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Biomedical subjects

M A Hall

Publications and source records attributed to M A Hall.

At least 127 records · Page 7Linked to original sources
PubMed1989

Neonatal renal function assessment.

Urine samples from neonates admitted to a special care baby unit were analysed to establish ranges for urinary retinol binding protein, albumin, and total protein concentrations in healthy term and preterm infants and to investigate changes seen in disease states. Urinary excretion of retinol binding protein was greater in preterm infants and was increased in sick infants. This was greater than would be predicted from changes in creatinine excretion with gestational or postconceptional age. Urinary retinol binding protein appeared more sensitive to illness than did urinary albumin or total protein.

Albuminuria↗
PubMed1988

Making sense of referral fee statutes.

State and federal prohibitions of referral fees have long plagued the health care sector because their broadly worded provisions threaten established and socially valuable business arrangements. Congress has recently instructed the Department of Health and Human Services to issue regulations that clarify the scope of the most threatening of these prohibitions, the Medicare and Medicaid felony referral fee statute. This article examines three possible analytical models for imposing a limiting construction on referral fee statutes by testing the models against three beneficial practices that the statute jeopardizes: physician recruitment, fee discounting, and efficiency bonuses. The article recommends primary reliance on an earned/unearned analysis that detects a prohibited referral fee by asking whether the fee is fully earned by legitimate, nonreferral services.

Fees, Medical↗
PubMed1988

A randomised prospective comparison of cefotaxime versus netilmicin/penicillin for treatment of suspected neonatal sepsis.

In an open prospective study performed in 2 neonatal units, infants with suspected neonatal sepsis (SNS) of unknown microbial cause were randomly allocated to receive treatment with either cefotaxime (CTX) or netilmicin plus penicillin (N + P). 236 patients were entered into the trial, of whom 222 were evaluable. The number of 'definitely' and 'probably' infected babies was similar in both groups. There was no difference in clinical outcome between patients in the 2 treatment groups and no side effects were recorded for either of the antibiotic regimens. Antibiotic sensitivity testing of bacterial isolates from peripheral sites showed almost universal sensitivity of potential pathogens to both antibiotic regimens at the start of treatment in all infants. Thereafter, organisms resistant to CTX were isolated from patients in both treatment groups, possibly reflecting the antibiotic sensitivity profile of the colonising bacteria in both neonatal units. The results of this study indicate that either CTX or N + P are suitable, in our units, for the 'blind' treatment of early SNS. In units where listerial infections are prevalent, specific cover should be added to CTX. For SNS developing after admission, the choice of antibiotics will depend upon the background antibiotic sensitivity profile of the colonising bacteria.

Bacterial Infections↗
PubMed1987

Pneumococcal septic arthritis in rheumatoid arthritis.

Septic arthritis is associated with a definite morbidity which may be related to a delay in diagnosis and hence treatment. The cases of three patients with rheumatoid arthritis and chronic chest disease where the joint sepsis was not the predominant feature are presented. The responsible organism was Streptococcus pneumoniae which had spread after recent chest infections. Minimal joint symptoms or general malaise in association with an unexplained rise in erythrocyte sedimentation rate in these circumstances warrant a search for joint sepsis.

Aged↗
PubMed1987

Sacroiliitis in juvenile chronic arthritis. A 10-year follow-up.

66 children with early juvenile chronic arthritis underwent HLA A and B typing in 1974; 16 carried HLA B27. Ten of these had a pauciarticular onset, 3 systemic and 3 poly-articular. At follow-up 10 years later bilateral sacroiliitis had developed in 9 of the 16 B27 positive children, all of whom had a pauciarticular onset. Males predominated and these children had an older age of onset and a predominantly lower limb arthropathy. Enthesopathy and acute iritis further distinguished this group clinically. Other sacroiliac changes, usually simple fusion associated with severe hip involvement, were seen in 7 of the patients, 6 were girls and 6 were HLA B27 negative. Back pain and limitation had developed in 5 children, 4 of whom were B27 positive, after an average of 8 years' disease and at a mean age of 17.3 years. It is concluded that the presence of HLA B27 in boys aged 9 or over, with an onset of pauciarticular disease, signifies that they belong to the spondylitic group.

Arthritis, Juvenile↗
PubMed1986

The use of cefotaxime for treating suspected neonatal sepsis: 2 years' experience.

In 1982, the antibiotic treatment policy for suspected sepsis in neonates admitted to the Southampton special care baby unit was changed from intravenous gentamicin plus penicillin to intravenous cefotaxime with or without penicillin. Analysis of blood culture results during the first 2 years following the change indicates that a higher proportion of blood culture isolates showed sensitivity to cefotaxime compared with gentamicin. Only one baby died with proven bacterial sepsis and this was not thought to be due to treatment failure. Our data suggest that, on our unit, cefotaxime is a suitable alternative to the aminoglycosides for the management of suspected sepsis in the newborn.

Bacterial Infections↗
PubMed1985

Azathioprine in 50 rheumatoid arthritic patients intolerant or unresponsive to gold or penicillamine.

This is a retrospective review of 50 rheumatoid patients who had experienced side effects with gold and/or penicillamine and who were treated with azathioprine in routine clinical practice. The mean duration of the disease at commencement of azathioprine was 9.4 years; despite attempts to maintain the dose at 2.5 mg/kg.d because of minor side effects the average daily dose was 1.68 mg/kg.d. By one year, 11 (22%) had discontinued the drug due to side effects; 6 (12%) had not improved in any respect, 20 (40%) had a reduction in the total number of active joints with maintenance of function and in 13 (26%) the total number of active joints had been reduced by more than a half. During year 2 a further 4 discontinued therapy for adverse reactions. No further formal analysis has been performed though 31 patients were still on the drug with a mean duration of therapy for a period of 5 years. Ten of these had less than half their originally affected joints still active; this condition was usually associated with a fall in ESR and rise in haemoglobin but this was not invariable.

Adolescent↗
PubMed1983

A comparison of low dose levamisole and penicillamine in rheumatoid arthritis.

Levamisole (150 mg once weekly) was compared with penicillamine (250 mg daily) in a single blind independent observer study in 28 patients with rheumatoid arthritis over twelve months. Fifty percent (8/16) of patients stopped levamisole, five within three months of starting, while only two of twelve stopped penicillamine. In those patients able to tolerate treatment for twelve months, both regimens produced a significant and comparable reduction in disease activity, with the onset of action of penicillamine occurring at three months compared with six to nine months for levamisole. Radiological progression of disease occurred in both groups. Levamisole in low dose may improve parameters of disease activity in rheumatoid arthritis but poor patient tolerance, slow onset of action and failure to prevent radiological progression limit its usefulness.

Arthritis, Rheumatoid↗
PubMed1982

Alpha-1-antitrypsin deficiency presenting as a bleeding diathesis in the newborn.

Three cases of alpha-1-antitrypsin deficiency are reported. Each infant presented in the newborn period with a haemorrhagic tendency which responded to vitamin K. Two of them subsequently developed cirrhosis, and Case 2 is one of the few reported cases in infantile cirrhosis associated with the heterozygous protease inhibitor (Pi) SZ phenotype. On the basis of these 3 patients we feel that the exclusion of alpha-1-antitrypsin deficiency by Pi phenotyping should be considered in any baby presenting with a bleeding diathesis, especially in view of the genetic implications of the homozygous Pi ZZ phenotype.

Hemorrhagic Disorders↗