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Biomedical subjects

A Howard

Publications and source records attributed to A Howard.

160 records · Page 9Linked to original sources
PubMedDate not supplied

A new approach: regional nerve blockade for angioplasty of the lower limb.

PURPOSE: An audit study investigated the pilot use of regional nerve block analgesia (as an alternative to sedative/opiate, general or central neuraxial anesthesia) performed by radiologists with the assistance of imaging techniques during complex prolonged angiography. METHODS: Radiologists were trained by anesthetic consultants to administer and use lower limb peripheral nerve block for difficult prolonged angioplasty procedures for patients with severe lower limb rest pain who were unable to lie in the supine position. In a pilot study 25 patients with limb-threatening ischemia received sciatic and femoral nerve blockade for angioplasty. The technique was developed and perfected in 12 patients and in a subsequent 13 patients the details of the angiography procedures, peripheral anesthesia, supplementary analgesia, complications, and pain assessment scores were recorded. Pain scores were also recorded in 11 patients prior to epidural/spinal anesthesia for critical ischemic leg angioplasty. RESULTS: All patients with peripheral nerve blockade experienced a reduction in their ischemic rest pain to a level that permitted angioplasty techniques to be performed without spinal, epidural or general analgesia. In patients undergoing complex angioplasty intervention, the mean pain score by visual analogue scale was 3.7, out of a maximum score of 10. CONCLUSIONS: The successful use of peripheral nerve blocks was safe and effective as an alternative to sedative/opiate, epidural or general anesthesia in patients undergoing complex angiography and has optimized the use of radiological and anesthetic department resources. This has permitted the frequent radiological treatment of patients with limb-threatening ischemia and reduced delays caused by the difficulty in enlisting the help of anesthetists, often at short notice, from the busy operating lists.

Aged↗
PubMedDate not supplied

Selective migration from Samoa: a longitudinal study of pre-migration differences in social and psychological characteristics.

In 1981 extensive questionnaire and interview data were collected on some 100 young Samoan adults. Five years later in 1986 we determined their whereabouts and divided the data in accordance with migration status. The answers of the 35 who had migrated in the intervening period were contrasted to those 65 who remained in Samoa. The migrants differed in several distinct areas. Migrants reported a higher degree of peer-reliance as a personal adaptive strategy. Migrants also reported larger numbers of individuals in social support networks, a higher quality of support and more community involvement. They also report less expressive display of anger. Those who did not migrate reported a slightly better view of life in Samoa and abroad, as well as better relations with their friends and neighbors. These findings support a hypothesis that migrants are pre-selected to fit into migrant communities and do not appear to be misfits who are unhappy with life in Samoa.

Adaptation, Psychological↗
PubMedDate not supplied

HLA antigen frequencies among patients with juvenile chronic arthritis and amyloidosis: a brief report.

Amyloidosis is seen in a small number of patients with juvenile chronic arthritis (JCA). In order to determine whether particular HLA markers might predispose to the development of amyloid in JCA a group of 45 patients with amyloidosis confirmed by biopsy was typed for the HLA-A, B, C and DR loci. The results confirmed previous smaller studies that no HLA antigen detected by standard serological techniques was associated specifically with the development of amyloidosis. Those antigens which showed an altered frequency (ie. DR4 and DRw8) were known to be associated with the different types of JCA onset represented in this group.

Amyloidosis↗
PubMedDate not supplied

IgA deficiency in juvenile chronic polyarthritis.

Immunoglobulins measured sequentially in 582 juvenile chronic polyarthritis patients revealed 12 with persistently absent IgA and 15 consistently below 20 mg/dl. There was an increased presentation with pauciarticular onset but systemic disease was the same as in the whole group. Follow-up showed that 9 of the 12 without IgA developed polyarthritis as have 11 of the 15 with low IgA; in contrast to previous studies, the disease has been severe in at least half of the patients.

Adolescent↗