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Biomedical subjects

D Wright

Publications and source records attributed to D Wright.

At least 19 recordsLinked to original sources
PubMed1995

Magnetic brain stimulation: safety studies.

We describe short-term and long-term safety studies after low repetition rate magnetic brain stimulation in 10 normal subjects. We obtained quantitative EEG data, psychometric test results, serum prolactin and cortisol levels before and after brain stimulation. EEG and psychometric data were also obtained in 5 of these subjects 16-24 months after the initial experiment. Short- and long-term studies did not show any deleterious effects. Randt delayed recalls, however, showed a transient reduction in the score immediately after stimulation which resolved on retesting in 2 weeks. To address the question of fatigue we repeated Randt tests in 4 subjects before and after magnetic brain stimulation but without the other extensive psychometric, EEG and blood tests. Pre- and post-stimulation scores on this occasion showed no significant difference in these 4 subjects suggesting that the transient changes in the previous Randt score were related to fatigue. We conclude that single-pulse magnetic brain stimulation has no deleterious effects after magnetic brain stimulation.

Adult↗
PubMed1995

Influence of physical, psychological and behavioural factors on consultations for back pain.

Over 34,000 questionnaires were used to study occurrence and consultations for back pain in the community. The 12-month period prevalence was 24% and 13% of the sample consulted a doctor. Elderly women were at greatest risk of back pain. The consultation rate increased in both sexes throughout middle age, but declined in men over the age of 55 yr. Back pain was associated with the Goldberg General Health Health Questionnaire score suggesting psychiatric morbidity [odds ratio (OR) = 2.05; confidence interval (CI) 1.89-2.23], obesity (OR = 1.59; CI 1.40-1.79), and cigarette smoking (OR = 1.52; CI 1.36-1.70). Vigorous daily activity was positively associated with back pain in men aged 18-39 yr (OR = 1.37; CI 1.02-1.85), and women aged 18-39 yr (OR = 1.50; CI 1.08-2.09), but was negatively associated with back pain in women aged over 65 yr (OR = 0.35; CI 0.16-0.76). Alcohol consumption was also negatively associated with back pain (OR = 0.72; CI 0.62-0.85). The prevalence of arthritis, constipation and respiratory disorders was increased in those who consulted for back pain corrected for the other variables. Thus back pain was substantially more common in women compared to men over 55 yr. Psychiatric morbidity, cigarette smoking and obesity were associated with back pain at all ages, but the effect of physical exercise appeared to change with age. Further studies are required to explain the sex differences and nature of the associations.

Adolescent↗
PubMed1995

Burkitt's lymphomas express VH genes with a moderate number of antigen-selected somatic mutations.

The normal counterpart of the neoplastic B cells occurring in Burkitt's lymphomas (BL) is an issue of controversial debate. To clarify this matter, a semi-nested primer polymerase chain reaction was performed to amplify the VDJ rearrangements of the immunoglobulin heavy chain (VH) gene of DNA extracts from 10 (8 sporadic and 2 endemic) BL cases. The resulting amplificates were sequenced for comparison with known germ line VH segments. The control cases comprised six cases of B cell chronic lymphocytic leukemia and six cases of mantle cell lymphoma known to display naive nonmutated, ie, pre-germinal center VH configurations; and eight cases of follicular center lymphoma known to display mutated VH genes with signs of a still-ongoing mutation reaction, characteristic for germinal center cells and lymphomas that derive therefrom. The results of this approach revealed that both sporadic and endemic BL express mutated VH genes with a mutation frequency considerably lower (4.9% and 5.4%, respectively) than that observed in follicular center lymphoma (11.8%). In addition, after subcloning the amplificates, sequence analysis revealed no signs of ongoing mutations. These results led us to conclude that the derivation of neoplastic B cells in BL is definitely not from naive, nonmutated pre-germinal center B cells. Instead, our findings support the view that BL cells stem either from early centroblasts that are arrested after an initial hypermutation reaction, or from germinal center B cells that have differentiated in terms of surface immunoglobulin profile and mutation pattern but not in terms of morphology and proliferation toward SIgM+ IgD- memory B cells because of the deregulated c-myc gene expression.

Burkitt Lymphoma↗
PubMed1995

The application of an anthropometric database of elderly and disabled people.

We report on the development of an anthropometric database of elderly and disabled people for use by designers. The problems encountered by the designer in developing products for the elderly and disabled are highlighted. Reference is made to previous work carried out using computer modelling to simulate the human product interface, and the problems in specifying the anthropometric data are discussed. From a review of existing anthropometric databases we have noted the lack of data on the elderly and disabled. Not only is there insufficient dynamic anthropometric data available, but there are no standards for the measurement techniques to produce this data. We report briefly on parallel work by the group which is looking at anthropometric measurement techniques, and the computer modelling of the human product interface for elderly and disabled people. The lack of dynamic anthropometric data that is appropriate for use by designers and rehabilitation engineers is the major area to be addressed by the database. We investigate the use of existing medical data available as a possible solution to the problem. The database will also seek to address the problem through its methodology of interpretation and presentation.

Aged↗
PubMed1995

Techniques in anthropometry applied to disabled and elderly populations.

We discuss the requirements of anthropometric and biomechanical data for specific application to the design of assistive devices and other products for elderly and disabled populations, including body size, shape, range of motion and strength data. We analyse available information and the practical and statistical problems involved in the collection of data from such populations. We comment on the different human interface design issues posed by various types of device and compare a task-specific approach to ergonomic analysis with the use of a generic biomechanical database. The specific requirements of a useful biomechanical data collection system intended to fulfil this need, and the conditions under which a practical system would have to operate are discussed. We review a range of available measurement techniques, including manual, mechanical, optical and electronic systems and discuss their relative fitness for the task in question. We propose an approach to the collection of multi-variable biomechanical data from the analysis of various tasks and discuss the use of computer models and other means of interpreting such data to make it available to product designers and engineers.

Aged↗
PubMed1994

The epidemiology of forestry work-related injuries in New Zealand, 1975-88: fatalities and hospitalisations.

AIM: This paper presents a detailed investigation of the injury experience of New Zealand forestry workers, including loggers and silviculture workers. METHODS: Record linkage of multiple data sources. RESULTS: During the period 1975-88, there were 81 work-related fatalities among loggers and 10 fatalities among silviculture workers, yielding fatality rates of 2.03 and 0.15 per 1000 workers/year, respectively. These figures were substantially higher than the fatal injury rate among the overall New Zealand workforce of 0.07 deaths per 1000 workers/year. In addition there were 1068 work-related injuries resulting in hospitalisation among loggers, and 478 among silviculture workers, yielding hospitalisation rates of 38.93 and 9.58 per 1000 workers/year, respectively. The types of injury contact involved in each incident were analysed. Contact with falling trees was the leading cause of death in forestry, accounting for over half of the fatal injuries among loggers and a third among silviculture workers. For loggers, the three commonest types of contact resulting in hospitalisation were: chainsaw injuries (n = 351; 33%), falling trees (n = 269; 25%), and rolling logs (n = 82; 8%). Among silviculture workers, the three commonest types of contact resulting in hospitalisation were: chainsaw injuries (n = 108; 23%), falling trees (n = 96; 20%), and falls/slips and trips (n = 94; 20%) CONCLUSION: There is clear need for continued efforts to improve the overall safety of forestry work in New Zealand.

Accidents, Occupational↗
PubMed1994

Hernia repair.

Explore the source record for details and available documents.

Hernia, Inguinal↗
PubMed1994

An economic evaluation of the introduction of vaccination against hepatitis A in a peacekeeping operation. The case of the United Nations Protection Force in Yugoslavia.

The costs and benefits of vaccinating troops on United Nations tours in Yugoslavia against hepatitis A were compared. The marginal cost of one case of hepatitis A avoided by vaccination was calculated and compared with the marginal cost of achieving the same outcome by passive immunization. The cost-benefit ratio (medium estimate) for troops at low risk of contracting hepatitis A was 0.01 and for those at high risk was 0.03. Vaccinating troops against hepatitis A for a single deployment appears to be an inefficient procedure, especially in troops at low risk. However, in professional troops from countries of low hepatitis A endemicity who are likely to be involved in several operational deployments, vaccination becomes more efficient the more times the same troops are deployed.

Cost-Benefit Analysis↗
PubMed1994

The role of the pre-symptomatic food handler in a common source outbreak of food-borne SRSV gastroenteritis in a group of hospitals.

A common source outbreak of small round structure virus (SRSV) gastroenteritis affected 81 patients and 114 staff in four hospitals served by one central hospital kitchen. Eating salad items was found to be significantly associated with illness. In a cohort study of a staff buffet function eating turkey salad sandwiches was associated with illness (relative risk = 2.4; 95% CI = 1.4-4.1; P = 0.003), and a case control study of patients in one hospital showed an odds ratio of 6.6 (95% CI = 1.0-71.6; P = 0.04) for eating tuna salad and becoming ill. One of two food handlers who prepared the salads became ill the day following food preparation; she also had a young child at home who had been ill with a gastrointestinal illness during the previous two days. Contamination of food by mechanical transmission of the virus from the child via clothes and hands of the mother, or pre-symptomatic faecal excretion in the mother are possible explanations of contamination of food.

Caliciviridae Infections↗
PubMed1994

Automatic recording and timing of defibrillation on general wards by day and night.

To measure the speed of response to ventricular fibrillation on general medical wards and to assess the importance of this and other factors for survival to leave hospital, 69 consecutive patients with ventricular fibrillation were studied prospectively using an automatic timing device in the hospital telephone exchange and an automatic timer and ECG recording during resuscitation. Twenty-seven patients were initially resuscitated and 17 were discharged from hospital. The median time to connect the monitor after recognition of a cardiac arrest was 127 s (range 0-277) for survivors and 132.5 s (range 0-620) for non-survivors. The median time ventricular fibrillation was displayed before the first shock was 43 s (range 4-75) for survivors and 52 s (range 10-454) for non-survivors. These differences were not significant; but logistic regression analysis identified primary ventricular fibrillation, short display time (logged data), 'early' time of day, absence of pre-existing non-cardiac illness, and post-defibrillation heart-rate > 30 beats.min-1 in rank order as independent predictors of survival. In spite of no significant diurnal variation in response time, successful resuscitations were concentrated in the early nursing shift (0730-1530 h). Four shocks were inappropriate. Clinical diagnosis was more predictive of outcome than the time to the first shock. The reasons for the poorer results in the evening and night are uncertain.

Aged↗
PubMed1994

Peripheral stem cell transplantation.

Peripheral stem cell transplantation (PSCT) affords many cancer patients the opportunity to use their own blood cells to recover from ablative chemotherapy. Bone marrow transplantation (BMT) also affords cancer patients this same opportunity; however, more problems are associated with this treatment. Medical-surgical nurses caring for patients receiving these innovations must be aware of current care guidelines.

Blood Component Transfusion↗