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Biomedical subjects

D Cameron

Publications and source records attributed to D Cameron.

At least 37 records · Page 2Linked to original sources
PubMed1996

Dynamic pelvic stabilization during hip flexion: a comparison study.

Although physical therapists sometimes provide stabilization training for individuals with low back problems, research verifying the capacity of such training to alter pelvifemoral rhythm is lacking. This study was conducted to determine if pelvic movement could be limited by individuals who attempted active cocontraction of the abdominal and trunk extensor muscles during hip flexion. An experienced group consisting of 13 physical therapists familiar with stabilization training was compared with a novice group of 13 healthy individuals unfamiliar with such training prior to participation. All subjects were videotaped while supine, performing bilateral hip flexion. Trials were recorded both with and without attempts at limiting pelvic movement, which was digitized and analyzed from the videotape using the Peak 2-D Motion Measurement System. Inferential statistics, including a 2 x 2 x 2 analysis of variance and post hoc t tests, revealed that in the experienced group stabilization attempts resulted in significantly less pelvic movement. No significant differences were found between the stabilized and unstabilized trials of the novice group. The results of this study indicate that pelvic movement can be actively limited during hip flexion by physical therapists familiar with stabilization training. No subject, however, was able to eliminate movement.

Abdominal Muscles↗
PubMed1995

Genetic mapping of the multiple endocrine neoplasia type 1 locus at 11q13.

Oncogenesis of tumours related to multiple endocrine neoplasia type 1 (MEN1) is associated with somatic deletions involving the MEN1 locus at chromosomal region 11q13, suggesting inactivation of a tumour-suppressor gene in this region. Here we describe the localization of the MEN1 gene to a 900-kb region, based on linkage analysis in affected families and deletion mapping of MEN1-associated tumours. In addition, a set of microsatellite markers mapped to the 11q11-13 region were used for linkage analysis in a large Tasmanian MEN1 pedigree, demonstrating the usefulness of these markers for presymptomatic testing in affected families.

Adult↗
PubMed1994

DDI pacing: indications, expectations, and follow-up.

The DDI mode of pacing that permits noncompetitive atrioventricular sequential bradycardia support was chosen in 65 of 480 (14%) patients selected for dual chamber pacing between February 1985 and March 1990. All patients were implanted with Pacesetter 283 or 285 pulse generators and programmed to DDI. The indications for pacing were sick sinus syndrome (n = 52), combined sinus node dysfunction and AV block (n = 13). Forty-two of these patients had a history of paroxysmal atrial arrhythmias. All patients received passive fixation atrial and ventricular leads. Follow-up thereafter was performed predischarge, and at 6 weeks, 3 and 6 months after discharge. The duration of follow-up ranged from 1-61 months (mean 31 months). Fifty-four of 65 (83%) patients chosen for DDI remain programmed in the DDI mode. Three patients were reprogrammed to VVI and eight to DDD. During the course of follow-up, six patients presented with effective VVI pacing with consistent ventriculoatrial conduction that was appropriately sensed by the atrial circuit with atrial output inhibition. A further four patients presented with "functional undersensing" due to ventricular blanking period (VBP) characteristics in these pulse generators and in this mode. Functional undersensing was eliminated in all but one patient by reprogramming the VBP to 13 msec with no subsequent episodes of provoked crosstalk inhibition. Effective VVI pacing was observed in patients with AV block during times of sinus acceleration.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Peripheral aneurysms.

Aneurysms of the peripheral arteries usually involve the femoral or popliteal regions. Although not as common as abdominal aortic aneurysms, they carry a significant morbidity if left untreated. Rupture is a rare complication, but embolization or thrombosis may frequently threaten the viability of the limb. Elective repair of peripheral aneurysms will prevent complications of these lesions. This paper outlines the history, diagnosis, and treatment of peripheral aneurysms with emphasis on nursing care.

Aneurysm↗
PubMed1994

Amnioinfusions in renal agenesis.

BACKGROUND: Renal agenesis causes severe oligohydramnios, which results in compression effects, lung hypoplasia, and rapid neonatal death. CASE: We report a case of renal agenesis identified in a fetus in which serial amnioinfusions were employed to prevent pulmonary hypoplasia and compression effects. A total of ten amnioinfusions were performed between 17-33 weeks' gestation. Chorioamnionitis led to preterm delivery at 33 weeks. The infant had no significant pulmonary hypoplasia and none of the compression effects usually associated with the oligohydramnios sequence. Peritoneal dialysis was provided for the infant with a long-term aim of eventual renal replacement therapy, but dialysis was unsuccessful and the infant died at the age of 23 days. Autopsy revealed slightly small lungs and extensive cavitating lesions in the brain, which were presumed to be of peripartum or antenatal origin. The chain of events leading to this unusual course of action is described, and the ethical aspects are outlined. CONCLUSION: At present, this type of procedure is not an appropriate intervention in cases of renal agenesis, and such management is strongly discouraged.

Adult↗
PubMed1994

Long-term results of flap reconstruction in median sternotomy wound infections.

Reconstruction of infected median sternotomy wounds using muscle and omental flaps has been shown to result in significantly reduced morbidity, mortality, and length of hospital stay. Despite these benefits, very little is known about the potential long-term sequelae of such procedures. The purpose of this study was therefore to evaluate the ultimate functional outcome in such patients. One-hundred and thirty-three consecutive patients underwent debridement and flap reconstruction of their infected median sternotomy wounds over an 8-year period. Eighty patients were available for follow-up and responded to a questionnaire. Forty-eight patients consented to a physical examination. The length of follow-up ranged from 15 to 108 months (average 48 months). Healed wounds were obtained in 99 percent of patients. Fifty-one percent of patients noted persistent pain or discomfort, particularly in the chest and shoulder. Forty-four percent noted areas of numbness/paresthesias, mainly on the chest. Thirty-four patients (42.5 percent) noted symptoms of sternal instability; of those consenting to an examination, 45 percent were confirmed to have instability. Twenty-six patients (32.5 percent) claimed postoperative weakness (shoulder/abdomen). Significant shoulder weakness was not demonstrated; however, abdominal weakness was substantial. Thirty-six percent of patients reported an inability to perform the same preoperative activities that were of importance to them (sports, housework, etc.). Of those patients eligible to return to work, 52 percent did not. Patients younger than age 60 had a somewhat higher chance of not returning to work. Scars were noted to be good to excellent in 75 percent, but contour abnormalities of the chest and abdomen were found in 85 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Muscles↗
PubMed1993

Retinal folds in Terson syndrome.

BACKGROUND: Perimacular retinal folds have been reported in the shaken baby syndrome, but have not been described in adults with Terson syndrome. METHODS: The authors present two patients with perimacular retinal folds in adults with Terson syndrome. In one patient, electron microscopy was used to examine the membrane spanning the fold. RESULTS: The membrane spanning the perimacular fold was found to be internal limiting membrane. The pathogenesis of these perimacular folds found in adults sustaining direct head trauma is probably different from that previously described for folds seen in infant eyes with shaken baby syndrome. CONCLUSION: Retinal folds occurring in Terson syndrome are clinically similar to those seen in the shaken baby syndrome.

Adult↗
PubMed1993

Inadvertent brain penetration during neonatal nasotracheal intubation.

During routine nasal intubation of a premature infant, the endotracheal tube penetrated the brain. Bloodstained cerebrospinal fluid and neural tissue was apparent. Initial cranial sonography was normal, but the infant later developed extensive intracranial haemorrhage. Rotation of an endotracheal tube to facilitate insertion angles the bevel at the tip upwards, increasing risk of brain penetration. Great care is required during nasal intubation; use of a small feeding tube over which to slide an endotracheal tube may be helpful.

Brain Injuries↗
PubMed1993

Anti-glutamate therapy in amyotrophic lateral sclerosis: a trial using lamotrigine.

Glutamate excitotoxicity is implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). We report the results of a double blind, placebo controlled, trial using 100 mg of oral daily lamotrigine (3,5-diamino-6-(2,3 dichlorophenyl)-1,2,4-triazine) which inhibits glutamate release. 67 patients were entered and at trial termination of 1.5 years 15 had withdrawn (9 active and 6 placebo) and 12 had died (6 active and 6 placebo). Mean age at entry was 57.5 years for the active and 58.6 years for the placebo groups. Patients were seen at 3 monthly intervals and scored according to neurological deficit based upon age of onset, bulbar and respiratory involvement, ambulation and functional disability. The mean change in clinical scores for the active versus placebo groups over the trial period was 7.1 +/- 3.3 and 9.0 +/- 3.3 respectively (0.05 < p < 0.10). Changes in cortical threshold and MEP/CMAP ratios to magnetic stimulation also did not differ significantly between the two groups. We conclude that lamotrigine in the doses administered does not alter the course of ALS.

Adult↗
PubMed1992

Use of telemetry functions in the assessment of implanted antitachycardia device efficacy.

Twenty patients (aged 50 +/- 21 years and mean left ventricular ejection fraction 37 +/- 17%) with recurrent ventricular arrhythmias were treated with an investigational, implantable combined antitachycardia-pacing cardioverter defibrillator. The device's telemetry capabilities include both stored (1-second snapshots) and real-time display of endocardial and device-circuit signals. The device can store these before, during and after up to 50 tachycardia and antitachycardia pacing episodes. All stored events are indexed to a 24-hour internal clock. During 10.1 +/- 5.1 months of follow-up, the device was used in 11 of 20 patients. In the entire group, antitachycardia pacing was activated on 44 +/- 14 occasions per patient (total 874) and shock delivery occurred on 8 +/- 14 occasions per patient (total 156). Reconstruction by stored telemetry of all device-therapy episodes was possible. Twenty-six percent of all shocks delivered were not appropriate and were due to atrial arrhythmias in 2 patients and dysfunction of the sensing lead in 3. The absence of a relation between symptoms and appropriate shock delivery was documented in 1 patient. Antitachycardia pace acceleration occurred in 5.3% of cases; 7% of attempts at pacing were unsuccessful and needed shock therapy. It is concluded that the enhanced telemetry available in newer antitachycardia devices enables more accurate assessment of device use and enhances diagnosis of inappropriate therapy delivery.

Electric Countershock↗
PubMed1992

Farm accidents in children.

OBJECTIVE: To examine the problem of accidental injury to children on farms. DESIGN: Prospective county based study of children presenting to accident and emergency departments over 12 months with injuries sustained in a farm setting and nationwide review of fatal childhood farm accidents over the four years April 1986 to March 1990. SETTING: Accident and emergency departments in Aberystwyth, Carmarthen, Haverfordwest, and Llanelli and fatal accidents in England, Scotland, and Wales notified to the Health and Safety Executive register. SUBJECTS: Children aged under 16. MAIN OUTCOME MEASURE: Death or injury after farm related accidents. RESULTS: 65 accidents were recorded, including 18 fractures. Nine accidents necessitated admission to hospital for a mean of two (range one to four) days. 13 incidents were related to tractors and other machinery; 24 were due to falls. None of these incidents were reported under the statutory notification scheme. 33 deaths were notified, eight related to tractors and allied machinery and 10 related to falling objects. CONCLUSIONS: Although safety is improving, the farm remains a dangerous environment for children. Enforcement of existing safety legislation with significant penalties and targeting of safety education will help reduce accident rates further.

Accidents↗
PubMed1992

Homocysteine-induced alterations in extracellular amino acids in rat hippocampus.

The effects of DL-homocysteine, and DL-homocysteate, on extracellular levels of amino acids in the rat hippocampus have been studied using brain microdialysis. Hippocampal electroencephalogram activity was monitored simultaneously using an electrode attached to the dialysis probe. DL-Homocysteine (1200 mg/kg; i.p. injection) produced epileptic activity in hippocampus in an inconsistent manner. Alterations in electroencephalogram activity were not observed in urethane anaesthetized animals, whereas 50% of Hypnorm anaesthetized animals exhibited epileptic activity. DL-Homocysteate (2 mu mol; i.c.v.) induced epileptic activity in a majority of animals anaesthetized using urethane. Dialysate levels of aspartate were significantly elevated by homocysteine in both groups of animals. Conversely, dialysis levels of GABA were reduced. Dialysate levels of other amino acids measured (glutamate, glutamine, taurine, alanine and valine) were not affected significantly. Dialysate levels of taurine were increased significantly in animals injected with homocysteate. These data suggest that the imbalance in excitatory:inhibitory neurotransmission in the hippocampus caused by these alterations in extracellular levels of neuroexcitatory (i.e. aspartate) and neuroinhibitory (i.e. GABA) transmitters could underly the epileptic effect of homocysteine.

Amino Acids↗
PubMed1992

Selective embolisation of intrahepatic aneurysms.

The radiological techniques that can be used to selectively embolise small arteries have improved markedly in the past few years. This article discusses the use of transcatheter embolisation in the management of three patients with aneurysms involving the intrahepatic arterial tree.

Adult↗
PubMed1992

Double blind, controlled trial of 4-aminosalicylic acid and prednisolone enemas in distal ulcerative colitis.

Corticosteroid or 5-aminosalicylic acid enemas are the treatment of choice for distal ulcerative colitis but up to one third of patients may be unresponsive. As an alternative therapy might be advantageous, the efficacy of six weeks' treatment with 2 g 4-aminosalicylic acid (4-ASA) (n = 24) and 20 mg prednisolone enemas (n = 21) were compared in a double blind, randomised trial in patients with acute distal (less than 30 cm from the anus) ulcerative colitis. Baseline demography and clinical severity were similar in both groups. Five of 24 patients receiving 4-ASA and 4 of 21 receiving prednisolone did not complete the trial because of deteriorating symptoms, failure to improve, or side effects. At the time of leaving the trial, 24 hour stool frequency, the presence of blood in the stools, and histological and sigmoidoscopic appearances were similar in both groups. Symptomatic improvement occurred in 17 of 24 patients receiving 4-ASA compared with 11 of 21 receiving prednisolone (chi 2 = 1.62, NS). Complete symptomatic improvement occurred in 9 of 24 patients receiving 4-ASA compared with 5 of 21 receiving prednisolone (chi 2 = 0.98, NS). Histological improvement was seen in 9 of 24 patients on 4-ASA compared with 7 of 21 on prednisolone (chi 2 = 0.08, NS). One patient receiving 4-ASA was considered to have an idiosyncratic reaction to the drug but other side effects were not considered to be drug related. Thus, 4-ASA, previously used in the treatment of tuberculosis (para-aminosalicyclic acid), is as good as prednisolone in the treatment of distal ulcerative colitis and should be considered in patients unresponsive to steroids or in whom steroid treatment is undesirable.

Aminosalicylic Acid↗