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Biomedical subjects

A Talbot

Publications and source records attributed to A Talbot.

29 records · Page 2Linked to original sources
PubMed1981

The telephone in primary care.

This paper presents a review of the use of the telephone in primary care medicine. The telephone is available to a large majority of United States citizens, a situation that is unusual in other countries. Between 15 and 20% of all primary medical contacts in the United States occur on the telephone. Approximately 40% of routine office telephone contacts are administrative in nature, the remainder involving direct requests for advice or treatment. After office hours, requests for immediate medical advice constitute almost all of the calls (for both daytime and after hours calls). Close to 70% of the medical calls are managed solely by use of telephone. Although the telephone is effectively used for medical consultation, teaching and survey purposes, it has been shown that health professionals are protocols or specific training tends to improve performance, but such programs are not a regular part of medical education.

Communication↗
PubMed1981

The telephone survey in family practice.

Patient surveys can be useful methods of obtaining information for the purposes of improving health services, practice management, or research in family medicine. The telephone interview is an effective and economical method of undertaking such a survey. The advantages and disadvantages of the telephone survey method are briefly illustrated by a study conducted in the Family Practice Center at the University of North Carolina concerning patient perspectives on their after-hours medical encounters with physicians.

Cost-Benefit Analysis↗
PubMed1980

Myelin-like structures seen intracellularly in renal tubule cells subjected to ischemia.

Renal cortex was studied during experimentally induced ischemia. A transient increase in anerobic glycolysis occurred with concomitant swelling of both the Golgi apparatus and mitochondria. These intracytoplasmic organelles underwent marked changes in their intracellular positions. Infolding of cytoplasmic membrane at the basal side of proximal tubule cells increased in complexity and proceeded to enclose various intracytoplasmic microorganelles such as mitochondria and the Golgi apparatus. Piling up in layers was particularly marked around mitochondria. This piling up appeared as myelin-like structures on the free surface of, and within, proximal tubule cells, and followed disruption of the brush border at the free surface. Histological examination of thin sections showed that the fused portions of this brush border were actually brush border cytoplasmic membrane piled up in layers giving the appearance of myelin-like structures. After two hours of ischemia, parts of the membrane of these myelin-like structures were disrupted. Large vacuoles developed and these were thought to be related to the large vacuoles seen during cell degeneration.

Acid Phosphatase↗
PubMed1979

The after-hours call in family practice.

Patient care after hours continues to be an important part of the work of family physicians, in spite of the trend towards increasing Emergency Room utilization. In this paper the literature concerning after-hours care in family practice is reviewed in terms of definition, demography, utilization, morbidity, and patient stereotypes. In the Family Practice Residency Program of the University of North Carolina, 4,760 after-hours calls were recorded over two years by residents and faculty physicians. Seventy-two percent of the calls were handled purely on the telephone with little variation for patient age groups. The overall call rate was 474 calls per 1,000 patients per year. Fever and skin wounds were the most frequent symptoms recorded and respiratory tract infections, minor trauma, and anxiety were the commonest diagnoses. Thirteen percent of the contacts engendered anger or frustration in the physician. A survey of patients calling after hours demonstrated a lack of congruence between physician and patient concerning the main reason for the call in over 30 percent of contacts.

Attitude of Health Personnel↗
PubMed1979

The after-hours call: a survey of United States family practice residency programs.

This article reports the results of a 1977 survey of 245 family practice residency programs providing after-hours care. The objectives of the study were: (1) to clarify the involvement of family practice residents in this aspect of medical care; (2) to investigate the organization of after-hours care in the family practice centers as a possible training model for future family physicians; and (3) to establish whether or not specific educational activity was based on after-hours calls. All the responding operational programs provided after-hours care to patients, using all levels of residents as providers. Most of the programs used an answering service. Only 67 percent documented all patient encounters in writing. Regular educational feedback to residents was undertaken by 71 percent of the residency programs.

Appointments and Schedules↗
PubMed1978

Scanning electron microscopy of the ischaemic kidney--changes in the surface microstructure of glomerular epithelial cells.

Domestic rabbits were used to study the changes that occur during ischaemic conditions in the kidney. With a scanning electron microscope, the microcellular changes at the surface of gomerular epithelial cells were observed regularly from the onset of ischaemia until five hours later. After one hour of ischaemia, the surface of the glomerular epithelial cells showed mild swelling and some change in its smooth appearance. One part had taken on a sponge-like appearance. After 2.5 hours of ischaemia, the epithelial cells had atrophied and the entire cell surface was clearly sponge-like. It was no longer possible to distinguish the small pore-like structures that had been seen on the cell surface in the normal. Moreover, 2.5 hours of ischaemia was the time when, biochemically, cell metabolism had completely ceased and the permeability of the cell membrane had altered. The cell was considered to have undergone irreversible change by this stage. After 5 hours of ischaemia, cells were markedly atrophied and the appearance of the surface had become even more sponge-like.

Animals↗
PubMedDate not supplied

Dynamic model of oxygen transport for transcutaneous PO2 analysis.

A dynamic model of oxygen transport through the outer skin layers and a polarographic sensor was developed for the analysis of transcutaneous oxygen tension (tcPO2). It provides a basis for quantifying the factors that determine the relationship between tcPO2 and arterial oxygen tension (PaO2). Model simulations show the importance of stratum papillare metabolic oxygen consumption; the oxygen permeability of the skin relative to that of the sensor membrane and electrolyte; and temperature and the oxyhemoglobin dissociation curve. These simulations were consistent with experimental data obtained by using microcathode transcutaneous oxygen sensors, which were placed on the skin of 10 healthy adults. Furthermore, the model indicates that accurate evaluation of arterial oxygen tension by using transcutaneous measurements requires continuous estimation of skin perfusion. On the basis of tcPO2 measurements made during arterial occlusion, simulations indicate that quantitative evaluation of the metabolic oxygen consumption of the viable skin tissues is possible only when the oxygen permeabilities of the skin and sensor are known.

Adult↗