PubMed Health⌕ Search

Biomedical subjects

M L Hall

Publications and source records attributed to M L Hall.

At least 37 records · Page 2Linked to original sources
PubMed1992

Plasmid profiles demonstrate that an upsurge in Salmonella berta in humans in England and Wales is associated with imported poultry meat.

Sixteen plasmid profile types have been identified in drug-sensitive isolates of Salmonella berta isolated from humans and human food in England and Wales in the ten-year period 1981-1990. Since 1988 six profile types of epidemiological importance have caused infections in widely-separated geographical areas and of these, four types have been identified in S. berta isolated from chicken carcasses imported from Denmark. The findings suggest that imported Danish poultry has substantially contributed to a recent upsurge of S. berta in humans in England and Wales.

Animals↗
PubMed1992

Polycystic ovaries as a relative protective factor for bone mineral loss in young women with amenorrhea.

OBJECTIVE: To examine the impact of polycystic ovaries (PCO) on bone mineral density in amenorrheic women of reproductive age. DESIGN: A retrospective analysis and comparison of polycystic ovarian syndrome (PCOS) with non-PCOS amenorrheic women. A subgroup of patients with ultrasound (US)-diagnosed PCO was also investigated. SETTING: Specialist clinic in reproductive endocrinology. PATIENTS, PARTICIPANTS: Six hundred ten consecutive cases, mean age of 29.8 +/- 7.5 years, with current history of amenorrhea of various causes. MAIN OUTCOME MEASURE: Bone mineral density in the lumbar spine (L1 to L4) as measured by dual energy x ray absorptiometry, in relation to PCOS, US-diagnosed PCO, and US findings of normal ovaries. RESULTS: Amenorrheic patients with PCOS were found to be younger (P less than 0.001), with higher body mass index (P less than 0.001), were more estrogenized, as measured by endometrial thickness and uterine cross-sectional area (P less than 0.001), and had higher bone mineral density (P less than 0.001) compared with non-PCOS amenorrheic patients. CONCLUSIONS: Patients with amenorrhea because of PCOS and those with US-diagnosed PCO have a higher bone density compared with amenorrheic patients with normal ovaries as detected by US scan.

Adult↗
PubMed1992

Assessment of myocardial viability with 201Tl SPET and reinjection technique: a quantitative approach.

The definition of viable myocardium after an acute myocardial infarction (MI) is important as it will determine which therapeutic option will be best for the patient. In 201Tl scintigraphy it has been shown that late redistribution (8-24 h) or reinjection may help to identify viable myocardium which does not appear to reperfuse on the 4 h redistribution image. In a prospective study 20 patients with a persistent defect seen on both stress and redistribution images were imaged after reinjection of 201Tl. On visual analysis a total of 180 segments were studied, 85 were normal, 18 reperfused at redistribution and a further nine (in six patients) after reinjection. Bull's-eye analysis at stress demonstrated a mean defect size of 279 pixels, S.D. +/- 74. After redistribution, there was no significant change in mean defect size (227 +/- 96 pixels). At reinjection, there was a significant reduction in mean defect size (189 +/- 107 pixels) (P < 0.05, paired 't'-test). Quantification shows a significant reduction in defect size between stress and reinjection. The use of the 201Tl reinjection technique in patients with a fixed perfusion deficit on stress and redistribution images improves the detection of viable myocardium and is to be preferred to a method of redistribution analysis alone.

Adult↗
PubMed1992

Proposal for an administrative curriculum in pediatric emergency medicine fellowship training.

Administrative tasks make up a significant component of the practice of pediatric emergency medicine (PEM) physicians. Our survey of 10 academic pediatric emergency departments revealed that PEM physicians who are primarily clinical spent an average of 15% of their time on administrative tasks, and PEM physicians whose positions are administrative as well as clinical spent 30 to 60% of their time on administrative tasks. Of the 101 programs responding to our survey of 220 pediatric residency programs, 80% did not address hospital administrative issues, and many that did address these issues allowed these topics only one hour of presentation time per year. It is clear that there is a discrepancy between the demands placed upon PEM physicians to perform administrative tasks and the sparse or nonexistent opportunities for learning about administrative issues during residency training. It is incumbent upon pediatric emergency fellowship programs to provide an inclusive and well-structured administrative curriculum for their trainees. This article suggests a framework for such a curriculum.

Curriculum↗
PubMed1992

Evaluation of a Salmonella-specific DNA probe by colony hybridization using non-isotopic and isotopic labeling.

A 2.3 kilobase (kb) Salmonella probe, JEO402-1, and two subfragments, F1214 (1.3 kb) and F1217 (0.8 kb), have been evaluated by colony hybridization using pure cultures of Salmonella serovars and non-salmonella bacteria. JEO402-1, and its subfragments, F1214 and F1217, hybridized to all of 156 different Salmonella serovars tested, while there was no reaction to 112 non-salmonella strains belonging to 19 genera and 37 species of Enterobacteriaceae. Together with previously published results, the JEO402-1 probe has now been shown to detect a total of 396 Salmonella strains belonging to 214 serovars of Salmonella subspecies I-VI. A total of 178 non-salmonella strains representing 23 genera and 51 species of Enterobacteriaceae have all tested negative with JEO402-1. The hybridization results obtained using a digoxigenin-labeled probe were similar to those obtained with 35S isotopic labeling when complete colony lysis was ensured.

Bacterial Typing Techniques↗
PubMed1992

Salmonella bacteraemia in England and Wales, 1981-1990.

AIMS: To report the incidence of nontyphoidal salmonellas in England and Wales and identified in the Division of Enteric Pathogens, London between 1981 and 1990. METHODS: Strains were serotyped and phage typed for Salmonella typhimurium, S enteritidis, and S virchow, using established methods. RESULTS: Overall, less than 2% of nontyphoidal salmonellas isolated from humans were from blood culture. The highest numbers of bloodstream isolates were from infections caused by S enteritidis and S typhimurium, but the highest incidence of septicaemias was attributable to infections with S cholerae-suis, S dublin, and S virchow. 2.2% of S typhimurium isolates phage type 204C were from blood culture; likewise, 5.5% of S virchow phage type 19. This could be a cause for concern as most isolates of both these phage types are multiresistant to antimicrobial drugs. CONCLUSIONS: Salmonella septicaemia is rare in England and Wales in other than a few serotypes of limited epidemiological importance.

Bacteremia↗
PubMed1991

A national outbreak of salmonellosis from yeast flavoured products.

A national outbreak of salmonellosis caused by a rare serotype occurred between July and November 1989. A total of 40 cases of Salmonella manchester infection were identified by the PHLS Division of Enteric Pathogens with a further 7 cases reported from Scotland. The median age of those affected was one year. All strains from the outbreak carried a 70mDal plasmid with a distinctive restriction endonuclease. A statistical association was found between infection and consumption of nationally distributed savoury corn snacks. Samples of autolysed yeast powder and flavourings used in the manufacture of many processed foods were also found to be positive for S. manchester.

Adolescent↗
PubMed1991

Postgastrectomy osteoporosis.

Osteoporosis is a recognized complication following partial gastrectomy and is more common than osteomalacia. Recent improvements in the measurement of bone mineral status (dual energy X-ray absorptiometry, DEXA) have assisted in measuring osteoporosis. Sixteen men who had undergone gastrectomy more than 30 years previously were examined. This study reports the effect of calcium supplementation in six patients in whom osteomalacia had been excluded and who showed abnormally low bone mineral densities on DEXA scanning. Calcium supplementation for 6 months (microcrystalline hydroxyapatite, Ossopan 8-32 g per day) produced no significant advantage for the treatment group at any site measured.

Absorptiometry, Photon↗
PubMed1991

Variation between femurs as measured by dual energy X-ray absorptiometry (DEXA).

It is commonly assumed that there is minimal variation between the hips in an individual, but is densitometry of one femur representative of the other? We performed bone mineral density (BMD) measurements of both hips using a Hologic QDR 1000 densitometer. There were 110 patients, all of whom were right handed, and three main groups of subjects: (1) normal volunteers (n = 36); (2) subjects with known hip pathology (n = 36); (3) subjects with medical conditions not affecting the hip (n = 38). The mean age of the subjects was 46 (21-87) years and a standard analysis protocol was followed in all patients. The coefficient of variation (COV) for femurs was 0.9-3%, depending upon the region studied and the BMD. The left femur had a greater BMD 48% of the time and there were variable differences between femurs in each group studied. While the greatest differences were found in people with unilateral hip pathology, all groups had mean differences greater than the COV. It may be acceptable to study only one hip, but the large variation between femurs in individuals should be borne in mind when interpreting data.

Absorptiometry, Photon↗
PubMed1990

Bone mineral loss in young women with amenorrhoea.

OBJECTIVE: To examine the impact of amenorrhoea on bone mineral density in women of reproductive age. DESIGN: Cross sectional study of 200 amenorrhoeic women compared with normally menstruating controls. SETTING: Teaching hospital outpatient clinic specialising in reproductive medicine. SUBJECTS: 200 Women aged 16-40 with a past or current history of amenorrhoea from various causes and of a median duration of three years, and a control group of 57 age matched normal volunteers with no history of menstrual disorder. MAIN OUTCOME MEASURE: Bone mineral density in the lumbar spine (L1-L4) as measured by dual energy x ray absorptiometry. RESULTS: The amenorrhoeic group showed a mean reduction in bone mineral density of 15% (95% confidence interval 12% to 18%) as compared with controls (mean bone mineral density 0.89 (SD 0.12) g/cm2 v 1.05 (0.09) g/cm2 in controls). Bone loss was related to the duration of amenorrhoea and the severity of oestrogen deficiency rather than to the underlying diagnosis. Patients with a history of fracture had significantly lower bone density than those without a history of fracture. Ten patients had suffered an apparently atraumatic fracture. CONCLUSIONS: Amenorrhoea in young women should be investigated and treated to prevent bone mineral loss. Menopausal women with a past history of amenorrhoea should be considered to be at high risk of osteoporosis.

Absorptiometry, Photon↗
PubMed1990

Assessment of the effect of oral corticosteroids on bone mineral density in systemic lupus erythematosus: a preliminary study with dual energy x ray absorptiometry.

Dual energy x ray absorptiometry and a wide range of blood and urine tests were used to assess the propensity of patients with systemic lupus erythematosus to develop an impairment of bone mineral density. Surprisingly, in this preliminary study no significant differences in bone mineral density were found when patients taking 10 mg or more of prednisolone for six months or longer were compared with those who had never taken prednisolone.

Administration, Oral↗
PubMed1990

The range of bone density in normal British women.

A study to determine the range of bone density in British females was carried out on a group of 165 normal women. The results showed an increase in mineral content with peak values occurring in the fourth decade (mean 1.06 g/cm2; 95% confidence limits 0.783-1.343) and subsequent decline with increasing age. There was no significant effect from any risk factor but strict exclusion criteria were applied. The results from each age group were compared with those from the USA and showed a difference in the timing of peak bone density (third decade for the USA). Age-matched, clinically well-defined normal controls should be used for comparison with groups of patients in future studies.

Absorptiometry, Photon↗
PubMed1988

Chest pain: relationship of psychiatric illness to coronary arteriographic results.

Seventy-four patients with chest pain and no prior history of organic heart disease were interviewed with a structured psychiatric interview immediately after coronary arteriography. The majority of patients with both negative and positive coronary angiographies had undergone previous exercise tolerance tests, but the patients with angiographic coronary artery disease were significantly more likely to have had positive results on a treadmill test. Patients with chest pain and negative coronary arteriograms were significantly younger; more likely to be female; more apt to have a higher number of autonomic symptoms (tachycardia, dyspnea, dizziness, and paresthesias) associated with chest pain, and more likely to describe atypical chest pain. Patients with chest pain and normal coronary arteriographic results also had significantly higher psychologic scores on indices of anxiety and depression and were significantly more likely to meet criteria of the Diagnostic and Statistical Manual of Mental Disorders, third edition, for panic disorder (43 percent versus 6.5 percent), major depression (36 percent versus 4 percent), and two or more phobias (36 percent versus 15 percent) than were patients with chest pain and a coronary arteriography study demonstrating coronary artery stenosis.

Age Factors↗
PubMed1988

Chest pain with negative cardiac diagnostic studies. Relationship to psychiatric illness.

A total of 98 patients with chest pain and no prior history of organic heart disease underwent a structured psychiatric interview at the time of cardiac diagnostic testing, either coronary arteriography or exercise treadmill. Patients with negative cardiac test results were significantly younger and more likely to be female, endorsed a greater number of autonomic symptoms with their chest pain, and were more likely to report atypical chest pain. These patients had significantly higher scores on measures of anxiety and negative life events and significantly greater prevalences of DSM-III panic disorder (47% vs. 6%), major depression (39% vs. 8%), and two or more simple phobias (43% vs. 12%) than did patients with cardiac test results demonstrating coronary artery disease. Using logistic regression, a model was developed to estimate the probability of negative cardiac test results from patient characteristics and psychiatric diagnoses.

Adult↗
PubMed1988

Hemorrhagic pulmonary edema associated with meat tenderizer treatment for esophageal meat impaction.

We describe a case of acute hemorrhagic pulmonary edema caused by aspiration of Adolph's meat tenderizer, used in an attempt to relieve an esophageal meat impaction. We performed an animal experiment in which bronchial instillation of a similar solution reproduced the clinical findings in our patient. This is a previously unreported and potentially lethal complication of a therapy that has never been submitted to clinical trials. We recommend against the use of this therapy for patients with complete esophageal obstruction or in those otherwise at risk for aspiration.

Acute Disease↗
PubMed1987

Capital planning can mean life or death to the healthcare provider.

Capital planning is a necessary framework for ensuring the financial and strategic viability of a healthcare organization. The organization that can respond to the marketplace with logical and informed financial decisions will have a significant competitive edge. Internally, the capital plan can help to provide focus and momentum to the overall strategic plan by creating a bridge between strategies and action. Capital planning enables management to gain control of the capital acquisition process and proceed confidently toward its goals.

Capital Expenditures↗