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Biomedical subjects

G Harper

Publications and source records attributed to G Harper.

At least 73 records · Page 4Linked to original sources
PubMed1989

Focal inpatient treatment planning.

Focal Inpatient Treatment Planning (FITP) is a new method of organizing and choosing among the many data available to the inpatient clinician. FITP emphasizes one Focal Problem, provides criteria for defining it, makes it possible to formulate the problem in operational language, channels free-ranging case discussion into workaday terms, invites the clinician to make explicit a sophisticated view of pathogenesis; including developmental, dynamic, and contextual factors, and ties formulation to intervention through explicit objectives. By requiring language that is jargon-free and accessible to patients and parents, FITP fosters empathy and alliance between the treatment community and the domain of the patient. This paper describes and illustrates FITP and provides guidelines for its implementation by an inpatient child and adolescent psychiatry service.

Adolescent↗
PubMed1989

Investigation of osteopaenia in anorexia nervosa.

Sixty-nine female patients, mean age 27.5 years (range 20-40), with a past or current history of anorexia nervosa (DSM III-R) had spinal trabecular bone density assessed by single energy quantitative CT scan. Current exercise and dietary calcium levels were assessed by detailed questionnaires and categorized. A semi-structured interview was used to record weight, menstruation, exercise and dietary calcium intake histories from early adolescence. Serum sex hormones and total calcium assays were measured. Bone density was significantly lower in the patients compared to 31 controls. Bone density was significantly positively correlated with body mass index, and negatively correlated with illness duration and duration of amenorrhoea. Exercise levels, dietary calcium intake and taking an oestrogen pill did not correlate significantly with bone density. Recovered patients did not have osteopaenia but they had shorter illness histories than non-recovered patients. Management to minimise bone loss should focus on weight gain and resumption of normal menstruation.

Adult↗
PubMed1986

Simultaneous determination of perhexiline and its monohydroxy metabolites in biological fluids by gas chromatography-electron-capture detection.

A rapid and sensitive method for the simultaneous determination of perhexiline and its cis-4-axial and trans-4-equatorial monohydroxy metabolites (M1 and M3, respectively) in human plasma, urine and bile is described. The assay utilises a single diethyl ether extraction, heptafluorobutyric acid anhydride derivatisation and separation and detection by gas chromatography-electron-capture detection. The limits of detection are 0.1 microgram/ml for perhexiline and 0.025 microgram/ml for the M1 and M3 metabolites. This method has been used in a five-day kinetic study of three healthy adult males who ingested a single 300-mg dose of perhexiline maleate. One of these volunteer subjects exhibited elevated plasma perhexiline and markedly reduced plasma and urinary M1 concentrations together with profoundly prolonged plasma and urinary M1 elimination times when compared with the other two subjects. These differences are thought to be of genetic origin. There were also obvious differences in urinary M3 concentrations which were discussed.

Adult↗
PubMed1984

Target size analysis of rhodopsin in retinal rod disk membranes.

Radiation inactivation of rhodopsin in situ using high-energy electrons gave a value for Mr of 20,200 by spectral assay, but 47,100 by assay of rhodopsin regeneration from opsin and 11-cis-retinal (sequence Mr = 38,840). No light/dark differences were seen. We conclude: (a) radiation inactivation measures the size of the functional unit, and the single hit hypothesis does not hold in our experiments; (b) 500 nm absorbance requires only about half the rhodopsin molecule to be intact, but reconstitution of rhodopsin from opsin requires the whole molecule; (c) we find no evidence for functional interactions between rhodopsin monomers in darkness or light.

Animals↗
PubMed1982

Maroteaux-Lamy syndrome, mild form--MPS vi b.

Mucopolysaccharidosis VI (Maroteaux-Lamy Syndrome) form B is a rare disease occurring in siblings. It may present with radiological features like Perthes' disease or hypothyroidism. We report two such cases, and discuss the differential diagnosis of the spondylo-epiphyseal dysplasias. We stress the importance of final diagnosis by identifying a particular glycosaminoglycan excess in the urine and an enzyme deficiency in the fibroblasts aryl sulphatase B and N-acetylgalactosamine-4-sulphatase.

Adolescent↗
PubMed1981

Unexplained disability: diagnostic dilemmas and principles of management.

Unexplained disability in childhood challenges the physician diagnostically and therapeutically. Clinical presentation is typically that of a chronically ill and increasingly disabled child, often with positive physical findings and erratic response to usual medical management. The physician experiences great pressure to diagnose, to counsel, and to cure. Family characteristics include an inability to speak in psychological terms, denial of the family's involvement in the child's symptoms, and an emphasis on equivocal biomedical findings. Diagnostic and therapeutic tools specific to these disabilities are defined, with clinical illustrations provided.

Adolescent↗
PubMed1980

Driving force behind day care for the mentally ill.

The Croft is a focus for mental health services in Derbyshire, writes Graham Harper, development officer (community services), Derbyshire Social Services. In a Joint Care Award entry he describes the enthusiasm and work which went into setting up a day centre for the mentally ill in a house scheduled for demolition to make way for a new by-pass.

Community Mental Health Centers↗
PubMed1980

Long-term antihypertensive drug treatment and blood pressure control in three hospital hypertension clinics.

Prescribing patterns and blood pressure control have been studied in 1101 patients treated at three specialist hypertension clinics in Britain. Seventy-four per cent of the patients were already receiving treatment at the time they were referred by their general practitioners. Though the initial improvement in blood pressure control was satisfactory, there was often some deterioration of control over the long term. The pressure exceeded 140/90 mmHg in the majority of patients followed for a year or more. During 1971-5 diuretics remained first preference, with increasing use of beta-blockers and a distinct decline in the use of sympathetic neurone blockers both by hospital staff and referring practitioners. Multiple drug treatment was common, nearly half the patients requiring more than one antihypertensive drug. In newly treated patients the frequency of cessation of a particular class of drug because of side effects or lack of efficacy ranged from 6 per cent with diuretics to 57 per cent with adrenergic neurone blocking drugs. Long-term blood pressure control still presents many problems, and the results contrast with the more optimistic interpretations sometimes placed on short-term clinical trials of antihypertensive effect.

Antihypertensive Agents↗
PubMed1979

Comparison of black and white patients attending hypertension clinics in England.

Reports suggest that hypertension and death due to hypertensive disease are commoner among black than among white people. One hundred and thirty-five black patients attending hypertension clinics at three English hospitals were compared with age-, sex-, and clinicmatched white patients. The black women had higher blood pressures and weighed more than the white women, but there were no differences between the men. The black patients had not increased risk from family, obstetric, or smoking history. Proteinuria and nocturia were more common in black patients while urinary infections were less common. Heart size and left ventricular voltage were greater in black patients. Haemoglobin and plasma cholesterol and triglyceride concentrations were smaller and serum globulin concentration greater in black patients. No difference in response to treatment, attributable to race, was observed during the period of clinic attendance, which averaged 1.7 years. There was a slightly greater rate of default among black men during the first year of attendance.

Adult↗
PubMed1975

Rapid methods for identification of yeasts.

Opportunistic infections by yeasts have been implicated as one of the major causes of complications in the compromised patient. Rapid recognition and identification of these yeasts is essential for patient management, but conventional liquid medium methods for completing identification tests are cumbersome and time consuming. Rapid tests have been devised based on modifications of methods commonly used in bacteriology. These rapid methods included tests for carbohydrate and nitrate assimilation, fermentation, and urease production. These were compared with several current methods for accuracy of results, for time to final identification, and for economy of time and reagents. In addition, the usual tests for pseudogerm tube formation, for production of hyphae or pseudohyphae, and for growth temperatures were included. The rapid tests achieved 96% or better accuracy compared with expected results, and 46 species of yeasts were identified in 1 to 2 days compared with the 10 to 14 days required by conventional liquid culture methods.

Blastomyces↗