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Biomedical subjects

P Greenwood

Publications and source records attributed to P Greenwood.

At least 19 recordsLinked to original sources
PubMed2005

Chest X-ray-confirmed pneumonia in children in Fiji.

OBJECTIVE: To calculate the incidence and document the clinical features of chest X-ray- (CXR-) confirmed pneumonia in children aged between 1 month and 5 years living in Greater Suva, Fiji. METHODS: A retrospective review was undertaken of children aged between 1 month and 5 years with a discharge diagnosis suggesting a lower respiratory tract infection (LRTI) admitted to the Colonial War Memorial Hospital in Suva, Fiji, in the first 10 days of each month from 1 January 2001 to 31 December 2002. Clinical data were collected and CXRs were reread and classified according to WHO standardized criteria for CXR-confirmed pneumonia. FINDINGS: Two hundred and forty-eight children with LRTI met the inclusion criteria. CXRs were obtained for 174 (70%) of these cases, of which 59 (34%) had CXR-confirmed pneumonia. The annual incidence of CXR-confirmed pneumonia was 428 cases per 100,000 children aged between 1 month and 5 years living in Greater Suva. If a similar proportion of the children for whom CXRs were unavailable were assumed to have CXR-confirmed pneumonia, the incidence was 607 per 100,000. The incidence appeared to be higher in Melanesian Fijian than Indo-Fijian children. The case-fatality rate was 2.8% in all children with LRTI, and 6.8% in those with CXR-confirmed pneumonia. CONCLUSION: This is the first study to document the incidence of CXR-confirmed pneumonia in a Pacific Island country, and demonstrates a high incidence. A significant proportion of hospital admissions of children with LRTI are likely to be preventable by the introduction of pneumococcal conjugate vaccine.

Benchmarking↗
PubMed2005

The performance of Pipelle endometrial sampling in a dedicated postmenopausal bleeding clinic.

Endometrial sampling using the Pipelle device is widely used in the UK especially in the investigation of postmenopausal bleeding. This study was aimed at evaluating the clinical benefit and diagnostic accuracy of the procedure in the setting of a dedicated one-stop clinic for women with postmenopausal bleeding. The study also examined the factors that would affect the adequacy of endometrial samples in terms of their suitability for histopathalogical examination. Data from 97 consecutive patients attending the clinic were collected and analysed. All the patients had a transvaginal ultrasound scan and an endometrial Pipelle sample was attempted unless refused by the patient. The analysis revealed that the procedure avoided the need for hysteroscopy in 61.5% of cases with an endometrial thickness of > 4mm. No cases of endometrial cancer were missed after successful Pipelle sampling. The ability to obtain an adequate endometrial sample was primarily affected by the endometrial thickness. There is only a 27% probability of getting an adequate endometrial sample in the group of women with an endometrial thickness of < 5 mm. The study recommends this procedure for the group of women with an endometrial thickness of > 4 mm. However, when the endometrial thickness is < or = 4 mm, little can be gained from endometrial sampling as malignancy is rare and the chance of getting an adequate sample is small.

Catheterization↗
PubMed2003

Inevitable risk of high-order multiple pregnancies following IUI, the need for strict criteria for its prevention: two case reports.

Intrauterine insemination with controlled super-ovulation (IUI/SO) is appropriate management of subfertility where the Fallopian tubes are healthy and patent and the sperm quality is satisfactory. The treatment is monitored by intermittent transvaginal ultrasound scans to assess follicular development. There is an unavoidable increased risk of multiple pregnancy including higher order pregnancy. These two case reports suggest the need for national standards regarding the abandonment of the treatment cycle to further reduce the risk of high order multiple implantations.

Adult↗
PubMed2001

Spinal-cord involvement in diabetic peripheral neuropathy.

The pathogenesis of diabetic distal symmetrical polyneuropathy (DSP) is poorly understood but there is some evidence that the disease process might extend beyond peripheral nerves. We used magnetic-resonance imaging to measure spinal-cord cross-sectional area in diabetic patients with and without DSP and in healthy controls. There were significant differences in cord area between the groups at C4/5 and T3/4 (p=0.004 and p=0.033, respectively), with a smaller cord area in those with DSP compared with controls (p=0.001 and p=0.016 for C4/5 and T3/4, respectively). These results indicate that DSP is not simply a disease of the peripheral nerve and that there is substantial involvement of the spinal cord.

Adult↗
PubMed2001

The analysis of forensic samples using laser micro-pyrolysis gas chromatography mass spectrometry.

Laser micropyrolysis gas chromatography-mass spectrometry is used for the analysis of paint, photocopier toner, and synthetic fiber materials to test the forensic potential of this emerging technology. It uses a laser microprobe to selectively target very small parts of the materials for GC-MS analysis. Whereas the paint and the toner samples were amenable to direct laser pyrolysis, the synthetic fibers proved transparent to the 1064 nm laser radiation. The difficulty with the fibers demonstrates that a specific laser wavelength may not be appropriate for all types of materials. Nevertheless, the fibers were able to be indirectly pyrolyzed by impregnation in a strongly absorbing graphite matrix. A vast array of hydrocarbon pyrolysates was detected from the different materials studied. Unique product distributions were detected from each sample and in sufficient detail to facilitate individual molecular characterization (i.e., molecular fingerprinting). The integrity of the laser data were confirmed by comparison to data obtained from the same samples by the more conventional pyroprobe pyrolysis GC-MS method. The high spatial resolution and selectivity of the laser method may be advantageous for specific forensic applications, however, further work may be required to improve the reproducibility of the data.

DNA Fingerprinting↗
PubMed1996

Directional-tip endotracheal tubes for blind nasotracheal intubation.

OBJECTIVES: To compare initial success rates of blind nasotracheal intubation using directional-tip endotracheal tubes vs standard endotracheal tubes. METHODS: A prospective trial comparing directional-tip and standard endotracheal tubes during initial attempts at blind nasotracheal intubation (BNTI) at a university hospital ED. Using an alternating schedule, the directional-tip or standard tube was used for the first attempt at BNT1. An attempt was defined as beginning when the tube was placed through the nose into the posterior pharynx and ending when the patient was intubated or the tube was removed from the nares. After the intubation, the physician graded the difficulty of the technique (i.e., easy/routine, intermediate, difficult, or unable to intubate nasally). RESULTS: There were 49 patients entered over 5 months. Patient presentations for the intubations were trauma (45.8%), overdose (33.3%), respiratory/cardiac event (12.5%), seizure (2.1%), and other (6.3%). Intubation was successful on the first attempt in 18 of 21 patients (86%; 95% CI, 64% to 97%) for the directional-tip tube vs 16 of 28 patients (57%; 95% CI, 37% to 76%) for the standard tube (p = 0.03). The groups did not differ in age, sex, clinical presentation, or perceived difficulty of intubation. Only 1 patient could not be intubated nasally and was subsequently intubated orally. CONCLUSION: The use of directional-tip tubes may improve the success rate of the first attempt at BNTI.

Adolescent↗
PubMed1994

Antiphospholipid syndrome in pregnancy: a diagnostic dilemma.

OBJECTIVE: To present a case of severe pre-eclampsia in which diagnosis of the antiphospholipid syndrome was made after delivery, and to discuss pointers to the diagnosis. CLINICAL FEATURES: A 32-year-old woman in her second pregnancy presented at 32 weeks' gestation with severe pre-eclampsia. Her persisting severe postpartum illness was investigated. The presence of anticardiolipin antibodies and lupus anticoagulant led to the diagnosis of antiphospholipid syndrome. INTERVENTION AND OUTCOME: Induction of labour was successful, with delivery of a healthy baby girl. The patient made a full recovery after treatment with corticosteroids and warfarin. CONCLUSION: The antiphospholipid syndrome should be considered in cases of severe early pre-eclampsia.

Adult↗
PubMed1994

Dance screen programs and development of dance clinics.

Dance movements can be stressful to the body, and the required extreme positions may place physiologic structures at risk for acute, subacute, or chronic injury. The authors designed a screening program, conducted by a team of physical therapists, orthopedists, and dance instructors, to evaluate dancers for musculoskeletal problems and to make recommendations that would improve movement compensation, strength, endurance, and mobility.

Ankle↗
PubMed1990

Dichotic perception and memory following electroconvulsive treatment for depression.

Verbal and visuospatial memory and dichotic listening performance were examined in 15 acutely depressed patients with no history of ECT, 17 depressed patients currently in remission, 15 remitted depressed patients who had received ECT six months or more in the past, and 20 normal controls. The neuropsychological functioning of an additional group of 10 acutely depressed patients was also studied before and two weeks after ECT. The results revealed some evidence of logical and autobiographical memory impairment two weeks following ECT, but no evidence that ECT impaired dichotic listening ability. Rather, a normalisation of hemispheric laterality was apparent on the dichotic listening task following ECT and the concomitant relief from depression. There was also no evidence of cognitive dysfunction on any task in individuals who were tested six months or more following their last ECT treatment.

Adult↗
PubMed1989

Sustained-attention capacity in young and older adults.

The sustained-attention capacity of young (21-29 years) and older (65-78 years) adults was examined using a high-event rate digit-discrimination vigilance task presented at three levels of stimulus degradation. Increased stimulus degradation led to a reduction in the hit rate and to a greater decline in hit rate over blocks (increased vigilance decrement). Sensitivity (d') declined over blocks only at the highest level of stimulus degradation. Older adults had a lower hit rate and showed greater vigilance decrement than young adults, particularly when stimuli were highly degraded. However, both age groups showed the same pattern of stability in sensitivity when stimulus degradation was moderate, and sensitivity decrement over time when stimulus degradation was high. The results suggest that the process of sustained allocation of capacity--as reflected in temporal changes in sensitivity--operates similarly in young and older adults.

Adult↗
PubMed1985

Use of impedance cardiography in evaluating the exercise response of patients with left ventricular dysfunction.

Invasive studies in patients with left ventricular dysfunction show that data at rest (e.g. ejection fraction-EF) are poor predictors of the changes in cardiac output (CO) which occur with exercise. This investigation was undertaken to determine whether impedance cardiography could be used in such patients to assess CO response to exercise. The method was compared with the direct Fick method. Over a range of COs between 4 and 18 min-1 there was no systematic error. Reproducibility for CO over one week was highly significant (r = 0.94; P less than 0.001). Impedance cardiography was incorporated into routine exercise testing on a bicycle ergometer for a group of 15 patients (mean age 53.2 +/- 3.0 yrs, SEM) who had sustained a major myocardial infarct 6 to 12 months previously, (EF 38.1 +/- 3.5%, SEM). CO was measured at the end of each 3-min stage. In eight patients (EF 40.0 +/- 3.4%, SEM) CO response was abnormal with either a decrease or a failure to increase with increasing workloads. Conventional end-points i.e. angina, attainment of 85% of predicted maximum heart rate, abnormal blood pressure response or excessive dyspnoea did not indicate consistently a need to terminate the test. It is suggested that impedance cardiography is a useful non-invasive method of evaluating patients with left ventricular dysfunction.

Adult↗
PubMed1984

A platelet release defect induced by aspirin or penicillin G does not increase gastrointestinal blood loss in thrombocytopenic rabbits.

Gastrointestinal blood loss was compared in groups of normal and thrombocytopenic animals treated with medications known to induce qualitative platelet dysfunction. Thrombocytopenia was induced in rabbits by the intraperitoneal injection of busulphan dissolved in polyethylene glycol (PEG) at a dose of 60 mg/kg. Control animals received PEG alone; each group subsequently received daily intravenous injections of penicillin G, aspirin, sodium salicylate or isotonic saline. Mean daily gastrointestinal blood loss was determined by monitoring the appearance of 51Cr radioactivity in the faeces following the administration of 51Cr-labelled erythrocytes prior to the administration of the test and control therapies. The administration of penicillin G was not associated with increased gastrointestinal blood loss in the thrombocytopenic animals as compared with the saline treated thrombocytopenic controls. Platelet aggregation studies confirmed the presence of a mild but significant defect in platelet aggregation. Aspirin produced a more pronounced defect in platelet aggregation but did not induce increased bleeding in the normal animals as compared with the controls, nor did it exacerbate the bleeding in thrombocytopenic animals. Sodium salicylate did not produce an aggregation defect and did not significantly modify gastrointestinal blood loss. It was concluded that drug-induced qualitative platelet dysfunction does not necessarily increase bleeding through intact vessels despite previous evidence of a significant effect on platelet plug formation as monitored by the bleeding time.

Animals↗
PubMed1984

Development of factor VIII:C antibodies in dogs with hemophilia A (factor VIII:C deficiency).

Classic hemophilia A (factor VIII:C deficiency) was diagnosed in a miniature Schnauzer dog and a breeding program established. Inbreeding and crossbreeding produced 16 hemophilic animals. All were initially treated with canine cryoprecipitate, as required, for sporadic hemorrhagic events. Five animals developed potent antibodies to canine factor VIII:C. All were the offspring of obligate carriers, resulting from the mating of a hemophilic purebred miniature Schnauzer male to a normal female Brittany spaniel. The mean age at first treatment and factor VIII exposure at the time of inhibitor development was 10.3 wk and 286.3 U, respectively. The remaining hemophilic animals have not developed antibodies, despite receiving a mean factor VIII dosage of 1.5 X 10(3) U. This group includes animals derived from a mating between the same purebred miniature Schnauzer hemophilic male and a purebred miniature Schnauzer carrier female. In each case, the antibodies recognize both canine and human but not porcine VIII:C. They are non-precipitating IgG immunoglobulins. Following inhibitor development, infusion of canine cryoprecipitate was hemostatically ineffective and factor VIII:C recovery at 30 min was negligible. Infusion of a concentrate of porcine factor VIII resulted in a correction of the hemostatic defect and optimal factor VIII:C recovery. All animals receiving porcine factor VIII:C subsequently developed antibodies to this protein. The chance occurrence of this complication should facilitate further studies directed at elucidating the pathogenesis and management of hemophilia complicated by the development of antibodies to factor VIII:C.

Animals↗
PubMed1981

Analysis of putative high-mobility-group (HMG) proteins in neuronal and glial nuclei from rabbit brain.

Putative high-mobility-group (HMG) proteins 1, 2, and 17 were detected in neuronal and glial nuclei isolated from the cerebral hemisphere of rabbit brain. Although divergent chromatin structures are present in these two populations of brain nuclei (i.e., neuronal nuclei exhibit a short DNA repeat length), no differences were apparent in the electrophoretic mobilities of putative HMG proteins 1, 2, and 17 on SDS gels.

Animals↗
PubMed1978

[Proprioceptive feedback and temporal regulation in cats].

Temporal regulation in cats was studied using operant conditioning techniques; milk was delivered according to either a two-lever response duration schedule or a two-lever DRL schedule. After an equal number of experimental sessions, the subjects on the DRL schedule reached larger delay values than the subjects on the response duration schedule. Hypotheses concerning the intervention of proprioceptive feedback in the temporal regulation of motor behavior are discussed.

Animals↗
PubMed1977

Dream report following commissurotomy.

This paper addresses the question of right hemisphere involvement in the visual components of dreaming. The rationale derives from an observed relation between reports of visual agnosia accompanied by dream cessation and the literature on right hemisphere specialization for visuo-spatial processes. All night sleep EEGs were recorded from subjects with partial or complete section of the corpus callosum and anterior commissure. Upon entering a EEG-, EOG- and EMG-defined REM episode, the subjects were awakened and questioned about dream content. All subjects examined in this fashion were able to recount some visual dream content. This result fails to support any notion of selective right hemisphere visual dream mediation.

Corpus Callosum↗