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Biomedical subjects

M Reid

Publications and source records attributed to M Reid.

At least 19 recordsLinked to original sources
PubMed1992

Intramuscular wire electromyography of the subscapularis.

The action of the subscapularis muscle is an important component in maintaining shoulder stability. Because of its relative inaccessibility, there have been few electromyographic (EMG) studies of its normal patterns of activity. The subscapularis is innervated by two or more distinct nerves, and therefore the upper and lower parts of the muscle may have different functional roles depending on the position of the humerus. The purpose of this study was to develop safe, reproducible insertion paths to the upper and lower parts of the subscapularis. Six subjects with no previous history of shoulder injury were evaluated. The paths of insertion were designed based on previous anatomical studies as well as dissections. Two pairs of intramuscular wire electrodes were inserted: one directed toward the upper subscapularis and one toward the lower subscapularis. Electrode locations were confirmed using posteroanterior and lateral radiographs and through electrical stimulation. EMG data were recorded during isometric internal rotation exercises with the humerus in 0 or 90 degrees abduction. Significant differences were observed in the EMG activity recorded from the two pairs of electrodes. The EMG activity of the upper subscapularis either remained the same or decreased in going from 0 to 90 degrees abduction, while that of the lower subscapularis increased. The observed differential response confirmed that the electrodes were in different parts of the subscapularis. These preliminary results suggest that in future EMG studies, the subscapularis should be considered as at least two independent muscle units.

Electric Stimulation↗
PubMed1992

Long term predictive value of Doppler studies in high risk fetuses.

OBJECTIVE: To determine whether the predictive value of Doppler ultrasonography extends beyond the perinatal period. DESIGN: Descriptive follow-up study. SETTING: Specially designated paediatric clinic in Royal Maternity Hospital. SUBJECTS: 40 children who as high risk fetuses had had assessment of umbilical artery flow velocity waveforms. INTERVENTIONS: Parental history, physical examination, anthropometry, Denver developmental screening test. OUTCOME MEASURES: Weight, height, head circumference, neurological impairment, Denver development screening test RESULT: Abnormal waveforms were an accurate predictor of neonatal outcome, with significant differences in birthweight, gestational age, need for nursery admission, and frequency of intrauterine growth retardation between normal and abnormal waveform groups. However, abnormal Doppler studies were not predictive of long-term adverse sequelae. There were no significant differences in height, head circumference, proportion with neurological impairment, or results of Denver developmental screening test at a median age of five years. CONCLUSION: The predictive value of Doppler ultrasonography is less for long-term growth and neurodevelopment than for perinatal outcome in the high risk fetus.

Child↗
PubMed1992

Oral fluticasone propionate in active distal ulcerative colitis.

Fluticasone propionate is a new corticosteroid with low systemic bioavailability. This study reports the outcome of a double blind clinical trial comparing oral fluticasone propionate (5 mg four times daily) with placebo for the treatment of active distal ulcerative colitis. Sixty patients were treated for four weeks, with assessments at two and four weeks. One patient was withdrawn when she was found to have amoebiasis. Thus, results are presented for 29 patients who received placebo and 30 who received fluticasone propionate. The two groups were well matched for age, sex, length of history, and extent of disease. After four weeks of therapy the clinical, sigmoidoscopic, and histological responses were similar in the two groups. It is concluded that fluticasone propionate (5 mg four times daily) is not effective treatment for active distal ulcerative colitis.

Administration, Oral↗
PubMed1992

Factors influencing morbidity and mortality in infants with severe respiratory distress syndrome treated with single or multiple doses of a natural porcine surfactant.

In an international multicenter trial infants with clinical and radiological signs of severe RDS (age 2-15 h, birthweight 700-2,000 g, mechanical ventilation, FiO2 greater than or equal to 0.6, no complicating disease) were randomized to receive either a single dose (n = 176) or up to three subsequent doses (n = 167) of a natural porcine surfactant (Curosurf). Using a logistic regression model, the effects of therapy, birthweight, sex, hospital and other clinical factors on survival and various outcome parameters were evaluated. Mortality (13 vs. 21%, p less than 0.05) and the incidence of pneumothorax (9 vs. 18%, p less than 0.01) were significantly lower in the multiple-dose group. Low birthweight, hospital allocation, low Apgar score and initial disease severity were associated with an increased mortality. Low birthweight, hypothermia (admission temperature less than 36 degrees C) and acidosis (pH less than 7.25) prior to surfactant treatment could be identified as risk factors for the development of intracranial hemorrhage.

Biological Products↗
PubMed1992

Microscopic colitis: can it be qualitatively and quantitatively characterized?

This study reports the histological features helpful in diagnosing microscopic colitis. Rectal biopsy specimens from 14 patients with microscopic colitis, 14 with active ulcerative colitis and 14 without colonic inflammation were pooled and then assessed by three observers according to a predetermined protocol. Inter-observer agreement was good except for Paneth cell metaplasia and endocrine cell metaplasia. Compared with healthy tissue, microscopic colitis showed a significant (p less than 0.05) increase in chronic inflammatory cells and a depletion of goblet cells but these changes were less pronounced than those seen in ulcerative colitis (p less than 0.05). In contrast to ulcerative colitis, microscopic colitis was associated with a more marked infiltration with eosinophils and an increase in intra-epithelial lymphocytes. These results show that microscopic colitis can be distinguished both from normal colonic tissue and from ulcerative colitis.

Adolescent↗
PubMed1992

Randomized European multicenter trial of surfactant replacement therapy for severe neonatal respiratory distress syndrome: single versus multiple doses of Curosurf.

There is now convincing evidence that the severity of neonatal respiratory distress syndrome can be reduced by surfactant replacement therapy; however, the optimal therapeutic regimen has not been defined. This randomized European multicenter trial was designed to determine whether the beneficial effects of a single large dose of Curosurf (200 mg/kg) in babies with severe respiratory distress syndrome (arterial to alveolar oxygen tension ratio approximately 0.10) could be enhanced by using multiple doses of surfactant. Preterm neonates (birth weight 700 to 2000 g) with severe respiratory distress syndrome requiring artificial ventilation with fraction of inspired oxygen greater than or equal to 0.6 were randomized into two groups at an age of 2 to 15 hours. Both groups received the usual dose of Curosurf (200 mg/kg) immediately after randomization. In neonates randomized to receive multiple-dose treatment, two additional doses of Curosurf (100 mg/kg each) were instilled into the airways (12 and 24 hours after the initial dose) provided that the patients still needed artificial ventilation with fraction of inspired oxygen greater than 0.21. In both groups (single dose: n = 176, multiple doses: n = 167) there was a rapid improvement in oxygenation as reflected by a threefold increase in arterial to alveolar oxygen tension ratio within 5 minutes after surfactant instillation (P less than .001), and peak inspiratory pressure and mean airway pressure could be reduced significantly during the first 6 hours after surfactant treatment. In addition, ventilatory requirement (peak inspiratory pressure, ventilatory efficiency index) was reduced in the multiple-dose group 2 to 4 days after randomization (P less than .05 to .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Biological Products↗
PubMed1991

Initial blood pressure response to enalapril in hospitalized patients (Studies of Left Ventricular Dysfunction [SOLVD]).

Studies of Left Ventricular Dysfunction (SOLVD) is a randomized trial of enalapril versus placebo in reducing mortality in patients with cardiac dysfunction (defined as left ventricular ejection fraction less than or equal to 35%). Before randomization, patients at risk for hypotension were hospitalized for a test dose of 2.5 mg of enalapril administered orally at baseline and again 12 hours later. As of February 1989, 89 of 7,539 (1.2%) patients had been studied during hospitalization. Baseline systolic and diastolic blood pressures were 115 +/- 18 and 73 +/- 10 mm Hg, respectively. After enalapril, systolic blood pressure decreased slightly but significantly 8 to 20 hours after the initial dose (mean reduction 8 to 11 mm Hg). In this highly selected group of 89 patients, symptoms relating to decrease in blood pressure were noted in 13 (15%). It is emphasized that most patients with cardiac dysfunction readily tolerate enalapril. However, the agent should be administered with caution to patients with advanced congestive failure and diminished baseline blood pressure, owing to a significant incidence of symptomatic hypotension.

Aged↗
PubMed1991

Stability of positive tuberculin tests: are boosted reactions valid?

To determine the stability and presumed significance of tuberculin skin tests, we followed a cohort of 380 tuberculin-positive patients living in chronic care facilities. Each patient had a positive reaction (greater than or equal to 10 mm induration to 5 tuberculin units of purified protein derivative) to one of three sequential baseline tuberculin tests. One year after the initial series, each patient had a single repeat skin test. Reversion to a negative test occurred in 98 (26%) of the 380 patients. Decreases in induration of 6 mm or more occurred in 88 (90%) of the reverters. Initially positive tests were more likely (p less than 0.001) to remain stable than tests that were "boosted" to positive reactions on the second or third initial administration. Stable responses were found in 96% of those whose tests had greater than or equal to 15 mm induration compared with 61% of those with reactions of 10 to 14 mm induration. Increasing age also was associated with a high rate of reversion. The instability of boosted tuberculin reactions brings into question the clinical significance of these tests. We propose limiting tuberculin testing to two sequential tests.

Aged↗
PubMed1991

Systemic neonatal candidiasis.

Forty-five cases of systemic neonatal candidiasis were diagnosed over a 9-year period in a neonatal intensive care unit; 42 infants weighted less than 1.5 kg. All had been very ill with preceding bacterial sepsis and other complications of low birthweight. Where treatment was instituted the mortality was low (4 out of 39 dying) and complications of treatment were transitory. We therefore recommend diligent examination for the presence of this infection, and treatment with a combination of amphotericin B and 5-flucytosine.

Amphotericin B↗
PubMed1990

The effect of steering on the physiological energy cost of wheelchair propulsion.

Previous studies of the energy cost of wheelchair propulsion have used ergometers or tracks requiring little steering. We have measured minute ventilation (VE), oxygen consumption (VO2), carbon dioxide output (VCO2) and heart rate (HR) during exercise in a two arm, hand-rim propulsion wheelchair on a treadmill, and on three tracks of increasing tortuosity in eight able-bodied subjects. During propulsion at 0.6 m/sec, VE, VO2, and VCO2 were significantly greater on the track with the maximal steering component than on that with the minimal steering component, or on the treadmill with no steering component. Heart rate was significantly higher on the maximal compared to minimal steering component track. Exercise at speeds varying from 0.2 to 1.0 m/sec showed that VO2 and VCO2 were significantly higher on the medium steering component track than on the treadmill at speeds of 0.6 m/sec and above. We conclude that the effort of steering contributes significantly to the energy cost of wheelchair propulsion particularly at higher speeds.

Adult↗
PubMed1989

A private red cell antigen, Jones, causing haemolytic disease of the newborn.

Two previously unpublished low-incidence antigens, Jones and Hol., are identical. The antigen is a dominant, autosomally inherited character that segregates independently from the loci for the ABO, MNS, Duffy and Yt blood group systems and is different from previously published infrequent antigens. The antigen is apparently unaffected by enzyme treatment and is well developed on red cells of neonates. The antibody reacts best by indirect antiglobulin testing, is IgG and has caused haemolytic disease of the newborn. This private blood group antigen, named Jones, has been assigned the ISBT number 700047.

Adult↗
PubMed1989

"My family and friends": six- to twelve-year-old children's perceptions of social support.

A psychometrically sound instrument is essential for the study of children's subjective impressions about social support. To evaluate such an instrument, 249 children, 6-12 years old, from a population-based sample of black and white families (50% single mothers, 50% two parents) were studied. The newly developed instrument, "My Family and Friends," consists of 12 dialogues, based on Vygotskian principles, and yields information about (a) children's perceptions of the availability of individuals in their networks to provide different types of social support and (b) their satisfaction with the help they receive. Children collaborate in interactive dialogues and manipulate personalized props. Collectively, the data indicate that subjective impressions about social support can be measured in a reliable and valid manner from early childhood through adolescence, and that children understand and care about the quality and the differentiation of support (i.e., emotional, informational, instrumental, and companionship) within their social support networks. Further, children report significant variations in social support when undergoing major family upheaval.

Audiovisual Aids↗
PubMed1988

Differential modulation of striatal dopamine release by intranigral injection of gamma-aminobutyric acid (GABA), dynorphin A and substance P.

The effects of intranigral injection of gamma-aminobutyric acid (GABA) (dose range: 10.0-300.0 nmol), dynorphin A (0.005-0.5 nmol) and substance P (0.00007-7.0 nmol) on striatal dopamine (DA) release, and dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) formation were studied by microdialysis. It was found that both GABA and dynorphin A produced a dose-dependent decrease in the release of striatal DA following injection into the ipsilateral substantia nigra, the pars reticulata. In contrast, intranigral injection of substance P produced an increase in DA release. However, the dose-response curve for the substance P effect had a biphasic shape. The maximum effect was produced by 0.007 nmol, whereas higher doses (0.07-0.7 nmol) produced less pronounced effects. At the highest dose (7.0 nmol), substance P produced a strong decrease of DA release. Striatal levels of DOPAC and HVA were enhanced by GABA, dynorphin A and substance P. The present results support the concept that substance P, directly or indirectly, provides a positive feed-back regulation for the release of striatal DA, whereas GABA and dynorphin exert a negative feed-back regulation.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1987

Hypovitaminosis A in feedlot cattle.

Hypovitaminosis A was diagnosed in a group of feedlot cattle that had been fed a diet low in carotene for 18 months. The primary signs of disease in the cattle were poor weight gain, ataxia, convulsions, night blindness, and total blindness. Serum vitamin A concentrations were used to confirm the diagnosis. The cattle were treated orally and intramuscularly with vitamin A, and the less severely affected herd members recovered rapidly.

Animals↗