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Biomedical subjects

J Whyte

Publications and source records attributed to J Whyte.

At least 91 records · Page 5Linked to original sources
PubMed1989

Sleep-related laryngeal obstruction presenting as snoring or sleep apnea.

The difference between snoring (with or without sleep apnea) and laryngeal stridor resulting from laryngeal dysfunction may not be readily apparent. Two cases of Shy-Drager syndrome and one undiagnosed case in which laryngeal dysfunction was exacerbated by sleep are reported. Such dysfunction might create life-threatening situations for which emergency tracheostomy should be considered. The importance of differentiating stridor from snoring is discussed.

Aged↗
PubMed1989

Evoked potential assessment: utility in prognosis of chronic head injury.

Brainstem auditory evoked potentials (BAEP) and somatosensory evoked potentials (SSEP) were performed on 29 patients an average of 12.4 months after traumatic brain injury (TBI). The study purpose was to predict long-term outcome in chronic TBI patients by using multimodality evoked potentials (MEP), the Rancho Los Amigos Scale (RLAS), and other clinical parameters. Neither the BAEP nor SSEP correlated significantly with the cognitive level on the RLAS at the MEP study approximately one year after TBI (RLAS1). Only 11.7% of RLAS1 could be predicted by the combined study of BAEP and SSEP. BAEP and SSEP obtained about one year after TBI jointly had a 15% predictive power of the long-term follow-up RLAS score obtained 18 months after performance of the MEP (RLAS2). Stepwise regression analysis showed that the best predictive indicator of the status of long-term outcome was RLAS1 which alone can predict 60% of long-term outcome. The predictive value of combinations of RLAS1 and age improved prediction of long-term outcome to 66.8%, and the combination of RLAS1, age, and SSEP further increased the value to 72%. Perhaps the MEPs were relatively insensitive in reflecting the patient's adaptation to fixed neuronal damage since patients can perform higher cognitive function by adaptation through behavioral modification and cognitive retraining despite little structural improvement. This adaptation would result in a discrepancy between MEP and RLAS scores in the late chronic phase.

Adolescent↗
PubMed1988

Teaching safe sex.

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Acquired Immunodeficiency Syndrome↗
PubMed1988

HIV testing.

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Acquired Immunodeficiency Syndrome↗
PubMed1986

Carbamazepine-erythromycin interaction. Case studies and clinical significance.

Because of significant and seemingly haphazard fluctuations in serum carbamazepine concentrations, we decided to investigate the possible link between erythromycin administration and potential changes in serum carbamazepine concentration. We studied four cases involving this combination. In every case, serum carbamazepine concentrations either rose dramatically (doubled or tripled previous steady-state concentrations) or dropped precipitously once erythromycin therapy was discontinued. In all cases, we report serum carbamazepine concentrations obtained before, during, and after concurrent erythromycin administration. We conclude that the combination of erythromycin and carbamazepine represents a clinically significant drug interaction and should be avoided where possible.

Adult↗
PubMed1986

Subcellular fractionation and distribution of cholinergic binding sites in fetal human brain.

Conventional subcellular fractionation techniques have been applied to human fetal brain (13-15 weeks gestation) and the fractions have been characterized by assaying for marker enzymes, cholinergic binding sites and electron microscopy. Fractionation of the homogenate resulted in a nuclear pellet (P1), a crude mitochondrial pellet (P2) and a supernatant (S2). Further resolution of the P2 fraction by density gradient centrifugation resulted in two bands at the gradient interfaces and a pellet. The P2 and subsequently the P2B fraction contained intact plasma membrane profiles as judged by the predominance of adenylate cyclase activity and the presence of occluded lactate dehydrogenase which constituted over 70% of the total activity in these fractions. Morphological examination of the gradient fractions revealed that the P2B fraction contains membrane bound structures which resemble synaptosomes prepared from neonatal rat brain. These structures have a granular matrix in which mitochondria and frequently, neurofilaments were observed. Very few synaptic vesicles were present and there was no evidence for post synaptic attachments. The cholinergic markers choline acetyltransferase, acetylcholinesterase and receptor sites defined by quinuclidinyl benzilate and alpha-bungarotoxin binding were enriched in fractions P2 and P2B which contained the bulk of nerve ending particles. This enriched preparation of fetal synaptosomes may be valuable for functional studies on pre-synaptic terminals in developing brain.

Brain↗
PubMed1985

Inspection time and intelligence in dyslexic children.

Dyslexics and normal readers aged 9-11 were compared on an inspection time task. Results indicated that dyslexics required significantly longer inspection times. The findings suggested, however, that there was greater individual variation among dyslexics than among normal readers and that the dyslexics benefited from practice to a considerable extent. Inspection times were not significantly related to IQ as measured by a non-verbal test.

Attention↗
PubMed1981

Prediction of the severity of ABO haemolytic disease of the newborn by cord blood tests.

Seventy-one ABO incompatible (heterospecific) infants and 71 controls, who were free from other potential causes of jaundice, were studied to ascertain which cord blood tests reliably predict the severity of ABO haemolytic disease of the newborn (ABO HDN). The modified Direct Antiglobulin Test (spin DAGT) was positive in all infants who required treatment for haemolytic jaundice and only DAGT positive children showed evidence of impending haemolytic anaemia or compensated haemolysis in cord or capillary blood. Cord serum bilirubin concentration had some predictive value, particularly when the level exceeded 85 mumol/l, but it was a less reliable indicator and had greater value if used in association with the DAGT. The elution test, which is frequently used as a diagnostic tool in ABO HDN, had no predictive value and we felt that its putative value is due to overdiagnosis of ABO HDN in jaundiced heterospecific infants. We conclude that the spin DAGT, despite the weakness of the reaction, reliably identifies infants at risk from severe ABO HDN and is sufficiently sensitive to be used as a single screening test for the early detection of the disorder.

ABO Blood-Group System↗
PubMed1977

Drug usage and adverse drug reactions in paediatric patients.

The development of epidemiological methods for the study of adverse drug reactions is reviewed in connection with the presentation of data obtained by intensive monitoring of 1 000 admissions to a medical paediatric unit. Compared with adults and American children, the patients received fewer drugs and experienced fewer reactions while in hospital. The drug usage pattern was different from that of American paediatric practice and general practice in the United Kingdom. Fifty-one (6%) patients experienced 119 adverse drug reactions. These occurred more frequently in children suffering from serious disorders and in the majority of cases the basic therapy was continued regardless of the severity of the drug side-effects. Treatment was required for the effects of 66 (55%) adverse reactions. It appears that drug monitoring in paediatric practice may be of greater value if surveillance programmes are designed to provide a "therapeutic audit" and extended to include children receiving drugs in the community.

Child↗
PubMed1976

Pattern and quality of recording pre-admission drug treatment in paediatric patients.

The pattern and quality of recording drug use before admission was examined in children admitted to a paediatric unit over eight months. The preadmission drug intake (1-7 drugs/patient) was lower than that of adults. Antibiotics were the most frequently prescribed drugs, but mild analgesics and antihistamine preparations were commonly used, often without medical advice. The simultaneous administration of prescribed and non-prescribed drugs appeared to be as common in children as in adults. The number of drugs taken was related to the number of domicilary consultation received and the number of doctors seen as as to confirm that most doctors' visits result in the prescription of medicine. The transfer and recording of drug information was poor, owing principally to lack of communication between doctors and failure to detect self-medication, but the modern practices of self-referral to hospital and use of multiple prescribers have further reduced the information available. The use of a "current treatment card" is required if the full significance of iatrogenic disease in childhood is to be investigated.

Adolescent↗
PubMedDate not supplied

The sexual behaviors of African American women living with HIV disease: is perceived HIV status altering sexual behavior?

The purpose of the study was to compare the sexual risk behaviors of heterosexual African American women living with HIV disease to women who perceive themselves to be HIV negative using a comparative descriptive design. Data were collected using a demographics questionnaire developed by the investigator and the Safe Sex Behavior Questionnaire (SSBQ). The HIV-positive sample was collected in two public service agencies that provide case management for HIV-positive individuals. The HIV-negative sample was collected in the surrounding community, populated primarily by low-income African Americans. The HIV-positive group demonstrated lower levels of income and education. Scores on the SSBQ indicated no statistical difference between the high-risk sexual behaviors of the HIV-positive and HIV-negative groups. No statistically significant difference was found in the reported past sexual experiences of the two groups, although mean SSBQ scores were higher in the HIV-positive group. The levels of sexual behaviors in both groups were consistent with the high-risk sexual behaviors of HIV-negative persons reported in the literature. This illustrates the need for nursing as a profession to improve programs directed toward altering the behaviors of those at high risk of contracting or transmitting HIV disease.

Adult↗
PubMedDate not supplied

Toward a methodology for rehabilitation research.

The field of rehabilitation is becoming increasingly important as the American population ages, seriously ill and injured individuals survive with impairments, and quality of life assumes greater importance in health outcomes assessment. Like other branches of health care, progress in rehabilitation depends on advances in research. However, the rehabilitation process is different from some other facets of health care in that it focuses simultaneously on health outcomes that range from cellular to social. This fundamental difference affects the research methodologies that are appropriate to the field. The strengths and limitations of existing research methods need to be taken into consideration and novel strategies developed to handle the complexity inherent in rehabilitation practice.

Clinical Protocols↗
PubMedDate not supplied

Modeling case mix adjustment of stroke rehabilitation outcomes.

Case mix adjustment models for long-term stroke rehabilitation outcomes should be developed (1) to facilitate equitable comparisons of outcomes across treatment settings, thereby reducing disincentives for treating complex cases, (2) to improve triage into the most appropriate level of rehabilitative care after discharge from acute care, and (3) to confirm that case mix factors are equated in treatment effectiveness studies and by random assignment across conditions in clinical trials. Case mix adjustment is necessary for valid quality improvement processes. A conceptual model of case mix adjustment of long-term rehabilitation outcomes is presented that (1) is diagnosis-specific, (2) includes demographic variables as important case mix factors, (3) encompasses triage into rehabilitation as well as treatment processes as aspects of quality of rehabilitative care, (4) contains outcomes measuring functional status as well as mortality and morbidity, and (5) keys timing of outcomes to onset of conditions requiring rehabilitation rather than discharge from rehabilitation. The number of potential interactions among case mix indicators requires a sophisticated analytic framework. Random factors in the model illustrate that case mix adjustment can never be perfect. Nevertheless, it is essential. A brief review of the stroke literature on prediction of long-term outcomes suggests that additional work is needed to specify relevant case mix indicators.

Activities of Daily Living↗