Bronchial bleeding with nebulised pentamidine.
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Biomedical subjects
Publications and source records attributed to S J Semple.
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A rapidly responding intra-arterial pH electrode has been developed to provide a continuous record of arterial pH (pHa) in the radial artery of adult humans and large mammals. The current method for measuring pHa is discontinuous and is achieved by taking blood samples and subsequently measuring pHa in a blood gas analyser. The development of an intravascular electrode is needed for studies on the chemical control of pulmonary ventilation when a continuous record of pHa is required. It will be particularly useful in rapidly changing circumstances such as at the onset and termination of exercise and at sleep onset and arousal. The sensor of the electrode system described here consists of a pH sensitive plastic membrane adherent to the tip of a catheter. This catheter is threaded down a radial artery catheter and protrudes 2-3 mm into the arterial lumen. The electrode system has been used in patients in an intensive care unit and in patients undergoing sleep studies. No adverse complications have occurred. The records obtained showed that arterial pH faithfully followed changes in pulmonary ventilation.
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A census of all consultant physicians in England and Wales was carried out on 2 January 1991 by the Royal College of Physicians of London. The total number, 3,573, agreed closely (97%) with the numbers known to the Department of Health (DoH). Of this total, 1,352 were general physicians. Their commonest specialty interests were cardiology, endocrinology, gastroenterology, and thoracic medicine; one-sixth of the geriatricians held posts with some general medical component. In all specialties there is a bulge in the number of consultants aged 40-50. This will lead to a substantial increase in the number of vacancies in the early part of the next century, and will need careful manpower planning. The proportion of women consultants in medical specialties, with perhaps the exception of dermatology, haematology, and geriatric medicine, remains low at 13%. An adequate 'safety net' of junior staff for the care of adult emergencies was present in most main district hospitals at the time of this census.
The potential importance of the obstructive sleep apnoea syndrome (OSA) has been recognized only in the last few years. Epidemiological studies suggest that symptomatic OSA occurs in 1-2% of middle-aged men and in approximately half that number of women. The relation of OSA to vascular disease is uncertain and the main indication for treatment is the relief of disabling sleepiness. Two recent evidence based analyses have produced diametrically opposed conclusions on the efficacy of treatment with nasal continuous positive airway pressure (CPAP). However, recent controlled studies confirm the overwhelming clinical experience of benefit. Facilities for the investigation and treatment of patients with OSA in the UK are subject to severe financial constraints and the availability of CPAP treatment lags markedly behind that in other countries for which data are available.