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Biomedical subjects

J Long

Publications and source records attributed to J Long.

At least 55 records · Page 3Linked to original sources
PubMed1998

Profile of pediatric bicycle injuries.

BACKGROUND: Bicycle injury data from local communities are important for developing injury prevention and control programs. This study represents the efforts of one community trauma center to describe bicycle injuries. METHODS: We conducted a retrospective analysis of bicycle injury data from hospital charts, emergency medical services reports, and medical examiner reports. The review encompassed a 4-year period. The study sample included 211 trauma alert patients, ages 1 through 15 years, who were treated for bicycle-related injuries at our level II pediatric trauma center. RESULTS: Bicycle injuries accounted for 18% of all pediatric trauma alert patients. The mean age of injured children was 10 years, and 79% were males. Bicycle-motor vehicle collisions caused 84% of injuries. Only 3 children (1.4%) wore bicycle helmets. Resulting injuries included external wounds (86%), head injuries (47%), fractures (29%), and internal organs (9%). Six children died. CONCLUSIONS: Bicycle injuries are a significant cause of mortality and morbidity for children in our community. Use of safety helmets by child bicyclists is inadequate. The data from this study can be used as a baseline in testing the effectiveness of local and state interventions, including new legislation mandating helmet use by children in our state.

Accidents, Traffic↗
PubMed1998

Daily physical activity in adults with mild and moderate learning disabilities: is there enough?

PURPOSE: Whilst the health benefits associated with regular physical activity are well known, little objective evidence exists regarding the activity profiles of adults with mild and moderate learning disabilities. The aims of the present study were to establish 7 day physical activity profiles for 24 adults with mild and moderate learning disabilities and to compare them with the general population and current Department of Health recommendations for physical activity. METHOD: A descriptive study was used, based on interviews with 24 adults with learning disabilities (mean age 34 years) triangulated by daytime and residential care workers. Participants volunteered from two residential homes and one social education centre (SEC) in a city in the North of England. RESULTS: The physical activity profiles show that the participants led sedentary lifestyles that were more exaggerated than those of the general population. Twenty-two participants (93%) performed significantly less than the minimum daily levels of physical activity recommended by the Department of Health. CONCLUSIONS: Few adults with learning disabilities can choose to walk to work, go for a run or visit the local swimming pool without adequate support. This study suggests that there may not be enough moderate or vigorous physical activity choices available in day and residential care settings to empower adults with mild and moderate learning disabilities to meet the minimum recommendations of the Department of Health. Hence some people with learning disabilities have no alternatives to a sedentary lifestyle and the health risks associated with physical inactivity.

Adult↗
PubMed1998

[Bilobate flap applied to the treatment of secondary deformity after cheiloplasty].

Secondary deformity after cheiloplasty was common and 7 cases (4 males, 3 females) were reconstructed with bilobate flap. The patients' age ranged from 16 to 30. Five of them with single cleftlip. The deformity of them included loose and shortening of the upperlip, scar, vermilion pitting, too large nostril etc. Lateral tissue of cleftlip was used to construct the bilobate flap which was applied to repairing secondary deformity after cheiloplasty. The method was matched with the principle of anatomy, and the effects were satisfactory.

Adolescent↗
PubMed1998

[The effects of nimodipine on cerebrovascular function in acute cerebral infarction].

OBJECTIVES: To use cerebrovascular hemodynamics indexes (CVDI) to evaluate the effects of nimodipine on cerebrovascular function in acute cerebral infarction (ACI), and to investigate the changes of blood pressure (BP), heart rate (HR), and electrocardiography (ECG). METHODS: 30 patients with ACI in internal carotid artery system within 72 h from the oneset of symptoms were given nimodipine (10 mg, 0.25-0.5 microgram/kg/min) by intravenous drip (i.v.) every day for 14 days. CVDI, BP, HR and ECG were examined at various times during treatment. RESULTS: Nimodipine improved cerebrovascular function significantly. Cerebral blood velocity and flow increased, cerebrovascular resistance and criticle pressure decreased, and cerebrovascular elasticity and autoregulation improved. BP dropped significantly at the third day, and mainteined stable afterward. HR dropped remarkably at the fourteen day (P = 0.011). It was reasonable that the treatment of nimodipine (i.v.) lasted 10 days or so. CONCLUSIONS: Nimodipine improves cerebrovascular function significantly, but monitoring of BP and ECG is necessary during its application.

Adult↗
PubMed1998

Discharge planning in a community hospital--a multidisciplinary approach.

The population of Singapore is ageing rapidly. Acute hospitals in Singapore are also experiencing an acute bed shortage. However, many elderly admitted to acute hospitals require a longer period of convalescence before they are able to go home. Community hospitals are most suitable to provide such care for the elderly patient. Patients could be discharged to the community hospitals to continue rehabilitation and convalescence. In addition this would also free the beds in the acute hospitals. However, there is a risk that without adequate discharge planning, the community hospitals would in turn also reach full capacity and no longer be able to accept patients. A discharge planning programme has been set up in a community hospital to address the following needs: 1) caring for a rapidly ageing population with increasing degrees of disability; 2) the shortage of beds in the acute hospitals; (3) the provision of holistic care and care-giver education, and 4) to prevent long term institutionalisation of the elderly as much as possible.

Aged↗
PubMed1997

African Tick-Bite Fever: A Case Report.

Mediterranean spotted fever, a disease caused by Rickettsia conorii, is a well-described syndrome among travelers returning from Africa.1 In the present issue of Journal of Travel Medicine2 a case of Rickettsia conorii disease is presented and discussed in context with recently described African tick-bite fever caused by Rickettsia africae. We report the clinical presentation and successful treatment of a traveler who likely had African tick-bite fever.

Journal Article↗
PubMed1997

Leptin, corticotropin-releasing hormone (CRH), and neuropeptide Y (NPY)in free-ranging pregnant bats.

Leptin, the product of the obese gene first identified in mice, restores fertility in obese mice, and accelerates puberty in mice. We hypothesized that leptin's putative role in reproduction may extend to pregnancy and lactation. Leptin levels were determined in Myotis lucifugus, the little brown bat, a free-ranging mammal with a seasonal breeding cycle. The present study shows that plasma levels of leptin progressively rise during pregnancy, supporting a potential role for leptin in the maintenancy of pregnancy. In contrast, leptin was significantly lower during lactation, a time when most mammals, including bats, demonstrate reduced fertility. In addition to its possible roles in reproduction, leptin appears important in regulation of energy balance. M. lucifugus spontaneously fasts for up to 16 h each day during the active season, which allowed us to test the hypothesis that acute fasting was associated with decreased leptin. Leptin was significantly lower in fasted (lactating) bats, compared to those that recently returned from nightly foraging. Although postprandial lactating bats had a significantly higher fat index than fasted bats, plasma leptin and body fat were not significantly correlated, and were only weakly correlated (r2 = 0.26) when both pregnant and lactating females were included in the analysis. Similar changes during pregnancy, lactation, and the daily feeding cycle were observed in the hypothalamic neuropeptide, corticotropin-releasing hormone (CRH), which is believed to play an important role in energy balance and reproduction. By contrast, neuropeptide Y (NPY) increased during pregnancy but did not change during fasting. These results suggest that leptin's putative role in reproduction may extend to pregnancy and lactation, and that spontaneous, acute fasting results in decreased circulating levels of leptin in M. lucifugus.

Adipose Tissue↗
PubMed1997

Adult vaccinations: a short review.

Rates of vaccination in adults fall far short of recommendations. We review the epidemiology, efficacy, safety, and recommended use of vaccines against pneumococcal pneumonia, influenza, hepatitis A and B, varicella, measles, mumps, rubella, tetanus, and diphtheria.

Adolescent↗
PubMed1997

Alteration of transcriptional and post-transcriptional expression of gamma-glutamylcysteine synthetase by diethyl maleate.

Gamma-glutamylcysteine synthetase (gamma-GCS), also known as glutamate-cysteine ligase (EC 6.3.2.2), is the rate-limiting enzyme in the synthesis of glutathione (GSH). The gene GLCLC encodes the catalytic subunit while GLCLR encodes the regulatory subunit. Although it has been shown that GLCLC can respond to a variety of stresses by increased transcription, it is not known whether a similar response occurs for GLCLR. Nor is it known whether post-transcriptional regulation of either gene product is altered during stress. The present investigation was undertaken to explore transcriptional and post-transcriptional regulation of GLCLC and GLCLR gene products when HepG2 cells were challenged with the radiation sensitizer diethyl maleate (DEM). Expression of steady-state GLCLC and GLCLR mRNA was enhanced 5-20-fold after DEM challenge. Nuclear run-off assays were performed on unstressed and stressed cells to determine whether the increased expression of GLCLC and GLCLR mRNA was due to altered transcriptional activity of these genes. The DEM treatment increased the transcription rates of both genes 2-5-fold. In unstressed HepG2 cells, the half-life of GLCLC mRNA transcripts was approximately 4 h. In contrast, the half-life of GLCLR transcripts was approximately 8 h. In cells treated with DEM, the half-lives of all transcripts were increased, indicating that message stabilization contributed to the increased expression of gene products. Finally, a PEST algorithm has identified a PEST (proline, glutamate, serine, threonine) motif within the catalytic subunit of gamma-GCS, suggesting that this subunit might exhibit conditional proteolytic regulation. These results imply that regulation of the products of the GLCLC and GLCLR genes may be altered at multiple levels during exposure to stress.

Amino Acid Sequence↗
PubMed1997

International experience with the CardioWest total artificial heart as a bridge to heart transplantation.

As the number of potential heart donors remains constant and the number of potential recipients continuous to increase, the need for circulatory devices to bridge patients becomes more important. The CardioWest total artificial heart (TAH) is a pneumatic, implantable system that totally replaces the failing ventricles. It has been utilized worldwide as a bridge to heart transplantation in 79 patients. There were 73 males and six females who received the TAH. Currently three patients remain on the device waiting for transplantation. A total of 55 patients (70%) were transplanted of which 50 survived (91% of patients transplanted) and were discharged home. Idiopathic/dilated cardiomyopathy was the most common etiology followed by ischemic cardiomyopathy. The mean duration of implant was 34 days (range 0-186 days) and the mean age of the group was 45 years (range 16-62 years). Twenty-one patients died while on the device. Multiple organ failure was the major cause of death. There were a total of 255 complications in this group that included reoperation, bleeding, hepatic failure, renal failure, respiratory failure, neurologic events, thromboembolic events, infections, device malfunction, and fit complications. This represented a mean complication rate of three events per patient. The survival rate for the CardioWest TAH of 91% of the patients who reached transplantation is an improvement over that of the Symbion registry (55% of those transplanted) probably as a result of a better patient selection and better control of the coagulation system. These results are also comparable to those survival results obtained with other biventricular and left ventricular assist devices currently available.

Adolescent↗
PubMed1996

Purchasing. The wasted millions.

In the wake of the Child B rationing controversy, the Anti-Rationing Group challenged purchasers to allow them to scrutinise their practice. Eight health authorities accepted and, say Colin Roberts and colleagues, the results show public money being needlessly wasted on a staggering scale.

Community Health Services↗
PubMed1996

Kawasaki disease presenting as focal colitis.

Kawasaki disease (mucocutaneous lymph node syndrome) typically presents with fever, rash, lymphadenitis, and mucositis. The colon is rarely involved and, to date, colitis has not been described as the presenting symptom. We report the imaging findings of a child with Kawasaki disease who presented with fever and focal left colitis.

Child, Preschool↗
PubMed1996

Breast cancer during pregnancy: quantifying the risk of treatment delay.

OBJECTIVE: To quantify the risk of axillary nodal metastases due to delayed treatment of breast cancer during pregnancy. METHODS: A mathematical model using recently published data was developed to correlate primary breast tumor size with the percentage of pathologically positive axillary lymph nodes. Using this relationship obtained from pathologic data and the accepted relationship of tumor growth and time, Y2 = Y1e(In2)n/DT, an equation estimating the increased risk of axillary metastases due to each day of treatment delay was derived: delta X = 3.7 n/DT, where X = percent positive axillary lymph nodes, n = number of days delay in treatment, and DT = tumor doubling time. RESULTS: A 1-month delay in treatment for an early-stage primary breast cancer with a 130-day doubling time increases the risk of axillary lymph node involvement by 0.9%. A 3-month delay increases the risk by 2.6%, and a 6-month delay by 5.1%. For breast cancer with a 65-day doubling time, a 1-month delay increases the risk by 1.8%, a 3-month delay by 5.2%, and a 6-month delay by 10.2%. CONCLUSION: Axillary lymph nodes are the most important prognostic indicator for survival in breast cancer. Our mathematical model suggests the daily increased risk of axillary metastases due to treatment delay is 0.028% for tumors with moderate doubling times of 130 days and 0.057% for tumors with rapid doubling times of 65 days. This minimal maternal risk may be acceptable to some third-trimester pregnant women with early breast cancer, who prefer organ-sparing treatment with radiation after delivery to a mastectomy during pregnancy. This model further quantitates the increased risk of mortality borne by pregnant women whose breast cancer diagnosis is delayed.

Axilla↗
PubMed1996

Cryoprostatectomy consistently elevates serum creatine kinase-MB isoenzyme.

STUDY OBJECTIVE: To measure serum CK-MB, a market of myocardial infarction (MI), in elderly men before and after cryoprostatectomy. DESIGN: Serum CK-MB was measured on each patient before and after cryoprostatectomy. Each patient's preoperative result was used as control measurement for comparison with measurements made after cryoprostatectomy. SETTING: Inpatient operating room and postanesthetic recovery unit of a university-affiliated general hospital. PATIENTS: 38 male patients, mean (SEM) age 69.1 +/- 1.4 years, undergoing cryoprostatectomy. INTERVENTIONS: All patients had a 12-lead ECG prior to surgery, in the recovery room, and 24 hours after surgery. Serum CK-MB was measured prior to induction of anesthesia, on arrival in the recovery room, and at 8 and 24 hours after surgery. Lactate dehydrogenase (LDH) and isoenzymes also were measured in 10 patients before and after cryoprostatectomy. MEASUREMENTS AND MAIN RESULTS: All patients underwent uneventful cryoprostatectomy. No patients had new ECG changes after surgery. All patients had normal serum CK and CK-MB concentrations before surgery. Serum CK and CK-MB were significantly elevated after cryoprostatectomy (p < 0.001). Enzyme values were greatest 8 hours after surgery: total CK mean 1453 +/- 145 U/L (range 199 to 3,356 U/L); CK-MB mean 52 +/- 3 ng/ml (range 12 to 114 ng/ml) or 5.0 +/- 0.5% of total CK (range 1.6% to 12.4%). All patients had significant elevations of LDH after cryoprostatectomy but did not show an increase in the ratio of LDH1 to LDH2 isoenzymes. Finally, unlike patients with an acute MI, the activity of CK-MB isoenzyme when measured by gel electrophoresis was two to three times greater (mean, 2.6 +/- 0.7) than the concentration measured with the monoclonal antibody assay in patients after cryoprostatectomy. CONCLUSION: Serum CK-MB is an unreliable test to diagnose an MI in patients who have undergone cryoprostatectomy.

Aged↗
PubMed1996

Functions of fish skin: flexural stiffness and steady swimming of longnose gar, Lepisosteus osseus

The functions of fish skin during swimming remain enigmatic. Does skin stiffen the body and alter the propagation of the axial undulatory wave? To address this question, we measured the skin's in situ flexural stiffness and in vivo mechanical role in the longnose gar Lepisosteus osseus. To measure flexural stiffness, dead gar were gripped and bent in a device that measured applied bending moment (N m) and the resulting midline curvature (m-1). From these values, the flexural stiffness of the body (EI in N m2) was calculated before and after sequential alterations of skin structure. Cutting of the dermis between two caudal scale rows significantly reduced the flexural stiffness of the body and increased the neutral zone of curvature, a region of bending without detectable stiffness. Neither bending property was significantly altered by the removal of a caudal scale row. These alterations in skin structure were also made in live gar and the kinematics of steady swimming was measured before and after each treatment. Cutting of the dermis between two caudal scale rows, performed under anesthesia, changed the swimming kinematics of the fish: tailbeat frequency (Hz) and propulsive wave speed (body lengths per second, L s-1) decreased, while the depth (in L) of the trailing edge of the tail increased. The decreases in tailbeat frequency and wave speed are consistent with predictions of the theory of forced, harmonic vibrations; wave speed, if equated with resonance frequency, is proportional to the square root of a structure's stiffness. While it did not significantly reduce the body's flexural stiffness, surgical removal of a caudal scale row resulted in increased tailbeat amplitude and the relative total hydrodynamic power. In an attempt to understand the specific function of the scale row, we propose a model in which a scale row resists medio-lateral force applied by a single myomere, thus functioning to enhance mechanical advantage for bending. Finally, surgical removal of a precaudal scale row did not significantly alter any of the kinematic variables. This lack of effect is associated with a lower midline curvature of the precaudal region during swimming compared with that of the caudal region. Overall, these results demonstrate a causal relationship between skin, the passive flexural stiffness it imparts to the body and the influence of body stiffness on the undulatory wave speed and cycle frequency at which gar choose to swim.

Journal Article↗