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Biomedical subjects

A MacFarlane

Publications and source records attributed to A MacFarlane.

36 records · Page 2Linked to original sources
PubMed1986

Place of delivery: a review.

Policies about place of delivery have tended to be formulated without either looking at existing evidence or doing new research into the relative safety for women and babies of delivery in different settings. This article reviews published research on the subject, and finds that many of the data required have not been collected. Furthermore, many analyses fail to take account of selection biases or differences in the birthweight distribution and the incidence of congenital malformations among babies born in different settings. Nevertheless, some tentative conclusions can be drawn. The available evidence does not support claims that, for the baby, the iatrogenic risks of obstetric intervention outweigh the possible benefits. At the same time, there is no evidence to support the claim that the shift to hospital delivery is responsible for the decline in perinatal mortality in England and Wales nor the claim that the safest policy is for all women to be delivered in hospital.

Delivery, Obstetric↗
PubMed1984

Results of a screening program for multiple endocrine neoplasia type II.

After the diagnosis of MEN IIa syndrome in five members of a British family, a further 180 members were identified, 167 of whom were still alive. From death certificates, a further three were found to have been affected. Of these eight patients, only two were diagnosed and survived. Over the next four years, these two survivors and 90 others (those over the age of ten years) attended a screening program using alcohol or pentagastrin stimulated plasma calcitonin for MCT or urinary catecholamines for pheochromocytoma. The two surviving patients and 12 others were thought to have abnormal screening tests. One patient with an abnormal catecholamine excretion level had bilateral pheochromocytomas removed. Of the 13 patients with abnormal stimulated plasma calcitonin levels, five underwent total thyroidectomy, but MCT was found in only two. One of these patients and two of those in whom no tumor was found had persistently elevated stimulated plasma calcitonin levels postoperatively, suggesting the presence of C cells and, thus, persisting risk of MCT. In all patients, plasma calcitonin concentrations were variable, and an established normal range of values is essential if unnecessary surgical treatment is to be avoided. Pheochromocytoma proved difficult to diagnose, and pentagastrin stimulated plasma catecholamines deserves evaluation as a screening test. Despite the large effort involved, permanent screening of all family members is recommended as the only means of reducing mortality. Following any treatment, screening should continue because new disease or recurrence is possible.

Adrenal Gland Neoplasms↗
PubMed1978

Variations in number of births and perinatal mortality by day of week in England and Wales.

Analysis of the births that occurred in England and Wales during 1970-6 showed that they followed a seven-day cycle, being concentrated from Tuesdays to Fridays and least numerous on Sundays. This pattern became increasingly pronounced during the period examined. Relatively few births occurred on bank holidays, especially Christmas Day and Boxing Day. In general perinatal mortality was higher among babies born at weekends than among those born on weekdays. It is likely that the pattern seen in the numbers of births is associated to a large extent with elective intervention. It is not possible to draw any conclusions about the pattern seen in perinatal mortality as so far the analysis has been confined to crude rates.

Birth Rate↗
PubMed1976

Carcinomas and carcinoid tumours of the appendix in a district general hospital.

In a retrospective series of 40 appendiceal tumours occurring over a 10-year period, 30 were carcinoid tumours of classical histological pattern, five were adenocarcinomas, and two were tumours intermediate in pattern between carcinoid and carcinoma. The remaining three tumours were secondaries from primary colonic tumours. The implications of the findings are discussed.

Adenocarcinoma↗
PubMed1975

Idiopathic progressive pulmonary fibrosis.

Five patients with progressive fibrotic lung disease are described. The dominant symptom was slowly increasing dyspnoea, and cough and sputum were not prominent. Marked weight loss was also a feature. There was severe restrictive impairment of ventilation with normal arterial gas tensions. The changes were confined to the upper parts of the lung in some but others had more generalized disease. The duration has varied so far from two to 17 years. The lung changes are considered to be due to dense progressive fibrosis. Necropsy in two confirmed this. Histologically there was monotonous fibrosis with lymphoid collections and secondary bronchiectasis, a picture similar to that found in association with ankylosing spondylitis. None of these patients had joint disease. Tuberculosis was excluded as a cause by exhaustive bacteriological tests and the failure of chemotherapy to stop deterioration. All other recognized types of infective and non-infective progressive lung fibrosis were also excluded, and this is not considered to be a variant of cryptogenic fibrosing alveolitis. Though these patients have many features in common they do not necessarily have the same pathogenesis. They are presented as an encouragement to further study.

Adult↗
PubMed1974

Fibrosing alveolitis and treatment with sulphasalazine.

A woman with ulcerative colitis was treated with sulphasalazine and prednisolone. After four months' treatment she began to get short of breath and she died a month later with severe subacute fibrosing alveolitis. It is believed that the lung disease was caused by sulphasalazine and that prednisolone was not able to prevent its development. A reversible form of lung disease has previously been attributed to this drug.

Autopsy↗
PubMedDate not supplied

Staff grade doctors.

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England↗