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Biomedical subjects

A Stewart

Publications and source records attributed to A Stewart.

At least 289 records · Page 16Linked to original sources

Ethical issues in child and adolescent psychiatry.

This paper concerns the special ethical problems in child and adolescent psychiatry which relate to the child as a developing being. Two themes are discussed--the sense of responsibility in the child, and the therapist's responsibility towards the child. As a background to understanding the former, ideas on moral and cognitive development are reviewed. The therapist's responsibility is discussed in relation to different styles of therapy and the ethical issues they raise. The article concludes with a number of suggested ethical principles.

Adolescent↗

Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome.

Many different treatments have been suggested for the premenstrual syndrome (PMS), including such nutritional supplements as vitamins, minerals and essential fatty acids. There is little agreement about the causes or treatments of the syndrome. The effect of a nutritional supplement, at high and low dosage, on premenstrual symptoms was assessed in a double-blind, placebo-controlled study. Also, the nutritional state of 11 women with PMS was evaluated. There was laboratory evidence of significant deficiencies in vitamin B6 and magnesium; other deficiencies occurred frequently, also. The multivitamin/multimineral supplement was shown to correct some of these deficiencies and, at the appropriate dosage, to improve the symptoms of premenstrual tension.

Adult↗

Cigarette smoking and risk of premature stroke in men and women.

A case-control study was carried out of the relation between cigarette smoking and hypertension and stroke. A total of 132 cases of stroke (79 in men, 53 in women) identified as a part of a population based register were compared with 1586 controls (1017 men, 569 women) from a survey of cardiovascular risk factors conducted in the same population. Cigarette smokers had a threefold increase in the risk of stroke compared with current non-smokers. This association remained significant after adjusting for hypertension. Those who both smoked and had hypertension had an increased risk of stroke of almost 20-fold compared with those who neither smoked nor had hypertension. Overall, in this population roughly 37% of stroke events may be attributed to cigarette smoking and 36% to hypertension.

Adult↗

Serum lipids, body mass, and exercise levels in Auckland, 1982.

The level of coronary heart disease risk factors was examined in a random sample of 1598 people aged 35 to 64 years in Auckland during 1982. Data on serum total cholesterol and high density lipoprotein cholesterol, height, weight, body mass index and exercise patterns, are reported. The mean serum cholesterol was 5.71 mmol/l in men and 5.81 mmol/l in women with 22% and 24% of men and women respectively having a serum cholesterol of 6.5 mmol/l or more. Total cholesterol levels were lower than in previous New Zealand studies at all ages and in both sexes. Approximately 54% of men and 48% of women in the sample were overweight or obese and only 37% of men and 30% of women reported taking regular exercise each week. These data indicate that there is considerable potential for the primary prevention of coronary heart disease in New Zealand.

Adult↗

Cardiovascular mortality in New Zealand and Australia 1968-1983: how can the diverging trends be explained?

Cardiovascular diseases are responsible for almost 50% of all deaths in New Zealand and Australia. In 1968 death rates were higher in Australia than in New Zealand for all causes of death, all cardiovascular disease, coronary heart disease and cerebrovascular disease. Over the period 1968-1983 death rates declined in both countries but at a significantly greater rate in Australia. By 1983 death rates for all categories were higher in New Zealand than Australia. The decline in cardiovascular disease accounted for approximately 90% and 70% of the decline in all causes of death in New Zealand and Australia respectively. Life expectancy has increased more rapidly for Australian middle aged men and women. From the limited cardiovascular morbidity and risk factor data available, it is not possible to identify the reasons for the differential rates of improvements in the two countries. Both nations require comprehensive and complementary studies which monitor changes in health practices such as diet, smoking and exercise, as well as surveys that allow differences in the patterns of medical and surgical practices to be determined.

Adult↗

Ocular sequelae of preterm birth and their relation to ultrasound evidence of cerebral damage.

The eyes of 177 very preterm (less than 33 weeks' gestation) infants, born between 1979 and 1982 and admitted to a neonatal intensive care unit, were examined as part of an ongoing follow-up study of neurodevelopmental outcome. Ocular pathology was diagnosed in 37 (21%) of the 177 infants: 14 (8%) had retinopathy of prematurity (ROP)--progressive in three--and nine (5%) infants had delayed visual maturation (DVM). The ocular pathology was permanent in 26 (15%) of the 177 infants. Refractive errors were the commonest problem and accounted for permanent sequelae in eight of the 14 infants with ROP and two of the nine with DVM. The presence or absence of ROP was related to a wide range of prospectively coded perinatal variables and to the results of routine neonatal ultrasound brain scans and neurodevelopmental follow-up assessments made in the first 18 months of life. As in previous studies, infants with ROP were of shorter gestation, lower birth weight, and required oxygen therapy for longer than unaffected infants, but the condition was only weakly associated with other indices of respiratory illness. In contrast, ROP was strongly associated with evidence of brain damage, often consistent with hypoxic ischaemic injury. We conclude that an underlying lesion in ROP may be hypoxic ischaemic damage to the retinal circulation.

Brain Diseases↗

Magnesium and the premenstrual syndrome.

Plasma and erythrocyte magnesium were measured in 105 patients with premenstrual syndrome (PMS) using a simple atomic absorption spectroscopy method. The erythrocyte magnesium concentration for the patients with PMS was significantly lower than that of a normal population. The plasma magnesium did not show this difference. The significance of this apparent cellular deficiency of magnesium is discussed.

Adult↗

Treating ulcers.

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Bandages↗

Risk factors for coronary heart disease: a case-control study.

Risk factors for myocardial infarction and sudden death have been examined in caucasians using data from a population-based register of coronary disease and an electoral roll sample of adult Aucklanders. The risk factors studied were past history of treatment for hypertension, cigarette smoking, body mass index, serum cholesterol and in men a history of vasectomy. A total of 625 myocardial infarction cases and 185 sudden death cases were compared with 1586 controls aged 35-64 years. In univariate and multivariate analyses in both sexes a history of treatment for hypertension and cigarette smoking were each associated with more than doubling of the risk for myocardial infarction and sudden death. Both men and women with a very high body mass index were at increased risk for myocardial infarction, and serum cholesterol was associated with an increased risk of myocardial infarction in men. Approximately one half of the myocardial infarction events and over half of the sudden death events occurring in this population were attributable to hypertension and smoking.

Adult↗

Computer analysis of laser dosimetry data: a method of accurate energy density delivery.

In the past, utilization of the laser in medicine has been limited by the lack of accurate quantification of the energies delivered to the tissue. Data obtained in the course of this investigation have demonstrated the relationships which exist between the energy delivered to the tissue and the optical system composed of the fiber and focusing lens. A continuous-wave multimode Nd:YAG laser (1,064 nm) was used in these experiments. Utilizing the beam scan technique previously described, we recorded over 100 beam profiles at various distances from the handpiece (fiber optic and lens). Computer analysis of our data established the mathematical correlation between the surface area of the irradiated spot and the distance of the handpiece to the target, thus allowing us to predict the surface area of the irradiated spot to any desired distance. By duplicating our methods with his particular optical system, the clinician or any laser user has the capacity to determine the energy delivered to the tissue (J/cm2) by knowing the power of the laser (watts), the time of exposure (seconds), and the distance of the handpiece to the treatment site (centimeters).

Computers↗

Changes in spontaneous SCE frequencies as a function of sampling time in lymphocytes from normal donors and cancer patients.

Spontaneous SCE frequencies were measured in cells undergoing their second mitosis at 54, 68, 72, 78 or 90 h after PHA stimulation of whole blood cultures from 7 normal donors. A consistent pattern of fluctuation of SCE levels was observed between 54 and 78 h. The magnitude of change in SCE frequency between consecutive fixation times was as high as 80% for some donors. These observations support the hypothesis of Snope and Rary (1979) that there are subpopulations of lymphocytes with different spontaneous SCE levels and different proliferation rates. In untreated cancer patients the patterns of change in SCE frequency with time were different from that seen in normal donors. This may be because of quantitative changes in T-lymphocyte sub-populations which have been observed in cancer patients. Changes in SCE frequency of less than about a factor of two, observed at a single sampling time may not be indicative of genotoxic events or genetic instability but simply represent changes in the composition of lymphocyte sub-populations and/or in their rates of proliferation in vitro.

Age Factors↗

Alcohol consumption and blood pressure.

The relationship between alcohol consumption and systolic and diastolic blood pressure was examined in a representative population sample of 1,429 men and women aged 35-64 years in Auckland, New Zealand during 1982. Univariate plots demonstrated a U-shaped relationship between alcohol consumption and systolic and diastolic blood pressures in men and in women aged 50 years and older, with light and moderate drinkers (less than 0-34 g alcohol/day) having lower blood pressure levels than either nondrinkers or heavy drinkers. No clear relationship was seen in younger women. The U-shaped relationship in men, particularly for systolic blood pressure, remained after controlling for potential confounders, whereas in women aged 50 years and older, there appeared to be a threshold level of approximately four drinks per day, below which drinkers had similar blood pressure levels to nondrinkers. In the multivariate analyses, it was calculated that among men, light and moderate drinkers had systolic levels 4.8 mmHg lower and diastolic levels 1.7 mmHg lower than nondrinkers and heavy drinkers, while among women aged 50-64 years, nondrinkers, light drinkers, or moderate drinkers had systolic levels 10.2 mmHg lower and diastolic levels 4.5 mmHg lower than heavy drinkers. These findings suggest that in men and in women aged 50 years and older, there is a nonlinear relationship between blood pressure and alcohol consumption, and that there is a level of alcohol consumption, of approximately four drinks per day, below which drinkers have either similar or lower blood pressure levels compared to nondrinkers.

Adult↗