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Biomedical subjects

J Hankinson

Publications and source records attributed to J Hankinson.

At least 19 recordsLinked to original sources
PubMed2004

Botulinum toxin for cerebral palsy; where are we now?

In this article, the evidence base for botulinum-A treatment acquired in recent years is outlined, and the practicalities involved in providing this service are described. Botulinum-A is relatively new, and possible improvements for the future are considered.

Botulinum Toxins, Type A↗
PubMed2002

Use of a lying hip abduction system in children with bilateral cerebral palsy: a pilot study.

Fourteen children aged 4 to 14 years with hip subluxation due to cerebral palsy (CP) were considered for a trial in a lying hip abduction system (Jenx Dreama, Jenx Limited, Sheffield, UK). Baseline data were recorded for 6 months, then assessments of the system were made for one year at 6 and 12 months. Assessments consisted of hip radiographs in the standard position, a parental questionnaire, and a sleep chart, which was completed by parents every Friday night during the trial. Three children could not enter the trial because of general sleep problems, and three could not complete it because they were unable to sleep with the system. One further child withdrew from the study just before the end because of unacceptable deterioration for which surgery was needed. The remaining seven children completed the trial and there was an overall improvement in rate of hip migration percentage on the right from 7% per annum in the baseline period to 4% with the system (p<0.05). On the left, changes were -3% and 0% respectively (ns). Average sleep at night changed from 9 to 9.4 hours (ns) and wakenings/night from 1 to 1.3 (ns). On the parental questionnaire, there were significant improvements noted with the system in position for seating and sleeping, ease of hip abduction for washing, and with pain reduction. This pilot study supports the use of this type of lying system but further studies are needed to establish the acceptability and efficacy of these systems, particularly in children aged 2 to 5 years when irreversible bony deformities of the hip tend to occur.

Adolescent↗
PubMed1996

Improvement in lung function measurements using a flow spirometer that emphasizes computer assessment of test quality.

We compared retrospective measurements of lung function from 101 steel workers using a commercially available spirometer to prospective lung function measurements performed, on average, 1.3 years later, with a newly developed spirometer. This spirometer was designed and developed to incorporate technology that provides immediate feedback on the quantitative and qualitative aspects of each forced expiratory effort. Of the 101 workers, 82 who had spirometry performed with each spirometer had at least two acceptable curves, and 51 workers tested with each spirometer had curves that met all American Thoracic Society (ATS) criteria for spirometry. No group showed the anticipated decline in forced expiratory volume in 1 second (FEV1) over time. The results showed an increased number of curves meeting ATS acceptability and reproducibility criteria, and a statistically significant increase in the FVC in all groups, and an increase in the FEV1 in the group encompassing all workers. Use of technology that strengthens the interaction between the spirometry technician, the data available to the technician on the computer, and the participant appears to represent true underlying lung function more accurately. Such an approach to the collection of lung function data should be considered by those evaluating spirometers for implementation in the workplace or pulmonary function laboratory as well as by those planning future spirometer development.

Humans↗
PubMed1988

Simple peroperative antimicrobial chemoprophylaxis in elective neurosurgical operations.

From August 1981 to February 1982 postoperative infections due to different strains of penicillin-resistant Staphylococcus aureus occurred in 20 of 467 patients (4.3%) undergoing elective cranial and spinal operations. These infections were not attributable to defects in procedures or the theatre environment, therefore chemoprophylaxis was instituted. In the following 8 months, when patients were given penicillin G and sulphadiazine for 5 days commencing immediately postoperatively, S. aureus infections occurred in five of 579 patients (0.9%). In a subsequent randomized uncontrolled study, infections occurred in six of 265 patients receiving penicillin (2.3%), three of 270 receiving penicillin and sulphadiazine (1.1%) and one of 45 receiving erythromycin (2.2%) immediately postoperatively for 5 days. In a further study in which 587 patients received penicillin for 5 days commencing immediately preoperatively, infections due to S. aureus occurred in six (1.1%). Infections due to gram-negative organisms were seen in five (0.4%) of 1167 patients in the two uncontrolled studies.

Drug Therapy, Combination↗
PubMed1986

Effects of industrial respirator wear during exercise in subjects with restrictive lung disease.

Few studies have examined the response of individuals with restrictive lung disease (RLD) to respirator wear. Such information should be of theoretical and practical interest when the need to determine fitness to wear respirators is considered. Seventeen females performed progressive submaximal treadmill exercise. Twelve control subjects with total lung capacity (TLC) = 5.71 +/- .19L (mean +/- SEM) and DLCO = 25.8 +/- 1.0 mL/min/mmHg were compared to five RLD subjects with TLC = 3.70 +/- 0.22 and DLCO = 14.5 +/- 0.7. Mean age, height and weight were similar. Separate exercise trials were performed with no added resistance (NAR), and with 5 cm H2O/L/sec inspiratory and 1.5 cm H2O/L/sec expiratory resistance (R2) to stimulate widely used respiratory masks. Comparisons of exercise data were made at an oxygen consumption of 0.8 L/min. With NAR, RLD subjects had significantly higher minute ventilation (VE) (29.0 vs. 21.2 L/min for controls), higher respiratory rate (RR), and lower tidal volume (VT). Heart rate, end-tidal PCO2 (PETCO2), and mouth pressure swing (Poral) were not different from control values. With R2 compared to NAR, the controls had reduced RR and VE; and increased VT, PETCO2, and Poral. While changes with R2 for the RLD subjects were in the same directions as controls, only the increase in Poral was statistically significant. Analysis of the differences showed that none of the changes with R2 in RLD subjects was different from control changes except for the greater increase in Poral and the smaller increase in VT. The former was explained by the RLD subjects' higher VE and flow rates, and the non-linear nature of R2 at higher flow rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1985

Spirometry reference values for nonexposed blue-collar workers.

Epidemiologic research into occupationally related lung disease often requires the comparison of a study population with an external reference group. To establish such a reference group, carefully selected blue-collar workers who had no obvious adverse occupational pulmonary exposure performed simple spirometry, were administered a standard questionnaire, and had standard chest roentgenograms taken. Prediction equations were established for six pulmonary function indices, and a method is given for using these equations to compare a study group with this external nonexposed group. Asymptomatic nonsmokers with negative roentgenograms were extracted from the overall group, and comparison with published data for other such normal groups indicated that the present group is similar to most of them, indicating that there are no serious biases in the present group.

Adult↗
PubMed1983

Effects of added resistance to breathing during exercise in obstructive lung disease.

Forty-nine men performed progressive submaximal treadmill exercise to determine the cardiopulmonary and subjective response to added resistance to breathing. Twenty subjects (controls), FEV1/FVC% = 79.2 +/- 1.4 (mean +/- SEM), were compared with 19 mildly obstructed men (OB1), FEV1/FVC% = 66.9 +/- 0.5, and 10 with moderate obstruction (OB2), FEV1/FVC% = 53.7 +/- 1.9. Separate exercise trials were performed with no added resistance (NAR), R1 = 3.5 cm H2O/L/s inspiratory and 1.5 cm H2O/L/s expiratory resistance, and R2 = 5 cm HKO/L/s inspiratory and 1.5 cm H2O/L/s expiratory resistance. Analysis of cardiopulmonary parameters was made at an oxygen consumption rate of VO2 = 1.5 L/min for all 3 obstruction groups at all 3 resistances. With NAR, all 3 groups had similar respiratory rate (RR), tidal volume (VT), minute ventilation (VE), end-tidal PCO2 (PETCO2), respiratory exchange ratio (R), heart rate (HR), and mouth pressure swing (Poral). With both R1 and R2 compared with NAR, control and OB1 subjects (at VO2 = 1.5 L/min) had reduced RR, VE, and R, and increased VT and Poral (p less than 0.01 for all). Changes with added resistance for OB2 subjects were in the same directions, but were significant only for VE and with R1 for RR. Heart rate did not change; PETCO2 increased in control subjects and with R2 in OB1 subjects. Separate analysis showed that except for the smaller increase in PETCO2 in OB2 subjects, none of the changes with added resistance in the OB1 or OB2 groups were different from changes in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

Incidence of lower extremity deep vein thrombosis in neurosurgical patients.

In 100 patients who underwent major cranial or spinal operations, the incidence of lower extremity deep vein thrombosis was 29%. Of importance was the presence of known risk factors, particularly leg weakness and a long operation. The subject of deep vein thrombosis and its complications in neurosurgical disorders is reviewed and its prophylaxis is discussed. The administration of low dose heparin based on an epidemiological analysis of the risks involved would seem to be an effective method of prophylaxis.

Adult↗
PubMed1979

An unusual case of multiple intracranial aneurysms.

A 49-year-old female patient with six intracranial aneurysms, all of which were treated successfully by direct surgery, is reported. She had a major subarachnoid haemorrhage 10 years ago. Because of difficulty in identifying the offending aneurysm she was not surgically treated at that time. The natural progression of intracranial aneurysms, the problem of identifying the lesion in a patient with multiple aneurysms, and an example of excellent recovery of visual function following surgical treatment are discussed.

Carotid Artery, Internal↗