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Biomedical subjects

J Dornan

Publications and source records attributed to J Dornan.

36 records · Page 2Linked to original sources
PubMed1992

Prevalence of spinal pain among the staff of a district health authority.

Being aware of the many neck and back problems which occur among staff, the departments of Occupational Medicine and Physiotherapy initiated a study to ascertain the scale of the problem among employees of the district health authority. A questionnaire was sent to a 10 per cent sample, stratified by occupation, of the 16,000 employees of a district health authority of which 84 per cent (1363) responded. Over half of all respondents had had a significant degree of spinal pain in the past year, mainly located in the back. In over half of those with pain, their discomfort had been significant enough to interfere with sport, work and sleep. Over one-quarter said they had taken time off work for spinal pain in the past five years. Nearly half of respondents under 25 years of age had some degree of spinal pain. Although a very small group, ambulance workers appear to have the greatest problems. Staff involved in lifting equipment and manual work had a lower prevalence of spinal pain than nurses or ambulance workers, but were more likely to have severe pain for which analgesics were taken. Nurses had a prevalence rate of 60 per cent, but less than one third had frequent or severe pain. Based upon this information an application has been made to implement a programme to reduce both the number of injuries and the severity of those that occur.

Adult↗
PubMed1990

Continuous wave Doppler flow velocity waveforms from the umbilical artery in normal pregnancy.

The objective was to establish a normal reference range of the indices of umbilical artery waveforms using continuous wave doppler ultrasound. A prospective longitudinal study was made of 85 uncomplicated singleton pregnancies between 16 and 40 weeks gestation (783 recordings). Pulsatility Index (P.I.), Resistance Index (R.I.) and A/B ratio were measured at each visit. The mothers all delivered normal healthy infants weighing more than the 10th centile for gestational age. All three indices have a positively skewed frequency distribution, a factor not generally appreciated until recently and the ranges are therefore described using non-parametric statistics. Placental resistance decreases as term approaches, the 50% PI at 16 weeks was 2.06, at 32 weeks was 1.08 and at 40 weeks was 0.85. The results show a comprehensive reference of normal values and provides a sound basis for the further study of abnormal pregnancy. It represents the largest published study of its type using continuous wave Doppler.

Adolescent↗
PubMed1989

Prevention and rehabilitation of osteoporosis program: exercise and osteoporosis.

Osteoporosis is a common crippling bone disease affecting post-menopausal and elderly women. It results in fractures, spinal deformity and chronic pain leading to decreased mobility and functional disability. A preventive program in Toronto, described in this article, aims to prevent bone loss and maximise the functional capacity of osteoporotic patients through a program with educational, social and exercise components. Evaluation of the program, also reported here, showed that 80 per cent of patients complied with the requirements of the exercise program and that those who exercised reported improvement in general well being, stamina, mobility and pain tolerance. The exercise group also showed a significant improvement in VO 2 max (p less than 0.001) and bone mass (p less than 0.02) after one year of exercise. None of the patients developed fracture as a direct result of the exercise. The exercise prescribed for osteoporosis is safe and beneficial. The program is a social success.

Aged↗
PubMed1988

Kenny syndrome: description of additional abnormalities and molecular studies.

An 18-month-old girl presented with clinical manifestations of Kenny syndrome including growth retardation, ophthalmologic abnormalities, a persistent open anterior fontanel, dysmorphic facies, anemia, radiologic skeletal abnormalities, and severe hypoparathyroidism. Analysis of restriction patterns of DNA with human parathyroid hormone (PTH) DNA probes revealed no gross abnormalities of the PTH gene that could contribute to the hypoparathyroidism. In addition to the previously described characteristics of the syndrome, hypoplastic nails, persistent neutropenia, abnormal T cell function and neonatal liver disease all occurred and may be additional manifestations of Kenny syndrome, requiring diagnostic or therapeutic consideration.

Abnormalities, Multiple↗
PubMed1987

The effect of exercise on bone mass of osteoporotic patients on fluoride treatment.

The study was conducted in order to determine the effect of exercise on osteoporotic patients with a mean age of 65 years. The majority of these patients had been on sodium fluoride for at least 2 years. Thirty-eight patients were assigned to either the hospital or home group. Nineteen were in the former group, which performed the 1 hour exercise twice weekly in the Hospital. The patients in the latter group were taught the exercises and were expected to continue them at home. The exercise protocol consisted of muscle-strengthening and aerobic activities. Bone mineral mass was determined by neutron activation analysis, which measured total calcium in the trunk and pelvis. It is expressed as a calcium bone index (CaBI), with a normal range of 0.75 to 1.2. The level of physical performance was determined by calculating the maximum oxygen uptake, VO2max, attained by a graded exercise test on the treadmill. Calcium bone index and VO2max were obtained before and after the 12.5 month study. Prior to the study, the hospital and home groups had low calcium bone index values (0.68 and 0.66 respectively). Both groups showed a significant increase in calcium bone index (p less than 0.001 for the hospital group, p less than 0.01 for the home group) after the study. When compared to the home group the hospital group was found to have a significantly higher post-study calcium bone index value (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Dopamine control of prolactin secretion in multiple endocrine neoplasia type I.

Taking advantage of high prevalence of prolactinomas in Newfoundland families with variant multiple endocrine neoplasia Type I (MEN I), we studied the control of prolactin secretion by dopamine in family members with prolactinomas (n = 6), family members who have hyperparathyroidism but no prolactinomas (n = 6), as well as healthy members (n = 8) in unaffected sibships. Four unrelated patients with empty sella syndrome were also studied as sella size controls for the prolactinoma group. Dopamine (2 micrograms/kg/min) was less effective in reducing serum prolactin in the prolactinoma group than in the other three groups studied; serum prolactin also showed little rebound in prolactin comparable to controls. Family members with hyperparathyroidism but no prolactinoma (and to a lesser degree the empty sella syndrome group) showed much less post-infusion rebound than controls. We conclude that family members genetically predisposed to prolactinoma (and patients with empty sella syndrome) may exhibit subtle abnormalities in dopaminergic control of prolactin secretion.

Adenoma↗
PubMed1982

Immunoglobulin levels, immunodeficiency and HLA in type 1 (insulin-dependent) diabetes mellitus.

In 129 patients with Type 1 (insulin-dependent) diabetes mellitus, 100 healthy control subjects and 91 non-diabetic first degree relatives of Type 1 patients, we investigated variation in serum IgA, IgG and IgM concentrations with sex and HLA-B phenotype. Two patients with onset before the age of 15 years were completely IgA-deficient. One additional patient was completely IgG-deficient. Excluding these three cases, diabetic patients had serum IgA and IgM concentrations comparable to control subjects. IgG levels of patients were, however, significantly lower than those of control subjects (11.66 versus 12.69 g/l, p = 0.003). Non-diabetic first degree relatives of patients had IgG levels intermediate between those of diabetic patients and control subjects. There was some indication that IgA concentrations were lower in the 53 patients with HLA-B8 (1.91 versus 2.21 g/l, p = 0.038). No association was found between IgM or IgG levels and HLA phenotypes.

Adult↗
PubMed1982

Factors affecting rehabilitation following aortocoronary bypass procedures.

Two hundred and ten men were referred consecutively to a rehabilitation program following aortocoronary bypass surgery. The program involved exercise tolerance testing 8 and 20 weeks postoperatively, with an intervening 12-week exercise program. A retrospective analysis of data showed 50% of these patients to be on no medication throughout their rehabilitation and the others on medications likely to affect cardiac performance. Factors likely to influence exercise tolerance such as age, medication and extent of revascularization were subjected to multivariate analysis in these two cohorts of patients. Age (up to 60 years) and the extent of revascularization did not appear to influence exercise tolerance. Following the 12-week exercise program, patients in both groups had improved significantly (P less than 0.01), but the initial and final performance of the cohort of patients requiring cardiac drugs was significantly poorer than those on no medication (P less than 0.01).

Adult↗
PubMed1980

Properdin factor B(Bf) allele BfF1 specifies an HLA-B18 diabetogenic haplotype.

We found the rare properdin factor B(Bf) variant F1 to be present in 11% of 72 patients suffering from insulin-dependent diabetes (IDDM) compared with 2% among 150 normal controls. BfF1 thus confers a relative risk for IDDM of 5.55. All eight patients and three controls who were BfF1 positive were also HLA-B18 positive, reflecting the strong linkage disequilibrium between these two factors. We suggest that BfF1 marks a 'diabetogenic' B18-bearing HLA haplotype. Studies of unselected families with one or more affected members suggest that the B18, BfF1 does not necessarily segregate with IDDM phenotype. This study provides further evidence for the genetic heterogeneity of IDDM.

Alleles↗
PubMed1978

Visual input: its importance in the control of postural sway.

A new and measurable parameter in the study of static equilibrium is described. Using a minicomputer, the locus of postural sway was measured during 1 minute periods in 144 volunteer subjects, including 105 control subjects and 39 persons with above-knee amputations. It was hypothesized that the above-knee amputee group had lost a relatively predictable degree of proprioception and kinesthetic sense. Vestibular mechanisms were normal and, therefore, constant in both groups. Using a simple arithmetic formula, the effect of such loss of proprioception was estimated by comparing the amputee group with the nonamputee group, while the contribution of visual input was estimated by comparing both groups with their eyes open and closed. Using this parameter, no clear age dependency was demonstrated. The mean locus of sway for the amputee group was the same as the nonamputee group with the eyes open. However, a comparison of the eyes open/eyes closed ratio in both groups demonstrated a significantly greater increase for the amputee group than for control subjects (p less than 0.001). In the future, mean locus of sway might provide a useful clinical method of measurement and the eyes open/eyes closed ratio might provide a simple and useful method to communicate the dependency upon vision in individual patients.

Adolescent↗
PubMed1974

Comparison of ibuprofen and acetylsalicylic acid in the treatment of rheumatoid arthritis.

A double-blind crossover study of ibuprofen and acetylsalicylic acid was carried out in 27 patients with rheumatoid arthritis. Patients were evaluated by joint counts, grip-strength determination, erythrocyte sedimentation rate, and number of acetaminophen tablets required in addition to the test drug, as well as by various biochemical measurements. In the doses used ibuprofen and acetylsalicylic acid appeared comparable in anti-inflammatory effect, but statistically fewer side effects were observed during administration of ibuprofen.

Acetaminophen↗
PubMedDate not supplied

The effect of moderate exercise training on oxygen uptake post-aortic/mitral valve surgery.

BACKGROUND: This study determined the response of aortic and/or mitral valve replacement/reconstruction (AVR/MVR) surgery patients to a 3-month exercise rehabilitation program (ERP) of moderate intensity, frequency, and duration that commenced approximately 9 weeks post-operatively. METHODS: Based on geographic proximity and availability of transportation to attend ERP classes, 29 experimental subjects were enrolled in the ERP and 20 control subjects received standard care that did not include the ERP, but did not prohibit activity/exercise. Exercise tolerance was determined from estimated oxygen uptake (VO2) during exercise tolerance testing (GXT) before and after standard care or the ERP. RESULTS: VO2 at the maximum stage of the GXT increased significantly (P < or = 05) for the experimental (4.89 +/- 5.07 mL/kg/min) and control (5.11 +/- 4.48 mL/kg/min) groups. No significant between-group differences were noted in VO2 at the maximum stage of the exercise testing or at the target heart rate (HR). Furthermore, reported exercise levels of subjects in both groups were comparable and sufficient for training effects to occur. CONCLUSION: Alternate strategies to improve exercise tolerance such as home-based rehabilitation programs should be investigated for relatively healthy aortic and/or mitral valve surgical patients.

Aortic Valve Insufficiency↗
PubMedDate not supplied

Statistical profile of traumatic brain injury: a Canadian rehabilitation population.

A retrospective clinical hospital chart study was undertaken to prepare a statistical profile of traumatic brain-injured patients in rehabilitation. It included 498 consecutive admissions to the Traumatic Brain Injury Rehabilitation Program of the Queen Elizabeth Hospital (Toronto, Canada) from 1978 to 1991. Descriptive statistics were obtained for age, gender, marital status, educational status, occupational status, history of drug and alcohol use, cause of injury, month of injury and length of coma. Comparisons are made between the studied population and several Canadian centres, as well as international brain injury demographics in the literature. Results are discussed in terms of the gender differences and lifestyle parameters associated with brain injury.

Adolescent↗
PubMedDate not supplied

Re-examining the concept of severity in traumatic brain injury.

This paper re-examines the theoretical concept of severe brain injury focusing on the duration of coma as a precise indicator of the clinical profile. A retrospective hospital chart study of 361 traumatic brain-injured patients was undertaken to determine the homogeneity of the subsample of the severely brain-injured (defined as 2 or more days of coma) with respect to the probability of four types of impairment: ataxia, contractures, paralysis and speech impairment. The current concept of severity assumes homogeneity among the 'severely brain-injured'. However, our results indicate significant differences in impairment within this population. The authors feel strongly that future studies must describe coma duration in finer gradations, and test for homogeneity within samples before inferences are made. Improvements in life-sustaining technologies have resulted in longer coma durations. The need to use coma days as an indicator of impairment rather than a broad category of severity is emphasized.

Adolescent↗
PubMedDate not supplied

The key to successful program planning.

For program planning to be cost-effective, it must combine clear vision and realistic strategy. Reliable demographic information on target populations is essential, and in-house research can contribute substantially to the accuracy of information that health care administrators use in such planning. This article describes research into the traumatic brain-injured population at Toronto's Queen Elizabeth Hospital and discusses how this information can be used by health care administrators.

Adolescent↗