Serodiagnosis in Q fever with special emphasis on the radioisotope precipitation test.
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Adult↗
Biomedical subjects
A M Millar
Publications and source records attributed to A M Millar.
Reduced venous compliance and increased transcapillary escape of protein in insulin-dependent diabetic patients.
Lower limb venous compliance and transcapillary escape rate of transferrin were measured in eight normotensive, insulin-dependent male diabetic patients and eight control subjects using a dual isotope technique. Technetium-99m labelled autologous erythrocytes were used to measure venous compliance and to correct for local changes in blood volume, whilst Indium-113m labelled transferrin was used to measure transcapillary escape of protein. The diabetic patients were found to have reduced venous compliance 1.5 (0.7 to 3.4) x 10(-2) mmHg-1 compared with controls 3.2 (2.4 to 4.1) x 10(-2) mmHg-1 (p less than 0.01). The diabetic patients were also found to have greater transcapillary escape of transferrin -2.7 (-1.5 to -5.3) x 10(-3), compared with control subjects -5.2 (-4.1 to -8.1) x 10(-3) (p less than 0.02) in response to increasing hydrostatic pressure. These results show reduced venous compliance in patients with a mean duration of diabetes of 15 years and with only at most, early complications of diabetes, and confirm previous observations showing increased transcapillary escape of protein.
Adult↗
A randomized controlled trial of fall prevention strategies in old peoples' homes.
BACKGROUND: Falls are a major cause of morbidity in old age. A small number of fall prevention trials in cognitively intact community-dwelling older people have been effective. This study set out to examine the preventability of falls in older people living in institutional care. OBJECTIVE: To evaluate the effectiveness of falls risk factor assessment/modification and seated balance exercise training in reducing falls among elderly people living in residential care. METHODS: 133 residents with a mean age of 84+/- (SD) 6.8 years were allocated at random by home to receive either a 6-month falls risk factor assessment/modification and seated balance exercise training programme (n = 77) or 6 months of reminiscence therapy (n = 56). The risk factors targeted were postural hypotension, polypharmacy, visual acuity, and ambient lighting levels. Falls risk factor assessments and recommendation for modifications were performed at baseline in the intervention group and assessments repeated at 6 months. Functional reach, reaction time, timed up-and- go, grip strength, spinal flexibility, and Philadelphia Geriatric Centre Morale Scale and Mini-Mental State Examination scores were determined at baseline and at 6 months by a 'blind' observer. Falls and fractures were then monitored in both groups during a 7- to 12-month falls-monitoring follow-up period. RESULTS: Only 90 of 133 (67.7%) residents completed the 6-month intervention period, and 84 (63.2%) completed the 7- to 12-month falls-monitoring follow-up period. Both prevalence of postural hypotension (p = 0.0005) and poor visual acuity (p = 0.04) were reduced in the intervention group. There was no difference between the groups in the number of falls sustained, the risk of falling [odds ratio 0.45 (95% CI 0.19-1.14)], or in the risk of recurrent falling [odds ratio 1.07 (95% CI 0.40-2.97)]. No significant differences were found between the groups with regard to change in other outcome measures. CONCLUSIONS: The high drop-out rate reduced the power of this study to detect any effect of the interventions used. It is possible that either the exercises were not sufficiently vigorous or that to improve balance exercises must be performed standing. Further research is required to identify effective fall prevention strategies for elderly people in residential settings.
Accidental Falls↗
The relationship between the pulmonary distribution of inhaled fine aerosols and tests of small airway function.
Gamma-camera lung images obtained after aerosol inhalation (2.2 micron mean aerodynamic diameter) were compared with those obtained during inhalation of krypton-81m gas. The penetration of the aerosol to the periphery of the lung appeared in both smokers and nonsmokers to be similar to the penetration of krypton-81m. An index of the inhomogeneity of deposition of the aerosol (aerosol distribution index, ADI) was calculated by dividing the variance of the cell by cell radioactivity counts by the mean count. This index was expressed as the mean value for both lungs (ADIM) or the value for the lung with the higher value (ADIH). ADIM and ADIH were correlated with the FEV1 and maximum expiratory flow rates at 50% and 25% of vital capacity and on average showed higher values for smokers than non-smokers. ADIH, forced expired time and partial expiratory time from 50% to 0% of vital capacity were correlated with pack-years of smoking. It is concluded that the results of tests of small airway disease are related to inhomogeneities of airflow in the periphery of the lung and that measurements of aerosol deposition may provide a sensitive indicator of disease of small airways. The future potential of the test is discussed.
Adult↗