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Biomedical subjects

D Hill

Publications and source records attributed to D Hill.

At least 325 records · Page 18Linked to original sources
PubMed1977

The General Medical Council: frame of reference or arbiter of morals?

Many members of the public think of the General Medical Council (GMC) as the body which tries doctors: the doctors' law courts, as it were. And, except in the more sober of newspapers and news reports, the 'offences ' which receive the most publicity are those concerning alleged improper relations between doctors and patients. Professor Sir Denis Hill, in the following paper, which he read in the spring of this year to the annual conference of the London Medical Group devoted to a discussion of human sexuality, chose to examine the whole function of the General Medical Council as a frame of moral reference for doctors. Judging allegations of professional misconduct by doctors is the function of the Council's Disciplinary Committee. Judging sexual misconduct forms only a small part of their work. The GMC's responsibility covers the whole notion of morals and morality as it concerns doctors in their professional work. Sir Denis Hill stresses the modern thinking that morality must be learned and that attitudes are always shifting as society alters its norms of what is moral conduct. That is not to say that all that was previously considered not to be moral has now become acceptable but rather that other concepts have entered the field of moral debate. Therefore the GMC must constantly review the frame of reference it offers to doctors and the public may be surprised to learn that that process is never static. Sir Denis Hill in this paper is speaking personally and not as a member of the General Medical Council or of any of that body's special committees.

Ethics, Medical↗
PubMed1977

Community education about cancer.

Telling people what they should do to guard against cancer does not necessarily produce the desired changes in attitude and behaviour. It is necessary to take account of the factors that obstruct these changes. Fear of cancer induces some people to employ psychological defences that might relieve their anxiety, but divert them from medical care. General practitioners can either "turn on" or "turn off" the community education process by the stance they adopt towards the recommendations made in educational programmes. Failur to sensitively appraise the patient's motives and feeling when seeking advice about a publicized cancer "warning sign" can both hurt the patient deter him from developing habits of early reporting. Preventive programmes of cervical cytology, instruction in breast self-examination and smoking advice can quite readily be initiated in general practice. The various media of communication in cancer education should be carefully selected and targeted. Since doctors are generally accepted as experts on health matters, their apparent undue pessimism about cancer prognosis is unfortunate. On the other hand, their low smoking rate sets a helathy example for patients to follow.

Attitude to Health↗
PubMed1976

Amputation for vascular disease.

Amputation for peripheral ischaemia still has a depressingly high early and late mortality, and morbidity and the end result are usually less than satisfactory. Individual surgeons probably see too few amputees to treat them with maximal efficiency, and these patients create a large burden on beds and resources. There is room for improvement in all aspects of our management of amputees. Primary healing rates might be better with less heroic attempts to obtain a distal amputation. Sepsis is lessened by the use of prophylactic antibiotics. Tight bandaging and the intra-operative fitting of prostheses are undesirable. Simple tests of skin blood pressure may aid prediction of the degree of ischaemia at the proposed level of limb section and the chances of healing. The late mortality is high and merits study of methods designed to reduce it such as long term anticoagulation.

Amputation, Surgical↗
PubMed1975

Pancreatic extract lung sensitivity.

Seven patients with respiratory tract sensitivity to powdered pig pancreatic extract were studied with regard to their atropic status and the immunological nature of this sensitivity. The results confirmed the role of allergen specific antibodies to pig pancreatic extract in this sensitization and underlined susceptibility of atopic subjects to develop respiratory sensitivity to allergens to which they are exposed.

Adolescent↗
PubMed1975

Staphylococcal food poisoning aboard a commercial aircraft.

On Feb. 3, 1975, 196 (57%) of 344 passengers and 1 steward aboard a commercial aircraft contracted a gastrointestinal illness characterised by nausea, vomiting, abdominal cramps, and diarrhoea; 142 passengers and the steward were admitted to hospital. Symptoms developed shortly after a ham and omelette breakfast had been served. An investigation strongly incriminated ham as the vehicle of the outbreak, and the source seems to have been a cook with lesions on his fingers. The attack-rate was 86% for passengers who ate the ham handled by this cook and 0% for passengers who ate ham handled exclusively by another food preparer. Before being served, the ham and omelette had been held at room temperature for 14 h and at 10 degrees C (50 degrees F) for 14 1/2 h Specimens of stool and vomitus from ill passengers, left-over food, and the finger lesions of the cook were positive for Staphylococcus aureus of identical phage types and antibiotic sensitivities. Preformed enterotoxin was detected in the left-over ham and omelette. This outbreak re-emphasises that people with infected lesion should not handle food and that foods must be stored at temperatures low enough to inhibit the growth of bacteria. To ensure against a common foodborne illness incapacitating the entire flight crew, cockpit crew members should eat different meals prepared by different cooks.

Adult↗
PubMed1975

Pimozide in chronic schizophrenic outpatients.

In a double blind placebo controlled clinical evaluation of maintenance therapy in chronic schizophrenic female outpatients, thiordazine in single daily doses not exceeding 375 mg./day for 6 months was shown to be effective maintenance treatment compared with PL, thereby establishing the sensitivity of the experiment. Pimozide was also shown to be effective in a single oral dose not exceeding 16 mg./day and comparable overall to the standard drug. The experimental design was based on the anticipated retrogression of PL treated subjects during the 6-month study period, which was reflected in 5 of 9 (56%) "treatment failures" in the PL group compared to 2 of 14 (14%) and 2 of 12 (17%) in the THI and PIM groups, respectively. In addition, in some instances improvement over baseline evaluations was noted in both drug groups, particularly on global impression. Though some items of the BPRS exhibited Drug: PL differences, the scale in general was felt to be rather insensitive for this kind of study. Social adjustment ratings on a special scale completed by the patients and families alike, were also found to be insensitive to treatment differences. Side effects most often seen with THI were sedation, EKG and liver function abnormalities. Headache and restlessness occurred most often with PIM. Extrapyramidal symptoms and insomnia were seen most often with PIM and PL equally.

Adult↗