 4 postoperative days and then stabilized at an accelerated level, which was sustained through the third posttransplant week. Rejection therapy with either 3 mg/kg/d prednisone or 15 mg/kg/d of methylprednisolone for 3 days further increased PCR, but there was no difference in PCR between these two regimens. Protein restriction did not decrease PCR and subjects offered a higher protein diet did not have further acceleration of PCR. We conclude that 60 mg/kg/d prednisone produces an obligatory acceleration of PCR that is further accentuated by higher steroid doses. The use of minimal maintenance doses of prednisone consistent with adequate immunosuppression seems wise. Protein balance may be improved if protein intake is increased to match individual rates of accelerated protein catabolism.

Adolescent↗