"Walking extradurals" in labour: a step forward?
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Analgesia, Epidural↗
Biomedical subjects
P Ali
Publications and source records attributed to P Ali.
Intramedullary nailing of femoral shaft fractures: reoperation and return to work.
OBJECTIVE: To define the functional outcome and residual disability in adults treated for isolated femoral shaft fractures. DESIGN: A retrospective case study of HMRI records. The mean follow-up was 34.5 months from the time of injury. SETTING: A tertiary-care teaching hospital. PATIENTS: One hundred and thirty adults with femoral shaft fractures. Of these, 47 were isolated and qualified for study. INTERVENTIONS: Primary reamed intramedullary nailing performed between April 1987 and September 1990. MAIN OUTCOME MEASURES: Reoperation and return to work. RESULTS: Of the 47 patients, primary healing occurred in 41 (87%) patients; 6 (13%) patients had delayed union or nonunion. Twenty (43%) patients had delayed implant-related pain after fracture healing; 85% of these had relief of pain after implant removal. Of 41 patients available for analysis of function based on return to work, 33 (80%) had returned to work full time in their original occupation at the time of follow-up, and 4 (10%) were working in other full-time employment; 3 (7%) were working part time. Only one (2%) patient was disabled and unable to work. CONCLUSIONS: Primary reamed intramedullary nailing is an effective method of achieving consistent primary union in adults with femoral shaft fractures. However, the majority of patients will require secondary surgery. Most patients will be able to return to work after these injuries.
Adult↗
Epidermal growth factor administered in pregnancy has little effect on placental, fetal and postnatal growth and development in rats.
Biosynthetic human epidermal growth factor (EGF) was injected daily into female rats (40 micrograms/rat/day) on days 14-20 of pregnancy in two experiments. Number in litter was significantly greater in EGF- than in vehicle-treated mothers in experiment 1 but not experiment 2. Number in litter affected fetal weight. When this factor was taken into account statistically, there was no significant effect of EGF treatment on fetal weight or placental weight, DNA and protein concentrations at 21 days of gestation; nor was birth weight affected by treatment. However, growth in body weight postnatally from 4 to 115 days was slightly but significantly depressed in the offspring of the EGF-treated mothers. A negative effect of additional EGF in pregnancy on subsequent milk production is postulated. The timing of attainment of developmental milestones in the offspring was not affected.
Analysis of Variance↗
Schistosoma mansoni: antigen preparations which induce antibodies to schistosomula surface antigens.
To determine the easiest method of raising antibodies to antigens exposed on the surface of schistosomula of Schistosoma mansoni, several crude preparations of the parasite were used to immunize mice. Schistosomula released products, whole worm homogenate, and parasite eggs all raised antibodies which bound to the surface of live schistosomula, although the anti-egg antiserum did so less strongly. Anti-schistosomula released products antiserum recognized three schistosomula surface antigens of Mr 15,000, 20,000, and 32,000, anti-whole worm homogenate recognized 20,000, 32,000, and 38,000 Mr surface antigens, and anti-egg recognized a less than 200,000 Mr surface antigen. None of these antigens was recognized when the labeled preparation was immunoprecipitated with its homologous antiserum. When these antisera were used to immunoprecipitate cell free translation products of adult worm RNA, the antischistosomula released products and anti-whole worm homogenate recognized an 11,000 Mr doublet while the anti-egg precipitated 14,000 and 44,000 Mr antigens. Other crude preparations were used to immunize rabbits; Formalin-fixed schistosomula, denuded adult worms, and purified worm tegument all induced antibodies which recognized the 20,000, 32,000, and 38,000 Mr schistosomula surface antigens.
Animals↗
Epidermal growth factor receptors in rat placenta, amnion and yolk sac: characteristics of specific binding are dependent on gestational age.
Studies of [125I]-EGF binding to the rat placenta, amnion and yolk sac were carried out on days 14, 17 and 20 of gestation. In the placenta EGF binding was detectable on all 3 days; in the amnion EGF binding was undetectably low on day 14 but was present on days 17 and 20, while in the yolk sac EGF binding was undetectably low on all 3 days. Although Scatchard analysis of EGF binding to placental tissue raised the possibility of high and low affinity receptors, a statistical analysis of the ligand binding data was consistent with the presence of only one type of EGF receptor. The overall affinity of the receptors did not change with stage of gestation. However, the concentration of EGF receptors was lower in placental tissue on day 17 than on days 14 or 20 of gestation; the receptor concentrations were similar on days 14 and 20. It is suggested that EGF binding to the placenta, amnion, and yolk sac may reflect the levels of cell proliferation in those tissues in the latter part of gestation.
Amnion↗
Pharmacologic approaches for the management of systemic hypertension in pregnancy.
Hypertension in pregnancy includes a group of distinct disorders that require special consideration in both prevention and pharmacologic treatment. In recent years, there have been few advances regarding the pathophysiology and prevention of preeclampsia, or in recommendations for first-line drug therapy of the hypertensive complications of preeclampsia. Similarly, the recommendations for pharmacologic treatment of women with chronic hypertension antedating pregnancy have changed little, primarily because first-line medications have the advantage of having been the subjects of extensive research experience. Recent clinical trials have demonstrated the efficacy and safety of various second-line drugs for treating hypertensive disorders of pregnancy; whether these therapies can eventually replace the standard recommended medications will require more extensive long-term investigation.
Chronic Disease↗