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Biomedical subjects

L E Jones

Publications and source records attributed to L E Jones.

At least 19 recordsLinked to original sources
PubMed2002

Management of the multiple limb amputee.

ISSUE: Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. METHOD: A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. CONCLUSION: Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation.

Adult↗
PubMed2002

Inter-observer reliability of clinical outcome measures in a lower limb amputee population.

PURPOSE: In an attempt to find a more clinically useful functional outcome measure specifically tailored for lower limb amputees undergoing inpatient prosthetic rehabilitation, a 6-month prospective assessment of inter-rater reliability for Harold Wood-Stanmore Mobility Scale Data, including two handicap scales, was undertaken. An analysis of the data is presented in this paper. METHODS: An inter-rater reliability study was undertaken using four observers to complete admission and discharge scores for the three disability/handicap scales on 14 consecutive patients over 6 months. RESULTS: The disability mobility scale demonstrated perfect observer agreement on admission and at discharge the inter-rater reliability for this measure was high (0.83). By contrast, reliability between observers for admission scores on the handicap mobility scale was poor at 0.49 but reasonably high on discharge (0.83). On admission, inter-rater reliability for handicap physical independence was very low (0.15). At discharge, reliability improved to 0.69 being more consistent with results achieved for the other axes. CONCLUSIONS: This study confirms the good inter-rater reliability demonstrated previously in the literature but reveals poor inter-rater reliability for the two handicap scales. The latter will require modification before they can be used with confidence in conjunction with the disability scale.

Adult↗
PubMed1999

Save that arm: a study of problems in the remaining arm of unilateral upper limb amputees.

A study has been made by questionnaire, personal examination and telephone interview of unilateral upper limb amputees seen at the Prince Henry Hospital, Australia between 1994 and 1997. There were 60 questionnaires posted. Replies were received from 46. Problems were noted in the remaining arm of 23 (50%). The respondents' problems not only consisted of overuse symptoms, but also of an exacerbation of pre-existing arthritis and injury due to trauma to the remaining arm during the accident. Case histories are given in 3 typical cases. Treating professionals are warned about the hazards that one arm amputations present to the remaining arm.

Activities of Daily Living↗
PubMed1997

Allegations of sexual misconduct: a risk management perspective.

Increasingly, patients are making complaints to state licensing boards and filing lawsuits against healthcare providers alleging sexual misconduct. This article addresses the risk management implications of patient allegations of sexual misconduct involving inappropriate touching by healthcare providers during an examination or treatment. From a risk management standpoint, techniques can be implemented before and after these incidents that can help reduce the facility's exposure.

Female↗
PubMed1996

Painful neuromata following upper limb amputation.

Painful neuromata occurring after upper limb amputation are a significant cause of stump pain and limit the success of prosthetic training and use. There is little information in the literature regarding incidence, consequences or outcomes of painful neuromata subsequent to upper limb amputation. This article reports an analysis of thirty-two consecutive upper limb amputees. Of these 25% had moderate-to-severe stump pain and clinical signs suggestive of neuromata. All patients with neuromata were limited in their ability to use a prosthesis prior to surgery and following failure of conservative measures, were referred for surgical opinion. Six patients have undergone surgical management. The results of surgery, with respect to pain and prosthetic usage, are discussed.

Adolescent↗
PubMed1992

Screening of nonfilamentous bacteria for production of cutin-degrading enzymes.

Two hundred thirty-two nonfilamentous bacterial strains, including saprophytes, plant pathogens, and opportunistic plant and human pathogens, were screened for the ability to produce cutinases (cutin-degrading esterases). Initially, esterase activity of culture filtrates of strains grown in nutrient broth-yeast extract medium supplemented with 0.4% apple or tomato cutin was determined by a spectrophotometric assay utilizing the model substrate p-nitrophenyl butyrate. The culture filtrates of the 10 Pseudomonas aeruginosa strains tested exhibited the highest esterase activity, with values of >500 nmol/min/ml. Of these 10 strains, 3 (K799, 1499A, and DAR41352) demonstrated significant induction (10-fold or above) of esterase activity by addition of cutin to nutrient broth-yeast extract medium. The ability of culture filtrates of the three strains to cause release of apple cutin monomers was confirmed by a novel high-performance liquid chromatography technique. Monomer identification was confirmed by gas chromatography-mass spectroscopy analyses. Addition of the nonionic detergent n-octylglucoside stimulated cutinase activity of culture filtrates from strains K799 and DAR41352, but not that of filtrates from strain 1499A. Time course studies in nutrient broth-yeast extract medium supplemented with apple cutin indicated maximal levels of cutinase in the culture fluids after cultures entered stationary phase. Incubation temperatures below the optimal temperature for growth (37 degrees C) led to maximal production of cutinase.

Journal Article↗
PubMed1991

The care of the limb deficient child in Australia.

The incidence of limb deficiency is given as is the prevalence of prosthetic use in Australia. The organisation of clinics and the Free Limb Scheme is described and its effects discussed.

Artificial Limbs↗
PubMed1989

Compact negatively curved manifolds (of dim [unk] 3,4) are topologically rigid.

Let M be a complete (connected) Riemannian manifold having finite volume and whose sectional curvatures lie in the interval [c(1), c(2)] with -infinity < c(1)[unk]c(2) < 0. Then any proper homotopy equivalence h:N --> M from a topological manifold N is properly homotopic to a homeomorphism, provided the dimension of M is >5. In particular, if M and N are both compact (connected) negatively curved Riemannian manifolds with isomorphic fundamental groups, then M and N are homeomorphic provided dim M [unk] 3 and 4. {If both are locally symmetric, this is a consequence of Mostow's rigidity theorem [Mostow, G. D. (1967) Publ. Inst. Haut. Etud. Sci. 34, 53-104].} When M has infinite volume we can still calculate the surgery L-groups of pi(1)M, even when dim M = 3, 4, or 5, provided M is locally symmetric. An identification of the weak homotopy type of the homeomorphism group of (finite volume) M is also made through a stable range. We have previously announced these results for the special case that c(1) = c(2) = -1.

Journal Article↗
PubMed1989

Prosthetic limb use in Australia 1981-1985 under the Free Limb Scheme.

A study has been made of data on 19,421 prosthetic limbs prescribed for 12,143 Australians under the Free Limb Scheme in the years 1981-1985. These prostheses consisted of 18,119 legs and 1,302 arms. The mean age of the lower limb prosthesis user was 52.8 and the upper limb prosthesis user 31.3 years. Males outnumbered females by 3 to 1 in the upper limb prosthesis users, and 2.8 to 1 with lower limb prosthesis users. Below-knee prostheses, patellar-tendon-bearing and thigh-lacing prostheses, made up 58.7% of all prostheses prescribed in the time span. Below-elbow prostheses were the commonest upper limb prostheses with children being the most frequent users. Comparisons with other studies of large number of prosthesis users show an older mean age in Australia and more below-knee prosthesis users than in American studies.

Adolescent↗
PubMed1988

The Free Limb Scheme and the limb-deficient child in Australia.

A review was undertaken of computerized data on 547 children aged 0-14 years, treated under the Free Limb Scheme in Australia in the years 1981-85, and of children in New South Wales, Queensland and South Australia having major amputations in some of these years. The male/female ratio was 1.8:1. There were 171 children with upper limb deficits and 376 children with lower limb deficits. The distribution of the limb deficits of the children treated under the free limb scheme is shown. The ratio of congenital:acquired limb deficiency is known for New South Wales and was 3.7:1. The prevalence of prosthetic use in Australian children is 14.8/100,000 children.

Adolescent↗
PubMed1987

Algebraic K-theory of discrete subgroups of Lie groups.

Let G be a Lie group (with finitely many connected components) and Gamma be a discrete, cocompact, torsion-free subgroup of G. We rationally calculate the algebraic K-theory of the integral group ring ZGamma in terms of the homology of Gamma with trivial rational coefficients.

Journal Article↗
PubMed1986

Algebraic K-theory of spaces stratified fibered over hyperbolic orbifolds.

Among other results, we rationally calculate the algebraic K-theory of any discrete cocompact subgroup of a Lie group G, where G is either O(n, 1), U(n, 1), Sp(n, 1), or F(4), in terms of the homology of the double coset space Gamma\G/K, where K is a maximal cocompact subgroup of G. We obtain the formula K(n)(ZGamma) [unk] [unk] congruent with [unk](i=0) (infinity)H(i)(Gamma\G/K; [unk](n-i)), where [unk](j) is a stratified system of Q vector spaces over Gamma\G/K and the vector space [unk](j)(GammagK) corresponding to the double coset GammagK is isomorphic to K(J)(Z(Gamma [unk] gKg(-1))) [unk] Q. Note Gamma [unk] gKg(-1) is a finite subgroup of Gamma. Earlier, a similar formula for discrete cocompact subgroups Gamma of the group of rigid motions of Euclidean space was conjectured by F. T. Farrell and W. C. Hsiang and proven by F. Quinn.

Journal Article↗
PubMed1983

Effect of rate and time of gain after weaning on the development of replacement beef heifers.

Three experiments were conducted during three consecutive years to compare rate and time of gain of weaned heifer calves on growth, reproductive development and future calf production. Three groups of Angus X Hereford heifers were fed in one of the following regimens from 45 d after weaning until breeding: (1) no gain the first one-half of the development period followed by .91 kg x head-1 x d-1 gain the last one-half; (2) .45 kg x head-1 x d-1 gain the entire trial and (3) .91 kg x head-1 x d-1 the first one-half of the development period and no gain the last one-half. The same diet was fed to all heifers, but the intake was varied to meet weight gain requirements. Wither height and heart girth increased (P less than .05) during the periods the heifers were fed to gain weight. By the end of the feeding trials, there were not differences (P greater than .05) in any of the growth measures. There were no differences (P greater than .05) in age at puberty, conception rate or calf production the following year. Adequate growth and development of replacement heifers is necessary, but much latitude exists in the rate and time of growth between weaning and breeding.

Animals↗