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Biomedical subjects

L Hunt

Publications and source records attributed to L Hunt.

At least 109 records · Page 6Linked to original sources
PubMed1990

Evaluating the outcomes of AIDS education.

AIDS provides a unique challenge to health educators, requiring continuous evaluation and modification of educational strategies. Pretest and posttest questionnaires were thus used to assess the outcomes of AIDS training sessions. Results show that hour-long sessions result in knowledge acquisition and increased confidence among a demographically representative sample of 3,966 U.S. trainees. Results also reveal the dynamic nature of a training session, with some trainees exhibiting learning and others retaining either correct or incorrect responses or changing from one incorrect to another incorrect answer. Content areas that showed the most learning were sharing a glass or food with and being sneezed on by someone infected with the human immunodeficiency virus (HIV). Areas resistant to learning included the possibility of transmission from receiving blood transfusions, eating in a restaurant where a cook is infected, being bitten by a mosquito, giving mouth-to-mouth resuscitation, and providing first aid to someone infected. Repeat training sessions that take into account affective dimensions as well as the diverse needs of adult learners are recommended.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Determinants of the serum concentration of 1,25-dihydroxyvitamin D in primary hyperparathyroidism.

1. The serum concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were measured in 44 patients with primary hyperparathyroidism. 2. In 14 patients the serum concentration of 1,25-dihydroxyvitamin D was greater than normal (142-337 pmol/l). One patient had a subnormal concentration of 1,25-dihydroxyvitamin D (36 pmol/l) but no other evidence of vitamin D deficiency. 3. The possible biological determinants of the serum concentration of 1,25-dihydroxyvitamin D were sought by multivariate analysis of relevant variables. The serum concentration of 1,25-dihydroxyvitamin D was found to be significantly and positively correlated with the serum concentrations of 25-hydroxyvitamin D (P less than 0.001) and parathyroid hormone (P less than 0.003), and with the glomerular filtration rate (P less than 0.03), and negatively correlated with the serum concentrations of calcium (P less than 0.02) and phosphate (P = 0.055) (multiple R = 0.638, P less than 0.002). 4. In primary hyperparathyroidism the major determinant of serum 1,25-dihydroxyvitamin D is the availability of precursor 25-hydroxyvitamin D. 5. The finding that serum 1,25-dihydroxyvitamin D is commonly normal in patients with primary hyperparathyroidism despite an adequate state of vitamin D nutrition, can be explained in terms of the constraining influences of hypercalcaemia and variable degrees of renal dysfunction on the biosynthesis of 1,25-dihydroxyvitamin D.

Adult↗
PubMed1988

Apolipoproteins (a), AI, and B and parental history in men with early onset ischaemic heart disease.

Middle-aged men who had had a myocardial infarction were compared with controls matched for social background, age, cigarette-smoking, blood pressure, and alcohol consumption. Serum cholesterol, triglycerides, very low density lipoprotein, low density lipoprotein, high density lipoprotein (HDL), HDL2 and HDL3 cholesterol, and serum apolipoproteins (apo) (a), AI, and B were measured. Discriminant analysis showed that the combination of these variables that best distinguished patients from controls was provided by apo AI and apo B and a knowledge of parental history of early cardiac death, the most discriminating single factor being apo B. No other variable contributed more than these. Apo (a), however, could be substituted for parental history, which had a major influence on the serum concentration of apo (a). Apo (a) concentration accounted for much of the familial predisposition to cardiac ischaemia. These findings may prove valuable in the clinical assessment of genetic susceptibility to myocardial infarction. They also support the hypothesis that serum apo (a) concentration is a genetic trait that predisposes to arterial thrombosis. Apo B emerged as the main lipoprotein determinant of coronary disease risk.

Apolipoprotein A-I↗
PubMed1988

Haptic identification of letters using the left or right hand.

The present study investigated the effects of the use of the right and left hands on haptic identification of letters of the alphabet. Each of the 64 right-handed subjects was given three series of randomly ordered presentations of the 26 letters of the alphabet. The subjects were asked to feel each letter and name correctly each letter as quickly but as accurately as possible. Analysis showed faster identification by those subjects using their left hands on Series 1 with no hand-differences appearing on Series 2 and 3. Significant over-all improvement in identification time occurred with practice. The results were interpreted in terms of a novelty hypothesis of right-hemisphere function and an explanation of perceptual learning of letter identification.

Adolescent↗
PubMed1987

Outcome in patients on continuous ambulatory peritoneal dialysis and haemodialysis: 4-year analysis of a prospective multicentre study.

In a study in seven large renal units in England, the morbidity and mortality of all patients starting continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis during 1983-85 were monitored prospectively over a 4-year period and related to reasons for choice of therapy and potential risk factors. 610 new patients (median age 52 years, range 3-80 years) started CAPD; 16% had diabetes mellitus and 21% cerebrovascular or cardiovascular disease. 329 patients (median age 48 years, range 5-77 years) started haemodialysis; 7% had diabetes mellitus and 17% cerebrovascular or cardiovascular disease. The Kaplan-Meier patient survival estimates at 4 years were 74% for haemodialysis and 62% for CAPD; technique survival figures for the same period were 91% for haemodialysis and 61% for CAPD. Cox's proportional hazards regression analysis showed that cerebrovascular/cardiovascular disease, age over 60 years, and diabetes mellitus were important predictors for survival in CAPD patients; there were no risk factors associated with permanent change to haemodialysis. In the haemodialysis group early change to CAPD was associated with presence of cerebrovascular or cardiovascular disease. The major cause of drop-out in both groups was transplantation. The mean length of hospital admission was 14.8 days per patient-year for CAPD and 12.4 days per patient-year for haemodialysis.

Adolescent↗
PubMed1987

A controlled trial of colchicine in primary biliary cirrhosis. Trial design and preliminary report.

Colchicine (1 mg/day), or an identical placebo, was given to 64 patients with primary biliary cirrhosis in a double-blind controlled trial. Due to a novel, pair-matched trial design, the two groups were exceptionally well matched at entry. In comparison with placebo, colchicine produced a beneficial effect on serum albumin and bilirubin levels at 3 months in patients who had abnormal liver function (bilirubin greater than 20 mumol/l) at entry: (albumin, P = 0.047; bilirubin, P = 0.022). In patients with normal liver function at entry (bilirubin less than 20 mumol/l), beneficial effects were noted on total globulin levels at 3 months (P = 0.013) and on immunoglobulin G levels at 3 and 6 months (P = 0.044 and 0.001, respectively). At 18 months, survival estimate in the colchicine and placebo groups were 84% and 69%, respectively. The difference did not reach significance. Colchicine produced an early improvement in liver function and immunoglobulin levels. Few serious side effects were encountered, and colchicine clearly merits long-term study in the treatment of primary biliary cirrhosis.

Bilirubin↗
PubMed1987

Keller arthroplasty: a prospective review.

A prospective study of the Keller procedure for hallux valgus was carried out on 44 female patients (75 feet) with an average age of 66 years. The average follow-up was 31 months (range, 12-64 months). The operation was effective in improving symptoms (joint pain and bunion tenderness), cosmesis, function (footwear and level of activity) and in decreasing the deformity. The operation did not have an influence on metatarsal calluses. Cock-up deformity was common postoperatively but did not affect the results. The overall patient satisfaction rate was 77%.

Aged↗
PubMed1987

Multi-centre study on outcome of treatment in patients on continuous ambulatory peritoneal dialysis and haemodialysis.

In a multi-centre study by seven large renal units in the United Kingdom, the morbidity and mortality of all patients starting CAPD and haemodialysis during a 2-year period (1983-1984) has been monitored prospectively and related to reasons for choice of therapy and potential risk factors. Over this period 338 new patients (mean age 48; range 3-77 years) started CAPD; 17% had diabetes mellitus and 25% had cerebro/cardiovascular disease. One hundred and seventy-five patients (mean age 45; range 5-73 years) started haemodialysis; 6% had diabetes mellitus and 14% had cerebro/cardiovascular disease. The Kaplan-Meier actuarial patient survival estimates at 2 years were haemodialysis 84% and CAPD 83%, whilst technique survival figures for the same period were haemodialysis 92% and CAPD 80%. Cox's regression analysis showed that cerebro/cardiovascular disease and age greater than 60 years were most important predictors for survival in CAPD patients, in whom smoking appeared to be a significant risk factor, for permanent change of therapy to haemodialysis. The major cause of 'drop out' in both groups was transplantation, whilst hospitalisation was 14.9 days per patient year for CAPD and 12.8 for haemodialysis patients. Within the CAPD group a temporary change to haemodialysis (less than 2 months) occurred on 106 occasions (each of mean of 19 days duration), amounting to 10 days per patient year of therapy. CAPD was used twice as often as haemodialysis for managing new patients. After 2 years hospitalisation technique and patient survival were comparable in the two groups, with cerebro/cardiovascular disease, age, and smoking being significant predictors of outcome.

Adolescent↗
PubMed1986

Serum apolipoproteins AI and B and lipoproteins in middle aged men with and without previous myocardial infarction.

The serum high density lipoprotein (HDL) subfractions, HDL2, and HDL3, and serum apolipoprotein AI and B (apo AI and B) were evaluated as potential indicators of the risk of ischaemic heart disease in men aged less than 60 years who had previously had a myocardial infarction and in controls with a similar socioeconomic background who had no history of myocardial ischaemia. Discriminant analysis confirmed that the combination of serum cholesterol, triglycerides, and total HDL cholesterol distinguished poorly between patients and controls. The best single discriminating variable was apo B. Stepwise discriminant analysis showed that this discrimination could be improved to a small extent by combining apo B with apo AI and parental history, but nothing was gained by measurement of serum cholesterol triglycerides, very low density lipoprotein cholesterol, low density lipoprotein cholesterol, HDL cholesterol, HDL2 or HDL3 cholesterol. Significantly more patients than controls with type IV hyperlipoproteinaemia had raised concentrations of serum apolipoprotein B, but the frequency of raised apolipoprotein B concentrations was no greater in patients with type IV hyperlipoproteinaemia than in those with normal serum lipids. The value of apo B as an indicator of cardiovascular risk should be assessed in prospective studies.

Apolipoprotein A-I↗
PubMed1982

Natural history of smouldering leukaemia.

The natural history of 45 cases of smouldering leukaemia has been studied. Males and females were equally represented, with a median age of 60.5. The median survival of the whole group was only 20 months, but rare cases lived 10 years or longer. 38% developed acute leukaemia; the remainder usually died of the results of marrow failure. Although it was possible to divide these marrow dysplasias morphologically into 3 major subgroups (refractory anaemia with excess of myeloblasts, chronic myelomonocytic leukaemia and chronic erythraemic myelosis), several displayed transitional features. Many showed refractory macrocytosis at diagnosis. The survival of the 3 groups was similar, though patients with high monocyte counts tended to present with less anaemia and fared rather better than the others. Statistical analysis suggests that increasing age, severe anaemia, thrombocytopenia and hepatomegaly are associated with a poor prognosis. Chemotherapy, when attempted, was usually unsuccessful.

Adult↗