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Biomedical subjects

D M Hall

Publications and source records attributed to D M Hall.

At least 55 records · Page 3Linked to original sources
PubMed1995

Lumbosacral skin markers and identification of occult spinal dysraphism in neonates.

Some skin lesions over the spine are known to be associated with occult spinal dysraphism, but the significance of common skin lesions, such as sacral pits and dimples, is uncertain. In this prospective study, 95 neonates (1.9% of 4989 live births) were referred with possible markers of occult spinal dysraphism. Seven of 94 babies examined had abnormalities demonstrated by spinal ultrasound, compared with 5 of 105 controls. In 2 of 94 and 3 of 105 of these, the conus medullaris was located at L3 but no other abnormalities were found. Of the 75 babies with a sacral dimple or pit alone, none had an abnormality, suggesting that these skin lesions do not indicate a high risk of occult spinal dysraphism.

Biomarkers↗
PubMed1994

Hyperthermia stimulates nitric oxide formation: electron paramagnetic resonance detection of .NO-heme in blood.

Previous experiments from our laboratory have demonstrated that severe hyperthermia results in a selective loss of splanchnic vasoconstriction. Using electron paramagnetic resonance spectroscopy to scan whole blood samples collected in vivo from the portal vein and femoral artery of conscious unrestrained rats, we observed an increase in the concentration of spectroscopy-detectable species in portal venous blood of all heat-stressed animals. These spectra consisted of at least three distinct species: one with a broad feature having an effective g factor for the unpaired electron (g) of 2.06 assigned to the copper-binding acute phase protein ceruloplasmin, and two with narrower features that evolved at core temperatures > 39 degrees C representing a semiquinone radical and .NO-heme. This heat-induced signal displays the classic nitrogen triplet hyperfine structure (nitrogen hyperfine splitting constant = 17.5 gauss, centered at g = 2.012) that is consistent with a five-coordinate heme complex and is characteristic of an unpaired electron coupled to nitrogen in the ferrous .NO-heme adduct [(alpha 2+NO) beta 3+]2. The intensity of this signal increased approximately twofold as core temperature rose to > 39 degrees C, peaking 1 h post-heat exposure at greater than threefold basal concentration. This species was not seen in corresponding arterial blood samples. This is the first demonstration that whole body hyperthermia produces increased concentrations of radicals and metal binding proteins in the venous blood of the rat and suggests that severe hyperthermia stimulates an enhanced local release of .NO within the splanchnic circulation.

Animals↗
PubMed1992

Child health promotion, screening and surveillance.

After the Second World War, as the incidence of infectious and nutritional disorders declined, professionals and parents began to seek more precise diagnosis and more effective therapy for children with cerebral palsy, mental handicap and related disorders. Although a handful of exceptional men and women had shown what could be accomplished (Shonkoff & Meisels, 1990), the prevailing view was that little could be done and indeed parents of these children were not infrequently advised to "put them in an institution". In the 1950s and 60s, new ideas began to create a more optimistic climate of opinion. It was thought that much, perhaps most, disability was caused by perinatal complications and was therefore potentially preventable; and that early intervention (e.g. physiotherapy for cerebral palsy) might lead to cure or at least substantial improvement. Research in child psychology offered a more scientific basis for the assessment and management of developmental disorders. A sense of urgency was created by the prevalent belief that the child's developing nervous system and psychological functioning were far more amenable to intervention in the first few months or years of life than subsequently (Anastasiow, 1990), and that if suitable therapy was not provided then, the opportunity would be lost for ever. This notion of a "critical period" in development, together with optimism regarding the possibility of intervention, led to a sense of urgency which was responsible for a gradual change in the provision of child health services. Previously, the paediatric health professional had simply waited for the parent to seek advice--the "passive" or "reactive" approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Health↗
PubMed1992

Post-traumatic tremor in head injured children.

In a survey of 289 severely head injured children the prevalence of significant tremor was estimated to be at least 45%. The tremor appeared at any time within the first 18 months after injury and in at least half the cases it subsequently subsided spontaneously. The implications of these findings are to question the mechanism of recovery and suggest that controlled trials of the treatment needed.

Adolescent↗
PubMed1991

Jubilee Lecture of the Scottish Paediatric Society. Do we really need community paediatricians? A summary of the lecture given at the Triennial Meeting of the Scottish Paediatric Society.

To summarise, I have supported the development of a specialty of "child development and rehabilitation" as an independent branch of paediatrics separate from neurology; emphasised the importance of expertise in child abuse for all paediatricians and not just those working in "the community"; described the changing role of specialist paediatric doctors in pre-school surveillance and the school health service; and suggested that we may need community paediatricians with a public health orientation. It is important to determine what community paediatricians should do and to ensure that the training they receive is relevant to the tasks required of them.

Community Medicine↗