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Biomedical subjects

D M Clark

Publications and source records attributed to D M Clark.

At least 91 records · Page 5Linked to original sources
PubMed1986

Respiratory control in the treatment of panic attacks: replication and extension with concurrent measurement of behaviour and pCO2.

A case series is reported in which nine patients who experienced phobic and/or nonphobic panic attacks were given a cognitive-behavioural treatment based on the supposition that catastrophic interpretations of sensations produced by hyperventilation played an important role in their attacks. Large and rapid reductions in panic attack frequency and questionnaire report of fear were observed. Patients' resting pCO2 was significantly lower than controls and rose to normal levels during treatment.

Adult↗
PubMed1986

Angio and peritoneal access for endstage renal disease in the community hospital: a cost analysis.

As the population requiring maintenance dialysis continues to grow, costs have become an important consideration to professionals dealing with this clinical problem. A four and one-half year experience with various methods of dialysis in a community hospital is reviewed. The overall base-level estimate for providing functional access of various types if $19,000 per patient per year.

Arteriovenous Shunt, Surgical↗
PubMed1985

Respiratory control as a treatment for panic attacks.

Eighteen patients who experienced frequent panic attacks were given a treatment derived from the literature on hyperventilation and anxiety. The treatment consisted of (i) brief, voluntary hyperventilation. This was intended to induce a mild panic attack; (ii) explanation of the effects of overbreathing and reattribution of the cause of a patient's attacks to hyperventilation; (iii) training in a respiratory control technique. Substantial reductions in panic attack frequency and in self-reported fear during a behaviour test were obtained after 2 weeks' treatment and these reductions occurred in the absence of exposure to feared situations. Further reductions in panic attack frequency were evident at 6-month and 2-year follow-up though interpretation of these results is complicated by the addition of exposure and other psychological treatments.

Adult↗
PubMed1985

Subclavian steal.

Explore the source record for details and available documents.

Angioplasty, Balloon↗
PubMed1984

Effect on lipoproteins of Trisequens, a combined hormone preparation.

Lipoprotein concentrations were measured in 31 post-menopausal women during 1 yr of treatment with Trisequens, a natural oestrogen-progestogen preparation. Serum triglyceride, high density lipoprotein and very low density lipoprotein cholesterol concentrations did not change significantly, but low density lipoprotein cholesterol concentrations fell over the first 6 mth. After 1 yr none of the lipoprotein fractions differed significantly in concentration from pre-treatment levels.

Adult↗
PubMed1984

The minimum effective dose of estrogen for prevention of postmenopausal bone loss.

In a controlled single blind study to determine the minimal effective dose of estrogen for protection against bone loss, conjugated equine estrogens in doses of 0.625 and 1.25 mg per day were equally effective in reducing bone loss in postmenopausal and oophorectomized women when bone mass was estimated by single-photon absorptiometry or radiogrammetry . Daily dose levels of less than 0.625 mg were essentially ineffective. Fifty percent response level was calculated to be 0.45 mg per day. Concomitant biochemical effects, reduction in urine calcium and hydroxyproline, were compatible with the observed effects on bone mineral.

Bone Resorption↗
PubMed1983

Placebo-controlled trial of atenolol in treatment of pregnancy-associated hypertension.

Atenolol was compared with placebo in a randomised and double-blind prospective study of 120 women with mild to moderate pregnancy-associated hypertension who were also initially managed conventionally by bed rest. Atenolol given once daily significantly reduced blood-pressure, prevented proteinuria, and reduced the number of hospital admissions. Loss of blood-pressure control leading to withdrawal from the study was commoner among the placebo group, whose babies had a high morbidity. Respiratory distress syndrome occurred only in the placebo group. Intrauterine growth retardation, neonatal hypoglycaemia, and hyperbilirubinaemia occurred with the same frequency in the two groups. Neonatal bradycardia was more common after atenolol but the systolic blood-pressure of the babies was the same in both groups. There was no difference between the groups in maternal symptoms which could have been attributed to beta-blocker therapy. Thus atenolol is more effective than conventional obstetric management in this form of hypertension and does not adversely affect mother or baby.

Adult↗
PubMed1982

The effects of hyperventilation; individual variability and its relation to personality.

Self-reported affective and somatic disturbances and heart rate changes resulting from a brief period of voluntary hyperventilation are presented and related to individuals' Eysenck Personality Questionnaire (E.P.Q.) scores. Considerable individual variability was observed in the effects of hyperventilation. Neuroticism was significantly correlated with affective but not self-reported somatic or objectively measured heart rate changes. Other possible determinants of observed variability and its possible relevance to the etiology of panic attacks are discussed.

Adult↗
PubMed1980

In vitro autohaemolysis during pregnancy.

In vitro autohaemolysis with and without the addition of glucose was performed on normal pregnant women chosen at random and on non-pregnant women of comparable age. Autohaemolysis was significantly greater in the pregnant than the nonpregnant. The relationship between the stage of gestation and in vitro autohaemolysis in normal pregnancy may be fitted by a quadratic curve.

Erythrocytes↗
PubMed1979

Haemolytic anaemia of pregnancy.

Haemolytic anaemia apparently induced by pregnancy is reported in an otherwise healthy woman, with a negative family history. Folate deficiency, haemoglobinopathies, enzymopathies, hereditary spherocytosis, paroxysmal nocturnal haemoglobinuria, interstitial haematomata, hypertensive toxaemia, auto-immunity and infections were excluded. The autohaemolysis test showed increased lysis in the presence of added glucose. This abnormality was corrected by insulin when excess glucose was present, but not by insulin alone. It is suggested that this patient's erythrocytes may have been altered by placental lactogen and/or prolactin in such a way as to make them abnormally dependent on insulin for the uptake of glucose.

Adult↗
PubMed1978

Bedside estimation of whole blood lactate.

A new instrument for the measurement of lactate in biological fluids, the Lactate Analyzer 640, has been evaluated. The method of use recommended by the manufacturer for blood samples was found to be inadequate. A new method of sample preparation for the instrument, based upon immediate haemolysis and fluoridation of blood, has been developed, allowing measurement of whole blood lactate concentration to be performed on samples as small as 150 microlitre within 5 min of withdrawal. The instrument is designed to be operated by a medical practitioner. Excellent correlation with a conventional enzymatic assay was found. These features make this new method particularly applicable to rapidly changing clinical situations such as shock in adult patients, asphyxia neonatorum and intrapartum foetal hypoxia.

Blood Chemical Analysis↗