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Biomedical subjects

D Lewin

Publications and source records attributed to D Lewin.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Ultrasonic images the day after voluntary termination of a pregnancy].

We have studied 75 cases of uterine echography, obtained 24 hours after an induced abortion. In 2 out of 3 cases, the uterus was not empty and, in a majority of cases, a pseudo-organized image was observed. The images displayed were a central trans-sonic zone, limited by a line of echoes and containing some echoes which are less or more organized. A few aspects were very difficult to diagnose from a persisting pregnancy.

Abortion, Induced↗
PubMed1987

[Peridural anesthesia with a bupivacaine-fentanyl combination. Effects on uterine contractility].

One hundred-and-four induced labours were monitored with extra-amniotic open-ended tocography. In every case, anaesthesia was epidural, using both Bupivacaine and Fentanyl. In most cases, uterine contractility was not changed by this type of anaesthesia. Four cases of hypertonia, nevertheless, were observed immediately after the epidural was injected with large dips in the recordings of the fetal cardiac rate. Hypertonia lasted for no longer than seven minutes and no consequences for children were observed at the time of birth.

Anesthesia, Epidural↗
PubMed1986

Elucidation and measurement of clinical learning opportunity.

Competence in nursing derives from the actual practice of the craft. The authors describe ways of assessing the variety and extent of opportunities for clinical learning available to student nurses. Cohorts of students from each of three different types of hospital (72 students in all) were followed from the beginning to the end of training. From interviews with ward sisters, observation on the wards, and examination of nursing notes the pattern of clinical conditions characteristic of each training ward is established and hence, by aggregation, the pattern for each of the three training schemes. However, it is argued that only by investigating the learning careers of individuals can one gain knowledge and insight in sufficient detail to act as a guide to reform. Information on allocation to training wards is used to construct individual profiles of clinical opportunity, one for each student. Clinical conditions are grouped into 13 categories and it is shown how, for some categories, there are large differences between the experiences of individuals within a cohort, especially in one hospital. Finally the authors explain how, with a minimum of effort, these methods and findings could be adapted to improve and facilitate training; the procedures could be used to monitor each developing profile and, by judiciously modifying the continuing process of allocation, tutors would be able to achieve equality of clinical opportunity for their students.

Clinical Competence↗
PubMed1986

Numerical measures of integration.

In a previous article the authors showed how, by following the clinical careers of individual student nurses, one could paint a coherent and illuminating picture of opportunities for clinical learning on the wards. By observing and counting, and using only the simplest methods of calculation, numerical measures of comparison were constructed. Here the authors turn to the question of the integration of classroom and ward. Indices of integration between theory and practice were devised and computed for three sets of students in three different training schools (72 students in all). The results were used to answer the following questions. Within each training school what was the degree of equality of educational opportunity? For each hospital what is the maximum level of integration which the organization of training makes possible, and what was the actual level achieved? What is the connection between the achieved levels of integration and the type of training scheme (modular, block, etc)?

Education, Nursing, Diploma Programs↗
PubMed1983

[Echographic detection of cervical incompetence. Comparison between the abdominal and perineal route].

Ultrasonographic measurements of the cervix in perineal and abdominal projections were compared in 61 women. Measured by the abdominal route the diameter of the internal os in most cases exceeded by 4 mm that measured by the perineal route, and cervical incompetence can be diagnosed when the internal os is equal or superior to 24 mm. For the abdominal measurement to be reliable the posterior vesical angle must be well marked, which means that the bladder must be moderately filled.

Abdomen↗
PubMed1983

[The cervix in primiparous women. A series of 320 perineal echographies].

Perineal ultrasound was carried out on a series of 320 primiparous women at their first antenatal visit. The results obtained show that an internal of that was larger than 20 mm was abnormal. A sign of a short cervix (less than 40 mm long on ultrasound) was of not much value but had to be taken notice of. In six cases it was found that clinically the cervix was absolutely normal and on ultrasound was incompetent.

Cervix Uteri↗
PubMed1982

Interferon inhibits PWM induced B cell differentiation but not onset of proliferation.

The dependence of B lymphocyte differentiation into plasmacytes on anteceding B and T cell proliferation was studied using interferon as a probe. Possible correlations of the effect of interferon on PWM induced T and B cell proliferation and B cell differentiation into either kappa or lambda light chain immunoglobulin synthesizing plasmacytes have been investigated. The hypothesis that the observed inhibition of the PWM induced formation of plasmacytes by interferon is due to putative enhanced suppressor cell activity resulting from increased T cell proliferation is tested. Human, peripheral blood lymphocytes were exposed to PWM in the presence or absence of human leukocyte interferon. Proliferation was assayed by pulse cytophotometric analysis of cell kinetics, as well as [3H]TdR labelling of S-phase cells. Incidence of plasmacytes was detected by immunofluorescence using kappa or lambda light chain specific antibody. During continuous [3H]TdR labelling of stimulated cells, interferon inhibited incorporation of precipitable label by 40% at 96 and 144 h, indicating reduced net DNA synthesis by interferon treated cells. The relative fraction of cells in S-phase as well as G1- and G2 + M- was similar for treated and untreated cells. The fraction of cells rosetting SRBC remained stable for both treated and untreated cells. The size of the interferon treated population was persistently smaller once proliferation began. The time of initiation of proliferation was comparable for treated and untreated cells. Consistent with the findings of others using cell lines, interferon apparently induces a dilation of all cell cycle phases, thereby reducing the rate of proliferation. The same reduction occurred for both T and B cells. Time of initiation of DNA synthesis was, in contrast, not delayed by interferon, suggesting it is specific for events during the proliferative cell cycle. The occurrence of both kappa and lambda light chain immunoglobulin secreting plasmacytes was inhibited by interferon. The degree of inhibition was comparable for both kinds of plasmacytes detected. While not delaying the onset of DNA synthesis, interferon apparently retards subsequent cell proliferation and inhibits the differentiation of B cells to plasmacytes. The data indicate that active cellular proliferation and B cell differentiation require interferon sensitive events which cells initially recruited from quiescence by PWM do not. The inhibition of the incidence of plasmacytes cannot be attributed to an imbalance of T cell proliferation relative to non-T cells.

B-Lymphocytes↗
PubMed1981

[A study of uterine contractility in the onset of labour (author's transl)].

We have studied uterine contractility in 100 inductions of labour at term. We have been able to compare the effects of oxytocic infusions with rupture of the membranes on contractility. Oxytocic infusions and rupture of the membranes seem to have similar effects on the amplitude as well as on the contractile surface and these effects are quantitatively reinforced by one another.

Extraembryonic Membranes↗
PubMed1981

[The different elements constituting the Bishop score in the induction of labour with epidural analgesia (author's transl)].

We have collected together the Bishop scoring factors in 100 inductions of labour at term. The length of labour does not seem to be related to the height of the presenting part at induction. On the other hand, the consistence and degree of dilatation of the cervix do have each a prognostic value which is comparable to that of the total Bishop score. Furthermore, the score, while it is didactically useful, does seem to have some theoretical drawbacks.

Anesthesia, Epidural↗