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Biomedical subjects

L J Taylor

Publications and source records attributed to L J Taylor.

At least 37 records · Page 2Linked to original sources
PubMed1993

A clinical trial of prostaglandin E2 in recurrent aphthous ulceration.

Thirty-five patients suffering from minor recurrent aphthous ulceration (RAU) entered a single-phase double-blind clinical trial of treatment with topical prostaglandin E2 (PGE2). The PGE2 was applied as a gel at a dose of 0.3 mg twice daily for 10 days. The vehicle alone acted as control. Patients were examined on days 1, 3, 5, 7 and 10 and also maintained daily diary cards. Of the 33 patients (94%) who completed the study, 18 had been allocated the active PGE2 and 15 the placebo. The two volunteers who failed to complete were excluded on technical grounds related to the strict study design and did not withdraw on the basis of adverse reactions to the trial preparation. Patients using the active PGE2 gel experienced significantly fewer new lesions than those on placebo (P < 0.05) over the 10-day trial period. There were no significant differences between the PGE2 and placebo gels in terms of speed of healing or pain relief of established aphthous ulcers. Prostaglandin E2 may, therefore, have useful prophylactic activity in RAU.

Administration, Topical↗
PubMed1993

Rheological basis of oral characteristics of fluid and semi-solid foods: a review.

Oral viscosity plays an important role in the textural appreciation of fluid and semi-solid foods. Oral assessments of viscosity, thickness, stickiness and sliminess correlate with both small-deformation and large-deformation rheological measurements. Small-deformation measurements of viscosity at an oscillatory frequency of 50 rad.s-1 have the highest correlation with assessed thickness of texture but there is still much speculation as to what forces actually operate in the mouth.

Drinking↗
PubMed1993

An evaluation of surveillance methods for detecting infections in hospital inpatients.

Eight selective surveillance methods were compared with a reference method for their ability to detect hospital infections in patients was also assessed. In the reference method, case records were reviewed three times a week, and during the 11-month period of study, 668 infections were identified amongst 3326 patients. Three hundred and thirty-eight were community acquired infections (CAI) and 330 were hospital acquired infections (HAI). The time for data collection was 18.1 h per 100 beds per week. Of the selective surveillance methods, those based on the review of treatment and temperature charts detected the highest proportion (70%) of CAI; and the review of microbiology reports with regular ward liaison identified the highest proportion (71%) of HAI. The time for data collection in the eight methods ranged from 1.2 h per 100 beds per week to 6.5 h per 100 beds per week. After considering the sensitivity for identifying patients with HAI and time for data collection, the review of microbiology reports with regular ward liaison was judged to be an effective and efficient method of surveillance.

Cross Infection↗
PubMed1993

Introduction of laboratory based ward liaison surveillance of hospital infection into six district general hospitals.

A previous study demonstrated that laboratory based ward liaison surveillance (LBWLS) of hospital infection was an effective and efficient method. The method involved the follow-up of positive microbiology reports by the review of patient records and liaison with ward nursing staff to consider whether any patients had infection. Here we report the introduction of LBWLS into six district general hospitals to determine whether it is feasible to use this method on an everyday basis. The time required for data collection was assessed and the method was compared with a reference method in one hospital to check its ability to detect infections. To assess reproducibility two infection control nurses (ICNs) performed LBWLS independently, but concurrently, for 5 weeks. The method could be used in all hospitals studied; however, the time for data collection ranged from 3.0 to 6.8 h/100 beds per week. In comparison with the reference method, LBWLS detected 15/41 (37%) of community acquired infections and 30/43 (70%) of hospital acquired infections. In the reproducibility assessment 72 patients were identified by both ICNs. There was agreement about the infected/non-infected status of 65 of these patients. The mean pair agreement and Kappa statistic were 0.88 and 0.72. Laboratory based ward liaison was readily used in all hospitals and was reproducible.

Adolescent↗
PubMed1992

An 11-month incidence study of infections in wards of a district general hospital.

Between March 1988 and January 1989, an incidence study of infections in patients occupying 122 beds in a district general hospital was undertaken. Nursing notes, medical notes, temperature charts, drug prescription charts and laboratory information were reviewed three times a week to determine if patients had infection which met strict case definitions. In addition, the surveyor consulted with ward nursing and medical staff for clarification of symptoms and signs indicative of infection. During the study, 668 infections were identified amongst 3326 patients. Three hundred and thirty-eight (51%) were community-acquired infections (CAI) and 330 hospital-acquired infections (HAI). Excluding 24 HAI acquired in other hospitals, the incidence rates were 9.2 HAI per 100 discharges, and 1.1 HAI per 100 patient days. The common types of CAI were pneumonia, abdominal infection and urinary tract infection. The main types of HAI were urinary tract infection, surgical wound infection and pneumonia. The microorganisms most frequently associated with CAI and HAI were Gram-negative bacilli.

Adolescent↗
PubMed1992

Increased production of tumour necrosis factor by peripheral blood leukocytes in patients with recurrent oral aphthous ulceration.

Much evidence suggests that recurrent oral aphthous ulceration (RAU) is an immunologically mediated disease. Tumour necrosis factor has multiple biologic properties, some of which may be relevant to the pathogenesis of RAU. This study has assessed its production by peripheral blood leukocytes from aphthous patients in active and remission phases of disease and from patients with nonaphthous ulceration (diseased controls). Each ulcer patient was studied in parallel with a matched healthy control volunteer. A bioassay against the standard mouse fibrosarcoma line, L929, was used to assess the levels of tumour necrosis factor-alpha (TNF). Significantly greater amounts of TNF were released from unstimulated monocyte-enriched and monocyte-depleted leukocyte fractions in active RAU compared with those from healthy control donors, suggesting that this cytokine may be associated with RAU.

Adolescent↗
PubMed1992

A double blind placebo controlled trial of recombinant tissue plasminogen activator in the treatment of digital ischemia in systemic sclerosis.

The treatment of digital ischemia in systemic sclerosis remains inadequate. We report a double blind, placebo controlled trial of recombinant tissue plasminogen activator (rtPA), a potent thrombolytic agent. Ten patients received rtPA. A potent, acute fibrinolytic effect was observed. During the infusion of rtPA, improvements in skin blood flow were seen. These improvements were shortlived.

Adolescent↗
PubMed1989

Skin blood flow and limited joint mobility in insulin-dependent diabetes mellitus.

Hand skin blood flow in 32 insulin-dependent (IDDM) diabetics was compared with 13 healthy controls at room temperature and after immersion of the hands in warm and cold water. Subjects were examined for limited joint mobility (LJM) to analyse the association between this and blood flow. Digital arteries remained patent in IDDM compared to controls after cold challenge (p = 0.0001), and the difference persisted to a lesser degree 15 min (p = 0.009) and 30 min (p = 0.03) after recovery. Capillary blood flow was reduced in IDDM at room temperature at the finger nailbeds (p less than 0.02) and the palms (p = 0.004) and remained so after warm water immersion in the palms (p = 0.002), where further vasoconstriction was observed immediately after cold water immersion (p less than 0.001) and 15 and 30 min into recovery (p = 0.07 and p = 0.009 respectively). Thermographic analysis confirmed a pattern of predominantly distal rewarming after cold challenge in IDDM with a greater mean index finger temperature than the controls. Together, these features suggested enhanced arteriovenous anastomotic blood flow. All IDDM and IDDM males with LJM had reduced palm capillary flow immediately after cold challenge (p less than 0.05). After warm water (p less than 0.03) and 30 min after cold challenge (p less than 0.05) IDDM males with LJM had reduced palm capillary flow compared to those IDDM without. A microvascular aetiology for LJM is proposed by virtue of reduced nutritional blood flow and evidence of enhanced arteriovenous shunting in the hands of insulin-dependent diabetics.

Adolescent↗
PubMed1988

Irreducible dislocation of the subtalar joint: a report of two cases.

Two patients with irreducible lateral dislocation of the subtalar joint are reported. In both patients the injury was closed and associated with a lateral calcaneal fracture. Open reduction confirmed the tendon of tibialis posterior was located around the lateral aspect of the neck of the talus and prevented reduction.

Adolescent↗
PubMed1988

Stress and anxiety in the disabled patient.

This article focuses on patients' feelings of anxiety and fear and the relationship of these feelings to stress. A model is described that identifies four steps in the perception of environmental stress and the emotional responses to it. A second model describes the stages of responses to stress. Both models are applied to the patient experience, and suggestions are offered for basic facilitative physical therapist behaviors. A strong request is made for physical therapists to observe the affective behavior of patients, perceive it in the context of stress, and respond effectively.

Anxiety↗
PubMed1988

Altered hand skin blood flow in type 1 (insulin-dependent) diabetes mellitus.

Disturbed upper limb skin blood flow has been described in insulin-dependent (Type 1) diabetes mellitus, but the pathophysiological mechanism remains unclear. Hand skin blood flow was therefore measured at room temperature and following immersion of hands in cold and warm water in 13 healthy control subjects, in 10 patients with Type 1 diabetes mellitus and cardiovascular autonomic neuropathy, and a further 10 Type 1 diabetic patients with normal cardiovascular autonomic tone. Following cold challenge there was failure of digital artery clampdown in all diabetic patients in comparison with healthy control subjects (p less than 0.005), and the index finger temperature fell less (p less than 0.05). Laser Doppler flow was reduced at the palms at room temperature or following the warm challenge (p less than 0.008), as well as on the dorsum at room temperature (p less than 0.05), in all diabetic patients. In addition laser Doppler flow in the diabetic patients was reduced at the palms and dorsum immediately following cold water challenge (p less than 0.004) and this reduction persisted 15 min (p less than 0.05) and 30 min (p less than 0.01) into the recovery phase. In comparison to those diabetic patients with normal cardiovascular tone, those with cardiovascular autonomic neuropathy had reduced laser Doppler flow at the pulp 15 min after cold water immersion (p less than 0.05), at the nailbed immediately after cold water immersion (p less than 0.01), and at the palms immediately after warm water challenge (p less than 0.01).

Adult↗
PubMed1988

Undocumented Mexican immigrants and the earnings of other workers in the United States.

This article examines the effects of undocumented Mexican immigrants on the earnings of other workers in geographical labor markets in the Southwest. The number of undocumented Mexicans included in the 1980 census in southwestern SMSAs is estimated. We then estimate the parameters of three specifications of a generalized Leontief production function with various demographic groups as substitutable factors. The statistically significant effects of undocumented Mexicans on the earnings of other groups are positive, but of slight magnitude. Legal immigrants' effects on native white earnings, however, are small and negative. The results are consistent with the possibility that undocumented Mexican immigrants' jobs complement those of other workers. The implications for public policy concerns about the effects of illegal Mexican immigration are discussed.

Economic Competition↗
PubMed1987

Acute effects of sublingual nifedipine in patients with Raynaud's phenomenon.

Measurements of peripheral blood flow using bolometry, thermography, ultrasonic Doppler index, and laser light scattering were made in nine patients with primary Raynaud's phenomenon before and after administration of 20 mg sublingual nifedipine and matching placebo. Following nifedipine treatment, there was some evidence of protection against reduction in blood flow, suggesting that this way of taking nifedipine is helpful. Self-administration of sublingual nifedipine before cold exposure may be an effective way of preventing the development of attacks of Raynaud's phenomenon in contrast with the conventional form of regular oral administration.

Administration, Oral↗
PubMed1987

Musculoaponeurotic fibromatosis. A report of 28 cases and review of the literature.

Although musculoaponeurotic fibromatosis (MAF) is a well-recognized entity, it still provides a histologic diagnostic enigma, particularly in its distinction from a well-differentiated fibrosarcoma. The lesion is histologically identical to a desmoid tumor. The lesion appears as a firm swelling in a limb or limb girdle, with a rare incidence of pain. Although it is more common in the second to fourth decades (premenopausal women predominantly), it does occur in children. The sex incidence in children is equal. A multicentric pattern of behavior may be evident. The mainstay of treatment has been surgical excision of varying extent. Local excision, even if radical, may be followed by up to a 65% recurrence rate. In this review, 40% of the cases had more than one recurrence. Recent evidence suggests radiotherapy, which has been reserved for inoperable lesions, may be of value as an adjunct to primary treatment. Limited local excision with adjunctive radiotherapy may decrease recurrence rate, minimize functional deficit, and improve cosmesis. Radical local resection (compartmental or amputation) may be avoidable. In children, amputation may not result in cure because of the multicentric behavior pattern and radiotherapy may lead to growth retardation. A shorter functional upper or lower limb is preferable to an amputation stump or a limb disfigured from radical excision.

Adolescent↗
PubMed1987

Severe spondylolisthesis and scoliosis in association with Marfan's syndrome. Case report and review of the literature.

Scoliosis in Marfan's syndrome may be painful, but severe spondylolisthesis with a cauda equina tension syndrome as the cause of pain has only recently been recognized. Scoliosis may be associated with spondylolisthesis. The scoliosis may be sciatic or structural. These may be true structural curves or secondary to the asymmetric slip of the spondylolithesis. Grade 4 spondylolithesis was treated with an in situ ala-transverse fusion combined with posterior decompression. The tension signs were rapidly dissipated. A plaster spica was applied for six months. Solid fusion was achieved without progression of spondylolisthesis or further rotation. Subsequently, the structural scoliosis was treated with a two-stage anterior release and posterior Harrington fusion. The progression of spondylolisthesis in Marfan syndrome may be related to the poor quality of the surrounding musculoligamentous structures. Sciatic scoliosis resolves after fusion of the spondylolithesis. The results of in situ fusion are satisfactory. Reduction of the spondylolithesis with combined anterior and posterior fusion offers the most satisfactory basis for subsequent treatment of a structural scoliosis but carries a significant risk of neurologic damage and recurrence of slip.

Child↗