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Biomedical subjects

J M Simpson

Publications and source records attributed to J M Simpson.

At least 19 recordsLinked to original sources
PubMed1992

Diversity of blood pressure recording during pregnancy: implications for the hypertensive disorders.

OBJECTIVE: To determine the number and type of methods used to measure blood pressure (BP) in pregnant women. DESIGN: Questionnaires were distributed to obstetricians and midwives concerning: method of recording BP (arm used, subject position, Korotkoff sounds recorded); accuracy of recording BP (cuff size, sphygmomanometer calibration); and definitions of hypertension in pregnancy. PARTICIPANTS: Obstetricians (academic, staff and private) in Sydney; members of the New South Wales Midwives' Association. MAIN RESULTS: Responses were received from 85 obstetricians (55% of those surveyed) and 173 midwives (43%); the overall response rate was 46%. Almost 80% of respondents agreed that diastolic BP above 90 mmHg constituted hypertension during pregnancy but at least six different methods were used to obtain BP readings, with a potentially large variability in the BP so obtained. Forty-five per cent of obstetricians and 72% of midwives stated that they always used a large cuff when necessary. Few had had their sphygmomanometer calibrated within the previous two years. CONCLUSIONS: There is considerable variability in the way BP is recorded in pregnant women. Hypertension in pregnancy may therefore be over or under diagnosed according to the method employed and there is an urgent need for international consensus on how to measure BP accurately in pregnancy.

Blood Pressure↗
PubMed1992

Mass media-led antismoking campaign can remove the education gap in quitting behavior.

This study investigated whether the effective mass media-led antismoking campaigns in Australia had the traditional differential effect across educational levels. Our population surveys included random samples of 12,851 people before the campaign and 11,609 several years after the campaign had started. No statistically significant differences were found in quitting across education levels in three of the four subgroups. Mass media-led antismoking campaigns may play an important role in getting the antismoking message to the less educated.

Adult↗
PubMed1992

Low lumbar burst fractures: comparison between conservative and surgical treatments.

Twenty-two low lumbar burst fractures (L3-L5) were treated, with an average follow up of 56.2 and 39.0 months in the conservative and surgically treated groups, respectively. Twenty patients were available for review; seven were treated conservatively and 13 were stabilized surgically. All patients were evaluated clinically for work status, activity level, residual pain, and subsequent development of neurologic symptoms. Roentgenograms were reviewed for severity of initial fracture, canal compromise, and maintenance of initial correction. In general, neurologically intact patients in both groups returned to similar postinjury employment levels. Persistent back pain was found to be more disabling in the surgically treated group, in which a fusion incorporating four or five lumbar segments was performed. There was no evidence of significant loss of initial reduction, and no patients experienced late neurological compromise in the surgical group. An average follow-up kyphosis of 9.2 degrees and 31% loss of vertebral height were observed in the conservative group, while a follow-up lordosis of 1 degree and 19% loss of vertebral height were observed in the surgical group. Conservative treatment of low lumbar burst fracture is a viable option in neurologically intact patients, but loss of lordosis and vertebral height may persist. Biomechanical and anatomic characteristics of the low lumbar spine differ from the thoracolumbar region and may account for the inherent stability of these injuries. If surgery is chosen, a long fusion with distraction instrumentation should be avoided in the low lumbar spine. A short rigid fixation with pedicular instrumentation may be of greater benefit.

Adolescent↗
PubMed1991

Effects of therapy in X-linked hypophosphatemic rickets.

BACKGROUND: Patients with X-linked hypophosphatemic rickets, which is clinically manifested by growth failure and bowing of the legs, are usually treated with phosphate and a vitamin D preparation. However, the efficacy of this treatment has been disputed, and nephrocalcinosis is a recognized complication of therapy. METHODS: We studied 24 patients with X-linked hypophosphatemic rickets (9 boys and 15 girls) ranging in age from 1 to 16 years (median, 5.3). The duration of combination therapy ranged from 0.3 to 11.8 years (median, 3.0). We measured height as a standard-deviation (SD) score (the number of SDs from the mean height for chronologic age). Measurements made before the age of two years or after the onset of puberty were excluded. We compared the results with those reported in 1971 for 16 untreated prepubertal Australian patients. We also determined the severity of nephrocalcinosis (on a scale of 0 to 4, with 0 indicating no abnormalities and 4 stone formation) with renal ultrasonography and whether it could be related to the dosage of phosphate or vitamin D or to other factors. RESULTS: Patients treated for at least two years before the onset of puberty (n = 19) had a mean height SD score of -1.08, as compared with -2.05 in the untreated historical controls. The 13 patients who had been treated with calcitriol and phosphate for at least two years had an increase in the mean height SD score of 0.33, from -1.58 to -1.25 (95 percent confidence interval, 0 to 0.67; P = 0.05). Nineteen of the 24 patients (79 percent) had nephrocalcinosis detected on renal ultrasonography. The grade of nephrocalcinosis was significantly correlated with the mean phosphate dose (r = 0.60, P = 0.002), but not with the dose of vitamin D or the duration of therapy. All patients had normal serum creatinine concentrations. CONCLUSIONS: Therapy with calcitriol and phosphate may increase the growth of children with X-linked hypophosphatemic rickets. Nephrocalcinosis in these children represents a complication of therapy and is associated with the dose of phosphate received.

Body Height↗
PubMed1991

Women's perceptions of screening mammography.

A random sample of women in Sydney were interviewed by telephone to determine their knowledge about and attitudes to mammography. A response rate of 56 per cent (628 women) was obtained. While the majority of women had had some experience with breast cancer, knowledge about which age groups were most at risk and treatment alternatives was limited. Only about half of the sample had heard about screening mammography before the survey. However, when a simple explanation was given, 79 per cent expressed a favourable attitude toward it. Only 22 per cent of women thought of themselves as being personally susceptible to breast cancer; the proportion was lower in women over 60 than in those in their 40s. Morbid concern about breast cancer was rare. About a quarter of the sample expressed concern about mammographically induced exposure to radiation. Attitudes and perceptions of personal susceptibility were not associated with knowledge about risks of breast cancer. However, having a favourable attitude and a lack of concern about radiation were associated with previously having heard about screening mammography. Women speaking a language other than English at home and from households where the main income earner was in an unskilled occupation were least likely to have heard of screening mammography. Suggestions for data-based recruitment strategies are discussed.

Attitude to Health↗
PubMed1991

Effect of obesity on endogenous secretion of growth hormone in Turner's syndrome.

Nocturnal growth hormone secretion over a 12 hour period was assessed at 20 minute intervals in 25 prepubertal subjects with Turner's syndrome and 11 normal prepubertal girls of short stature to try and elucidate the relationship between body weight and endogenous secretion of growth hormone in Turner's syndrome. There were no differences in mean growth hormone concentration, age, height, or growth velocity between the two groups. There was an age related decline in mean growth hormone concentration in patient's with Turner's syndrome in contrast to the age related increase in controls. Mean percentage of ideal body weight was significantly higher in the Turner's syndrome group than among controls and it increased with age. There was a strong inverse relationship between mean growth hormone concentration and percentage of ideal body weight in those with Turner's syndrome. Covariate analysis of the multiple linear regression of mean growth hormone concentration on age and percentage of ideal body weight in Turner's syndrome indicated that percentage of ideal body weight had a significant effect on endogenous secretion of growth hormone when age was held constant, but not the other way round. We conclude that the age related decline in endogenous secretion of growth hormone in Turner's syndrome is partly the result of increasing body weight with age. The significant influences of biological variables such as age and body weight in the interpretation of measurements of endogenous secretion of growth hormone in Turner's syndrome should be emphasised.

Adolescent↗
PubMed1991

Ipsilateral radial head dislocation and radial shaft fracture. A case report.

Dislocation of the radial head in an adult is an uncommon injury. The mechanism of injury is considered to be due to hyperpronation of the forearm. Fracture-dislocations of the forearm are well described and involve both the radius and the ulna. A dislocation of the head of the radius with an ipsilateral fracture of the shaft of the radius seems not to have been reported; the mechanism of injury can only be postulated.

Adult↗
PubMed1990

The effect of a needle and syringe exchange on a methadone maintenance unit.

In November 1986, a pilot needle and syringe exchange was established in Sydney adjacent to a methadone maintenance unit. A retrospective study was carried out to determine the effect of increasing the availability of sterile needles and syringes on the treatment outcome of the methadone maintenance unit. In this study, an increase in availability of sterile needles and syringes was not found to be associated with an increase in the presence of illicit injectable drugs in the urine specimens of clients of the methadone programme compared to a control methadone unit where there was no known change in needle and syringe availability. This study suggests that an increase in the availability of sterile needles and syringes does not appear to lead to an increase in the frequency of intravenous drug use. The possibility of drug and alcohol treatment centres acting as needle and syringe exchange or distribution outlets therefore requires consideration.

Australia↗
PubMed1990

Posterolateral bone graft of the tibia.

A series of 30 high-energy tibial diaphyseal fractures in 30 patients were treated with posterolateral bone grafting (1984-1987). All of the fractures were open, a majority being Gustillo Type III with significant soft-tissue injury, comminution, or segmental bone loss. The common mechanisms of injury included motorcycle, pedestrian versus automobile, and motor vehicle accidents. Nineteen of 30 fractures were treated with a posterolateral bone graft within six months of the initial injury, and 11 of 30 were grafted after established nonunion. Union was obtained in 29 of 30 fractures (97%). Healing time from the time of grafting ranged from three to 12 months, with an average of 4.7 months. One patient had a below-knee amputation because of uncontrolled chronic osteomyelitis, drainage, and nonunion. Posterolateral bone grafts consistently produced rapid healing of delayed union as well as established nonunion.

Adult↗
PubMed1989

Encouraging attendance at screening mammography: knowledge, attitudes and intentions of general practitioners.

We surveyed a random sample of 200 general practitioners from the Sydney metropolitan area about their attitudes to and knowledge of screening mammography. General practitioners' knowledge about some aspects of screening mammography was found to be limited; only 25% of the sample knew that the risk of breast cancer increases with age and only 30% of the sample knew that the evidence for a reduction in mortality as a result of mammographic screening is weakest for women of less than 50 years of age. Ninety-five per cent of general practitioners were of the opinion that breast self-examination and clinical examination were important for asymptomatic women of more than 45 years of age compared with the 75% of respondents who viewed mammography in the same way. Scores on a scale that was constructed to measure attitudes to mammographic screening showed that 20% of general practitioners had a "very favourable" attitude, and that a further 67% of general practitioners had a "favourable" attitude. No general practitioners had a "very unfavourable" attitude. Eighty-four per cent of general practitioners indicated that they would recommend that their patients attend a free screening-mammography service. Willingness to recommend mammographic screening was predicted by a general practitioner's attitude score. The strongest component of this prediction was a belief that the benefits of screening mammography outweighed the radiation risks. General practitioners need to be supplied with correct information about target groups for screening, so that women in the appropriate age-groups are encouraged to attend screening programmes.

Age Factors↗
PubMed1989

Assessing agreement.

Explore the source record for details and available documents.

Analysis of Variance↗
PubMed1989

Primary dapsone chemoprophylaxis for Pneumocystis carinii pneumonia in immunocompromised patients infected with the human immunodeficiency virus.

During a 12-month period from August 1, 1986 to July 31, 1987, a study of primary chemoprophylaxis with dapsone for Pneumocystis carinii pneumonia was undertaken in immunodeficient patients who were infected with the human immunodeficiency virus. One attack of P. carinii pneumonia occurred among 16 patients who received chemoprophylaxis immediately that a T-helper (CD4) lymphocyte count of less than 0.2 x 10(9)/L was recorded compared with 16 attacks in the historical control group of 46 similar patients who did not receive chemoprophylaxis (log-rank test, chi 2(1) = 3.72; P = 0.05).

AIDS-Related Complex↗
PubMed1988

Renal transplantation: the non-starters.

Renal transplants do not always function immediately and this non-function may be related to poor long-term graft survival. The causes of this primary non-function (PNF) are poorly understood. The incidence of PNF in 106 consecutive renal transplants was found to be 57 per cent. Using stepwise logistic regression analysis of 20 prospectively collected variables for each transplant two have been found to be positively associated with PNF of the transplant: (1) the use of cyclosporin as an immunosuppressant and (2) a second warm ischaemia (anastomosis) time of more than 30 min. It is proposed that the use of cyclosporin be restricted in the early post-transplant period until initial function of the transplant is established. The surgical procedure of kidney transplantation should be planned to minimize the anastomosis time prior to recirculation of the graft.

Cyclosporins↗
PubMed1988

The effect of halofuginone on the excretion of Salmonella typhimurium by experimentally infected chickens.

The effect of feeding halofuginone at 3 and 6 ppm on the excretion of Salmonella typhimurium by experimentally infected chickens was studied. A standardized procedure was used involving the oral inoculation of 72-h-old specific pathogen-free chickens with 10(8) organisms of a nalidixic acid-resistant mutant of a strain of S. typhimurium. At weekly intervals, cloacal swabs were taken and a semi-quantitative assessment was made of the numbers of Salmonella organisms excreted. When compared with the control group of infected chickens fed unmedicated food, the group fed halofuginone at 3 ppm showed no significant increase in excretion rate. The group fed 6 ppm showed a slight increase in excretion which was statistically significant.

Animal Feed↗
PubMed1988

Recovery of cutaneous immune responsiveness after PUVA therapy.

We studied sensitization to dinitrochlorobenzene (DNCB) in psoriatic patients before, during and 2, 4, and 6 weeks after a course of photochemotherapy (PUVA). The inhibition of sensitivity observed during PUVA was completely reversed after 6 weeks. Thus the PUVA-mediated inhibition of cutaneous immune responsiveness is of short duration. However, whether there are long-term sequelae remains to be established.

Dinitrochlorobenzene↗
PubMed1988

Simple method of estimating severity of pulmonary fibrosis on a numerical scale.

A continuous numerical scale for determining the degree of fibrosis in lung specimens was devised for correlation with other pulmonary variables such as lung function tests or mineral burden. Grading was scored on a scale from 0 to 8, using the average of microscope field scores. The system allows fibrosis to be measured in small samples of tissue (1 cm) which can provide a detailed description of the changes in a lung, currently not possible with most existing methods.

Humans↗