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Biomedical subjects

H Wright

Publications and source records attributed to H Wright.

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

Outpatient treatment of patients with chronic pain: an analysis of cost savings.

To control costs, the University of Tennessee Center for Pain Management added an ambulatory pain rehabilitation program to its existing inpatient hospitalization program. The impact of this program was assessed by comparing the first 25 patients treated in 1985 (prior to the introduction of outpatient management) with the first 25 patients treated in 1987 (after outpatient management was established). Twenty of the 25 patients seen in 1985 required hospitalization, while in 1987 nine patients were hospitalized and 10 patients were placed in outpatient rehabilitation. The total cost for treating 25 patients in 1985 was $571,200 but decreased to $191,000 in 1987. Hospital charges were the greatest single cost factor in 1985 ($321,500) but were only $61,000 in 1987. Success rates as measured by a return to previous employment were not significantly changed (13 of 25 returned to work in 1985, and 11 of 25 returned to work in 1987).

Adult↗
PubMed1989

Loss of a rural hospital obstetric unit: a case study.

As family and general practitioners who provide a substantial portion of the obstetric care in rural areas quit their obstetric practice, small rural hospital obstetric units are at risk of closing. Using a case study design, we examined the impact of the loss of obstetric services at a small rural hospital in Missouri. This unit was the site of delivery for less than one-half of the infants born to women living within its service area. However, it was the most likely source of care for women who were young, undereducated and unmarried (p less than 0.01). Evidence derived from birth certificates showed that women who delivered there had good perinatal outcomes compared with local women who delivered at larger hospitals. A gradual decline in the number of physicians providing obstetric care preceded the closing of the hospital unit. Women from the hospital service area who presented late for prenatal care were twice as likely to have had a low birthweight infant in the year after the local hospital unit closed (16.7% versus 7.4%), although this difference and other comparisons of outcomes were not statistically significant.

Evaluation Studies as Topic↗
PubMed1989

Immediate memory in the orally trained deaf: effects of 'lipreadability' in the recall of written syllables.

Immediate recall of written lists was compared in strictly orally trained born-deaf teenagers and in hearing controls. The lists were of syllables of CV form (e.g. SHA NA ZA DA). The deaf subjects showed a significant effect of consonant 'lipreadability'. Syllable lists containing consonants like D, SH and Z whose place of articulation is not visibly distinctive and which are therefore hard to lipread are less well recalled than (phonetically and orthographically matched) syllable lists containing consonants like F, TH and B which are produced with the tongue, teeth and lips in visible configuration. We conclude that for these deaf youngsters the phonological representation of written consonants is less secure for speech sounds that are hard, rather than easy, to lipread. The oral training of these youngsters has had an effect on their internal representation of written speech. Hearing subjects showed no 'lipreadability' effect in their recall of these lists. Reading-age matched controls (aged 8-10 years) showed significantly shorter span for both list types than the deaf group. Older hearing controls (14-16 years) matched the deaf group in span and tended to recall most accurately written syllables which are not easily lipread. We discuss these comparisons and conclude that while this group of deaf subjects is using a phonological code in the recall of written syllables, it is qualitatively different from that used by hearing subjects in this task. In particular, not only hard-to-lipread consonants but also vowels may be less strongly represented in these deaf readers' 'inner voice'.

Adolescent↗
PubMed1988

Rickets associated with vitamin D deficiency in young sheep.

An outbreak of rickets in sheep under a year old (hoggs) appeared clinically as stiffness and rotation of the carpal joints. Histological studies confirmed the diagnosis and biochemical analyses of blood demonstrated a primary vitamin D deficiency.

Animals↗
PubMed1988

Olfactory deficits in boys with cleft palate.

An odor identification task was used to determine whether individuals with cleft palate (with or without cleft lip) also have an increased prevalence of olfactory deficits. Olfactory responses of 35 affected subjects (7 to 22 years of age) were compared with those of 68 subjects of comparable age without cleft palates. Subjects were requested to identify the smell of ten common household odors. They selected their responses from an alphabetized list of the test odorants. After a practice trial, the set of odorants was presented five times in randomized sequences. The percentage of correct responses increased with age for prepubertal and pubertal subjects without cleft palates. Although the olfactory scores of girls without cleft palates continued to increase after puberty, this trend was absent in boys. On the average, the girls with cleft palates, compared with only three of 34 boys without cleft palates, had olfactory scores less than 60% correct. There was no evidence of heterogeneity in the magnitude or direction of the relationship between any of the subtypes of cleft palate and olfactory dysfunction. In this study, cleft palate is more strongly associated with olfactory deficits in boys than in girls, suggesting the possibility that the deficit may be a sex-influenced trait.

Age Factors↗
PubMed1987

Effect of vitamin D supplementation during pregnancy on the vitamin D status of ewes and their lambs.

Pregnant ewes were injected intramuscularly with 300,000 iu of vitamin D3 in a water miscible vehicle either 10, seven or four weeks before the expected lambing date and the effects on plasma concentrations of 25-hydroxyvitamin D3 were monitored. The concentrations increased quickly and remained high at parturition but at no time were they outside the normal physiological range. The concentrations in the plasma of the newborn lambs were higher than in uninjected controls and were well correlated with the concentrations in their mothers. Dosing pregnant ewes with 300,000 iu of vitamin D3 in a rapidly available form, approximately two months before lambing, provided a safe means of increasing the vitamin D status of the ewe and the newborn lamb by preventing the seasonally low concentrations of 25-hydroxyvitamin D3.

Animals↗
PubMed1985

Effects in sheep of high dietary levels of vitamin D3 as measured by circulating concentrations of some vitamin D metabolites and skeletal examination.

Housed non-pregnant ewes were given diets supplemented with five, 10, 20, 40 and 80 times the Agricultural Research Council's recommended requirement for vitamin D for 16 weeks. The effects on vitamin D status were assessed by measuring 25-hydroxylated vitamin D metabolites (25-OHD) in plasma at intervals. After 16 weeks, animals on the lowest and two highest vitamin D intakes were killed for histological examination of selected soft tissues and bones. Circulating concentrations of 25-OHD increased with intake and time during the experiment. However the increases were not proportional to intake and only when intakes exceeded 20 times the recommended requirement were concentrations greater than those seen in summer in grazing sheep. There was some evidence for the production of an additional vitamin D metabolite in animals on high vitamin D intakes. No abnormalities were detected in any of the tissues examined histologically.

Animals↗
PubMed1985

Effect of parenteral vitamin D3 on plasma 25-hydroxyvitamin D3 concentration in sheep.

Vitamin D3 ranging in total amount from 10(5) iu (2.5 mg) to 9 X 10(5) iu (22.5 mg) was given intramuscularly either as a single injection or in three aliquots at three-weekly intervals to housed nonpregnant ewes on a vitamin D deficient diet. The effects on plasma concentrations of 25-hydroxyvitamin D3 (25-OHD3), the major metabolite of vitamin D, were monitored. The increase in plasma 25-OHD3 showed a large variation between animals and was related to, but not proportional to, the dose. None of the treatments produced 25-OHD3 concentrations greater than those in grazing sheep in summer. Repeated dosing provided for more efficient use of the injected vitamin D3.

Animals↗
PubMed1984

Relative contributions of diet and sunshine to the overall vitamin D status of the grazing ewe.

Circulating concentrations of 25-hydroxyvitamin D2 (25OHD2) and 25-hydroxyvitamin D3 (25OHD3) provide, respectively, a measure of the contributions of the diet and sunshine to the overall vitamin D status. These indices were measured in grazing sheep over a 16 month period which included their first pregnancy. Seasonal fluctuations in 25OHD3 concentrations were very marked, demonstrating both the dominance of photobiosynthesis as a source of vitamin D in the summer and also the lack of an effective storage mechanism. The concentration of 25OHD2 was subject to much smaller fluctuations, but when young grass was being consumed it was significantly lower than when mature grass or hay was fed. Supplementation in winter maintained circulating concentrations at a satisfactory level and may be a wise precaution in practice.

25-Hydroxyvitamin D 2↗
PubMed1983

Continuity of care in the referral process: an analysis of family physicians' expectations of consultants.

A total of 497 referrals from a rural family practice training center are analyzed from the perspective of the referring physicians' expectations for continuing care of the referred patient. Those expectations were stated explicitly at the time of referral within three mutually exclusive categories. Referral expectations are partitioned by diagnostic groups and by specialty of the consultant. Analysis suggests that the referring physicians' expectations for continuing care of the referred patient vary significantly depending upon the specialty of the consultant.

Continuity of Patient Care↗
PubMed1982

Immunology of human gastric cancer: a preliminary report.

The immunological spectrum in fifteen patients with gastric cancer is presented. Patients were divided in three groups. Those with nonadvanced cancer, those with advanced but resectable lesions and those with advanced but nonresectable tumors. Preoperatively, elevated levels of circulating immune complexes (CIC) associated with hyporesponsiveness to phytohemagglutinin (PHA) and in mixed lymphocyte culture (MLC) as well as a positive leukocyte inhibitory serum factor (LIF-S) were found in nearly half of the patients. Inhibitory or enhancing autologous serum factors were detected. Postoperatively, immunologic parameters return to normal in patients with nonadvanced cancer, while in advanced cancer, antibody and cell-mediated immune response remained altered, with some changes associated with chemotherapy. These findings are probably related with the presence or absence of tumor and offer a distinct approach in evaluating the immunologic response of a tumor-bearing patient.

Adult↗