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Biomedical subjects

G Ford

Publications and source records attributed to G Ford.

72 records · Page 4Linked to original sources
PubMed1984

Outcome in infants with birth weight 500 to 999 gm: a regional study of 1979 and 1980 births.

During 1979 and 1980, 351 infants weighing 500 to 999 gm were born in the State of Victoria, Australia; 89 (25.4%) survived to 2 years of age. Survival was better for tertiary center births (29%) than for those born elsewhere (17%). Multidisciplinary teams reviewed 83 of the survivors at 2 years of age postterm; some data were available for the other six children. Overall, 22.5% of infants had severe functional handicap, 29.2% had either moderate or mild handicap, and 48.3% had no handicap. Severe functional handicap was present in 50% of outborn infants; this was significantly more common than in those born in tertiary centers (15.5%), and the Bayley Mental Developmental Index was also significantly lower in outborn infants. The prevalence of cerebral palsy (13.5%), bilateral blindness (3.4%), and severe sensorineural deafness (3.4%) did not differ significantly in the inborn and outborn infants. Singleton inborn infants of appropriate weight for gestational age had significantly less severe functional handicap (9.1%), compared with 37.5% for the group of infants who were either small for gestational age or one of multiple births. Six of the 18 outborn infants could have been transferred in utero, and improvements in immediate neonatal care were possible in seven other infants.

Age Factors↗
PubMed1984

Active mobility of the extremities in older subjects.

The purposes of this study were to expand the data base of active range of motion (ROM) in the upper and lower extremities of older persons measured by goniometry and to determine if differences exist related to age, sex, and physical activity. Active ROM was measured with a clinical goniometer in 28 joint motions of the upper and lower extremities of the right side in 60 older subjects. Thirty men and 30 women were equally divided in two age groups of 60 to 69 and 75 to 84 years of age. Multivariate analysis of variance showed no significant differences in ROM that were attributable to sex and age. In univariate tests, however, 12 motions were significantly different (p less than .05) between the sexes, but only in 4 motions was the difference greater than intertester error. Physical activity, as assessed by a questionnaire and a rating scale, was not related to specific changes of joint range. Within the older subjects, however, a significant relationship between ROM and age or ROM and physical activity cannot be assumed. These results suggest that a data base of normative values is needed for older individuals.

Aged↗
PubMed1984

Outcome of extremely low birth-weight infants in relation to the hospital of birth.

There were 351 liveborn infants of birth-weight 500-999 g born in the State of Victoria in the years 1979 and 1980; 89/351 (25.4%) survived to the age of 2 years: 42 (47.2%) survivors were of gestational ages of 24 to 26 weeks and 47 (52.8%) were born at 27 to 32 weeks' gestation. Survival of these extremely low birth-weight infants was significantly better (71/245, 29%) for births in tertiary centres compared with those born elsewhere (18/106, 17%). Of the 351 livebirths, 69.8% occurred in 1 of the 3 tertiary centres. All 89 survivors were traced; 84 (94.4%) were assessed at the age of at least 2 years by a multidisciplinary team. Three children had been fully assessed at 1 year of age and paediatric reports were available for 2 children. The quality of survival of children born in tertiary centres was significantly better than those transferred to a tertiary centre after birth; the prevalence of serious functional handicap was 72.2% (13/18) for outborn children compared with 22.5% (16/71) for those born in tertiary centres. The prevalence of serious functional handicap in the inborn survivors was lowest (9/55, 16.4%) in singleton births who had been of appropriate birth-weight for gestation. A review of the 18 surviving outborn infants' records indicated that 6 (33.3%) could have been transferred to a tertiary centre in utero and for the 12 infants where birth in a tertiary centre was not feasible, improvements in the early neonatal care were possible in another 7 infants.

Australia↗
PubMed1983

Collaborative study of very-low-birth-weight infants. Correlation of handicap with risk factors.

Two large maternity services studied consecutive inborn infants (birth weight range, 500 to 1,500 g) born between 1977 and 1978. The multidisciplinary team members used identical assessment methods and documentation. Of 259 long-term survivors, 252 (97.3%) were seen at 2 years of age. Survival rates for hospitals 1 and 2 were 68.5% and 69.0%, respectively. Cerebral palsy rates for hospitals 1 and 2 were 11.8% and 11.2%, respectively. Major handicaps (cerebral palsy, mental developmental index [MDI] on the Bayley scales less than 69, epilepsy, deafness, or blindness) occurred in 30 (18.6%) and 17 (17.3%) of hospitals 1 and 2 survivors, respectively. Both cerebral palsy and developmental delay (MDI below 75 without severe or moderate cerebral palsy) were significantly correlated with a number of perinatal variables, but none were common to the two hospitals. Of the 30 children with cerebral palsy, 15 (50%) were not ventilated, and 28 (93%) had a five-minute Apgar score greater than 4; there was no indication that selective treatment to prevent cerebral palsy was possible.

Blindness↗
PubMed1983

Risk groups and selective case finding in an elderly population.

As the preventive approach gains ground in the care of the elderly there is increasing interest in screening or case-finding. Given the impracticability of visiting all those over a certain age, most GPs and health visitors concentrate on those considered to be at greatest risk of medical and social deterioration. This paper draws on data from a random sample of the elderly population of Aberdeen to examine the nature and extent of 'risk' experienced by those falling into a number of conventionally defined risk groups. It shows that few of these groups are comprehensively disadvantaged and most are inefficient for selective case-finding. An alternative approach based on answers to a carefully selected set of screening questions is shown to be more efficient, and suggestions are offered for further improvements.

Activities of Daily Living↗
PubMed1983

Reappearance of epidermal Langerhans cells after PUVA therapy.

Epidermal Langerhans cells (LC) disappear during photochemotherapy (PUVA) with 8-methoxypsoralen (8-MOP) and long wavelength ultraviolet (UV-A) radiation. The time course of their disappearance during treatment and their reappearance after its completion was followed. Langerhans cells lost ATPase activity before they disappeared by ultrastructural criteria: thus 90% of ATPase-stained cells had disappeared after seven treatments (2 weeks) whereas it was only after fifteen treatments (5 weeks) that they were seen to be reduced on electron microscopy. Their numbers remained low throughout the course of treatment but they had returned to normal by 3 weeks after cessation of therapy. Since PUVA lamps also emit traces of medium wavelength UV (UV-B) the separate effects of UV-A and UV-B in the presence and absence of 8-MOP were examined. Within the dose range normally used for therapy, the LC disappeared only with the combination of UV-A and 8-MOP.

Adenosine Triphosphatases↗
PubMed1982

Infants born before 29 weeks gestation: survival and morbidity at 2 years of age.

In a collaborative study involving two hospitals with large maternity services, 166 liveborn infants of gestational age from 24 to 28 weeks were born in the calendar years 1977 and 1978. Of these infants, 75 (45.2%) died either in hospital or after discharge home. At the age of 2 years, 16 (9.6%) of the cohort had a major handicap [cerebral palsy, Mental Developmental Index (MDI) under 69, deafness or blindness]. An additional 20 children (12.0%) had significant developmental delay (MDI 69 to 84, -2 to -1 SD below mean) and 53 (31.9%) were considered to be free of these handicaps. Psychological assessments were not performed on two survivors (1.2%) but reliable reports indicated that they were free of major handicaps. Long-term survival increased in a stepwise fashion from 9.1% at 24 weeks to 68.5% at 28 weeks gestation, and there was a trend for major handicap and significant developmental delay to decrease in incidence with increasing maturity. Of the 58 children who had presented by the vertex 42 (72.4%) were free of significant handicap; however, of the 31 children in whom there had been either a breech presentation or a transverse lie, only 11 (35.5%) were free of significant handicap (chi 2 = 9.69, P less than 0.01). The mode of delivery (vaginal or caesarean section) did not significantly affect the handicap rate in the survivors.

Australia↗
PubMed1982

Changing outcome over 13 years of very low birthweight infants.

The survival prospects for infants of birthweight less than or equal to 1500 g born in recent years have improved. Evidence for a corresponding decrease in long-term morbidity of survivors is conflicting but recent reports from some centers indicate that high morbidity rates are occurring. Until additional satisfactory reports are available on the outcome of very low birthweight (VLBW) infants born after 1975, preferably from a community or region, uncertainty will continue. The outcome of three cohorts of VLBW infants, born in the Royal Women's Hospital, Melbourne between 1966 and 1978 is reported; more than 90% of each cohort were fully assessed, aged 2-8 years. There were 169 long-term survivors from the first cohort (1966-1970 births) and 72 from the second cohort (1973-74 births); survival rates were 37.1% and 37.3% respectively; however, for the 1977-78 births, there were 161 survivors, a significant increase to 68.3%. In the first cohort, 32.7% had one or more visual defects and 3.9% were blind but visual morbidity decreased progressively in cohorts 2 and 3; 3% of the second cohort and 1.2% of the third cohort were blind. There was a trend for a decrease in severe sensorineural deafness. Cerebral palsy increased progressively, respectively 2.6%, 4.5% and 11.9% in the first, second and third cohorts. There was a significant increase in the mean Mental Developmental Index of the Bayley Scales at the age of 2 years from 75.38 for the 64 children born in 1966-70 compared with 90.96 for 150 children in the 1977-78 cohort. Although there had been an increase in upper social class families in the more recent cohort, improvement in test scores was still highly significant when higher social classes (1-3 Congalton Scale) were excluded. However, there was no significant improvement in the 6 year psychological test scores of the first and second cohorts. There was a steady increase in occurrence of cerebral palsy. Significance associations in the 1977-78 cohort were found with only 2 perinatal variables (use of theophylline and necrotizing entercolitis). Furthermore, 17 (89.5%) of children had a five-minute Apgar score greater than 5 and 14 (73.7%) did not require ventilatory support: Prevention of cerebral palsy by selective treatment in the delivery room or nursery was not feasible for prediction of this condition was not possible from perinatal risk factors.

Australia↗
PubMedDate not supplied

Clinical experience with hyperthermia in conjunction with radiation therapy.

The authors have reviewed the medical records of 421 sessions of hyperthermia treatments in 73 patients treated between 1987 and 1992 at the University Heights Cancer Center and the Indiana University Medical Center in Indianapolis, Ind. Temperatures attained during the course of therapy on each patient have been averaged and the results were evaluated for complete, partial, or no response. All patients had previously failed conventional radiation therapy, chemotherapy and surgery. Responses were defined as: (1) Complete response-lesions that completely disappeared during treatment and the response was sustained for a minimum of 6 months. (2) Partial response-lesions that underwent a reduction in size of greater than 50%. (3) No response-less than 50% reduction in tumor size during the course of treatment. Response varied somewhat according to histology and anatomical site of treatment; however, complete response was achieved in 45%, partial response in 48% (for an overall response of 93%), and no response in 7% of the patients. The response achieved varied with temperature attained and a minimum temperature of 40 degrees C for 40 min produced the greatest number of responses. Response to hyperthermia was directly related to the temperature achieved and the length of time the temperature was applied.

Combined Modality Therapy↗
PubMedDate not supplied

Differential aging: an exploratory approach using cluster analysis.

This article uses cluster analysis to identify different patterns of personal resources within a random sample of the well, elderly population. Ten such patterns or natural groupings are identified and their implications for coping and successful aging are discussed. It is apparent that there are a number of ways both of aging well and aging badly, and that these patterns cannot be predicted solely on the basis of structural data. The article poses a number of questions on the performance of cluster members over time and draws attention to the importance of longitudinal data.

Adaptation, Psychological↗
PubMedDate not supplied

The mechanism underlying sudden death from electric shock.

Much has been written on the effects of electric shock on the body. However, in those cases in which victims become pulseless and therefore die suddenly, the underlying event has assuredly been ventricular fibrillation. In this condition of the heart, all of the muscle fibers of the ventricles, the main pumping chambers, contract and relax randomly and pump no blood. Simple protracted cardiac arrest, in this circumstance, is most unlikely. It generally is believed that only low-frequency alternating current can induce ventricular fibrillation; this assumption is invalid, because a single pulse of current applied to the body, as well as high-frequency current, can induce ventricular fibrillation. The important variables are the type and magnitude of the current and the manner in which it is applied to the body. To date, the current pathway has received too little attention. This article reviews the various mechanisms by which a single shock or a train of pulses can induce ventricular fibrillation.

Animals↗