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Biomedical subjects

C Maher

Publications and source records attributed to C Maher.

15 recordsLinked to original sources
PubMed1996

A comparison of pisiform and thumb grips in stiffness assessment.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether two versions of the posteroanterior (PA) pressure test provide similar stiffness information. SUBJECTS: Twenty subjects were asked to judge the magnitude of five stiffness stimuli provided by a mechanical device. METHODS: Subjects were required to rate the stiffness magnitude on a five-point scale using both the thumb-grip and pisiform-grip versions of the PA pressure test. Using signal detection theory methods, measures of both a subject's ability to discriminate between the stiffness stimuli and a subject's bias in perceived stiffness magnitude due to the testing method were obtained. These values were compared using analysis of trend within an analysis of variance framework. RESULTS: The two methods of performing the PA central pressure had similar stimulus discriminability. With the thumb-grip method, however, a substantial bias occurred, making the mechanical stimuli appear to be stiffer than when the pisiform grip was used. CONCLUSION AND DISCUSSION: The method of performing the PA central pressure test affects the perceived magnitude of stiffness stimuli. This results suggests that the two versions of this clinical test should not be used interchangeably.

Adult↗
PubMed1995

Is the clinical concept of spinal stiffness multidimensional?

BACKGROUND AND PURPOSE: This study investigated whether the poor reliability of judgments of posteroanterior (PA) spinal stiffness is due to rater bias or is a consequence of raters each having individual concepts of PA stiffness. SUBJECTS: Three pairs of manipulative physical therapists with a minimum of 5 years of experience took part in the study. METHODS: The raters were required to make stiffness judgments of a series of metal springs, and their performance at this task was compared with that obtained when they rated the PA stiffness of patients with low back pain. A range of reliability indices were calculated and evaluated to establish whether rater bias contributed to poor reliability in either task. The relationship between each rater's estimates of the magnitude of the stimuli and the measured stiffness of the springs was also assessed using the Pearson Product-Moment Correlation Coefficient. RESULTS: The average intraclass correlation coefficient (2, 1) for rating spring stiffness was found to be .60, whereas for human spines it was found to be .19. There was no evidence of rater bias contributing to poor reliability for rating stiffness of human spines. The average correlation between the rater's estimates of the magnitude of the stimuli and the measured stiffness of the stimuli was .80. CONCLUSION AND DISCUSSION: Physical therapists demonstrated much better ability to judge spring stiffness than the PA stiffness of human spines. This difference in performance implies that mechanical stiffness is not equivalent to the clinical concept of PA stiffness. Posteroanterior stiffness may have more than one dimension, and individual interpretation of stiffness as a construct may lead to rater disagreement in the clinic. The reliability of judgments of PA spinal stiffness may be enhanced in the future if its dimensions can be identified, defined, and taken into account during clinical procedures.

Biomechanical Phenomena↗
PubMed1995

Spinal models.

Explore the source record for details and available documents.

Biomechanical Phenomena↗
PubMed1994

Reliability of pain and stiffness assessments in clinical manual lumbar spine examination.

BACKGROUND AND PURPOSE: The purpose of this study was to determine the intertherapist reliability of judgments of stiffness and pain at L-1 to L-5 made using posteroanterior (PA) central pressure testing. SUBJECTS: Three pairs of manipulative physical therapists with a minimum of 5 years of experience were asked to rate pain and stiffness in a total of 90 patients with low back pain. METHODS: Each pair of therapists assessed 30 patients within their own clinic, using their preferred technique to perform an examination using the PA central pressure test at the five lumbar levels. Each pair of therapists recorded their ratings of pain and stiffness. Reliability of judgments was evaluated by intraclass correlation coefficients (ICC) and percentage of exact agreement scores. RESULTS: The ICC values for pain judgments for the group as a whole ranged from .67 to .72, with agreement scores ranging from 31% to 43%. The ICC values for stiffness judgments ranged from .03 to .37, with agreement scores ranging from 21% to 29%. CONCLUSION AND DISCUSSION: Judgments of stiffness made by experienced manipulative physical therapists examining patients in their own clinics were found to have poor reliability, whereas pain judgments had good reliability. Further investigation of this test is required in order to develop a more reliable method of assessing PA stiffness.

Adult↗
PubMed1993

Staphylococcal septicaemia after endometrial destruction.

Two cases of staphylococcus aureus septicaemia secondary to endometritis following endometrial destruction are presented. After surgical endometrial destruction, endometritis has been reported rarely, but there are no previous reports of staphylococcal septicaemia.

Adult↗
PubMed1993

Hepatitis B vaccination of high-risk neonates in the South West Region of New South Wales: evaluation of program coverage.

The authors evaluated the high-risk neonate hepatitis B vaccination program in the South West Region of New South Wales. Infants from ethnic groups with a high rate of chronic hepatitis B virus (HBV) infection and infants of HBV carrier mothers were targeted. The program identified 323 infants born between October 1987 and December 1990 who were at high risk of HBV infection, of whom 68.7 per cent were Aboriginal. Overall, 194 infants (60.1 per cent) received three doses of vaccine. Although the number of infants identified increased from 46 in 1988 to 119 in 1990, the proportion fully vaccinated each year did not increase, remaining at around 60 per cent. The authors stress the importance of promoting the program and educating the high-risk groups and health professionals involved, in order to improve vaccination coverage.

Carrier State↗
PubMed1993

The effect of manipulation on range of movement at the ankle joint.

Manipulation is commonly used by physiotherapists in the treatment of musculoskeletal disorders; however, there have been few studies evaluating its use in peripheral joints. The purpose of this study was to investigate the effect of manipulation on dorsiflexion range of movement at the ankle joint. Twenty asymptomatic subjects participated, one ankle acting as the experimental ankle and receiving the manipulation intervention, while the other ankle acted as the control. The manipulation studied was a longitudinal talocrural manipulation. Dorsiflexion range of movement was measured at 5 consecutive torque levels pre and post manipulation intervention in the experimental ankle and pre and post no intervention in the control ankle. These values were compared using analysis of trend within an analysis of variance framework. There was no statistically significant change in dorsiflexion range of movement following manipulation. It was concluded that in the case of asymptomatic subjects these results did not provide support for the experimental hypothesis that a single talocrural manipulation alters dorsiflexion range of movement. It was suggested that future research investigate the effects of manipulation in a symptomatic population.

Adult↗
PubMed1993

Audit of a general practice.

A clinical activities audit is a method of obtaining interesting information about one's general practice. It is likely to generate improvement in practice, thereby fulfilling the most important requirement of quality assurance, even in the absence of nationally accepted standards of general practice. A five-day audit of clinical activities in one practice is detailed, and some of the changes that this prompted in consultation time management, investigation and referral rates, and conditions managed are frankly discussed.

Appointments and Schedules↗
PubMed1987

Mucosal defences and gastroduodenal disease.

Peptic ulcer disease occurs when there is an imbalance between aggressive factors and mucosal resistance. Mucus plays a key role in mucosal resistance. The mucus layer is relatively resistant to peptic digestion, it provides a layer through which there is a movement of hydrogen ions from the parietal cell to the lumen but a resistance to back-diffusion of hydrogen ions in the opposite direction. It maintains a pH gradient by 'sequestering' secreted bicarbonate and by its resistance to H+ back-diffusion. Colloidal bismuth subcitrate (De-Nol) binds to mucus to stabilize the mucous layer and increase the resistance to back-diffusion of hydrogen ions without significantly modifying the ion-exchange properties of mucus.

Adult↗
PubMed1984

Pre-cystectomy intra-arterial cis-diamminedichloroplatinum II with local bladder hyperthermia for bladder cancer.

A total of 6 patients with bulky pelvic bladder cancer underwent combination cis-diamminedichloroplatinum II (cisplatin) hypogastric artery infusion and local bladder hyperthermia as a preoperative adjunct to radical cystectomy. Pathological examination showed extensive tumor necrosis on the luminal side, with a gradient of tumor destruction to viable tumor on the serosal surface in 4 of the 6 bladders, while 2 specimens showed no tumor. Uninvolved portions of the bladders showed minor changes in the urothelium, submucosal edema and no effect on detrusor muscle or perivesical fat. Analysis of tissue for platinum revealed uptake by the tumors and normal tissues. Systemic effects of spillover cisplatin were not seen. Adjunctive preoperative hypogastric artery infusion of cisplatin is safe and well tolerated. Further study is required to determine the upper limits of safety of the regimen.

Carcinoma, Transitional Cell↗
PubMed1983

Effects of dietary fat and gel-forming substances on rat jejunal disaccharidase levels.

Wistar rat jejunal disaccharidases were measured after feeding low fat, low fat + 5% pectin, low fat + 0.4% galactomannan, high fat, high fat + 5% pectin and high fat + 0.4% galactomannan diets for 16 weeks. All rats fed high fat diet had significantly lower jejunal sucrase and maltase levels when compared with their respective low fat groups. Lactase was significantly lowered in the high fat pectin group compared with the low fat pectin group, but was not significantly different when comparing the high fat or high fat galactomannan with their respective low fat groups. There was no significant difference in lactase, sucrase or maltase levels between the low fat groups, or between the high fat groups. We conclude that in Wistar rats an increased dietary fat level lowers jejunal sucrase, maltase and lactase levels, while the gel-forming substances pectin and galactomannan added at the levels of 5% and 0.4%, respectively, have no effect.

Animals↗
PubMed1979

Deficits in psychologic and classroom performance of children with elevated dentine lead levels.

To measure the neuropsychologic effects of unidentified childhood exposure to lead, the performance of 58 children with high and 100 with low dentine lead levels was compared. Children with lead levels scored significantly less well on the Wechsler Intelligence Scale for Children (Revised) than those with low lead levels. This difference was also apparent on verbal subtests, on three other measures of auditory or speech processing and on a measure of attention. Analysis of variance showed that none of these differences could be explained by any of the 39 other variables studied. Also evaluated by a teachers' questionnaire was the classroom behavior of all children (2146 in number) whose teeth were analyzed. The frequency of non-adaptive classroom behavior increased in a dose-related fashion to dentine lead level. Lead exposure, at doses below those producing symptoms severe enough to be diagnosed clinically, appears to be associated with neuropsychologic deficits that may interfere with classroom performance.

Attention↗