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G D Maclean

Publications and source records attributed to G D Maclean.

17 recordsLinked to original sources
PubMed1992

A preliminary evaluation of education material prepared for the Safe Motherhood Initiative Educational Project.

Maternal death is a tragedy which is all too familiar in much of the world. As part of the Safe Motherhood Initiative the World Health Organization is developing and producing a learning package designed specifically for midwives. Through a modular system of learning incorporating aspects of community, prevention, treatment and follow-up the package seeks to address the five main causes of maternal mortality. In this paper the first pre-testing of the educational material in an African country is described. The extent of the evaluation is limited at this early stage but the initial analysis of the results is encouraging and have led to modifications of the original package. The evaluation has confirmed that a tool such as this package can be a valuable resource for midwife teachers attempting to improve the relevance of education for their midwifery students. The midwifery students whilst being 'with woman' in childbirth are also grappling with the realities of death in their everyday practice. The educational package has also reinforced the sense of urgency fundamental to completing this extensive project so that it can be made available to midwives throughout the developing world at the earliest opportunity.

Botswana↗
PubMed1989

Developing a midwifery workload management system: a preliminary report.

Individualised care, quality assurance and resource management are words frequently on the lips of midwives today. This paper describes a project currently being undertaken in West Glamorgan Health Authority where these criteria each form an important part of the study. It is in considering these varying aspects concurrently that the authors claim a unique approach. Resources are only considered to be managed appropriately when client centred quality care is provided. As an additional benefit, the review of policy and practice and an evaluation of the implementation of the 'midwifery process' form an integral part of the study.

Adult↗
PubMed1987

The treatment of advanced recurrent carcinoma of the uterine cervix with platinum based cytotoxic chemotherapy.

Nineteen patients with advanced recurrent carcinoma of the uterine cervix received platinum based chemotherapy between February 1982 and April 1984. All patients had received prior pelvic irradiation. Eleven patients received combination chemotherapy with platinum, vinblastine and bleomycin (PVB), and 8 patients received a regimen of platinum and 5-fluorouracil (PF). Two patients achieved a complete response and 4 patients achieved a partial response, a total response rate of 33%. Five out of 6 responders received PVB. The median survival (MS) was 8 months (1-38) months from the first treatment with cytotoxic chemotherapy. In those patients achieving a response, MS was 13.5 months (6-38+ months) with 1 patient alive at 38 months, compared to an MS of 5 months (1-15 months) in those patients without response. Toxicity was significant with nausea and vomiting in the majority of patients. Two patients refused treatment after the first course because of toxicity. The morbidity of treatment was such that despite an encouraging response rate, particularly to PVB (45%), the routine use of such treatment must be questioned.

Adolescent↗
PubMed1982

Preference of the early murine immune response for polymorphic determinants on human lymphoid-leukemia cells and the potential use of monoclonal antibodies to these determinants in leukemia-typing panel.

28 monoclonal antibodies (MCAs) which were produced following immunization of mice with human lymphoid leukemia or lymphoma cells were subjected to extensive specificity testing using immunofluorescence and complement-mediated cytotoxicity assays. All except one of the MCAs reacted with lymphocytes from at least one normal donor, but only 36% reacted with at least one subpopulation of lymphocytes from every normal donor tested. 60% of the MCAs detected polymorphic determinants, the frequency of polymorphism ranging from 27 to 91%, 50% of these MCAs reacting with B lymphocytes but not T lymphocytes. The marked heterogeneity observed when testing human lymphoid leukemias with these MCAs could be explained by both polymorphism and heterogeneity in lymphocyte differentiation marker expression. An awareness of the preferential murine immune response to polymorphic determinants on human lymphoid leukemia cells is essential when interpreting unexpected positive or negative results when testing with MCAs. An MCA believed to be detecting a monomorphic determinant may be detecting a high-frequency (supratypic) polymorphic determinant, and a putative leukemia-specific MCA may be detecting a low-frequency polymorphic determinant. Our panel, which includes MCAs which detect polymorphic determinants, appears useful in following the course of leukemia and may be useful for leukemia classification.

Animals↗
PubMed1982

Wanted: encouragement.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMedDate not supplied

Possible utility of serum determinations of CA 125 and CA 27.29 in breast cancer management.

The utility of measurement of serum levels of the tumor associated antigens CA 125 and CA 27.29 in detecting the presence of disease and in monitoring changes in disease status was examined in 63 patients with breast cancer. In patients with clinically detectable disease the CA 125 level was elevated in 59%, the CA 27.29 level in 59.5% and one or both markers in 84.6%. Specificity for presence of disease was 83.6% for CA 125, 88% for CA 27.29, and 69.1% for the two markers combined. Changes in marker levels of more than 50% correlated with clinical changes in disease status in 58% of cases for either CA 125 or CA 27.29 alone. In 87.5% of cases with clinically progressive disease one or both marker levels increased by more than 50% from the previous levels. In no case with greater than 50% increase in a marker level was there regression of disease. Thus, the use of these markers in combination might have utility in cases where diagnosis of recurrent disease is difficult or where monitoring of response to treatment is hampered by lack of measurable disease.

Adenocarcinoma↗
PubMedDate not supplied

Clinical evaluation of a new two-site assay for CA125 antigen.

As appropriate surgery and chemotherapy can improve both quality of life and survival of patients with ovarian adenocarcinoma, there has been a pressing need for "serodiagnostic" assays to enable close patient monitoring. CA 125 antigen has previously been described as a useful tumor marker of ovarian cancer. This is the first clinical evaluation of a radioimmunoassay using two new monoclonal antibodies, B27.1 and B43.13, that react with separate sites on the glycoprotein marker CA 125. Using the new assay, the majority of patients with clinically or radiologically detectable disease had serum CA 125 antigen levels well above the upper limit seen with random apparently healthy donors, while only three patients who were believed free of disease had elevated levels. Disease progression was associated with increasing values of serum CA 125 antigen, while response to therapy was associated with a steady decline in serum CA 125 antigen levels. Seven patients had steadily rising serum CA 125 antigen levels after initially having normal levels. The mean lead time between rise above normal and clinical or radiological evidence of relapse was 5 months (range 2 to 12 months). The merits of further surgical intervention are illustrated by the serial values of two patients followed after chemotherapy. The assay appears to have value in monitoring response to therapy and in detecting disease relapse at a time when appropriate therapeutic intervention is still possible or likely to be beneficial. Furthermore, monitoring CA 125 antigen was shown to be of benefit in assessing response to chemotherapy in a few patients with metastatic adenocarcinoma of unknown primary, and may be useful in this group of patients in determining those likely to benefit from aggressive chemotherapy.

Adenocarcinoma↗