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Biomedical subjects

H Parker

Publications and source records attributed to H Parker.

At least 19 recordsLinked to original sources
PubMed1995

The use of the pain drawing as a screening measure to predict psychological distress in chronic low back pain.

STUDY DESIGN: The ability of three new methods of scoring the Pain Drawing to predict psychological distress in two cohorts of 100 patients with chronic low back pain was investigated. OBJECTIVES: Patients completed a Pain Drawing and questionnaire measures of psychological distress and were given a standard physical examination. SUMMARY OF BACKGROUND DATA: The two cohorts were significantly different on all variables (except for disability). METHODS: The relationship between the three new scoring systems and measures of distress, physical factors, and disability was investigated. RESULTS: The new scoring methods had high reliability. Pain Sites was a more accurate predictor of distress, but was unable to do so with sufficient specificity/sensitivity. Body Map did not correlate with physical/disability measures. CONCLUSION: Using the new scoring systems, it was not possible to identify distressed patients with sufficient sensitivity/specificity, nor to differentiate between organic and nonorganic pain patterns.

Chronic Disease↗
PubMed1994

Drosophila melanogaster genes encoding three troponin-C isoforms and a calmodulin-related protein.

Using low-stringency hybridization and polymerase chain reaction (PCR)-based DNA amplification, we have isolated three Drosophila melanogaster genes that encode troponin-C isoforms and one specifying a protein that is closely related to calmodulin. Two of the troponin-C genes, located within the 47D and 73F subdivisions of chromosomes 2 and 3, respectively, encode very closely related isoforms. That specified by the 47D gene accumulates almost exclusively in larval muscles, while that encoded by the 73F gene is present in both larvae and adults. The third gene, located within the 41C subdivision of chromosome 2, encodes a more distantly related troponin-C isoform that accumulates only within adults. The gene that encodes the calmodulin-related protein is located within the 97A subdivision of chromosome three. The protein encoded by this gene has a different primary sequence from that of conventional calmodulin, which is specified by a gene located within the 49A subdivision of chromosome 2. Our report is the first to describe insect troponin-C isoforms and further avails genetic methods for investigating the in vivo functions of the troponin-C/myosin light-chain/calmodulin protein superfamily.

Amino Acid Sequence↗
PubMed1994

Early onset diabetes: parents' views.

During 1990-91 postal questionnaires were sent to the parents of 309 children living in the United Kingdom who developed diabetes before the age of 2 years during 1972-1981. The aim of the survey was to explore how they had coped with their child's condition. Completed questionnaires were returned by 85% of parents. The children had a mean age of 14 (range 9-19) years and diabetes for a mean duration of 13 (range 9-18) years. The cohort's mean age for starting self-injection was reported to be 8 years and most of the children (82%) were still attending full-time education. Diabetes-related difficulties of school were reported for 34% (95% C I 28-40) of the children and 70 (27%, 95% C I 22-32) were estimated to have missed more schooldays than their peers. With increasing duration of diabetes, parents expressed a reduction in anxiety about practical aspects of management such as injections and monitoring, but concern about hypoglycaemia and long-term vascular complications remained high. Parents of girls were more likely to express worries compared to parents of boys, and this excess was significant for worry about diet (chi 2 1df = 17.021, p < 0.001). The paediatric diabetes team caring for early diagnosed children should be aware of the need to discuss the long-term implications of the disorder and be sensitive to the transition period when the child takes progressively more responsibility for self management and the parent's role diminishes.

Adolescent↗
PubMed1994

The normalization of recreational drug use amongst young people in north-west England.

An anonymous self-report survey of drug use among a cohort of 776 14-15 year olds in North-West England was conducted at the end of 1991, aiming to estimate prevalence and profile users. Six in 10 reported being offered drugs, and 36 per cent to using drugs (20 per cent in the past month). Over half of those offered drugs had tried them. Lifetime prevalence was highest for cannabis (32 per cent), with five other drugs each being used by 10-14 per cent. Three groups identified were cannabis smokers, solvents sniffers, and stimulant/psychedelic (or dance drug) users. The population parameters of drug use were estimated at 33-40 per cent, suggesting up to 200,000 local young adults have used drugs. Most significantly, the proportion of young women being offered and using drugs and the prevalence of drug trying amongst young people in 'middle-class' schools, suggests a substantial social transformation is underway in respect of recreational drug use. The results of this survey confirm a general trend apparent in other British studies. As this cohort is tracked into the mid 1990s, the sociological implications will be significant.

Adolescent↗
PubMed1992

Diabetes diagnosed before the age of 2 years: mortality in a British cohort 8-17 years after onset.

Childhood diabetes diagnosed before the age of 24 months presents specific management problems. We report here on the establishment (using the British Diabetic Association [BDA] Children's Register) and mortality of a cohort of children with diabetes diagnosed before age 24 months. Children registered during the period 1972-1981 were traced by contacting consultants or by using the National Health Service Central Registers (NHSCR) of the Office of Population Censuses and Surveys (OPCS). Standardized mortality ratios (SMR) were estimated using person-years of follow-up for each child and age-specific death rates for the England and Wales population for the years 1972-1989. Of 339 children notified during 1972-1981, 231 were traced through consultants and 99 of the remaining 108 through the NHSCR. Twenty were found to be ineligible. The cohort available for mortality analysis comprised 310 (97%) of 319 eligible children. Their age at the time the cohort was established was 8-18 years, and their duration of diabetes 8-17 years. The male:female ratio is 1.4:1. Of 310 children studied, seven have already died: SMR 5.4 (95% CI: 2.5-11.5). We have established a large, unique cohort of children with diabetes diagnosed before age 24 months and still living in the UK and Ireland. The natural history including mortality and occurrence of complications will be analysed prospectively in this cohort and compared to other cohorts of similar disease duration, but later age at onset.

Adolescent↗
PubMed1992

Race and ethnicity in health research.

'Race' and 'ethnicity' are increasingly being used as variables in health research. However, studies have been mainly descriptive and have not been used to develop and evaluate strategies to improve health care. In part this reflects the poor analytical standards. The status of the concepts of 'race' and 'ethnicity' as research tools are rarely considered and there is poor consistency in terminology. This paper gives an overview of the research literature and raises questions about the validity of 'race' and 'ethnicity' as epidemiological variables. The tendency to collect routine ethnic data and include ethnic variables in an ad hoc and uncritical way in the United Kingdom and other countries may help transform minorities into mere statistical categories and produce data and findings which reinforce stereotypes. Multiculturalist ethnic health explanations also tend to displace more material explanations of health outcomes. It is concluded that more thought and care is needed before data are routinely categorized by ethnicity, or race or ethnicity are included as variables in research.

Epidemiologic Methods↗
PubMed1983

Prognosis of patients with acute pulmonary edema and normal ejection fraction after acute myocardial infarction.

To assess the prognostic importance of resting left ventricular function in survivors of acute myocardial infarction with pulmonary edema, we retrospectively identified 39 consecutive patients who presented with acute pulmonary edema and myocardial infarction. Sixteen patients had radionuclide ejection fractions 10 +/- 2 days postinfarction of greater than 0.45 (group A, mean 0.55 +/- 0.06), and 23 patients had ejection fractions less than or equal to 0.45 (group B, 0.32 +/- 0.06). There were no significant differences between the two groups for age or sex, but group A patients had a significantly greater incidence of first myocardial infarction predominantly inferior in location. The calculated stroke work index during the acute event was significantly greater in group A than in group B (33.4 +/- 2.4 vs 23.4 +/- 2.0) (p less than 0.05). During a follow-up of 9 +/- 3 months, mortality was not significantly different between the two groups: Four (25%) died in group A and seven (30%) died in group B. In addition, eight patients (50%) in group A were hospitalized for recurrent angina, new myocardial infarction or recurrent pulmonary edema, compared with 11 (48%) in group B (NS). Three deaths in group A were preceded by infarction of the anterior wall of the left ventricle, confirmed at autopsy, and two nonfatal infarctions were anterior by electrocardiography. Four patients in group A had coronary arteriography performed during the follow-up period because of unstable angina, and all had significant (greater than or equal to 70% stenosis) three-vessel disease and two had left main coronary artery disease. Therefore, the predischarge ejection fraction did not predict prognosis for this group of patients. Patients with acute pulmonary edema in the course of myocardial infarction form a high-risk group despite good resting left ventricular function at discharge. They have a significant incidence of recurrent myocardial infarction and death and, because they have good residual left ventricular function, are excellent candidates for surgical intervention.

Acute Disease↗
PubMed1983

Rupture of a spontaneous aortoduodenal fistula visualized with Tc-RBC scintigraphy.

We present what we believe is the first reported case of a spontaneous aortoduodenal fistula, with massive rupture into the duodenum during the performance of a radionuclide study of gastrointestinal bleeding. Our experience suggests that nuclear scintigraphy with labeled red blood cells can help in the diagnosis of this disorder by demonstrating both the presence of an abdominal aortic aneurysm and bleeding in the gut.

Aged↗
PubMed1980

Social perspectives in Huntington's chorea.

The social implications of Huntington's chorea are serious and far-reaching, affecting all members of the family and the community as a whole. The relativly common occurrence of suicide and of major and minor crimes are cause for concern. The disease imposes a significant economic burden on both the family and society. The minimum direct cost to the state of a single affected prson with Huntington's chorea in South Africa is estimated at R23 000.

Crime↗
PubMed1980

N-isopropyl-[123I] p-iodoamphetamine: single-pass brain uptake and washout; binding to brain synaptosomes; and localization in dog and monkey brain.

The kinetics of N-isopropyl-p-[123I]iodoamphetamine in rat brains were determined by serial measurements of brain uptake index (BUI) after intracarotid injection; also studied were its effects on amine uptake and release in rat's brain cortical synaptosomes; and its in vivo distribution in the dog and monkey. Serial BUI correspond to a first-pass extraction efficiency of 100% and a washout half-time of approximately 318 sec. The S-(+)-isomer inhibited norepinephrine uptake in synaptosomes as strongly as D-amphetamine, but was more potent in inhibiting synaptosomal uptake of serotonin. Both isomers were comparable to D-amphetamine in causing release of serotonin from synaptosomes, but the S-(+)-isomer promoted release of dopamine, whereas D-amphetamine did not. No specific localization in brain nuclei of the dog was seen, but there was progressive accumulation in the eyes. Rapid initial brain uptake in the ketamine-sedated monkey was noted, and further slow brain uptake occurred during the next 20 min but without retinal localization. High levels of brain activity were maintained for several hours. The quantitative initial single-pass clearance of the agent in the brain suggests its use in evaluation of regional brain perfusion. Its interaction with brain amine-binding sites suggests its possible application in studies of cerebral amine metabolism.

Amphetamines↗
PubMed1978

Carotid-cavernous fistula. Demonstration of asymptomatic vascular "steal".

Abnormal distribution of cerebral vascular flow was studied in a patient who had a traumatic carotid-cavernous sinus fistula. Serial studies were performed using a method for determining relative cerebral vascular flow:99mtechnetium-diethylenetriamine pentaacetic acid (99mTc-DTPA) was injected intravenously and flow data were processed by a digital computer. Serial studies documented the occurrence of a vascular "steal" during temporary carotid occlusion; postoperative studies showed disappearance of the steal and obliteration of thiling arterial structures and capillary filling in the brain, and in demonstrating alteration in the cerebral circulation.

Adult↗
PubMed1977

Neurologic diagnosis using the 80-lens optical camera.

This article describes the clinical application of the 80-lens optical camera in the diagnosis of cerebral infarction, subdural hematoma, intracranial tumor, and hydrocephalus. The 80-lens camera is a simple noncomputerized addition to the Anger scintillation camera that permits an estimation of the cerebral blood flow. The study is noninvasive and quick, minimizing the effect of movement artifact and showing areas of either increased or decreased blood flow. Abnormal tumor vessels appear, and subdural hematomas show brain displacement away from the skull edge. Interpretation of blood flow pattern is not affected by scalp or skull trauma, eliminating a source of error incurred with static scans.

Aged↗
PubMed1975

Rationale and indications for the "hanging hip" procudure: a clinical and experimental study.

A series of 71 patients treated by "hanging hip" procedures was followed for up to 12 years. The procedure provided a satisfactory result in patients even with severe hip joint degeneration as long as the congruity of the joint is preserved and there was no concentration of stress. When these conditions are not fulfilled the results are poor. An experimental study was carried out to try and ascertain the physiological rationale for the "healing" seen in patients with good preoperative indications. The articular cartilage of one hip in cats was denuded with a curette. This was accompanied in half the animals with a "hanging hip" procedure. The hips of the animals with "hanging hip" went onto fibrocartilaginous and chondroid healing of their articular surfaces and clinically did well. The hips of the animals who did not have multiple tenotomies developed osteoarthrosis. Full thickness cartilage defects in weight-bearing areas in adult animals are capable of functional healing if the mechanical stress on the joint is sufficiently decreased. The "hanging hip" operation should no longer be considered a salvage procedure. A physiological rationale exists for it in properly selected patients and represents a reasonable alternative to total hip replacement.

Adolescent↗