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Biomedical subjects

D Hill

Publications and source records attributed to D Hill.

At least 145 records · Page 8Linked to original sources
PubMed1995

Excision of endometriosis in the pouch of Douglas by combined laparovaginal surgery using the Maher abdominal elevator.

Twenty-one patients with stage 3 or 4 endometriosis in the pouch of Douglas had combined laparovaginal surgery using the Maher abdominal wall elevator. Opening the pouch of Douglas at the beginning of the operation allowed the combined surgery. Instruments were introduced through both the vagina and accessory laparoscopic incision. And a finger was placed in the vagina to palpate and detect abnormal tissue and assist in blunt dissection. The extent of pathologic tissue in the pouch of Douglas was easily identified. This approach allowed flexibility in maximizing the optimum route, vaginal or laparoscopic, to remove the uterus, and facilitated rectal surgery. The alternatives of laparoscopic and laparotomy surgery have limitations compared with combined laparovaginal surgery, particularly deep in the pelvic cavity.

Abdomen↗
PubMed1995

Bridging the professions: an integrated and interdisciplinary approach to teaching health care ethics.

In 1993, the authors introduced an interdisciplinary course in health care ethics at the University of British Columbia. They were motivated by two convictions: (1) an interdisciplinary approach to health care decision making is best; and (2) every significant health care decision has an ethical component. They wanted to encourage students from the various health care disciplines to participate in interdisciplinary decision making in their future practices by giving them an opportunity to study health care ethics together during their training. The authors give detailed descriptions of the objectives, format, curriculum, and evaluation of this innovative course in the hope that other educators who may want to develop similar courses can learn from their experience.

British Columbia↗
PubMed1995

Carmalt splinter forceps: a useful instrument.

Most dermatologic surgeons have favourite instruments that they like to use. One of mine is the Carmalt splinter forceps. These forceps are short (about 10 cm in length) and have triangular pointed tips with serrations that are kept in alignment by a small pin at the broadest area of the tip.

Dermatology↗
PubMed1995

Outcome of patients with neurotrauma: the effect of a regionalized trauma system.

A system of regionalized trauma care was introduced to Sydney in early 1992. This study was carried out to assess the effect of regionalization on the outcome of patients suffering major head injury within the central Sydney area. A prospective before and after study extending over 3 years and centred on the time of designation of Royal Prince Alfred Hospital (RPAH) as a trauma centre, was the methodology used. The study group consisted of all patients admitted with head injury (Glasgow Coma Score < 9; admission systolic blood pressure > 90 mmHg; Injury Severity Score > 15) to RPAH from the central Sydney area. Outcome criteria include survival rates, transfer numbers, and time to definitive neurosurgical care. Fifty patients were entered during the first 18 months of the study, and 38 during the second 18 months. Fifteen in the first group required evacuation of intracranial mass lesions, as did nine in the second group. The overall mortality fell from 42 to 26% (P = 0.13). During the study period there were 77 primary retrievals and 20 required evacuation of mass lesions. The median time from injury to commencement of operation in these patients was 2 h 13 min (range 1 h 3 min-5 h 35 min). There were 11 transfers, four requiring craniotomy. The median time from injury to surgery was 7 h 24 min (range 3 h 2 min-10 h 25 min; P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Prevalence of cigarette smoking among Australian secondary school students in 1993.

The prevalence of cigarette smoking in Australian secondary school students in 1993 was estimated from a survey of 22 696 12- to 17-year-old students from 332 secondary schools (and feeder schools) in all states and the Northern Territory. Self-administered questionnaires were answered anonymously by groups of up to 20 students selected randomly from school rolls, a method that replicated previous surveys in 1984, 1987 and 1990. Current smoking (smoking at least one cigarette in the week preceding the survey) at 12 years of age was 8 per cent in boys and 7 per cent in girls, but in those 17 years of age the prevalence was much higher (28 per cent of boys, 31 per cent of girls). Age was also associated with the mean number of cigarettes smoked per week by current smokers (8.6 in boys and 7.0 in girls at age 12 and 43.8 in boys and 32.0 in girls at age 17). After controlling for sex, age, school type and state of residence, the percentage of 12- to 15-year-olds who were current smokers rose from 15.7 per cent to 17.5 per cent between 1990 and 1993, an effect that was more pronounced in boys. On the other hand, the mean number of cigarettes smoked by 12- to 15-year-old current smokers dropped from 23 per week to 19.5, and the reduced consumption was greatest in boys. Furthermore, there was no increase in the proportion of students who smoked on three or more days per week, which suggests the increase was limited to occasional, casual or social smoking.

Adolescent↗
PubMed1995

Effects of carbohydrate supplementation during intense training on dietary patterns, psychological status, and performance.

The purpose of this study was to determine the effects of carbohydrate supplementation during intense training on dietary patterns, psychological status, and markers of anaerobic and aerobic performance. Seven members of the U.S. National Field Hockey Team were matched to 7 team counterparts (N = 14). One group was blindly administered a carbohydrate drink containing 1 g.kg-1 of carbohydrate four times daily, while the remaining group blindly ingested a flavored placebo during 7 days of intense training. Subjects underwent pre- and posttraining aerobic and anaerobic assessments, recorded daily diet intake, and were administered the Profile of Mood States (POMS) psychological inventory prior to and following each practice. Results revealed that the carbohydrate-supplemented group had a greater (p < .05) total energy intake, carbohydrate intake, and change (pre vs. post) in time to maximal exhaustion following training while reporting less postpractice psychological fatigue. However, no significant differences were observed in remaining psychological, physiological, or performance-related variables.

Adult↗
PubMed1995

Public understanding of medical screening.

AIM: To estimate the extent of public understanding of mass screening for disease and of the benefits and limitations of screening. METHODS: Telephone interviews were conducted with a national sample of 835 Australians. RESULTS: Of total respondents, 68% claimed to have heard of screening tests, but only 21% correctly understood that screening tests are for asymptomatic people. This understanding was related to education. The most frequently named tests were mammography (51%) and Pap tests (33%), and for all age groups these were mentioned by more women than men. Around 27% of respondents thought that the Pap test would detect 95% or more of case, 45% thought the test would detect 90% or more, while 60% of respondents thought the test would detect 80% or more of cases. Around 29% of respondents thought that mammography would detect 95% or more of cases, 49% thought the test would detect 90% or more, while 65% of respondents thought the test would detect 80% or more of cases. Of all respondents, 33% favoured compensation when cases were "missed" by screening provided people were warned beforehand, 58% were not in favour, and 9% were unsure. CONCLUSIONS: There are misconceptions among the public concerning the purpose of screening and the accuracy of screening tests. However, most people accept that some cases of disease will be missed by screening and that if people are adequately informed beforehand compensation should not automatically follow for those whose disease is missed.

Adolescent↗
PubMed1995

Transtracheal oxygen--setting up a home care program.

Available care for patients with transtracheal oxygen is becoming more diverse. This program uses strict standards that include staff training to ensure quality care for a specific population of patients, setting an example for other high-tech programs in home care.

California↗
PubMed1995

Definitive identification of an exceptionally high methanol concentration in an intoxication of a surviving infant: methanol metabolism by first-order elimination kinetics.

Intoxication by methanol was identified in a five-week-old infant suffering from moderate metabolic acidosis. The initial serum methanol at admission was 1148 mg/dL as measured by gas chromatography. The osmolal gap and formic acid concentrations were consistent with methanol intoxication. The child was treated with folic acid and a continuous ethanol infusion and survived without any apparent permanent problems. Because expected toxic symptoms did not develop in this case, and the methanol concentrations were at levels that might be deemed to be incompatible with life, blood and urine samples were assayed by a specific enzymatic assay, and by gas chromatography/mass spectrometry (GC/MS). Positive results definitively confirmed the presence of methanol. In contrast to previous reports, the elimination of methanol in this case appeared to following first-order kinetics. If hepatic ADH activity is low in neonates and young infants, another enzyme system such as catalase may be involved to explain this data. The lack of formic acid accumulation may have been due to folic acid therapy.

Acidosis↗
PubMed1995

Chromosome 17 numerical abnormalities in 55 patients with non-Hodgkin's lymphoma: a fluorescence in situ hybridization study.

Monosomy 17 and structural abnormalities of the short arm of chromosome 17 have been reported to influence prognosis and treatment outcome in patients with non-Hodgkin's lymphoma (NHL). In diffuse large cell lymphoma, these abnormalities were associated with refractoriness to chemotherapy, higher proliferative rate and poor prognosis. We studied the incidence of chromosome 17 abnormalities in 55 patients with NHL by using fluorescence in situ hybridization with a directly conjugated centromeric probe for chromosome 17. Twenty-three patients (42%) were previously untreated. Thirty-four patients (62%) had diffuse large cell lymphoma, 18 (33%) had follicular low-grade lymphoma, one had small lymphocytic lymphoma, one had diffuse mixed cell lymphoma, and one had mantle cell lymphoma. Cells from benign lymphoid hyperplasia were used as controls. Eight patients (15%) had trisomy 17 in 1.2-40.7% of cells and one patient (1.8%) had monosomy 17 in 68.8% of cells. We conclude that monosomy 17 is not common in NHL. Chromosome 17 deletions should be investigated with region-specific probes to determine their clinical relevance in NHL.

Adolescent↗
PubMed1994

Measles immunisation in children with allergy to egg.

OBJECTIVE: To examine the occurrence of adverse reactions to measles vaccine given as a single dose to children with egg allergy, and to determine if the administration of single dose to children with a positive result in an intradermal skin prick test with the vaccine is associated with adverse reactions. DESIGN: Review of results of immunisation and prospective study of 96 consecutively presenting children given intradermal skin testing with the vaccine. SETTING: Children's allergy centre. SUBJECTS: 410 children sensitive to egg referred to the allergy unit for advice about measles immunisation. MAIN OUTCOME MEASURES: Nature and severity of reactions associated with the administration of measles vaccine. RESULTS: All children had a positive result in a skin prick test with egg white, and five had a positive result in a skin prick test with vaccine. Of 96 consecutive children, 46 had a positive result in an intradermal test with vaccine. After immunisation with a full dose (0.5 ml) of vaccine adverse reactions were associated with a mild reaction in four children, none of whom required treatment. Only one of the 46 children with a positive result in an intradermal vaccine skin test had a reaction associated with vaccine administration. None of the children with a positive result in a skin prick test with measles vaccine reacted to the vaccine. The rate of minor reactions to the vaccine not requiring treatment was 0.98% (95% confidence interval 0.27% to 2.48%) and serious reactions requiring treatment was 0% (0% to 0.9%). CONCLUSION: Children with IgE mediated allergic reactions to egg protein should be investigated and managed by practitioners with special knowledge in this subject. Measles immunisation should be performed in a setting where any adverse reactions can be dealt with appropriately. Skin tests and measles vaccine and desensitisation are not necessary.

Child, Preschool↗
PubMed1994

Polysomy of chromosome 12 in 60 patients with non-Hodgkin's lymphoma assessed by fluorescence in situ hybridization: differences between follicular and diffuse large cell lymphoma.

Sixty consecutive evaluable specimens from patients with non-Hodgkin's lymphoma (NHL) were studied for the incidence of polysomy of chromosome 12 by fluorescence in situ hybridization (FISH) with probes for the repetitive DNA sequence in the centromeric region of chromosome 12. Thirty-six samples were from follicular lymphomas (FLs), and twenty-four were from diffuse large cell lymphomas (DLCLs). Fifty-two specimens (86%) were obtained by fine-needle aspiration of a diseased node, seven (11.6%) were from involved bone marrows, and one specimen was from a pleural effusion. Twelve of the thirty-six (33%) cases with FL had trisomy 12 in 3-41% of the cells (median, 10%) (normal controls had three signals in 1.4 +/- 0.7% of cells). Trisomy 12 was found in 62% of the patients who had had FL for more than 5 years. Nine of the twenty-four cases (37%) with DLCL had more than two copies of chromosome 12 in 4-92% of the cells (median, 78%), and all nine cases were of B-cell phenotype. Unlike FL cells, some DLCL cells had 4-6 copies of chromosome 12. In previously untreated patients, 54% of DLCLs and 26% of FLs had subpopulations of cells containing more than two copies of chromosome 12 (P = 0.04). Only 2/7 cases of DLCL with polysomy 12 had rearrangement of the BCL2 gene, indicating that the majority of DLCL cases with polysomy 12 did not result from histologic transformation of low grade follicular lymphomas. These data demonstrate that FISH of interphase cells is a sensitive method for detecting numerical abnormalities of chromosome 12 in NHL.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneuploidy↗
PubMed1994

Present status of the ovine gene map (Ovis aries); comparison with the bovine map (Bos taurus).

The status of the sheep map to the end of June 1993 is presented. Mapping information is available for a total of 107 loci comprising 16 anonymous DNA segments. This is an increase of 66 loci since 1990. No loci have been mapped on 10 of the 26 autosomes. Comparison of the cattle (350 loci) and sheep maps confirms their close evolutionary and genetic relationship and will reduce the effort required for their gene mapping.

Animals↗