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H Mills

Publications and source records attributed to H Mills.

13 recordsLinked to original sources

Implementing the Agency for Health Care Policy and Research pain management pediatric guideline in a multicultural practice setting.

This article describes the implementation, monitoring, and evaluation of a clinical practice guideline for managing pediatric patient pain. The standard of care used was the Agency for Health Care Policy and Research acute pain management guideline. It was used to assess current levels of care and to make recommendations for improvements. Information was gathered from a sample of 240 pediatric patients aged 1 week to 14 years. Recommendations for improving care are given. The guideline was found to be clinically useful as a general standard of care, but more work needs to be done to individualize care for specific populations, age groups, and cultures.

Adolescent↗

The incidence of hip fractures in Maori and non-Maori in New Zealand.

AIMS: To investigate the incidence of hip fractures in Maori and nonMaori in New Zealand. METHODS: The number of femoral neck fractures in patients over 60 in New Zealand for the years 1989-91 were obtained. The population data for 1991 was obtained from the 1990 census. The number of fractures was standardised for age, and the rate of fractures per 100,000 of population calculated. RESULTS: The age standardised rates of hip fracture per 100,000 of population 1989-91 for Maori males was 197, Maori females 516, nonMaori males 288 and nonMaori females 827. These rates were higher than the rates recorded between 1973 and 1975. CONCLUSIONS: The age-specific hip fracture rate is rising in New Zealand. However in Maori males the rate is not rising.

Age Distribution↗

Safe hunting.

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Athletic Injuries↗

Structural similarity between the p17 matrix protein of HIV-1 and interferon-gamma.

The human immunodeficiency virus (HIV) matrix protein, p17, forms the outer shell of the core of the virus, lining the inner surface of the viral membrane. The protein has several key functions. It orchestrates viral assembly via targeting signals that direct the gag precursor polyprotein, p55, to the host cell membrane and it interacts with the transmembrane protein, gp41, to retain the env-encoded proteins in the virus. In addition, p17 contains a nuclear localization signal that directs the preintegration complex to the nucleus of infected cells. This permits the virus to infect productively non-dividing cells, a distinguishing feature of HIV and other lentiviruses. We have determined the solution structure of p17 by nuclear magnetic resonance (NMR) with a root-mean square deviation for the backbone of the well-defined regions of 0.9 A. It consists of four helices connected by short loops and an irregular, mixed beta-sheet which provides a positively charged surface for interaction with the inner layer of the membrane. The helical topology is unusual; the Brookhaven protein database contains only one similar structure, that of the immune modulator interferon-gamma.

Amino Acid Sequence↗

Candida albicans vertebral osteomyelitis in chronic renal failure.

Invasive candidal infections are encountered with increasing frequency in compromised hosts but bone infection is uncommon. A woman with systemic lupus erythematosus and end-stage renal failure managed by continuous ambulatory peritoneal dialysis developed a painful thoracic kyphosis and a lytic lesion in the vertebral bodies of T10 and T11. Blood cultures were sterile but bone biopsy material contained Candida albicans which also grew on culture. Circulating immune complexes were measured in high levels and contained candida antigens and specific anti-candida antibody as determined by isoelectric focusing, immunoblotting and immunoprinting techniques. Pain persisted after anti-fungal therapy had sterilized the lesion necessitating surgical excision of affected vertebrae, kyphosis correction and iliac crest bone grafting. The titres of circulating immune complexes and anti-candidal precipitins closely paralleled the clinical course.

Adult↗

Liquid protein diets and torsade de pointes.

Three women, aged 27, 33, and 35 years, experienced recurrent syncope five months after losing 36 to 41 kg using liquid protein diets. No abnormalities were noted during physical examination except in one who was hypothyroid. Serum potassium levels varied between 2.9 and 3.9 mEq/liter. The ECGs demonstrated prominent U waves, QUc prolongation, and ST and T wave abnormalities, with left axis deviation in two patients. Syncopal episodes were due to ventricular tachycardia and fibrillation, which were not responsive to conventional antiarrhythmic agents used in two patients. Patients using liquid protein diets may thus experience reversible QUc prolongation giving rise to serious arrhythmias that are probably best treated with drugs that shorten the QTc interval. Caution should be exercised in the use of liquid protein diets for weight reduction in obesity.

Adult↗