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Biomedical subjects

Julie Ward

Publications and source records attributed to Julie Ward.

5 recordsLinked to original sources
PubMed2005

Globus pallidus volume is related to symptom severity in neuroleptic naive patients with schizophrenia.

This study compares globus pallidus (GP) volume between neuroleptic naive patients with schizophrenia and healthy controls using structural MRI. The volume of the external segment of the GP (GPe) was positively correlated with the severity of global symptoms, as measured by the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms (SANS/SAPS, Andreasen and Olsen, 1982). The volume for the GP, GPe, and internal segment (GPi) did not differ between groups.

Adult↗
PubMed2005

Thoracic epidural versus intercostal nerve catheter plus patient-controlled analgesia: a randomized study.

BACKGROUND: Pain control is an important issue after thoracotomy. Ideal methods should have a high success rate, with easy implementation and minimal complications. Debate exists over the optimal pain control method. This randomized trial was designed to compare epidural (EPI) and intercostal nerve catheter with patient-controlled analgesia (ICN-PCA) for pain control after thoracotomy. METHODS: The study included 124 randomized patients; 91 had sufficient data for analysis (44 EPI, 47 ICN-PCA). The primary endpoint was pain measurement using a composite of a visual analogue scale, numerical rating, and categorical rating. A second endpoint was the success rate of each method. Pulmonary function tests, antibiotics, intensive care unit (ICU), and hospital days, and use of nonprotocol pain medications were also compared. RESULTS: There were 12 pain observations per patient (90% completed on days 1 to 5). The pain composite revealed an average postoperative pain score of 2.4 on a scale from 0 (no pain) to 10 (worst pain). There was no difference between the groups. Failures of the planned method of analgesia included 9 in the EPI group and 4 in the ICN group (p = 0.23). Another 20 patients were excluded (no difference between groups) due to unsuspected mediastinal metastases precluding thoracotomy (n = 13), and other miscellaneous factors precluding follow-up (n = 7). The EPI group had an increased number of urinary catheter days (2.5 days vs 1.7, p = 0.002) and increased narcotic supplements (p = 0.03) compared with ICN. Mean ICU days (0.9) and hospital days (6.2) were similar for both groups, and there were no differences in arrhythmias, pneumonias, transfusions, and antibiotic use. Significant differences were seen (p = 0.001) between preoperative and postoperative pulmonary function tests in both groups. However, there were no differences in pulmonary function when the groups were compared with each other. CONCLUSIONS: Satisfactory pain control was achieved after thoracotomy using either EPI or ICN-PCA. The ICN-PCA achieved equivalent pain control compared with EPI, and was placed by the surgeon with no delays in surgery, and demonstrated a decreased requirement for Foley catheter duration.

Adult↗
PubMed2002

Body fatness, insulin sensitivity and muscle oxygen supply in adolescents.

Muscle blood flow can be reduced in insulin-resistant states. The present study examined the importance of body fatness and insulin sensitivity as variables that may be associated with muscle oxygen supply. We studied 38 adolescents (22 males, 16 females; age 15.3-18.6 years; body mass index 17.7-34.7 kg/m(2)) and used near-IR spectroscopy to measure the muscle re-oxygenation rate after ischaemic finger flexion exercise. Total body fat content was estimated by bioelectrical impedance analysis, and insulin sensitivity was assessed by homoeostasis model assessment. Regional lipid compartments were also assessed for potential associations with muscle oxygen supply. Abdominal adiposity (visceral and subcutaneous) was assessed by magnetic resonance imaging, and soleus intramyocellular lipid levels were determined by magnetic resonance spectroscopy. Total body fat content ( r =0.67, P <0.001), abdominal subcutaneous fat area ( r =0.78, P <0.001), abdominal visceral fat area ( r =0.54, P <0.001) and intramyocellular lipid levels ( r =0.68, P <0.001) were significantly related to forearm re-oxygenation half-time. After adjusting for insulin sensitivity, both total body fat content ( r =0.395, P =0.02) and abdominal subcutaneous fat area ( r =0.543, P =0.001) remained positively associated with relatively reduced muscle oxygen supply in adolescent subjects. After adjusting for body fat content, abdominal subcutaneous fat area ( r =0. 511, P =0.002) was significantly associated with muscle oxygen supply. Thus muscle oxygen supply is associated with body fat content, and certain fat compartments may be more influential than others.

Abdomen↗
PubMed2002

Fetal nutrition and muscle oxygen supply in childhood.

Fetal undernutrition may increase the risk of insulin resistance syndrome in adult life and low birth weight carries with it the risk of endothelial dysfunction. We studied 59 prepubertal and adolescent children whose birth weight exceeded 2.5 kg. We related their birth weight and ponderal index (PI) (weight/length(3)) at birth to muscle oxygen supply (assessed by near infrared spectroscopy [NIRS]) and to variables associated with increased risk of developing the insulin resistance syndrome (ie, abdominal subcutaneous and visceral fat volumes, percentage body fat, fasting leptin, insulin, and glucose levels). Birth weight was not associated with muscle oxygen supply or any other independent variable measured. In the prepubertal group, there was a significant inverse relation between PI and muscle reoxygenation half-time in both the male (R =.58, P =.03) and female (R =.72, P =.009) groups. This relationship was not present in either the male (R =.03, P =.90) or female (R =.09, P =.75) adolescent groups. In a population in which low birth weight subjects were excluded, low PI at birth is associated with poor muscle oxygen supply in early childhood, but this relationship is not present in adolescence.

Adolescent↗