Search PubMed⌕ Search

Biomedical subjects

J Fletcher

Publications and source records attributed to J Fletcher.

At least 55 records · Page 3Linked to original sources
PubMed2000

Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using the LARS artificial ligament.

The purposes of this study are to compare patient satisfaction with the objective measurement of knee stability and assess early complications following ACL reconstruction using a LARS artificial ligament. Forty-seven patients were reviewed 8-45 months after surgery. Assessment was made by the Knee and Osteoarthritis Outcome Score for patient satisfaction, a modified International Knee Documentation Committee form for clinical knee stability, and a Telos stress radiography for PA stability. Complications were assessed at interview and were double-checked with charts. The LARS artificial ligament may be a safe device to reconstruct an ACL tear. Documenting mechanical stability of the knee is inadequate when reporting follow-up studies and a questionnaire assessing patient satisfaction should be added to provide a better picture of the outcome and results.

Journal Article↗
PubMed2000

Therapeutic and physical fitness exercise prescription for older adults with joint disease: an evidence-based approach.

Aging with joint disease does necessarily result in chronic pain, adoption of a sedentary lifestyle, and functional dependency. Several randomized controlled trials clearly show that regular exercise does not exacerbate pain or accelerate disease progression. On the contrary, these studies suggest that exercise training may increase the physiologic reserve and reduce the risk for functional dependency in older adults with joint disease. The goals for an exercise program should be directed toward increasing flexibility, muscle strength, endurance, and cardiovascular fitness. An exercise training program that is tailored specifically to an older adult's physical limitations may achieve these goals, and by optimizing patient safety lead to improve long-term exercise compliance.

Aged↗
PubMed2000

Common elements of spiroplasma plectroviruses revealed by nucleotide sequence of SVTS2.

DNA of SpV1-like spiroplasma plectroviruses (rods with single-stranded circular DNA) is scattered in the genome of the phytopathogen Spiroplasma citri and has significant consequences for evolution of the S. citri genome. We determined the complete nucleotide sequence of SVTS2, a SpV1-like virus of S. melliferum, a honeybee pathogen, to ascertain, by comparison with S. citri SpV1 viruses (GenBank U28974 and X51344), the defining features of this important group. The 6,824 nt DNA contains nine ORFs homologous to ORFs of S. citri SpV1 viruses and five ORFs unique to SVTS2. The predicted amino acid sequences of the homologous ORFs were 17-38% identical to those of their S. citri counterparts. The SVTS2 predicted ORF 1 product (Mr 47,031) was considerably smaller than those of known S. citri SpV1 viruses. Also, in contrast to those viruses, SVTS2 lacked an ORF with recognizable similarity to a transposase. ORF 2 of all three viruses had a homologue among the products of genes of MVL-1, a virus of Acholeplasma laidlawii, another plectrovirus. The results suggest that, at most, only slightly more than half of SpV1 genomes consists of genes shared by all spiroplasma viruses of the group.

Amino Acid Sequence↗
PubMed2000

Implicit learning differences: a question of developmental level?

A. S. Reber's (1992) proposition that the implicit learning system should demonstrate invariance of intellectual level (IQ) was examined by comparing 20 children with intellectual disability (mean mental age [MA] = approximately 5.8 years) with 20 intellectually gifted children (mean MA = approximately 12.4 years) of similar chronological age (CA; approximately 9.5 years). Implicit learning was assessed using a task involving covariation of 2 incidental cues. Explicit learning was assessed using a task of similar logical structure. Contrary to the IQ-invariance proposition, implicit learning as well as explicit learning varied with intellectual level. A secondary aim was to distinguish the contributions of CA, IQ, and MA to implicit learning. This was done by combining the samples of children in the present study with 2 samples of younger and older children of average ability from a study by M. Maybery, M. Taylor, and A. O'Brien-Malone (1995). Analyses showed that MA is critical to implicit learning.

Association Learning↗
PubMed2000

Demonstration of scrotal disease on bone scintigraphy.

The identification of scrotal disease on a bone scan is reportedly rare. Most previous reports involve abnormally increased accumulation of radioisotope in the scrotal region. This article includes a compilation of three cases of incidental scrotal photopenic defects on bone scintigraphy and a brief review of the literature.

Aged↗
PubMed2000

Neutrophil function in pregnancy and rheumatoid arthritis.

BACKGROUND: Pregnancy exerts suppressive effects on rheumatoid arthritis (RA). An attenuation in neutrophil function in late pregnancy which may explain this amelioration has previously been reported. OBJECTIVE: A longitudinal investigation of neutrophil activity in healthy pregnant women (n=9) and pregnant patients with RA (n=9), compared with age matched non-pregnant patients with RA (n=12) and healthy controls (n=22). METHODS: Neutrophil activation was measured in response to the physiological receptor agonists, n-formyl-methionyl-leucyl-phenylalanine (fMLP) and zymosan activated serum (ZAS). Superoxide anion production (respiratory burst) was determined by lucigenin enhanced chemiluminescence (LUCL); secondary granule lactoferrin release by enzyme linked immunosorbent assay (ELISA); and CD11b, CD18, and CD62L expression by flow cytometric analysis. RESULTS: Stimulated neutrophil LUCL was significantly reduced in both pregnant women with RA and healthy pregnant women in the second (fMLP 43% and 69%, ZAS 43% and 59%, respectively) and third trimesters (fMLP 24% and 44%, ZAS 32% and 38%, respectively). Responses returned to normal within eight weeks of delivery and unstimulated levels remained unchanged throughout pregnancy. Basal and stimulated CD11b, CD18, and CD62L expression showed no variations throughout gestation for both pregnancy groups. Likewise, stimulated lactoferrin release and plasma lactoferrin remained unchanged. Certain morphological differences in RA neutrophils were highlighted by the flow cytometric analysis. Moreover, resting neutrophils and stimulated cells from patients with RA, including pregnant subjects, showed a marked increase in LUCL, but a reduction in CD11b, CD18, and CD62L. Low dose prednisolone and methylprednisolone had no effect on neutrophil parameters over the period of treatment with non-steroidal anti-inflammatory drugs. CONCLUSION: The attenuation to neutrophil respiratory burst in both healthy and RA pregnancies may offer an explanation for the pregnancy induced remission of this inflammatory disorder.

Adult↗
PubMed2000

Nitric oxide and cardiac autonomic control in humans.

Cardiac autonomic control is of prognostic significance in cardiac disease, yet the control mechanisms of this system remain poorly defined. Animal data suggest that nitric oxide (NO) modulates cardiac autonomic control. We investigated the influence of NO on the baroreflex control of heart rate in healthy human subjects. In 26 healthy male volunteers (mean age, 23+/-5 years), we measured heart rate variability and baroreflex sensitivity during inhibition of endogenous NO production with N(G)-monomethyl-L-arginine (L-NMMA) (3 mg/kg per hour) and during exogenous NO donation with sodium nitroprusside (1 to 3 mg/h). Increases from baseline (Delta) in high-frequency (HF) indexes of heart rate variability were smaller with L-NMMA in comparison to an equipressor dose of the control vasoconstrictor phenylephrine (12 to 42 microg/kg per hour): Deltaroot mean square of successive RR interval differences (DeltaRMSSD)=23+/-32 versus 51+/-48 ms (P<0.002); Deltapercentage of successive RR interval differences >50 ms (DeltapNN50)=5+/-15% versus 14+/-12% (P<0.05); and DeltaHF normalized power=-2+/-7 versus 9+/-8 normalized units (P<0.01), respectively. Relative preservation of these indexes was observed during unloading of the baroreflex with sodium nitroprusside compared with a matched fall in blood pressure produced by a control vasodilator, hydralazine (9 to 18 mg/h): DeltaRMSSD=-8+/-8 versus -24+/-15 ms (P<0.001); DeltapNN50=-6+/-11% versus -15+/-19% (P<0.01); DeltaHF normalized power=-7+/-13 versus -13+/-11 normalized units (P<0.05), respectively. The change in cross-spectral alpha-index calculated as the square root of the ratio of RR interval power to systolic spectral power in the HF band (although not alpha-index calculated in the same way for the low-frequency bands or baroreflex sensitivity assessed by the phenylephrine bolus method) was attenuated with L-NMMA compared with phenylephrine (Delta=4+/-8 versus 14+/-15 ms/mm Hg, respectively; P<0.02) and with sodium nitroprusside compared with hydralazine (Delta=-7+/-6 and -9+/-7 ms/mm Hg, respectively; P<0.05). In conclusion, these data demonstrate that NO augments cardiac vagal control in humans.

Adolescent↗
PubMed2000

Do out-of-hours co-operatives improve general practitioners' health?

General practitioners (GPs) have been found to have a higher level of anxiety and depression then hospital managers and consultants. In 1995 and 1998, we surveyed GPs in Buckinghamshire. We found that the development of out-of-hours co-operatives was an important factor in the improvement in GPs' health status.

Female↗
PubMed2000

Colour Doppler diagnosis of perigraft flow following endovascular repair of abdominal aortic aneurysm.

BACKGROUND: Endovascular repair of abdominal aortic aneurysm is a relatively new surgical technique which is less invasive than conventional open abdominal surgery but is associated with a significant specific complication of endoleak. The aim of this study was to determine the accuracy of duplex ultrasound imaging, utilising colour Doppler, as the primary method for post surgical monitoring of endovascular aneurysm repair. METHODS EXPERIMENTAL DESIGN: a case cohort study of 45 patients undergoing endovascular repair of abdominal aortic aneurysm. SETTING: angiography, CT scanning and surgery performed at Westmead Hospital, a teaching hospital of the University of Sydney; patients followed postoperatively at the Westmead Vascular Laboratory, a dedicated vascular diagnostic ultrasound facility. PATIENTS: Forty males and five females, mean age 69.1 years (range 51 to 84). INTERVENTIONS: patients underwent attempted insertion of an EVT (endovascular prosthesis) for exclusion of abdominal aortic aneurysm (mean diameter 5.3 cm; range 4.0 to 8.4 cm). Conversion to open repair was required in three cases (6.6%). An aorto-biliac graft was inserted in 28 patients, a tube graft in eight and an aorto-unilateral iliac graft with femorofemoral (or ilioilial) crossover graft in six. MEASURES: patients were followed over a period of 53 months (median follow-up time 15 months) with 106 colour Doppler scans of 39 endovascular grafts (mean of 2.9 scans per patient). RESULTS: All aneurysms decreased in diameter (range 0.1 cm to 4.3 cm, mean 0.9 cm). Abnormal flow in the residual aneurysmal sac was found in three patients. In all three cases of endoleak the colour Doppler diagnosis was supported by CT scan and confirmed on angiography. The CT scans did not provide any additional information to that obtained by colour Doppler imaging. CONCLUSIONS: Colour Doppler provides an effective means of non-invasive follow-up assessment of patients who have had endovascular repair of abdominal aortic aneurysms.

Aged↗
PubMed1999

Malignant fibrous histiocytoma of the trachea.

Primary tracheal sarcomas are rare. Only 23 cases have previously been reported in the English literature. The present case describes a 72-year-old woman with a malignant fibrous histiocytoma of the trachea. She underwent an endoscopic resection followed by radiotherapy and is well at 12 months follow up. Other cases are reviewed. Tracheal resection is the standard care. However, local resection with postoperative radiotherapy remains an option. Adjuvant chemotherapy may improve local control. Long-term survival has been documented.

Aged↗