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Biomedical subjects

M Pitts

Publications and source records attributed to M Pitts.

At least 37 records · Page 2Linked to original sources
PubMed1996

A multicenter evaluation of total intravenous anesthesia with remifentanil and propofol for elective inpatient surgery.

Remifentanil is a mu-opioid receptor agonist with a context sensitive half-time of 3 min and an elimination half-life < or = 10 min. This study sought to evaluate the efficacy of remifentanil and propofol total intravenous anesthesia (TIVA) in 161 patients undergoing inpatient surgery. Remifentanil 1 microgram/kg was given intravenously (i.v.) followed by one of two randomized infusion rates: small dose (0.5 micrograms.kg-1.min-1) or large dose (1 microgram.kg-1.min-1). Propofol (0.5-1.0 mg/kg i.v. bolus and 75 micrograms.kg-1.min-1 infusion) and vecuronium were also given. Remifentanil infusions were decreased by 50% after tracheal intubation. End points included responses (hypertension, tachycardia, and somatic responses) to tracheal intubation and surgery. More patients in the small-dose than in the large-dose group responded to tracheal intubation with hypertension and/or tachycardia (25% vs 6%; P = 0.003) but there were no other differences between groups in intraoperative responses. Recovery from anesthesia was within 3-7 min in both groups. The most frequent adverse events were hypotension (systolic blood pressure [BP] < 80 mm Hg or mean BP < 60 mm Hg) during anesthesia induction (10% small-dose versus 15% large-dose group; P = not significant [NS]) and hypotension (27% small-dose versus 30% large-dose group; P = NS), and bradycardia (7% small-dose versus 19% large-dose group; P = NS) during maintenance. In conclusion, when combined with propofol 75 micrograms.kg-1.min-1, remifentanil 1 microgram/kg i.v. as a bolus followed by an infusion of 1.0 microgram.kg-1.min-1 effectively controls responses to tracheal intubation. After tracheal intubation, remifentanil 0.25-4.0 micrograms.kg-1.min-1 effectively controlled intraoperative responses while allowing for rapid emergence from anesthesia.

Adult↗
PubMed1996

A multicenter evaluation of remifentanil for early postoperative analgesia.

We evaluated the use of an infusion of remifentanil to provide postoperative analgesia during recovery from total intravenous anesthesia (TIVA) with remifentanil and propofol. One hundred fifty-seven patients from seven medical centers underwent abdominal, spine, joint replacement, or thoracic surgery. Remifentanil was titrated in an effort to limit pain to 0 or 1 on a 0-3 scale. At the end of the 30-min titration period, 78% of infusion rates were in the range of 0.05 to < or = 0.15 microgram.kg-1.min-1, 5% were < 0.05 microgram.kg-1.min-1, and 17% were > 0.15 microgram.kg-1.min-1. Pain scores were 0 or 1 in 64% of patients. Nausea occurred in 35% and emesis in 8% of patients; the peak incidence of nausea followed discontinuation of the remifentanil infusion at the time of administering morphine. Respiratory adverse events (oxygen saturation by pulse oximetry [Spo2] < 90% or respiratory rate < 12) affected 29% of patients. Apnea occurred in 11 patients (7.0%). There was a large variation in the incidence of respiratory depression between the centers, ranging from 0 to 75%. The explanation for the large variability in respiratory outcome was not evident.

Abdomen↗
PubMed1995

Reactions to repeated STD infections: psychosocial aspects and gender issues in Zimbabwe.

This study explores psychosocial and gender issues related to multiple STD infections within the context of marriage. Thirty men and thirty women, currently married and attending a municipal clinic for treatment for repeated STD infections were interviewed. A semi-structured interview schedule was administered to explore themes of knowledge and beliefs about STDs, psychological reactions to repeated infections and power aspects of sexuality. It was found that men and women differed in how they interpreted and reacted to multiple STD infections. There was clear evidence of women's lack of power to negotiate safe sex within marriage and of the lack of social support networks for infected women.

Adolescent↗
PubMed1994

The practice of testicular self examination: a comparative study of British and Zimbabwean undergraduates.

The practice of testicular self examination was investigated amongst a sample of 170 British and 153 Zimbabwean male undergraduates using a questionnaire based on the health belief model. Knowledge of testicular cancer and of self examination was found to be low in both groups. Both groups, though, showed high general health awareness and a perception that the benefits of self examination would be great. It is recommended that knowledge of testicular cancer and the value of self examination should become part of general community based health programmes in both countries.

Adult↗
PubMed1993

Press coverage of AIDS in Zimbabwe: a five-year review.

Five years of newspaper coverage of HIV and AIDS in Zimbabwe is examined. Both the number of items and the amount of space devoted to the topics has increased steadily over the 5 years. The nature and content of the items show a continuing bias towards issues more closely associated with western patterns of the epidemic, and comparative neglect of personal stories, local issues and items with a counselling focus. Language is also examined and found to reflect a victim and war imagery. The implications for health education in the country are considered and specific recommendations for more constructive media coverage are made.

Acquired Immunodeficiency Syndrome↗
PubMed1993

No joking matter: formal and informal sources of information about AIDS in Zimbabwe.

One hundred and forty-two social work students in Harare, Zimbabwe, were questioned concerning their sources and memory of information concerning the human immunodeficiency virus (HIV) and AIDS. Newspapers were cited most frequently as the major source of information. Family and friends were not reported to be major sources of information. An analysis of the kinds of items most frequently recalled showed that articles concerning personal portrayals were the most powerful vehicles for AIDS information. Metaphors and similes for AIDS produced by the students mirrored those commonly reported elsewhere. Jokes were studied as indicators of informal opinions, and these showed negative views of American involvement in AIDS issues.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The use of herbal and other agents to enhance sexual experience.

This study examines the use of herbal and other agents prior to sexual intercourse. This practice is thought to be common in central and southern Africa. The study comprises an analysis of the behavioural and psychological aspects of the practice. Structured interviews were conducted with 63 Zimbabwean women, 33 were attenders at an urban health clinic, 30 were nurses. Eighty-seven percent of the sample reported using herbs and other agents regularly as a preparation for sexual intercourse. The health and social consequences of such practices are examined; the problems of cervical cancer and HIV and their relation to these practices is discussed.

Administration, Intravaginal↗
PubMed1992

Nurses' views of parasuicide in a developing country.

This study examines the knowledge, beliefs, attitudes, intentions and experiences of nurses at various stages of their careers with regard to patients who have made suicide attempts. It focuses particularly on the relationship of traditional Shona beliefs about suicide and considers how they interact with western medical beliefs. A detailed questionnaire covering these elements was administered to three groups of nurses. They were sampled at either the beginning or end of their training or after approximately ten years experience. Knowledge of suicide was found to be poor and attitudes towards parasuicide were negative. Traditional beliefs were held strongly by all groups of nurses; western beliefs were strongest amongst experienced nurses. Practical implications of these attitudes and beliefs for training are considered.

Adult↗
PubMed1991

The understanding of common health terms by doctors, nurses and patients.

A survey by multiple choice questionnaire of 40 doctors, 60 health support staff and 120 patients investigated the understanding of common medical and psychological terms. Significant differences in levels of understanding were found between these groups, and level of medical education predicted the level of correct understanding. The widest gap in doctor-patient understanding was shown for common psychological terms. These terms constitute a major part of doctor-patient interactions and such differences could cause difficulty in effective doctor-patient communication.

Communication↗
PubMed1991

Assessments of personal and general risks of HIV and AIDS in Harare, Zimbabwe.

This study examines the relationship between perceptions of personal risk and perceptions of general risk of HIV infection. It relates these perceptions to the likelihood of behavioural change, and to the health belief model. It is argued that as part of the education campaign concerning HIV and AIDS it is important to present images and messages which can be personalized by different sections of the community.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Attitudes, knowledge, experience and behaviour related to HIV and AIDS among Zimbabwean social workers.

A recent study of Samuels & Boyle (1989) examined knowledge, attitudes, and behaviours of social service team members in Newham, East London in relation to HIV and AIDS. This study extends theirs to investigate social workers, both experienced and in training, in Harare, Zimbabwe, Whilst overall, there appear to be high levels of knowledge and positive attitudes displayed by these social workers, detailed examination of their responses shows gaps in knowledge and ambivalent attitudes and behaviours. These issues should be addressed when planning AIDS training courses.

Acquired Immunodeficiency Syndrome↗
PubMed1989

AIDS and the press: an analysis of the coverage of AIDS by Zimbabwe newspapers.

An analysis of articles about HIV and AIDS in Zimbabwe newspapers for the period January 1987 to September 1988 reveals several areas of concern. An analysis of coverage before and after a Government campaign designed to increase awareness of issues related to AIDS indicated only a short term increase in press coverage of such issues. Articles were assigned to one of seven content categories: statistics, cure or vaccine, prevention, education and awareness, transmission and risk, counselling and care, and policy and economics. The relative lack of articles on counselling and care and on transmission and risk indicates possible gaps in public awareness of susceptibility to AIDS. There were few articles with a local basis, nor were there any personalized stories. This is likely to encourage feelings of distance and relatively low personal risk. In general, Zimbabwe newspapers show little of the sensationalist and prejudiced accounting of AIDS found in some British press coverage.

Acquired Immunodeficiency Syndrome↗
PubMed1980

Counterimmunoelectrophoretic studies of serum prostatic acid phosphatase.

A counterimmunoelectrophoretic (CIEP) assay for the specific determination of prostatic acid phosphatase (PAP) is described. PAP was obtained from benign human prostatic tissue and a specific antiserum to this enzyme was produced in rabbits and goats. The lowest detectable activity of PAP was at 0.3 IU/l or 4 ng./0.1 ml. This CIEP method was compared to a standard biochemical method (Roy) on a wide spectrum of prostatic and nonprostatic disease. Nonprostatic malignancies and other disorders associated with hyperacidphosphatasemia by the biochemical method were found to be nonreactive for PAP by CIEP. Patients under treatment with various stages of prostatic carcinoma showed comparable elevations by both methods (35%). In untreated patients, the CIEP was statistically most sensitive in stage A (39% by CIEP and 14% by chemical).

Acid Phosphatase↗
PubMed1976

Neonatal pneumopericardium.

Six cases of pneumopericardium in neonates with hyaline membrane disease were observed during a six-month period. Five babies were receiving positive inspiratory or expiratory pressure or both. All but one had other extra-alveolar air collections. In three cases, sudden decrease in PaO2 was the only recorded sign that led to diagnosis. Pericardial aspiration was performed in four babies; one died and three either survived or died later of unrelated disease. One neonate was not treated and died of other causes. Treatment was delayed in the sixth infant; the pneumopericardium disappeared spontaneously but soon reappeared and contributed to a fatal outcome, although a drainage catheter was inserted. This experience and review of other authors' observations suggest that prompt drainage by catheter and continuous suction is indicated.

Drainage↗