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Biomedical subjects

H R Ward

Publications and source records attributed to H R Ward.

4 recordsLinked to original sources
PubMed1995

Audit incorporating avoidability and appropriate intervention can significantly decrease perinatal mortality.

OBJECTIVE: To evaluate the role of the ICA (Identification, Cause, Avoidable factor) Solution method of perinatal audit in reducing perinatal mortality. DESIGN: Retrospective audit of 1,060 perinatal deaths between 1 January 1991 and 31 December 1992. SETTING: Livingstone Hospital Maternity Service. SUBJECTS: One thousand and sixty perinatal deaths, where the gestational age exceeded 28 weeks or, when gestational age was unknown, the birth weight was equal to or exceeded 1,000 g. MAIN OUTCOME MEASURES: All perinatal deaths were identified and classified by primary obstetric cause for perinatal loss. In the second year of the study avoidable factors were sought and, if found, graded and categorised. RESULTS: The major primary obstetric causes of perinatal loss identified and amenable to intervention were intrapartum trauma, intrapartum asphyxia and infection. In the second year of study potentially avoidable factors were sought and identified in almost 50% of perinatal deaths. Appropriate intervention lowered the perinatal mortality rate by 23% (P < 0.05; odds ratio 0.76; 95% confidence interval 0.67-0.86). CONCLUSION: The ICA Solution method of perinatal audit identified problems in overall obstetric care, facilitating a significant fall in perinatal mortality.

Cause of Death↗
PubMed1989

Effect of 1-(m-chlorophenyl)piperazine and 1-(m-trifluoromethylphenyl)piperazine on locomotor activity.

The piperazine-type 5-hydroxytryptamine (5-HT) agonists 1-(m-trifluoromethylphenyl)piperazine (TFMPP), 1-(m-chlorophenyl)-piperazine (m-CPP), 1-(p-chlorophenyl)piperazine (p-CPP) and MK-212 [6-chloro-2-(1-piperazinyl)pyrazine], produced a dose-dependent suppression of spontaneous ambulatory behavior in rats. Pretreatment with the 5-HT antagonists metergoline, methysergide or mianserin, but not selective 5-HT2 or catecholamine antagonists, blocked the reduction of activity caused by TFMPP suggesting that the stimulation of 5-HT receptors was involved in causing this behavioral effect. Other behavioral signs of 5-HT receptor stimulation, such as the 5-HT behavioral syndrome or head-shaking behavior, were not observed in rats injected with TFMPP, m-CPP or MK-212 except at toxic doses. The ability of piperazine agonists to reduce locomotor activity in rats was altered by long-term changes in 5-HT neurotransmission. The destruction of 5-HT neurons by i.v.t. injection of the neurotoxin 5,7-dihydroxytryptamine potentiated the ability of m-CPP to inhibit ambulatory behavior. On the other hand, elevating 5-HT content by administering the monoamine oxidase inhibitors phenelzine or nialamide for 7 days reduced the ability of m-CPP to suppress locomotor activity. Acute administration of the monoamine oxidase inhibitors, or chronic administration of other antidepressants such as desmethylimipramine or iprindole, failed to alter m-CPPs activity-suppressant effects. These studies suggest that chronic changes in 5-HT neurotransmission produce compensatory changes which alter the behavioral response to these piperazine agonists. Taken together with other evidence that both TFMPP and m-CPP are agonists at 5-HT1B and 5-HT1C receptors, the effects of TFMPP and m-CPP on locomotor activity may be associated with the selective activation of 5-HT1C, or possibly 5-HT1B, receptors.

Animals↗