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Biomedical subjects

A Freeland

Publications and source records attributed to A Freeland.

10 recordsLinked to original sources
PubMed1997

Imaging of the hand and wrist.

This article reviews many of the most commonly used modalities for imaging the hand and wrist. Particular attention is paid to proper radiographic positioning, with emphasis on the four-view wrist series. Standard wrist measurements are detailed, and wrist arthrography is also discussed. Techniques for cross-sectional imaging, computed tomography, and MR imaging are reviewed, and several examples are presented as to where MR imaging is diagnostically valuable.

Anthropometry↗
PubMed1997

Antipolysaccharide antibodies in 450 children with otitis media.

We have measured antibodies to pneumococcal and Haemophilus polysaccharides in a prospective study of 450 children aged 2-16 years with otitis media requiring grommets (ear tubes). Pneumococcal antibody levels were significantly higher in the 2-6 year (P < 0.004) and 7-10 year (P < 0.04) study groups in comparison with age-matched controls. There was no difference in Haemophilus antibody levels between the study and control group children for the age groups 2-6 years and 11-16 years. Haemophilus antibody levels were significantly lower in the 7-10 year (P < 0.003) group in comparison with age-matched controls. Eighty-eight out of 450 (19.6%) children had pneumococcal antibody levels below the 25th percentile. Nineteen out of 88 (21.6%) children with pneumococcal antibody levels below the 25th centile were test immunized with 23 valent Pneumococcal polysaccharide and unconjugated Haemophilus type b capsular polysaccharide. Of these 19 children (aged 4-11 years), five mounted suboptimal responses to both polysaccharide antigens, whilst one child failed to respond to Haemophilus polysaccharide alone. There was no significant difference in the prevalence of IgG subclass deficiency between the normal responders and poor responders to immunization (P = 0.12). We found no evidence of specific polysaccharide antibody deficiency in the vast majority of the 450 children studied. However, the significance of poor antibody responses to test immunization in a small minority of children with otitis media is unclear. Long-term follow up of these children is required to determine whether poor immunization responses herald the development of frank antibody deficiency.

Antibodies, Bacterial↗
PubMed1995

Suggestions for implementing community psychiatry training in existing residency programs.

OBJECTIVE: To demonstrate how an experience of partnership evolved when a group of psychiatry residents moved beyond the traditional hospital setting and began to question their current training. METHOD: We describe our experience in the context of the current literature and suggest ways of implementing community psychiatry training in existing residency programs. RESULTS: Principles of community psychiatry--partnership, respect and shared responsibility--are good standards in psychiatric care. CONCLUSIONS: Community psychiatry training may be possible in existing resident rotations, although teaching in the community setting may also be of value. Research and clinical work in "community psychiatry" need to be valued. Problems may be enriching if they are resolved collaboratively.

Canada↗
PubMed1990

Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children.

61 snoring children selected for adenotonsillectomy, mainly for recurrent tonsillitis, were compared with a matched group of 31 healthy children for symptoms of sleep apnoea, extent of sleep hypoxaemia, and amount of sleep disturbance. The studies were repeated six months postoperatively, and after six months in the healthy children. Preoperatively, 61% of the children had degrees of sleep hypoxaemia above normal and 65% had abnormally disturbed sleep. A questionnaire administered to the parents about their children showed abnormal patterns of answers about sleep problems daytime sleepiness, hyperactivity, aggression, learning difficulties, restless sleep, and odd sleeping positions. After adenotonsillectomy, the abnormal hypoxaemia, excessive sleep disturbance, and multiple symptoms almost resolved; a growth spurt also occurred.

Adenoidectomy↗
PubMed1986

The effectiveness of adenoidectomy in the treatment of glue ear: a randomized controlled trial.

One hundred children with glue ear, in whom surgical treatment was indicated, were randomly allocated to 1 of 4 treatment groups. Children in 2 of the groups underwent adenoidectomy plus various combinations of ear operations while in the other 2 groups surgery was confined to the ears. The effect of adenoidectomy was assessed 6 weeks, 6 months and 1 year after surgery by means of audiometry, impedance tympanometry and parental opinion. Improvements in hearing were greater in those children who underwent an adenoidectomy than in those who did not (4.0 dB at 6 weeks; 2.4 dB at 6 months; 0.7 dB at 1 year). However, these differences are of little clinical significance and were only statistically significant (P less than 0.05) 6 weeks after surgery. Middle ear function, measured by tympanometry, revealed a similar pattern of response to treatment. Despite this, 6 months after surgery a higher proportion of parents were satisfied with their child's condition if an adenoidectomy had been performed. Possible explanations of this discrepancy between clinical and parental assessments of outcome are discussed.

Acoustic Impedance Tests↗