MR imaging of linitis plastica of the rectum.
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Humans↗
Biomedical subjects
A Hearn
Publications and source records attributed to A Hearn.
Hypothalamic-pituitary-adrenal axis function in patients with chronic depression.
BACKGROUND: Hypothalamic-pituitary-adrenal (HPA) axis function in patients with chronic depression has previously been shown to be normal when measured using the dexamethasone suppression test (DST). We examined patients with chronic depression using the sensitive dexamethasone/corticotropin releasing hormone (dex/CRH) test and the dexamethasone suppression test (DST) to establish whether HPA axis abnormalities are present in this group. We also compared the sensitivity of the two tests and compared the results with previous studies in depression that have not specifically selected chronic patients. METHOD: Twenty-nine patients with the chronic subtype of major depressive disorder and 28 matched controls underwent examination of HPA axis function. RESULTS: Neither the cortisol response to the DST or the dex/CRH test differed significantly between the patient and control groups. There was a trend in favour of more patients than controls having an abnormal response to the dex/CRH test (P = 0.052). Neither the patients with an abnormally enhanced response, nor the magnitude of response could be predicted by any illness or demographic variable. CONCLUSION: The HPA axis is not overtly abnormal in chronic depression. This contrasts with previous findings in acute depression and bipolar disorder and may suggest that the HPA axis abnormalities present in acute depression resolve, but are not accompanied by symptom resolution. Alternatively, a subgroup of depressives with less HPA dysfunction may progress to chronicity. This has implications for treatment and prognosis. The dex/CRH is a more sensitive test of HPA axis function than the DST in patients with chronic depression.
Adult↗
Cervical SNAGs: a biomechanical analysis.
A sustained natural apophyseal glide (SNAG) is a mobilization technique commonly used in the treatment of painful movement restrictions of the cervical spine. In the manual therapy literature, the biological basis and empirical efficacy of cervical SNAGs have received scant attention. In particular, an examination of their potential biological basis in order to stimulate informed discussion seems overdue. This paper discusses the likely biomechanical effects of both the accessory and physiological movement components of a unilateral cervical SNAG applied ipsilateral to the side of pain when treating painfully restricted cervical rotation. The use of flexion and extension SNAGS, and rotation SNAGS performed contralateral to the side of pain are not considered. Although a cervical SNAG may clinically be able to resolve painfully restricted cervical spine movement, it is difficult to explain biomechanically why a technique which first distracts (opens) and then compresses (closes) the zygapophyseal joint ipsilateral to the side of pain, and perhaps slightly distracts the uncovertebral cleft, would be superior to a technique which distracts the articular surfaces with both accessory and physiological movement components. Therefore, the reported clinical efficacy of cervical SNAGs cannot be explained purely on the basis of the resultant biomechanical effects in the cervical spine.
Back Pain↗
What's old is new again: change at VON (Victorian Order of Nurses) means return to core values. Interview by Matthew D. Pavelich.
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Canada↗
Walking the talk: how effective boards accelerate performance. Interview by Elizabeth Preiss, Ron Shulman, and Patrick O'Callaghan.
The interviews demonstrated the belief that boards are accountable for ensuring the effective performance of their organizations. A board's obligation and authority is not limited to recruiting, appointing and replacing the organization's CEO and officers. It must also guide, shape, improve and reward what people do on the job. Performance management is not a simple process. It depends on a number of contributing factors operating in concert. To perform well, people must understand what is expected of them, their work context and their role. They must receive appropriate feedback on how they are doing from someone whom they respect and trust, someone with insight into their jobs and authority to manage them. The board's ability and obligation to contribute leadership, to be the primary force steering the organization, rests on the effectiveness with which it is able to play the performance management role.
Canada↗