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Biomedical subjects

A Casey

Publications and source records attributed to A Casey.

At least 37 records · Page 2Linked to original sources
PubMed2000

Use of an outcome by gestation table for extremely premature babies: a cross-sectional survey of the views of parents, neonatal nurses and perinatologists.

OBJECTIVES: To promote family-centered care and strengthen the process of informed consent it is essential that parents have access to information on the problems their baby may face. We have constructed an Outcome by Gestation Table (OGT) with information on survival, short-term complications plus treatments of the most recent cohort of babies born at different gestations from 23 to 28 weeks. This study documents the views on the table from parents of babies < 29 weeks gestation, neonatal nurses, and doctors. STUDY DESIGN: A copy of the OGT and a questionnaire seeking views regarding the OGT was sent to the parents' support group (Preemie-List), 71 randomly chosen perinatologists in Australia and to the 35 nurses working in our NICU. Differences between groups were analyzed using chi 2 analysis. RESULTS: Forty-eight parents participated in the study. Forty-three (60.5%) doctors and 24 (68.5%) neonatal nurses replied. The three groups agreed that the OGT is not misleading. The majority of doctors feel that the table: is easy to understand but has too much information; is useful but they are ambivalent about using it in their practice. The results were highly significant with parents being most positive and accepting of the OGT, next nurses and finally doctors. CONCLUSION: It is important to seek the views of both consumers and carers on any aid in communication in the NICU.

Attitude↗
PubMed2000

Does dietary creatine supplementation play a role in skeletal muscle metabolism and performance?

Fatigue sustained during short-term, high-intensity exercise in humans is associated with the inability of skeletal muscle to maintain a high rate of anaerobic ATP production from phosphocreatine hydrolysis. Ingestion of creatine monohydrate at a rate of 20 g/d for 5-6 d was shown to increase the total creatine concentration of human skeletal muscle by approximately 25 mmol/kg dry mass, some 30% of this in phosphorylated form as phosphocreatine. A positive relation was then shown between muscle creatine uptake and improvements in performance during repeated bouts of maximal exercise. However, there is no evidence that increasing intake > 20-30 g/d for 5-6 d has any potentiating effect on creatine uptake or performance. In individuals in whom the initial total creatine concentration already approached 150 mmol/kg dry mass, neither creatine uptake nor an effect on phosphocreatine resynthesis or performance was found after supplementation. Loss of ATP during heavy anaerobic exercise was found to decline after creatine ingestion, despite an increase in work production. These results suggest that improvements in performance are due to parallel improvements in ATP resynthesis during exercise as a consequence of increased phosphocreatine availability. Creatine uptake is augmented by combining creatine supplementation with exercise and with carbohydrate ingestion.

Adenosine Triphosphate↗
PubMed2000

Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function.

BACKGROUND: The use of creatine (Cr) as a nutritional supplement to aid athletic performance has gained widespread popularity among athletes. However, concerns have recently been expressed over potentially harmful effects of short and long term Cr supplementation on health. METHODS: Forty eight young healthy subjects were randomly allocated to three experimental protocols aimed at elucidating any potential health risks associated with five days (20 g/day) to nine weeks (3 g/day) of Cr supplementation. Venous blood samples were collected before and after periods of Cr supplementation and were analysed for some haematological indices, and for indices of hepatic, muscular, and renal dysfunction. FINDINGS: All measured indices were well within their respective normal range at all times. Serum creatinine concentration tended to be increased the day after Cr supplementation. However, values had returned to baseline six weeks after the cessation of supplementation. These increases were probably attributable to increased creatinine production rather than renal dysfunction. No indication of impairment to the haematological indices measured, hepatic function, or muscle damage was apparent after Cr supplementation. INTERPRETATION: These data provide evidence that there are no obvious adverse effects of acute or more chronic Cr supplementation on the haematological indices measured, nor on hepatic, muscle, and renal function. Therefore there is no apparent health risk associated with Cr supplementation to healthy people when it is ingested in quantities that have been scientifically proven to increase muscle Cr stores.

Adult↗
PubMed2000

Effect of carbohydrate ingestion on glycogen resynthesis in human liver and skeletal muscle, measured by (13)C MRS.

This study investigated the effect of carbohydrate (CHO) ingestion on postexercise glycogen resynthesis, measured simultaneously in liver and muscle (n = 6) by (13)C magnetic resonance spectroscopy, and subsequent exercise capacity (n = 10). Subjects cycled at 70% maximal oxygen uptake for 83 +/- 8 min on six separate occasions. At the end of exercise, subjects ingested 1 g/kg body mass (BM) glucose, sucrose, or placebo (control). Resynthesis of glycogen over a 4-h period after treatment ingestion was measured on the first three occasions, and subsequent exercise capacity was measured on occasions four through six. No glycogen was resynthesized during the control trial. Liver glycogen resynthesis was evident after glucose (13 +/- 8 g) and sucrose (25 +/- 5 g) ingestion, both of which were different from control (P < 0.01). No significant differences in muscle glycogen resynthesis were found among trials. A relationship between the CHO load (g) and change in liver glycogen content (g) was evident after 30, 90, 150, and 210 min of recovery (r = 0.59-0. 79, P < 0.05). Furthermore, a modest relationship existed between change in liver glycogen content (g) and subsequent exercise capacity (r = 0.53, P < 0.05). However, no significant difference in mean exercise time was found (control: 35 +/- 5, glucose: 40 +/- 5, and sucrose: 46 +/- 6 min). Therefore, 1 g/kg BM glucose or sucrose is sufficient to initiate postexercise liver glycogen resynthesis, which contributes to subsequent exercise capacity, but not muscle glycogen resynthesis.

Adult↗
PubMed2000

Direct anterior screw fixation for recent and remote odontoid fractures.

OBJECT: The management of odontoid fractures remains controversial. Only direct anterior screw fixation provides immediate stabilization of the spine and may preserve normal C1-2 motion. To determine the indications, optimum timing, and results for direct anterior screw fixation of odontoid fractures, the authors reviewed the surgery-related outcome of patients who underwent this procedure at two institutions. METHODS: One hundred forty-seven consecutive patients (98 males and 49 females) who underwent direct anterior screw fixation for recent (< or = 6 months postinjury [129 patients]) or remote (> or = 18 months postinjury [18 patients]) Type II (138 cases) or III (nine cases) odontoid fractures at the University of Utah (94 patients) and National Institute of Traumatology in Budapest, Hungary (53 patients) between 1986 and 1998 are included in this study (mean follow up 18.2 months). Data obtained from clinical examination, review of hospital charts, operative findings, and imaging studies were used to analyze the surgery-related results in these patients. In patients with recent fractures there was an overall bone fusion rate of 88%. The rate of anatomical bone fusion of recent fractures was significantly (p < or = 0.05) higher in fractures oriented in the horizontal and posterior oblique direction (compared with anterior oblique), but this finding was independent (p > or = 0.05) of age, sex, number of screws placed (one or two), and the degree or the direction of odontoid displacement. In patients with remote fractures there was a significantly lower rate of bone fusion (25%). Overall, complications related to hardware failure occurred in 14 patients (10%) and those unrelated to hardware in three patients (2%). There was one death (1%) related to surgery. CONCLUSIONS: Direct anterior screw fixation is an effective and safe method for treating recent odontoid fractures (<6 months postinjury). It confers immediate stability, preserves C1-2 rotatory motion, and achieves a fusion rate that compares favorably with alternative treatment methods. In contradistinction, in patients with remote fractures (> or = 18 months postinjury) a significantly lower rate of fusion is found when using this technique, and these patients are believed to be poor candidates for this procedure.

Adolescent↗
PubMed1999

Antihypertensives.

Management of hypertension requires a thorough knowledge of currently available antihypertensive drugs. This article reviews the mode of action of the major classes of antihypertensives, indications for their use, and adverse effects. The main emphasis is placed on their use, in physiatric practice.

Antihypertensive Agents↗