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Biomedical subjects

A Wilkie

Publications and source records attributed to A Wilkie.

13 recordsLinked to original sources
PubMed2005

Geographical access to imaging facilities for stroke patients in Scotland.

This study examines the geographical access to imaging facilities for suspected stroke patients in Scotland. A survey of Scottish clinical directors of radiology was initially undertaken to determine the current and future provision of brain imaging for the diagnosis of stroke. We analysed geographical and digital population data with geographical information systems software to determine access to brain imaging services for stroke patients during 'normal' working hours and 'out-of-hours'. The findings suggest that, in general, most departments are able to deliver scanning for stroke as set within current guidelines, at least in normal working hours. However, radiological departments are generally operating at full capacity, and there is restricted availability of scanning services for stroke in certain regions during weekend periods. It is vital that policy makers consider these findings when reviewing the guidelines for recommending scanning for stroke.

Diagnostic Imaging↗
PubMed2005

Cataract surgical coverage and outcome in the Tibet Autonomous Region of China.

BACKGROUND: A recently published, population based survey of the Tibet Autonomous Region (TAR) of China reported on low vision, blindness, and blinding conditions. This paper presents detailed findings from that survey regarding cataract, including prevalence, cataract surgical coverage, surgical outcome, and barriers to use of services. METHODS: The Tibet Eye Care Assessment (TECA) was a prevalence survey of people from randomly selected households from three of the seven provinces of the TAR (Lhoka, Nakchu, and Lingzhr), representing its three main environmental regions. The survey, conducted in 1999 and 2000, assessed visual acuity, cause of vision loss, and eye care services. RESULTS: Among the 15,900 people enumerated, 12,644 were examined (79.6%). Cataract prevalence was 5.2% and 13.8%, for the total population, and those over age 50, respectively. Cataract surgical coverage (vision <6/60) for people age 50 and older (85-90% of cataract blind) was 56% overall, 70% for men and 47% for women. The most common barriers to use of cataract surgical services were distance and cost. In the 216 eyes with cataract surgery, 60% were aphakic and 40% were pseudophakic. Pseudophakic surgery left 19% of eyes blind (<6/60) and an additional 20% of eyes with poor vision (6/24-6/60). Aphakic surgery left 24% of eyes blind and an additional 21% of eyes with poor vision. Even though more women remained blind than men, 28% versus 18% respectively, the different was not statistically significant (p = 0.25). CONCLUSIONS: Cataract surgical coverage was remarkably high despite the difficulty of providing services to such an isolated and sparse population. Cataract surgical outcome was poor for both aphakic and pseudophakic surgery. Two main priorities are improving cataract surgical quality and cataract surgical coverage, particularly for women.

Adult↗
PubMed2003

Blindness and eye diseases in Tibet: findings from a randomised, population based survey.

BACKGROUND: Public health officials of the Tibet Autonomous Region (TAR) of China requested a survey of blindness, eye diseases, and eye care service utilisation to assist the development of a 10 year blindness prevention and treatment plan. The objective of the survey was to determine the prevalence of blindness and visual impairment, as well as cataract surgical coverage and surgical outcome in the TAR. METHODS: The Tibet Eye Care Assessment was a cross sectional prevalence study of three of the seven prefectures (provinces) of the TAR (Lhoka, Nakchu, and Lingzhr) selected to represent its three main environmental regions. The survey sample was selected using a random multistage cluster method. Two teams conducted the survey in a standardised fashion in each prefecture, Lhoka during May and Nakchu during June 1999, and Lingzhr during May 2000. Visual acuity, cause of vision loss, trachoma, and vitamin A deficiency were included in the clinical examination. RESULTS: Among the 15,900 people enumerated, 12,644 were examined for an overall response rate of 79.6%. The crude prevalence of blindness (presenting better eye visual acuity of less than 6/60) was 2.3%; age and sex adjusted blindness prevalence was 1.4% (95% CI 1.3 to 1.5). Visual impairment (better eye presenting visual acuity of 6/24 to 6/60) was found in 10.9% (95% CI 10.5 to 11.2) of the population (age and sex adjusted). Cataract was the primary cause of blindness (50.7%), followed by macular degeneration (12.7%) and corneal opacity (9.7%). CONCLUSION: Blindness is a serious public health problem in Tibet, with prevalence higher than in similar studies in eastern China. As elsewhere in the world, women have an excess burden of blindness compared to men. About 75% of blindness in Tibet can be either prevented or treated. Eye care planning for Tibet must focus on cataract, particularly among women.

Adult↗
PubMed1994

Laband syndrome. Report of two cases, review of the literature, and identification of additional manifestations.

Twenty-six persons with Laband syndrome have been reported in the literature to date. We report two further unrelated cases and suggest that a skeletal anterior open bite and symmetric soft tissue swelling of the vault of the palate be added to the variable features associated with the syndrome. There is clear evidence in the literature of autosomal dominant inheritance but our analysis indicates that in some cases recessive transmission is likely.

Abnormalities, Multiple↗
PubMed1994

Ginseng--a root just like a carrot?

Ginseng has been used for thousands of years in the East as a 'tonic', and in recent years its use has extended to Western society. In the light of the current interest in complementary medicine, we summarize the effects and purported mechanisms of action of ginseng and present two vignettes of its use in relation to psychiatric patients, followed by a general discussion of the implications of the use of herbal products by these patients.

Adult↗
PubMed1993

A community wide promotion of asthma self management: process evaluation.

AIMS: During the months February through July 1991, a community wide promotion of asthma self-management was undertaken as a pilot study for the national launch of an asthma action plan developed by the Asthma Foundation of New Zealand in conjunction with the Royal New Zealand College of General Practitioners. METHODS: A multidisciplinary team of hospital and community-based health workers was established, with the aim of educating and resourcing general practitioners, practice nurses and retail pharmacists to enable them to effectively promote and distribute the asthma action plan. 332 general practitioners and 148 retail pharmacists were surveyed through postal and telephone questionnaires at the completion of the promotion, to assess its impact on health professionals and to obtain feedback for the national promotion of the asthma action plan. RESULTS: 108 (73%) of pharmacists who responded and were involved with the promotion found their participation to be worthwhile, although some had difficulty allocating sufficient time to give detailed advice to patients. Of the 240 general practitioners who responded, 77% indicated that they had used the asthma action plan with their patients. They were positive about the use of the workshop format that had provided education and resources for the plan, and of those that had used the plan, 94% indicated that they would continue to promote the plan, or one similar. CONCLUSIONS: The promotion of the asthma action plan in Canterbury had a major impact on health professionals. The community-wide promotion might have had a greater impact on people with asthma had television advertising been used. The pilot project provided useful feedback for the Asthma Foundation in their preparation for the national launch.

Asthma↗
PubMed1991

Where are the mu receptors that mediate opioid analgesia? An autoradiographic study in the HAR and LAR selection lines.

One line (strain) of mouse has been selectively bred in our laboratory for 15 generations to exhibit a very high sensitivity to levorphanol-induced analgesia on the hot plate assay (HAR or high antinociceptive response line). Concurrently, a second line (LAR or low antinociceptive response line) has been bred in the opposite direction, i.e., to exhibit a very low sensitivity under the same conditions. This has resulted in a 7-fold difference in sensitivity between HAR and LAR mice as a result of changes in gene frequency. Receptor autoradiographic studies with 3H-DAGO were carried out in the central gray to find receptor populations differing greatly in density between HAR and LAR mice to parallel their in vivo sensitivity differences: such receptors would then be implicated in mediating in vivo analgesia. The caudal portions of the dorsal raphe nucleus (DRN) showed 1.5- to 2-fold differences in density of mu sites, while the periaqueductal gray (PAG) showed relatively small differences. These results strongly suggest that mu receptors in a portion of the DRN are involved in mediating analgesia due to systemically administered opioids in this population of mice.

Animals↗
PubMed1988

Isolation and Characterization of Xylan-Degrading Strains of Butyrivibrio fibrisolvens from a Napier Grass-Fed Anaerobic Digester.

Six new xylanolytic bacterial strains have been isolated from a Napier grass-fed anaerobic digester. These strains were identified as Butyrivibrio fibrisolvens and were similar in many respects to ruminal isolates described previously. The new isolates exhibited a high degree of DNA homology with several ruminal strains of B. fibrisolvens. Xylan or xylose was required to induce the production of enzymes for xylan degradation, xylanase and xylosidase. Production of these enzymes was repressed in the presence of glucose. Xylanase activity was predominantly extracellular, while that of xylosidases was cell associated. The new isolates of B. fibrisolvens grew well in defined medium containing xylan as the sole carbon source and did not produce obvious slime or capsular layers. These strains may be useful for future genetic investigations.

Journal Article↗
PubMedDate not supplied

Harmful drinking in military veterans with post-traumatic stress disorder: association with the D2 dopamine receptor A1 allele.

AIMS: The frequency of the Taq I A alleles (A1 and A2) of the D2 dopamine receptor (DRD2) gene was examined in Caucasian post-traumatic stress disorder (PTSD) patients and controls. RESULTS: In 91 PTSD patients, the frequency of the A1 allele was higher (P = 6.12 x 10(-3)) than in the 51 controls. In the 38 PTSD harmful drinkers (>or=60 g alcohol/day), A1 allelic frequency was higher (P = 3.91 x 10(-2)) than in the 53 non-harmful drinkers (<60 g alcohol/day), the former being also higher (P = 3.76 x 10(-4)) than in controls. However, there was no difference between non-harmful drinkers and controls. Based on DRD2 allelic association, the 35 PTSD patients with the A1(+) (A1A1, A1A2) allele consumed more than twice the daily amount of alcohol than the 56 patients with the A1(-) (A2A2) allele (P = 1.94 x 10(-3)). When the hourly rate of alcohol consumed was compared, A1(+) allelic patients consumed twice the rate of the A1(-) allelic patients (P < 10(-7)). CONCLUSION: The DRD2 A1 allele was associated with PTSD. However, this association was found only in the harmful drinkers. PTSD patients with the A1(+) allele consumed more alcohol than patients with the A1(-) allele. The importance of determining alcohol consumption in DRD2 association studies with PTSD is suggested.

Adult↗
PubMedDate not supplied

Patients with medically unexplained symptoms.

Numerous patients in hospital medicine present with physical symptoms but can be given no substantive medical diagnosis. In this article we describe certain characteristics and management problems associated with this difficult group of patients and propose effective approaches to management.

Communication↗