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Biomedical subjects

M Le May

Publications and source records attributed to M Le May.

15 recordsLinked to original sources
PubMed1998

Three into one will go! Collaborative practice in practice.

This paper is concerned with three speech and language therapy services from neighbouring NHS trusts and the single education authority they all share. The authors have always been committed to working collaboratively with local services but found the competitive health care environment of the late 1980s and early 1990s often-made this difficult. It describes how the three services came together to identify common service issues for children of school-age with speech and language difficulties and how these were addressed.

Age Factors↗
PubMed1998

What is the outcome of the outcomes? Evaluation of the therapy outcome measures.

In 1996, the Speech and Language Therapy Departments of First Community Health NHS Trust and Kidderminster Care NHS Trusts agreed to take part in a year's pilot study of the Therapy Outcome Measures developed by Enderby and John (1997). This paper will discuss the rationale for choosing to pilot these outcome measures and discuss the implementation of the project from a service manager's perspective. The discussion will focus upon what has been learnt from piloting the Therapy Outcome Measures.

Evaluation Studies as Topic↗
PubMed1994

Effects of monotherapy with an HMG-CoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography. The Canadian Coronary Atherosclerosis Intervention Trial.

BACKGROUND: 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are widely prescribed for hyperlipidemia, yet their effect on the evolution of coronary atherosclerosis has not been defined. METHODS AND RESULTS: To address this issue, 331 patients with diffuse but not necessarily severe coronary atherosclerosis documented on a recent arteriogram and with fasting serum cholesterol between 220 and 300 mg/dL were enrolled in a randomized, double-blind, placebo-controlled trial. All patients received intensive dietary counseling. Lovastatin or placebo was begun at 20 mg/d and was titrated to 40 and 80 mg during the first 16 weeks to attain a fasting low-density lipoprotein (LDL) cholesterol < or = 130 mg/dL. The mean lovastatin dose was 36 mg/d. Coronary arteriography was repeated after 2 years. In 299 patients (90%), 3858 coronary segments containing 2309 stenoses were measured blindly on pairs of films with an automated computerized quantitative system. Total and LDL cholesterol decreased by 21 +/- 11% and 29 +/- 11%, respectively, in the lovastatin-treated group but changed by < 2% in placebo patients. The primary end point, coronary change score, defined as the per-patient mean of the minimum lumen diameter changes (follow-up minus baseline angiogram) for all lesions measured, excluding those < 25% on both films, worsened by 0.09 +/- 0.16 mm in the placebo group and by 0.05 +/- 0.13 mm in the lovastatin group (P = .01). Progression (a worsening in minimum diameter of one or more stenoses by > or = 0.4 mm) with no regression at other sites occurred in 48 of 146 lovastatin and 76 of 153 placebo patients (33% versus 50%, P = .003). New coronary lesions developed in 23 lovastatin and 49 placebo patients (P = .001). The beneficial effect of treatment was most pronounced in the more numerous, milder lesions and in patients whose baseline total or LDL cholesterol levels were above the group median. CONCLUSIONS: Lovastatin slows the progression of coronary atherosclerosis and inhibits the development of new coronary lesions.

Canada↗
PubMed1993

A survey of aphasia services in the United Kingdom.

A survey of the service available, in speech and language therapy departments, to adults with aphasia revealed that many districts in the United Kingdom are unable to fulfil the professional recommendations for the care of aphasic clients. Although individual 'good practice' criteria could be satisfied, only a minority of districts were able to provide a comprehensive service. Levels of staffing for the adult neurological caseload are variable and even, at best, hinder therapists in delivering the recommended standard of management to aphasic clients and their carers.

Aphasia↗
PubMed1990

A comparative study of virus isolation, polymerase chain reaction, and antigen detection in children of mothers infected with human immunodeficiency virus.

We report on an investigation designed to compare the polymerase chain reaction (PCR) with culture and p24 measurement for the diagnosis of human immunodeficiency virus (HIV) infection in infants and children. Forty-five children born of mothers with antibodies to HIV type 1 were studied; P24 antigen was measured in plasma, and HIV-1 proviral DNA was sought in peripheral blood mononuclear cells after amplification by PCR. In 26 cases, blood specimens were cultured for HIV; in all but two instances cultures were established at the same time that the PCR test was performed. Primer pairs in three regions of the proviral genome were used for the PCR test. There was good agreement between the results obtained from PCR tests and from cultures; of 24 children in whom both tests were done at the same time, 10 had positive results on both the culture and the PCR test, 1 had positive results on the PCR test but negative culture results, and 13 had negative results on both tests (concordance 96%). Measurement of p24 antigen in plasma was, in contrast, an insensitive marker of infection: 6 of 12 infants with positive cultures had positive p24 test results, and 8 of 18 infants had positive PCR test results. Sixteen children with subsequent seronegativity for HIV-1 had negative PCR results. This study provides further evidence that the PCR test is a valid alternative to viral culture for the diagnosis of pediatric HIV infection.

Blotting, Western↗
PubMed1981

Investigation and management of orbital trauma.

Clinical examination and conventional radiography of the orbit following recent orbital trauma often gives an incomplete picture of the damage present. In many infra-orbital blowout injuries, damage to the medial orbital wall occurs with prolapse and sometimes incarceration of orbital contents into both the maxillary and ethmoidal air sinuses. Late enophthalmos is thought to be caused by both atrophy of orbital fat and its loss into the paranasal sinuses. Hypocycloidal tomography in an antero-posterior plane is helpful in the recognition of those defects, but it does not distinguish between the presence of blood clot and soft tissue. Computerised axial tomography (C.A.T.) and ultrasonography are currently available investigative techniques which do distinguish between the presence of air, blood clot, soft tissue and bone and, in addition, there is a significant reduction in radiation dosage when compared with tomography. A comparison of these techniques and the clinical findings is described. These investigations should indicate the necessity for surgical intervention and prevent some of the late complications, such as enophthalmos.

Humans↗
PubMed1979

Diagnosis of cranial asymmetries in cerebral arteriovenous malformations.

Nine of 29 patients with cerebral arteriovenous malformations exhibited abnormal cranial asymmetries on computed tomography (CT). Two of these patients showed no other abnormalities on their precontrast CT scans. Assessment of cranial asymmetry is recommended in all patients suspected of having an arteriovenous malformation.

Diagnosis, Differential↗
PubMed1978

Asymmetries of the cerebral hemispheres on computed tomograms.

Numerous cerebral asymmetries are shown on cerebral computed tomography (CT). Those seen most commonly are: (a) the left occipital pole is frequently wider and protrudes further posteriorly than the right; (b) the right frontal area often measures wider than the left, and the right frontal pole usually protrudes either as far forward as the left or extends beyond the left; and (c) the calcified glomus of the left lateral ventricle commonly lies posterior to that of the right when there is posterior protrusion of the left occipital pole beyond the right. The above hemispheral asymmetries are more common in right handed individuals. Hemispheral asymmetries tend to be less striking in left handed individuals, but widening of the left frontal and right occipital regions is more common in left handers than right handers. In both right and left handers, the central portion of the right hemisphere is frequently wider than the left; the pineal therefore often lies slightly to the left of the midline in normal brains. A study of cerebral asymmetries should help in the detection of early mass lesions and may also help in the study of hemispheral specialization for behavioral function.

Adolescent↗
PubMed1975

The language capability of Neanderthal man.

Considerable publicity has been given a recent article by Lieberman and Crelin ('71) which argues that Neanderthal man lacked the physical features necessary for speech. This present paper presents statistics on some modern men with normal speech who show physical features in common with Neanderthal man. The brain of Neanderthal man was as large as, or larger than, that of modern man. The brain reflected by endocranial cast of the La Chapelle-aux-Saints skull resembles that of modern man in an area important for speech and therapy suggests Neanderthal man had the neural development necessary for language.

Achondroplasia↗
PubMed1975

Arteriographic correlates of handedness.

Bilateral intracranial arteriograms of 123 right-handed patients and 38 left-handed patients were evaluated for: (1) the angulation of the branches of the right and left middle cerebral arteries as they leave the Sylvian fissure, (2) the position of the posterior saggital sinus with respect to the anatomic saggital midline, and (3) the dominant right-sided and left-sided superficial cortical venous drainage (Labbé, Trolard, and Sylvian). Arteriographic evaluations of these points may prove useful in assessing cerebral dominance.

Carotid Arteries↗