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Biomedical subjects

L Willoughby

Publications and source records attributed to L Willoughby.

9 recordsLinked to original sources
PubMed2005

Neuroanaesthetists' experience of workload-related issues and long-duration cases.

A survey of the members of the Neuroanaesthesia Society of Great Britain and Ireland was conducted to examine issues arising from the management of long cases. Replies were received from 47% of neuroanaesthetists. The survey highlights that consultants are working for prolonged periods without adequate rest. This may compromise patient safety, job satisfaction and recruitment to the specialty. These pressures are likely to increase as the European Working Time Directive reduces the availability of trainees, and because of expansion in neurosurgery and neuroradiology. Similar concerns are likely to extend into other anaesthetic specialties with long-duration cases and may apply to our surgical colleagues.

Anesthesiology↗
PubMed1992

Osseous expansion of the cranial vault by craniotasis.

A study of cranial vault lengthening using a custom expandable fixation-distraction (craniotatic) appliance was performed in the young-adult rabbit model. Ten 24-week-old rabbits underwent circumferential suturectomy plus expansion (expanded group), 10 underwent circumferential suturectomy without expansion (sham control group), and 10 served as normal controls. The appliance was lengthened at a rate of 2.5 mm per week for 5 weeks. Serial lateral cephalometry, comparative dry-skull anthropometric measurements, and histologic examinations were performed. The expanded group demonstrated a significantly longer skull, cranial vault, anterior cranial base, posterior face, and orbit as compared with the control groups (p less than 0.05). Callus bone filled the distracted suturectomy and united the frontofacial complex to the posterior cranium. In conclusion, skull lengthening by distraction osteogenesis is possible in the rabbit model and offers a new technique for future investigation in the treatment of coronal synostosis.

Analysis of Variance↗
PubMed1989

Components of variability of umbilical arterial Doppler velocimetry--a prospective analysis.

This study prospectively analyzed the components of variance and error contributions of umbilical arterial Doppler indices in a normal pregnant population (308 women) with gestational ages ranging from 27 to 40 weeks. A continuous-wave Doppler instrument with a 4 MHz transducer was used. The Doppler indices measured were systolic/diastolic ratio, diastolic/average ratio, pulsatility index, and resistance index. The contributions of gestational age, fetal heart rate, location of measurement, interobserver variability, and intraobserver variability on the variance were studied. The investigation demonstrated that the gestational age and fetal heart rate contributed to 33% to 46% and 15% to 18% of the variance, respectively. The location of the Doppler measurement contributed to 29% to 46% of the error variance. Additionally, the interobserver and intraobserver error variance amounted to 10% to 14% and 5% to 9%, respectively. Of these various factors, the interobserver and intraobserver variance were related to the nonhemodynamic phenomena and therefore represented error components. It is obvious that these factors that affect the variance of the Doppler indices should be considered before the diagnostic reliability of this technique can be critically evaluated.

Analysis of Variance↗
PubMed1989

Effect of fetal heart rate on umbilical arterial Doppler indices.

Umbilical arterial Doppler indices (UaDI) are recognized as potentially useful tools for fetal surveillance. However, elucidation of the diagnostic reliability of UaDI requires further analysis of the factors that affect the variance of the indices. This prospective study was undertaken to analyze the effects of one such factor, the fetal heart rate (FHR). The study population consisted of 194 cases of uncomplicated pregnancy with normal outcome, with the gestational age (GA) ranging from 27 to 39 weeks. A continuous wave Doppler instrument with a 4-MHz transducer was used. The UaDI measured were diastolic/average (D/A) ratio, systolic/diastolic (S/D) ratio, pulsatility index (PI), and resistance index (RI). Linear regression of the data grouped in 2 week GA intervals demonstrated a moderate but statistically significant (p less than .05) correlation between FHR and UaDI. The influence of FHR on UaDI was then further analyzed by multiple regression technique using GA as the second independent variable. The regression demonstrated that 15% to 18% of the total UaDI variance was attributable to FHR effect. Moreover, when UaDI data were standardized for a FHR of 140 beats per minute and GA of 34 weeks using a multiple regression-based equation, the 95% limits of the UaDI were reduced by 32%, 34%, 26%, and 32% for D/A, S/D, PI, and RI, respectively. This study demonstrates a statistically significant effect of FHR on UaDI. However, clinical significance of this observation requires further investigation.

Adult↗
PubMed1986

Argon laser trabeculoplasty in a residency program.

The following article discusses the outcome of 60 eyes with various forms of glaucoma undergoing resident-performed argon laser trabeculoplasty (ALT). The majority (46/60) of eyes had primary open-angle glaucoma. Decrease in intraocular pressure (IOP) was not as great as reported in the literature. Our results suggest that initially treating 180 degrees of the angle is associated with improved overall results. ALT has proved to be a safe and effective alternative to conventional surgery for glaucoma in a residency training setting.

Adult↗
PubMed1979

Efficacy of cognitive/noncognitive measures in predicting resident-physician performance.

There has been relatively little research on the relationship between the clinical performance of physicians and the criteria used by medical school admissions and promotions committees. The studies which have been done primarily relate clinical performance to cognitive criteria. They have usually found only negligible relationships. By considering both cognitive and noncognitive variables, several investigators recently have improved the prediction of clinical performance in medical school. The present authors attempt to determine the increase in predictive efficiency attained by adding noncognitive variables to cognitive variables in predicting clinical performance of residents. The results of this investigation indicate that a combination of cognitive and noncognitive predictor variables functions much better than any individual variable or even any specific class of variables in predicting the postgraduate clinical performance of physicians.

Clinical Competence↗
PubMedDate not supplied

A randomized trial of a somatostatin analog for preserving beta cell function in children with insulin dependent diabetes mellitus.

In an attempt to rest the beta cells of newly diagnosed children with type I diabetes mellitus (IDDM) and thus possibly preserve beta cell function, ten children were given Octreotide, a somatostatin analog, for the first 21 days after diagnosis. Ten age-matched diabetic children served as controls. Although there were no differences in either insulin requirements or in hemoglobin A1 levels, there were significant increases in the glucagon-stimulated C-peptide levels of the experimental group at six and 12 months after diagnosis, compared to control patients.

Adolescent↗