Hip dysplasia in cerebral palsy.
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Biomedical subjects
Publications and source records attributed to G Baird.
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The development of the fast field and parabolic equation solutions to the wave equation has made it possible to solve for the combined effects of refraction in a layered atmosphere and the interaction of sound with a complex impedance ground surface. In many respects the numerical methods have advanced beyond our understanding of the basic phenomena. In an earlier study [J. Acoust. Soc. Am. 89, 107-114 (1991)], the residue series solution for upward refraction was investigated and provided insight into the nature of the interaction of refraction and ground reflection. In this paper results are presented of a similar normal mode solution for downward refraction above a complex impedance ground surface. This model is used to investigate when the surface wave is excited for downward refraction conditions and to develop criteria for the maximum range of cylindrical decay as a function of phase and magnitude of the ground impedance and the magnitude of the sound velocity gradient.
The incidence of lymphoma and myeloma is increased in rheumatoid arthritis (RA), though the reasons for this are incompletely understood. The predictive value of monoclonal gammopathy in RA for the later development of lymphoproliferative malignancy was assessed. A serum paraprotein was discovered in 23 patients (14 female) with a median age of 58 years and a median duration of RA of six years. The paraprotein was quantified and further investigations, including a bone marrow examination and skeletal survey, were undertaken to study the possible development of a lymphoproliferative disorder. Secondary Sjögren's syndrome was noted in 12 patients. The paraprotein was monoclonal in 21 patients and was classed as IgG (12 cases), IgA (six cases), or IgM (three cases). Biclonal paraproteins were seen in two patients. Free light chains were found in the urine of eight patients. Bone marrow abnormalities were found in 13 subjects. The bone marrow was abnormal in four of six patients with an IgA paraprotein, in two of three with an IgM paraprotein but in only five of 12 patients with an IgG paraprotein. Patients were followed up for a median of four years, and five patients with an abnormal bone marrow developed myeloma, of whom three had an IgA lambda paraprotein. Two other patients developed non-Hodgkin's lymphoma. Extra-articular bone erosions were seen in four patients, three of whom developed myeloma, but the presence of urinary free light chains was not specific for the development of malignancy. Paraproteinaemia in RA indicates monoclonal B cell proliferation and carries a high risk of malignant transformation.
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We describe a case of severe acute thrombocytopenia in a 72 year old man treated with De-Nol for erosive biliary gastritis.
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There is little agreement about what constitutes good developmental paediatric practice at the level of primary care. Many of the available screening tests are intrinsically unsatisfactory or badly performed, but screening is only a small part of developmental paediatrics. Every primary care doctor should be familiar with the scientific basis of the subject even if a decision is made not to embark on a formal screening programme.
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The Mary Sheridan Centre serves the needs of two health districts with a population of over half a million. The assessment of the handicapped child is combined with a Day Nursery and Observation Unit which provides therapeutic, educational and supportive guidance. During the year May 1973-74, 207 children were referred for assessment of whom only 11 were found to have no handicap. One-third of these referrals were from the hospital follow-up baby clinic and two-thirds came from community and general practitioner sources. The average age of referral was two years for girls and two and a half years for boys. Of the 196 handicapped children, 33 had neurological disorders, 30 congenital anomalies and 50 an adverse perinatal history. Social factors were thought to contribute significantly in 72; 35 children came from single parent families. Behaviour problems were noticed in a high proportion (68). Forty-four children regularly attend the Centre's day nursery whose staff include preschool teacher, occupational therapists and trained nurses for play, speech stimulation and specific therapy; 48 attend for speech therapy and 19 for physiotherapy. The prime aim is to help the parents continue with the therapy and care of their child in their own home.
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