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Biomedical subjects

P Disler

Publications and source records attributed to P Disler.

13 recordsLinked to original sources
PubMed2004

Improving left hemispatial neglect using virtual reality.

BACKGROUND: In hemispatial neglect, space can be dissociated on the basis of "near" peripersonal vs "far" extrapersonal space. The clinical manifestations of neglect can be modified by having patients use a tool to explore "far" extrapersonal space. An explanation for this is that the use of a stick produced an extension of body space resulting in a remapping of "far" space as "near" space. OBJECTIVE: S: To determine whether the remapping of space can be generalized to the amelioration of the "affected" vs the "nonaffected" space, rather than being confined to the selective amelioration of "far" vs "near" neglect; and to determine whether tool use is a necessary condition for the remapping of space. METHODS: Using virtual reality, the authors asked six hemispatial neglect patients to reach and grasp a real object while simultaneously observing the grasping of a virtual object located within a virtual environment by a virtual hand. The virtual hand was commanded in real time by their real hand. RESULTS: After a period of adaptation, hemispatial neglect patients coded the visual stimuli within the neglected space in an identical fashion as those presented within the preserved portions of space. CONCLUSIONS: It is possible to re-create links between the affected and the nonaffected space. Wielding a tool is not a necessary condition in reopening neglected space.

Aged↗
PubMed2000

The Australian National Sub-acute and Non-acute Patient Casemix Classification (AN-SNAP): its application and value in a stroke rehabilitation programme.

OBJECTIVE: To investigate whether the Australian National Sub-acute and Non-acute Patient Casemix Classification (SNAP) and Functional Independence Measure and Functional Related Group (Version 2) (FIM-FRG2) casemix systems can be used to predict functional outcome, and reduce the variance of length of stay (LOS) of patients undergoing rehabilitation after strokes. DESIGN AND SETTING: The study comprised a retrospective analysis of the records of patients admitted to the Cedar Court Healthsouth Rehabilitation Hospital for rehabilitation after stroke. SUBJECTS: The sample included 547 patients (83.3% of those admitted with stroke during this period). Patient data were stratified for analysis into the five SNAP or nine FIM-FRG2 groups, on the basis of the admission FIM scores and age. MAIN OUTCOMES: The AN-SNAP classification accounted for a 30.7% reduction of the variance of LOS, and 44.2% of motor FIM, and the FIM-FRG2 accounts for 33.5% and 56.4% reduction respectively. Comparison of the Cedar Court with the national AN-SNAP data showed differences in the LOS and functional outcomes of older, severely disabled patients. Intensive rehabilitation in selected patients of this type appears to have positive effects, albeit with a slightly longer period of inpatient rehabilitation. CONCLUSIONS: Casemix classifications can be powerful management tools. Although FIM-FRG2 accounts for more reduction in variance than SNAP, division into nine groups meant that some contained few subjects. This paper supports the introduction of AN-SNAP as the standard casemix tool for rehabilitation in Australia, which will hopefully lead to rational, adequate funding of the rehabilitation phase of care.

Activities of Daily Living↗
PubMed1995

[An overview of snow-boarding injuries].

Snowboarding is increasing dramatically in popularity in Switzerland as well as other countries. Work aimed at improving the design of the boards and of the boots and bindings has also increased rapidly during recent years. Most injured snowboarders are fit young men and boys who describe themselves as beginners and have had a minimal amount of instruction at an officially approved training centre. Appropriate snowboard training has mostly been quite inadequate, and protective devices (e.g. waterproofed support gloves). The anatomical distribution and the types of injuries sustained in snowboarding differ from those in alpine skiing. The wrist (and forearm) and the ankle are the most frequent locations of injuries (23%) as against the knee and thumb in alpine skiing. Sprains and strains were the most frequent types of injuries (46%), followed by fractures (28%) and contusions (13.5%). The snowboard injury rate was higher than in alpine skiing (1.7-8/1000 snowboard days versus 2-4/1000 ski days). Falling forward on the slope was the major mechanism of injury (80%), and torsion the next most frequent (20%). Snowboarding injuries were sustained most often on ice and hardpacked snow, compared with soft powder snow for alpine skiing injuries. Appropriate preseason conditioning, snowboarding lessons from a certified instructor, appropriate selection of rigorously tested equipment and use of protective devices are the main steps that must be taken to prevent injuries.

Adolescent↗
PubMed1985

The cost effectiveness of the Philani Nutrition Day Centre in Crossroads squatter camp, Cape Town.

One hundred and seventeen children aged 0-7 years who had been treated at Philani Nutrition Day Centre were sought in Crossroads squatter camp near Cape Town after discharge; 61 were traced and complete records were obtained for 42. Twenty-seven (64,2%) of the 42 were below the third percentile (weight for age, National Center for Health Statistics standards) at the time of admission to the centre and 3 (7,1%) were still below it at discharge 1-26 (mean 7,8) months later. Six (14,3%) were below the third percentile when they were traced 1-23 months (mean 10,3 months) later. Total attendances from 1982 to 1983 were estimated at 12 300 child-days. Expenditure on the centre for this period was estimated at R29 759, of which R20 282 (68,2%) was spent on salaries, R6 340 (21,3%) on food and R3 137 (10,5%) on sundries (including R2 500 on drugs). The estimated cost per child per day's attendance was R2,42. The duration of treatment was estimated to be 80 attendances for a severe and 32 attendances for a moderate case of undernutrition, giving an estimated cost of between R194 and R73 per child for complete treatment. We conclude that this expenditure: (i) benefited most of the children who were originally below the third percentile; (ii) sustained children not actually admitted to the centre by feeding them or their siblings, probably resulting in there being more food available at home; and (iii) prevented the (costly) admission to hospital of some children.

Ambulatory Care Facilities↗
PubMed1982

Treatment of hemodialysis-related porphyria cutanea tarda with plasma exchange.

A patient with hemodialysis-related porphyria cutanea tarda was treated with plasma exchange. A rapid clinical response occurred coincidentally with a significant fall in the plasma porphyrin level. The level fell further over the following few months without additional therapeutic intervention, whereafter a slow rise occurred without recurrence of skin disease. We suggest that this form of treatment may be ideal for the patient with porphyria cutanea tarda and chronic renal failure in whom no alternative therapy is available for the cutaneous problem.

Adult↗
PubMed1976

Patterns of iron storage in dietary iron overload and idiopathic hemochromatosis.

Bone marrow iron stores rise in proportion to the total body iron store in dietary iron overload. The situation in the genetic disorder of idiopathic hemochromatosis is not as clear. A method for measuring the storage iron concentration chemically on samples of bone marrow obtained by trephine needle biopsy was therefore developed. Its value as a measure of tissue iron stores was established in a preliminary investigation in which specimens of liver, spleen, and bone marrow were obtained at necropsies on 66 South African Negroes among whom dietary iron overload is common. A wide range of nonheme iron concentrations was found, but in each individual there was a highly significant correlation between the concentrations in the three tissues. Nonheme iron concentrations were then determined on trephine bone marrow biopsy specimens from eight Caucasian patients with untreated idiopathic hemochromatosis, and on percutaneous liver biopsy specimens from four of them. The concentrations in the livers were in the anticipated range of 5,000 mug per gram wet weight (2 per cent dry weight). In contrast the geometric mean value for bone marrow iron concentration was 186 mug per gram wet weight, a figure that fell below the fiftieth percentile for marrow iron concentrations in the South African Negroes, whereas the geometric mean liver iron concentration was above the ninetieth percentile. These findings indicate that subjects with idiopathic hemochromatosis whose liver iron stores are grossly increased do not show a comparable rise in bone marrow iron stores.

Adult↗
PubMed1975

G6PD hillbrow: a new variant of glucose-6-phosphate dehydrogenase associated with drug-induced haemolytic anaemia.

A new genetic variant of the red cell enzyme glucose-6-phosphate dehydrogenase is described. It was observed in a patient presenting with severe haemolytic anaemia and renal failure following ingestion of an overdose of Beserol (paracetamol and chlormezanone). The enzyme in the red cell had 12% of the activity of a normal B+ control, but only slightly lower activity in the kidney compared with a normal control. The red cell enzyme showed normal electrophoretic mobility and thermostability, a biphasic pH optimum curve, higher than normal utilization of the substrate analogues 2-deoxy-glucose-6-phosphate and deamino-NADP, and lower than normal Michaelis constants for both substrates, glucose-6-phosphate and NADP. The enzyme was strongly inhibited in vitro by high concentrations of paracetamol and chlormezanone. The extent of inhibition was similar to that for the enzyme from a normal B+ individual.

Acetaminophen↗
PubMedDate not supplied

Caregivers of people with multiple sclerosis: a survey in New Zealand.

A survey carried out in the Manawatu and Wanganui area of New Zealand was designed to locate all those known to have multiple sclerosis; as part of the research, 31 primary caregivers (20 males, 11 females) of MS patients in the study were interviewed to gain information about their roles, self-defined tasks, and life situations.

Adaptation, Psychological↗