Biomedical subjects
Publications and source records attributed to M Cameron.
A 21 year old woman presented with a two year history of right sided clonic hemifacial spasm. Investigations showed a large arteriovenous malformation on the right side of the posterior fossa and surgical exploration was undertaken. Early follow-up at six months showed a complete cure.
In an attempt to reduce the incidence of persistent amblyopia and related disorders, routine screening of the visual function of pre-school children has been introduced in Ayrshire, the tests being carried out by orthoptists. A pilot study confirmed the feasibility of the screening. Under the definitive scheme, whose first three months' results are presented, the children are examined as near as possible to their homes and the average attendance rate has been 86%. Thirty-seven of 442 children were referred to an ophthalmic clinic with suspected abnormalities (only one of which was not confirmed) that had not been picked up by the GP or welfare clinic. It is concluded that visual screening of pre-school children is administratively feasible and welcomed by parents, and that it can detect abnormalities missed by traditional procedures-which according to these results may be more than half of the total.
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There were no differences in mean intestinal worm burdens 8 days after subcutaneous injection of 4000 infective larvae of Strongyloides ratti into rats in dioestrus, pro-oestrus, oestrus and metoestrus. Thus, changes in the hormonal environment of the migrating larvae dependent on the oestrous cycle did not alter the worms' destination or affect their potential for development. In particular, the results are prima facie evidence that prolactin is not, on its own, responsible for the re-orientation of larvae in the tissues of nursing mothers. Other sources of variability in experimental S. ratti infections are analysed and the 'exact dose' technique offered as a corrective for some procedural errors.
Eight days after mother rats were injected with 4000 infective larvae of Strongyloides ratti at different stages of lactation the numbers of adult worms in their intestines were uniformly low (less than 3% of the dose) compared with unmated controls (mean = 25%). Those in their litters varied from 12% on day 5 to a maximum of 47% on day 17 post partum. These data, which do not correlate with lactational performance, imply that parasite movements in lactating rats are controlled by qualitative, not quantitative, consequences of humoral events. The numbers of worms in litters are concluded to be the result of the interaction of dynamic determinants of larval routes in the mother and changes in the suitability of the neonatal gut as an environment for worm development. The timing of events leading to milk-borne infection is defined. Injected larvae were closely synchronized in their movements, which were completed in 36 h. Larvae experimentally diverted into the mother's tissues during her first lactation were not available for the infection of a second litter.
An on-line computer-assisted pathology encoding and reportying system (CAPER) has been developed by the Department of Pathology and Laboratory of Computer Science of the Massachusetts General Hospital for a department of surgical pathology that processes more than 25,000 specimens yearly. CAPER performs clerical functions, including the accessioning of specimens, monitoring their state of completion, production of log books, billing, statistics, and transfer of diagnoses to other hospital departments. It also permits instantaneous display of all diagnoses rendered within two years, printout within 24 hours of all older diagnoses for any patient, and retrieval of all specimens with any given diagnosis, further defined by any data item (e.g., age) stored in the computer file.
Appropriate use of antibiotics is enhanced by the effective application of data on antimicrobial susceptibility. A number of methods are currently available for routine determination of susceptibilities, including agar dilution, broth dilution, agar diffusion, and several semiautomated methods. If susceptibility testing is properly done, it can serve as the basis for the generation of statistical data of use to the clinician. Periodically updated tables detailing the antimicrobial susceptibilities of commonly isolated organisms enable the physician to make appropriate choices of antibiotics for prophylaxis and for the initial treatment of serious infections, before the susceptibilities of the infecting organisms are known. With computer assistance, it is possible to use susceptibility data for quality control and for more sophisticated epidemiologic purposes. For the past several years, we have studied a number of potential uses of computer-generated data at the Massachusetts General Hospital. Several of these applications, especially as they might relate to the prophylactic use of antibiotics, are discussed in this paper.
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Information about patients in ambulance service records has been linked to that in the patients' hospital records in an attempt to make the most efficient use of a special ambulance service for patients suspected of having heart attacks. During one week 248 emergency (999) calls for an ambulance were made by the public in the city of Nottingham. The quality of information given to the ambulance centre was poor, and all four patients eventually found to have had a myocardial infarction were described as having collapsed. A further study of patients who were also described as having collapsed has led to a system which allows an ambulance controller to send a "coronary ambulance" only in answer to those emergency calls where there is a reasonable possibility that the patient has had a heart attack.
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The prevalence of hematozoa (diagnosed from blood films) in a sample of 4200 anatids representing 14 species collected in New Brunswick, Nova Scotia and Prince Edward Island during the period 1969-1973 is given. Thirty percent of the birds harboured hematozoa; the commonest blood parasite was Haemoproteus (Parahaemoproteus) nettionis (in 18% of the sample), followed by Leucocytozoom simondi (in 14% of the sample). Four species of Plasmodium occurred in 5% of the sample-Plasmodium circumflexum was the most frequently encountered of the four. Prevalence of infection varied markedly from year to year and locality to locality. Ducks from Northwestern New Brunswick-Bathurst area were the most heavily infected while those from Prince Edward Island had a low hematozoan prevalence. Black ducks (anas rubripes) were the most heavily infected of the 14 species of waterfowl sampled and possibly hematozoa may act as a limiting factor on populations of this duck. Bluewing teal (Anas discors) showed the lowest prevalence (7.1%) of the 14 species studied and the prevalence was in marked contrast to that of the greenwing teal (ANAS CAROLINENSIS) (39.5%).
The gynaecological disorders most likely to be met by the general surgeon are those that present with acute abdominal symptoms and those unexpectedly encountered at laparotomy. The former group includes ectopic pregnancy, acute salpingitis, and complications of ovarian cysts and abortion and the latter endometriosis, ovarian tumours, and myomatosis. The characteristics and treatment of these various conditions are described and principles outlined for the guidance of the general surgeon in dealing with gynaecological problem.
Frequently, diabetes educators in hospitals report meeting severe organizational barriers when attempting to implement advances in diabetes patient education (DPE). This paper reports on how eight successful diabetes patient education programs coped with potential barriers. The results are based on interviews of professionals who played central roles in introducing and sustaining the programs. Many of the identified problems centered around two issues--acquiring needed resources and communicating about the program to a variety of key groups.
The ideas in this article arose from discussions between two nurse educators brought together from different professional backgrounds to teach on a new Project 2000 course. It is a frank and honest account of a partnership involving two teachers--a nurse and a sociologist. It is also an illustration of theory-in-use; of an attempt in the workplace to move away from the split between theories in sociology, nursing and education and their practical application. The authors discuss how they worked in partnership--planning, delivering and evaluating their contribution to the course's 18 month long common foundation programme.