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M Rothwell

Publications and source records attributed to M Rothwell.

4 recordsLinked to original sources

Acute changes in haematological parameters on cessation of smoking.

Cigarette smoking is known to affect many haematological parameters but little is known of their rate of return to normal on withdrawal of cigarettes. Two groups of chronic smokers were studied whilst smoking and in the 2 weeks after cessation. A rapid return towards normal was found in the elevated haemoglobin concentration, packed cell volume, red cell count, white cell count, neutrophil count, lymphocyte count and platelet count, indicating that at least some of the abnormalities in these parameters are an acute, reversible effect of cigarette smoking rather than being a response to tissue damage.

Adult

Conn's syndrome can cause malignant hypertension.

We present a case in which a patient, having already sustained an episode of malignant hypertension, was subsequently found to have an underlying Conn's adenoma. Ablation of the adenoma improved control of her hypertension. When a second adenoma developed in her remaining adrenal gland, control of her hypertension deteriorated.

Adenoma

Haemorheological changes in the very short term after abstention from tobacco by cigarette smokers.

A study was made of the haemorheological changes that took place in the days immediately following tobacco withdrawal from cigarette smokers. In both males and females substantial and persistent reductions in blood viscosity occurred within 2 d, the fall at high shear rate corresponding to about 8% while at low shear rate it was approximately twice as much. These changes were due partly to a fall in packed cell volume (PCV), but also to reductions in total plasma protein and fibrinogen concentrations which led to reductions in plasma viscosity and rouleaux formation. These plasma protein-related changes were less pronounced in the female group. The results indicate that, even in the very short-term, abstention from cigarettes leads to substantial improvements in the haemorheological profile of heavy smokers.

Adult

Problem-oriented approach to practice. I. Economic impact.

The problem-oriented system provides a unique management tool for medical practice. It follows basic management principles for any complex human endeavor (ie, define goals, set standards, audit performance to those standards, and assess results). The basic tool is the problem-oriented record, which demands that statements of medical action be explicit to permit audit. This concept can be extended to provide and assess care for an entire practice. Five years of cumulative data were assessed. The following changes were noted: (1) The ratio of patients to physicians doubled. (2) The total hospitalization rate fell by more than 20% and general medical portion by 60%. (3) Ambulatory use and cost decreased by approximately 20%. (4) Expenditures for services fell by 22%, while national expenditures for physician services increased by 28%.

Adult