Biomedical subjects

P Wing

Publications and source records attributed to P Wing.

6 recordsLinked to original sources

PubMed1992

Diurnal changes in the profile shape and range of motion of the back.

The diurnal height change reported to occur in young adults was investigated to characterize changes in the lumbar range of motion, spinal profile, and range of motion of the back. Twelve subjects aged 18-22 years were measured using stereophotography and standard clinical examinations in the evening and after a minimum of 8 hours of complete bed rest. The average increase in height was 20 mm. Forty percent of the height increase took place in the lumbar spine without change in the depth of the lordosis, and forty percent took place in the thoracic curve with a decrease in the kyphosis. The remaining 20% of the height increase was not located, but no measurements were taken of the cervical spine. Range of motion studies revealed that lumbar flexion, as measured using the lumbar flexion increment, was decreased in the morning, and straight leg raise was decreased when measured clinically but not when measured photographically. Extension, rotation, and femoral stretch test were not affected. The authors conclude that stereophotogrammetry offers an accurate, noninvasive way to study spinal profiles. Further work is needed to assess and quantify the relative motion of the skin and the underlying structures.

Adult↗

PubMed1992

A pilot study of anabolic steroids in elderly patients with hip fractures.

OBJECTIVE: To determine the safety and efficacy of the anabolic steroid nandrolone in elderly patients with hip fractures. DESIGN: A randomized double-blind placebo-controlled trial. SETTING: The orthopedic ward of a university teaching hospital. PARTICIPANTS: 29 frail elderly females with hip fractures. INTERVENTION: Subjects received nandrolone 2 mg/kg (n = 15) or placebo (n = 14) by weekly injection for 4 weeks or until discharge. MEASURES: Baseline functional status was assessed by the Lawton-Brody ADL and IADL. Hemoglobin, transferrin, thyroid-binding prealbumin, albumin, liver function tests, creatinine, weight, MAMC, bioelectric impedance, standard anthropometrics and grip strength were measured at baseline and weekly intervals. Rehabilitation parameters and length of stay were recorded. RESULTS: The placebo and nandrolone groups were similar in age, although the control group had slightly higher baseline ADL scores. There was no difference between groups in biochemical parameters, anthropometrics, body composition, grip strength, rehabilitation end points or length of stay. One subject in the nandrolone group had a doubling of AST and was withdrawn from the study. CONCLUSIONS: Nandrolone can be given safely to frail elderly subjects with hip fractures but is likely to be of minimal benefit at the doses we employed.

Activities of Daily Living↗

PubMed1992

Investigation of the Knoll Assessment Scale in a tertiary care facility.

The purpose of this study was to assist in assessing the validity and reliability of adaptation of the Knoll Tool, Assessment of Pressure Ulcer Potential. Data were retrospectively collected from charts of a random sample of patients (n = 62) who were admitted to a tertiary care facility. Total risk scores ranged from 0 to 22 with a mean of 8.7 and a standard deviation of 6.37. The alpha for the total assessment tool was .6352 with a standardized item alpha of .5973. Discriminant analysis predicted group membership at 62.9%. Group membership was most accurately predicted in Group 1 (76.9%). Discriminant analysis using a score of 11 predicted only 46.8% of group membership, although Group 1 predicted 88.5% and Group 4 predicted 85.7%. Low predictions may be related to small sample size.

Adolescent↗

PubMed1991

Teaching epidemiology and biostatistics through interactive problem solving.

Medical education should prepare students for the reasoning and decision making that are required in a physician's clinical work. The disciplines of epidemiology and biostatistics, as combined in clinical epidemiology, lend themselves very well to this purpose. A lecture course in epidemiology and biostatistics was redesigned to emphasize interactive learning through problem-solving workshops in which students worked with actual data from two epidemiologic studies. A third workshop provided experience in the critical appraisal of an epidemiologic study from the current literature. Students respond favorably to these active learning experiences, which deal with relevant contemporary health problems. The concepts of clinical epidemiology should be integrated into clinical teaching in all stages of training.

Biometry↗

PubMed1990

Predictive value of the Glasgow Coma Scale for tracheotomy in head-injured patients.

Patients with severe head trauma often require prolonged intubation and subsequent tracheotomy. The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify that subpopulation of trauma victims who will ultimately undergo tracheotomy. This retrospective study demonstrates through discriminant analysis that the likelihood of tracheotomy is significantly greater in patients with a GCS rating less than or equal to 7 than it is in patients with a GCS rating greater than 7 (p = .0001). Conversely, the presence of thoracoabdominal or maxillofacial injury is associated with but not predictive of eventual tracheotomy. In the hope of minimizing complications and enhancing the utilization of hospital resources, this study argues for early tracheotomy in patients with a GCS score less than or equal to 7 who do not undergo craniotomy and are otherwise stable.

Adolescent↗

PubMed1988

The availability of physician services: a geographic analysis.

This article describes a new technique for estimating the availability of physician services in small geographic areas. Given counts or estimates of the number of physicians practicing in small geographic areas (e.g., zip codes), the technique allocates a portion of the services of each physician in an area to his home area and to nearby areas in proportion to both the propensity of patients to travel for medical care and the availability of potential patients. The longer the time required for a patient to travel to the physician, the smaller the proportion of the physician's services allocated to the patient's area, with the precise relationship determined by a special analysis. The final estimate of the availability of physician services in each small area is the sum of the service proportions of every physician in all of the small areas. The total supply of physician services is the same as the original total, but the distribution is adjusted to reflect the time that patients are willing to spend traveling to obtain medical care. Although this technique requires considerable data processing, it permits more accurate estimation of the supply of physician services in small geographic areas than is possible with traditional methods. It better represents the probabilistic and interpenetrating nature of physician service areas than alternative techniques and appears to be particularly applicable in estimating the supply of primary care physician services. Actual data for pediatricians and children in northeastern New York using zip codes as the geographic units illustrate the technique. Limitations, applications, and possible extensions are discussed.

Catchment Area, Health↗