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Biomedical subjects

H Taylor

Publications and source records attributed to H Taylor.

At least 55 records · Page 3Linked to original sources
PubMed1998

The MRI appearance of the optic nerve sheath following fenestration for benign intracranial hypertension.

Optic nerve fenestration is carried out in cases of severe benign intracranial hypertension. This study aimed to monitor the optic nerve sheath appearances and orbital changes that occur following this procedure. The eight patients were all female with an average age of 37.3 years and a range of 20-58 years. The duration of symptoms was 2-6 years. Symptoms included headaches, diplopia and visual obscurations. Examination revealed severe papilledema. All investigations, including MRI, biochemical and immunological tests, were negative. Patients had fenestration of a 2 mm x 3 mm segment of the medial aspect of the optic nerve sheath. Imaging was obtained with a 1 T MRI machine using a head coil. Coronal, axial and sagittal 3 mm contiguous sections using STIR sequences with TR 4900 ms, IT 150 ms and TE 60 ms were obtained. Five patients showed clinical improvement. The post-operative MRI findings in four of these included a decreased volume of cerebrospinal fluid (CSF) around the optic nerve sheaths and a localized collection of fluid within the orbit. There were no MRI changes in the three patients with no clinical improvement. Decreased CSF volume around the optic nerve and a fluid collection within the orbit may indicate a favorable outcome in optic nerve fenestration.

Adult↗
PubMed1998

ORBIS--training nurses worldwide in ophthalmic care.

The unique nature of the ORBIS teaching mission is reflected in many arenas. The ORBIS organization recognizes that the nurse's role is critical to achieving their mission of preventing blindness through education, hence the emphasis on nurse education. The roles of the head nurse, nurse educator, staff nurses, and the biomedical engineering department are discussed briefly with emphasis on the needs assessment and the different programs offered to meet the identified needs.

Aircraft↗
PubMed1998

Computed tomography and positron emission tomography in the pre-operative staging of oesophageal carcinoma.

UNLABELLED: Because patients with carcinoma of the oesophagus usually present with advanced disease and surgery has a high mortality with cure in less than 10% of patients, pre-operative staging to select appropriate patients is necessary. Computed tomography (CT) plays an important role in staging but has well recognized limitations. Positron emission tomography (PET) which provides physiological information may therefore be a better alternative. OBJECTIVE: To compare the findings of CT and positron emission tomography (PET) with 2-[18fluorine]-fluoro-2-deoxy-D-glucose (FDG) in the pre-operative staging of oesophageal carcinoma. MATERIALS AND METHODS: Twenty-five patients with biopsy proven oesophageal cancer had pre-operative staging using CT and FDG-PET. The studies were read independently and full histological confirmation was obtained in 19 patients. Four parameters were studied: the primary tumour, peri-oesophageal lymph nodes, liver metastases and left gastric lymph nodes. RESULTS: PET visualized all primary tumours; CT missed one. CT identified 4/8 patients with involved peri-oesophageal nodes and PET 3/8. CT identified 5/9 patients with left gastric adenopathy and PET 1/9. PET visualized a liver metastasis missed on CT and appeared to be better in assessing residual tumour. PET did identify distant metastases not seen on CT in seven patients. CONCLUSIONS: The two techniques are both effective in showing the primary tumour and about equally sensitive in the demonstration of peri-oesophageal nodes. PET is probably more sensitive than CT for the detection of distant metastases.

Esophageal Neoplasms↗
PubMed1998

Androgen-dependent modulation of calbindin-D28K in hypothalamic tissue during prenatal development.

We examined the influence of androgens on fetal medial basal hypothalamic and preoptic area (MBH-POA) calbindin-D28K levels (via Western analysis) by treating pregnant rats with testosterone or flutamide, (an androgen receptor blocker). MBH-POA calbindin-D28K levels were significantly decreased in flutamide-treated male fetuses, whereas, MBH-POA calbindin-D28K levels were significantly increased in testosterone-treated female fetuses compared to controls. These results suggest that MBH-POA calbindin-D28K is modulated during prenatal development by androgens.

Anal Canal↗
PubMed1998

Inequality in infant morbidity: causes and consequences in England in the 1990s. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

STUDY OBJECTIVE: To examine the effect of deprivation, crowding, maternal smoking, and breast feeding on morbidity from wheeze and diarrhoea in the first six months after birth. DESIGN: A geographically located population survey using maternal responses on self completion questionnaires. SETTING: The three health districts of Bristol. SUBJECTS: 8501 infants from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) in which all women expecting a baby between April 1991 and December 1992 in Bristol were invited to participate. MAIN OUTCOME MEASURES: The prevalence and severity of wheeze at six months after birth. The prevalence of diarrhoea and the duration of the worst bout at six months after birth. RESULTS: Logistic regression analyses using a conceptual hierarchical framework showed that wheeze was significantly more likely to be reported for infants if they lived in rented accommodation (OR = 1.20, 95% CI = 1.04, 1.39), if they lived in crowded housing conditions (OR = 1.26, 95% CI = 1.06, 1.49), if they were one of a number of siblings (OR = 1.78, 95% CI = 1.52, 2.07), and if their mothers smoked (OR = 1.38, 95% CI = 1.21, 1.58). They were significantly less likely to have wheeze if they were breast fed (OR = 0.68, 95% CI = 0.59, 0.79). Each of these factors was independently related to the prevalence of wheeze. For infants with wheeze those who were breast fed for three or more months were significantly less likely to have three or more episodes in the first six months after birth (OR = 0.76, 95% CI = 0.58, 0.99). A higher prevalence of diarrhoea in infancy was associated with living in rented accommodation (OR = 1.25, 95% CI = 1.10, 1.41) and lower maternal education (OR = 0.76, 95% CI = 0.69, 0.84) and a lower prevalence with breast feeding (OR = 0.42, 95% CI = 0.37, 0.48). An episode of diarrhoea was significantly less likely to last for six or more days if an infant lived in mortgaged accommodation (OR = 1.34 95% CI = 1.03, 1.75) and was breast fed for three or more months (OR = 1.34 95% CI = 1.03, 1.75). CONCLUSION: Deprivation was associated with heightened morbidity from common conditions such as wheeze and diarrhoea for this geographical cohort of infants in England in the 1990s. Results supported evidence suggesting that breast feeding is protective against such conditions and is particularly associated with reduced severity and duration. Implications for future research and policy are discussed.

Breast Feeding↗
PubMed1997

Hydroxyaluminosilicates and acute aluminium toxicity in fish

The essentiality of silicon in biology might be explained in the terms of its chemistry with aluminium. In a previous study we demonstrated the elimination of acute aluminium toxicity in fish by silicon. We suggested that the reaction of silicic acid with aluminium to form hydroxyaluminosilicates reduced the biological availability, and hence toxicity, of aluminium. Though assumed in a burgeoning number of studies and contended in others this detoxification mechanism has remained unproven. Herein we have tested the toxicity of hydroxyaluminosilicates in fish and in doing so we have provided evidence which strongly supports a role for hydroxyaluminiosilicates in the elimination of acute aluminium toxicity in fish by silicon.Copyright 1997 Academic Press Limited Copyright 1997 Academic Press Limited

Journal Article↗
PubMed1997

Pain scoring as a formal pain assessment tool.

This article describes the introduction of subjective pain scoring as a pain assessment tool to the surgical unit of a district general hospital. The author highlights the advantages, and explains the actions taken to overcome the problems of changing practice through the introduction of a formal pain assessment tool.

Health Services Research↗
PubMed1997

Quantification of latent tissue reservoirs and total body viral load in HIV-1 infection.

The capacity of HIV-1 to establish latent infection of CD4+ T cells may allow viral persistence despite immune responses and antiretroviral therapy. Measurements of infectious virus and viral RNA in plasma and of infectious virus, viral DNA and viral messenger RNA species in infected cells all suggest that HIV-1 replication continues throughout the course of infection. Uncertainty remains over what fraction of CD4+ T cells are infected and whether there are latent reservoirs for the virus. We show here that during the asymptomatic phase of infection there is an extremely low total body load of latently infected resting CD4+ T cells with replication-competent integrated provirus (<10(7) cells). The most prevalent form of HIV-1 DNA in resting and activated CD4+ T cells is a full-length, linear, unintegrated form that is not replication competent. The infection progresses even though at any given time in the lymphoid tissues integrated HIV-1 DNA is present in only a minute fraction of the susceptible populations, including resting and activated CD4+ T cells and macrophages.

Anti-HIV Agents↗
PubMed1997

Blepharospasm and hemifacial spasm. Randomized trial to determine the most appropriate location for botulinum toxin injections.

PURPOSE: The purpose of the study is to analyze the effectiveness and side effects of botulinum toxin using four different treatment site applications to determine the most successful treatment regime with the least side effects. METHODS: In a prospective trial, 92 patients (50 blepharospasm and 42 hemifacial spasm) were assigned randomly to 1 of 4 different treatment groups (standard [S], brow [B], inner orbital [IO], or outer orbital [OO]). Each treatment group had a different pattern of injection sites in the orbicularis. A total of 285 treatments were given, and the mean follow-up time was 16.4 months. RESULTS: In the blepharospasm group, patients assigned to the standard group had a significantly longer duration of effect than for those in the brow, inner orbital, and outer orbital groups (8.1 weeks compared with 4.5, 4.2, and 3.1 weeks, respectively; P < 0.001). In the hemifacial spasm group, patients in the outer orbital group had significantly shorter duration of effect than those in standard, brow, or inner orbital group (7.2 weeks compared with 12.6, 12.8 and 10.4 weeks, respectively; P < 0.001). The four major complications of botulinum toxin treatment were epiphora, ocular irritation, ptosis, and diplopia. The inner orbital treatment produced significantly more episodes of ptosis (13% of treatments). However, the standard treatment produced the most epiphora and ocular irritation (18% of treatments). CONCLUSIONS: The position of the injection sites around the orbicularis influences the effectiveness and side effects of botulinum toxin treatment for patients with blepharospasm and hemifacial spasm. The further the treatment is away from the eyelid margin, the lower the risk of ocular side effects. The standard treatment produces the longest duration of effect in the blepharospasm group but with the most transient ocular irritation and epiphora. In the hemifacial spasm group, the brow treatment has an equally long duration of effect as that of the standard treatment with fewer side effects.

Aged↗
PubMed1997

Late recurrences and the necessity for long-term follow-up in corneal and conjunctival intraepithelial neoplasia.

PURPOSE: The purpose of the study was to elucidate the natural history of corneal-conjunctival intraepithelial neoplasia (CIN) and suggest treatment and follow-up guidelines. METHODS: The records of all histologically proven cases of CIN at the Royal Victorian Eye and Ear Hospital between 1979 and 1994 were reviewed. RESULTS: Seventy-nine eyes of 76 patients had a pathologic diagnosis of CIN and were observed for up to 15 years. The lesion recurred in 31 eyes (39%) overall. There was no statistical difference shown in the likelihood of recurrence based on histologic classification. Complete excision was attempted in each case. In 18 eyes, dysplastic cells were evident at the excision margin. Ten (56%) of these tumors recurred, compared to a 33% recurrence rate in completely excised lesions. The time to the first recurrence ranged from 33.0 days to 11.5 years between the first and second surgeries, with 11 lesions recurring after more than 4 years. Incompletely excised lesions reappeared more rapidly (average, 2.5 years) than did those with clear surgical margins (average, 3.8 years). Seven cases progressed to invasive squamous cell carcinoma and four cases led to blindness or removal of the eye. CONCLUSIONS: This study suggests that excision margin at the time of surgery is the most important factor in predicting recurrence. The slow growth of the recurrent lesions combined with the ever-present malignant potential leads the authors to suggest that all patients with a history of CIN warrant annual follow-up for the remainder of their lives.

Adult↗
PubMed1997

The relationship between condition-specific morbidity, social support and material deprivation in pregnancy and early motherhood. ALSPAC Survey Team. Avon Longitudinal Study of Pregnancy and Childhood.

Poorer health has been consistently associated with both low levels of social support and material deprivation. It has been proposed that social support constitutes a causal link between health and deprivation such that those with lower socio-economic status have poorer health because their lack of social support makes them more vulnerable to disease. This assumption was tested in this study for women moving from pregnancy to early motherhood. The sample of 9208 women was drawn from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Health status was measured by self-report of morbidity for three contrasting conditions: backache, depression and urinary infection. Data were collected by self-completion questionnaire at eight weeks prepartum and at eight weeks postpartum. The sample was divided into four groups for each condition on the basis of identification of the condition (1) on both occasions, (2) on neither occasion, (3) at eight weeks prepartum only, and (4) at eight weeks postpartum only. Chi-square tests were used to measure the association between presence or absence of a condition as defined above, material deprivation and low social support. Responses on an eight item social support questionnaire tapping emotional, instrumental and communal aspects of perceived social support were compared between these groups for each condition. Results showed significant associations, in late pregnancy and early motherhood, between poorer health and both material deprivation and low social support for two of the three conditions, depression and urinary infection. Changes in levels of perceived social support occurred as a consequence of motherhood; the percentage of women perceiving their partner to be supportive decreased as did the percentage of those who felt that their family or friends would help with financial difficulties; in contrast, the percentage of those perceiving that other mothers/neighbours offered support increased from late pregnancy to early motherhood. The extent and direction of such change was consistently associated with the presence or absence of depression, but not with backache or urinary infection. When mental health "improved", in that depression was present pre- but not postpartum, the percentage feeling supported increased and vice versa. This pattern was in evidence across all items of social support. It was concluded that perceived social support was unlikely in itself to constitute a causal link between poorer health and lower socio-economic status. In this context the relationship between social support and depression requires further consideration, particularly the extent to which they constitute component parts of a more general feeling of emotional well-being, a construct which is, in its turn, in need of further articulation in relation to health outcomes.

Adult↗
PubMed1997

Predictability of excimer laser treatment of myopia and astigmatism by the VISX Twenty-Twenty. Melbourne Excimer Laser Group.

BACKGROUND: To determine the predictability of excimer laser photorefractive keratectomy (PRK) to correct myopia, astigmatism, or both between -1.00 and -19.00 diopters (D). SETTING: Royal Victorian Eye and Ear Hospital, East Melbourne, Australia. METHODS: This study comprised 1218 consecutive eyes treated with a VISX Twenty-Twenty excimer laser and followed prospectively for 12 months. Low myopia was treated with one ablation zone (6.0 mm), high myopia with two ablation zones (5.0 and 6.0 mm), and extreme myopia with three ablation zones (4.5, 5.0, and 6.0 mm). Maximum spherical treatment was 15.00 D at the corneal plane. Data were analyzed to determine the predictability of the postoperative outcomes by preoperative refraction. RESULTS: Nine hundred eighty eyes (80.5%) were available for the 12 month follow-up. The predictability of refraction and uncorrected and best corrected visual acuities progressively decreased with increasing myopia, although a comparable percentage of spherical correction was achieved at each diopter of myopia. The likelihood of losing lines of best corrected visual acuity and corneal haze increased with increasing myopia. CONCLUSION: These data can be used to counsel patients of likely outcomes of excimer laser PRK to correct myopia.

Adult↗
PubMed1997

Alternative medical treatment for endometriosis.

Although a limited number of drugs make up the mainstay of treatment of endometriosis, many alternative medications have been used in an attempt to improve efficacy. Some have been rigorously evaluated and are of proven benefit, while others show promise in preliminary trials or in animal models. Proper methods of evaluating medical therapy and outcomes are essential. This chapter provides a review of new medical therapies for the treatment of endometriosis and their evaluation.

Complementary Therapies↗
PubMed1997

Inequality in health and health service use for mothers of young children in south west England. Survey Team of the Avon Longitudinal Study of Pregnancy and Childhood Team.

OBJECTIVE: To establish the degree of association between relative deprivation and any variation in condition specific morbidity and in consultations with general practitioners for mothers of young children. STUDY DESIGN: Condition specific morbidity and general practitioner consultation (GP) rates were recorded by means of self reports on a postal questionnaire. Subjects were asked to record whether they had suffered from any of 16 common conditions and, if so, whether they had consulted the GP. Relative deprivation was measured using indicators such as home ownership, overcrowded living conditions, car ownership, and partners' employment status. Information was also collected about the women's own employment status, their ages, and parity. SETTING: The three district health authorities of Bristol. All women expecting a baby between April 1991 and December 1992 were invited to participate. SUBJECTS: Altogether 11040 mothers who completed questionnaires about their own health and well being at 8 months postpartum as part of the Avon longitudinal study of pregnancy and childhood. OUTCOME MEASURES: The percentage of mothers reporting any of 16 common conditions since the birth of their child and the proportion of them who consulted the GP if a condition was reported. chi 2 tests of independence were used to examine the association between condition specific morbidity and social, demographic, and maternal characteristics. Latent class analysis was used to "cluster" mothers according to the particular configuration of social, demographic, and maternal characteristics associated with levels of morbidity for each of the six most commonly reported conditions. The probability of consulting a GP was then compared between clusters. RESULTS: Relative deprivation had a greater impact on morbidity and GP consultation for stress related conditions such as depression, anxiety, and headache/migraine. For all these conditions, higher levels of self reported morbidity and a greater probability of consulting the doctor were associated with a cluster of social disadvantage-living in rented accommodation, non-employment, younger age, and lower educational status. For other conditions such as backache, haemorrhoids, and cough/cold, however, higher morbidity was associated with a cluster of advantage-home ownership, uncrowded living conditions, use of car, and partner in employment. Where there was variation in the probability of consulting the GP for these conditions, it was linked to parity rather than socioeconomic factors. Higher levels of morbidity for all but one condition (backache) were also associated with having more than one child, but this cross-cut socioeconomic and demographic cluster characteristics; both more affluent, older mothers and younger, more deprived mothers were likely to be multiparous. CONCLUSIONS: Relative deprivation was associated with poorer mental but not physical health for this population of mothers of young children. These findings have implications for a more targeted approach to reducing inequality in health. The importance of examining inequality in health for women in relation to their own material circumstances, their employment status, and parity, is emphasised.

Adult↗