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Biomedical subjects

A Whitfield

Publications and source records attributed to A Whitfield.

At least 19 recordsLinked to original sources
PubMed2005

Recognition and management of intra-abdominal hypertension and abdominal compartment syndrome.

OBJECTIVE: To determine ICU registrars' level of awareness regarding measurement of intra-abdominal pressure (IAP), features of intra-abdominal hypertension (IAH), and management of abdominal compartment syndrome (ACS). METHODS: We surveyed 40 Australasian ICU registrars attending a post-graduate teaching course in 2004. The survey questions explored clinical experience and understanding of IAP, methods of measurement of IAP, diagnosis and causes of IAH and management of ACS in critically ill patients. RESULTS: The survey recorded a 90% response rate. Ninety two percent of the ICU registrars had used IAP in their clinical practice; 52% of those with experience in IAP measurement had only employed it infrequently. While 90% affirmed their knowledge that IAP can rise due to intraperitoneal pathology, causation of IAH by retroperitoneal conditions was poorly understood. Ninety two per cent correctly said that ACS should be treated by abdominal decompression. Only 70% of our respondents felt confident not to perform a computed tomography (CT) scan of the abdomen before treating a patient with ACS. The majority understood the need for, and the modes of, therapy for ACS; but 33 % erroneously said that they would treat IAP > 30 mmHg regardless of organ dysfunction and another 22 % were unsure of the threshold of therapy for ACS. CONCLUSIONS: ICU registrars in Australasia appreciate the techniques for, and significance of, IAP measurements and recognise and treat ACS appropriately. Retroperitoneal causes of IAH and the threshold for treatment for ACS were not well understood by the respondents.

Journal Article↗
PubMed2003

Assessment of noise annoyance in three distinct communities living in close proximity to a UK regional airport.

Previous researchers have considered demographic variables relating to deprivation such as income, social status and home ownership, and their relationship with both community and individual reaction to environmental noise. These variables have been found not to be important. Intuitively this seems implausible and the findings of a recent African study increase the doubt. The present study aims to look at the effect of deprivation using an index of deprivation developed and adopted in a different context. A postal questionnaire was used to survey three communities around Birmingham International Airport, UK. The main selection criterion for these areas was the Townsend overall index of deprivation (ODI). The typical aircraft noise exposure levels for all of the survey areas were determined from the aircraft noise exposure contours provided by Birmingham International Airport. An overall response rate of 40% was achieved and it was found that the area of lowest deprivation (greatest affluence) has a significantly greater proportion of highly annoyed persons due to aircraft noise than the other two areas, with the lowest noise exposure category accounting for the significant difference. The differences in reaction are not explained by deprivation as measured by the ODI nor by other factors previously reported in the literature and by those that were measured in this study. However, a link between housing type and noise annoyance due to aircraft noise suggests an avenue for further research.

Aircraft↗
PubMed2000

A population-based study of the prevalence, clinical characteristics and effect of ethnicity in epilepsy.

UNLABELLED: The aim of this study was to determine the prevalence and clinical characteristics of epilepsy and seizure disorders in Bradford. The method used was a community-based cross-sectional study. Case ascertainment was by review of medical records identified by searching practice databases using diagnostic codes and from repeat prescribing data. A specialist epilepsy nurse reviewed the records in 39 practices covering a population of 225 439. Clinical review was undertaken where there was limited information available in the records. In total, 1643 cases of epilepsy were identified (prevalence 7.3/1000). The prevalence of epilepsy increased with age. Classification of patients by internationally agreed definitions showed 1013 (62%) of cases with active epilepsy (prevalence 4. 5/1000); 421 (26%) with epilepsy in remission on treatment and 209 (13%) with epilepsy in remission off treatment. The standardized rate for all patients of South Asian origin was 3.6/1000 compared to 7.8/1000 in the rest of the population (OR 0.46; 95% CI 0.38, 0.57). An underlying aetiology was identified in 29.5% of cases. Cerebrovascular disease and head injuries were the commonest causes. CONCLUSIONS: The prevalence of epilepsy supports previous epidemiological estimates and highlights the public health importance of epilepsy. The low prevalence in the South Asian population is a surprising finding and further research into cultural attitudes to epilepsy and the impact of stigma in the South Asian population in the UK is required.

Adolescent↗
PubMed1995

Backache and epidural analgesia: a retrospective survey of mothers 1 year after childbirth.

A questionnaire was sent to 2065 mothers 1 year after delivery as part of a larger study into patient satisfaction with all aspects of their obstetric care. The response rate adjusted for non-delivered mail was 67.1%. There was a high incidence of new long-term backache in mothers who had received epidural analgesia (26.2% at one year) compared to the mothers who had not (1.7%). Further analysis of the data revealed no other significant associated factor.

Journal Article↗
PubMed1994

The effects of Entonox and epidural analgesia on arterial oxygen saturation of women in labour.

The arterial oxygen saturation of 40 mothers in the first stage of labour was monitored using pulse oximetry. Half the mothers received epidural analgesia and the rest inhaled Entonox for pain relief. Eight mothers in the Entonox group and six in the epidural group had at least one episode of significant hypoxia (saturation < 90%). There was little difference in the number of hypoxic episodes experienced by either group (29 in the Entonox and 21 in the epidural) although their mean duration and severity was greater in the Entonox group. Women in labour who inhale Entonox have an appreciable incidence of arterial desaturation. Epidural analgesia reduces the severity of hypoxic episodes although it does not eliminate them.

Adult↗
PubMed1993

A case of myopathy associated with a dystrophin gene deletion and abnormal glycogen storage.

A 30-year-old man with no family history of muscle disease presented with a progressive proximal myopathy and calf hypertrophy characteristic of Becker muscular dystrophy. A deletion of exons 45 to 48 in the dystrophin gene was confirmed by Southern blotting and multiplex polymerase chain reaction. However, muscle biopsy showed massive accumulation of glycogen, although no significant abnormality of glycolytic pathway enzymes could be demonstrated. This patient therefore has a previously undescribed myopathy associated with both Becker muscular dystrophy and a glycogen storage disorder of unknown aetiology.

Adult↗
PubMed1992

Repeated unilateral epidural blockade.

Unilateral epidural analgesia occurring in a parturient three times in successive pregnancies is reported. Possible causes are reviewed, and clinical and radiological evidence in support of the most likely explanation are presented.

Adult↗
PubMed1990

Alkalinisation of prilocaine for intravenous regional anaesthesia. Suitability for clinical use.

Eighty unpremedicated patients undergoing day-case hand surgery under intravenous regional anaesthesia were randomly allocated to receive, in a double-blind study, either 40 ml 0.75% prilocaine hydrochloride, with 5 ml 8.4% sodium bicarbonate or 5 ml 0.9% saline. The alkalinised group had significantly less pain on injection (p = 0.0045), during surgery (p = 0.0074) and 5 minutes after the tourniquet was deflated (p = 0.0027). The time elapsed between insertion of the block and commencement of surgery was not affected.

Adolescent↗
PubMed1990

Time course of cerebra; magnetic resonance changes after electroconvulsive therapy.

Nuclear magnetic resonance images of the non-dominant cerebral hemisphere were obtained in 20 unipolar depressed patients immediately before and 25 minutes after electroconvulsive therapy (ECT). T1 values rose about 1%. Repeated scanning up to 24 hours after ECT was carried out in 13 of these patients. The greatest change in magnetic resonance images was two hours after ECT, and thereafter images gradually returned to baseline values. There was no correlation between magnetic resonance changes and the time taken to become reorientated after ECT.

Adult↗
PubMed1989

Effect of general anaesthesia on the magnetic resonance imaging signal from the brain.

Magnetic resonance images of the brain were obtained in 10 female patients before and 2-6 h after a standard general anaesthetic. The longitudinal magnetic relaxation times (T1) showed a non-significant decrease, whereas the transverse magnetic relaxation times (T2) increased in all scans, with significant increases in the pons and corpus callosum. This suggests that general anaesthesia may be associated with structural changes in the brain at a molecular level.

Adult↗
PubMed1988

Postoperative analgesia by continuous extradural infusion of bupivacaine and diamorphine.

Three solutions administered by continuous extradural infusion for postoperative analgesia were compared in a randomized, double-blind manner. All patients underwent major abdominal gynaecological surgery and received 0.125% bupivacaine in 0.9% saline, diamorphine in 0.9% saline (0.5 mg in 15 ml) or diamorphine mixed with 0.125% bupivacaine (0.5 mg in 15 ml), at a rate of 15 ml h-1. The bupivacaine-diamorphine mixture provided significantly superior analgesia compared with either bupivacaine or diamorphine alone. No major side effects were encountered.

Abdomen↗
PubMed1987

Cerebral and brain stem changes after ECT revealed by nuclear magnetic resonance imaging.

Nuclear magnetic resonance images of the brain were obtained in fourteen patients with major depression during a course of ECT. The T1 relaxation time rose immediately after the fit, reaching a maximum 4-6 h later. The T1 values then returned to their original level; no long-term increase occurred over the course of treatment. These results are consistent with an extensive but temporary breakdown of the blood-brain barrier during ECT.

Brain↗
PubMed1986

Deletion on the X chromosome detected by direct DNA analysis in one of two unrelated boys with glycerol kinase deficiency, adrenal hypoplasia, and Duchenne muscular dystrophy.

In studies of the X chromosomes of two unrelated boys with adrenal hypoplasia, glycerol kinase deficiency, Duchenne muscular dystrophy, and mental retardation, conventional G banding did not reveal any numerical or structural abnormality, but direct DNA analysis with the X short-arm probes 754, C7, and OCT revealed a deletion in 1 of these patients. It is likely that both boys have a deletion at Xp21 affecting a number of closely linked disease-specific gene loci.

Adrenal Insufficiency↗
PubMed1986

Duchenne muscular dystrophy with adrenal insufficiency and glycerol kinase deficiency: high resolution cytogenetic analysis with molecular, biochemical, and clinical studies.

A syndrome of Duchenne muscular dystrophy (DMD), adrenal hypoplasia, glycerol kinase deficiency, and mental retardation has been recognised. We report a further case ascertained from a history of DMD, severe mental retardation, and an Addison-like disorder. Cytogenetic analysis of the proband revealed an interstitial deletion of the short arm of the X chromosome. from Xp21.1 to Xp22.11, comprising about 9% of the length of the normal X chromosome. His mother was heterozygous for the deletion, but his maternal grandmother and sister both had two normal X chromosomes. DNA probe analysis confirmed the existence of a deletion in the affected boy, as probes 754, C7, XJ1-1, and pERT87 consistently failed to hybridize to his DNA. His sister was heterozygous for the RFLP associated with 754, thus confirming that she had two normal X chromosomes. There was no evidence of chronic granulomatous disease, other immunological defect, or retinitis pigmentosa in this case. Biochemical studies revealed gross glyceroluria and hyperglycerolaemia, indicating glycerol kinase deficiency which has been confirmed enzymatically. We have subsequently screened 21 other boys with DMD for glyceroluria and found one other case. Cytogenetic analysis has also been performed in nine other families, where a boy with DMD has been shown to have a deletion of DNA sequences localised to the region Xp21. None of these cases demonstrated any cytogenetic abnormality, nor has their clinical course been unusual.

Adolescent↗
PubMed1985

Right-hemisphere interactions in picture-word processing.

The processing of pictures was investigated in three experiments which eliminated the response effects involved in naming. When a categorization task was used, clear advantages in response latency and accuracy were observed for left visual-field (LVF) presentations. This was in contrast to previous investigations which have used a naming task and which have reported right visual-field (RVF) advantages. When a distracting word was added to the display, the pattern of influence also changed from that reported previously. The use of naming tasks has indicated predominantly left-hemisphere effects, with demonstrations of interactions between pictures and words in the RVF. With a categorization task in Experiment 2, however, the only effective words were those related in meaning to the picture, and only when they were projected to the right hemisphere. The third experiment confirmed the LVF advantage for picture processing with masked displays, but found no reliable asymmetry with unmasked presentations. The pattern of semantic facilitation was also confirmed with the masked displays, but when the mask was removed an inhibition effect replaced the facilitation effect. These effects are interpreted as indicating that picture recognition is localized within the right cerebral hemisphere. It is suggested that the facilitating effect of related words is restricted to the left hemisphere because it is an effect upon recognition processes, whereas the inhibition effect reflects response competition. It is also suggested that previous reports of left-hemisphere interference effects are due to effects of response competition in naming tasks.

Adult↗