Biomedical subjects
Publications and source records attributed to M Last.
Since its inception in 1957 the BMA's annual film competition has fulfilled three roles--promoting the effective use of film and video in medical education, encouraging the production of high quality audiovisual material, and helping to increase the holdings of its film library. The BMA awards recognise programmes for their clinical accuracy, educational value and creative use of the medium.
Save the Children Fund in 1923 and UNICEF in 1990 both declared that children must come first in receiving relief. Whereas SCF's call was a corporate credo for the world, for use whenever disaster struck, UNICEF's was offered as a strategic policy document applicable at all times. In contrast, the 1989 UN Convention on the Rights of the Child, as a legally-binding document in the field of human rights, omitted all reference to giving such priority to children. The reason for transforming the original credo is that the principle of 'children first', if it includes every child and is to be applied literally in the field, is not only impracticable but unacceptable in many cultures. The social value of a particular child's life--or of human life generally--is simply not an absolute, in all circumstances, in all cultures.
Recent studies have shown that in boys a steady-state of blood lactate is maintained at exercise levels above the anaerobic threshold. Therefore, the explanation hitherto provided for the steeper increase in blood lactate beyond the anaerobic threshold, i.e. the onset of anaerobic metabolism, needs modification. Investigations were carried out in ten boys, aged 11-12 years, during treadmill running. Maximal oxygen uptake (VO2max) and maximal blood lactate were determined during incremental exercise. Subsequently each boy performed four runs at different high constant speeds of 16 min duration, in order to determine maximal steady-state blood lactate. The underlying data also served to estimate roughly the lactate anaerobic threshold. Oxygen uptaken (VO2) was measured at 0.5 min intervals during the initial 7.5 min of each constant-speed run. Maximal steady-state blood lactate was 5.6 mmol/l corresponding to 92% of VO2max. The mean blood lactate at which the anaerobic threshold was reached or just exceeded was 2.7 mmol/l corresponding to 82% of VO2max. Oxygen transport transient kinetics were computed from the mean 0.5 min VO2-values during the constant-speed runs near the maximal steady-state blood lactate and from runs near the anaerobic threshold. Half-times of VO2 response were shorter than values previously reported for adults due to a faster increase in VO2 at the onset of exercise. Half-times increased with increasing work rates as did the oxygen deficit, due to a slower increase in VO2 along with a longer time required to attain a steady-state at higher work rates.(ABSTRACT TRUNCATED AT 250 WORDS)
Paraileostomy ulcers (PSU) are uncommon after construction of an ileostomy and are difficult to manage. Seventeen patients with Crohn's disease developed 28 parastomal ulcers at least 1.5 cm in diameter from two weeks to seven years after ileostomy construction (mean 45.6 weeks, median 8 weeks). Some patients had multiple episodes of parastomal ulceration. The etiology and clinical features of PSU are discussed. Conservative management included debridement, curettage, unroofing of the ulcer complex, pouching of the stoma with Telfa strips placed in the ulcer base and a conventional appliance or a Perry Model #51 device. Most of the ulcers healed between two and 32 weeks (mean 12.7 weeks, median 8 weeks). In the six patients in whom the ulcers did not heal, Crohn's disease or another ileostomy complication necessitated ileostomy relocation. This conservative management allowed most patients to be treated on an outpatient basis, carrying out their daily tasks and delaying or obviating the need for ileostomy relocations. When required, relocations were done electively.
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