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Biomedical subjects

P M Higgins

Publications and source records attributed to P M Higgins.

14 recordsLinked to original sources
PubMed1992

Streptococcal pharyngitis in general practice. 1. Some unusual features of the epidemiology.

This report is based on a study of acute infections of the upper respiratory tract in 1965 and detailed records of such infections in 1963 and 1964. A change from illnesses mainly yielding viruses to illnesses mainly yielding group A streptococci was noted around the age of 5 years. A positive culture for group A streptococci in patients over 4 years of age was highly correlated with a complaint of sore throat and with serological evidence of streptococcal infection. A bimodal age distribution curve for pharyngitis associated with a positive culture for group A streptococci was consistently noted. The incidence was highest in children aged 5-9 but a second smaller peak occurred among adults in the 30-39 age group. The evidence suggests that being female increases the risk of acquiring group A streptococci and of experiencing sore throat.

Adolescent↗
PubMed1992

Streptococcal pharyngitis in general practice. 2. A note on dual infection and transient urinary abnormalities.

In an incomplete study in 1965 microscopic haematuria in the second or third week after acute pharyngitis was found four times more often in patients with either microbiological or clinical evidence of dual infection with both group A streptococci and a virus than in patients with evidence only of infection with group A streptococci. Prospective studies of the role of viruses in the aetiology of transient haematuria and of acute post streptococcal glomerulonephritis are feasible in general practice and would be most productive if concentrated in children 5-9 years of age.

Adolescent↗
PubMed1992

Splenomegaly in acute infections due to group A streptococci and viruses.

Over a period of 9 years in general practice temporary enlargement of the spleen was found in 29 episodes of pharyngitis or tonsillitis, in 2 episodes of acute upper respiratory tract infection other than pharyngitis and in 6 episodes of acute cervical lymphadenitis. In five patients more than one episode of illness associated with splenomegaly was recorded. In 26 of the 37 episodes a possible aetiology was identified. Evidence only of infection with group A streptococci was found in 14 episodes, adenoviruses or coxsackie B viruses were isolated alone in 4 episodes and in 4 episodes the only finding was the presence in the blood of more than occasional atypical mononuclear cells; in 4 episodes there was evidence of both streptococcal and viral infection. Episodes with evidence of streptococcal infection only tended to be of shorter duration and to be more evenly distributed over the year than were episodes without such evidence. Temporary splenomegaly was noted also in two children with varicella (one of whom also had streptococcal infection) and in an adult with probable rubella.

Acute Disease↗
PubMed1991

Management of acute retention of urine: a reappraisal.

Our standard policy for the management of retention of urine due to prostatic hypertrophy is that the patient is catheterised and sent home, later to be seen and assessed in the Out-patient Department where he is given an admission date for operation. A detailed audit of 166 patients cared for in this way is presented and the results compared with those in 25 patients who remained in hospital in the interval between catheterisation and operation and in 402 patients not previously catheterised. Although the mortality rate was significantly higher in the retention group (3.3 vs 0.25%), we feel that this is a reflection of the fitness of the patients with retention rather than a consequence of the management policy. The advantages of the "catheterise and send home" policy are discussed.

Acute Disease↗
PubMed1990

Idiopathic retroperitoneal fibrosis--an update.

Our belief in a non-operative approach to the management of RPF hinges on the differential diagnosis; the closer the approach to the certainty in establishing the diagnosis, the less is the risk of error in medical treatment. Careful history taking and intelligent use of the available range of investigations should allow near certainty in diagnostic accuracy and thus the progression to non-operative management in most patients. The cause of RPF remains obscure, further research into the possibility of an auto-immune reaction, perhaps a response to some factor introduced in the latter half of this century would seem to offer most prospect of success.

Diagnostic Imaging↗
PubMed1990

Temporary Munchausen syndrome.

Over 14 years a patient was admitted at least 91 times to at least 25 general and four psychiatric hospitals and treated for a wide range of conditions that she did not have. She appears to have recovered. The medical and psychiatric care she received probably contributed to the onset of this disorder in a person already vulnerable, and to its maintenance.

Adult↗
PubMed1989

Teaching medicine in general practice: the Guy's experience.

The development of teaching in general practice at Guy's Hospital Medical School is described. Important features of the current programme (a new programme for the United Schools of Guy's and St Thomas' Hospitals will come into effect this year) are the emphasis on learning directly from patients and the active role and responsibility given to clinical students. Students welcome the opportunities to see patients first, to deal with undifferentiated problems, to work with one clinical teacher, to put to use knowledge and skills and to test themselves as clinicians. In these circumstances they gain confidence and display the human qualities required of doctors. An acceptable service to patients, the essential basis for effective clinical teaching, requires the general practitioner teachers devote more of their time to service than to clinical teaching.

Attitude of Health Personnel↗
PubMed1978

Haematuria.

Explore the source record for details and available documents.

Adult↗
PubMed1975

Intrarenal vascular changes in adult patients with recurrent haematuria and loin pain--a clinical, histological and angiographic study.

Clinical features have been correlated with renal function, histology and selective renal angiography in 19 patients with recurrent painless haematuria, recurrent loin pain, or both haematuria and loin pain in whom urinary infection, calculi and anatomical abnormalities of the urinary tract had been excluded. No deterioration in renal function was observed in any patient over periods of up to nine years. Although all patients showed similar glomerular changes histologically, consisting of focal and segmental mesangial thickening and proliferation and periglomerular fibrosis, mild tubular damage was more common in those with loin pain. All patients with loin pain whether or not they had haematuria, had abnormal renal angiograms consisting of focal or generalized vascular lesions sometimes associated with cortical infarcts. The possible aetiological factors are discussed with particular reference to oestrogen-containing compounds.

Adolescent↗