Search PubMed⌕ Search

Biomedical subjects

L G Walker

Publications and source records attributed to L G Walker.

At least 55 records · Page 3Linked to original sources
PubMed1996

Behavioural oncology: psychosocial aspects of understanding and treating malignant disease.

Behavioural, or psychosocial, oncology refers to the application of the findings and methods of psychology (or more generally the social sciences) to understanding and treating malignant disease. The diagnosis and treatment of cancer are stressful experiences and clinicians can do much to promote adjustment by establishing good rapport, providing appropriate information and by involving patients in management decisions if they wish. Randomized clinical trials of various psychological interventions have shown that a great deal can be done to minimize distress, improve control of various side-effects and enhance quality of life. Although several randomized studies have found that patients who have received a psychological intervention live longer, more studies are urgently needed to confirm this. If survival can be prolonged in this way, it is likely that the underlying psychobiology will vary from one tumour type to another. Attention needs to be directed at how behavioural oncology services should best be delivered within the context of different health services.

Humans↗
PubMed1996

The cognitive effects of recombinant interleukin-2 (rIL-2) therapy: a controlled clinical trial using computerised assessments.

It has been suggested that patients undergoing treatment with recombinant interleukin-2 (rIL-2) may develop cognitive impairment. To evaluate these effects, 17 patients with advanced colorectal cancer took part in a randomised, parallel group study of rIL-2 with chemotherapy (5-fluorouracil and leucovorin) and chemotherapy alone. Assessments were carried out daily whilst patients were in hospital and regularly between cycles of treatment using state-of-the-art computerised cognitive assessment, as well as traditional psychometric tests. Rigorous discontinuation criteria were applied to ensure that the effect of time-related variables did not influence the results. One patient developed repeated transient psychotic episodes associated with rIL-2 infusions and another regularly became confused. Computerised cognitive assessments revealed that immunochemotherapy produced significant impairment in various tasks, especially reaction time, picture recognition and vigilance. These effects were not due to sleep deprivation or pyrexia. For most patients, cognitive functioning was restored to the baseline level within 10 days following the cessation of rIL-2. In conclusion, during infusions of rIL-2, some patients experience severe confusion and amnesia which resembles some of the major cognitive impairments associated with dementias such as Alzheimer's disease. Computerised cognitive assessment using the Cognitive Drug Research system provides a feasible, sensitive and reliable method of evaluating cognitive changes in patients with cancer. It could usefully be included in quality of life assessments in clinical trials where treatment-related cognitive changes need to be evaluated.

Aged↗
PubMed1995

Painful olecranon physeal nonunion in an adult weight lifter. A case report.

Only 3 cases of persistent olecranon physes in adults have been reported previously in literature. In each case, physeal nonunion was present bilaterally and either unilateral, bipartite, or tripartite patellae were present. A case of painful unilateral physeal nonunion in an adult weight lifter is presented. The patient had begun competitive weight lifting when he was 14 years old. Radiographs of the contralateral olecranon and patellae were normal. After failure of conservative treatment, surgical union was achieved, using tension band wiring augmented with autologous iliac crest bone graft. The author proposes that unilateral olecranon physeal nonunion has a mechanical etiology as opposed to a genetic etiology in individuals with bilateral physeal persistence. Surgical treatment in the former group is best delayed until after age 19, to allow adequate time for spontaneous union.

Adult↗
PubMed1994

Stabilization of the distal radioulnar joint after ulnar styloid nonunion using Mitek anchors.

Nonunion of the ulnar styloid is a relatively common injury that can often be ignored. In patients presenting with pain, compromised range of motion, and decreased grip strength, careful physical examination, and dynamic radiographic evaluation may document distal radioulnar joint instability. Mitek anchors provide a simple, effective means of triangular fibrocartilage complex reattachment, providing stabilization of the distal radioulnar joint.

Equipment Design↗
PubMed1991

Total hip arthroplasty in ankylosing spondylitis.

Total hip arthroplasty was performed on 29 hips in 19 patients diagnosed with ankylosing spondylitis over a 13-year period. The results were analyzed retrospectively with an average follow-up period of more than four years. Complete pain relief was achieved in 97%, and significant gains were made in ambulatory capacity. The limited gains in total range of motion (average improvement 75 degrees) were felt to be primarily due to the high incidence of Brooker Class III and IV myositis ossificans (23%) and long-standing soft tissue contractures.

Adult↗
PubMed1990

Hepatic encephalopathy induced by small bowel obstruction in a noncirrhotic child with portal vein thrombosis.

A case of hepatic encephalopathy in a noncirrhotic child, who has undergone a previous mesocaval shunt for extrahepatic portal vein thrombosis, is presented. Hepatic encephalopathy developed 5 years after the operation and is believed to have been precipitated by the presence of small bowel obstruction. Exploratory laparotomy and lysis of an adhesion relieved the obstruction and led to the resolution of the encephalopathy.

Adolescent↗
PubMed1990

Pathologic fracture of the proximal ulna through a bone graft donor site.

Complications of harvesting autologous bone graft from the iliac crest and tibia are well known; exclusive use of upper extremity donor sites in hand surgery has therefore been advocated. Six weeks of postoperative elbow splinting has been recommended after harvest of large proximal ulnar grafts. We report two cases of pathologic fracture of the proximal ulna complicating local bone grafting and question whether the risk of fracture and the attendant patient inconvenience and potential joint stiffness incurred by postoperative immobilization are exceeded by the morbidity of carefully done iliac crest grafting.

Aged↗
PubMed1990

Pediatric herpetic hand infections.

Fourteen cases of pediatric herpetic hand infection were admitted over a 15-year period. Five cases were documented by viral culture, four by Tzanck smear; the remainder were diagnosed on clinical grounds. The natural history of herpetic hand infections is similar in adult and pediatric populations. Adult infections are most frequently found in medical and dental personnel; pediatric infections are most common in children between 5 months and 6 years of age. Whereas adult infections are usually the result of exogenous occupational or sexual exposure, 11 (80%) of 14 pediatric cases exhibited coexistent oral lesions. Treatment in all cases is nonsurgical; resolution is complete within 3 to 4 weeks. Antibiotics are indicated only in the advent of bacterial superinfection.

Child↗
PubMed1990

The measurement of anxiety.

Selected contemporary highlights and issues in the field of anxiety measurement are discussed. The concepts of state and trait anxiety, and the most widely used measures of these, are reviewed. A measure of state anxiety is essential in some clinical and experimental research and it is often very useful in clinical practice. Whilst existing measures are satisfactory for some purposes, none adequately assesses the psychological, somatic and behavioural components of anxiety. The measurement of trait anxiety is also important in some clinical research and as part of the assessment of selected patients. In some circumstances, self report measures of trait anxiety should be used in conjunction with a measure of social desirability. Patients who score low both on trait anxiety and social desirability may respond differently to experimental stressors from those who score low on trait anxiety and high on social desirability. This may have a number of implications, for example in the area of psychoimmunology. Four scales are reviewed in more detail: the Courtauld Emotional Control Scale, the Hospital Anxiety and Depression Scale, the Clinical Anxiety Scale and the Fear Questionnaire. Finally, some future directions for research are outlined.

Anxiety Disorders↗