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Biomedical subjects

R M Gibson

Publications and source records attributed to R M Gibson.

At least 55 records · Page 3Linked to original sources
PubMed1980

Conservative management of pituitary prolactinomas; evidence for bromocriptine-induced regression.

Thirty-six women with sustained hyperprolactinaemia, 29 showing radiological abnormality of the pituitary fossa, were managed conservatively; 28 accepted bromocriptine treatment which controlled hyperprolactinaemia in all and was associated with improvement in the radiological appearance of the pituitary in 4 cases. Two of the 8 patients who did not accept bromocriptine showed radiological extension of the pituitary lesion; one showed radiological improvement. Bromocriptine should be regarded as a drug to control the pituitary tumour, not merely one which inhibits the endocrine effects.

Adult↗
PubMed1980

New frame for stereotaxic surgery. Technical note.

A new frame designed for stereotaxic surgery allows performance of a one-stage procedure without the need for mathematical calculation or the use of atlases or diagrams. This frame simulates the reference line in the center of the brain with two lines, one on each side of the head (on the frame) parallel and equal in length to the reference line and at equal distance from the midline. Lesions can be made easily and accurately on either or both sides in a one-stage procedure with use of precise data for the target through any specific or pre-existing burr hole.

Humans↗
PubMed1980

National health expenditures, 1979.

Outlays for health care in the nation reached $212.2 billion in calender year 1979--12.5 percent higher than in 1978, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $943 per person in the United States and was equal to 9.0 percent of the Gross National Product. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing.

Delivery of Health Care↗
PubMed1979

Effect of etomidate on intracranial pressure and cerebral perfusion pressure.

Ten patients with intracranial lesions, anaesthetized with thiopentone and nitrous oxide (70%) in oxygen (30%) received etomidate 0.2 mg kg-1 i.v. Ventilation was controlled in each patient. Intracranial pressure (i.c.p.) and mean arterial pressure (m.a.p.) were recorded. I.c.p. decreased significantly in all patients (0.01 greater than P greater than 0.001). Although PaCO2 decreased during the period of measurement, the extent and time-course of this change suggested that it was not mainly responsible for changes in i.c.p. M.a.p. decreased in most patients, but the decrease was statistically significant only at 3 and 4 min after the administration of etomidate (0.05 greater than P greater than 0.02). The changes in cerebral perfusion pressure (c.p.p.) and heart rate were not clinically or statistically significant. We conclude that etomidate can be used for the induction of anaesthesia in patients with intracranial space-occupying lesions without increasing i.c.p. or seriously reducing c.p.p.

Adult↗
PubMed1979

National health expenditures, 1978.

Outlays for health care in the Nation reached $192.4 billion in calendar year 1978--13 percent higher than in 1977, according to preliminary figures compiled by the Health Care Financing Administration. This estimate represented $863 per person in the United States and was equal to 9.1 percent of the GNP. This latest report in the annual series representing national health expenditures provides detailed estimates of health care spending by type of service and method of financing. Revised estimates are presented extending back to 1965.

Economics, Hospital↗
PubMed1979

Age differences in health care spending, fiscal year 1977.

This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65.

Adult↗
PubMed1978

Effects of tracheal intubation on intracranial pressure following induction of anaesthesia with thiopentone or althesin in patients undergoing neurosurgery.

Intracranial pressure (i.c.p.) and mean arterial pressure (m.a.p.) were studied in 20 patients during the induction of anaesthesia for craniotomy. Tubocurarine was administered as the muscle relaxant and either thiopentone or Althesin for the induction of anaesthesia. No significant differences were found in the i.c.p. changes with induction, intubation or pharyngeal packing, between the thiopentone and the Althesin groups. Except for two patients (one in each group) the increases in i.c.p. associated with intubation were small. In these two patients moderate increases from normal values to 28 and 37 mm Hg were recorded, but in one of these patients coughing and straining followed intubation. Marked decreases in m.a.p. were noted in both groups, but the recovery of m.a.p. was significantly more rapid in the Althesin group. Only two patients had i.c.p. values greater than 20 mm Hg before operation and in neither did i.c.p. increase above control values during induction and intubation. Packing the pharynx produced minimal changes in i.c.p. in all patients.

Adult↗
PubMed1978

Effects of fentanyl on intracranial pressure and cerebral perfusion pressure during hypocapnia.

Ten patients presenting for carniotomy were studied. Each was anaesthetized with thiopentone or Althesin followed by tubocurarine and the lungs were hyperventilated with nitrous oxide in oxygen. Fentanyl 0.2 mg was administered i.v. and the intracranial pressure (i.c.p.) and mean arterial pressure were recorded continuously for 10 min. At the time of administration of fentanyl nine of the 10 patients were hypocapnic (PaCO2 less than 4 kPa). The changes in i.c.p. were small. Cerebral perfusion pressures less than 50 mm Hg were observed in two patients who had moderate hypotension before the drug was given. We conclude that fentanyl is a valuable agent in the hyperventilation technique in patients with intracranial space-occupying lesions, provided that hypotension is absent.

Adult↗
PubMed1978

National health expenditures, fiscal year 1977.

The Nation spent $163 billion for health care in fiscal year 1977 or $737 per person, according to preliminary figures compiled by the Health Care Financing Administration. This figure was 12 percent higher than spending for such purposes in the previous 12 months and represented an 8.8-percent share of the GNP. Public spending, which financed 42 percent of all health care in 1977, increased 11 percent while private spending rose 13 percent. Spending for hospital care went up 14 percent to $68.4 billion, and the total spent for physicians' services ($32.2 billion) reflected a 13-percent rise. Third-party payments financed 70 percent of all personal health care in the country.

Delivery of Health Care↗
PubMed1977

Intracranial pressure changes in neurosurgical patients during hypotension induced with sodium nitroprusside or trimetaphan.

Intracranial pressure has been measured in 45 patients undergoing neurosurgery during the induction of deliberate hypotension using either sodium nitroprusside or trimetaphan. A statistically significant increase in intracranial pressure (ICP) occurred during the early stages of the infusion of nitroprusside in normocapnic patients. A non-significant increase in ICP was obtained in hypocapnic patients. The mean ICP increased from 6.3 mm Hg to 11.7 mm Hg when the arterial pressure was reduced slightly, but the response in individual patients varied widely (range -1.6 mm Hg to +20.9 mm Hg). When the arterial pressure (BP) had decreased to 70% of the value existing before infusion of nitroprusside, mean ICP returned to control values and thereafter decreased with further reductions in BP. In patients rendered hypotensive with trimetaphan, there was no change in mean ICP but two patients showed moderate increases (+9.3 mm Hg and +5.7 mm Hg). The mechanism of the increase in ICP with nitroprusside is thought to be expansion of the intracranial blood volume as a result of cerebral vasodilatation. Trimetaphan does not usually produce ICP changes except when intracranial compression is severe, for in these circumstances a small change in intracranial blood volume consequent upon autoregulation may trigger an increase in ICP.

Blood Pressure↗
PubMed1977

National health expenditures, fiscal year 1976.

The Nation's spending for health in fiscal year 1976 reached $139.3 billion, or $638 per person, according to preliminary figures. This total was 14 percent higher than the $122.2 billion spent for health in 1975. In the 2 years since price controls on the health industry were lifted, expenditures have risen $33.0 billion (31 percent). During this period, the economy has grown at a relatively slow pace with the gross national product increasing 18 percent. Thus, the percentage of the GNP attributed to health care reached 8.6 percent in 1976. Public and private spending rose 16 percent and 13 percent, respectively, in 1976, with the rise in public expenditures appreciably below the 22-percent increase of 1975. Third-party financing affected slightly more than two-thirds of all personal health care--the private insurance share at 26 percent and that of government 40 percent.

Education, Medical↗
PubMed1977

Age differences in health care spending, fiscal year 1976.

Of the $120.4 billion spent by the Nation for personal health care in fiscal year 1976, 29% was spent for those aged 65 or older, 15% for those under age 19, and the remaining 56% for those aged 19-64. The average health bill reached $1,521 for the aged, $547 for the intermediate age group, and $249 for the young. Public funds financed 68% of the health expenses of the aged with Medicare and Medicaid together accounting for 59%. Private sources paid 74% of the health expenses of the young and 70% of the expenses of those aged 19-64. Third-party payments met 65% of the health expenditures of all those under age 65.

Adolescent↗