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Soliman L, Ahn S, Hunt V, Sobti N, Woo AS. Gaining Closure: Do Cranial Sutures Fuse at Reported Age Ranges? Plast Reconstr Surg Glob Open 2023; 11:e5013. [PMID: 37360234 PMCID: PMC10287138 DOI: 10.1097/gox.0000000000005013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Luke Soliman
- From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I
| | - Sophia Ahn
- From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I
| | - Victor Hunt
- From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I
| | - Nikhil Sobti
- From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I
| | - Albert S. Woo
- From the Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, R.I
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Hunt V, Anderson D, Lowrie R. P144 Specialist domiciliary pharmacy intervention may reduce exacerbation frequency and hospitalisation in patients with severe chronic obstructive pulmonary disease. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alakeson N, Flett T, Hunt V, Ramgolam A, Reynolds W, Hartley K, Hegarty M, von Ungern-Sternberg BS. Difficult airway equipment: a survey of standards across metropolitan Perth. Anaesth Intensive Care 2014; 42:657-64. [PMID: 25233181 DOI: 10.1177/0310057x1404200517] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The importance of appropriate equipment to manage the difficult airway has been highlighted by the publication of the Australian and New Zealand College of Anaesthetists (ANZCA) guidelines in 2012. We set out to audit compliance with these guidelines in all public and private sites providing general anaesthesia in metropolitan Perth. Public and private health care websites identified 39 sites of which 37 were studied. Institutional and ethics approval was obtained. A tick-box design audit tool, based on the ANZCA guidelines, was used to collect information regarding the dedicated difficult airway container (DDAC) at each site. As recommended in the guidelines, only equipment within the DDAC was considered. Further data about each site, including the number of theatre suites, satellite anaesthetic areas, use of capnography and categories of patients treated (adult, obstetric and paediatric) were collected. An adult DDAC was found at 92% of all sites, but none of the sites had all the essential equipment listed in the ANZCA guidelines. There was limited provision of adult difficult airway equipment within private sites compared to public, and less provision of paediatric difficult airway equipment across all sites treating paediatric patients in metropolitan Perth. Capnography was available in 76% of post anaesthesia care units and used regularly in 27%. Adherence to the ANZCA guidelines regarding the DDAC could be improved. Standardised equipment across a metropolitan region would be of value in the management of the difficult airway.
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Affiliation(s)
- N Alakeson
- Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Subiaco, Western Australia
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McConnell KB, Wagner M, Urbina E, Daniels S, Helmicki A, Hunt V, Amin RS. Central aortic pressure wave changes with sleep stage and disordered breathing in children estimated by application of an arterial transfer function to peripheral blood pressure. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:3864-6. [PMID: 17271139 DOI: 10.1109/iembs.2004.1404081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We have developed an arterial transfer function using aortic and peripheral blood pressure waves measured simultaneously in healthy children undergoing diagnostic catheterization. We have applied this transfer function to peripheral blood pressure pulses measured during specific stages of sleep and at distinct points in the respiratory cycle in a different set of children with and without sleep disordered breathing to estimate the central aortic pressure wave shape.
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Affiliation(s)
- K B McConnell
- Department of Electrical Engineering, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Abstract
This article reports the lessons learnt from a period of retraining and from discussion with others who have been involved in a similar process. The conclusions are that retraining should only be undertaken once there is full agreement between all parties involved that it is necessary and feasible. There must also be agreement in advance of the criteria which will constitute successful retraining, and the actions which will be taken to ensure the rapid return of the retrainee to the type of practice which is being offered and has been accepted. The process of retraining requires especially close supervision and is very stressful for the retrainee. It is likely that this should only be undertaken in units specially staffed and funded to accommodate this type of work.
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Affiliation(s)
- C Bulstrode
- Nuffield Department of Orthopaedic Surgery, University of Oxford, UK.
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Abstract
Complementary therapies have continued to increase in popularity in healthcare and it is widely accepted that they can be incorporated into the nursing role. However, this acceptance does not necessarily mean that the introduction of therapies into the nursing arena has been without confusion and without professional and legal implications. Consequently, this small-scale, qualitative study aimed to explore the perceptions and lived experiences of paediatric nurses of two therapies, namely massage and aromatherapy massage. There is a dearth of literature exploring nurses' perceptions to the incorporation of these therapies, especially in the arena of paediatric nursing where massage and aromatherapy massage are common practice. Semi-structured interviews were undertaken with qualified nurses and revealed the themes of 'benefit', 'family centred care', 'nursing care' and 'being held back'. It was found that at some stage during their professional career each nurse had performed massage and/or aromatherapy massage. All nurses were able to recall certain benefits of the therapies for the children that they had observed and many discussed the importance of involving the family as a way of including them in to the care of their child. However, for the nurses in this study, it was evident that the incorporation of complementary therapies into the nursing role was determined by the context in which they practised. Due to the dominance of the medical model, nurses faced pressures and conflicts in the realities of their nursing work, which meant they were often unable to carry out these therapies.
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Affiliation(s)
- V Hunt
- Childrens Unit, Chelsea and Westminster Hospital, London, UK
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Abstract
If the public are to be assured that surgeons are safe, then there must be some form of competence assessment on which a licence to practice is based. However, the assessment and the licence needs to be both appropriate to the training received by the surgeon and to the requirements of the post they propose to take up. The 'key-concept' described in this paper attempts to address this problem.
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Affiliation(s)
- C Bulstrode
- University of Oxford Medical School, Headington, Oxford, UK
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Abstract
The current method for selecting surgeons of the future is neither objective nor relevant to present day needs. An assessment is needed which ranks potential trainees according to aptitude, motivation and diligence, all of which is validated. This task should be a core duty for the Royal Colleges of Surgeons working in close co-operation with surgical specialty associations.
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Affiliation(s)
- C Bulstrode
- University of Oxford Medical School, Headington, Oxford, UK
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Hunt V, Bulstrode C, Baldwin P, Bulstrode H, Mansfield C. Training teachers--changing practice? J R Coll Surg Edinb 2002; 47:619-22. [PMID: 12363187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A three-day course was designed to improve the skills of those who provide clinical training to medical students. This long-term follow up of past participants shows a sustained improvement to their skills, especially in terms of involving students in their own learning, and giving them positive feedback.
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Affiliation(s)
- V Hunt
- John Radcliffe Hospital, Oxford, UK
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Bulstrode C, Hunt V. NCAA has not been given sufficient tools to identify poorly performing doctors. BMJ 2001; 322:426. [PMID: 11179180 PMCID: PMC1119643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Affiliation(s)
- C Bulstrode
- Education Department, Royal College of Surgeons of Edinburgh, UK
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Haq C, Ventres W, Hunt V, Mull D, Thompson R, Rivo M, Johnson P. Where there is no family doctor: the development of family practice around the world. Acad Med 1995; 70:370-380. [PMID: 7748381 DOI: 10.1097/00001888-199505000-00012] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Family physicians are generalists trained at the postgraduate level to address the majority of primary care needs of patients of all ages in communities they serve. Throughout the world there is a need for family physicians to serve as cornerstones of comprehensive health care systems that provide high-quality, cost-effective medical and public health services to the entire population. To meet this need, each country must value and adequately finance essential medical and public health services and must provide family physicians with a thorough education focused on the relevant health care problems of the population being served. The authors present an overview of the status of this training throughout the world, outline challenges to the development of such training, and suggest strategies for successful development accompanied by illustrative case studies from South Korea, Venezuela, and Pakistan.
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Affiliation(s)
- C Haq
- Department of Family Medicine, University of Wisconsin Medical School, Madison, USA
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Smith GF, Madlon-Kay DJ, Hunt V. Clinical evaluation of ankle inversion injuries in family practice offices. J Fam Pract 1993; 37:345-348. [PMID: 8409887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND The use of radiography in evaluating inversion ankle injuries remains high despite several studies suggesting that x-ray examination should be limited to patients meeting certain clinical criteria. These studies were all done in emergency departments. The present study examined detection of ankle fractures by clinical evaluation alone in private family practice offices. METHODS Twelve physicians in three family practice offices participated. Check-off forms were developed to record clinical data. The physicians all attended a session to standardize terminology. The physicians then evaluated 94 consecutive patients with inversion ankle injuries. RESULTS Eight fractures were detected by radiography, five of which had not been suspected on clinical examination (5.9% false-negative rate). Only one fracture required treatment different from that for a sprain. Tenderness on the dorsum of the foot, impaired weight-bearing ability, recentness of injury (less than 12 hours earlier), and presence of additional injuries were significantly associated with a fracture. Unlike several previous studies, swelling was not associated with fractures. If radiography had been limited to patients presenting with inability to bear weight fully or tenderness on the dorsum of the foot, none of the fractures would have been missed, and the use of radiography would have been reduced from 90% to 61%. CONCLUSIONS The fracture rate in these family practice offices is lower than that reported in most emergency department studies. It is important that family physicians order radiographs judiciously rather than routinely for patients with inversion ankle injuries. The clinical criteria reported here are likely to reduce unnecessary ordering of radiographs and are compatible with recently published, prospectively validated rules for acute ankle injury in an emergency department setting.
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Affiliation(s)
- G F Smith
- East Side Medical Center, St. Paul, MN 55106
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Duggan ME, Alberts AW, Bostedor R, Chao YS, Germershausen JI, Gilfillan JL, Halczenko W, Hartman GD, Hunt V, Imagire JS. 3-Hydroxy-3-methylglutaryl-coenzyme a reductase inhibitors. 7. Modification of the hexahydronaphthalene moiety of simvastatin: 5-oxygenated and 5-oxa derivatives. J Med Chem 1991; 34:2489-95. [PMID: 1875346 DOI: 10.1021/jm00112a027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Modification of the hexahydronaphthalene ring 5-position in simvastatin 2a via oxygenation and oxa replacement afforded two series of derivatives which were evaluated in vitro for inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase and acutely in vivo for oral effectiveness as inhibitors of cholesterogenesis in the rat. Of the compounds selected for further biological evaluation, the 6 beta-methyl-5-oxa 10 and 5 alpha-hydroxy 16 derivatives of 3,4,4a,5-tetrahydro 2a, as well as, the 6 beta-epimer 14 of 16 proved orally active as hypocholesterolemic agents in cholestyramine-primed dogs. Subsequent acute oral metabolism studies in dogs demonstrated that compounds 14 and 16 evoke lower peak plasma drug activity and area-under-the-curve values than does compound 10 and led to the selection of 14 and 16 for toxicological evaluation.
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Affiliation(s)
- M E Duggan
- Merck Sharp & Dohme Research Laboratories, West Point, Pennsylvania 19486
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Culpepper L, Jack B, Hunt V, McGuire A, Mattis N. Perinatal care and learning disorders: a community view. R I Med J (1976) 1991; 74:265-74. [PMID: 1887189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- L Culpepper
- Department of Family Medicine, Brown University, Providence, Rhode Island
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Abstract
Huntington's disease (HD) is an autosomal dominant inherited disorder of the central nervous system. Consequently, a child of an affected parent has a 50% risk of developing the disease. This article provides an overview of HD by providing a brief history of the disease and describing progressive symptoms of chorea, dystonia, incoordination and decreased mental acuity. Steps in diagnosis, treatment and prognosis are outlined. Because persons at risk for HD have usually witnessed the deterioration of an HD parent, they are often dominated by fears of developing HD themselves. Life's choices, such as whether or not to have children, then become dilemmas. The importance of maintaining a positive life perspective, while making practical choices about employment, marriage, children and other concerns needs to be addressed.
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Affiliation(s)
- V Hunt
- Department of Neurology, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103
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Hunt V, Waudby E. The nursing research model at St. Elizabeth's Hospital, Boston. J Nurs Adm 1990; 20:4-5. [PMID: 2213222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hunt V, Stark JL. Advanced concepts in networking: the Nursing Research Network of Boston revisited. J Nurs Adm 1989; 19:8, 33. [PMID: 2703904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- V Hunt
- St. Elizabeth's Hospital, Brighton, MA
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Woldum KM, Hegedus KS, Joy L, Fisher F, Hunt V, Stark JL. Development of a Clinical Research Conference. J Contin Educ Nurs 1984; 15:209-12. [PMID: 6438195 DOI: 10.3928/0022-0124-19841101-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Stark JL, Hunt V. HELPING YOUR PATIENT WITH CHRONIC RENAL FAILURE. Nursing 1983; 13:56-64. [PMID: 6554488 DOI: 10.1097/00152193-198309000-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hunt V, Stark JL, Fisher F, Hegedus K, Joy L, Woldum K. Networking: a managerial strategy for research development in a service setting. J Nurs Adm 1983; 13:27-32. [PMID: 6553598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
An innovative managerial strategy--networking--used to establish and promote a nursing research program within three teaching hospitals in Boston is outlined in this article. Networking provides an opportunity for research and program development experts to share resources to meet common needs and goals. One of the advantages of a research network is that it can provide educational offerings that will stimulate all levels of professional nursing staff independent of their research background. Results of a survey the network conducted to determine a citywide profile of nursing research needs are presented.
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Starling JR, Hunt V. Antral G-cell hyperplasia (gastrinosis, gastrincytoma). Wis Med J 1981; 80:23-5. [PMID: 7269631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Barbiasz JE, Hunt V, Lowenstein A. Nursing documentation: a format not a form. J Nurs Adm 1981; 11:22-6. [PMID: 6914380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Nurses have a difficult time committing themselves to the documentation of patient care. Various forms, assessment sheets, and checklists have been created only to prove ineffectual or to be discarded. Our format allows for the documentation of health status and permits nurses to document in the style with which they are most comfortable. The format is designed to elicit critical information and to reflect the hospital's established nursing practice standards. Subjective and objective evaluations conducted over a three month period demonstrated an appreciation for the format, a marked increase in nursing documentation, and a strong commitment by the nursing staff to reflect nursing practice in nursing documentation. A format not a form-is a method that has proven successful.
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Alberts AW, Chen J, Kuron G, Hunt V, Huff J, Hoffman C, Rothrock J, Lopez M, Joshua H, Harris E, Patchett A, Monaghan R, Currie S, Stapley E, Albers-Schonberg G, Hensens O, Hirshfield J, Hoogsteen K, Liesch J, Springer J. Mevinolin: a highly potent competitive inhibitor of hydroxymethylglutaryl-coenzyme A reductase and a cholesterol-lowering agent. Proc Natl Acad Sci U S A 1980; 77:3957-61. [PMID: 6933445 PMCID: PMC349746 DOI: 10.1073/pnas.77.7.3957] [Citation(s) in RCA: 1040] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Mevinolin, a fungal metabolite, was isolated from cultures of Aspergillus terreus. The structure and absolute configuration of mevinolini and its open acid form, mevinolinic acid, were determined by a combination of physical techniques. Mevinolin was shown to be 1,2,6,7,8,8a-hexahydro-beta, delta-dihydroxy-2,6-dimethyl-8-(2-methyl-1-oxobutoxy)-1-naphthalene-hepatanoic acid delta-lactone. Mevinolin in the hydroxy-acid form, mevinolinic acid, is a potent competitive inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase [mevalonate: NADP+ oxidoreductase (CoA-acylating), EC 1.1.1.34]; its Ki of 0.6 nM can be compared to 1.4 nM for the hydroxy acid form of the previously described related inhibitor, ML-236B (compactin, 6-demethylmevinolin). In the rat, orally administered sodium mevinolinate was an active inhibitor of cholesterol synthesis in an acute assay (50% inhibitory dose = 46 microgram/kg). Furthermore, it was shown that mevinolin was an orally active cholesterol-lowering agent in the dog. Treatment of dogs for 3 weeks with mevinolin at 8 mg/kg per day resulted in a 29.3 +/- 2.5% lowering of plasma cholesterol.
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Birch CJ, Glaun BP, Hunt V, Irving LG, Gust ID. Comparison of passive haemagglutination and haemagglutination-inhibition techniques for detection of antibodies to rubella virus. J Clin Pathol 1979; 32:128-31. [PMID: 438343 PMCID: PMC1145596 DOI: 10.1136/jcp.32.2.128] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Because of the technical problems and length of time involved in the satisfactory performance of the haemagglutination-inhibition test for detection of rubella-specific antibodies, a commercially available passive haemagglutination (PHA) kit utilising rubella antigen-sensitised human erythrocytes was tested for its suitability for use in diagnostic laboratories. The immune response to acute rubella infections as measured by PHA was considerably delayed compared to the response measured by haemagglutination-inhitition. Titres of rubella-specific antibody only became comparable six months after the infection. The commercially available PHA kits is a useful addition to diagnostic laboratories for the determination of immune status and, in conjunction with the haemagglutination-inhibition test, can be an indicator of recent rubella infection.
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