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Biomedical subjects

M Hibbert

Publications and source records attributed to M Hibbert.

At least 19 recordsLinked to original sources
PubMed2000

Serial serum human chorionic gonadotropin (hCG) levels in ectopic pregnancy and first trimester miscarriage.

Serial serum hCG levels were measured in 50 patients with a tubal ectopic pregnancy and 50 patients with spontaneous miscarriage of an intrauterine pregnancy. Serum samples were obtained at intervals of 3-5 d and more frequently if clinically indicated. The final diagnosis was confirmed by laparoscopy and/or dilatation and curettage. Data were analyzed using a linear regression model. Initial hCG concentrations ranged from 91 to 3,050 mIU/mL. Eighty percent of ectopic pregnancies and 35% of miscarriages were associated with rising hCG concentrations and no significant differences were noted in daily increments of hCG in the two groups (210 +/- 30 mIU/mL/day for ectopic pregnancies versus 311 +/- 55 mIU/mL/d for miscarriages). Twenty percent of ectopic pregnancies and 65% of miscarriages had falling hCG concentrations and significant differences were noted in the daily decrements of hCG for EP and AB (270 +/- 52 mIU/mL/day for ectopic pregnancies versus 578 +/- 28 mIU/mL/d for miscarriages (P < or = 0.05).

Abortion, Spontaneous↗
PubMed1999

Urinary incontinence among female soldiers.

A self-administered questionnaire was developed to assess the prevalence of urinary incontinence among active duty female soldiers. The questionnaire also addressed basic demographic information, including height, age, weight, and the subjects' present and past military activities. Adaptive measures that the soldiers commonly used to continue exercising and perform their duties were also explored. Seven hundred thirteen questionnaires were handed out to female soldiers at Fort Lewis (Washington), Fort Benning (Georgia), and Fitzsimons Army Medical Center (Colorado) during preparation for physical fitness tests. Of the 563 soldiers (79%) who returned completed questionnaires, 31% indicated that they commonly experienced urinary incontinence during duty and/or training to the extent that it interfered with job performance, hygiene, or was socially embarrassing. Thus, urinary incontinence is a pervasive problem among female soldiers.

Activities of Daily Living↗
PubMed1999

Female circumcision: the prevalence and nature of the ritual in Eritrea.

This study evaluates the prevalence, complications, and attitudes concerning the practice of female circumcision among the women of Eritrea. Four hundred thirty-six Eritrean women from rural and urban environments were questioned about their perceptions and beliefs concerning female circumcision. Eighty-eight percent of those interviewed had undergone some form of female circumcision. Those who favored the continuation of the practice were more likely to be rural dwellers with little formal education, and they did so primarily out of tradition or cultural conformity. The direct and indirect consequences of this practice to the health of women and infants are considerable and as complex as the social, religious, and traditional factors that have led to its preservation.

Adult↗
PubMed1998

Microlaparoscopic tubal ligation under local anesthesia.

Local anesthesia to perform laparoscopic tubal ligation is of increased interest due to potential safety and cost benefits. We performed tubal ligation using microlaparoscopic techniques with local anesthesia and continuous intravenous sedation in 16 women desiring sterilization. Operating and recovery times and patient satisfaction were recorded and compared with values for 30 similar women undergoing microlaparoscopic tubal ligation under general anesthesia. Mean +/- SD operating and recovery times for local and general anesthesia were 29.3+/- 8.1 versus 33.6 +/- 11.1 minutes, and 83.9 +/- 59.4 versus 114.5 +/- 69.8 minutes, respectively. Patient satisfaction was high. The potential for cost savings when performed in an outpatient or clinic setting is significant.

Adult↗
PubMed1998

The course of early smoking: a population-based cohort study over three years.

AIMS: To examine the uptake and course of smoking in a representative adolescent cohort. DESIGN: Six-wave cohort study. PARTICIPANTS: Secondary school students initially aged 14-15 years at 44 schools in the state of Victoria, Australia. MEASUREMENTS: Computerized questionnaire including 7-day retrospective recall for tobacco use. FINDINGS: Prevalence rates for smoking in the past month rose from 25% to 31% and daily smoking 9% to 18% across the 3-year follow-up. Forty-five per cent of the sample smoked at some point but only 18% were daily smokers at the end-point. High rates of short-term cessation were observed for both experimental and daily smokers, but 70% of daily smokers relapsed within 12 months. Occasional smoking at the outset was the strongest predictor of later daily smoking and was also predictive of lower cessation and higher relapse rates. Parental divorce and parental daily smoking were associated with smoking at the outset and parental smoking was strongly predictive of the course of daily smoking. In contrast, prevalence rates of smoking in a subject's school did not significantly predict either smoking initiation or subsequent course. Female daily smokers were half as likely as males to cease smoking, a finding that accounted for gender differences in smoking prevalence in this sample. CONCLUSIONS: The strength of association between occasional and later daily smoking indicates the importance of primary prevention but the variability in the early course indicates that there should be much scope for promotion of adolescent efforts to quit. Both the diminished likelihood of smoking cessation in young women and parental influences on smoking course deserve further exploration.

Adolescent↗
PubMed1998

Depression, anxiety, and smoking initiation: a prospective study over 3 years.

OBJECTIVES: This report considers the extent to which depression and anxiety predict smoking onset in adolescence. METHODS: A 6-wave cohort design was used to study a sample of 14- and 15-year-old students (n = 2032) drawn from 44 secondary schools in the state of Victoria, Australia. The students were surveyed between 1992 and 1995 with a computerized questionnaire that included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS: Experimental smokers were 29 times more likely than non-smokers to make a transition into daily use in the subsequent 6 months. Depression and anxiety, along with peer smoking, predicted initiation of experimental smoking. Specifically, depression and anxiety accentuated risks associated with peer smoking and predicted experimentation only in the presence of peer smoking. CONCLUSIONS: The finding that experimental smoking is an overwhelmingly strong predictor of later daily smoking focuses attention on smoking initiation. Depressive and anxiety symptoms are associated with higher risks for initiation through an increased susceptibility to peer smoking influences. Promoting the psychological well-being of adolescents and addressing perceived interpersonal benefits of smoking may play a role in the prevention of adolescent tobacco use.

Adolescent↗
PubMed1998

Ambulatory urodynamics of female soldiers.

The purpose of this study was to assess the accuracy of ambulatory urodynamic monitoring compared with conventional urodynamic studies for the detection of exercise-induced urinary incontinence in the female soldier. Fifty active duty female soldiers with exercise-induced urinary incontinence and 10 asymptomatic control soldiers underwent conventional multichannel cystometry and then ambulatory monitoring during work or exercise. Ambulatory monitoring detected a greater number of abnormalities than conventional multichannel urodynamic studies in exercise-induced urinary incontinence. This greater sensitivity is valuable in formulating more effective treatment. Behavioral interventions were effective in treating exercise-induced urinary incontinence in this population. Test results normalized after behavioral intervention. It is neither cost-effective nor efficacious to require sophisticated urodynamic testing before instituting behavioral interventions.

Adult↗
PubMed1997

Childhood asthma and lung function in mid-adult life.

The longitudinal lung function data in 286 subjects from a 28 year follow-up of childhood asthma is reported. Airway obstruction in mid-adult life was present mainly in those with moderately severe asthma. Subjects who had been wheeze free for at least 3 years, even if asthma had been persistent in childhood, had normal lung function and no increased bronchial reactivity. Only two subjects, both with persistent asthma from childhood, failed to show an improvement in FEV1 of greater than 10% following inhalation of a beta-adrenergic agonist. Subjects with relatively mild asthma who had not taken inhaled steroids did not appear to be disadvantaged with respect to lung function.

Adult↗
PubMed1997

Tumour microembolism presenting as "primary pulmonary hypertension".

Pulmonary tumour microembolism is a rare cause of pulmonary hypertension. A case of rapidly progressive pulmonary hypertension in a patient with a past history of breast carcinoma is presented. Despite active consideration and investigation for malignancy as a cause, correct diagnosis was only made at necropsy.

Adenocarcinoma↗
PubMed1996

The association between secondary amenorrhea and common eating disordered weight control practices in an adolescent population.

PURPOSE: This study examined the relative importance of low weight, in contrast with other symptoms of eating disorder, as a determinant of amenorrhea. METHODS: A cross-sectional survey was conducted of students at Year 10 (mean age 15.0 years) attending 43 schools in the state of Victoria. Amenorrhea and symptoms of eating disorder were assessed using the Branched Eating Disorders Test, administered through the medium of a notebook computer. RESULTS: The survey response rate was 84% (n = 886). A total of 23% (n = 205) reported either fasting or purging in the previous month. Secondary amenorrhea of at least 3 months duration was reported by 4.1% (n = 35). No statistically significant association was found between amenorrhea and body mass index. In contrast, 40% of amenorrheic subjects reported fasting or purging (P = .03), an association most evident in the heaviest subjects. CONCLUSION: These finding suggests that secondary amenorrhea may develop in normal and above-weight teenagers who engage in eating disordered weight control practices.

Adolescent↗
PubMed1996

Is smoking associated with depression and anxiety in teenagers?

OBJECTIVES: An association of smoking with depression and anxiety has been documented in adult smokers. This study examines this association in a representative group of teenage smokers. METHODS: A two-stage cluster sample of secondary school students in Victoria, Australia, were surveyed by using a computerized questionnaire, which included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS: Subjects reporting high levels of depression and anxiety were twice as likely to be smokers after the potential confounders of year level, sex, alcohol use, and parental smoking were controlled for. Regular smokers were almost twice as likely as occasional smokers to report high levels of depression and anxiety. In a stratified analysis, an association between regular smoking and psychiatric morbidity was found in girls of all ages but for boys only in the youngest group. CONCLUSIONS: The cross-sectional association is consistent with the use of smoking by teenage girls as self-medication for depression and anxiety. Therefore, future health promotional campaigns might consider strategies that attend to perceived psychological benefits of smoking.

Adult↗
PubMed1995

Gender differences in lung growth.

Annual measurements of lung volumes and forced expiratory flows were made in 281 boys and girls from 8 to 12 years and in another cohort of 287 from 12 to 20 years to measure longitudinal lung growth. Gender differences in growth of lung function were documented, with girls generating greater volume-standardized maximal expiratory flows until age 18.5 years. Beyond that age boys generated higher expiratory flows in proportion to total lung capacity (TLC). There was a time lag of up to 1 year between the age of peak growth velocity in lung volume and peak growth velocity in height. Age at peak growth in flow lagged another year behind that in volume. This was noted more in boys than girls. Dysanaptic lung growth was found with differing rates of growth of maximal expiratory flow compared with TLC or vital capacity (VC).

Adolescent↗
PubMed1995

Patterns of common drug use in teenagers.

To ascertain current levels of drug use among teenagers and to examine interrelationships in use, a two-stage cluster sample of Victorian secondary school students in years 7 (aged 12 to 13 years), 9 (14 to 15 years) and 11 (16 to 17 years) were surveyed using a questionnaire on computer. Tobacco use and alcohol consumption were evaluated by self-reported frequency of use and seven-day retrospective diaries. Marijuana and coffee consumption were assessed by self-reported frequency of recent use. The questionnaire was completed by 2525, a participation rate of 83 per cent. Tobacco use rose with year, with 24 per cent of young women and 16 per cent of young men in year 11 being regular smokers. Trends across year level for heavier alcohol consumption were also observed, with just under 10 per cent of year 11 students reporting a weekly consumption higher than the current recommended guidelines for adults. Strong interrelationships in drug use were found, with a pattern of association between smoking and drinking consistent with a mutual elevation of risk. Frequent use of tobacco and alcohol had a high risk for associated marijuana use. Coffee consumption carried a significant independent association with regular smoking. Teenage substance use is common and most occurs at low level and frequency. However, for a substantial and increasing minority across the teenage years, high levels of tobacco and alcohol consumption potentially compromise health. Frequent alcohol or tobacco use rather than heavy intermittent consumption is most likely to be associated with concurrent substance use potentially damaging to health.

Adolescent↗
PubMed1993

The role of antibiotic prophylaxis for tubal microsurgery.

OBJECTIVES: Antibiotic prophylaxis is effective in preventing postoperative wound infections and pelvic cellulitis for a variety of gynecologic procedures. Though frequently used, there is no uniform agreement and little data descriptive of the efficacy of antibiotic prophylaxis for infertility surgery. The purpose of the present study was to determine the incidence of postoperative infection-related complications after microsurgical tubal repair for infertility and to assess the possible role (if any) of antibiotic prophylaxis for tubal surgery. DESIGN: Retrospective; non-comparative; descriptive. MATERIALS AND METHODS: Three hundred and forty-eight tubal procedures were performed over a 3 1/2 year period and included tubal reanastomosis (n = 194), distal salpingostomy (n = 107), fimbrioplasty (n = 15), and tubal reimplantation and cornual isthmic anastomosis (n = 32). All procedures were performed under general anesthesia using standard microsurgical techniques. No prophylactic antibiotics were given. When used, the operating microscope was not draped. Patients were monitored postoperatively for any infection-related complications to include postoperative febrile morbidity, wound infections, and pelvic cellulitis. A computer search of discharge diagnoses and chart review was made to determine the postoperative outcome and hospital course. RESULTS: There were 3 cases of febrile morbidity without localizing signs (0.8%), 3 wound infections (0.8%), 2 incisional seromas (0.5%), and one case of pelvic cellulitis (0.2%). There were no cases of bacteremia, septic shock, or septic pelvic vein thrombophlebitis. All patients responded promptly to incisional drainage or combination antibiotic therapy. CONCLUSION: Data of the present study suggest that the incidence of infection-related complications after tubal surgery without antibiotic prophylaxis is very low. These data suggest that for tubal microsurgery where hemostasis is precise and tissue handling gentle, prophylactic antibiotics may not be necessary. Antimicrobials for prophylaxis, in these circumstances, may offer no advantage in reducing infectious complications that are already extremely low and may in fact cause unfavorable selective processes on endogenous flora and untoward side effects in selected individuals.

Adult↗
PubMed1985

Rib cage mobility in pectus excavatum.

Pectus excavatum is generally regarded as a cosmetic deformity; however, some children with pectus excavatum complain of chest pain and exercise limitation. Physiologic studies sometimes show mild restrictive changes and suggest an increased oxygen cost of breathing. Limitation of rib cage mobility related to the deformity may explain these findings. If rib cage mobility is limited, the ability of the actively inspiring rib cage to lower abdominal pressure would be decreased. If this were so, increased swings in abdominal pressure would be seen during the respiratory cycle, especially at times of stress such as during exercise. To test the hypothesis that pectus excavatum is associated with decreased rib cage mobility, we studied 11 patients with pectus excavatum and 11 control subjects. Four control subjects were also studied with rib cage mobility restricted by chest wall strapping sufficient to decrease vital capacity by 5, 10, and 40%. Gastric pressure was measured using balloon catheters and was used as an index of abdominal pressure. Flow at the mouth was recorded and integrated to give volume. Measurements were made at rest, immediately after exercise, and during graded voluntary inspiration to total lung capacity. Gastric pressure was related to tidal volume, and pressure-volume loops were constructed. There were no differences in abdominal pressure swings during respiration between the patients with pectus excavatum and the control subjects. Both groups showed moderate increase in gastric pressure during inspiration at rest and smaller increases or even decreases in abdominal pressure at end inspiration after exercise and at total lung capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Assessment of proximal airway obstruction in children by analysis of flow-volume loops.

The usefulness of maximal expiratory and inspiratory flow-volume (F-V) loops was assessed in ten children with clinical evidence of tracheal or laryngeal obstruction. Normal values from 514 healthy children are presented. Measurement of maximal flow, and expiratory/inspiratory flow ratios and observation of the characteristic contours of the F-V loops distinguished between proximal and peripheral airways obstruction in all cases. Most children over the age of 7 years could perform the test adequately. F-V loop analysis is a valuable technique in the assessment of the child with proximal airway obstruction. Unlike endoscopic and radiological investigation, it measures the functional rather than the anatomical degree of obstruction, and provides a simple non-invasive way of monitoring the response to treatment.

Adolescent↗