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Biomedical subjects

L Hunt

Publications and source records attributed to L Hunt.

At least 73 records · Page 4Linked to original sources

Parent-infant cosleeping: the appropriate context for the study of infant sleep and implications for sudden infant death syndrome (SIDS) research.

Nearly all laboratory research on human infant sleep assumes that solitary sleeping is the normal and desirable environment. Yet solitary sleeping in infancy is a very recent custom limited to Western industrialized societies, and most of the world's people still practice parent-infant cosleeping. A hypothesis is presented that cosleeping provides a sensory-rich environment which is the more appropriate environment in which to study normal infant sleep. In addition, two preliminary, in-laboratory, polygraphic investigations of mother-infant cosleeping are reported in normal infants within the peak age range for sudden infant death syndrome (SIDS). Five mother-infant pairs coslept for 1 night in the first study; in the second, three additional pairs slept separately for 2 nights and coslept the third consecutive night. The results suggest that cosleeping is associated with enhanced infant arousals and striking temporal overlap in infant and maternal arousals. Infant sleep also showed subtle alterations with cosleeping, as manifested in increased overlap with corresponding maternal sleep stages and decreased amount of Stage 3-4. These are the first in-laboratory investigations of parent-infant cosleeping. The implications of the hypothesis and preliminary results for research on the normal development of infant sleep and on SIDS are discussed.

Adult↗

Analysis of pre- and post-donation haematological values in plateletpheresis donors.

Pre- and post-donation haematological values were measured in 112 donors undergoing plateletpheresis using Haemonetics PCS machines. We found significant differences between pre- and post-donation means for males (M) and females (F) for haemoglobin (M: pre 14.73 g/dl, post 15.25 g/dl; F: pre 13.57 g/dl, post 13.94 g/dl), haematocrit (M: pre 0.418, post 0.431; F: pre 0.389, post 0.4), total protein (M: pre 73.1 g/l, post 66 g/l; F: pre 72.2 g/l, post 63.7 g/l) and albumin (M: pre 42.2 g/l, post 38.5 g/l; F: 41.4 g/l, post 37 g/l). Significant differences were also seen for platelet count (pre 258.6 x 10(9)/l, post 229.2 x 10(9)/l), total white cells (pre 5.3 x 10(9)/l, post 5.55 x 10(9)/l) and neutrophils (pre 3.15 x 10(9)/l, post 3.33 x 10(9)/l), but there were no differences between males and females. This information was of value in establishing post-donation reference ranges which could be utilised when reviewing the suitability of donors for subsequent donations.

Adult↗

Does elective cryopreservation of all embryos from women at risk of ovarian hyperstimulation syndrome reduce the incidence of the condition?

OBJECTIVES: To analyse the incidence and factors associated with the ovarian hyperstimulation syndrome (OHS) in our IVF/GIFT programme before and after the introduction of a strategy to cryopreserve all embryos from women judged to be at risk. DESIGN: Two hundred forty-one consecutive IVF/GIFT cycles from January to December 1989. SETTING: Specialist fertility unit, Manchester, UK. INTERVENTIONS: Pituitary suppression was effected by a daily subcutaneous injection of buserelin (500 micrograms) beginning 7 days before the expected menses. The ovarian stimulation was with variable amounts of human menopausal gonadotrophin. Ovulation was induced with 10,000 i.u. human chorionic gonadotrophin (hCG). From January to May (period A), gametes/embryos were replaced and 2000 i.u. hCG given, irrespective of the serum oestradiol (E2) concentration. From June to December (period B), all the embryos from women with an E2 > 3500 pg/ml on the day of ovulatory trigger were electively cryopreserved. MAIN OUTCOME MEASURES: Serum E2, features of moderate or severe OHS, clinical pregnancies. RESULTS: The OHS occurred in 10/105 (9.5%) and 12/136 (8.8%) cycles in periods A and B, respectively. Fewer women (6% versus 60%, P < 0.05) who had their embryos cryopreserved developed severe OHS compared with women with an E2 > 3500 pg/ml who became pregnant after gamete/embryo transfer in period A. The main factors associated with the development of OHS were serum E2 concentrations > 3500 pg/ml, whether gamete/embryos were replaced and the additional hCG given, the occurrence of a pregnancy and the presence of polycystic ovary disease. CONCLUSION: The elective cryopreservation of all embryos from women with high E2 levels reduced the severity, but not the incidence of symptomatic OHS.

Adult↗

Driving performance in persons with mild senile dementia of the Alzheimer type.

OBJECTIVE: To assess the effect of mild senile dementia of the Alzheimer type (SDAT) on driving ability. DESIGN: Cross-sectional study with correlation analysis. SETTING: A university-based Alzheimer's Disease Research Center, which evaluates community-living older adult volunteers, and the university's Program in Occupational Therapy. PARTICIPANTS: Healthy elderly controls (n = 13) and subjects with very mild (n = 12) and mild (n = 13) SDAT. Dementia severity was staged by the Washington University Clinical Dementia Rating. MEASUREMENTS: The driving ability of participants on the in-car road test was scored independently by a driving instructor, blinded to the study design and to the dementia status of the subjects, and an unblinded occupational therapist. Interview-based perceptions of driving ability were obtained independently from the subjects and their collateral sources. Attentional and visuospatial performances of the subjects were assessed prior to the road test. RESULTS: All control and very mild SDAT subjects were judged to be "safe" drivers (ie, passed the in-car road test), but five (40%) of the mild SDAT subjects had driving impairment sufficient to "fail" the road test. Neither subject self-assessment nor caregiver perceptions of driving ability consistently predicted driving performance. Attentional task performance correlated well with road test results. CONCLUSIONS: Some SDAT subjects retain "safe" driving skills. The greater the dementia severity, the greater the likelihood of poor driving ability. Performance-based (road test) evaluations are necessary to properly determine driving skills at present, but attention and other cognitive screening measures should be developed.

Aged↗

Aging and the visual system.

The ocular aging process involves everyone. Misconceptions about visual changes from aging versus visual changes from a disease have resulted in needless vision loss for many in the older population. Lack of understanding and misinformation may cause a delay in seeking medical attention for diagnosis and treatment.

Aged↗

Assessment and education of the diabetic with vision loss.

An educational program is essential for patients whose diabetes is complicated by significant visual loss. Nurses have a unique opportunity to assess the patient's learning needs and to provide pertinent educational experiences for the patient. A check off educational assessment tool can provide a quick survey of patient teaching and discharge needs. A patient teaching record can be utilized to document when and what is taught as well as patient response. A teaching packet can be designed that contains the purpose, teaching objectives, methods of teaching, and available resources for the patient. Appropriate tools will encourage staff involvement in patient teaching and documentation by making the process easier.

Diabetes Complications↗

Vision screening for infants and preschool children.

Eye examinations and vision screening at the recommended ages are preventive health measures that can yield immense benefits in preventing visual loss. Educational programs can be designed to provide parents and healthcare workers about children's eye screening and referral procedures.

Child, Preschool↗

Human ehrlichiosis--an overview.

Canine ehrlichiosis, previously thought to be restricted to dogs, has gained prominence in the human population since 1986. In the United States, human ehrlichiosis is a newly recognized disease ranging from a mild infection to a severe life threatening or fatal disease. Since antibody titers were found to be highest to E. canis in human ehrlichiosis patients, it was believed that E. canis or a closely related species was the etiologic agent. Investigators from the Centers for Disease Control recently have isolated a bacterium believed to be the etiologic agent of human ehrlichiosis and proposed the name Ehrlichia chaffeensis. Human cases of the disease have been identified primarily in the southeastern and south-central areas of the United States. Although relatively few cases are diagnosed, Oklahoma, according to one source, has been found to have the highest incidence rate. The human disease could be misdiagnosed as Rocky Mountain spotted fever, murine typhus fever, or Q fever.

Ehrlichiosis↗

Renal carcinoma in patients undergoing nephrectomy: analysis of survival and prognostic factors.

A series of 155 patients who underwent nephrectomy for renal carcinoma between 1965 and 1985 at Manchester Royal Infirmary were analysed for survival in relationship to presenting features, surgical staging and histopathology. Univariate and multivariate analyses were carried out. Five-year survival estimates for stage 1 disease were 81%, for stage 2 disease 65%, for stage 3 disease 39% and for stage 4 disease 6%. An erythrocyte sedimentation rate (ESR) greater than 30 mm/h was associated with worse survival and a history of hypertension was associated with better survival. Renal vein invasion alone was related to worse survival. Perinephric fat invasion was also associated with worse survival and this association in the multivariate analysis was more significant than expected, suggesting that the principles of radical surgery should be observed. The presence of granular cells as opposed to clear cells worsened survival. Patients with papillary tumours had a better survival than those with solid tumours.

Adult↗

Prediction of birthweight by fetal ultrasound biometry.

A total of 104 women with singleton pregnancies who were delivered between 37 and 42 weeks gestation had ultrasound scans during the fortnight before delivery. The biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) were measured in all cases. Estimation of fetal weight (EFW) was done by four different methods: using AC alone, AC/BPD, AC/FL and AC/BPD/FL. Results were compared with values of actual birthweights at delivery. There was no significant difference between the mean birthweights of the 47 boy and 57 girl fetuses studied. The EFW(Shepard) method showed the least bias overall: mean percentage error 1.7%, standard deviation (SD) 10.6%. The other three methods significantly underestimated birthweights on average: EFW(Deter), mean error 2.2%, SD 9.3%, p < 0.02; EFW(Campbell), mean error 5.4%, SD 9.5%, p < 0.001; EFW(Hadlock), mean error 5.6%, SD 9.3%, p < 0.001. The percentage error in each group was significantly negatively correlated (p < 0.001) with the scan-delivery interval. Two new equations were generated which gave more accurate predictions for the cases under study using AC, BPD and FL as a combination and also in addition to scan-delivery interval (SDI) in days.

Abdomen↗

Does catheter immobilization reduce exit-site infections in CAPD patients?

This study was undertaken to ascertain the effectiveness of an immobilization device in reducing exit site infections (ESI) in CAPD patients, and whether immuno-suppressive therapy, diabetes, disconnect system and Staphylococcus aureus nasal carriage had any bearing on the incidence of ESI. Sixty-six patients having a Tenckhoff catheter placement were randomly allocated into one of three groups; immobilizer, tape and non-immobilized group. The groups were monitored for the incidence of ESI over a total period of 347 patient months. The results show no significant difference in infection rates between the three groups, nor do the factors mentioned have any bearing on ESI rate. Whilst immobilization is important, the ineffectiveness of this device was probably related to its design problem.

Bacterial Infections↗

Eyeglasses and common complaints.

About one-half of the population wear eyeglasses. For them, a pair of eyeglasses is a necessary aid and when properly fit, can provide clear and comfortable vision for a variety of daily activities.

Eyeglasses↗