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Biomedical subjects

P A Hurley

Publications and source records attributed to P A Hurley.

6 recordsLinked to original sources
PubMed1999

Senior House Officer training: some myths exposed.

A prospective study of general surgical experience obtained by 13 first year Senior House Officers (SHOs) in South East Scotland is presented. On average a Senior House Officer (SHO) operating as the principal surgeon performed 15 appendicectomies (range 7-26), 17 inguinal herniorrhaphies (range 7-42) and 17 varicose vein operations (range 5-33) over their first 12 months. The senior author, as a first year SHO in 1985, performed 23 appendicectomies, 36 inguinal herniorrhaphies and 18 varicose vein operations as the principal surgeon. The operative supervision of SHOs provided either by the Consultant or the Registrar varied widely between units despite a uniformity in available training operations. Clearly many opportunities are being lost within the region and greater organisation is necessary in some units to capitalise on existing training opportunities and thus optimise SHO training. In general, it is still possible, despite the reduction in working hours, for SHOs to receive similar operative experience now as was possible 13 years ago.

Appendectomy↗
PubMed1993

Serum PAPP-A measurements in first-trimester screening for Down syndrome.

Serum PAPP-A measurements taken from 254 women in the first trimester are reported. Eleven chromosomal abnormalities were detected. The mean serum PAPP-A levels in cases of Down syndrome were 0.44 MOM at 9 weeks gestation, 0.15 MOM at 10 weeks, and 0.29 MOM at 11 weeks. The PAPP-A level at 10 weeks was below those of pregnancies which aborted spontaneously. At 11 weeks, the pregnancies with Down syndrome recorded the lowest PAPP-A levels at that gestation. On this small sample, offering chorionic villus sampling to women with singleton pregnancies and a PAPP-A level below 0.3 MOM (approximately 6.5 per cent of this at-risk group) would have detected all the Down syndrome fetuses at 10 weeks and 50 per cent at 11 weeks without selecting those cases destined to abort. This suggests that serum PAPP-A should continue to be investigated as a potential first-trimester screening test for Down syndrome.

Adult↗
PubMed1992

Fetal therapy.

In the past year, the results of the European trial comparing chorionic villus sampling and amniocentesis have been published, supporting the findings of the Canadian Collaborative Study of an increased risk associated with chorionic villus sampling. The reporting of an increase in limb reduction abnormalities with chorionic villus sampling before 9 weeks has made us review our current practice. Other developments covered by this review include the management of mild cerebral ventriculomegaly, the treatment of tachyarrhythmias, and developments in fetal surgery. Throughout, the needs for continued collaboration, pooling of data, and the formation of international registers to extend the database from which both doctors and patients may benefit are highlighted.

Amniocentesis↗