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Biomedical subjects

D Stephens

Publications and source records attributed to D Stephens.

At least 127 records · Page 7Linked to original sources
PubMed1993

In-the-ear and behind-the-ear hearing aids in the elderly.

A significant proportion of new hearing aid fittings are rejected by elderly patients. One of the reasons for this is their inability to correctly fit the earmould and hearing aid correctly. In this study we compared the ease of fitting of a behind-the-ear hearing aid with a specially modified skeleton earmould with an in-the-ear (ITE) hearing aid, in an elderly subject group. The modified skeleton earmould was found to be easiest to use. However, the ITE hearing aid presented handling problems only in subjects over 75 years of age. Further analysis of the results revealed that the majority of handling problems are found in female subjects in the over-75 age group.

Aged↗
PubMed1992

Antibody response to Bordetella pertussis antigens after immunization with American and Canadian whole-cell vaccines.

Because of apparent differences in the incidence and epidemiology of pertussis in the United States and Canada, we measured the antibody response to four Bordetella pertussis antigens and to a whole-bacteria preparation in children immunized with American and Canadian whole-cell pertussis vaccines. All infants received combined pertussis, tetanus, and diphtheria vaccines from one of two American manufacturers or a single Canadian manufacturer. The Canadian children received either oral poliomyelitis vaccine, inactivated poliomyelitis vaccine as a separate injection, or a product that combined inactivated poliomyelitis vaccine with diphtheria, tetanus, and pertussis components. The Canadian trivalent diphtheria, tetanus, and pertussis vaccine given with oral poliovirus vaccine induced lower anti-pertussis toxin antibody titers than did the American vaccines (p < or = to 0.05) but higher antifimbriae and anti-69-kilodalton outer-membrane protein (pertactin) antibody titers (p < or = to 0.02). Canadian children immunized with inactivated poliomyelitis vaccine either as a separate injection or as a combined diphtheria, tetanus, and pertussis vaccine had consistently lower pertussis antibody titers than did those who received oral poliomyelitis vaccine (p < or = 0.001). We conclude that there is a wide range of antibody responses to B. pertussis antigens after immunization with various whole-cell pertussis vaccines, and that these responses may be influenced by concurrent administration of other vaccines.

Antibodies, Bacterial↗
PubMed1992

Auditory and psychological factors in 'auditory disability with normal hearing'.

Patients who have 'Auditory Disability with Normal Hearing' (ADN) complain of hearing difficulties even although their hearing is audiometrically 'normal'. The auditory and psychological factors involved in ADN have been investigated by comparing 20 patients of employment age with 20 controls (matched for age, sex and socioeconomic group) on appropriate auditory tests and questionnaires. From the results it was concluded that both auditory and psychological factors are involved in ADN. The principal finding was that as a result of their problems with discriminating speech in noise, individuals with ADN have a tendency to anxiety, depression and loneliness. In addition the otological history of an individual was found to be important in the development of ADN. Finally, it was suggested that bad coping strategies may lead to increased anxiety in those with ADN.

Adaptation, Psychological↗
PubMed1992

Hearing impairments in middle age: the acceptability, benefit and cost of detection (ABCD).

The major epidemiological investigations of hearing impairment, disability and handicap show that the elderly are the group most disabled by their hearing impairment. There is considerable debate concerning the most efficient way of reducing this inevitable burden of age-related hearing impairments in the next generation. Early fitting of 'targeted' individuals with hearing aids may help but there are a large number of methodological problems associated with conducting and evaluating such a programme of research (especially retrospectively). The logical prerequisite to early fitting as a means of reducing later disability is to ascertain the acceptability of and benefit given by intervention at this early stage. This study therefore set out to investigate the age/sex register provided by the primary physician (GP) as an appropriate base to identify candidates for early aid fitting among a sample of middle-aged patients (50-65 years) living in Roath, Cardiff. Of the 662 who replied to an initial contact letter (1050 were on the age/sex register), 21 already possessed hearing aids. After screening and examination 66 people were offered some form of management which was accepted by 43 during the course of the study. Aid use thereby increased from about 3% to over 9% in this middle-aged group. A 2 year follow-up indicated continued use of the aids, and benefit on a speech reception task was measured. The cost of detecting those who might benefit was calculated using a two-question 'paper and pencil' screen as the first step. A national programme for Wales would cost at least 188,000 pounds per annum at 1990 prices over an initial 5 year span if a criterion which aimed to find at least 45 dB HTL impairments over mid-frequencies was implemented. For a criterion of 35 dB the cost would be 378,000 pounds pa.

Auditory Threshold↗
PubMed1991

Phase II trial of daily oral etoposide in patients with advanced non-small cell lung cancer.

Forty-six previously untreated patients with advanced non-small cell lung cancer (NSCLC) were entered into a Hoosier Oncology Group phase II trial of daily oral etoposide 50 mg/m2/d. The dose limiting toxicity was granulocytopenia. The non-hematologic toxicity was mild, with only 19% of patients developing Grade 3 or 4 leukopenia. Two partial responses of 10 and 16 weeks duration were seen in 43 evaluable patients, for an overall response rate of 4%. We conclude that daily oral etoposide has minimal activity in advanced NSCLC, and does not improve response rates over conventional 1-5 day intravenous etoposide administration.

Administration, Oral↗
PubMed1991

S-adenosylhomocysteine levels are not involved in the spasmolytic activity of 3-deazaadenosine in guinea-pig lung parenchyma.

The effects of two S-adenosylhomocysteine (SAH) hydrolase inhibitors, MDL 28,842 and 3-deazaadenosine (3-DAA), on the tissue levels of SAH, cAMP and cGMP and on the contractile responses to leukotriene D4 and histamine were compared in guinea-pig lung parenchyma. MDL 28,842 and 3-DAA (both in the presence of L-homocysteine) increased tissue levels of SAH to the same degree, indicating that both compounds had inhibited SAH hydrolase. However, only 3-DAA inhibited the contractile response of the lung parenchyma. The spasmolytic activity of 3-DAA was inhibited by co-incubation with MDL 28,842, suggesting that 3-DAA must be metabolized by SAH hydrolase, probably to 3-deazaadenosylhomocysteine, in order to exert its effect. 3-DAA did not elevate tissue levels of cAMP or cGMP. Although the mechanism by which 3-DAA exerts its spasmolytic effects is unknown, direct inhibition of methyltransferase is a plausible explanation. These data indicate that SHA levels do not regulate the contractile response of guinea-pig lung parenchyma.

Adenosine↗
PubMed1991

Impairment, disability and handicap in audiology: towards a consensus.

Within this paper, we argue that the WHO definitions of impairment, disability and handicap have a useful role in understanding the processes of audiological rehabilitation. We have endeavoured to clarify some of the confusions arising from the various uses of the terms in the audiological literature and propose further classifications of the three. In particular we discuss the complexities of handicap together with the interactions between hearing-impaired individuals and their significant others in its production.

Activities of Daily Living↗
PubMed1990

Tired, weak, or in need of rest: fatigue among general practice attenders.

OBJECTIVES: To determine the prevalence and associations of symptoms of fatigue. DESIGN: Questionnaire survey. SETTING: London general practice. PARTICIPANTS: 611 General practice attenders. MAIN OUTCOME MEASURES: Scores on a fatigue questionnaire and reasons given for fatigue. RESULTS: 10.2% Of men (17/167) and 10.6% of women (47/444) had substantial fatigue for one month or more. Age, occupation, and marital status exerted minor effects. Subjects attributed fatigue equally to physical and non-physical causes. Physical ill health, including viral infection, was associated with more severe fatigue. Women rather than men blamed family responsibilities for their fatigue. The profile of persistent fatigue did not differ from that of short duration. Only one person met criteria for the chronic fatigue syndrome. CONCLUSIONS: Fatigue is a common complaint among general practice attenders and can be severe. Patients may attribute this to physical, psychological, and social stress.

Adult↗
PubMed1990

Arterial blood gases: clinical application.

The interpretation of arterial blood gases (ABGs) is an essential assessment skill for the PACU nurse. ABG analysis can be fun and exciting, as well as an important tool for patient care. Acid-base imbalances are associated with various clinical conditions. Using ABGs as an assessment tool, the PACU nurse can determine the patient's acid-base status and initiate prompt, appropriate nursing intervention and medical consultation.

Acid-Base Imbalance↗
PubMed1989

Predicting who will use a hearing aid.

Elderly patients receiving a hearing aid have usually experienced a hearing disability for many years. Simple methods of screening the pre-retirement age group for hearing impairment are described. Screening is feasible and effective.

Aged↗
PubMed1989

[Comparison of auditory threshold and loudness in the Bing test].

The threshold and loudness comparison techniques of the Bing test were performed in a quantitative manner in both ears of 14 subjects. The results were related to their air-bone gap at 500 Hz. The study showed that the air-bone gap influenced a positive occlusion effect, but did not influence its subsequent magnitude. The magnitudes of the results of the occlusion test performed in these two ways were significantly related to each other.

Adult↗