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Biomedical subjects

P Harvey

Publications and source records attributed to P Harvey.

At least 91 records · Page 5Linked to original sources

Bee sting anaphylaxis in an urban population of South Australia.

The clinical manifestations and circumstances of bee sting anaphylaxis have been studied retrospectively in 98 subjects. Most reactions occurred in children but the most severe reactions were seen in adult males, of whom 7 lost consciousness and 2 required cardiopulmonary resuscitation. Most stings causing anaphylaxis occurred on the unprotected feet whilst the subject was on lawn in the afternoons in December, January and February when the maximum daily temperature was between 20 and 30 degrees C. This is the temperature range when bees are particularly active in gathering pollen. However, a significantly greater frequency of anaphylactic reactions occurred at higher temperatures when bees are less active, suggesting that high environmental temperature may predispose the individual to greater exposure to bees or possibly to anaphylactic reactions per se. The presence of atopy did not appear to predispose subjects to bee venom hypersensitivity. Considerable anxiety and lifestyle alteration were identified in some subjects. The alleviation of this anxiety is considered an appropriate indication for bee venom immunotherapy.

Adolescent↗

Bee-sting mortality in Australia.

Death as a result of a bee sting is uncommon in Australia. During the 22 years from 1960 to 1981, 25 individuals have been recorded by the Australian Bureau of Statistics as having died shortly after a bee sting. This gives a mortality incidence of 0.086/1 000 000 population per year, but may be an underestimate, as we report two additional fatalities that did not appear in the records of the Bureau of Statistics. South Australia has the highest mortality rate from bee stings of all the Australian States, with a recorded fatality rate of 0.26/1 000 000 population per year. As in other surveys, fatalities occur predominantly in men over 40 years of age, which suggests that there may be other contributory risk factors, for example, coronary atherosclerosis. No deaths were reported in individuals aged from six to 19 years, the age group in which bee-sting anaphylaxis is particularly common. It thus appears that the prevention of death per se is not a strong rationale for routine bee-venom immunotherapy in schoolchildren and young adults.

Adolescent↗

A method for producing normocarbia during general anaesthesia for caesarean section.

Twenty-six patients were anaesthetised for Caesarean section using the Bain anaesthetic system for intermittent positive pressure ventilation. There was an inverse relationship between maximum end tidal carbon dioxide tension and the fresh gas flow (FGF) to the system. A significant difference existed between the patients receiving 80 ml/kg/min FGF and those receiving 120 ml/kg/min. Estimated carbon dioxide levels in the pregnant term patient were higher at each FGF rate than the levels reported in non-pregnant patients by other workers. In order to maintain maternal arterial carbon dioxide tension at or close to the normally quoted term value of 4.1-4.4 kPa, when using positive pressure ventilation with a Bain system, a fresh gas flow rate of at least 120 ml/kg body weight/minute is required.

Anesthesia, General↗

[Proposal for a surgical evaluation index card for ovarian cancers].

The authors propose a computer card for registering the main information required in the management of ovarian cancers. The data include a detailed description of the lesions noted at operation, the surgical procedure, and postoperative lesions. They concern both the initial laparotomy and any second-look operations.

Computers↗

Subsequent physical and mental development in infants with positive contraction stress tests.

Little knowledge exists concerning long-term sequelae in children born of pregnancies complicated by chronic uteroplacental insufficiency. This follow-up study evaluates 12 children with positive contraction stress tests (CSTs) 5.5 months to 4.75 years following birth. Subsequent physical growth was uniformly normal in the four infants classified as appropriate for gestational age at birth; however, continued postnatal growth deficiency was present in 50% of the eight infants who suffered from intrauterine growth retardation. No major neurologic abnormalities were detected, and 10 of the 12 displayed normal mental and motor function, as determined by the Denver Developmental Screening Test, Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence. Two of the 12 infants were depressed at birth and had serious neonatal complications. These were the only two children who scored poorly on the Bayley test. Although no conclusions regarding minimal brain dysfunction can be made, the majority of infants with positive CSTs demonstrate grossly normal neurologic and psychologic development.

Apgar Score↗

Malaria and growth stunting in young children of the highlands of Papua New Guinea.

In a Highlands Valley, at low altitude, malaria is a contributing factor to stunting of growth, an expression of chronic malnutrition, in young children. The affect is most marked in children under two years of age, and may result from retarded intrauterine growth, although malaria also possibly exerts a direct affect on growth in young children. In the absence of a malaria control programme, distribution of amodiaquine to young children and chloroquine to pregnant women and mothers of young children, could reduce not only unnecessary mortality and ill health, but also contribute to the nutritional well being of growing children. In accessible areas the regular MCH clinics held every month could effect such a prophylaxis programme among these at risk groups.

Amodiaquine↗

[Results of radiotherapy of 406 carcinomas of the cervix (T2 distal and T3). Comparison between classical irradiation in one phase and split-course irradiation (author's transl)].

Between 1963 and 1971, a total of 406 inoperable cases of cervical cancer were treated by high-dose radiotherapy at the Centre René-Huguenin. Most of the patients (243) were irradiated by continuous therapy. In the other group (163) there was a 3-week interval in the middle of the treatment. The five-year survival rates (direct method) were respectively 60 and 39 per cent for the patients staged as T2 and T3. Local cure rates were 85 per cent for T2 and 65 per cent for T3. Unfortunately a high rate of complications was noted (12%), 4 per cent of which were fatal. Classical radiotherapy proved to be more beneficial than "split-course" technique considering survival rates. Yet, the rate of local cure is identical in both procedures, and the large rate of death in "split-course" seems to be irrespective of the method. Nevertheless, we have abandoned the "split-course" because the incidence of sequelae had not improved and in as much as the total dose had been reduced, the continuation of such therapy was less justified.

Adult↗

The influence of alcohol on the persistent effects on human performance of the hypnotics Mandrax and Nitrazepam.

Psychotropic drugs are prescribed to modify human behavior but they have persistent central sedative activity which may become a troublesome side-effect. Alcohol is known to interact with psychotropes, often to potentiate their central effects. We have previously shown that residues of some hypnotic drugs persist in the body for up to a week after a single therapeutic dose and have demonstrated that alcohol decreases the elimination rate of methaqualone even when taken 2 or 3 days after the drug. We have therefore looked at the influence of alcohol on the residual effects of Mandrax and nitrazepam on three measurements of human performance. The study was a double-blind, 3-way, cross-over study in which the following treatments were used: drug + alcohol, drug + alcohol placebo, and drug placebo + alcohol. In each case the alcohol or alcohol placebo was given 1, 2, and 3 days after the drug or placebo. The subject's kinetic visual acuity was measured 40 minutes after the alcohol had been taken. This was followed by a Stroop test. Changes in mental state and arousal were measured by an 18-item visual analogue scale. An interaction between alcohol and Mandrax was apparent in the results obtained from the Stroop and visual analogue scale on the third day. However, no interaction with nitrazepam could be clearly demonstrated by any of the tests on any occasion. The application of these results to the "real life" situation is discussed.

Adult↗