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Biomedical subjects

J G Jenkins

Publications and source records attributed to J G Jenkins.

At least 37 records · Page 2Linked to original sources

Power spectral analysis of the electrocardiogram in diabetic children.

In recent years it has been shown that alteration in heart rate variability can be used for the objective assessment of autonomic function in adult diabetic patients. Using a microcomputer based system for on-line monitoring and analysis of heart rate variability by power spectral analysis, 100 children with Type 1 (insulin-dependent) diabetes mellitus were studied. A highly significant negative correlation was identified between heart rate variability and duration of diabetes (r = -0.88, p less than 0.0001). The mean heart rate variability in patients with diabetes of duration 3 years or more was significantly lower in comparison to age-matched control subjects. A highly significant negative correlation was evident between heart rate variability and mean HbA1 in patients with duration of diabetes of 5 years or more. A mean HbA1 over 10% during this period was associated with the greatest reduction in heart rate variability. Serial measurements of heart rate variability in diabetic children may be of predictive value prior to the onset of symptomatic neuropathy.

Adolescent↗

Adult respiratory distress syndrome (ARDS) complicating meningococcaemia.

We describe a one year old boy with meningococcaemia complicated by the adult respiratory distress syndrome. Maintenance of oxygenation required a positive end-expiratory pressure of 20 cm H2O. Resultant barotrauma produced pneumothorax and pneumomediastinum. Prompt recognition and treatment of this complication can reduce its high mortality rate.

Humans↗

Continuous epidural infusion of 0.075% bupivacaine for pain relief in labour. A comparison with intermittent top-ups of 0.5% bupivacaine.

Seventy-three women who requested epidural analgesia during labour were randomly allocated in a prospective study to receive either a continuous epidural infusion of 0.075% bupivacaine at a rate of 12-18 ml/hour (38 mothers) or intermittent top-ups of 0.5% bupivacaine (35 mothers). Both groups received an initial dose of 6-8 ml bupivacaine 0.5%. Patients were asked to score their pain using a 10-cm linear scale prior to insertion of the epidural, 30 minutes after its insertion and hourly thereafter. The quality of analgesia in the continuous infusion group was significantly better than in the intermittent top-up group (p less than 0.025). There was no significant difference in the total dose of bupivacaine given to the two groups.

Adolescent↗

The measurement of preoperative anxiety.

Preoperative anxiety was assessed using the hospital anxiety and depression (HAD) scale, multiple affect adjective check list (MAACL) and linear analogue anxiety scale (LAAS) in 100 consecutive day case patients undergoing termination of pregnancy. The HAD scale, a recently introduced self assessment scale comprising 7 multiple choice questions, was readily accepted and easily understood by patients. There was a high degree of correlation between the HAD scale and both the MAACL (correlation coefficient 0.74) and the LAAS (correlation coefficient 0.67). There was only a moderate degree of correlation between the HAD scale and the anaesthetist's assessment of anxiety (correlation coefficient 0.46). The HAD scale is a useful method of subjective measurement of preoperative anxiety.

Abortion, Induced↗

Reye's syndrome: assessment of intracranial monitoring.

Direct measurements of arterial blood pressure and intracranial pressure were recorded in 39 patients aged 3.6 months to 5 years 11 months with Reye's syndrome judged to be stage 2 or beyond. Of 33 patients who survived, 27 made a full recovery and six were severely handicapped. Measurement of cerebral perfusion pressure, which is greatly reduced in the more severe forms of Reye's syndrome, was a better guide to prognosis and management than intracranial pressure alone. The findings emphasise that maintenance of cerebral perfusion pressure is essential if mortality and morbidity are to be reduced. Intracranial monitoring is mandatory in all but the mildest cases of Reye's syndrome.

Blood Pressure↗

Anaesthesia for colobronchial fistula.

The case of a patient with a colobronchial fistula is presented. The anaesthetic management using endobronchial intubation and one-lung anaesthesia is described and the problems presented by this rare condition discussed.

Aged↗

Reye's syndrome.

Reye's syndrome, an uncommon childhood encephalopathy of uncertain aetiology, is an important cause of mortality and permanent handicap. Since its recognition treatment has changed, current management focusing upon prevention or control of raised intracranial pressure. Prognosis is radically improved by early recognition and prompt transfer to a specialist centre.

Cerebrovascular Circulation↗

Management of childhood urinary tract infection.

Experience with childhood urinary tract infection is reviewed in conjunction with recent information on the management of the problem by family practitioners in the same health board. The need for bacteriological confirmation of the diagnosis in every case is confirmed and the importance of radiological investigation of the urinary tract after a first infection irrespective of age or sex is emphasised, as 17% of intravenous pyelograms and 31% of micturating cystogram examinations showed significant abnormality.

Child↗