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Biomedical subjects

A Morton

Publications and source records attributed to A Morton.

At least 19 recordsLinked to original sources
PubMed1991

Principles behind practice. 5. Clinical disagreement.

With clinical information it is frequently difficult or impossible to make objective measurements to prove that a particular finding is correct. In these circumstances, the agreement of experienced clinicians is the best guide to the accuracy of clinical findings. However, studies of clinical judgement usually show a distressingly high level of disagreement among clinicians. We examine why such disagreement is so common, how clinical disagreement can be measured and how clinicians can be trained so that they are able to agree on important findings.

Adult↗
PubMed1991

AIDS in California family medicine. Changing experiences, knowledge, and geographic distribution.

Information regarding practice patterns specific to acquired immunodeficiency syndrome (AIDS) was obtained in 1988 from 1774 family physicians in California using a mail survey. Data were analyzed across the following county groupings: Los Angeles County, other counties in standard metropolitan statistical areas, and counties outside standard metropolitan statistical areas. Comparisons were made with the data from a telephone survey conducted in 1986. Differences over time were analyzed. By 1988, the percentage of physicians treating or referring patients for possible AIDS had more than doubled in counties outside standard metropolitan statistical areas. The percentage of physicians reporting one or more diagnosed cases of AIDS had tripled, a finding that suggests the importance of AIDS in family medicine is increasing at a rapid rate. In addition, survey results indicate that a majority of those surveyed still lack the AIDS-related knowledge and competency necessary to effectively deal with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Comparative trial of low-dose, intradermal, recombinant- and plasma-derived hepatitis B vaccines.

The immunogenicity and reactogenicity of low-dose, recombinant DNA and plasma-derived hepatitis B vaccines were investigated in a prospective, double-blind, randomized, controlled trial. Volunteers (153) received either recombinant vaccine, 10 micrograms in 1 ml intramuscularly; plasma-derived vaccine, 2 micrograms in 0.1 ml intradermally or recombinant vaccine, 1 microgram in 0.1 ml intradermally at 0, 30, and 150 days. Peak geometric mean concentrations of antibody to hepatitis B surface antigen at day 200 were 1094, 387, and 43 mIU/ml, respectively. By day 360, these concentrations had fallen to 346, 124, and 19 mIU/ml, respectively (P less than .05 between groups both dates). Number of subjects with antibody greater than or equal to 10 mIU/ml at day 200 was similar between the 10-micrograms recombinant and 2-micrograms plasma-derived groups (94% vs. 90%), while only 78% of the 1-microgram recombinant group had protective concentrations of antibodies (P less than .05). Erythema and induration occurred in most subjects in both intradermal groups, while pain was prominent at the intramuscular site especially after the second dose. Thus, plasma-derived vaccine, 2 micrograms in 0.1 ml intradermally, appears to be an acceptable cost-saving method for hepatitis B immunization, while recombinant-derived vaccine, 1 microgram in 0.1 ml intradermally, produced less satisfactory results.

Adult↗
PubMed1990

Selection of admissions to a therapeutic community using a group setting: association with degree and type of psychological distress.

Henderson Hospital is a therapeutic community offering treatment for personality disordered young adults. The community operates a unique system of selection, whereby a group of residents and staff jointly decide upon offering admission to new referrals. This study is a preliminary investigation examining, in part, the basis upon which the selection group makes its decision. A measure of symptomatic psychological distress (SCL-90) was completed by 156 selection candidates. Comparison of those candidates selected with those who were rejected showed no difference between groups in number of symptoms reported nor the degree of distress attributable to those symptoms. However, analysis of symptom sub-scale scores revealed that those subjects not selected scored significantly higher on measures of somatisation, obsessive-compulsive features and phobic anxiety. It could be argued that these three symptoms are indicative of a tendency to deny or avoid feeling emotional distress. We propose that at one level, the selection group may operate by identifying those candidates who are more able to verbalise their distress, i.e. those presumed most likely to benefit from the Therapeutic Community's psychotherapeutic approach.

Adult↗
PubMed1977

Post-operative flow-volume loops.

A study of flow-volume curves pre- and post-operatively demonstrated a marked difference between bronchitic and non-bronchitic patients. All bronchitic patients showed lower flow rates at low lung volumes post-operatively, when compared with their pre-operative values. Non-bronchitic patients all had higher flow rates for the same comparison.

Abdomen↗
PubMed1977

Post operative pulmonary compliance.

Lung compliance was studied pre-operatively and post-operatively in a group of patients having abdominal surgery. Lung compliance was shown to be markedly reduced post-operatively especially in the patients with chronic bronchitis.

Abdomen↗
PubMed1977

Postoperative arterial hypoxaemia.

Postoperative arterial oxygen tension was measured in a group of patients. Unacceptably low levels were found in 32% of the patients and this hypoxaemia persisted in some cases for three days. The results enforce the principle that some patients whould be given prolonged oxygen therapy and this should cease only when blood gas analysis demonstrate the patients ability to maintain a safe PaO2 breathing air.

Humans↗
PubMed1977

Radiological lung volume in surgical patients.

Radiological total lung capacity (T.L.C.) was measured preoperatively and postoperatively in a group of patients. A decrease in T.L.C. postoperatively in patients who smoke was demonstrated. The use of radiological T.L.C. in the study of postoperative respiratory dysfunction is suggested.

Aged↗
PubMed1977

Post-operative respiratory resistance.

Respiratory resistance was studied pre-operatively and post-operatively in a group of patients undergoing abdominal surgery. Respiratory resistance was shown to be markedly increased post-operatively in patients with chronic bronchitis and slightly increased in non-bronchitic patients.

Abdomen↗
PubMed1977

The effect of oral contraceptives on colour vision in diabetic women.

The results of previous studies of the effect of oral contraceptives on visual function have produced discrepancies and have lacked specific restraints on the control and experimental groups. We compared 14 diabetics with normal acuity who were taking oral contraceptives with equivalent diabetic and control groups and used the Pickford-Nicholson anomaloscope and the Farnsworth-Munsell 100-Hue test. Diabetics using oral contraceptives showed a definite trend to increases in tritanomaly and extended red-green matching ranges. When these losses were classified by degree of defect a significantly higher incidence of major defects was found among diabetics on "the pill". Partial correlations for colour variables, duration of diabetes and duration of contraceptive therapy revealed a compounding effect. While subjects using oral contraceptives demonstrated trends toward the extreme scores, these effects were found only in one out of every four users.

Adolescent↗
PubMed1976

Patient monitoring.

Optimum results are obtained in the care of the critically ill patient if efforts are directed to maintaining the internal environment in a state as near normal as possible. This cannot be done without the use of basic monitoring procedures. Complex investigations may have a legitmate and necessary role as research tools. There is, however, a real risk of complex procedures becoming an end in themselves in general intensive therapy units, where they are apt to distract overworked nurses and medical attendants from the care of their patients. It is important, therfore, for clearcut indications for various monitoring procedures to be defined, and in this paper an attempt has been made to outline alogical approach to the monitoring of critically ill genral surgical patients admitted intensive therapy units.

Blood Pressure↗
PubMed1976

Pulmonary water content in critical illness.

Pulmonary extravascular water content was measured using a double indicator technique and results compared with chest radiography. It is concluded that careful chest radiography is an effective and simple technique for assessing the pulmonary extravascular water content.

Body Water↗
PubMed1976

Post-operative respiratory function: a ventilation-perfusion study.

Many studies have shown that after uncomplicated abdominal surgery arterial hypoxaemia frequently occurs because of regional underventilation in relation to perfusion. This paper produced evidence that shows a small increase in physiological dead space to tidal volume ratio following general anaesthesia for abdominal surgery. This increase is thought to be due to tachypnoea rather than alteration in pulmonary blood flow.

Abdomen↗
PubMed1975

Pulmonary oedema in chronic bronchitis - a haemodynamic study.

Right heart catheterization was performed in ten patients with pulmonary oedema. Mean wedge pressures in excess of 12 mmHg above the mid-axillary line were regarded as abnormal and indicating left heart failure. If the wedge pressure was less than 12 mmHg, and pulmonary congestion was present, frusemide was given. Brief descriptions of the ten cases are given.

Aged↗