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Biomedical subjects

L Harding

Publications and source records attributed to L Harding.

At least 19 recordsLinked to original sources
PubMed2001

A controlled study of children born at gestation 28 weeks or less: psychological characteristics at seven to ten years of age.

Forty seven children aged between seven and ten years who were born at 28 weeks gestation or less were followed up and assessed using psychometric tests, questionnaires and a parental interview. Birth and post-birth medical details were also collected. A control group of 47 normal gestation/birth weight children, matched with the children in the low gestation (LG) cohort on nine other criteria, were assessed using the same procedures. Children in the LG cohort were of average intelligence and attainment, but differed from the control group in that they had significantly lower scores on the WISC-R (VIQ, PIQ and FSIQ, Freedom from Distractibility), information processing, visual motor memory, speech and auditory discrimination, mathematics, spelling and restlessness. Handedness was related to birth weight. In addition to birth weight, centile score (weight in relation to gestation) was found to predict later FSIQ, VIQ and reading, spelling and mathematics. Neurological factors such as the absence of suspected intracranial haemorrhage or seizures were predictors of PIQ and Freedom from Distractibility, respectively. Although children in the LG cohort scored significantly lower than control children on various cognitive tests, only two had Full Scale IQs below 70 and most functioned at least at the normal range of intelligence.

Achievement↗
PubMed1999

Cause, prevalence, and response to occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants.

BACKGROUND AND PURPOSE: Physical therapists (PTs) and physical therapist assistants (PTAs) are susceptible to occupational musculoskeletal injuries. The purpose of this study was to examine the reported causes and prevalence of occupational musculoskeletal injuries to PTs and PTAs during a 2-year period. SUBJECTS: A questionnaire was mailed to 500 PTs and 500 PTAs randomly selected from the American Physical Therapy Association 1996 active membership list. Six hundred sixty-seven questionnaires were returned, giving a response rate of 67%. METHOD: Based on a literature review and a pilot study, an occupational injury questionnaire was constructed and mailed. Self-reports of injuries were obtained. RESULTS: Thirty-two percent of the PTs and 35% of the PTAs reported sustaining a musculoskeletal injury. The highest prevalence of injury was to the low back (62% of injured PTs and 56% of injured PTAs). The PTs reported the upper back and the wrist and hand as having the second highest prevalence (23%). The PTAs reported the upper back as having the second highest prevalence (28%). The PTs and PTAs reported making changes in their work habits of improved body mechanics, increased use of other personnel, and frequent change of work position. The majority of PTs and PTAs reported they did not limit patient contact time or area of practice after sustaining an injury. CONCLUSION AND DISCUSSION: Although PTs and PTAs are recognized to be knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.

Adult↗
PubMed1999

Management options and survival in malignant melanoma of the sinonasal mucosa.

OBJECTIVES/METHODS: To determine whether surgery combined with radiotherapy confers any survival benefit on radical local excision alone in the management of mucosal malignant melanoma of the nose and sinuses. STUDY DESIGN: Retrospective review. METHODS: From a cohort of 72 patients treated between 1963 and 1996 within a single unit, complete data were available for 58 individuals who were examined to determine whether there was any significant statistical difference in local control and/or survival between those receiving surgery and those receiving combined surgery and radiotherapy. RESULTS: There were 30 men and 28 women. Their ages ranged from 39 to 90 years (mean, 64 y). Twenty-nine patients underwent surgery alone; 23 patients underwent surgery and radiotherapy; 6 patients received surgery and chemotherapy; and 3 patients received surgery, chemotherapy, and radiotherapy. Primary surgery included lateral rhinotomy (42 cases), maxillectomy (8 cases [orbital clearance in 3 cases]), craniofacial resection (3 cases), total rhinectomy (3 cases), and endoscopic clearance (2 cases). Survival ranged from 1 to 228 months with rapid patient loss due to local (and/or systemic) disease during the first 36 months, irrespective of the treatment modality. Overall 5-year actuarial survival was 28%, and overall 10-year actuarial survival 20%, with a median survival of 21 months. There was no statistical difference in local control or survival between patients receiving surgery alone and those receiving surgery and radiotherapy, irrespective of whether this treatment was given in the early part of the series (i.e., before 1983) or thereafter. The addition of chemotherapy had no impact on survival, nor did the site of the tumor, the surgical procedure, the presence of lymph node metastases or the age of the patient. CONCLUSION: In this large cohort of sinonasal melanoma, overall survival was poor and did not appear to be improved by the addition of radiotherapy.

Adult↗
PubMed1999

HL7 document patient record architecture: an XML document architecture based on a shared information model.

The HL7 SGML/XML Special Interest Group is developing the HL7 Document Patient Record Architecture. This draft proposal strives to create a common data architecture for the interoperability of healthcare documents. Key components are that it is under the umbrella of HL7 standards, it is specified in Extensible Markup Language, the semantics are drawn from the HL7 Reference Information Model, and the document specifications form an architecture that, in aggregate, define the semantics and structural constraints necessary for the exchange of clinical documents. The proposal is a work in progress and has not yet been submitted to HL7's formal balloting process.

Humans↗
PubMed1998

Assessing occupational stress in psychiatric nurses using the full job strain model: the value of social support to nurses.

The present research examined the effects of occupational stress in psychiatric nursing on employee well-being using the full Job Strain Model. The Job Strain Model was assessed for its ability to predict employee well-being in terms of job satisfaction and mental health. The original Job Strain Model was expanded to include social support based on previous research concerning the impact of social support on well-being. In the present study, both work support and non-work were assessed for their contribution to well-being. The results of this study indicate that the full Job Strain Model can be used to significantly predict job satisfaction and mental health in this sample of Australian psychiatric nurses. Furthermore, social support was shown to be an important component of the Job Strain Model.

Adult↗
PubMed1997

Inhibition of neuronal high voltage-activated calcium channels by insect peptides: a comparison with the actions of omega-conotoxin GVIA.

The whole cell variant of the patch clamp technique was used to investigate the actions of two novel insect peptides on high voltage-activated Ca2+ currents in cultured dorsal root ganglion (DRG) neurones. The insect peptides (PMP-D2 and PMP-C) were isolated originally from insect brains and fat bodies, and have been found to have similar three-dimensional structures to the N-type Ca2+ channel inhibitor omega-conotoxin GVIA (omega-CgTx GVIA). High voltage-activated Ca2+ currents were activated from a holding potential of -90 mV by depolarizing step commands to 0 mV. Extracellular application of synthetic PMP-D2 or PMP-C (1 microM) attenuated high voltage-activated Ca2+ currents. The effects of PMP-C were strongly dependent on the frequency of current activation, but inhibition was apparent and reached a steady state after 20 steps when currents were evoked for 30 msec at 0.1 Hz. The actions of the two insect peptides overlapped both with each other and with omega-CgTx GVIA, suggesting that N-type Ca2+ current was predominantly sensitive to these peptides. Low voltage-activated T-type current and 1,4-dihydropyridine sensitive L-type Ca2+ currents were insensitive to 1 microM PMP-D2 and PMP-C, which indicates a degree of selectivity. The presence of a fucose group on PMP-C abolished the ability of this peptide to attenuate high voltage-activated Ca2+ currents, which may reflect a mechanism by which peptide function could be regulated in insects. The electrophysiological data are supported by studies on 45Ca2+ influx into rat cerebrocortical synaptosomes. Both PMP-D2 (10 microM), PMP-C (10 microM) and omega-CgTx GVIA (1 microM) attenuated a proportion of 45Ca2+ influx into the synaptosomes, but additive effects of these peptides were not observed. We conclude that these naturally occurring peptides obtained from invertebrate preparations have inhibitory effects on N-type Ca2+ channels. Although the peptides have related three-dimensional structures, they have distinct amino acid sequences and appear to have different mechanisms of action to produce inhibition of mammalian neuronal high voltage-activated Ca2+ channels.

Amino Acid Sequence↗
PubMed1996

Stimulation of prostaglandin E2 synthesis by interleukin-1beta is amplified by interferons but inhibited by interleukin-4 in human amnion-derived WISH cells.

Human amnion-derived WISH cells synthesize little prostaglandin E2 at the basal state. However, the cells were stimulated greatly to synthesize prostaglandin E2 by interleukin-1beta in a dose-dependent manner. Stimulation by interleukin-1beta was synergistically increased by pretreatment of the cells with interferon alpha or gamma, which alone were inactive. Synergism by interferons was dose-dependent. Stimulation by interleukin-1beta, on the contrary, was inhibited by preincubation of the cells with interleukin-4. Inhibition by interleukin-4 was also dose-dependent. Regulation of prostaglandin E2 synthesis by cytokines was further examined at the m-RNA level of cyclooxygenase-2. Quantitative reverse transcription-polymerase chain reaction indicated that the m-RNA level was not increased by interferon-gamma but was synergistically increased by interferon-gamma plus interleukin-1beta. Furthermore, the m-RNA level increased by interleukin-1beta was attenuated by interleukin-4. These results indicate that regulation of interleukin-1beta-stimulated prostaglandin E2 synthesis by interferons and interleukin-4 is controlled at the m-RNA level of cyclooxygenase-2.

Amnion↗
PubMed1996

Drug history taking and the identification of drug related problems in an accident and emergency department.

OBJECTIVE: To determine the incidence of drug related problems that fail to be noted on casualty cards in patients subsequently admitted, and to compare medication histories as recorded by accident and emergency (A&E) senior house officers (SHOs) and a pharmacist. METHODS: An initial retrospective survey of 1459 acute inpatient admissions through A&E over a three month period was followed by a prospective study of 33 elderly patients. RESULTS: In the retrospective survey, 52 medication related problems were confirmed after examination of the medical records, of which only 16 were identified in A&E. In the prospective study, 125 currently prescribed items were identified by the pharmacist compared to 77 by A&E SHOs; 66% of the missed information was clinically relevant. Of 17 previous adverse drug reactions identified by the pharmacist only six were also recorded by the A&E officer. Only four over the counter medicines were identified by the A&E SHOs compared to 30 by the pharmacist. CONCLUSIONS: More accurate recording of drug history on casualty cards should be undertaken, particularly in respect of over the counter medication and the identification of drug related problems.

Accidents↗
PubMed1995

Management of retraction pockets of the pars tensa in children by excision and ventilation tube insertion.

Retraction pockets of the pars tensa in children can result in erosion of the ossicles leading to hearing loss and eventually cholesteatoma formation. Several different types of treatment for the more severe grades of retraction pocket have been described. The aim of this pilot study was to assess the outcome following simple excision and ventilation tube insertion of grade II, III and IV retraction pockets of the pars tensa. The eardrums were graded according to Sadé's classification (1979). There were seven grade II and four grade III retractions. Ten eardrums healed completely in a mean time of 3.6 months (mean follow-up 16 months) and there was one residual perforation. Two retractions recurred and both of these were only grade I. Clinically, an improvement in hearing was reported in seven children (eight ears) and the average air conduction threshold gain for these patients was 16 dB. A larger prospective study is currently underway.

Auditory Threshold↗
PubMed1983

Chloramphenicol pharmacokinetics in the newborn.

We studied pharmacokinetics of chloramphenicol in 9 neonates having a mean gestational age of 31.2 +/- 1.9 weeks (mean +/- SEM). The studied dose was the final dose of treatment in 8 of these and the first dose in 2 of these. 1 neonate was studied twice. Concentrations of chloramphenicol and its 3-monosuccinate and 1-monosuccinate esters were measured in serum by high performance liquid chromatography. Apparent total body clearance of chloramphenicol correlated with postnatal age (r = 0.81, p less than 0.01). Mean apparent clearance was 1.1 ml X min-1 X kg-1. Serum concentrations of succinate esters were below assay sensitivity after 6 h postdose. Factors leading to excessive chloramphenicol concentrations (greater than 25.0 mg/l) were evaluated in another 44 newborns. Instability of the patient's clinical condition was an important cause of excessive serum concentrations during ongoing therapy.

Age Factors↗
PubMed1980

Bacteriology of sputum in cystic fibrosis: evaluation of dithiothreitol as a mucolytic agent.

Liquefaction and homogenization have been recommended to ensure accurate, representative sputum cultures. We evaluated dithiothreitol (DTT) as mucolytic agent for culturing sputum samples obtained from 79 cystic fibrosis (CF) patients. Liquefaction with DTT was not superior to direct plating of specimens for routine qualitative cultures. Unliquefied sputum cultures failed to direct 3 of 47 Pseudomonas aeruginosa isolates; DTT-treated specimens missed 5 of 13 Candida albicans isolates. Neither treated nor untreated sputum cultures were completely successful in detecting Staphylococcus aureus or Enterobacteriaceae. Since Haemophilus influenzae was recovered from only two qualitative cultures, we could not evaluate the effect of DTT on the receovery of this organism. However, 27 of 29 strains of H. influenzae were inhibited by concentrations of DTT near the recommended final working concentration of 50 micrograms/ml, suggesting that liquefaction might impair isolation of this organism. Liquefaction with DTT permitted quantitative cultures of CF sputum. The predominant pathogen in our CF population was P. aeruginosa; 37 of 43 (86%) patients were colonized with this organism. Median densities of rough and mucoid strains were 3.2 x 10(7) and 4.3 x 10(7) colony-forming units per ml, respectively. Previous oral antistaphylococcal therapy may have accounted for the observed low density of S. aureus (mean density, 3.5 x 10(3) colony-forming units per ml). We conclude that DTT treatment does not improve recovery of organisms from qualitative cultures but does facilitate quantitative studies of S. aureus and P. aeruginosa in CF sputum.

Candida albicans↗
PubMed1977

Hotel nurse.

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London↗