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Biomedical subjects

J Middleton

Publications and source records attributed to J Middleton.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Post-polio syndrome: assessments, pathophysiology and progression.

While there have been many reports of the decline in motor function in patients with prior-polio, there have been few reports of quantitative changes in muscle function and the pathophysiological mechanisms for the deterioration are poorly understood. This paper describes the establishment of a postpolio clinic and the principles adopted in quantitative muscle testing using twitch interpolation. Peripheral endurance and/or voluntary drive to muscles is impaired in about 30% of prior-polio patients attending the clinic. Progression of these deficits is slow and not easily predicted by factors associated with the original illness.

Ambulatory Care Facilities↗
PubMedDate not supplied

Flexural and creep properties of human jaw compact bone for FEA studies.

The aim of this work was to improve the constitutive model of the human mandible and dentition system by taking into account the non-linear material properties of the structural boney matrix that forms the human jaw bone or mandible. Due to the specific structure of the jaw bone the time dependence of the mechanical properties also forms an important stage of the quantification process. The lack of specific experimental data of this type of material prevents the implementation of these properties into finite element simulations which results in poor quality modelling. Here an attempt was made to determine elastic and viscoelastic mechanical characteristics of the compact bone tissue forming the mandible. The elastic properties of compact bone were determined experimentally from 3 point bending tests and the viscoelastic properties were evaluated from creep tests in compression. A particular human jaw from this complex study was used to reconstruct a geometric model for further numerical experiments.

Aged↗
PubMedDate not supplied

Crime is a public health problem.

Crime is a public health issue. It shares common causes with ill health, particularly poverty, and fear of violent crime is itself a major cause of anxiety. Community development in pre-school education, parental education, and among ethnic minorities, both reduces crime and promotes better health, for example in reducing the effects of alcohol and illicit drugs. Health workers should contribute in full to community development.

Adolescent↗
PubMedDate not supplied

Aortotomy site infections: case presentation and review of the literature.

A patient with Aspergillus fumigatus infection involving an aortotomy site with multiple peripheral emboli following implantation of an aortic valve prosthesis for rheumatic heart disease is described. Eleven aortotomy site infections are reviewed from the literature. Eight cases were caused by fungi with Aspergillus sp accounting for four cases. Presenting symptoms were nondiagnostic and multiple. However, the diagnosis of aortotomy site infection should be entertained in patients who have had aortic valve surgery who develop fever and embolic phenomena with or without positive blood cultures coupled with no evidence of valve dysfunction, and who respond inappropriately to antibiotic therapy. Ten of the 11 patients reviewed from the literature died. Therapy should be directed at early recognition followed by prompt early surgery combined with the use of proper antimicrobial agents directed against the isolated microorganism.

Aorta↗
PubMedDate not supplied

Abduction strength following intramedullary nailing of the femur.

OBJECTIVES: To assess hip abductor function, strength and complaints following insertion of a femoral intramedullary nail. DESIGN: Retrospective clinical review. SETTING: Department of Orthopaedics, Adelaide Women's and Children's Hospital, Adelaide. Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia. PATIENTS: 1. 32 of 37 patients who had an intramedullary nail inserted for an isolated femoral shaft fracture at the Royal Adelaide Hospital between 1987 and 1990. 2. 14 of 18 patients who had closed femoral shortening for leg length discrepancy, at the Adelaide Women's and Children's Hospital between 1985 and 1987. Patients with pathology involving the abductor mechanism were excluded. 3. 40 asymptomatic controls. INTERVENTION: Intramedullary fixation for femoral shaft fractures or as part of closed femoral shortening. All procedures were performed on a traction table via a gluteal splitting approach with reamed nails. MAIN OUTCOME MEASUREMENTS: Complaints included, pain, stiffness, limp and diminished walking distance. Examination of abductor function and measurement of abductor strength. Radiological assessment at followup. RESULTS: Complaints included trochanteric pain (40%, 40%), thigh pain (10%, 8%) and limp (13%, 42%) in the femoral fracture and closed femoral shortening groups respectively. There was significant difference in the abduction strength (p < 0.01) and abduction ratio (p < 0.01) between the control and each treatment group. Abductor weakness correlated (r = 0.30) with the incidence of complaints. CONCLUSION: Pain, limp and weakness are common following insertion of a femoral intramedullary nail. Agluteal retracting approach may minimize abductor weakness.

Adult↗
PubMedDate not supplied

Primary healthcare workers: training needs in mental health.

Particular attention is currently being given to the role of primary healthcare workers in supporting people with mental health problems in primary care (McFadyen et al, 1996). The aim of this study was to survey the views of primary healthcare workers regarding their previous mental health training and to identify their current perceived mental health training needs. A sample of 200 primary healthcare workers within Trent Health Region were interviewed using a short semi-structured interview schedule. Forty-six completed questionnaires were also received. An additional 22 respondents participated in exploratory in-depth interviews. Respondents included GPs, health visitors, practice nurses, district nurses, midwives and community psychiatric nurses. The need for further training in communication skills, particularly basic counselling skills, was highlighted. Respondents also perceived a need for additional training in coping with their own personal stress, the assessment and treatment of depression and stress/anxiety management in clients. Several themes which developed from the research were explored, including communication skills training, problems with collaborative working, coping with personal stress, the prevention of burnout and depression training. The reason why some respondents had no mental health training needs whatsoever was also addressed.

Communication↗