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Biomedical subjects

L Donaldson

Publications and source records attributed to L Donaldson.

49 records · Page 3Linked to original sources
PubMed1991

Effect of left hepatic vein ligation on hepatic circulation, function, and microanatomy in dogs.

Eighteen healthy dogs were allotted to 3 groups (n = 6 dogs each). All dogs were evaluated at the beginning of the study by complete physical examination; total and differential WBC counts; serum biochemical analysis (alanine transaminase and alkaline phosphatase activities and bilirubin and albumin concentrations); sulfobromophthalein excretion, ammonia tolerance, and glucagon response testing; portal and intraparenchymal pressure determinations; operative mesenteric portography; and histologic assessment of hepatic biopsy specimens. The left hepatic vein was ligated completely in dogs of groups 1 and 2. Group-3 (control) dogs had a ligature placed loosely around the left hepatic vein. Dogs of groups 1 and 3 were reevaluated 24 hours after surgery by use of the aforementioned hematologic and biochemical tests. Group-1 dogs were reevaluated by use of portal and intraparenchymal pressure determinations, jejunal vein portography, and complete necropsy at 48 hours after surgery. At 4 weeks after surgery, dogs of groups 2 and 3 were reevaluated by use of all aforementioned tests. Results indicated transient hepatic congestion, which resolved by the fourth postoperative week. Longstanding effect on hepatic structure, circulation, or function was not found. We concluded that left hepatic vein ligation in clinically normal dogs does not cause severe or permanent liver damage.

Alanine Transaminase↗
PubMed1991

How psychiatrists weigh risk factors when assessing suicide risk.

The clinical assessment of suicide risk is a difficult task that the traditional literature contributes to in a limited way. This study aims to complement the traditional literature by determining the ranking of suicide risk factors by a group of 81 psychiatrists. Hopelessness was ranked the most important risk factor, followed by Suicidal Ideation, Previous Attempts, the Level of Mood and Affect, Quality of Relationships, Signs and Symptoms of Depression, and Social Integration. Less highly ranked risk factors are also noted. The significance of these findings is discussed with respect to the literature and commonly used textbooks of psychiatry.

Attitude of Health Personnel↗
PubMed1990

Psychiatrists' experience of suicide in their patients.

Ninety-nine psychiatrists from a defined geographical area were sent a questionnaire asking them to report on clinical, social and demographic characteristics of patients who suicided while under their care. Seventy-three psychiatrists returned the questionnaire and reported having seen a total of 122 suicides. This resulted in a mean of 0.12 suicides per psychiatrist per year of practice. Twenty-four percent of the patients were reported to have had a diagnosis of schizophrenia which is significantly higher than in studies based on coroner's cases. Evidence of withdrawal, considering oneself a burden to others and help negation are factors that had frequently been present in the month prior to the suicide. The authors recommend that these three factors should be examined further by using a prospective strategy.

Adolescent↗
PubMedDate not supplied

Laparoscopic colopexy in horses.

OBJECTIVE: To describe a technique for laparoscopic colopexy in horses. STUDY DESIGN: Description of a technique to perform laparoscopic colopexy in horses. ANIMALS: Six healthy adult horses between 3 and 23 years of age and weighing between 440 and 636 kg. METHODS: Horses were positioned in dorsal recumbency, and the abdomen was insufflated to an intraabdominal pressure of 15 mm Hg. A laparoscope portal was placed at the umbilicus, and instrument portals were placed cranial to the laparoscope and lateral to midline. The lateral taenia of the left ventral colon was laparoscopically identified and retracted with Babcock forceps to the peritoneal surface and sutured with two strands of size 2 monofilament nylon in a continuous pattern via laparoscopic observation. All horses were euthanatized 90 days after surgery, and the colopexy adhesion was examined histologically. RESULTS: Laparoscopic colopexy was successful in all six horses. There were no intraoperative or postoperative complications. Initial abdominal insufflation to 15 mm Hg required an average of 38 L (range 32 to 46 L) of carbon dioxide and 9.8 minutes (range 9 to 11 minutes) to be completed. A total of 132 L of carbon dioxide (range 64 to 196 L) was needed for the entire procedure. The laparoscopic colopexy procedure required 95 minutes (range 60 to 142 minutes) to perform. Laparoscopic colopexy resulted in a firm, fibrous adhesion of the colon to the abdominal tunic. Microscopically the colopexy adhesion was mature fibrous tissue with no evidence of inflammation. CONCLUSIONS: Laparoscopic colopexy can be successfully performed in horses with minimal abdominal invasion.

Animals↗
PubMedDate not supplied

Disease emergence and health transitions in the last millennium.

For most of the first millennium, average expectation of life was only 30 or 40 years. The beginning of the 20th century saw the start of improvements, which by the century's end meant that a baby boy could expect an average 75 years of life, a baby girl even longer. The successes of the 20th century were not products of advances in medicine alone, but consequences of the great sanitary reforms that fuelled the public health movement in late Victorian Britain. However, health challenges also grew and changed: the rise in so-called modern epidemics (coronary heart disease, cancer, accidents and mental illness); the ageing of the population; the containment of the costs of rapid technological advances; the marked and intractable inequalities in health status between rich and poor, and between North and South. The dawn of a new millennium sees many of these health problems carried over from the late 20th century, whilst communicable diseases, once thought conquered, continue to pose a serious threat to human health because of their global significance. This paper traces progress in the health of the population and identifies some of the key challenges for medicine in the 21st century.

Chronic Disease↗
PubMedDate not supplied

[The meaning and implementation of clinical governance].

Under the 1999 Health Act a statutory duty of "quality" was given to National Health Service (NHS) organisations in the United Kingdom. This was matched by a comprehensive quality program. In this paper we look at the meaning of clinical governance as a mechanism for ensuring local delivery of high quality clinical care in the UK, the national structures which have been put in place to develop, reinforce and implement clinical governance and the role of the NHS Clinical Governance Support Team (CGST) in delivering clinical governance "on the ground". As part of the quality program, the CGST is working to enable national clinical governance policy to be translated into practice locally by supporting the development of better ways of working by individuals, clinical teams and health organisations to deliver a continuous, integrated approach to quality healthcare for patients.

Health Personnel↗
PubMedDate not supplied

An informal assessment of nutritional status in acute stroke for use in an international multicentre trial of feeding regimens.

Patients with acute stroke may become malnourished because of feeding difficulties, so dietary supplementation may improve outcome. We investigated the validity and reliability of an 'eyeball' assessment of nutritional status for use in an international trial of different feeding following acute stroke. One hundred and one inpatients (mean age 75 years), of whom 40 had suffered an acute stroke, were independently observed by two medical students, a doctor and a nurse, and categorised as underweight, normal weight or overweight. Body mass index (BMI) was calculated using height and weight. Sensitivity of the informal assessment for correctly classifying the patient as underweight (BMI < 20 kg/m2), normal (20-30 kg/m2) and overweight (BMI > 30 kg/m2) ranged from 64% to 100% and specificity from 71% to 100%. Interobserver agreement between different pairs of observers was moderate to good. An 'eyeball' assessment of nutritional status is valid and reliable enough for use in a multicentre trial of feeding regimens following acute stroke.

Acute Disease↗