Pitfalls in the diagnosis of subarachnoid haemorrhage.
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Humans↗
Biomedical subjects
R Owen
Publications and source records attributed to R Owen.
Magnetic resonance angiography of the pelvis and lower extremities. Works in progress.
Two-dimensional time-of-flight (TOF) magnetic resonance angiography (MRA) of the lower extremities has recently been rediscovered as a technique that can be used to find small vessels in the foot and leg for surgical revascularization in patients with severe peripheral vascular disease. The purpose of this article is to acquaint the reader with some of the common problems that may be encountered in this imaging technique and to show their derivations and solutions were applicable. In addition, the authors show receiver operator curve analysis of one radiologist's ability to determine the location and patency of arteries using this technique to be outstanding (AZ, 0.9737). This represents a promising new technique for imaging the arterial system in patients with severe peripheral vascular disease.
Blood Vessels↗
Typing of methicillin resistant and susceptible Staphylococcus aureus strains by ribosomal RNA gene restriction patterns using a biotinylated probe.
Nine methicillin-sensitive (MSSA) and 37 methicillin-resistant (MRSA) Staphylococcus aureus isolates of various phage types and resistotypes from seven countries were investigated. Chromosomal DNA was restricted with HindIII or EcoRI, Southern blotted and hybridised with a cDNA probe to 16S+23S rRNA derived from MRSA NCTC 10442. Resulting rDNA profiles could be differentiated on the basis of 22 patterns which were unaffected by changes in plasmid, transposon, enterotoxin A or phage content. Percentage similarity values were calculated using the Dice coefficient and UPGA clustering. Australian and epidemic (EMRSA-1) isolates from the UK showed a high degree of similarity, but the pattern was not unique and was also found in MSSA and other MRSA, e.g. NCTC 10442. An MSSA of phage group II was the most distinct isolate. The method shows potential as an additional tool in a complex typing system, types non-phage typable strains and may provide clues to the clonal evolution of MRSA and MSSA.
Bacterial Typing Techniques↗
Monoclonal antibody to TNF in severe septic shock.
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Adult↗
Early open reduction for congenital dislocation of the hip.
We have reviewed 82 children with congenital dislocation of the hip, after treatment by anterior open reduction followed by derotation femoral osteotomy. The clinical and radiological results were significantly better in the group that had open reduction before the appearance of the capital femoral epiphysis; this group also had a lower incidence of avascular necrosis. We conclude that, when it is clearly indicated, the earlier an open reduction is carried out the better the results.
Child, Preschool↗
Tendinitis and tendon ruptures in successful renal transplant recipients.
The musculoskeletal system of 167 successful renal transplant recipients was examined for locomotor complications. Apart from avascular necrosis and spontaneous fractures, two new clinical entities were identified: tendinitis and spontaneous tendon ruptures. Tendinitis was found in the supraspinatus and calcaneal tendons in 12 patients (7.2%). Pretransplant hyperphosphatemia and posttransplant hypercalcemia were seen in patients developing tendinitis. Spontaneous tendon ruptures were observed in the calcaneal tendons in four patients (2.4%). Pretransplant hyperphosphatemia was observed in this group of patients. The cumulative dose of prednisolone was not significantly different than in asymptomatic patients.
Adolescent↗
Functional assessment of elderly patients after percutaneous aortic balloon valvuloplasty: New York Heart Association classification versus functional status questionnaire.
Monitoring functional status in patients with cardiac disease has traditionally been done by using the New York Heart Association (NYHA) classification system. For various reasons, we found the NYHA system difficult to apply to elderly patients. We proposed that the functional status questionnaire (FSQ), which measures the ability to perform tasks, would more accurately assess the functional status of the elderly. In a study in 37 patients with a mean age of 76 years, who had aortic stenosis, we measured FSQ and NYHA scores at baseline, 1 month and 3 months. The difference in questionnaires was evident by the 3-month measurement. Individual patients were better evaluated by the FSQ. Six patients had an FSQ score of less than 72 (suggesting severe functional impairment) at 3 months but only two patients gave symptoms scored as NYHA class III or IV (cardiac disability). Five of six patients had a recurrent cardiac event subsequent to the 3-month follow-up. Changes in functional performance preceded symptomatic deterioration that was reflected only by the FSQ scores. The FSQ system more reliably predicted outcome than the NYHA system and appears to be a more useful tool in the evaluation of elderly patients with cardiac disease.
Activities of Daily Living↗
Cardiorespiratory responses to aerobic training by patients with postpoliomyelitis sequelae.
We examined the cardiorespiratory responses of 16 patients with postpoliomyelitis sequelae to a 16-week aerobic exercise program. The patients exercised at 70% of maximal heart rate. Dependent variables were resting and maximal heart rates, systolic and diastolic blood pressures, maximum oxygen consumption, maximum carbon dioxide consumption, respiratory quotient, and maximum expired volume per unit time. The exercise group was superior to the control group in watts, exercise time, maximum expired volume per unit time, and maximum oxygen consumption. No untoward events or loss of leg strength occurred as a result of the exercise regimen. We conclude that the aerobic training program employed in this study is a safe, short-term procedure and that patients with postpolio sequelae respond to training in a manner similar to healthy adults.
Adult↗
Menarche: the black American experience.
There is an increasing awareness that attitudes learned during socialization into a cultural/ethnic group may influence one's perception of and response to menarche. To date, studies have primarily involved white Americans. There is a lack of information regarding the experience of menarche among diverse ethnic groups. Our study of a sample of black American girls (mean age 13.5 years) revealed that the proportion of blacks who felt they were not prepared for menarche was almost twice that of whites. A comparison of the black adolescents' assessment of their level of preparedness suggests that the less prepared they perceive themselves to have been, the more negative feelings they express toward menarche--which is comparable to the findings among white Americans. The black and white adolescents alike attributed the most positive feelings about menarche to their mothers, compared with their own and their fathers' emotional response.
Adolescent↗
Anecdotal, historical and critical commentaries on genetics.
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Genes, MHC Class II↗
Comparative assessment of efficacy and withdrawal symptoms after 6 and 12 weeks' treatment with diazepam or buspirone.
Fifty-one out-patients presenting with generalised anxiety disorder were included in a double-blind trial, and treated with either buspirone (a new non-benzodiazepine antianxiety drug) or diazepam over 6 or 12 weeks, after which they were abruptly withdrawn and continued on placebo to 14 weeks. Ratings of anxiety and other symptoms were administered fortnightly and additional withdrawal symptoms noted. Forty patients completed the study; 8 of the 11 drop-outs were taking buspirone. Both drugs reduced anxiety, diazepam more rapidly, but with greater withdrawal symptoms, particularly after 6 weeks. Regular treatment with diazepam for 6 weeks leads to a significant risk of pharmacological dependence that is not present with buspirone.
Adolescent↗
Scoliosis surgery in the Prader-Willi syndrome.
There is a high incidence of spinal deformity in children with the Prader-Willi syndrome. We have encountered major complications following spinal surgery in this condition. We report our experience and conclude that spinal surgery is a formidable undertaking and the risks should be appreciated by the surgeon and the parents.
Child↗
Black adolescents' emotional response to menarche.
There has been substantial agreement in the literature that cultural attitudes influence females' reaction to menarche. Recently, growing interest has been shown in the ways cultural traditions affect the response to this event. To date, studies of the emotional impact of menarche have involved primarily white middle class populations. To determine whether the black American experience is similar to or different from that of a white American sample, the questions and measure used previously on a white sample were replicated in a group of middle class black adolescents. Although the black and white mean scores on positive feelings were similar (slightly positive), the blacks indicated somewhat greater negative feelings than did the whites. The black perception of menarche as more negative than positive is in accord with findings from other studies concerning the reaction to this event in this culture. Several explanations are suggested as possible bases for the negative feelings surrounding first menstruation in the United States.
Adolescent↗
Do children need routine preoperative blood tests and blood cross matching in orthopaedic practice?
A review of 315 children admitted for elective orthopaedic surgery on 346 occasions showed that 88.7% had a full blood count and 8.1% had serum urea and electrolyte estimations performed preoperatively. Two abnormal haemoglobin concentrations were found. One was known beforehand and the other clinically suspected. No other haematological or urea and electrolyte abnormality was found. On 82 occasions (23.7%) blood was cross matched. Blood was transfused on 15 occasions (18.3%) using 23% of cross matched blood. Routine preoperative full blood count, serum urea and electrolyte estimations are not indicated in healthy children. In our experience, only children who may need blood transfused postoperatively need a preoperative haemoglobin concentration estimation as a baseline. These are patients undergoing major spinal, pelvic girdle and upper femoral surgery.
Adolescent↗
Calmodulin antagonists of improved potency and specificity for use in the study of calmodulin biochemistry.
Syntheses are described for a range of N-(omega-aminoalkyl)-5-iodo- and -5-cyanonaphthalene-1-sulphonamides. The selective activity of these compounds as inhibitors for calmodulin-dependent phosphodiesterase (EC 3.1.4.17) is compared with their activity for the calmodulin-independent but calcium-dependent enzymes protein kinase C and transglutaminase (EC 2.3.2.13). The results show a drastic improvement in the selectivity of effect for the 5-iodo-compounds compared with the widely-used drug, W7, N-(6-aminohexyl)-5-chloronaphthalene-1-sulphonamide.
Calmodulin↗
Spontaneous renal disease in laboratory animals.
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Animals↗
The impact of alcohol ingestion on the orthopaedic and accident service.
There is a well recognized association between the ingestion of alcohol and trauma. The incidence of orthopaedic injuries related to alcohol ingestion and requiring admission has not previously been reported. In a pilot study from the Royal Liverpool Hospital we found that in 22.4% of patients requiring admission, alcohol had been consumed prior to the accident. The incidence of spinal and ankle fractures was higher in the inebriated patients and the circumstances of their injuries differed from those who were sober. Injuries following drinking occurred mainly in young and middle aged males. We discuss simple methods of recognising problem drinking among accident and orthopaedic patients.
Adult↗
Classification of congenital abnormalities of the sacrum. Patterns of associated dysfunctions.
Fifty-eight patients with a congenital abnormality of the sacrum were studied; a modified classification is suggested. Type 1a is characterized by an abrupt termination of the sacrum with an otherwise normal spinal column. Type 1b shows a similar sacral deficit, but with abnormalities evident higher in the spine. In Type 2 the terminal spine is malformed, and in Type 3 there is posterior sacral dysraphism. A high incidence of concomitant congenital abnormalities was found in Types 1 b and 2. Bladder dysfunction in the absence of typical clinical signs was often found in Types 1a and 1b.
Abnormalities, Multiple↗