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Biomedical subjects

J Hooper

Publications and source records attributed to J Hooper.

At least 19 recordsLinked to original sources
PubMed1992

The importance of activity and pretreatment in the prevention of suxamethonium myalgias.

We have studied the effectiveness of pretreatment with atracurium 0.05 mg kg-1 and placebo before administration of suxamethonium, in the prevention of postoperative myalgia in inpatients having surgery in which rapid postoperative mobilization was possible (vaginal hysterectomy). On the second day after operation, the patients pretreated with atracurium had significantly fewer postoperative myalgias than those receiving placebo (P < 0.025). All patients were significantly more active on the second day compared with the first day after operation (P < 0.025). Possible causal relationships are discussed.

Adult↗
PubMed1991

Blood lactate and mixed venous-arterial PCO2 gradient as indices of poor peripheral perfusion following cardiopulmonary bypass surgery.

Conventional indices of tissue perfusion after surgery involving cardiopulmonary bypass (CPB) may not accurately reflect disordered cell metabolism. Venous hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V-aCO2 gradient) has been shown to reflect critical reductions in systemic and pulmonary blood flow that occur during cardiorespiratory arrest and septic shock. We therefore measured plasma lactate levels and V-aCO2 gradients in 10 patients (mean age 57.2 years) following CPB and compared them with conventional indices of tissue perfusion. Plasma lactate levels, cardiac index (CI) and oxygen uptake (VO2) all increased significantly (p less than 0.05 vs baseline levels) up to 3 h following surgery. Oxygen delivery (DO2) did not change. Plasma lactate levels correlated significantly with CI (r = 0.47, p less than 0.01). V-aCO2 fell significantly with time (p less than 0.01 vs baseline). There was an inverse relationship between V-aCO2 and cardiac index and V-aCO2 and lactate (r = -0.37, p less than 0.05; r = -0.3, p less than 0.05 respectively). We conclude that blood lactate, CI and VO2 increase progressively following CPB. An increase in lactate was associated with a decrease in V-aCO2. An increase in V-aCO2 was not therefore associated with evidence of inadequate tissue perfusion as indicated by an increased blood lactate concentration.

Acidosis, Lactic↗
PubMed1991

'Solubile': decision-making in the diagnosis of jaundice.

We have designed a computer program 'Solubile' to aid clinicians in the diagnosis of jaundice. Based on Bayes' theorem, 'Solubile' uses up to 47 items of information about the patient to produce the most probable diagnosis from 22 possible diseases. In a prospective analysis of 50 patients, 74% were correctly diagnosed in first place and 94% within the first three choices. The possibility of using 'Solubile' at differing locations was tested by prospectively diagnosing 100 cases at a second centre having a significantly different patient population. 75% of these patients were correctly diagnosed in first place and 89% within the first three choices. The diagnostic ability of 'Solubile' was compared with that of 20 clinicians of various grades. The clinicians correctly diagnosed 49.5% of cases (Solubile 74%) and placed 68.5% (Solubile 94%) within the first three choices. 'Solubile' will be of use to aid clinicians in aspects of the diagnosis and management of jaundice.

Bayes Theorem↗
PubMed1989

Full-time women general practitioners--an invaluable asset.

It has been said that women doctors do not fulfil the same role as men doctors in general practice. This is inaccurate as previous studies of workload in general practice have not excluded from the analyses women principals who are part time, that is, have a less than full profit share at parity. In a postal questionnaire to 501 women principals 308 (62%) replied, of whom 143 (46%) were full time with respect to profit share. Respondents were asked to record aspects of workload over a four-week period for themselves and three of their full-time men partners. Analysis of their responses showed that they did an equal workload to their full-time men partners in terms of number of surgeries, length of surgeries and number of home visits. Equal numbers of full-time women did out-of-hours work as their men partners and the number of nights and weekends on-call as well as use of deputies were similar. The analysis also showed that full-time women did more specialized clinics than men, thus emphasizing the special role of women doctors in preventive care.

Employment↗
PubMed1989

Part-time women general practitioners--workload and remuneration.

A postal questionnaire survey was conducted comparing the workload and remuneration of part-time women principals in group practices in the Northern and Oxford regions. Part time was defined as receiving less than a full profit share at parity. Of 501 women principals 308 (62%) responded of whom 146 (47%) were part-time. Respondents were asked to record aspects of workload over a four-week period for themselves and their full-time partner who did the most sessions within the practice. The results showed that although two-thirds of the part-timers had 50% or less of a full profit share, part-time principals overall did about 76% of the daytime clinical work (surgeries and home visits) done by their full-time partners, excluding specialized clinics. The lower the profit share the wider this discrepancy. Although 33% of the respondents did not out-of-hours work, the remainder did more than their profit share would indicate. Twenty per cent of the 116 principals with 40% or more of a full profit share and 57% of the 30 principals with less than 40% of a full profit share felt that their share was unfair. Lack of involvement in practice business and feeling that opinions did not carry equal weight were associated with feelings of unfairness.

Female↗
PubMed1987

The incidence of HTLV-III/LAV seroconversion and non-A, non-B hepatitis in recipients of plasma products.

Several groups including ours at Hyland have studied the incidence of HTLV-III/LAV seroconversion and non-A, non-B hepatitis (NANBH) in recipients of products made from unscreened plasma. Of 18 previously untreated patients who received heat-treated factor VIII concentrate (HEMOFIL T), none seroconverted for HTLV-III/LAV. However, 11 of 13 similarly treated patients showed aminotransferase elevations indicative of NANBH. None of 21 patients receiving anti-inhibitor coagulant complex (Autoplex) seroconverted for HTLV-III/LAV, while 28 of 50 patients receiving other forms of treatment did seroconvert. Of 30 recipients of AUTOPLEX, 9 had elevated aminotransferase levels. Since all patients had hepatitis B markers when the study began, a diagnosis of NANBH cannot be made. Of 16 patients who received large doses of immune globulin for intravenous administration (IGIV, GAMMAGARD), none seroconverted for HTLV-III/LAV. Retrospective and prospective studies of 157 recipients of GAMMAGARD did not reveal a single case of NANBH attributable to receipt of this product. In contrast, NANBH has occurred following administration of HEMOFIL T, indicating that heating in the dried state does not eliminate the NANBH agent(s). In spite of lingering concerns about NANBH infectivity, the available data strongly suggest that heat treatment and/or cold ethanol fractionation render these plasma products safe from HTLV-III infectivity.

Antibodies, Viral↗
PubMed1976

Pyogenic osteomyelitis of the spine.

The records of 30 patients who had suffered from vertebral osteomyelitis were reviewed. They conformed to a constant pattern, though varying in tems of: (i) the severity of the disease due to host-organism interrelationship; and (ii) age distribution. Causative organisms could not always be identifed, though all lesions settled with conservative measures of rest and antibiotics. A high proportion of the patients who were followed up for more than one year were back at work. The anatomical distribution of the lesions can be explained by our knowledge of the vascular supply to the vertebral bodies.

Adolescent↗
PubMedDate not supplied

A parental perspective on the Honeylands Home Visiting Project for severely handicapped infants provided by three mothers of older handicapped children.

Three mothers of severely handicapped children, who had not attended Honeylands nor received any home visiting, were asked to attend and participate in the monthly group meetings for the second year of the three year project (Rayner 1978). They each then decided to visit a family with their home therapist. They comment on the responsibility undertaken by all parties to this work; parents, therapist and supportive team.

Adaptation, Psychological↗