Allopurinol/N-acetylcysteine for carbon monoxide poisoning.
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Biomedical subjects
Publications and source records attributed to I D Green.
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Twelve students were selected from each of the three clinical undergraduate years, two from each year interviewing one of six simulated patients. The interviews were video recorded and scored by two clinicians on a rating system involving sixteen criteria. In addition to the expected differences between individual students, when the scores were placed in rank order a pattern of differences between years of study emerged. Students of the third clinical year performed better than those of first year and both were better than those of the intermediate second year. Junior students displayed more personal concern for the patients, while senior students tended to conduct a more controlled and structure interview.
A child receiving busulphan treatment for adult-type chronic myeloid leukaemia responded well for four years before the onset of complications leading to "busulphan lung'. Pulmonary function tests (PFT) were useful in monitoring the development of this condition and we recommended regular PFT for patient receiving busulphan treatment.
The interviewing skills of six medical students were recorded on videotape annually during their years of clinical training. Many faults were identified, and an overall style of interview tended to persist through to the pre-registration year. However, individual students changed in different ways that could not be predicted from the results of the first interview.
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The heart rate response to exercise was studied in 17 normal subjects before, during and after a 21-day Himalayan trek to 5490 m. The group were fitter before the trek when compared to normal subjects of a similar age (P less than 0.001) having a lower heart rate response to exercise for their lean body mass. The trek significantly increased the 'fitness' of the group as a whole (P less than 0.025) but this was not seen in the 5 members of the group who had severe acute mountain sickness. Similar changes were noted within the first 8 days of the trek before symptoms of mountain sickness occurred. The group had normal pulmonary function before the trek but peak expiratory flow rate and vital capacity decreased with altitude. The effect was more marked in the subjects with acute mountain sickness.
By immunofluorescent microscopy of sputum from 67 cases of bronchitis Pseudomonas aeruginosa was detectable in 14 as compared with nine by cultural methods.
Agglutinin titres to Haemophilus influenzae, Streptococcus pneumoniae, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Proteus vulgaris in the serum of patients with acute exacerbations of chronic bronchitis, patients producing mucoid sputum, and healthy controls were determined. Serological evidence of infection with H. influenzae was found in 38 of 57 patients with acute exacerbations, and Str. pneumoniae infection in 10 of the 57 patients, but was generally absent from healthy control subjects and from patiens producing mucoid sputum. No serological evidence of infection with other organisms named above was found to be associated with exacerbations of chronic bronchitis. Ten patients with acute exacerbations were without serological evidence of infection by any of the bacteria tested.
Comparison of the results of cultures from blood and sputum with those of agglutinin response in 40 cases of bacterial pneumonia and 36 controls suggests that a provisional identification of causal bacteria, for purposes of antibiotic therapy, may be made by the serological tests with much greater rapidity and comparable accuracy. A combination of these methods is recommended.
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