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Biomedical subjects

D Hull

Publications and source records attributed to D Hull.

At least 55 records · Page 3Linked to original sources
PubMed1992

Is hearing assessed after bacterial meningitis?

A questionnaire was sent to 686 paediatricians in the UK to discover whether or not they referred children for hearing assessment after bacterial meningitis and if not, why not; 90% replied. Of these, 10% did not refer all children. The reasons given were based on misunderstandings of the aetiology and not on a lack of provision.

Child↗
PubMed1992

Maternal fever at parturition and its effects on the newborn rabbit.

The febrile response to administration of endotoxin has been reported to be suppressed in both pregnant animals at term and in their newborn. In a previous study we found that newborn rabbits under appropriate conditions to develop a febrile reaction to injected endotoxin. In this investigation we sought to discover whether pregnant rabbits at term had a febrile response to endotoxin, and if so, its effect on thermoregulation in their newborn. Endotoxin (E. Coli LPS) was injected into 19 pregnant rabbits at term. Six delivered spontaneously within an hour. At one hour, 13 were given oxytocin, and a further 8 delivered within five minutes. The colonic temperature (Tc) of the mothers before endotoxin administration and at delivery, and of their young, was measured. The results were compared with those of 10 pregnant rabbits not given endotoxin, and their young. Within 15 min of delivery newborn rabbits from each litter were placed on a thermal gradient to assess their thermoregulatory responses. Pregnant rabbits at term developed an impressive febrile response to injected endotoxin and their young were born with high colonic temperatures. Newborn rabbits from febrile mothers selected higher thermal environments and maintained a higher colonic temperature than the newborn of non-febrile mothers. We conclude that fever is sustained in the first hours of life in the newborn of mothers injected with endotoxin. The possible mechanisms are of considerable interest. None of the pregnant rabbits died after endotoxin administration, but the stillbirth rate was 50% compared with 10% in non-febrile does.

Animals↗
PubMed1992

Liver transplantation for acute fulminant hepatic failure.

Orthotopic liver transplantation (OLT) remains the only option for progressive acute fulminant hepatic failure (FHF). The overall one-year survival is approximately 58% versus 75% for all patients undergoing OLT. Nevertheless, this is superior to the results obtained with medical management alone, which carries a mortality of approximately 60-85%. Seven of 32 patients at Hartford Hospital (22%) received liver transplants for acute FHF; the one-year survival was 57%. Four of seven patients are alive with complete neurologic recovery. One case is presented in detail.

Acute Disease↗
PubMed1991

A randomised single blind trial of a combined mumps measles rubella vaccine to evaluate serological response and reactions in the UK population.

Four hundred and twenty children were randomly assigned to receive either mumps measles rubella (MMR) vaccine (207) or measles vaccine (213) in a single blind study, to investigate the reactogenicity and serology of the MMR vaccine. There was no significant difference between the number of children developing symptoms after MMR vaccination to those developing symptoms after measles vaccination. Both vaccines are associated with a rash, temperature and restlessness five to thirteen days after vaccination. The serological response to measles vaccine was similar in both groups with 92-6% seroconverting with MMR, and 96-8% with measles. Seroconvertion against mumps and rubella with the MMR vaccine was 88% and 96% respectively. This study confirms the safety and efficacy of the MMR vaccine in a UK population.

Drug Combinations↗
PubMed1991

Maternal and umbilical venous plasma lipid concentrations at delivery in the mare.

The concentrations and fatty acid composition of the plasma free fatty acid, triacylglycerol and phospholipid fractions were determined in maternal and umbilical cord vein blood samples taken at delivery from 17 mares. Maternal and umbilical vein plasma free fatty acid concentrations were of a similar order and a positive correlation was found between the two levels suggesting that the equine placenta is permeable to fatty acid. Substantial amounts of the essential fatty acids and their longer chain derivatives were seen in both umbilical vein plasma free fatty acid and phospholipid fractions supporting this view. Certain long chain polyunsaturated derivatives of the essential fatty acids found in the umbilical venous plasma phospholipid fraction were not seen in the maternal circulating lipids. The precursor fatty acids were readily available to both foetal and placental tissues and therefore must have been elongated and incorporated into phospholipid by either or both. Very small amounts of the essential fatty acids were found in adipose stores in the newborn foal and virtually no fat stores at all in the newborn foal liver.

Adipose Tissue↗
PubMed1991

A dose ranging study of ibuprofen suspension as an antipyretic.

A double blind trial was conducted to determine the dose of ibuprofen suspension, which is effective in reducing the body temperature. The principal measure of efficacy was a reduction in axillary temperature of 1 degree C or more three hours after dosing. A second objective of the trial was to compare the incidence and severity of side effects and the palatability of a range of ibuprofen doses. Ninety three children were included in the analysis. All four doses of ibuprofen studied (0.625 mg/kg-5 mg/kg) were associated with temperature reduction and only the lowest dose failed to satisfy the principal measure of efficacy. The influence of dose on the magnitude of the body temperature reduction was significant and the 5 mg/kg dose achieved the largest mean reduction in body temperature (2 degrees C). The tolerability and palatability of all doses studied were excellent. These findings suggest that ibuprofen is a good alternative to paracetamol as an antipyretic.

Child, Preschool↗
PubMed1991

Gastroplasty for Morbid Obesity after Cardiac and Renal Transplantation.

The success of vertical banded gastroplasty (VBG) in the obese transplanted population is measured by a low operative morbidity and mortality in the context of a good record of permanent weight loss and an enhanced quality of life. Selection of transplanted patients for gastroplasty should be guided by the prevailing standards for the general population. VBG is the procedure of choice because of proven efficacy and has the benefit over gastric bypass of not producing malabsorption. The operation causes early satiety while allowing consistent absorption of immunosuppressive medication from the upper gastrointestinal tract, essential in these patients. This risk of hypertension, diabetes mellitus, hyperlipidemia, and immunosuppressive medication toxicity may be decreased by substantial long-term weight loss afforded morbidly obese transplant patients by gastric restrictive surgery. Cardiac risk factors associated with morbid obesity and immunosuppressive therapy are lessened with sustained weight reduction.

Journal Article↗
PubMed1991

Noncompliance in organ transplant recipients.

The frequency of noncompliance with postoperative medical therapy ranges from 2% to 43% in organ transplant recipients and causes more graft loss than uncontrolled rejection in compliant patients. Retrospective and prospective studies undertaken at our center showed no difference in the rate of noncompliance between males and females or between recipients of cadaveric kidneys and those from living, related donors. Patients less than 20 years of age were statistically the most noncompliant (p = 0.0001) compared with those over 40 years. A significant difference in compliance was seen among blacks, Hispanics, and non-Hispanic whites, with the greatest frequency in blacks. This was not due to race, but to socioeconomic status, with those in the low socioeconomic group the most noncompliant. Problems of noncompliance may be reduced if they are identified early in the treatment course.

Humans↗