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Biomedical subjects

M J Hare

Publications and source records attributed to M J Hare.

At least 19 recordsLinked to original sources
PubMed1995

Sweating rate and sweat composition during exercise and recovery in ambient heat and humidity.

The objective of this study was to determine the composition and extent of sweat losses during submaximal exercise under hot and humid conditions and to compare these findings with the same exercise protocol conducted under cool, dry and hot, dry conditions. Five Thoroughbred horses (age 3 to 6) completed exercise tests under each of 3 environmental conditions in random order: cool, dry (CD), room temperature (T) = 20 degrees C, relative humidity (RH) = 45-55%; hot, dry (HD), T = 32-34 degrees C, RH = 45-55%; and hot, humid (HH), T = 32-34 degrees C, RH = 80-85%. Horses exercised at 50% of their predetermined VO2max on a treadmill set at a 10% slope until attainment of a pulmonary artery blood temperature of 41.5 degrees C followed by a 60 min recovery. Sweat was collected from a sealed polyethylene pouch enclosing a 150 cm2 area on the lateral thorax. During exercise and the first 30 min of recovery, sweat fluid losses were 7.9 +/- 0.7 litres, 9.9 +/- 0.5 litres and 6.6 +/- 1.2 litres (mean +/- s.e.m.) for CD, HD and HH, respectively. Sweating rate (SR), calculated from sweat volume per unit area of enclosed skin, was lowest in CD and similar in HD and HH during exercise such that at end of exercise in HH (16.5 min) calculated sweat losses were approximately 5% and 32% higher than in HD and CD, respectively. In recovery, SR declined in all conditions but was significantly lower in CD (P < 0.05). Sweating was detectable until 30 min recovery in CD, 45 min recovery in HD and 60 min recovery in HH. Sweat composition and osmolality was different under the 3 environmental conditions and changed gradually during exercise and recovery in all conditions. Osmolality and [Na] was highest in HD and lowest in CD. During exercise, [Na] increased with increasing SR. Although exercise duration was significantly decreased in HH (16.5 +/- 1 min) when compared to HD (28 +/- 2 min) and CD (37 +/- 2 min), fluid and ion losses in HH were comparable to those in HD as a result of a high SR and prolonged sweating during recovery.

Animals↗
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↗
PubMed1987

Day case laparoscopic sterilization--time for a rethink?

The postoperative experiences of 50 women undergoing laparoscopic sterilization as a day case procedure were sought together with the views of their general practitioners. The women were not visited routinely at home and few contacted their general practitioners. All the women had chosen day care but one-third of those eventually discharged on the day of the operation wished that their stay had been longer; most of their general practitioners seemed unaware of these feelings. The importance of adequate discussion with the patient about postoperative pain is reviewed. The arrangements for postoperative care following the patient's return to the community is discussed.

Ambulatory Surgical Procedures↗
PubMed1987

Evaluation of an integrated community antenatal clinic.

The obstetric outcome and experience of care of 96 pregnant women attending an integrated community antenatal clinic staffed by general practitioners, a community midwife and an obstetric accredited senior registrar were compared with those of 100 women receiving traditional shared antenatal care. The views of the women and their practitioners were sought; obstetric data were obtained from obstetric notes, hospital records and cooperation cards.Fewer women attending the community clinic suffered from hypertension than women receiving shared care. The women attending the clinic reported that it had a friendly, relaxed and personal atmosphere. They also reported less inconvenience and a shorter waiting time for the obstetrician than women receiving shared care. They received greater continuity of care from the obstetrician but less from the general practitioners and community midwives than the control women. There was greater satisfaction with communication with staff among women attending the clinic, with the exception of the midwife whose role was not sufficiently well delineated. Practitioners in the integrated scheme appreciated the close working arrangements but experienced an increase in administrative tasks.

Community Health Services↗
PubMed1986

Should women carry their antenatal records?

A study of women's views on carrying their medical records during their pregnancy was conducted in Cambridge in 1982. Eighty eight women who were given their full records were compared with a control group of 83 women who carried the traditional cooperation card, both groups answering postal questionnaires about the advantages and disadvantages of carrying their respective records. Most women found advantages in carrying the complete record, although it was too large to carry for practical purposes. Both groups experienced difficulty in understanding what was written on their cards.

Attitude to Health↗
PubMed1986

Womens' views on keeping fetal movement charts.

This study reports the views of 132 women on filling in fetal movement charts during pregnancy. All appeared to have received an adequate explanation of how to fill in the chart. Although just over half the sample of women were reassured by filling in the chart, 23% were worried by it and 16% made other unfavourable comments on its use. Analysis of the comments made suggests that women are probably not given an adequate explanation for the reasons for keeping a kick chart regularly, or of the possible importance of a reduction in fetal activity.

Attitude to Health↗
PubMed1984

The infrequent occurrence of mycoplasmas in amniotic fluid from women with intact fetal membranes.

As human genital mycoplasmas have been associated with various forms of reproductive failure, the present study was undertaken to investigate whether M. hominis and U. urealyticum organisms (ureaplasmas) are capable of crossing intact fetal membranes. Nearly 300 women in Denmark and England were investigated. Most of them were seen at about the fourth month of gestation and the remainder towards or at the time of birth, all with unruptured membranes. A swab was taken from the uterine cervix or vagina and M. hominis was isolated from 9% of the women and ureaplasmas from half of them. The presence of these mycoplasmas was not associated with an abnormal outcome of pregnancy. In contrast to the frequent presence of mycoplasmas in the lower genital tract, amniotic fluids obtained by transabdominal amniocentesis or at cesarean section did not contain M. hominis and ureaplasmas were isolated from only one of them. This was associated with the same ureaplasmas serotype being recovered from the cervix and also from the blood of both infant and mother, whose case differed from the others as labor had already started when the amniotic fluid was obtained. Thus, in our populations, we have no evidence that mycoplasmal invasion of the amniotic fluid occurs before the onset of labor. During labor, despite intact membranes, it seems that genital mycoplasmas may occasionally invade the fetal--placental unit, probably by the hematogenous route after strong uterine contractions, or otherwise directly after membrane rupture. Since both these events are followed usually by immediate delivery, there would seem to be insufficient time for the genital mycoplasmas to cause fetal damage.

Amniotic Fluid↗
PubMed1984

Community antenatal care--a local study.

Views of 16 general practitioners and 14 midwives on "shared antenatal care" revealed local differences in organization, in policy, in the roles of the professionals involved, and in the level of communication and co-operation between them.

Community Health Services↗
PubMed1984

A colposcopic and histological study of experimental chlamydial cervicitis in marmosets.

A total of 14 marmosets were inoculated intra-vaginally with Chlamydia trachomatis and the development of genital tract disease was assessed microbiologically, by colposcopic examination of the cervical and vaginal mucosa and by cytological and histological examination of biopsy and autopsy specimens. Eight animals had infections which persisted microbiologically for 2-5 weeks, and six animals, three of which had been inoculated on multiple occasions in a previous study, apparently eliminated their infection within 1 week of inoculation. Colposcopic examination showed that four of the eight infected animals developed acute cervicitis characterized by erythema, occasional slight oedema, and the presence of cloudy or purulent cervical mucus. The other four infected animals showed minimal signs of cervical inflammation. Three of the six animals which rapidly cleared their infections developed slight cervical inflammation characterized by erythema and cloudy cervical mucus during the fortnight after inoculation. Six control animals inoculated with medium displayed minimal cervical changes. The diagnosis of acute cervicitis in the infected animals was confirmed by examination of histological sections and cervical smears, which revealed the presence of polymorphonuclear leucocytes, with lymphocytes occasionally being seen. Although inflammatory changes were occasionally noted in specimens from control animals, the changes were relatively mild and occurred at a later time than those seen in infected animals. Intracytoplasmic chlamydial inclusions in epithelial cells were not detected in any of the specimens studied. Examination of genital tract tissue obtained at autopsy from five inoculated animals generally showed inflammation of the cervix and vagina, but in only one of these animals was there evidence of endometriosis and salpingitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗