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Biomedical subjects

R Hetherington

Publications and source records attributed to R Hetherington.

11 recordsLinked to original sources
PubMed2006

Peripherally inserted central catheters and upper extremity deep vein thrombosis.

The purpose of the study was to determine the incidence and risk factors for venous thrombosis in patients with a peripherally inserted central catheter (PICC). A retrospective study of all upper extremity venous duplex scans was carried out in the Vascular Medicine department from year 2000 to 2002 inclusive. A chart review of positive scans was undertaken to identify possible thrombotic risk factors. Of 317 upper extremity venous duplex scans carried out, 115, or 32%, were positive for upper extremity deep vein thrombosis. Three main risk factors were identified - presence of a central line, malignancy and administration of chemotherapy. PICC were the most common central line present. Symptomatic thrombosis occurred in 7% of PICC inserted for chemotherapy compared with 1% of PICC inserted for other reasons. Ten per cent of the patients receiving chemotherapy through a PICC developed a thrombosis. The post-thrombotic syndrome was infrequent following upper extremity deep vein thrombosis. Patients receiving chemotherapy through a PICC are at increased risk of thrombosis. There may be a role for prophylactic low-dose anticoagulation in these high-risk patients.

Adolescent↗
PubMed2005

Functional outcome in young adults with spina bifida and hydrocephalus.

INTRODUCTION: Quality of life was studied in 31 adult survivors of spina bifida, each with Verbal or Performance IQ score over 70. METHODS: Instruments measured physical and occupational function, cognitive/psychological function, somatic sensation, and social interaction in the context of the ability to live independently. RESULTS: Domain group means except motor independence were in the average range (+/- 1 standard deviation). Variability within the group with respect to physical phenotype (high spinal lesions were associated with poorer motor independence) and medical history [a greater number of shunt revisions (> 4) were associated with poorer functional numeracy] was predictive of quality of life. Both spinal lesion level and number of shunt revisions influenced occupational status. DISCUSSION: There was a relation between everyday mathematics, reading skills, and quality of life. The consequences of the physical, medical, and cognitive effects of spina bifida extend into young adulthood and have an impact on quality of life.

Activities of Daily Living↗
PubMed2003

Time perception deficits in attention-deficit/ hyperactivity disorder and comorbid reading difficulties in child and adolescent samples.

BACKGROUND: Our objective was to investigate time perception in Attention-Deficit/Hyperactivity Disorder (ADHD) with and without comorbid reading difficulties (RD) in child and adolescent participants. METHOD: In study 1, 50 children with ADHD (31 ADHD, 19 ADHD+RD) and age-matched healthy controls (n = 50) completed three psychophysical tasks: duration discrimination (target duration of 400 ms versus a foil duration), frequency discrimination (a control condition to evaluate general perceptual ability), and a duration estimation task using the method of reproduction for intervals of 400 ms, 2000 ms, and 6000 ms. Study 2 used the same tasks with an adolescent sample (35 ADHD, 24 ADHD+RD, 39 controls). RESULTS: In both studies, children and adolescents with ADHD and ADHD+RD displayed some impairments in duration discrimination and the precision with which they reproduced the intervals on the estimation task, particularly the shorter 400 ms interval. The most severe impairments tended to occur in the comorbid ADHD+RD group. No impairments were found on the frequency discrimination task. ADHD participants also displayed significant intra-individual variability in their performance on the estimation task. Finally, short-term and working memory, estimated full-scale IQ, and teacher report of hyperactivity/impulsivity were found to differentially predict performance on the time perception measures in the adolescent clinical sample. CONCLUSIONS: Deficits in duration discrimination, duration estimation, and intra-individual performance variability may have cascaded effects on the temporal organisation of behaviour in children and adolescents with ADHD and ADHD+RD.

Adolescent↗
PubMed2000

Perception and estimation of time in long-term survivors of childhood posterior fossa tumors.

We examined short duration perception (400 ms), long duration estimation (30 and 60 min), and spatiotemporal estimation in long-term survivors of childhood cerebellar tumors with a mean time since diagnosis of 14.2 years. Groups of individuals with tumors treated with surgery only (astrocytoma, N = 20) were compared to those with tumors treated with surgery, focal radiation, and craniospinal radiation (medulloblastoma, N = 20), and to age-matched controls (N = 40). Childhood lesions of the cerebellum produced enduring deficits in short-duration perception, but spared the ability to functionally estimate long durations, regardless of the pathology or treatment of the tumor. Evidence did not support any functional recovery over time of the cerebellar system that underlies short-duration perception. Younger age at treatment was not a protective factor. Although no group differences were present in the functional measures of long-duration estimation, tumor-related prospective memory deficits interfered with the ability to produce long-duration prospective estimates. The utilization of sensory and somatomotor information to refine real-world spatiotemporal estimates was compromised in the medulloblastoma group only.

Adult↗
PubMed1983

Communication between doctors and psychologists.

Changing roles of the psychologist over the past 30 years or so have been rapid and fundamental. This has led to difficulties when psychologist and doctor do not see the former's role in the same way. Psychologists achieve clinical independence for their work rather sooner than doctors do, and if this is not understood there can be difficulties in communication. If the doctor and psychologist employ different theoretical models of illness, this may affect the ease with which agreed therapeutic strategies are reached. The respective roles played by the doctor and the psychologist may be consonant, in that both are research, or both are clinically, oriented. When this is not the case, difficulties may occur. It is suggested that job descriptions should be agreed before appointments are made. Unresolved tensions concerning clinical responsibility may cause communication difficulties. It is suggested that the claims of functional leadership over status leadership be examined.

Communication↗
PubMedDate not supplied

Subjective experiences of anesthesiologists undergoing epidural anesthesia.

BACKGROUND AND OBJECTIVES: This study reports subjective experiences of nine anesthesiologists undergoing three consecutive epidural anesthetics. METHODS: Eight anesthesiologists and one nurse anesthetist, all ASA physical status 1, underwent three lumbar epidural anesthetics as part of another study. Epidural catheters were inserted via a 17-gauge Tuohy needle without sedation after local anesthesia with pH adjusted lidocaine at the second, third, or fourth lumbar interspace. Three local anesthetics (2% lidocaine HCl, 3% chloroprocaine HCl, and 0.75% bupivacaine HCl) were administered each separated by at least 48 hours. The local anesthetic was incrementally injected via the epidural catheter to achieve at least a T-1 dermatome level of analgesia. Each subject completed a written questionnaire at the end of the study regarding their experience. RESULTS: Most of the subjects (7 of 9) had no prior epidural anesthesia. Eight of nine subjects experienced at least one paresthesia during catheter insertion; this was uniformly described as a "poorly localized burning sensation," radiating to the hip or leg. All subjects reported difficulty taking a deep breath and coughing with a T-1 level of analgesia. Eight of nine subjects reported dysphoria during lidocaine epidural anesthesia. Eight of nine subjects reported moderate back pain after dissipation of chloroprocaine epidural anesthesia. CONCLUSIONS: All volunteers stated that they would change their anesthetic practice as a result of participation in this study. They believed that having experienced an epidural anesthetic made them better qualified to prepare patients for this anesthetic technique.

Adult↗