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Biomedical subjects

G Avery

Publications and source records attributed to G Avery.

16 recordsLinked to original sources
PubMed2001

WHO report 2000.

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Developed Countries↗
PubMed2000

Medium- and long-term functional outcomes in a multicenter cohort of children with juvenile dermatomyositis.

OBJECTIVE: To evaluate functional outcomes in a cohort of patients with juvenile dermatomyositis (DM). METHODS: A retrospective inception cohort of patients diagnosed as having juvenile DM between January 1, 1984 and January 1, 1995 was established at 4 Canadian tertiary care pediatric centers. Informed consent was obtained. Each subject was interviewed by telephone or in person. The primary outcome was physical function, as measured by the Childhood Health Assessment Questionnaire (CHAQ). Additional outcomes were educational and vocational achievement, growth, development of calcinosis, patient satisfaction with outcome, and development of other illnesses. Data regarding illness presentation, treatment, and disease course were obtained through chart review. RESULTS: Sixty-five of 80 patients (81%; 46 females and 19 males) could be contacted. The median followup time was 7.2 years (range 3.2-13.9 years), with a median age at followup of 13 years (range 7-26 years). Twenty-four patients (37%) had a monocyclic course, while the remaining 41 (63%) had a chronic continuous or polycyclic course. Sixty-two patients (95%) were treated with corticosteroids, while 41 (63%) received a second-line agent. Physical function was excellent, with a median CHAQ score of 0 (range 0-2.50). Eighteen patients had scores >0, and only 5 had moderate-to-severe disability, as defined by a CHAQ score >1.0. Females had higher CHAQ scores, and all but 1 of the patients with scores >0 were female (range 0-2.50; P = 0.015). Patients with a chronic continuous course also had higher CHAQ scores. Sixteen patients in the chronic continuous group had CHAQ scores >0 (range 0-2.50; P = 0.0009). Calcinosis developed in 22 patients (34%) and persisted to followup in 14. Development of calcinosis was not related to initial therapy, sex, or disease course, but was significantly associated with higher CHAQ scores (range 0-1.0 versus 0-2.5; P = 0.01). At the time of followup, 26 patients (40%) still had rash, 15 (23%) still reported weakness, and 23 (35%) continued taking medications, despite the fact that all were at least 3 years postdiagnosis. There was 1 death. CONCLUSION: In general, patients in this cohort had favorable outcomes. Most had CHAQ scores of 0, and only 8% met our definition of moderate-to-severe disability. However, many patients continued to have chronic disease, persistent rash, and continued taking medications >3 years after diagnosis. Further research is needed to improve outcomes for patients with juvenile DM.

Adolescent↗
PubMed2000

Middle Stone Age stratigraphy and excavations at Die Kelders Cave 1 (Western Cape Province, South Africa): the 1992, 1993, and 1995 field seasons.

Die Kelders Cave 1, first excavated under the direction of Franz Schweitzer in 1969-1973, was re-excavated between 1992 and 1995 by a combined team from the South African Museum, SUNY at Stony Brook, and Stanford University. These renewed excavations enlarged the artefactual and faunal samples from the inadequately sampled and less intensively excavated lower Middle Stone Age (MSA) layers, increased our understanding of the complex site formation processes within the cave, enlarged the hominid sample from the MSA deposits, and generated ESR, TL, and OSL dates for the MSA layers. Importantly, these new excavations dramatically improved our comprehension of the vertical and lateral characteristics of the MSA stratigraphy. Surface plotting of the MSA layers has led to the identification of at least two major zones of subsidence that significantly warped the layers, draping some along the eroding surface contours of major blocks of fallen limestone roof rock. A third zone of subsidence is probably present in the older excavations. Dramatic roof falls of very large limestone blocks occurred at least twice-once in the middle of Layer 4/5 where the roof blocks were only slightly weathered after collapse, and at the top of Layer 6 where the blocks weathered heavily after collapse, producing a zone of decomposed rock around the blocks. Many of the sandy strata are cut by small and localized faults and slippages. All of the strata documented by Schweitzer's excavations are present throughout the exposed area to the west of his excavated area, where many of them thicken and become more complex. Layer 6, the thickest MSA layer, becomes less diagenetically altered and compressed to the west.

Animals↗
PubMed1999

Duinefontein 2: an Acheulean site in the Western Cape Province of South Africa.

Excavations at Duinefontein (DFT) 2 near Cape Town, South Africa have recovered numerous stone artefacts and animal bones on an ancient surface sealed within iron-stained eolian sands. U-series analysis of an overlying calcrete places the sands before 150 ka ago, while the large mammal taxa imply an age between 400 and 200 ka ago. The artefacts include a classic Acheulean handaxe and probable biface shaping flakes that support this age estimate. The principal mammalian species are long-horned buffalo, black wildebeest, greater kudu, Cape zebra, and grysbok/steenbok, which imply a grass-and-bush mosaic instead of the historic small-leafed shrubland. Hippopotamus and reedbuck indicate that water stood nearby, probably in dune swales. The large mammal bones are mostly vertebrae and other axial elements, often in near-anatomical order. Both proximal and distal appendicular elements are rare. Bones with carnivore damage are common, but ones with stone tool marks are scarce. The sum suggests a water-edge attritional death site where people played a minimal role and carcasses were disarticulated mainly by carnivore feeding and by trampling. Stone tool marks tend to be equally rare at other Acheulean attritional death sites, and the implication may be that Acheulean people rarely obtained large mammals, whether by hunting or scavenging. Human scavengers at DFT2 would not have encountered a disproportionate number of distal (versus proximal) limb elements, and it follows that the tendency for distal elements to dominate many archeological assemblages need not reflect scavenging versus hunting. Even if DFT2 was not itself a locus of intense human activity, it provides a useful baseline for evaluating bone damage, skeletal part representation, and other variables at sites where people were deeply involved.

Animals↗
PubMed1993

Accelerated glycolysis in early hypertensive left ventricular hypertrophy.

Changes in energy metabolism have been demonstrated in established left ventricular hypertrophy (LVH). It is not known if cardiac energy metabolism is shifted toward anaerobic pathways during the early stage of hypertensive LVH. Accordingly, glycogen, pyruvate, and lactate levels from left ventricular homogenate were measured in 8-week-old spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Systolic arterial pressure and left ventricular weight were determined to establish hypertensive state and LVH, respectively. The glycogen and pyruvate levels in SHR versus WKY were lower by 19 (p < 0.05) and 12% (NS), respectively. The lactate level in the SHR was 14% higher (p < 0.05) than in WKY. The lactate/pyruvate ratio in the SHR was higher than in the WKY, but did not reach statistical significance. These data suggest that the anaerobic metabolism is induced early in the development of hypertension, before the development of substantial LVH.

Animals↗
PubMed1986

Acidosis and hepatic portal venous gas: indications for surgery in necrotizing enterocolitis.

A retrospective review of cases of necrotizing enterocolitis seen at the Children's Hospital National Medical Center during the past 5 years was performed to identify factors that indicate a need for surgical intervention. The study group consisted of 92 neonates. Persistent acidosis and hepatoportal venous gas were significantly more common in babies requiring surgery than in those who were managed medically. Other physical, radiologic, and laboratory factors did not occur more frequently in those children going to surgery. Neonates with hepatoportal venous gas or persistent acidosis should be treated aggressively, and surgical intervention should be considered early in this group. Such an approach may serve to reduce morbidity and mortality in the future.

Acidosis↗
PubMed1983

Ophthalmic manifestations of mucoceles.

Two patients with mucoceles are described. The first case had exophthalmos, and the second had visual loss suggestive of retrobulbar optic neuritis. Possible ocular manifestations of mucoceles are discussed, and the computed tomography findings of these are shown. The treatment of mucoceles is reviewed, and it is stressed that a team approach involving ophthalmology, otorhinolaryngology, and radiology is essential for accurate diagnosis and treatment. Paranasal sinus mucoceles can present with a multitude of different symptoms. The type of presentation is usually determined by the original site of the mucocele, whether it be frontal, ethmoidal, or sphenoidal.

Adult↗
PubMedDate not supplied

Quality, research and ritual in nursing.

The purchaser/provider system has brought the dynamic association between quality, volume and cost into clear focus. Any consideration of this tri-partite relationship is incomplete, however, unless the additional dimensions of research and ritual are also included. This article analyses how the monitoring systems now in place offer nurses a unique opportunity to drive for the replacement of ritualised practice by research-based practice.

Clinical Nursing Research↗