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Biomedical subjects

J P Southern

Publications and source records attributed to J P Southern.

4 recordsLinked to original sources
PubMed1991

Magnetic resonance imaging of the head and spine: effective for the clinician or the patient?

OBJECTIVES: To test how the results of magnetic resonance imaging influence clinicians' diagnoses and management plans for patients with cranial and spinal problems and to assess changes in the quality of life of these patients. DESIGN: Survey of patients undergoing cranial and spinal magnetic resonance imaging with questionnaires about diagnoses and intended management plans before and after imaging and quality of life questionnaires at the time of imaging and again four months later. SETTING: Regional magnetic resonance imaging and spectroscopy unit. SUBJECTS: 100 consecutive patients referred for cranial imaging in early 1989; 100 similar patients referred for spinal imaging. MAIN OUTCOME MEASURES: Changes in clinicians' leading diagnoses after magnetic resonance imaging and their confidence in these diagnoses; changes in intended management plans; assessment of the contribution to the future management of the patient; changes in patients' quality of life. RESULTS: Magnetic resonance imaging altered the clinicians' leading diagnoses in 35 of 169 (21%) cases. The clinicians became more confident about their leading diagnoses in 90 of 167 (54%). There was a change in management plan in 113 of 182 (62%). The clinicians considered that magnetic resonance imaging made an important contribution to management in 119 of 162 (73%) patients. Overall, the patients' quality of life was unchanged at the four month assessment. CONCLUSIONS: Magnetic resonance imaging of patients with cranial and spinal problems influences clinicians' diagnoses and management plans, but the quality of life of these patients remains unchanged.

Adolescent↗
PubMed1990

Bird attack on milk bottles: possible mode of transmission of Campylobacter jejuni to man.

A case-control study was carried out to test the hypothesis that the rise in the rate of Campylobacter jejuni infection in the Brigend area of South Wales during May was due to the consumption or handling of milk from bottles that had been attacked by birds. 32 of 36 cases meeting the case definition were interviewed, along with 2 controls per case, matched for age, sex, and area of residence. There were strong associations between campylobacter infection and doorstep delivery of milk bottles, a history of milk bottle attack by birds, milk bottle attack by birds during the week before illness, and consumption of milk from attacked bottles during the week before illness. There was a very strong dose-response relation between frequency of bird attack and illness. Controls with a history of milk bottle attack by birds were more likely than cases to have taken preventive measures against bird attack and consumption of contaminated milk. Although few people witnessed the attacks, the likely culprits are magpies (Pica pica) and jackdaws (Corvus monedula).

Adolescent↗
PubMed1990

"Short report" staffing in practice: five years' experience of a consultant based service in obstetrics and neonatal paediatrics.

Recent government plans include the concept of a core of doctors of intermediate grade providing 24 hour emergency cover in hospital departments. Hinchingbrooke Hospital has, since its opening in 1983, been run on a two tier basis, with consultants and a part time senior registrar supported only by senior house officers in their first post, usually on general practice vocational training schemes. With a planned rate of around 2000 deliveries per year all high risk obstetric and neonatal paediatric procedures, including ventilation of very small babies, have been carried out within the hospital. A study of the first five complete years of operation of the obstetric and paediatric departments showed that the perinatal mortality rate was low (hospital rate 4.7/1000 in 9149 deliveries during 1984-8 v district rate 5.1/1000 during 1986-8), and patient satisfaction seemed to be high. In a separate prospective study of out of hours work performed by consultants in paediatrics (four weeks) and obstetrics (20 days) three consultants in paediatrics spent 71 hours working out of hours; for the obstetricians, of the 56 request for advice and 38 interventions, only five and six respectively occurred between midnight and 9 am. Although successful at this hospital, the two tier system would be expensive under the Royal College of Obstetricians' guidelines of one consultant to a maximum of 500 deliveries. An equal mixture of two tier and three tier systems might be the best solution for patient care and training of junior doctors.

Consultants↗