Search PubMed⌕ Search

Biomedical subjects

M Wood

Publications and source records attributed to M Wood.

At least 307 records · Page 17Linked to original sources
PubMed1981

A conversion code from ICHPPC-1 to ICHPPC-2.

Faculty members from four departments of family medicine participated in the production of a definitive conversion from the first to the second versions of the International Classification of Health Problems in Primary Care (ICHPPC). A detailed conversion code with the appropriate ICHPPC-2 equivalent for each ICHPPC-1 diagnostic title is provided. Differences between the two classifications are discussed and suggestions are made for the use of the conversion code.

Disease↗
PubMed1981

The road to mental recovery.

GROW--a community mental health movement--uses its group method derived from the experience of former sufferers of mental ill health to help people rebuild their lives and grow to maturity.

Community Mental Health Services↗
PubMed1980

The sympathetic response to profound hypothermia and circulatory arrest in infants.

It has been suggested that the increased incidence of ventricular arrhythmias recognized below 30 degrees C might be catecholamine mediated. Elevate catecholamine concentrations have been reported in experimentally induced hypothermia in animals. Plasma concentrations of epinephrine and norepinephrine were measured during profound hypothermia and total circulatory arrest in infants under one year of age undergoing surgical correction of congenital cardiac defects. There was no significant change in either epinephrine or norepinephrine levels during surface cooling to 28 degrees C. Circulatory arrest and exsanguination at 18 degrees C were not associated with a rise in catecholamine levels. However, there was a striking rise in the levels of both epinephrine and norepinephrine with the recommencement of bypass and rewarming. The mean plasma norepinephrine concentration rose from 466 pg/ml (SE +/- 81) at circulatory arrest to 4543 pg/ml (SE +/- 2058) on rewarming bypass (p less than 0.02), while the mean plasma epinephrine concentration rose from 218 pg/ml (SE +/- 54) at circulatory arrest to 3724 pg/ml (SE +/- 1064) on rewarming bypass (p less than 0.02). The plasma catecholamine concentrations fell once cardiopulmonary bypass was discontinued, when the infant's temperature was 37 degrees C. It would, therefore, appear unlikely that the ventricular irritability recognized below 30 degrees C is due to catecholamine excess. The accumulation of catecholamines and/or metabolic products in the infants during circulatory arrest with their subsequent release into the circulation during rewarming may account for the elevation of catecholamine levels during rewarming bypass.

Body Temperature↗
PubMed1980

Laparotomy for pelvic fracture.

To establish criteria for laparotomy, the records of 224 patients admitted with an acute pelvic fracture were reviewed. Forty-four patients underwent laparotomy; 2 had no intraabdominal injury. The mechanisms of injury was blunt trauma in 31 patients and gunshot wound in 13. All four patients who died had blunt trauma. Major or minor pelvic fracture classification did not predict intraabdominal visceral injury, except for bilateral pubic rami fractures, which were commonly associated with bladder rupture. The accuracy of the indications for laparotomy was calcualted and criteria were established. Signs of an acute abdominal disorder, the presence of a penetrating wound, abnormal findings on pyleography or cystography, persistent shock, evisceration, and diminished distal pulses, singly or in combination, had a 90 percent accuracy in indicating correctable traabdominal injury. Peritoneal lavage was less reliable, with a 57 percent accuracy. Additional criteria to be considered are enlarging palpable abdominal hematoma, fracture or dislocation with bony fragments protruding into the pelvis, signs of persistent bleeding, and rectal injury or a large perineal wound.

Adolescent↗
PubMed1980

Halothane-induced hepatic necrosis in triiodothyronine-pretreated rats.

Hepatic centrilobular necrosis developed in rats pretreated with triiodothyronine (T3) and then anesthetized with halothane, 1 per cent, for two hours at an ambient oxygen concentration. Increasing oxygen concentrations decreased the severity of the lesion, there being a significantly (P less than 0.05) less severe lesion with oxygen, 99 per cent, as compared with 21 per cent. Pretreatment with phenobarbital alone resulted in hepatic necrosis only when hypoxia (FIO2 0.14) was also present, and there was no significant worsening of the T3-induced lesion when phenobarbital was added at any oxygen concentration studied. However, the lesion produced by T3 and oxygen, 14 per cent, was significantly worse than the lesion produced by phenobarbital and oxygen, 14 per cent. Glutamic pyruvic transaminase (SGPT) was significantly elevated to 776 (+/- 226) U/1 in the T3-treated rats (10 mg/kg/day, orally) immediately after halothane anesthesia. There was a significant decrease in glutathione to 1.48 (+/- 0.06) mg/g liver 24 hours after T3 administration (1 mg/kg subcutaneously for five days), but no further decrease with continued T3 pretreatment or with halothane anesthesia. Pretreatment with T3 caused a significant decrease in cytochrome P-450 to 0.41 (+/- 0.01) nmol/mg microsomal protein, and halothane anesthesia caused a further significant decrease to 0.27 (+/- 0.04) nmol/mg microsomal protein. The mechanism for the hepatic toxicity of halothane in this model remains to be determined.

Alanine Transaminase↗
PubMed1980

Effect of a single transfusion of donor-specific and nonspecific blood on skin allograft survival in mice.

The effect of a single transfusion of donor-specific or nonspecific blood on skin allograft survival was studied in ALS-treated mice. In the weak H-2-incompatible C3H/He to B6AF1 combination, transfusion of outbred CF1 blood induced significant prolongation of C3H/He skin graft survival when given over a wide interval of days between transfusion and skin grafting. In contrast, donor-specific C3H/He blood was effective only when given 10 days before grafting. Transfusion of either red blood cells or lymphocytes separated from CF1 or C3H/He whole blood also prolonged C3H/He skin graft survival. In the relatively strong H-2 incompatible DBA/2 to B6AF1 combination, significant prolongation of DBA/2 skin grafts was induced only by transfusion of donor-specific DBA/2- and H-2-compatible BALB/c blood. A single transfusion of C3H/He or CF1 blood failed to prolong DBA/2 skin graft survival. In the strong H-2-incompatible DBA/1 to B6AF1 combination, donor-specific DBA/1 blood was effective in prolonging DBA/1 skin graft survival. These results demonstrate that the effectiveness of donor-specific or nonspecific blood is dependent on (1) the degree of H-2 incompatibility of donor-recipient pairs and (2) timing of the blood transfusion relative to skin grafting.

Animals↗
PubMed1980

Elevated plasma free drug concentrations of propranolol and diazepam during cardiac catheterization.

Patients who undergo cardiac catheterization are frequently taking propranolol and are often premedicated with diazepam. Because the intensity of a drug's action is determined by free, or non-protein-bound, levels in plasma, changes in the degree of protein binding may profoundly alter the pharmacologic effect. We examined the effects of heparin on the free levels of propranolol and diazepam in six patients who underwent cardiac catheterization. After heparinization, the free fraction of diazepam increased more than fourfold, from 1.8 +/- 0.1% to 7.9 +/- 1.2% (p < 0.002) and the free levels increased from 2.0 +/- 0.5 to 8.4 +/- 2.2 ng/ml (p < 0.025); the free fraction of propranolol increased from 7.4 +/- 0.9% to 12.5 +/- 1.4% (p < 0.001). The increase in free drug concentration was associated with elevated free fatty acid levels, which rose from 181 +/- 7 micrograms/ml to 596 +/- 119 micrograms/ml (p < 0.02). Increases in the free levels of propranolol and diazepam produced by heparinization during cardiac catheterization may result in increased pharmacolaogic effect, such as excessive sedation or respiratory depression.

Adult↗
PubMed1980

Traumatic arteriovenous fistula of the superior mesenteric vessels.

A case of traumatic arteriovenous fistula of the superior mesenteric vessels is added to a collective review of 16 previous cases. Nausea, vomiting, cramping abdominal pain, diarrhea, abdominal thrill and bruit were usually present. Arteriography was diagnostic. Four patients operated upon immediately or within 11 hours after penetrating abdominal trauma had superior mesenteric arteriovenous injuries repaired; the remainder had a mesenteric vascular injury missed at initial laparotomy. The location of the fistula determined the method of repair. Spontaneous obliteration occurred in one patient. In two of the three deaths, portal hypertension was persent and a fistula was discovered at autopsy; the other occurred 3 months after massive bowel resection. Thorough exploration of hematomas and lacerations of the mesentery will minimize or eliminate subsequent formation of an arteriovenous fistula.

Abdominal Injuries↗
PubMed1980

Psychosocial and psychosomatic diagnoses in primary care of children.

In this study in seven primary care facilities the proportion of children recognized as having behavioral, educational, or social problems was much higher than generally assumed. Although there was great variability among the facilities, at least 5% and as many as 15% of children seen in one year were diagnosed as having these problems in all but the hospital teaching facilities. The prevalence was even higher among children from poor families. The variability among facilities was much less for psychosomatic problems, which were diagnosed in 8% to 10% of the children. For both psychosocial and psychosomatic types of problems, but especially for psychosocial ones, the proportion of visits with the diagnoses was much lower than the proportion of children with them, so that these problems engendered fewer visits for their management than might have been expected from their frequency in the population. However, available evidence suggests that individuals with unresolved psychosocial problems make more than their share of visits for other diagnoses. The findings of this study have implications for the content of educational programs for primary care practitioners, for the organization of primary care practice, and for the current debate over policy concerning reimbursement and benefit packages.

Adolescent↗
PubMed1980

A family practice education system based on patient care outcomes in family practice settings.

The philosophy, goals, objectives, methodology, and results of a family practice faculty development program are described. Developing family practice educators who will create an education system based on patient care outcomes in family practice settings is the central philosophical purpose of this faculty development program. On completion of the program all participants recognized the essential nature of this philosophical goal and were more comfortable and confident in their ability to: (1) determine resident learning needs; (2) organize curriculum units; (3) use different teaching techniques; and (4) understand their own personal teaching needs and interests. The implications of these changes for developing a family practice curriculum based on patient needs are described.

Faculty, Medical↗