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Biomedical subjects

H Smith

Publications and source records attributed to H Smith.

At least 19 recordsLinked to original sources
PubMed1979

Clinical performance and specialty choice of COTRANS students.

The clinical performance and specialty choice of 33 Coordinated Transfer Application System (COTRANS) students accepted with advanced standing into the third year of an American medical school were compared with the performance and choice of students from other American medical schools. The undergraduate grade point average of the COTRANS group was considerably lower than that of the other students. The science Medical College Admission Test scores in science were comparable, and the performance on part I of the National Board of Medical Examiners was considerably higher. Clinical performance, choice of specialty, and affiliation of graduate program of the COTRANS students did not differ from those of students entering the curriculum in year 1. Carefully selected students completing the first two years of basic science in a foreign medical school can successfully compete with students already enrolled in the American medical curriculum.

Career Choice↗
PubMed1979

Influence of experience on major clinical decisions. Training implications.

We studied 779 walk-in psychiatric patients presenting to 32 first- or second-year residents and 772 patients presenting to 25 third-year residents or attending physicians as to the decision to admit to the hospital or to administer medication to those not admitted. There were no significant demographic or clinical differences between patients presenting to the two groups. The more experienced staff admitted half as many patients and treated serious depression with tricyclics twice as frequently. Inexperienced psychiatrists used hospitalization more frequently when these patients suffered from suicidal ideation, hallucinations, delusions, and inability to cope. When the training procedure was modified and second-year residents were introduced into a more structured setting, their decision-making quickly approached that of third-year residents and attending physicians. We suggest that specific training can modify decision-making, where general clinical experience may not. Implications for resident and medical student training are discussed.

Clinical Competence↗
PubMed1979

Renal function in gout. V. Factors influencing the renal hemodynamics.

Renal hemodynamics as measured by inulin clearance (Cinulin) and para-aminohippurate clearance (CPAH) was evaluated in 149 patients with primary gout over intervals of two to 22 years. In over 30 per cent of the patients plasma urate was greater than 10 mg/dl and urinary uric acid greater than 800 mg/min. A linear trend in decreasing frequency of hyperuricemia and excessive uricosuria is significantly related to the patient's age at the onset of gout. Group I consisted of 84 patients with uncomplicated gout in both clearance studies. Cinulin and CPAH were somewhat lower in patients larger than or equal to 50 years of age with longer duration of gout. Further reduction in clearances was minimal at the second clearance study in intervals of approximately 10 years. Group II included 27 patients who had no associated disease at the time of the first clearance study but in whom associated disease had developed by the time of the second clearance study. A striking reduction in Cinulin and CPAH was noted, especially in those 50 years old or above. There were 38 patients in group III with associated diseases at the time of both clearance studies. They had lower Cinulin and CPAH at the time of the first study, particularly the older patients. Further reduction during the second study was less striking than that in group II. Analyses of variance suggest that various coexisting vascular diseases with associated nephropathy have the most significant impact on the status of renal function in gout, with aging the second most important and duration of gout, the third.

Adult↗
PubMed1979

Clinical comparison of dipivalyl epinephrine and epinephrine in the treatment of glaucoma.

Dipivalyl epinephrine, 0.1%, though slightly less effective in decreasing intraocular pressure, showed significantly fewer side effects than epinephrine hydrochloride, 2%. Seventeen patients with symmetrically increased intraocular pressures who completed a six-month double-masked crossover study showed a significant decrease in intraocular pressure averaging 23.7% for dipivalyl epinephrine over the entire study and 27.4% for epinephrine. In the first treatment period, dipivalyl epinephrine was slightly less effective than epinephrine. In the second treatment period, dipivalyl epinephrine was statistically less effective than epinephrine. Two of the original 25 patients were dropped from the study because of epinephrine allergy or intolerance, one had uncontrolled pressures with either drug, and five failed to maintain adequate follow-up. Complaints of side effects such as burning and irritation occurred much more frequently in eyes receiving epinephrine (24%) than dipivalyl epinephrine (3%). Mild mydriasis occurred with each drug, averaging +0.65 mm with dipivalyl epinephrine and +0.55 mm Hg with epinephrine. No effect on blood pressure or pulse rate was found for the two drugs.

Adult↗
PubMed1979

Female genital actinomycosis.

Four cases of female genital actinomycosis are added to the reported total of about 300. The relationship of the disease to the normal microbial flora, intrauterine contraceptive device usage and pelvic sepsis is explored. It is suggested that the disease may be more frequent than hitherto realized.

Abscess↗
PubMed1979

Aryloxyalkyloxy- and aralkyloxy-4-hydroxy-3-nitrocoumarins which inhibit histamine release in the rat and also antagonize the effects of a slow reacting substance of anaphylaxis.

The syntheses and structure--activity relationships of a number of 4-hydroxy-3-nitrocoumarins, which are both antagonists of a slow reacting substance of anaphylaxis and potent inhibitors of antigen-induced histamine release in the rat, are described. Most active among these are 7-[3-(4-acetyl-3-hydroxy-2-n-propylphenoxy(-2-hydroxypropoxy] derivatives having hydrogen or lower alkyl substituents at the C-8 position of the coumarin ring, 168, 171, 173, and 174.

4-Hydroxycoumarins↗
PubMed1979

Zinc deficiency in the West of Scotland? A dietary intake study.

1. The intake of zinc in the West of Scotland was determined by atomic absorption spectrometry, in ninety-six items of food which make up the local standard diet for 1 week. 2. The diet contained less Zn than the recommended daily allowance ((US) National Academy of Sciences, 1974). This finding either indicates the need for a revision of the suggested allowances or suggests that a change of diet is necessary. 3. The change could be made simply by the substitution of wholemeal flour for white flour. Other changes in diet were considered but they were unlikely to be acceptable. Even with changes the requirement of pregnant or lactating women would not be met. If the recommended allowances are valid these women must be deficient in Zn.

Adult↗
PubMed1979

The mobility of curium-244 dioxide in the bronchially intubated rat.

The mobility of curium dioxide in the rat after pulmonary intubation has been investigated by administering suspensions containing different particle size ranges of the oxide. A major factor influencing the movement of curium from lungs to blood is the formation of hydroxide or hydrous oxide particles about 0.001 micrometer in diameter. This process is sufficiently rapid for the lung clearance kinetics of the dioxide to resemble those of a soluble compound more closely than those of an insoluble one. Filtration of 0.001 micrometer particles through the kidneys results in considerably enhanced excretion of curium relative to administered curium citrate. It is concluded that current metabolic models, which assume that solubility in the lung is a prerequisite for transport in body fluids, do not adequately describe the behaviour of curium fromthe standpoint of radiological protection.

Animals↗
PubMed1979

The reactions of 1.0 nanometre diameter plutonium-238 dioxide particles with rat lung fluid.

The reactions of 1.0 nm particles of plutonium-238 dioxide with rat lung fluid have been studied both in vivo and in vitro. In both cases two products have been identified, (i) plutonium-labelled pulmonary surfactant and (ii) a heterogeneous plutonium-labelled material isolated by column chromatography. The formation of plutonium-labelled pulmonary surfactant results in the rapid translocation of plutonium from lungs to blood and in a high urinary excretion relative to administered plutonium citrate.

Animals↗
PubMed1979

Comparisons of virulence of influenza virus recombinants in ferrets in relation to their behaviour in man and their genetic constitution.

Two parent viruses, A/Finland/4/74(H3N2) and A/Okuda/57(H2N2), virulent and attenuated respectively for man, showed similar differences of virulence in ferrets as judged by estimations of 50% minimal infectious doses (MID50), the level and persistence of nasal infection, the height and duration of pyrexia and the level of lung infection. In ferrets, two recombinant clones, WRL 94(H3N2) and WRL 105(H3N2), were almost as virulent as A/Finland and indistinguishable from one another, a result which agreed well with genetic analysis (Hay et al. 1977); the RNA pieces of these recombinants appeared identical and largely derived from the virulent parent (A/Finland). The results in ferrets did not agree with tests on clone WRL 94 in small numbers of human volunteers but they were not inconsistent with those on clone WRL 105 in larger numbers. It is possible therefore that careful tests in ferrets may yield more accurate information on the virulence of strains than limited tests in human volunteers. A rapid test for virulence in ferrets is described. It could be used to screen many additional recombinants thereby yielding information on the genetical basis of virulence and indicating possible vaccine strains for more thorough testing in ferrets and in man.

Animals↗