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Biomedical subjects

H King

Publications and source records attributed to H King.

210 records · Page 12Linked to original sources
PubMedDate not supplied

The impact of spinal pathology on bowel control in children.

There are two basic mechanisms of bowel control: anatomic and neurologic. The structures involved in bowel control include the colon, rectum, internal and external anal sphincters, and pelvic musculature. Also involved is the process of neural innervation. A pediatric patient's bowel function and control are altered as a result of spinal pathology. Upper motor neuron lesions leave the reflex arc intact but with a lack of voluntary control. Stimulation and timing are important in the development of a successful bowel program for pediatric patients with these lesions. In contrast, lower motor neuron lesions impair the reflex arc and result in a flaccid bowel. The pediatric patient's rectum may be extremely compliant and store copious amounts of hard stool. In such cases, bowel control is much more difficult to attain. This article presents implications for rehabilitation nursing practice for each type of lesion in pediatric rehabilitation patients.

Child↗
PubMedDate not supplied

New trends in the management of congenital heart disease.

Considerable improvements have been made in the diagnosis and treatment of congenital heart disease during the last decade. Many congenital heart lesions are now treated successfully during the neonatal period that previously were associated with high mortality. Improved echocardiographic imaging, catheterization techniques, and earlier surgical repair are factors that have resulted in greater success in the treatment of congenital cardiac disease. Diagnosis has been improved greatly with advancements in echocardiography and angiography. Better ultrasound technology combined with doppler techniques and transesophageal echocardiography allow more accurate preoperative assessment and therefore more successful surgical repair. Cardiac catheterization techniques have also improved and, when combined with treatment such as balloon angioplasty, have changed the treatment of certain cardiac anomalies such as pulmonary stenosis or coarctation of the aorta. Operative treatment of congenital heart disease has improved the short- and long-term survival of most infants with congenital cardiac anomalies. Improved cardiopulmonary bypass techniques, better suture material, and the ability to perform cardiac transplantation are examples of technology that allows earlier, more complete repair of these complex cardiac defects. Reviewed here are improvements in the treatment of four complex cardiac anomalies that occur in newborns and are associated with high mortality when left untreated. All four anomalies have undergone significant changes in the approach to their treatment with dramatic improvements in survival.

Aortic Valve Stenosis↗
PubMedDate not supplied

Weight change amongst Nauruans over 6.5 years: extent, and association with glucose intolerance.

We are reporting here the extent of weight change over 6.5 years of follow-up amongst 366 randomly selected Nauruans initially surveyed in 1975-1976. Although the initial level of obesity was high (mean body mass index: males 30.8 kg/m2, females 33.0 kg/m2), further increase in body mass index subsequently occurred in 285 subjects (78%). The weight loss that occurred amongst the other 81 subjects was generally mild (mean = 5.3 kg), and only 12 persons lost more than 10 kg. Weight loss was far more common amongst the older subjects: 40% of those older than 50 years compared with 10% of those less than 30 years showed a decrease in body mass index (P less than 0.001). After age adjustment, greater initial obesity was associated with subsequent weight loss (P less than 0.001), and higher baseline plasma glucose (P less than 0.001), and triglyceride levels (P less than 0.05) and lower plasma uric acid levels (P less than 0.01) were also predictive of some weight loss. Obesity and diabetes remained the major predictors of weight loss in the multivariate analysis. Subjects who lost weight showed similar deterioration in glucose tolerance over the 6.5 years (mean increase = 1.8 mmol/l) to those not losing weight (mean = 1.0 mmol/l) and weight loss was not associated with glucose tolerance improvement (or less deterioration) for either those diabetic, or those not diabetic initially. This result suggests that weight loss is not invariably associated with improvement in glucose tolerance amongst Nauruans.

Adult↗
PubMedDate not supplied

Diet and blood nutrient correlations with ischemic heart, hypertensive heart, and stroke mortality in China.

Though major differences exist in subcategory mortality levels, cardiovascular disease remains a leading cause of death among both Asian Chinese and Westerners. This paper examines the possible relationship between cardiovascular mortality and biochemical, diet and lifestyle factors based on two surveys in China. Statistically significant associations indicate five variables negatively correlated: molybdenum, oleic acid, liquor consumption (males), legumes, and age at first pregnancy with ischemic heart disease; molybdenum, oleic acid (females) and age at first pregnancy with hypertensive heart disease; and legumes and age at first pregnancy with stroke. Five variables were positively correlated: triglycerides and herpes antibodies with ischemic heart disease; salt and phosphorus (females) with hypertensive heart disease; and only albumin (males) with stroke. Some findings confirm those observed in the West (salt, triglycerides, herpes, legumes, oleic acid, and liquor), but molybdenum and age at first pregnancy have not been emphasized previously. Still others significant in the West have not been observed here, such as cholesterol and smoking.

Adolescent↗
PubMedDate not supplied

Non-insulin-dependent diabetes (NIDDM) in a newly independent Pacific nation: the Republic of Kiribati.

A population-based survey of 2938 subjects has demonstrated a high prevalence of non-insulin-dependent diabetes (NIDDM) in the Micronesian population of Kiribati (formerly the Gilbert Islands). This finding provides further support for evidence from Nauru, Guam, and the Marshall Islands that Micronesians are particularly susceptible to NIDDM. The age-standardized prevalence was over twice as high in an urban, as compared with a rural, sample (9.1 versus 3.0 in men, 8.7 versus 3.3 in women). To test the a priori hypotheses that obesity, reduced physical activity, and a nontraditional diet are associated with NIDDM, indices of these factors were compared in rural and urban subjects. The rural population was found to be leaner, to have a higher estimate of habitual physical activity, and to have a lower percentage of daily energy intake derived from imported foods. Further analysis demonstrated that obesity alone was insufficient to explain the rural-urban difference in prevalence of NIDDM. The multiple logistic regression model demonstrated a significant association between the prevalence of NIDDM and both obesity and urbanization in men. In women, obesity, physical inactivity, and urbanization were all associated with increased prevalence of NIDDM.

Adult↗
PubMedDate not supplied

The prevalence of Chlamydia trachomatis in a young, sexually-active population.

A prospective study was carried out to determine the prevalence of Chlamydia trachomatis among 1000 sexually-active women at the Family Planning Association Clinic in Melbourne. This organism was isolated from the cervices of 5.1% of screened women. The women were surveyed about their sexual and gynaecological history, and symptoms of discharge or pain. It was found that women who gave positive results for the presence of Chlamydia were younger, and had commenced intercourse at an earlier age. Risk factors of multiple sexual partners, cervical ectopy and symptoms of urethritis were identified. We recommend that women who have more than one sexual partner should ask their partners to use condoms or, failing this, undergo annual screening for Chlamydia by immunofluorescent staining.

Adult↗
PubMedDate not supplied

Surgical ligation of the patent ductus arteriosus in low birth weight pre-term infants. A review of 67 consecutive cases.

Between March 1978 and October 1983, sixty-seven low birth weight infants (600-1500 gm) with gestational age of 26-33 weeks had surgical ligation of PDA in our unit. Thirty-six (54%) had previous failed indomethacin therapy. Congestive cardiac failure (61), respiratory distress syndrome (48) and failure to thrive (34) were the presenting features. Nine patients had severe acidosis (pH 6.8-7.18) on admission. A trans-pleural approach was used in all. Ventilation was required for 1-13 days. There were no intra-operative deaths. Sixteen (24%) died of the problems of prematurity. The others have continued to thrive. We believe that ligation of PDA is a safe and effective procedure in the low birth weight premature infant, but should only be undertaken in a well set up paediatric cardiac surgical unit.

Ductus Arteriosus, Patent↗
PubMedDate not supplied

Respiratory distress with left aortic arch, right descending aorta, and right ligamentum arteriosum: a case report.

A 7-year-old girl manifested the rare anomaly of a ventricular septal defect (VSD) with left aortic arch, right descending aorta, and right ligamentum arteriosum. After open-heart surgery to correct the VSD, symptoms of tracheal obstruction on spontaneous breathing developed, due to tracheal compression by the right ligamentum arteriosum. The compressed segment of the trachea was found to be thin and unstable following division of the ligamentum. Positive-pressure breathing and continuous positive airway pressure breathing effectively splinted the patient's airway during the postoperative period, with recovery of the patient.

Aortic Arch Syndromes↗