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Biomedical subjects

R Land

Publications and source records attributed to R Land.

6 recordsLinked to original sources
PubMed2001

Personal preferences of obstetricians towards childbirth.

Our objective was to determine obstetricians' personal choices in relation to modes of delivery and long-term outcomes. A structured confidential survey was mailed out to all Australian and New Zealand Fellows, Members, and Australian Trainees with The Australian and New Zealand Journal of Obstetrics and Gynaecology November 1999 edition. The response rate overall was 26% (478). Eleven per cent (54) chose to have an elective Caesarean section (ECS) in the absence of any clinical indication. The most common reason for this was fear of faecal and urinary incontinence (82%). Two-thirds (318) were agreeable to patients requesting an ECS in this same setting. Twenty-six per cent said they would choose ECS if the estimated fetal weight (EFW) was > 4000 g which more than doubled to 55% (261) if EFW was > 4500 g. Ventouse delivery was the most popular method of assisted rotational delivery at 45% (214) followed closely by Keilland's forceps at 40% (189). Caesarean section (CS) was chosen by only 14% (65) in this scenario. ECS was the preferred method for breech delivery at 38% (181) followed by trial of breech delivery at 23% (109). Thirty-two per cent (154) of respondents would attempt external cephalic version prior to deciding mode of delivery. Respondents felt the most important factors for postnatal incontinence included: antenatal incontinence (64%), length of second stage > one hour (50%), forceps delivery (46%), and EFW > 4000 g at term (44%).

Attitude of Health Personnel↗
PubMed1996

Ethics and health in a changing world.

Seven advisers from a wide variety of health-related professions met with some 30 staff at WHO to discuss ethical issues currently arising in health and international cooperation. Far-reaching questions of responsibility and legitimacy were raised. The following observations are adapted from the final report on the meeting.

Ethics↗
PubMed1990

Emergency eye injuries.

This study analyses all patients presenting with eye complaints to the casualty section of a Brisbane Hospital during a one month period. Eye complaints constituted 3.6 per cent of all patients. A foreign body was involved in 57 per cent of all eye injuries. The patients were subject to a trial assessing the effectiveness of antibiotic treatment following removal of the foreign body. There was no significant difference between antibiotic and placebo (sterile saline).

Corneal Injuries↗
PubMed1986

Body schema: does it depend on bodily-derived sensations?

Body image, as judged by estimation of lengths of parts of the body, was studied in 12 children with spina bifida who were matched for age, sex and IQ with 12 control children without spina bifida. With one exception, the estimations of the children with spina bifida did not differ significantly from those of the controls. The exception was that the children with spina bifida underestimated leg length less than the control children, but the authors believe that was a chance finding and that children with spina bifida develop an accurate representation of the body by means other than those depending on enteroceptive sensation.

Adolescent↗
PubMedDate not supplied

Routine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva.

We set out to study whether computerized tomography (CT) scanning of the vulva and the groin and groin ultrasound scanning (USS) alone or with fine needle aspiration cytology (FNAC) (USS/FNAC) influenced or could influence the surgical management of primary squamous cell carcinoma of the vulva (SCCaV). Forty-four patients underwent surgery for primary SCCaV following radiologic imaging by one or more modalities. Patient details included the clinical assessment of the carcinoma, radiologic findings, the operation performed, and whether the decision regarding the type and extent of surgery for the vulval carcinoma and, in particular, for the groin node dissection was or could be influenced by the radiologic findings. The age range was 38-87 years, with a median of 74 years. A total of 75 groin dissections were performed. Twenty-five of the 44 patients (56.8%) did not have groin node metastasis, 14 had unilateral metastasis (31.8%), and 5 (11.4%) had bilateral metastasis. All cases with histologically proven nodal status were analyzed to compare the preoperative imaging status with the histology. The calculated sensitivity, specificity, negative predictive value, and positive predictive value for CT were 58%, 75%, 75%, and 58%, for USS alone-87%, 69%, 94%, and 48%, and for USS-guided FNAC-80%, 100%, 93%, and 100%, respectively. There was no patient in whom surgical planning for the vulval carcinoma or the groin nodes was or could be altered by the CT findings. The data do not support the routine use of CT scanning in patients with primary SCCaV, either in assessment of the primary vulval carcinoma or in detecting groin nodal metastases. For the groin nodes, USS/FNAC is superior to CT in assessing disease status. In contrast to CT, USS/FNAC may have a useful clinical role in the management of the groin nodes in vulval carcinoma.

Adult↗