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Biomedical subjects

A Perry

Publications and source records attributed to A Perry.

At least 19 recordsLinked to original sources
PubMed1992

Stress and family functioning in parents of girls with Rett syndrome.

Mothers and fathers of 29 girls with Rett syndrome provided data about their levels of parenting stress, marital adjustment, and family functioning. Their scores were compared to normative and clinical samples. The parents of girls with Rett syndrome reported more stress, lower marital satisfaction, and certain adaptations in family functioning compared to norms. However, most parents scored in the normal range on most measures and their scores were not related to SES. There was little relationship between specific characteristics of the daughter with Rett syndrome, such as her age and level of functioning, and her parents' scores on these measures. There were few significant differences between mothers' and fathers' scores. Results are discussed in terms of patterns of family adaptation and coping. Clinical implications are also discussed.

Activities of Daily Living↗
PubMed1992

Effects of public and professional education on reducing the delay in presentation and referral of stroke patients.

BACKGROUND AND PURPOSE: Several emerging stroke therapies require patients to be treated within several hours of symptom onset. Past studies have documented a significant delay between symptom onset and hospital presentation. As part of an experimental treatment study using tissue-type plasminogen activator, we began a multifaceted program of public and professional education to reduce the delay in presentation and referral of acute stroke patients. METHODS: The educational efforts focused on improving the recognition of stroke symptoms, the study enrollment criteria, and the need for rapid treatment of stroke patients. This program included 1) interviews on television and radio, 2) newspaper articles, 3) lectures to local and regional primary care and emergency department physicians, 4) mailings to several thousand local physicians, 5) having neurologists on-call for referrals 24 hrs/day, and 6) use of the Duke Life-Flight helicopter. RESULTS: Since starting our program, 139 of 159 (86%) patients with cerebral infarction presented primarily to our were referred to our facility within 24 hours of symptom onset, compared with 70 of 187 (37%) before our educational efforts (p less than 0.00001). No significant change was seen in patients with intracerebral hemorrhage (23 of 30 +AD77%+BD within 24 hours after program, compared with 25 of 40 +AD63%+BD before educational efforts; p = 0.30). CONCLUSIONS: These findings suggest that educational efforts aimed at the public and health professionals may increase recognition of stroke symptoms and reduce the delay in presentation and referral of stroke patients.

Cerebral Hemorrhage↗
PubMed1992

Early recurrent ischemic stroke. A case-control study.

BACKGROUND AND PURPOSE: Data concerning potentially treatable risk factors for early recurrent stroke are limited. Therefore, we carried out a retrospective case-control study to identify factors predisposing to early reinfarction. SUMMARY OF REVIEW: We identified all patients admitted to Duke University Hospital or the Durham Veterans Administration Medical Center during 1 year having two documented ischemic strokes within 90 days (n = 12 of 273). Twelve randomly selected patients matched for age, sex, and race but having only a single stroke served as controls. There were no significant differences between the groups with respect to a variety of factors including the presence of hypertension, diabetes, a history of transient ischemic attack, a history of stroke, cerebral site of the index stroke, and subtype of the index stroke. A potential cardioembolic source was more frequently identified in the patients with early recurrent stroke (seven of the 12 case-control pairs were discordant for a potential cardioembolic source; McNemar's chi 2 test, p less than or equal to 0.02). CONCLUSIONS: Of the variables examined, the presence of a potential cardioembolic source was the single statistically significant factor associated with reinfarction within the first 90 days after ischemic stroke. The limitations and possible therapeutic implications of these results are discussed.

Aged↗
PubMed1991

The relationships between physical activity and health-promoting behaviours in mid-life women.

The purpose of this study is to examine the inter-relationships among participation between physical activity, perceived well-being, self-esteem, health status, health locus of control and health-promoting lifestyle activities of middle-aged women in a rural context. Since women comprise the largest (living) segment of the older population, it is extremely important to study the predictors of health promoting activities in this age group prior to old age. Recent research has noted that participation in physical activity acts as an entry point to reflect on health behaviour practices, creating a ripple effect to other areas of lifestyle behaviours. The research questions were framed within the Health Promotion Model. The study utilized a longitudinal experimental design. The findings of this study contribute to the small, but growing, research base on physical activity as a health-promoting lifestyle behaviour and physical activity as a lifestyle practice of women in the mid-life years. Findings also provide a base for the development of community physical-activity programmes and other intervention strategies to enhance the health and well-being of women, particularly those residing in a rural setting.

Adult↗
PubMed1991

Child behaviours as stressors: replicating and extending the use of the CARS as a measure of stress: a research note.

Autistic children represent a source of stress for their parents, but the most appropriate way to measure this stress is not clear. Two studies in the literature compared parents' and professionals' ratings of symptom severity, and had parents rate the stressfulness of each symptom. The present study sought to replicate past research, and to extend it by validating this method of measuring parental stress compared to more traditional measures. Results indicated that mothers, fathers, and professionals agreed on the severity of child behaviours. Mothers found these behaviours significantly more stressful than fathers. The stress related to specific child behaviours was significantly correlated with more general measures of parental stress.

Adaptation, Psychological↗
PubMed1991

Surgical voice restoration with the Blom-Singer prosthesis following laryngopharyngoesophagectomy and pharyngogastric anastomosis.

Surgical voice restoration using the Blom-Singer technique is a well-established procedure in patients who have undergone simple laryngectomy. Operations for hypopharyngeal carcinoma are more extensive and require reconstruction using regional skin or myocutaneous flaps, or reanastomosis with colon, jejunum, or stomach. We report the use of the Blom-Singer prosthesis in four patients who had undergone pharyngogastric repair following laryngopharyngoesophagectomy and who had failed to achieve a satisfactory voice. All patients initially developed good speech using the prosthesis. Two patients subsequently had their prostheses removed: one because of recurrent malignant disease and one because the procedure had not significantly altered the quality of the voice. The remaining two patients have continued to use the device at 2 and 5 years after insertion with good voice production.

Anastomosis, Surgical↗
PubMed1991

Rett syndrome: a comprehensive review of the literature.

A comprehensive review of Rett syndrome, a recently identified developmental disability found only in females, was presented. The syndrome involves severe physical and mental handicaps. The rapidly accumulating research on Rett syndrome was reviewed for readers without a medical background. A brief history of Rett syndrome, the diagnostic criteria for this disorder, and the clinical stages that have been noted were presented. Information on the incidence of Rett syndrome and a discussion of issues in differential diagnosis (particularly with autism) was also included. The etiological data and genetic theories were then discussed as were treatment approaches and prognosis.

Autistic Disorder↗
PubMed1991

The effect of ethanol on bone mineral.

Chronic alcoholics frequently have osteopenia. This usually leads to an increase in long bone fractures. The exact cause of these changes is unknown. They could be caused by a change in the calcium metabolism or a change in the organic phase of bone. To elucidate the exact mechanism by which these changes occur, the following study was done. Forty-six Sprague-Dawley rats were divided into four groups. Two groups received alcohol, and two groups served as control. One set of each group received a fracture to the leg in order to study any change that might occur in the organic phase of bone. Our findings in these animals demonstrated that alcohol causes osteopenia due to a change in calcium metabolism and does not appear to effect the organic phase of bone.

Animals↗
PubMed1990

Approaches to localizing disease genes as applied to cystic fibrosis.

Using chromosome jumping and walking and restriction fragment length polymorphism (RFLP) analysis, we have defined the region which must contain the cystic fibrosis gene. DNA segments spanning approximately 250 kb in the direction of the gene were isolated and used to identify several new polymorphisms informative in cystic fibrosis families. These RFLPs include a highly polymorphic, CA/GT repeat, and a 10 bp insertion uncovered using the polymerase chain reaction. By analyzing a family with a recombination near the gene, we can exclude this region as containing the mutation. Data on the extent of linkage disequilibrium of these markers provides additional information on where the gene is located.

Base Sequence↗
PubMed1990

Reading a thermometer by use of temperature zones.

Previous studies have suggested that poor, urban parents are often unable to identify the presence of fever by use of a mercury glass thermometer. We investigated whether 145 mothers whose children received care in an urban hospital ambulatory care center could accurately read a thermometer. If they could not, their ability to identify zones of temperature, either by use of colors or numbers, was assessed. Although 57.9% of parents owned a mercury glass thermometer, only 9.7% could accurately read three thermometers presented to them. When those parents who were unable to accurately read were asked to identify the zones of temperature within which the mercury fell, 87.0% could successfully identify number zones; 78.6% could correctly identify color zones. Teaching the zone-reading techniques required only 15 to 30 seconds. We conclude that for parents unable to read a thermometer by conventional means, the use of color zones or number zones is a technique that is easily taught and reliably carried out.

Educational Status↗
PubMed1990

Radiological assessment of post laryngectomy speech.

Laryngectomy for carcinoma of the larynx has a five year survival rate of approximately 80% but the operation has a high morbidity as most patients do not develop effective alaryngeal speech. The published literature states that poor speech is occasionally due to anatomical or physiological problems in the reconstructed pharynx but is usually due to psychological, sociological or educational difficulties. We devised a radiological technique using a combination of video-fluoroscopy and static or spot films to assess the anatomy and function of the reconstructed pharynx of post-laryngectomy patients, and investigated 24 good and 134 poor or failed speakers. We examined the pharynx during the acts of swallowing, attempted phonation and attempted phonation with air insufflation. A single vibrating segment (P-E segment) in an otherwise dilated pharynx was present in all good speakers, but was absent in poor or failed speakers whom we classified as hypotonic (19), hypertonic (40), spastic (62) and strictured (13) according to the radiological appearances. This classification has been used to plan subsequent clinical management and 46 of the 55 patients treated to date (84%) have developed effective alaryngeal speech.

Deglutition↗