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Biomedical subjects

C Aitken

Publications and source records attributed to C Aitken.

18 recordsLinked to original sources

Comparative efficacy of oral doses of clindamycin and erythromycin in the prevention of bacteraemia.

Two antibiotics, clindamycin and erythromycin, were compared in a double-blind trial to test their efficacy in the prevention of post-dental extraction bacteraemia with streptococci in a group of 40 healthy patients. Tolerance to the oral doses was tested by questionnaire. Levels of drug in the serum were estimated using a microbiological assay. An in-vitro blood culture system was used as an analogy of the persistence of a bacteraemia in the presence of high levels of antibiotic. Isolates of streptococci were identified to species level. Minimum inhibitory concentrations of clindamycin and of erythromycin for each isolate were estimated. Results showed satisfactory levels of antibiotics in the blood for activity against oral streptococci. Clindamycin was slightly more effective than erythromycin in the prevention of post-extraction streptococcal bacteraemia but that efficacy was only 45%. Clindamycin as a single oral dose of 600 mg was well tolerated by patients compared with erythromycin 1.5 g.

Abdominal Pain

Diagnosing respiratory syncytial virus by nasal lavage.

Nasal lavage was compared with nasopharyngeal aspiration for diagnosis of respiratory syncytial virus infection. Nasal lavage and nasopharyngeal aspiration were performed on 50 occasions in 32 infants (median age 5.6 months) with acute viral wheezing. Compared with nasopharyngeal aspiration, nasal lavage had a positive predictive value of 95.6% and negative predictive value of 92.5%. These comparable results and lack of adverse effects make nasal lavage the preferred method.

Child, Preschool

Psychosomatics for all--past, present and future.

It used to be fashionable to begin consideration of psychosomatics about philosophy of mind and body. Nowadays it is a topic about health and practical care of patients--principally about the psychological aspects of any illness. Pathogenesis is becoming understood with some risk factors clearly identifiable. The high incidence of symptoms attributable to emotional disturbance has now been described in so many conditions that it is altering the delivery of health services. The boundaries of psychosomatics are extending. No longer is the topic confined to a few chronic diseases, even including new ones like AIDS, but it now includes support for carers and education about behaviour for health, to name two currently important aspects. The responsibility for the biopsychosocial approach does not lie alone with doctors, and certainly not only psychiatrists, but the many professionals involved in clinical care. The aim is not simply reducing symptoms, but improving functional capabilities and preventing social disadvantage. The more the advance of knowledge, the more intriguing become the questions awaiting answers. The risk factors due to predisposition or unhealthy behaviour and stress still only account for a small contribution to aetiology. Coping mechanisms, whether in personality or social support, still defy enough understanding to predict which patients will develop emotional disturbance, and which patients will respond to appropriate treatment. Perhaps, the most intriguing question is why, when certain relevant facts about unhealthy behaviour are beyond dispute, such as the effect of drinking excessive alcohol, smoking nicotine, having unsafe sex, poor family caring or receiving insensitive treatment, it remains so difficult to bring about improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological

Care of disabled people in the community.

The initiatives raised by the International Year of Disabled Persons led to an understanding that the community may well be the best place to help disabled people. It is important to ensure that any major switch of resources from institutional to community care should be properly appraised, not just on cost-effectiveness grounds but also on the needs of the disabled persons themselves. Apart from the traditional medical input there is an imperative need to involve other professional and informal helpers to ensure the best possible outcome.

Community Health Services

Psychosocial aspects of disease and their management.

The pathogenesis of psychosomatic distress is considered. This emphasises interest in aetiology of distress rather than solely of disease. The influence of psychological aspects is as important whether the disease is of known or unknown aetiology, and can be of greater importance in poorer socio-economic circumstances. The doctor's role is to tease out the influence of these many factors. Certainly a holistic approach is necessary to assess and manage appropriately patients with disability. There is an important role for psychiatrists within services for management of such patients. Leadership by all doctors and psychiatrists in particular to apply the holistic approach should be encouraged.

Humans

Elusive allowances.

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Attitude to Health

Dr. Denis Leigh.

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History, 20th Century

Psychosomatic approach to medical rehabilitation.

The author records his views about the future of medical rehabilitation. He reports some of the evidence on which to advocate the psychosomatic approach for the management of all disease and injury prone to chronic morbidity. As the causes of distress are multiple, clinical service is required from a multiprofessional team. The success of outcome is to be judged in the social adaptation achieved, recognising that this is influenced by such intangible concepts as morale and motivation.

Emotions

Prospects and services for medical rehabilitation.

In the developed world, comprehensive services for disabled patients are usually well established for children and elderly people. Services for rehabilitation of middle-aged patients generally consist of specific treatment facilities, such as for physiotherapy. On the other hand, a range of services of psychiatric patients is now established, with a model suitable for most disorders. Arrangements are flexible, ranging from crisis intervention to long-term care, in some places being remarkably comprehensive and well coordinated. There is a need to plan development of medical and social services for patients prone to chronic morbidity from whatever cause; this plan for the physicially disabled should take account of their many needs, and of the many facilities now available, some statutory, some voluntary. There is reason to believe that redeployment of resources existing in many countries could improve the standard of medical rehabilitation for patients of all ages.

Adolescent

Clinical psychosomatic research.

Psychosomatic medicine embrances the influence of psychological factors on the development and course of diverse physical symptoms. Reasons are given why it is recognized that physical morbidity is influenced by such factors, with illustrations from the authors' research on acute ischemic heart disease, peptic ulcer and bronchial asthma. The nature of the psychological factors can be elucidated with the use of recently developed psychometric tests; these relate particularly to mood disturbance, either attributable to affective disorder or prominent personality traits. To insure that samples studied are representative of the disease or symptom being considered, and that all relevant variables are taken into account, the research approach usually necessitates a multidisciplinary team.

Affective Symptoms