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Biomedical subjects

R Macdonald

Publications and source records attributed to R Macdonald.

At least 73 records · Page 4Linked to original sources

The epidemiology of Ascaris lumbricoides and other soil-transmitted helminths in primary school children from Ile-Ife, Nigeria.

An epidemiological survey of intestinal helminthiases was conducted on 766 primary school children aged 5-16 years from Ile-Ife, Nigeria. On the basis of stool examinations, the prevalence of Ascaris lumbricoides, Trichuris trichiura, hookworm and Strongyloides stercoralis was 88.5, 84.5, 33.1 and 3% respectively. Intensity of infection was measured indirectly by egg counts for each species of helminth and also by counting worms passed after chemotherapy in the case of A. lumbricoides. The influence of host age and sex on infection levels was assessed. Relationships between the intensities of A. lumbricoides, T. trichiura and hookworm in individual children were identified. After anthelmintic treatment with levamisole, the frequency distribution of A. lumbricoides per host and the relationship between parasite fecundity and worm burden were investigated. Reinfection patterns of A. lumbricoides were assessed at two 6-monthly intervals and even within the narrow age range described, differences were found. In addition, evidence was obtained for predisposition of individuals to heavy or light infection with A. lumbricoides.

Adolescent↗

Caesarean section at 27 weeks gestation with removal of phaeochromocytoma.

We describe the anaesthetic management of a 31-yr-old woman undergoing combined Caesarean section and removal of phaeochromocytoma during the 27th week of pregnancy. The technique used (general anaesthesia with extradural block) provided good operating conditions and a relatively stable haemodynamic state.

Adrenal Gland Neoplasms↗

The teaching of dento-maxillo-facial radiology in Australian dental schools.

The skills necessary to successfully perform radiological procedures in general dental practice are described and should be used as criteria when developing an effective undergraduate curriculum and as determinants of the contents of continuing education programmes. The present status of undergraduate curricula. continuing education, and postgraduate programmes as well as the recognition of the specialized nature of dento-maxillo-facial radiology, are discussed and recommendations for future developments are made.

Australia↗

Idiopathic myoglobinuria in the early puerperium.

Myoglobinuria is rare in association with pregnancy. We report a case of idiopathic myoglobinuria in the early puerperium in a patient who had a spontaneous vaginal delivery. Acute muscular pain and port wine staining of the urine should alert the clinician.

Adult↗

Epidural catheter migration during labour.

A study was undertaken to determine the incidence, magnitude and direction of catheter migration in 100 patients who had epidural analgesia for pain relief in labour. Over 50% of catheters migrated from the original position at siting. The relevance of this migration and the usefulness of its measurement are discussed.

Anesthesia, Epidural↗

Spinal anaesthesia with hyperbaric lignocaine for elective caesarean section.

This study was carried out in 30 patients undergoing elective Caesarean section to assess the predictability and reliability of spinal anaesthesia with 5% hyperbaric lignocaine, with a view to incorporating the technique in our failed intubation drill. The spinal was performed with a 25-gauge needle in either the sitting (15 patients) or left lateral position (15 patients). The speed of onset of anaesthesia to T6 was significantly faster (p less than 0.01) in the lateral group, but the duration of action was similar in both groups. Twelve patients had hypotension and four developed severe postspinal headaches. The block progressed to the C2 dermatome in four patients and was associated with dysphagia. This was totally unpredictable and may be due to altered cerebrospinal fluid dynamics in late pregnancy. Therefore, the use of spinal anaesthesia with heavy lignocaine may be inadvisable in obstetric patients, especially following failed intubation.

Anesthesia, Obstetrical↗

Sleep and comfort after caesarean section.

To compare postoperative well-being after general and epidural anaesthesia, 58 women undergoing Caesarean section were divided into a general anaesthetic group receiving intramuscular opioid postoperatively (26), and an epidural group receiving morphine via the epidural route (32). The epidural group required less analgesia (p less than 0.01 at 0.5 and 8 hours, p less than 0.001 at 4 hours). There was no difference in the use of oral analgesics. At 1, 4 and 24 hours after delivery more patients in the general anaesthesia group described themselves as very comfortable (p less than 0.05). More in the epidural group had a very good night's sleep during each night studied. Patients in the epidural group were slower to use the ward toilet (p less than 0.01) and had more itching (p less than 0.001). Our conclusion is that patients progressed well in both groups.

Adolescent↗

Extradural morphine and pain relief following episiotomy.

One hundred and fifty obstetric patients, who had received intrapartum extradural analgesia with bupivacaine, and had required episiotomy, were given a final postpartum injection of preservative-free morphine in saline, or saline alone, on a double-blind basis. The degree of perineal analgesia was assessed by linear analogue scale at intervals up to 36 h, and oral analgesic requirements were recorded. A significant degree of analgesia was obtained for up to 12 h with morphine 2 mg, compared with saline. Increasing the dose to 4 mg increased the occurrence of side-effects, and was associated with less marked analgesia.

Adolescent↗

Continuing education in pulmonary disease for primary-care physicians.

A continuing medical education program was implemented and evaluated in 16 community hospitals. It was targeted at primary-care physicians and used physicians identified by their peers as being educationally influential for the dissemination of information. Self-study materials were used, followed by an intensive 2-wk preceptorship that resulted in a significant increase in physician knowledge. Inpatient chart audits identified a series of changes in the management of chronic obstructive pulmonary disease in the intervention hospitals that were not noted in the control hospitals. These included the increased use of intravenously administered fluids, loading doses of intravenously administered bronchodilators, aerosolized and single agent bronchodilators, and respiratory therapy services. Continuing medical education, delivered through community-based educationally influential physicians, is an effective way of changing physician behavior in small communities with no prior ongoing educational programs. This approach should improve patient care and may reduce the need for participation of academic faculty in traditional continuing education programs.

Education, Medical, Continuing↗

Plasma phosphate and red cell 2,3-diphosphoglycerate following abdominal surgery.

Changes in plasma phosphate have been serially examined in 20 patients undergoing uncomplicated abdominal surgery. These studies confirm previous reports that a fall in plasma phosphate occurs in the postoperative period, but this does not appear to be metabolically deleterious to the patient since it is not accompanied by a significant concomitant fall in red cell 2,3-DPG. These investigations form a basis for studies in complicated patients and serve to refute the suggestion that phosphate supplements should be added to all routine postoperative infusions.

Abdomen↗

Laryngeal oedema and pre-eclampsia.

A case of laryngeal obstruction secondary to laryngeal oedema and a superimposed upper respiratory tract infection in a pre-eclamptic patient is reported. The management of the case is described and the possible effects of drug therapy on the uterus are discussed. Other reports of asymptomatic laryngeal oedema in pregnancy are reviewed.

Adult↗