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Biomedical subjects

D W Yates

Publications and source records attributed to D W Yates.

At least 55 records · Page 3Linked to original sources
PubMed1988

2-Hydroxyethylation of haemoglobin in man.

Exposure of humans to 2-hydroxyethylating agents, such as ethylene oxide, results in the formation of N-(2-hydroxyethyl)valine (HOEtVal) at the N-terminal amino acid of haemoglobin. A novel method using gas chromatography-mass spectrometry (GC-MS) has been used to monitor the presence of this adduct in smokers and control subjects, and dose-response relationships were investigated between HOEtVal in haemoglobin, number of cigarettes smoked per day and plasma cotinine levels.

Cotinine↗
PubMed1987

Factors affecting the plasma insulin concentration shortly after accidental injury in man.

There are conflicting reports on plasma insulin concentrations in the acutely injured. Plasma insulin and glucose concentrations have been measured in 504 patients within 8 h of injury, and related to the severity of injury as assessed by the injury severity score (ISS). As in previous surveys of injured patients, an extremely wide range of insulin concentrations was found (2-141 mU/l). Most of the variability occurred at lower severities of injury. In very severely injured patients (ISS greater than or equal to 30), insulin concentrations were uniformly suppressed (less than 20 mU/l), especially in relation to the hyperglycaemia in these patients. Two small subgroups, patients dying within 3 h of injury and known psychiatric patients on psycho-active drugs, differed from the general pattern in displaying elevated insulin concentrations despite very severe injuries. The results bear out the idea that insulin secretion is usually acutely suppressed by adrenaline after severe injury; after less severe injuries, however, the response is much less uniform.

Accidents↗
PubMed1987

Alcohol consumption of patients attending two accident and emergency departments in north-west England.

The impact of alcohol use on the workload of two accident & emergency departments in north-west England was assessed by blood alcohol concentration (BAC) measurement, inspection of clinical records and interview of all patients aged 16 and over attending throughout a two-week period. The frequency of intoxication was similar to the previous reported rate in Scotland: 13.2% of all patients had a positive BAC. Inebriated injured patients arrived at all times of the day--varying in frequency from 2.5% of midday attenders to 78% of those presenting after midnight. The incidence of alcohol-related industrial accidents was low, but 60% of all assaulted patients were inebriated, many having sustained head injuries. Of patients attending within 2 hours of an accident at home, 19% also had a positive BAC, but 92% of those with ankle sprains were sober. Patients in lower social classes reported higher rates of alcohol consumption. The popularity of beer in comparison to wines and spirits was inversely related to age and unrelated to social class. Alcohol abuse is commonly associated with injuries sustained at home and with assaults occurring in public places. Prevention campaigns directed at the reduction of these types of incidents should be as concerned with the inebriation of the patient as with the architectural, environmental and legal framework within which the 'accident' occurs.

Accidents↗
PubMed1986

Plasma catecholamines in the acute phase of the response to myocardial infarction.

Plasma catecholamine (adrenaline, noradrenaline and dopamine) concentrations have been measured in 48 patients within 6 hours of the onset of symptoms of an acute myocardial infarction. The concentrations of all three catecholamines were elevated, and there were positive correlations between plasma noradrenaline concentrations and the severity of infarct as assessed by the coronary prognostic index and serum LDH levels. Plasma glucose, free fatty acid, lactate and cortisol levels were elevated while insulin levels were reduced. The site of infarction did not influence the pattern of hormonal and metabolic responses although heart rate was significantly lower in the inferior than in the anterior infarct group. Seven patients went into ventricular fibrillation shortly (less than 1.8 h) after blood sampling. Plasma catecholamine concentrations were markedly elevated in these patients with levels similar to those previously reported after cardiac arrest.

Adult↗
PubMed1986

Sprain or fracture? An analysis of 2000 ankle injuries.

A retrospective survey of over 2000 patients with inversion injuries of the ankle joint was undertaken to examine the validity of criteria commonly used in an accident and emergency department to assess severity. Swelling alone is an unreliable indicator of the severity of the injury. Patients with severe pain and inability to weight bear show a high incidence of fractures and must be X-rayed. Conversely, a combination of minimal pain and swelling, and ability to bear weight are indicative of a soft-tissue injury. Young people sustain most inversion injuries and have a lower incidence of significant fractures of the lateral malleolus. Analysis of presenting features did not reveal any reliable indicants which could be used to reduce the number of radiographs requested, without substantially increasing the risk of missing patients with significant fractures. However, it has been possible to formulate guidelines for the more rational and consistent use of X-rays in the initial assessment of patients with ankle sprains.

Adolescent↗
PubMed1985

Plasma catecholamines in patients with acute myocardial infarction and in cardiac arrest.

Plasma catecholamine concentrations in cardiac arrest (ventricular fibrillation and asystole) are significantly higher than after myocardial infarction. The levels reached are well above those normally required to stimulate cardiac activity. Possible reasons for the failure of the myocardium to respond to the catecholamines are discussed and the rationale for giving more catecholamines is questioned.

Adult↗
PubMed1984

Clinical experience with a new hydrogel wound dressing.

A new dressing is described which appears to improve wound healing after partial-thickness skin loss. The period between dressing changes is increased and patient discomfort decreased. It has been particularly useful in the treatment of scalds in children. There is no evidence of an increased infection rate. Alternative methods of sterilization may reduce the small number of minor hypersensitivity reactions.

Burns↗
PubMed1984

The effects of minor and moderately severe accidental chest injuries on pulmonary function in man.

Pulmonary function has been measured at intervals after direct chest injuries of mild and moderate severity in 46 patients. Ventilatory capacity (e.g. FEV1) and vital capacity were reduced and the residual volume was increased. Total lung capacity and alveolar volume were also reduced and as a result total pulmonary diffusing capacity (transfer factor) was decreased, however, the remaining lung had a normal diffusion coefficient. Intercostal nerve block at the fracture site did not improve ventilatory capacity although marked pain relief was achieved. Recovery was slower in those patients not admitted to hospital than in the more seriously injured patients who were admitted. It is suggested that more attention should be paid to the outpatient follow-up of such patients, perhaps paying particular attention to physiotherapy.

Accidents↗
PubMed1984

Mild analgesics and the accident and emergency department--cost and safety more important than potency?

A prospective controlled trial involving over 1000 patients did not reveal any difference between four drugs commonly used in accident and emergency departments for the relief of mild to moderate pain. There were no significant variations in therapeutic effect, side-effects or patient compliance. When considering the supply of analgesics which may be no more potent than those available without prescription from retail chemists, cost and safety are more important than analgesic effect. By restricting the choice of analgesics available, the accident and emergency department should be able to increase awareness among its staff of the actions and side-effects of a small number of prescribed drugs and to contain costs.

Acetaminophen↗
PubMed1983

The training of junior doctors for accident and emergency work: a case for urgent treatment?

The experience of casualty officers at the time of appointment has been compared, by questionnaire survey, with abilities and responsibilities 3 months after starting work in Accident and Emergency Medicine. Initial clinical and practical knowledge frequently did not match the demands of the new post. Some doctors felt unable to assume initial responsibility for important and commonplace clinical conditions. Many expressed dissatisfaction with the teaching they received. Only one-fifth of respondents had received any form of introductory course. Accident and Emergency work provides useful training for Senior House Officers pursuing a variety of careers, but adequate preparation is essential. This is not provided in the preregistration year. It is recommended that medical schools make greater efforts to ensure relevant comprehensive experience amongst their students before graduation. Introductory courses should be arranged for all new casualty officers and greater emphasis placed on the immediate availability of experienced supervisory staff in Accident and Emergency Departments.

Emergency Medicine↗
PubMed1980

Metabolic aspects of hypothermia in the elderly.

1. Plasma concentrations of glucose, lactate, amino acids, non-esterified fatty acids, glycerol, ketone bodies, insulin and cortisol were measured in 43 elderly patients with hypothermia. In 15 of these patients forearm arteriovenous differences were also measured. Core temperatures ranged from 25.9 to 35.5 degrees C. 2. The metabolic state was of mobilization of glycogen and triacylglycerol stores, with high plasma concentrations of lactate and lipid metabolites. The plasma concentration of glucose was raised in those with hypothermia of a short duration (less than 6 h). In other patients it was low in those with core temperatures around 30 degrees C, but below this temperature it was variable and often high. Concentrations of other metabolites or hormones were not related to core temperature. 3. Plasma concentrations of cortisol were high and positively correlated with those of lactate and glycerol, suggesting active involvement in stimulation of muscle glycogenolysis and of lipolysis. 4. Plasma concentrations of insulin ranged from very low to very high and appeared to depend on the concentrations of both glucose and alanine. 5. Arteriovenous differences were generally small. There was peripheral release of lactate and of amino acids but no overall peripheral uptake of glucose. In nine out of 15 patients there was a significant peripheral release of glucose.

Aged↗