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Biomedical subjects

R E Day

Publications and source records attributed to R E Day.

At least 19 recordsLinked to original sources
PubMed1992

A clinical exercise system for paraplegics using functional electrical stimulation.

A low cost clinical exercise system was developed for the spinal cord injured, based on a bicycle ergometer and electrical stimulation. A pilot project was conducted, using the system, to examine the effects of stimulation induced cycling in long term paraplegics. The project comprised 2 phases of exercise, a strengthening phase involving a 12 week programme of electrical stimulation to the quadriceps and hamstrings and a 12 week cycling phase. Physiological, morphological and biochemical parameters were measured for each subject, at the beginning of the programme and following each phase. Results showed that a programme of stimulation induced lower limb exercise increased the exercise tolerance of all patients, as determined by a progressive increase in exercise time, cycling rate and exercise load. The enhanced exercise tolerance was a result of increases in local muscle strength and endurance. Increases in thigh muscle area and joint range of motion were recorded and all incomplete subjects reported an improvement in functional capabilities and general wellbeing.

Adult↗
PubMed1991

Dysequilibrium/ataxic diplegia with immunodeficiency.

A girl with purine nucleoside phosphorylase (PNP) deficiency is described. The nature of the motor disorder is similar to other children since found to have PNP deficiency. It is suggested that the diagnosis be considered in any child with unexplained dysequilibrium/ataxic diplegia. Other previously unreported features are intracytoplasmic neutrophil inclusion bodies and an improvement in the neutropenia after intravenous immunoglobulin.

Female↗
PubMed1990

Intra-articular synovial folds of thoracolumbar junction zygapophyseal joints.

Transverse histological sections from T10-11, T11-12, T12-L1, and L1-2 zygapophyseal joints were examined in 32 post-mortem spines, using light microscopy, to record the presence of intra-articular synovial fold inclusions. In addition, three mid-joint sections from each joint were photographed using 35 mm colour film. From these slides, linear dimensions of the extent of intra-articular synovial fold projection between the zygapophyseal joints were measured using computer-aided planimetry. Small, fibrous folds were commonly found at the joint margins extending from the ligamentum flavum and the fibrous joint capsule. Larger, fibro-adipose synovial folds, projecting between the articular surfaces, were also noted, particularly at T12-L1 and L1-2.

Adolescent↗
PubMed1990

Influence of zygapophyseal joint orientation on hyaline cartilage at the thoracolumbar junction.

Hyaline articular cartilage from 102 thoracolumbar junction zygapophyseal joints was examined using light microscopy. One section from the upper, middle and lower third of each joint at the T10-11, T11-12, T12-L1 and L1-2 spinal levels was photographed using 35 mm color film. Hyaline articular cartilage cross-sectional area of the superior and inferior articular processes of each joint pair, at each level, was digitized using computer-aided planimetry. Differences in area were compared with joint orientation (symmetry or tropism) and geometry of each joint pair at each spinal level. Variation in hyaline cartilage cross-sectional area between joint pairs could be attributed to: a) geometric differences, b) the presence of a mortice joint, or c) osteoarthritic changes, with or without tropism. These findings were most frequently demonstrated at the transitional levels of T11-12 and T12-L1.

Adolescent↗
PubMed1989

Radiologic study of the influence of zygapophyseal joint orientation on spinal injuries at the thoracolumbar junction.

The change from coronal to sagittal plane orientation of the zygapophyseal (facet) joints at the thoracolumbar junction, coupled with differences in lumbar and thoracic spine mobility, may predispose the T10 to L2 segments to injury. To test for an association between the level of injury and variations in orientation of the zygapophyseal joints, CT investigations of 44 spinal injured patients were studied. Of these, 28 sustained burst/compression fractures and 16 demonstrated a rotation injury with disruption to one or both zygapophyseal joints. Injuries were examined to determine whether more congruent "mortice" joints localised the segmental level of trauma. The Chi-square statistic was used: to compare the transitional characteristics of 44 clinical cases with a "normal" patient database (n = 630); to examine differences in transition patterns between the "compression" and "rotation" injury groups; and to compare the incidence of mortice joints between the clinical and normal series. A significant difference between the transition patterns of the clinical and normal series (p less than 0.001) appeared to account for the higher frequency of abrupt transitions in the 44 injury cases. No significant differences distinguished the transition patterns of the two injury groups. A higher incidence of mortice joints was demonstrated in the injury group compared with the normal population (p less than 0.02). These findings suggest that individuals with an abrupt transition have a greater predisposition to injuries at the thoracolumbar junction.

Adolescent↗
PubMed1988

Variations in zygapophyseal joint orientation and level of transition at the thoracolumbar junction. Preliminary survey using computed tomography.

Variation in zygapophyseal joint orientation at the thoracolumbar transitional junction was investigated using computed tomography (CT). The study population (N = 214) comprised 176 cases of abdominal scans, 9 thoracolumbar junction referrals and 29 cadaveric vertebral columns. Scans through the superior endplates of T11, T12, L1 and L2 were selected and joint angles calculated using a computer aided digitiser. Analysis revealed 29% of cases presented coronally oriented superior and sagittally orientated inferior joint processes at T12. This pattern occurred in 16% of cases at T11 and 0.5% at L1. A gradual transition occurred in 54% of cases and involved the adjacent inter-segmental joints of T11 and T12. Articular tropism (greater than 20 degrees) was most frequent at T11-12 (21%), followed by T12-L1 (9%).

Adolescent↗
PubMed1985

Thyroid dysfunction in Down's syndrome.

One hundred and sixteen children with Down's syndrome, living in the community, were examined for clinical or laboratory evidence of thyroid dysfunction. Three were hypothyroid and one was hyperthyroid. Twenty eight (29%) had thyroid autoantibodies. Autoimmune conditions were present in first or second degree relatives of 35 (30%) of the children, and in 17 (15%) this was a thyroid disorder. The families of normal control children also showed a 30% incidence of overt autoimmune conditions, and 19 (16%) families showed overt thyroid disease.

Adolescent↗
PubMed1983

Alcohol and the fetus in the west of Scotland.

Forty children with the fetal alcohol syndrome were identified in the west of Scotland. All were growth retarded and had abnormal facial features, and all those who were tested were found to have neurological or developmental abnormalities. Two children died of associated physical defects. Most of the mothers were socially deprived, and all had drunk heavily while pregnant. Three women had subsequently died. These findings provide clear evidence that in the west of Scotland maternal alcohol abuse during pregnancy is a significant cause of morbidity and mortality in children.

Adult↗
PubMed1981

Solvent encephalopathy.

Nineteen children aged 8-14 years were admitted over a six-year period with an acute encephalopathy due to toluene intoxication. Seven had a history of euphoria and hallucinations. The remainder presented with coma (4), ataxia (3), convulsions (3), and behaviour disturbance with diplopia (2), A history of glue sniffing was elicited in 14, but in the remainder toluene assay confirmed the diagnosis. Thirteen children recovered completely; five still had psychological impairment and personality change on discharge from hospital but were lost to follow-up, and one has a persistent cerebellar ataxia one year after the acute episode, despite absence of further exposure. Toluene inhalation is an important cause of encephalopathy in children and may lead to permanent neurological damage. Diagnosis is most important if further damage due to continued abuse is to be prevented, and toluene assay is a valuable aid to diagnosis.

Adhesives↗
PubMed1979

Normal children with large heads--benign familial megalencephaly.

Fifteen normal children with large heads (circumference greater than 0.5 cm above the 98th centile) were studied. CAT scans were pefrormed to exclude hydrocephalus, and ventricular size was compared with that of hydrocephalic children. In 11 of the 13 families in which the parents' heads were measured, one parent (10 fathers and one mother) was found to have a large head, as had 6 of 17 siblings. Head circumference at birth was large in 7 of 10 babies and rate of head growth was excessive in 8 of 13. Skull x-ray showed suture diastasis in 7 infants. These families have a benign familial megalencephaly. It is important to recognise this so as to avoid unnecessary investigation and anxiety about normal children with large heads.

Brain↗
PubMed1978

Computerised axial tomography and acute neurological problems of childhood.

The results of computerised axial tomography (CAT) in 80 children with neurological symptoms and/or signs of less than 3 months' duration are discussed in relation firstly to intracranial pathology and secondly to clinical presentation. 26 children had intracranial space-occupying lesions (tumour, abscess, haemorrhage, infarct). CAT was abnormal in 25 of these and diagnostic in 18. A further 20 children had meningitis or encephalitis, and CAT was abnormal in 12. In contrast with this high rate of scans showing pathology, CAT was abnormal in only 4 of the remaining 34 children who had less definite or no intracranial disease. Analysis of clinical presentation showed that 42 of 69 children presented with persisting neurological signs and of these, 25 had an intracranial space-occupying lesion and 29 had abnormal CAT. Only 5 of 27 children who had symptoms alone or signs lasting less than 24 hours had abnormal CAT, and no intracranial lesion requiring specific treatment was missed. CAT is useful for demonstrating the site, size, and nature of many lesions. The scan may not initially be abnormal in brain stem gliomas and in small subdural collections of fluid.

Adolescent↗
PubMed1977

Peritoneal dialysis in children. Review of 8 years' experience.

During the years 1968-75, 59 periods of peritoneal dialysis were performed on 44 children aged from 2 days to 17 years. The commonest complication was peritoneal infection, which affected 68% of those under 2 years and 30% of older children. This was satisfactorily treated in all but one case which was due to Candida albicans. The use of combined intramuscular and intraperitoneal gentamicin therapy is described. 2 patients died as a result of massive intraperitoneal haemorrhage and one had a nonfatal intestinal perforation. In experienced hands peritoneal dialysis is a convenient, effective, and reasonably safe way of treating acute renal failure; it is best performed in centres capable of handling complex metabolic problems and investigating and treating the underlying renal disease.

Adolescent↗
PubMed1976

Maternal diabetes mellitus and congenital malformation. Survey of 205 cases.

Twenty-five out of 205 (i.e. 12%) babies born to diabetic mothers in the Birmingham Maternity Hospital in the period 1969-1974 were malformed as against 6% in a control group. The incidence was highest in the group where mothers were on insulin at the time of conception (17 out of 117, i.e. 15%). No correlation was observed between major malformation in this group and age of onset or duration of the diabetes, progressive vascular complications, maternal age, or parity. Cardiovascular malformations were over-represented.

Abnormalities, Drug-Induced↗