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Biomedical subjects

M Llewellyn

Publications and source records attributed to M Llewellyn.

18 recordsLinked to original sources
PubMed2004

Effect of backpack fit on lung function.

Carrying loads close to the trunk with a backpack causes a restrictive type of change in lung function in which Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 s (FEV1) are reduced without a corresponding decrement in the FEV1.FVC( - 1) %. It is not known whether this is due to the weight of the load acting on the chest or to the tightness of fit of the shoulder and chest straps and waist belt of the pack harness. This study examined FVC, FEV1, FEV1.FVC( - 1) %, peak expiratory flow (PEF), forced expiratory flow between 0.2 and 1.2 s (FEF0.2 - 1.2) after the start of expiration and between 25 and 75% of each FVC (FEF25 - 75%) in 12 healthy males wearing a 15 kg backpack in which the shoulder and chest straps and hip belt were loosened by 3 cm from a 'comfort fit' to achieve a 'loose pack' fit (LPF) and tightened by 3 cm from CF to achieve a 'tight pack' fit (TPF). In comparison with the control condition of no pack, a loose pack fit significantly reduced FVC (by 3.6%, p < 0.01), FEV1 (by 4.3%, p < 0.01) and FEF25 - 75% (by 8.4%, p < 0.01). A tight pack fit significantly reduced FVC (by 8.1%, p < 0.01) and FEV1 (by 9.1%, p < 0.001). It also significantly reduced FEF0.2 - 1.2 (by 7.3%, p < 0.05) and FEF25 - 75% (by 21%, p < 0.01). In comparison with a loose pack fit, the tight pack fit was associated with a significantly lower FVC (by 4.6%, p < 0.01), FEV1 (by 5.0%, p < 0.01), FEF25 - 75% (by 13.8%, p < 0.01) and a fall in FEF0.2 - 1.2 (by 5.5%). The latter was approaching significance (p = 0.077). There were no significant changes in FEV1.FVC( - 1)% and PEF. It is concluded that tightening the fit of a backpack significantly affects lung function in a manner that is typical of a restrictive change in lung function and is very similar in pattern to that of wearing a loosely fitted loaded backpack. The effect of tightness of fit is additional to that due to the weight of the load alone and may also reduce expiratory flow at low lung volumes.

Adult↗
PubMed2004

Wound-related osteomyelitis: a case of containment not cure.

Community nurses need to be aware that some patients with osteomyelitis are treated with antibiotics alone. Such patients often have co-morbidities and quality of life issues that directly impact on the decision to treat osteomyelitis surgically. However, adopting a conservative approach to osteomyelitis management is associated with an increased risk of osteomyelitis recurrence. The rationale for managing chronic wound-related osteomyelitis with antibiotics is discussed. Community nurses caring for patients that have received antibiotics alone to treat osteomyelitis need to be aware of the potential for osteomyelitis recurrence and how to make the diagnosis.

Adult↗
PubMed2001

Managing gravitational eczema and allergic contact dermatitis.

Venous leg ulceration is a common chronic problem in the community, and gravitational eczema is a common complication of it. The presence of gravitational eczema can lead to further ulceration and may also impair wound healing. Treatment often requires more than one topical preparation, to gain control and prevent relapse. Knowledge of the benefits and risks of these therapeutic modalities is essential, in this article we aim to provide a practical approach to the treatment of gravitational eczema. We also discuss allergic contact dermatitis, a common complication of gravitational eczema.

Administration, Topical↗
PubMed2000

Molecular cloning, genomic organization and cell-binding characteristics of mouse Spalpha.

Several group B scavenger receptor cysteine-rich (SRCR) proteins have been shown to function as modulators in the immune response. Recently, we reported the cloning of a new member of this family, human Spalpha (hSpalpha). Herein we report the cloning and characterization of the mouse homologue of hSpalpha. Like its human counterpart, mouse Spalpha (mSpalpha), is a secreted protein containing three SRCR domains. Most lymphoid tissues express RNA transcripts encoding mSpalpha. Characterization of a genomic clone encoding the mature mSpalpha protein showed that each of the SRCR domains of mSpalpha is encoded by a single exon. Comparison of the sequence of mSPalpha with those of other published proteins indicates that it is the same as the recently reported protein named AIM (apoptosis inhibitor expressed by macrophages). Cell-binding studies with a mSpalpha immunoglobulin (mSpalpha-Rgamma) fusion protein indicated that mSpalpha is capable of binding to spleen-derived CD19+ B cells and minimally to peritoneal cavity-derived CD19+ B cells but not to peripheral blood-derived B cells. Spleen-derived CD3+ T cells also bound mSpalpha-Rgamma; however, no binding was observed to either peripheral blood mononuclear cells or peritoneal cavity-derived CD3+ T cells. The mSpalpha-Rgamma fusion protein was also shown to bind to the mouse cell lines WEHI3 (monocytic) and EL-4 (thymoma, T cell). The cloning of cDNA and genomic clones encoding mSpalpha and the identification of cells expressing a putative mSpalpha receptor(s) should facilitate in vivo studies designed to investigate the function of Spalpha in the immune compartment.

Amino Acid Sequence↗
PubMed2000

Factors predicting return to work following mild traumatic brain injury: a discriminant analysis.

Studies of mild traumatic brain injury (MTBI) suggest that most individuals recover rapidly and return to their everyday activities. However, a percentage of MTBI patients report persistent problems with cognitive, physical, and emotional symptoms. There is also evidence that some experience changes in occupational functioning following MTBI. The current study used a stepwise discriminant function analysis (DFA) to examine the role of injury severity variables, cognitive performance, and ratings of symptoms of TBI in predicting work status following MTBI. Subjects included 121 MTBI patients who were all active-duty military personnel. The stepwise DFA revealed that age and three cognitive variables (verbal memory, verbal fluency, and a speed test of planning and strategy) were predictive of work status 3-15 months following a documented MTBI, correctly classifying work status 68.8% of the time. A cross-validation DFA was conducted, with a 66.1% correct classification rate. These findings highlight the importance of cognitive impairments in identifying those at risk for occupational impairment following MTBI.

Activities of Daily Living↗
PubMed1999

More space, more speed. Scanning technology and COLD help improve document imaging.

UNLABELLED: Children's Hospital Medical Center, Akron, Ohio PROBLEM: The 100-year-old-plus medical center needed a reliable, economical and easy-to-use document storage method that provided a long and secure archival life. SOLUTION: Children's adopted Hewlett-Packard magneto-optical jukeboxes and Optika software. RESULTS: Since the jukeboxes became operational in January 1998, Children's has maintained "24 x 7 availability" of its stored documents for up to 150 concurrent users without any downtime. KEYS TO SUCCESS: "We started implementation in the accounting department with patient billing, hospital general ledger, accounts payable and employee payroll, and the document imaging system has quickly gained acceptance in other departments as well."

Hospital Information Systems↗
PubMed1990

Human H-reflexes are smaller in difficult beam walking than in normal treadmill walking.

Hoffman (H) reflexes were elicited from the soleus (SOL) muscle while subjects walked on a treadmill and on a narrow beam (3.5 cm wide, raised 34 cm from the floor). The speed of walking on the treadmill was selected for each subject to match the background activation level of their SOL muscle during beam walking. The normal reciprocal activation pattern of the tibialis anterior and SOL muscles in treadmill walking was replaced by a pattern dominated by co-contraction on the beam. In addition, the step cycle duration was more variable and the time spent in the swing phase was reduced on the beam. The H-reflexes were highly modulated in both tasks, the amplitude being high in the stance phase and low in the swing phase. The H-reflex amplitude was on average 40% lower during beam walking than treadmill walking. The relationship between the H-reflex amplitude and the SOL EMG level was quantified by a regression line relating the two variables. The slope of this line was on average 41% lower in beam walking than treadmill walking. The lower H-reflex gain observed in this study and the high level of fusimotor drive observed in cats performing similar tasks suggest that the two mechanisms which control the excitability of this reflex pathway (i.e. fusimotor action and control of transmission at the muscle spindle to moto-neuron synapse) may be controlled independently.

Electromyography↗
PubMed1989

Muscle afferent contribution to control of paw shakes in normal cats.

1. The discharge of various hindlimb muscle afferents was recorded during paw shakes in normal cats with the use of floating dorsal root electrodes. 2. Muscle spindle group Ia-afferents and tendon organ group Ib-afferents fired during muscle lengthening, reaching very high peak discharge rates and then silencing at or shortly after the onset of shortening. The timing of Ia firing was consistent with the predictions of a linear model as well as the responses of Ia endings subjected to identical length variations in separate anesthetized cats. 3. In the latter "reconstruction" experiments, waxing and waning dynamic fusimotor action straddling whole paw-shake sequences gave the most consistent matches with the data from the normal cats. The reproducibility of the inferred fusimotor action justifies the inclusion of paw shakes as a class of movement in which fusimotor set is high. 4. The peak ensemble Ia activity from single hindlimb muscles was estimated to be approximately 20 kiloimpulses/s (Kips). Ankle extensor and hamstrings length variations were nearly in phase in the first cycles of a paw-shake sequence. From published data on spindle populations in these muscles, this indicated that peak Ia input to the spinal cord exceeded 0.2 megaimpulses/s (Mips). 5. The phase relationship between origin-to-insertion muscle length and Ia firing during paw shakes was little affected by doubling or tripling the moment of inertia of the foot. We argue that this refutes the notion that in paw shakes phase reversals occur between muscle fibers and tendons in the muscles studied. 6. Inertial loading of the foot led to small but significant reductions in mean paw-shake frequency. This is consistent with an afferent contribution to the generation of these movements. 7. We conclude that in paw shakes in normal cats, the CNS "chooses" to sensitize Ia-afferents to muscle length variations by increasing dynamic fusimotor action. The resulting ensemble Ia input is very large and is likely to play a significant role in reflexly shaping the alpha-motoneuronal activity responsible for the paw shakes.

Action Potentials↗
PubMed1986

Functional tolerance to chlormethiazole and cross-tolerance to ethanol in the rat: importance of test and mode of drug administration.

Tolerance to the effects of chlormethiazole on circular maze performance, and cross-tolerance to ethanol, were investigated in rats. Tolerance to chlormethiazole in the moving belt test was also measured in the same rats. Treatment with a total daily dose of subcutaneous chlormethiazole, 200 mg/kg, for 20 days produced clear tolerance to chlormethiazole and cross-tolerance to ethanol in the circular maze test. This treatment, however, failed to produce tolerance to chlormethiazole in the moving belt test. No evidence of physical dependence was found. In other studies, continuous intravenous infusion of chlormethiazole, 30-50 mg/kg/h for 9 days, resulted in clear functional tolerance to chlormethiazole and cross-tolerance to ethanol in the moving belt test. Similarly, chronic ethanol treatment, 4-6 g/kg daily for 3 weeks, resulted in functional tolerance to ethanol and cross-tolerance to chlormethiazole in the same test. These results indicate that the demonstration of functional tolerance to chlormethiazole and cross-tolerance to ethanol is dependent both on the sensitivity of the behavioural measurement tests employed, and on the degree of continuity of exposure of the central nervous system to the drug. It is concluded that, for doses that are equipotent in acute log-dose studies, chlormethiazole produces less tolerance and physical dependence than ethanol, perhaps because of a shorter half-life.

Animals↗
PubMed1982

Nifedipine in unstable angina: a double-blind, randomized trial.

We assessed the efficacy of adding nifedipine to the conventional treatment of unstable angina in 138 patients in a prospective, double-blind, randomized, placebo-controlled trial. There was no difference between the two groups in the dose of conventional antianginal medication or in age, prior myocardial infarction, ejection fraction, or other risk factors. Failure of medical treatment (defined as sudden death, myocardial infarction, or bypass surgery within four months) occurred in 43 of 70 patients given placebo and in 30 of 68 given nifedipine. Kaplan-Meier survival-curve analysis of the number and time dependence of treatment failures demonstrated a benefit of nifedipine over placebo (P = 0.03). The benefit was particularly marked in patients with ST-segment elevation during angina (P = 0.02). Side effects (transient hypotension or diarrhea) required withdrawal of the drug from four patients given nifedipine and from one given placebo. We conclude that the addition of nifedipine to conventional therapy is safe and effective in unstable angina.

Adult↗
PubMed1978

Extramammary Paget's disease.

In a 74-year-old man extramammary Paget's disease of the scrotal and perianal areas masqueraded as tinea cruris and chronic dermatitis for 7 years before it was diagnosed. Topical therapy with 1% 5-fluorouracil cream resulted in clinical improvement but not histologic clearing.

Aged↗