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Biomedical subjects

D Hill

Publications and source records attributed to D Hill.

At least 235 records · Page 13Linked to original sources
PubMed1990

Practice of breast self-examination and the treatment of primary breast cancer.

Past experience of breast self-examination (BSE), family history of breast cancer, method of detection of the tumour, tumour size, node status, tumour attachment and type of treatment used for primary breast cancer, were surveyed on a sample of 117 female breast cancer patients diagnosed in Tasmania during May 1986-June 1987. Family history of breast cancer was associated with higher levels of BSE practice. Three-monthly or more frequent BSE in the year prior to diagnosis was associated with smaller tumours at presentation and less axillary node involvement. Breast-conserving surgery was utilized in 38% of all cases treated, and 84% of these patients received radiotherapy as part of primary treatment.

Adult↗
PubMed1990

Is mucaine an appropriate medication for the relief of heartburn during pregnancy?

A double blind comparative study comparing Mucaine, Mucaine without oxethazaine, and placebo was carried out with 50 patients with symptoms of heartburn during late pregnancy. We found that the 2 active treatments were more effective than placebo for the relief of heartburn, but there was no statistically significant difference between groups for the relief of nausea and regurgitation. There was a significant difference in the percentage of days of use of each medication, with the placebo being used least frequently. Although not statistically significant, for the 3 measures for which placebo differed from the active treatments, patients showed a better response to mucaine. This suggests that the addition of oxethazaine may be of benefit. The lack of statistical significance may be due to the relatively small number of cases, and the findings are promising. No side effects were recorded for any treatment.

Adult↗
PubMed1990

Laser laparoscopy in the treatment of endometriosis. A 5-year study.

The carbon-dioxide laser used laparoscopically provides a precise and virtually bloodless technique for the vaporization of endometriotic implants in the pelvis. The technique has been used at St Luke's Hospital, Guildford, for the past 6 years and this report presents 228 consecutive patients with endometriosis treated during the 5 years between 1982 and 1987 and followed up for between 1 and 6 years. Pain was improved in 70% and 80% of the 56 infertile patients with endometriosis as the only identifiable abnormality conceived. Of the 54 pregnancies, only 37 (69%) had a successful outcome, reflecting the high pregnancy failure rate found in women with endometriosis. Hospital stay was relatively short and complications were few and usually minor and there was no injury or morbidity caused by laser energy. The main advantage of laser laparoscopy in endometriosis is that patients may be treated at the time of diagnosis with less need for medication and no delay before conception is attempted.

Adolescent↗
PubMed1990

Effects of workplace smoking bans on cigarette consumption.

A sample of staff working in the Australian Public Service (n = 2113) were surveyed two to four weeks before a mandated total ban on workplace smoking was introduced, and again five to six months later. Among the 391 smokers on whom complete data were available, the workplace smoking bans were associated with reduced rates of smoking, particularly among heavier smokers where the reduction in consumption was over 25 percent.

Australia↗
PubMed1990

Long-term effectiveness of mass media led antismoking campaigns in Australia.

A community antismoking campaign began in Sydney, Australia in 1983, and in Melbourne in 1984. These campaigns purchased prime-time television advertising spots to set the community agenda. An intense effort was made to ensure that antismoking activities were maximized at the school, organizational, and community level. Smoking prevalences in both cities from 1981 were fitted with a statistical model to identify any underlying trend, to assess any immediate impact, and to assess the longer term effect of continuing to conduct such campaigns, i.e. to identify any change in the underlying trend. During the years before the antismoking campaigns, there was no observable trend in smoking prevalence in either city. At the beginning of the campaigns, there was an immediate drop of more than two percentage points in male and female smoking prevalence in both cities. Thereafter, a decline of about 1.5 percentage points per year was observed among males. No post campaign trend was observed in smoking prevalence for women in either city. These data support conducting coordinated community campaigns to reduce current smoking prevalence.

Adolescent↗
PubMed1990

Why the tobacco industry fears the passive smoking issue.

The tobacco industry has identified the passive smoking issue as the single most important problem confronting its economic future. During the 1980s, the industry has been engaged in an elaborate and expensive international campaign seeking to refute the evidence against passive smoking's effects on health and to position the issue as one essentially concerned with civil liberties and smokers' "rights." There are three main reasons for the industry's concern: first, the passive smoking issue allows a widening of the definition of smoking beyond its discussion as a personal habit, legitimizing it as a social problem; second, successful cases of litigation against employers by workers with histories of chronic exposure to environmental tobacco smoke have created an industrial climate of concern leading to workplace smoking restrictions and bans, and third, the proliferation of smoking restrictions reduces smoking opportunities and thus reduces total cigarette consumption and hence financial returns to the industry. Based on the results of a large Australian study of a workplace smoking ban, an estimated 654.88 million cigarettes with a retail value of $A6,549 thousand would be forgone annually in Australia alone if 50 percent of white-collar worksites were to ban smoking. Finally, the passive smoking issue can be considered a Trojan horse to its less discussed effects: the reduced morbidity and mortality likely to result in smokers from the significant reductions in smoking frequency that occur with the proliferation of smoking restrictions introduced in the name of concern for the health of nonsmokers.

Commerce↗
PubMed1990

Diurnal variations of beta-endorphin at rest and after moderate intensity exercise.

To determine the effect of time of day on circulating beta-endorphin concentrations 14 men exercised at 75% of their maximal capacity at 0600, 1200, 1800 and 2400 hr. Each trial was separated by 3-5 days and preceded by a normal sleep cycle except for the 0600 hr trials which was preceded by 6 hr sleep. Resting physiological data indicated normal diurnal variations in heart rate, core temperature and oxygen uptake, being lowest during the 0600 hr trials and highest during the 1800 hr trials. Resting plasma beta-endorphin concentrations averaged 11.9 +/- 8.4 pmol/l during the 0600 hr trials, significantly greater than the 2400 hr trials (6.4 +/- 3.6 pmol/l; P less than 0.05). No other significant differences existed at rest. Post exercise beta-endorphin concentrations were elevated and found to be inversely related to time of day with the 0600 hr trials having the highest mean (25.7 +/- 14.7) and the 2400 hr trials the lowest (14.7 +/- 8.3). These data suggest that the plasma beta-endorphin concentrations at rest and after exercise are affected by the time of day. The results also suggest that the changes in beta-endorphin associated with exercise are not major contributors to cardiorespiratory control or changes in psychological effect associated with exercise.

Adolescent↗
PubMed1990

Hospital-based group smoking cessation programs.

Since 1983, a standard eight-session group smoking cessation course (Fresh Start) has been disseminated throughout Victoria by the Anti-Cancer Council of Victoria with participation of various health agencies, including hospitals. During the five years since the Fresh Start program began, 94 groups were conducted under the auspices of hospitals and there were attended by 894 smokers (43% men, 57% women). Their mean age was 40.6 years. They had smoked for an average of 20 years. Their average precourse daily consumption of cigarettes was 27.7. One year after the course, 24% of the total initial enrollment reported themselves to be not currently smoking. The more course sessions participants attended, the more likely they were to succeed in quitting.

Health Promotion↗
PubMed1990

Effect of somatostatin analog on peptide release and tumor growth in the Zollinger-Ellison syndrome.

The clinical presentation of Zollinger-Ellison syndrome (ZES) is the result of gastrin hypersecretion and may be modified by secondary peptide hypersecretion. Treatment is medical (H2-blockers) or surgical (tumor excision and total gastrectomy). H2-blocker escape occurs up to 23 per cent and surgical mortality ranges to 15 per cent. Treatment of advanced disease has limited success. Sandostatin (SMS 201-995) has been shown to decrease basal gastrin and gastric acid secretion in ZES. We hypothesized that SMS would suppress basal and provoked gastrin and secondary peptide secretion in ZES. A patient with refractory, metastatic gastrinoma underwent provocative testing (test meal, calcium infusion, secretion bolus and tolbutamide bolus). Thirteen peptides were drawn at set intervals during these provocative tests. Testing was repeated during SMS therapy (100 micrograms subcutaneously three times per day). Gastrin, pancreatic polypeptide (PP) and glucagon levels were elevated at baseline. SMS suppressed all three peptides (mean 74 per cent) (p less than 0.05). Gastrin, PP and glucagon were provoked by all four tests (means above baseline, 19, 155 and 138 per cent, respectively). Gastrin-releasing peptide, gastric inhibitory peptide and insulin were provoked by calcium infusion (427, 306 and 162 per cent above baseline, respectively). SMS suppressed 14 of 15 of these peaked-provoked peptide levels (mean 72.5 per cent, p less than 0.05). Gastric analysis during calcium infusion showed SMS suppression of hourly gastric secretory volume by 77.5 per cent and of acid production (milliequivalents of acid) by 87.5 per cent. During a 20 month follow-up period, the patient was maintained on SMS, 200 micrograms subcutaneously three times per day. She has remained asymptomatic. Interval peptide profiles at two, eight and 18 months show normal gastrin, PP and glucagon levels. A computed tomographic scan at eight months shows a remarkable regression of primary and metastatic tumor. Regrowth, however, was noted at 19 months. SMS may be useful in ZES by suppressing basal and provoked gastrin and secondary peptide secretion and may occasionally give palliation by yielding temporary tumor registration.

Aged↗
PubMed1990

Adult onset nesidioblastosis: response of glucose, insulin, and secondary peptides to therapy with Sandostatin.

Adult onset nesidioblastosis (AON) is an extremely rare entity associated with hypersecretion of insulin. Previous reports have demonstrated that the somatostatin analog, Sandostatin (SMS), will control the clinical symptoms induced by infantile nesidioblastosis. We hypothesized that insulin, C-peptide, and secondary peptide secretion from AON is provocable. We also hypothesized that SMS would suppress both basal and provoked primary and secondary peptide secretion in AON. To test this hypothesis, in a patient with AON, 13 gut peptide levels were determined at set intervals during provocative testing with a test meal, a calcium infusion, a secretin bolus, and a glucagon bolus. These tests were repeated under the influence of SMS. Insulin, C-peptide, and pancreatic polypeptide (PP) levels were elevated in the basal state. SMS suppressed all three peptides (mean 68%) (p less than 0.05). Basal fasting glucose rose by 65%, and glucose ratios were raised throughout all four tests. Insulin:glucose ratios decreased during SMS therapy. Insulin and PP secretion was increased by all four provocative tests (mean 458% and 665% above baseline, respectively). C-peptide was provoked by three tests (mean 204%). Peptides with normal basal values were also provocable. GRP and glucagon were provoked by secretin stimulation (182%, 186%, respectively). Calcium infusion stimulated CIP release by 372%. SMS suppressed the peak provoked peptide levels in all positive provocation tests (p less than 0.05). Peak provoked insulin values were decreased by 59%, C-peptide by 75%, and PP by 92%. Peak provoked glucagon, CRP, neurotensin, and GIP levels were decreased by 20%, 65%, 51%, and 73%, respectively. The patient has been maintained on SMS (25 micrograms bid) for 1 yr and has shown decreased insulin levels, normal glucose levels, and, at 1 yr, leads an asymptomatic normal life. SMS is able to suppress primary and secondary peptide secretion in both the fasting and provoked state. The long-term efficacy of SMS may be predicted by its ability to suppress primary peptide release during peak provocation.

Aged↗
PubMed1989

Staff members' acceptance of the introduction of workplace smoking bans in the Australian public service.

The acceptability to employees of workplace smoking bans is an important factor in their introduction and in subsequent compliance. This study describes the acceptance by affected staff members before the ban on smoking in Australian public-service premises. Four thousand, two hundred and fifteen (79% of those who were approached) public servants were surveyed from areas of six departments across three states. Twenty-five per cent of the sample were current smokers. Support for the bans was strong, with 76% of the sample approving over all. Approval among smokers was less, with 40% of smokers approving, compared with 82% of ex-smokers and 90% of "never" smokers. Thus, the results show a generally favourable attitudinal milieu among employees who were facing an impending ban on smoking, and far-from-unanimous opposition from smokers. Among smokers, acceptance of the bans was predictable from the attitudes towards smoking acceptance of the bans was predictable from the attitudes towards smoking in general, and from the perceived impact of the bans on smokers. The existence of restrictions on smoking at the time of the survey was associated with slightly higher levels of approval of the impending total ban, especially when the restrictions were not seen as being imposed on the respondents by others.

Attitude↗
PubMed1989

The relationship of process to outcome in brief experiential psychotherapy for chronic pain.

Six adult females with active rheumatoid arthritis were treated with a 10-session course of focused Gestalt Psychotherapy with the intent of assessing the relationship between key psychotherapy processes and both session and final outcome. Results suggested that high levels of patient participation were related to reduced patient distress, while high ratings of both session depth and session smoothness were related to increased positive feelings at the end of sessions. However, these session results did not generalize to final treatment outcome.

Adult↗
PubMed1989

Changes in cardiac output after acute blood loss and position change in man.

Thoracic bioimpedance cardiac output (Qtbi) was measured at 1-min intervals in 27 volunteers before, during, and after withdrawing 500 ml (3.7 to 8.5 ml/kg; mean 5.8) of blood. The effects of passive leg raising (PLR) and standing on Qtbi were measured before and after blood withdrawal. Arterial oxygen saturation (SaO2), transcutaneous oxygen tension (PtcO2), mean arterial BP (MAP), and heart rate (HR) were also measured before and after blood withdrawal. Thoracic bioimpedance cardiac index (CI) decreased 18% (0.8 +/- 0.1 L/min.m2, p less than .0001) and stroke volume index (SI) decreased 22% (14.8 +/- 2.7 ml/beat.m2, p less than .0001) after blood withdrawal. HR, MAP, SaO2, and PtcO2 were not significantly different after blood withdrawal. Before blood withdrawal PLR increased CI 6.8% (0.3 +/- 0.1 L/min.m2, p less than .0001); after blood withdrawal PLR increased CI 11.1% (0.4 +/- 0.1 L/min.m2, p less than .0001). PLR can increase stroke volume and cardiac output in hypovolemic humans.

Acute Disease↗