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Biomedical subjects

D Hall

Publications and source records attributed to D Hall.

At least 199 records · Page 11Linked to original sources
PubMed1985

Maternal height and shoe size as predictors of pelvic disproportion: an assessment.

A total of 351 women who gave birth in the Paddington and North Kensington Health District were studied in order to establish a factual basis for recording height and shoe size as indicators of pelvic adequacy. Because only 19 women had radiological pelvimetry assessment, type of delivery and length of labour were used as proxy measures of disproportion. Of the 57 women with a shoe size less than 4 1/2, 21% were delivered by caesarean section compared with 10% of the group with shoe size between 4 1/2 and 6 and only 1% of the group with shoe size greater than or equal to 6 1/2. Similar relations with height were not generally found. The data were further examined using logistic regression models of the expected percentages of mothers having an adverse delivery. The models confirmed and extended the more simple analysis.

Body Height↗
PubMed1984

Improving communication: a practical programme for teaching trainees about communication issues in the general practice consultation.

This paper describes a teaching programme, for use in general practice vocational training, which provides a theoretical and practical framework for exploring key aspects of the consultation with trainees. A particular emphasis is on the educational or 'cognitive' outcomes of the consultation and skills for improving them. The five stages of the programme are described and an example of experience of each stage is given. The paper concludes with an evaluation of the programme by the trainers, trainees and social scientist involved.

Communication↗
PubMed1984

Antileishmanial activity of chlorpromazine.

The antiprotozoal activity of chlorpromazine against the pathogenic protozoan Leishmania donovani, in both its amastigote and promastigote stages, was characterized. Chlorpromazine at concentrations greater than or equal to 3.12 micrograms/ml (9.8 X 10(-6) M) produced a significant reduction in viable promastigotes. The minimal protozoacidal concentration for promastigotes, defined as that concentration which produced greater than or equal to 90% reduction in viable parasites after 18 h, was 13.8 micrograms/ml. The results were similar when promastigote viability was assessed by flagellar motility or by the ability of drug-exposed or control promastigotes to incorporate [3H]uridine and [3H]leucine. Exposure of promastigotes to 50 micrograms of chlorpromazine per ml reduced O2 consumption by 87% within 30 min and immobilized 97% of parasites. Morphological disruption of promastigotes was observed by electron microscopy. The mean minimal protozoacidal concentration of chlorpromazine for amastigotes was 13.2 micrograms/ml. Chlorpromazine given orally (20 mg/kg per day for 14 days) reduced the parasite burden in L. donovani-infected hamsters by 64.2% (P less than 0.01) as measured by the number of amastigotes in touch preparations of livers and by 67.9% (P = 0.03) as measured by the number of promastigotes derived from homogenates of spleens. This dose is ca. 10-fold greater than that tolerated by patients being treated for psychiatric illness. Although chlorpromazine will probably not be useful in the treatment of human visceral leishmaniasis, the data suggest that less-toxic phenothiazines might prove to be effective.

Animals↗
PubMed1984

Percutaneous transluminal coronary angioplasty: current procedure and future direction.

Atherosclerotic coronary artery disease is a progressive process for which effective palliative methods have been developed. The evolution of surgical bypass grafting over the past two decades now permits its application to most symptomatic patients. In 1977 an alternative, transluminal angioplasty, was first performed in man and has become widely accepted. Advanced radiographic equipment is required for adequate visual control of the placement of catheters, guide wires, and balloons. Careful manipulation of catheters is crucial to success and safety. Procedural details and proper follow-up are described. While a discrete stenotic lesion in a proximal single vessel is the ideal indication, some patients with double-vessel disease are now being accepted. In a personal experience of 2000 cases, successful dilatation was achieved in 88%. Emergency bypass surgery was required in 3.3%. Myocardial infarction occurred in 1.2%, and there were two deaths. In a larger, multiinstitutional study, the primary success rate has averaged 61%. Recurrent stenosis occurs in about 30%; redilatation is possible. Some perspectives about this effective, nonsurgical alternative are offered, including its potential for massive savings in the cost of handling obstructive coronary artery disease.

Angioplasty, Balloon↗
PubMed1984

Increased intracranial pressure: an indication to decompress a tension pneumomediastinum.

A 7-yr-old boy undergoing treatment for respiratory failure after near-drowning developed a pneumomediastinum. Intracranial hypertension refractory to previously successful therapy led to placement of a mediastinal tube, after which intracranial pressure decreased and was easier to control. A pneumomediastinum may cause intracranial hypertension by interfering with venous drainage from the cranium.

Child↗
PubMed1983

Plasma alkaline phosphatase as a criterion for determining biological availability of phosphorus for swine.

One hundred thirty-nine pigs, with an average initial weight of 15.9 kg, were used in three trials to evaluate plasma alkaline phosphatase (AP) as a criterion for estimating available P in feedstuffs for swine. The first two trials were designed to determine the effect of adding graded levels of P (as KH2PO4) to a basal diet on the AP response pattern and degree of linear fit with time. Plasma AP increased (P less than .05) with time and, when regressed on the concentration of total P (.26 to .50%), provided the best linear fit by d 14 (r = -.996). This high degree of fit was maintained through d 21 (r = -.983). The poor correlation observed at 7 d (r = -.828) indicated that the AP pattern was not fully established, whereas departure from the close association by 28 d (r = -.913) may be related to a decline in the magnitude of P deficiency with increasing weight. In a third trial, available P was determined in high moisture corn (HMC, 24.6% moisture) using both AP and bone breaking strength (BKS) as response criteria. A standard curve was established by supplementing the basal diet (.26% P, .65% Ca) with graded levels of KH2PO4. High moisture corn was substituted for dextrose on an equal dry matter basis. Blood samples were acquired on d 14 and 21 for AP analysis and pigs were killed on d 28 for determination of metatarsal BKS. Phosphorus from HMC was determined (slope-ratio technique) to be 41.3% available using BKS as the criterion (KH2PO4, r = .961; HMC, r = .994) and 43.8% when AP at 14 d was used (KH2PO4, r = -.988; HMC, r = -.999). The data indicate that AP is a sensitive index potentially useful in P availability studies.

Alkaline Phosphatase↗
PubMed1982

Lethal effect of phenothiazine neuroleptics on the pathogenic protozoan Leishmania donovani.

Phenothiazine drugs, which are widely used for their antipsychotic, antianxiety, and antiemetic effects, have been found to have protozoacidal effects on the human pathogen Leishmania donovani. These compounds are lethal to both the extracellular stage of the organism, which is inoculated into humans by the sand fly, and the intracellular stage, which is found solely in human macrophages during established infection.

Animals↗
PubMed1982

The blocked bed. Definition of a problem.

The 'blocked bed' is a term familiar to doctors and hospital administrators, but has no conventional definition. Estimates of the prevalence of bed blockage vary and are largely subjective. A survey of Area and Regional Health Authorities in the U.K. was used to collect information on the nature and extent of bed blockage. The definitions offered focus on the match between patient characteristics and services provided, and refer in the main to elderly patients in acute hospital beds. It is argued that the emergence of blockage as a problem is related to a dominant model of acute care in hospitals, which does not accurately reflect the situation of elderly patients or their needs for treatment.

Aged↗
PubMed1982

Concomitants of clumsiness in young schoolchildren.

Teachers in four schools for normal children aged between five and eight years took part in a two-year investigation of developmental clumsiness. After a year's preliminary discussion they identified 20 children from a total of 400 who met the following criteria: (1) had poor motor co-ordination for their age and (b) whose poor motor co-ordination was affecting their schoolwork. The teachers' assessments were compared with those of a paediatric neurologist and a psychologist, and were shown to be very accurate. The group of children identified as 'clumsy' scored significantly poorly in relation to a control group on several measures of motor performance, and had a higher incidence of other educational and social problems. The heterogeneity of the group emphasised the difficulty of identifying a specific syndrome of 'clumsiness' in children.

Achievement↗