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Biomedical subjects

M Milner

Publications and source records attributed to M Milner.

At least 19 recordsLinked to original sources
PubMed1992

The impact of maternal age on pregnancy and its outcome.

There were 28,600 deliveries of 500 g or more to women at the Rotunda Hospital between January 1st 1985 and December 1st 1989. Of these, 595 were to women aged 40 years and over. Thirty-five variables of clinical significance were analyzed, comparing those of 40 years of age and more with those under 40. The older group had significant increases in gestational diabetes, ante-partum hemorrhage, fetal distress, prematurity, low birth weight and perinatal mortality. Chromosome congenital abnormalities were significantly higher, particularly Down syndrome. There were significantly increased rates of induction and cesarean section in the older women. Some evidence of interaction of age with other factors was found, however these were difficult to separate out in the clinical setting. We therefore recommend it wiser to manage all elderly gravidas in a high risk manner dealing with cases individually within this framework. Intervention should, however, need to be justified in the older as in the younger woman.

Adult↗
PubMed1992

Effects of seat-surface inclination on postural stability and function of the upper extremities of children with cerebral palsy.

This study investigated the effects of seat-surface inclination on parameters of postural stability and functional use of the upper extremity. 10 non-impaired children and 10 children with cerebral palsy, aged between four and 15 years, were studied. Seat-surface inclinations of 0 degree, 5 degrees anteriorly and 5 degrees posteriorly were used as the experimental conditions. Significant differences were observed on most dependent measures between the two groups. The results suggest that anteriorly tilting the seats of children with cerebral palsy may disturb postural stability, without improving performance of the upper extremity.

Adolescent↗
PubMed1992

Ventilation and swallowing interactions of normal children and children with cerebral palsy.

The respiratory inductance plethysmograph was used to analyse the ventilatory cycle during drinking, chewing and swallowing of normal and cerebral-palsied children aged between five and 12 years. 33 children were divided equally into three groups: normal, spastic CP and athetoid CP. A few of the children with spastic CP and over half of those with athetoid CP were unable to perform the 'big breath' task. In the remaining trials, the children with CP held their breath for a shorter time than normal children. Many children with CP required multiple swallows to consume 5mL of liquid. In the majority of trials, normal children swallowed liquids at or near the peak of inspiration, whereas the children with CP did not. Supplementary swallows and solid-bolus swallows occurred at any point in the ventilatory cycle in all groups. The children with CP had a greater need to inspire at the end of liquid tasks, especially during the 75mL task.

Cerebral Palsy↗
PubMed1992

Cord insulin and C-peptide--distribution in an unselected population.

OBJECTIVE: To assess the distribution of cord blood insulin in an unselected population, and examine its relation to birthweight centiles. SETTING: District General Hospital in Nottinghamshire. SUBJECTS: 209 unselected singleton births. MEAN OUTCOME MEASURE: Cord blood insulin; cord blood C-peptide; birthweight centiles. RESULTS: Hyperinsulinaemic babies (greater than 97th centile for cord insulin) were found at all birthweight centiles. 15% of high birthweight babies were hyperinsulinaemic. For low birthweight babies, the distribution of cord insulin/C-peptide was skewed indicating a high number of low values. Hypoinsulinaemic babies were present up to the 50th centile for birthweight. CONCLUSIONS: Abnormalities of fetal insulinisation may be found in babies of all birthweights.

Birth Weight↗
PubMed1992

Changing characteristics of Irish menopausal women seeking assistance.

In the two years since its inception 425 patients have been seen at the Menopause Clinic. Audit of the first 100 women attending against 100 first seen one year later have revealed some significant differences in referral patterns. The earlier group were likely to have significantly more social problems whereas in the latter, more were likely to show concern for osteoporosis or need modification of ongoing treatment.

Age Factors↗
PubMed1991

A comparison of multilesion percutaneous transluminal coronary angioplasty in elderly patients (greater than 70 years) and younger subjects.

Results of multilesion percutaneous transluminal coronary angioplasty (PTCA) were compared in 210 elderly patients (70 to 92 years, [group I] and 210 younger patients (40 to 69 years, [group II]. The elderly patients included more women (43% versus 24%) and patients with unstable angina (73% versus 55%). PTCA was successful in 87% of lesions in group I and in 94% in group II (p less than 0.001). Only circumflex artery dilatation was less successful in group I (78% versus 91%, p less than 0.002). PTCA was successful in all lesions of at least one vessel in 89% of group I patients and in 94% of group II patients (p less than 0.06). Successful dilatation of all lesions was achieved in 77% of group I and in 85% of group II patients (p less than 0.05). Complication rates were similar for both groups. These data demonstrate a high rate of success and safety in elderly patients undergoing multilesion PTCA despite the presence of several risk factors (advanced age, female sex, unstable angina). The lower PTCA success rate in these patients compared with younger subjects is almost entirely attributable to reduced success for circumflex artery lesions.

Age Factors↗
PubMed1991

Halogenated inhalation anesthetic agents decrease transepithelial electrical measurements across the isolated iris-ciliary body.

Transmembrane electrical measurements were performed on the isolated rabbit iris-ciliary body (I-CB) to study the direct effects of halogenated inhalation anesthetic agents on the ciliary epithelium. Addition of either halothane, enflurane, or isoflurane to the control 95% O2:5% CO2 gas mixture resulted in a dose-dependent decrease in the short-circuit current (SCC) and potential difference (PD). This response was reversible after the anesthetic gas was discontinued. Pretreatment with either alpha-adrenergic or beta-adrenergic antagonists (phentolamine or timolol) had no effect on the halothane-induced decrease in SCC. Delivery of the analgestic gas N2O did not alter baseline electrical measurements across the isolated I-CB.

Analysis of Variance↗
PubMed1990

Rehabilitation engineering in pediatrics.

Applications of science and technology in the (re)habilitation of children and young adults can have dramatic, positive influences on their lives. Prosthetics, orthotics, mobility, postural support and seating, communication and education are responsibilities of the rehabilitation engineer. A holistic approach in meeting individual needs for technology is essential. The concerted rehabilitation engineering programme at The Hugh MacMillan Rehabilitation Centre supports service programmes with relevant research and development work.

Biomedical Engineering↗
PubMed1989

Development of a multidisciplinary feeding profile for children who are dependent feeders.

The multidisciplinary feeding profile (MFP) is the first statistically based protocol for the quantitative assessment of feeding disorders in severely disabled children. This assessment can be completed in 30-45 min with foods and facilities that are available in homes, hospitals, and chronic care units. This paper describes the state of current testing methods, the parameters of successful feeding activity, the development of the test protocol, and the results of statistical analyses.

Adolescent↗
PubMed1989

The multidisciplinary feeding profile: a statistically based protocol for assessment of dependent feeders.

The development of the multidisciplinary feeding profile entailed a level of statistical analyses not commonly utilized in test development. This paper describes the statistical analyses and offers an explanation of why specific statistical tests were chosen. It also serves to identify where clinical knowledge and experience overrode specific statistical tests.

Persons with Disabilities↗
PubMed1987

A new noninvasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction: based on signal-averaged electrocardiogram, radionuclide ejection fraction and Holter monitoring.

A prospective study of the prognostic significance of the signal-averaged electrocardiogram (ECG), left ventricular function and 24 hour Holter ECG monitoring was performed in 102 patients (age 63 +/- 11 years) after myocardial infarction. The signal-averaged ECG (40 Hz high pass bidirectional filtering) was obtained 10 +/- 6 days after the acute myocardial infarction and all three tests were performed within 72 hours of each other. Ejection fraction was determined by radionuclide ventriculography. An abnormal signal-averaged ECG was seen in 44% of patients; abnormal ejection fraction (less than 40%) in 52% and high grade ectopic activity (greater than or equal to 10 ventricular premature depolarizations/h or couplets, or nonsustained ventricular tachycardia, or a combination of these) in 62%. During a 12 +/- 6 month follow-up period, 15 patients (14.7%) had an arrhythmic event defined as sustained ventricular tachycardia or sudden cardiac death, or both. The event rates were higher in patients with an abnormal versus a normal signal-averaged ECG (29 versus 3.5%, p = 0.003), an abnormal versus a normal ejection fraction (24 versus 6%, p = 0.001) and the presence versus the absence of high grade ectopic activity (23 versus 9%, p = 0.09). Patients with an abnormal signal-averaged ECG and an abnormal ejection fraction had a significantly higher (p = 0.0007) event rate than did patients in whom both the tests were normal (36 versus 0%; odds ratio 30.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

Biofeedback techniques and behaviour modification in the conservative remediation of drooling by children with cerebral palsy.

In an attempt to decrease the rates of drooling of 12 children with cerebral palsy, the authors investigated the effectiveness of EMG auditory feedback training of the orbicularis oris, of making the act of swallowing a conscious one, and of providing an auditory signal to cue swallowing by means of an Accularm interval timer. After biofeedback training there was a significant decrease in drooling rates and a small increase in swallowing rates. After the Accularm was used the children maintained the decreased drooling rates and there was a further small improvement in swallowing rates. One month after treatment stopped there was a non-significant regression in the rates of both drooling and swallowing. The marked decrease in drooling after biofeedback training must be attributed to more effective swallowing as a result of improved oral motor control, rather than to increased rates of swallowing.

Adolescent↗
PubMed1986

A three-quarter type below-elbow socket for myoelectric prostheses.

The Muenster and Northwestern sockets have become universally prescribed for below-elbow amputees with myoelectric prostheses. The most attractive feature of these sockets is that they are self-suspending, thereby obviating the need for a harness. The sockets are designed to encompass the patient's whole elbow. Because of the intimate fit, heat build-up inside the socket is a problem. Patients with myoelectric prostheses are denied the benefit of a stump sock. Ventilation inside the socket is almost zero and excessive perspiration occurs. This leads to maceration and skin problems which negatively affect control, comfort and wearing time. This paper reports on a technique whereby the problem of no ventilation is overcome through the removal of the proximal-posterior quadrant of the socket.

Adult↗