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Biomedical subjects

V Little

Publications and source records attributed to V Little.

At least 19 recordsLinked to original sources
PubMed1995

Improving stroke care through action research.

Stroke accounts for approximately 20% of beds occupied on general medical wards yet nurses felt inadequately prepared to participate fully in the interdisciplinary approach to stroke rehabilitation. An action research project was established to improve stroke care and rehabilitation in a general medical ward. Results indicate a correlation between knowledge and attitudes: the greater the nurse's understanding the more positive the nurse is towards nursing involvement in rehabilitation. It was concluded that nurses have a vital part to play in the rehabilitation of stroke patients and that their contribution can be enhanced through greater understanding. Further research is needed to determine the effects of greater nursing involvement in terms of quality of patient recovery and length of patient stay.

Cerebrovascular Disorders↗
PubMed1993

Health and efficiency.

Measuring efficiency is essential but purchasers and providers should treat the perverse incentives of the efficiency index with caution, warn John Appleby and Val Little.

Abstracting and Indexing↗
PubMed1991

Maltreated children's self-concept: effects of a comprehensive treatment program.

Perceived competence and social acceptance scores of 17 maltreated children enrolled in therapeutic day treatment were compared to those of 17 maltreated children who had not received the program services. Multivariate and follow-up univariate analyses indicated developmental gains and enhancement of self-concept among the treatment group when compared to controls and to their own pretreatment levels.

Child Abuse↗
PubMed1988

Unexplained infertility--the value of Pergonal superovulation combined with intrauterine insemination.

Sixty-two women with unexplained infertility were studied. Fifteen (group 1) had timed intrauterine insemination (IUI), 25 (group 2) were treated by Pergonal (Serono Laboratories, Ltd., Welwyn Garden City, England) superovulation, and 22 (group 3) underwent Pergonal superovulation combined with IUI. Where Pergonal treatment was followed by insemination, a significantly greater pregnancy rate per cycle (P less than 0.05) was achieved, whether this group of patients was compared with those treated by IUI alone or with those treated with Pergonal alone. Moreover, the pregnancy rate in group 3 was comparable to that reported following gamete intrafallopian transfer (GIFT). The authors therefore suggest this form of treatment for patients with unexplained infertility prior to their referral to the more invasive procedure of GIFT.

Adult↗
PubMed1981

Isoxsuprine in the perinatal period. II. Relationships between neonatal symptoms, drug exposure, and drug concentration at the time of birth.

Forty preterm infants with maternal isoxsuprine exposure less than 24 hours delivery and 40 matched control infants were studied prospectively to determine the acute neonatal effects of maternal ISX exposure. The cord ISX concentration correlated inversely with the drug-free interval before delivery (P < 0.001). Cord ISX concentrations > 10 mg/ml were seen only with intravenous maternal therapy and a drug-discontinuance to delivery interval of two hours or less. The plasma half-life of ISX in neonates ranged from 1.7 to 8 hours; gestationally younger infants required a longer time for drug clearance. Ileus was 13 times more common in the ISX group and was not directly related to the cord ISX concentration. The incidence of hypotension and hypocalcemia rose directly with the cord ISX concentration, reaching 89% and 100%, respectively, when the cord ISX level exceeded 10 ng/ml. The incidence of respiratory distress syndrome was low in the ISX infants with low cord drug values, but increased to that of the control group when the cord ISX concentration reached > 10 ng/ml.

Administration, Oral↗
PubMed1981

Risk:benefit considerations for the use of isoxsuprine in the treatment of premature labor.

Seventy patients treated with isoxsuprine for premature labor were studied. In patients with intact membranes prolongation of pregnancy for more than 7 days occurred in 77% of women with 50% cervical effacement or less and 3 cm dilatation or less at the initiation of therapy, and in none with more than 50% effacement and more than 3 cm dilatation. Cervical effacement was the primary factor in determining success. Cord isoxsuprine concentrations averaged 90% of maternal concentrations at delivery. Maternal and cord isoxsuprine concentrations at delivery were inversely correlated with the drug-free interval before delivery. An interval of more than 5 hours was necessary to attain a cord concentration of less than 2 ng/ml, a level not associated with neonatal problems. Drug-free intervals of 2 hours or less usually resulted in cord isoxsuprine values of more than 10 ng/ml, levels that are associated with severe neonatal problems. Seventy-seven percent of infants with cord isoxsuprine concentrations of more than 2 ng/ml and 91% with values of more than 10 ng/ml were delivered of mothers with more than 3 cm dilatation or more than 50% effacement at the initiation or reinstitution of intravenous therapy. Most severe neonatal problems are preventable if patients are selected carefully.

Female↗
PubMed1979

Induction of ovulation in women with hyperprolactinemic amenorrhea using clomiphene and human chorionic gonadotropin of bromocriptine.

Clomiphene citrate (Clomid), when given alone, is generally considered ineffective in inducing ovulation in women with hyperprolactinemia. This study reports the treatment of 29 infertile women with hyperprolactinemic amenorrhea. Twenty-one patients (eighteen of whom had previously had no ovulation response to Clomid alone) were treated with a combined regimen of Clomid (100 to 200 mg/day for 5 days) and two injections of 5000 IU of human chorionic gonadotropin (HCG), the first 8 to 10 days after Clomid withdrawal and a second injection 1 week later. Basal body temperature charts, conception, and/or plasma progesterone measurements showed that 19 patients ovulated (90%). There were 17 pregnancies in 12 of 21 patients (57% pregnancy rate) with 15 single live births and two abortions. When bromocriptine (Parlodel) became available, a total of 22 patients (including 14 patients previously treated with Clomid/HCG, six of them successfully) with amenorrhea associated with hyperprolactinemia were treated with this drug with dosages varying from 2.5 mg to 15 mg/day. Ovulation was confirmed in 20 patients (90%). There were 17 pregnancies in 15 patients (68% pregnancy rate) with 15 single live births and two first-trimester abortions. In all, 21 of 29 patients (73%) achieved one or more pregnancies resulting in live births with one or both of the above treatments. It is concluded that a combined Clomid/HCG regimen can often be used as an effective alternative to bromocriptine therapy in the treatment of infertility associated with hyperprolactinemic amenorrhea.

Adult↗
PubMed1978

Prolactin and luteal insufficiency.

The relationship between mid-luteal plasma levels of progesterone and prolactin was studied in 75 women with regular menstrual cycles. Eighteen women had normal prolactin (mean 260 +/- 51.7 mU/l) and normal progesterone levels (mean 67 +/- 21.3 nmol/l). Thirty-nine women had elevated prolactin levels (mean 850 +/- 503 mU/l): progesterone levels were normal in all cases (mean 61 +/- 22.3 nmol/l). Eighteen women had evidence of luteal deficiency (mean progesterone 15.3 +/- 7.7 nmol/l); prolactin levels were normal in all cases (mean 243 +/- 106 mU/l). There was no correlation between plasma prolactin and progesterone levels.

Adult↗
PubMed1978

The treatment of mild adrenal hyperplasia and associated infertility with prednisone.

Thirty patients with mild post-pubertal adrenal hyperplasia, characterized by raised urinary 17-oxosteroid levels and variable combinations of irregular menses, hirsuties, infertility, and spontaneous abortion, were treated with 2.5 to 10 mg of prednisone per day and all conceived (55 pregnancies). With this treatment, regular, ovulatory cycles occurred immediately in 25 patients, and after two to six months, in the rest. Treatment reduced raised 17-oxosteroid levels to normal and brought about some improvement in hirsuties and acne. Forty-seven pregnancies ended in the birth of liveborn infants; one of these died of prematurity and another had congenital emphysema. One pregnancy was terminated, two were of unknown outcome and five (9.4%) ended in abortion. Before treatment, 20 out of 22 pregnancies (91%) had ended in abortion.

17-Ketosteroids↗
PubMed1978

Induction of ovulation with clomiphene and human chorionic gonadotrophin in women with hyperprolactinaemic amenorrhoea.

Seventeen women complaining of infertility (one with primary amenorrhoea, 14 with secondary amenorrhoea, and two with oligomenorrhoea) all had hyperprolactinaemia and were treated with clomiphene citrate and human chorionic gonadotrophin (HCG), and plasma oestradiol, FSH and LH levels were measured. Although adequate pre-ovulatory oestradiol levels were present, the surge of LH was absent until the injection of HCG after which all patients ovulated. There were 12 pregnancies in 9 patients resulting in 10 full-term livebirths, one premature livebirth and one continuing pregnancy. The relevance of these findings to the possible role of prolactin in amenorrhoea is discussed.

Adult↗
PubMed1972

Sextuplet pregnancy.

In a sextuplet pregnancy which followed gonadotrophin therapy the principal problems were threatened abortion, premature labour, and placental insufficiency. Delivery was by caesarean section soon after the onset of labour at 32 weeks. The five liveborn babies thrived. The sixth was a macerated stillbirth.

Abortion, Threatened↗