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Biomedical subjects

R Fielding

Publications and source records attributed to R Fielding.

10 recordsLinked to original sources
PubMed1992

A comparison of case retrieval times: film versus picture archiving and communications systems.

One of the advantages that a picture archiving and communications system (PACS) is supposed to provide over a film-based operation is improved performance in retrieving images. Although it seems self-evident that this should be so, this experiment was intended to verify this and to provide some time comparisons for the two methods. The experiment consisted of randomly selecting ultrasound and computed tomography cases and determining how long it took to retrieve files at a PACS workstation or in person from the file room. To simulate actual retrieval volumes, a total of 40 cases from current to 6 months old, 20 cases from the past year, and 10 cases more than 1 year old was selected. Results indicate that PACS retrieval can indeed be faster than file room retrieval. However, the difference is less for recent cases than for older cases. For cases 6 or fewer months old, the workstation retrieval was approximately 2.5 minutes faster per case than the film file room. This time difference increased markedly when extended to the 1-year and older-than-1-year groups. This report details the results of this study and provides information about the reliability of the two archives.

Filing↗
PubMed1992

Alteration in the levels of thyrotropin releasing hormone, substance P and enkephalins in the spinal cord, brainstem, hypothalamus and midbrain of the Wobbler mouse at different stages of the motoneuron disease.

The present study was undertaken to quantify selected neuropeptides (thyrotropin releasing hormone, substance P, methionine and leucine enkephalin) in the cervical spinal cord and other regions of the central nervous system of Wobbler mice by radioimmunoassays during several stages of the motoneuron disease compared with age- and sex-matched normal phenotype littermates. In Wobbler spinal cord, thyrotropin releasing hormone is higher early in the disease, whereas in the brainstem it is higher at a later stage. Substance P in spinal cord is also higher late in the disease. Leucine enkephalin levels are greater at all stages in diseased spinal cord and brainstem, but methionine enkephalin increases only late in the disease. Highly significant increases of the peptides (except thyrotropin releasing hormone) appear in hypothalamus and midbrain only late in the motoneuron disease. Regression analyses show that thyrotropin releasing hormone in spinal cord and brainstem decreases normally with age in the control mice and at a faster rate related to the extent of motor impairment in Wobbler mice. Thyrotropin releasing hormone and methionine enkephalin in the Wobbler brainstem correlate (P less than 0.05) with the progress of the motoneuron disease. Methionine enkephalin increases faster in Wobbler brainstem and decreases faster in control spinal cord with age. The increase of leucine enkephalin in the Wobbler spinal cord correlates significantly with age and with the progress of the disease, but leucine enkephalin declines slightly with age in the controls. The changes of substance P in spinal cord and brainstem do not correlate significantly with the progress of the disease. In the hypothalamus, increasing values for substance P in control specimens and enkephalins in Wobbler specimens are significantly correlated with age. However, in the midbrain, higher methionine and leucine enkephalin levels are significantly associated with age only in the control mice. Alterations of neuropeptides in the Wobbler mouse spinal cord and brainstem may result from the degeneration of bulbospinal raphe neurons projecting to the ventral spinal cord, or from primary afferent or interneuronal nerve terminals. The data imply that the neuronal degeneration process in the Wobbler motoneuron disease is not limited to motoneurons. In the spinal cord, the data support our previous hypothesis that neuronal sprouting presynaptic to the motoneurons may account for increased neuropeptide concentrations. Alternatively, synthesis and/or degradation of these peptides may be altered. In addition, it is proposed that enkephalinergic neurons may develop abnormally in Wobbler mice. The early increase of leucine enkephalin in the Wobbler spinal cord possibly indicates its importance in the etiology of the motoneuron disease.

Animals↗
PubMed1992

Effects of social interaction on distress and recovery from minor surgery in elective paediatric patients.

Thirty-six children aged 2-10 years, the majority of whom were males admitted for urogenital surgery, were observed for level and frequency of distress and type of social interaction over the duration of hospitalization. The results indicate that high levels of observed distress were associated with longer post-operative hospital stays. Staff interactions were associated with higher levels of distress while peer caretaking interactions were associated with lower levels of distress. We tested the hypothesis that social interaction lowered distress, leading to a briefer hospital stay. Using path analysis, we found peer caretaking interactions accounted for a small but significant percentage of the observed variance in duration of post-operative hospital stay. These data illustrate the potential importance of social environments in the maintenance of reduction of distress before and after paediatric surgery. This raises the expectation that certain types of social environments could facilitate recovery from surgery.

Child↗
PubMed1991

Depression and acute myocardial infarction: a review and reinterpretation.

Depression is widely accepted as occurring in response to acute myocardial infarction (AMI), and to be an important determinant of recovery. A review of the literature reveals that three categories of patients with depressive symptomatology may be identifiable. First, many patients show depressive symptoms before admission with AMI; these may intensify during hospitalisation. For these patients, the depressive symptoms may contribute etiologically to the onset of AMI or derive from a common source along with AMI. The second group constitute patients with a history of AMI, and who on readmission with chest pain or suspected AMI are more likely to report depressive symptoms. The third group of patients are non-depressed first time admissions for AMI. These patients appear to show transient depressive reactions, much of which it is argued, occurs as a reaction to hospitalisation and not to AMI per se. This review considers the theoretical context whereby depressive symptoms may arise from the same circumstances that generate the coronary heart disease which underlies AMI, and links this to the generation of helplessness and cardiopathic processes.

Adaptation, Psychological↗
PubMed1991

Leucine metabolism during fasting and exercise.

Whole body leucine kinetics were examined in seven healthy young men while in a 14-h postabsorptive state (PAS) and after a 3.5-day fast (FS). Subjects received a primed constant intravenous infusion of L-[1-13C]leucine while resting for 3 h and then while exercising on a cycle ergometer at 45% maximal O2 uptake to exhaustion. Blood samples drawn during isotopic steady state were analyzed for 13C enrichment of leucine and alpha-ketoisocaproic acid, and expired gas samples were analyzed for 13CO2. Resting leucine flux was higher in the FS, and there was a slight increase in leucine oxidation. During exercise, leucine flux did not differ between PAS and FS but leucine oxidation rose markedly. In the FS, leucine oxidation was 25 +/- 7 (SD) mumol.kg-1.h-1 at rest and rose to 75 +/- 21 mumol.kg-1.h-1 during exercise; in the PAS, oxidation was 20 +/- 5 mumol.kg-1.h-1 at rest and 52 +/- 17 mumol.kg-1.h-1 during exercise. These data indicate that the high rate of leucine oxidation previously found during exercise was increased further by a 3.5-day fast.

Adult↗
PubMed1989

The role of communication in the alteration of patient-care practices in hospital--a prospective study.

In infection control, ward practices often need alteration, as in Queen Mary Hospital, Hong Kong, when a policy was introduced to discontinue the recapping of needles among nurses. Nine randomly selected wards were divided into three groups (A, B and C) of 3 wards each. From an initial survey, nurses were divided into those who agreed with the discontinuation (the 'agreeables') and those who did not (the 'non-agreeables'). Methods used to introduce the policy included a simple announcement through the nursing hierarchy in group A (control), a passive method (posters and pamphlets) was added in group B and both passive and active methods (in-service lectures) were used in group C. Five weeks later, behavioural change was assessed by another survey and by an unannounced direct needle-count. Only 21% of the nurses changed their practice by simple announcement. For the 'agreeables', 85% changed by the passive method and no further improvement was observed when the active method was added. However, 83% of the 'non-agreeables' changed their practice when the active method was used while the passive method alone changed only 21%. Six months later, a third survey indicated that when the active method was included the change persisted at over 85%, while a 36% change was noted for the 'agreeables' who were only exposed to the passive method.

Communication↗
PubMed1989

A note on early indicators of non-adherence to a cardiac rehabilitation programme.

Of 44 patients enrolled in a study to examine rehabilitation efficacy from myocardial infarction (MI), seven experimental subjects did not adhere to the rehabilitation programme. Serendipitous differences in early cortisol levels following admission for MI differentiated adherent from non-adherent subjects at six to 12 weeks post-MI.

Combined Modality Therapy↗
PubMed1985

Energy expenditure during front crawl swimming: predicting success in middle-distance events.

Male (n = 25) and female (n = 14) competitive swimmers were studied during tethered (breaststroke) and free (front crawl) swimming to determine the validity of calculating exercise oxygen uptake (VO2) from expired gas samples taken immediately after the activity. Based on a single 20-s recovery VO2, the swimmers' VO2 max was correlated with performance in a 400-yd (365.8-m) front crawl swim. The best predictors of VO2 max for trained swimmers were lean body weight and stroke index (r = 0.97). The single best predictor of performance in the 365.8-m front crawl swim was the distance per stroke (r = 0.88), whereas the combination of distance per stroke and VO2 max (ml/kg LBW/min) correlated 0.97 with performance in the swim. This study demonstrates that it is possible to accurately determine the VO2 during maximal and submaximal swimming using a single, 20-s expired gas collection taken immediately after a 4-7 min swim. These findings demonstrate the importance of stroke technique on the energy cost and variations in performance during competitive swimming.

Adolescent↗
PubMed1985

Metabolic characteristics of skeletal muscle during detraining from competitive swimming.

After 5 months of intense training, eight male swimmers were studied during 4 wk of inactivity. Biopsy specimens from the deltoid muscle revealed that its respiratory capacity (QO2) decreased by 50% (5174 to 2559 microliter X h-1 X g-1) after 1 wk of inactivity. Subsequent weeks of detraining did not change the QO2. Although the trained swimmers' muscle phosphofructokinase and phosphorylase activities were significantly higher (P less than 0.05) than those from a group (N = 8) of untrained men, 4 wk of detraining had no effect on these enzyme activities. Mean (+/-SE) resting muscle glycogen concentrations were significantly higher (P less than 0.05) for the trained swimmers (153 +/- 3 mmol X kg-1) than for the untrained men (85 +/- 7.5 mmol X kg-1). Over the 4 wk of inactivity, the swimmers' muscle glycogen progressively decreased from 153 (+/- 3) to 93 (+/-7) mmol X kg-1. After a standard 183-m swim at 90% of the swimmer's best time for that distance, blood lactate rose from a mean of 4.2 (+/-0.8) at week 0 to 9.7 (+/-0.8) mmol X 1(-1) at week 4. These observations demonstrate dramatic changes in the metabolic characteristics of the swimmer's muscle with a 1-4-wk interruption in training.

Adult↗