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Biomedical subjects

P Harvey

Publications and source records attributed to P Harvey.

At least 73 records · Page 4Linked to original sources
PubMed1993

Ocular sequelae in premature infants.

OBJECTIVE: The authors report on the incidence of myopia and strabismus at 12 and 24 months postterm in a cohort of 190 premature infants with birth weights of less than 1251 g born in 1986 and 1987. METHODS: The neonatal and follow-up eye charts of a cohort of 190 premature infants were retrospectively reviewed. All 138 children who survived the neonatal period had at least one eye examination between day 28 and 42 of life that documented the presence and staging of retinopathy of prematurity (ROP) according to the International Classification of ROP. No infants received cryotherapy. Eye examinations conducted at 12 and 24 months postterm included assessment of vision, fundus, ocular motility, anterior segment abnormality, and refractive error. Eyes were refracted using cycloplegic retinoscopy. Strabismus was detected using the Hirschberg and cover tests. Eye reports were available for 80% (n = 110) at 12 months and 36% (n = 50) at 24 months. RESULTS: Fifty-three percent of the cohort exhibited ROP in the neonatal period; 12% of these progressed to stage 3 or 4 ROP. Myopia was observed in 16% (18/110) of the cohort at 12 months of age; 4.5% (5/110) measured more than 4.0 diopters of myopia. Children with birth weights of less than 751 g were 3.2 times more likely than those with birth weights between 751 and 1000 g and 10 times more likely than those with birth weights between 1001 and 1250 g to develop myopia in the first year of life. The likelihood of myopia at 12 months doubled with each increment in ROP stage. Of the 50 children reexamined at 24 months postterm, more than 80% demonstrated deteriorating vision. The incidence of myopia increased to 38% (19/50) overall, with 24% (12/50) of the cohort showing severe myopia. Astigmatism and anisometropia were highly correlated with severe myopia. Strabismus was seen with increasing frequency through the second year of life. All children with grade III or IV intraventricular hemorrhage in the neonatal period developed esotropia. CONCLUSION: This study emphasizes the significant roles of low birth weight, ROP, and intraventricular hemorrhage in the development of myopia and strabismus. Follow-up to 2 years of life is recommended given the demonstrated deterioration in our cohort.

Anisometropia↗
PubMed1992

Noradrenergic responses to clonidine in acute and remitted depressed male patients.

To investigate noradrenergic function in depression, plasma 3-methoxy-4-hydroxyphenylglycol (MHPG), plasma norepinephrine (NE), mean arterial pressure (MAP), and heart rate responses to intravenous clonidine (2 micrograms/kg), an alpha 2-adrenergic agonist, were measured in 27 acutely depressed patients, 18 remitted depressed patients, and 27 normal control subjects; a placebo infusion was administered to a subgroup. Clonidine compared with placebo, over a 150-minute time course, decreased plasma NE, MAP, and heart rate, but not plasma MHPG, in the control subjects. Plasma MHPG, plasma NE, MAP, and heart rate at baseline or in response to clonidine and placebo over 150 minutes did not indicate any group differences. The only significant plasma MHPG response to clonidine in the normal control subjects occurred 60 minutes after the infusion. A significantly diminished plasma MHPG response to clonidine at 60 minutes was found in the acutely depressed group compared with the normal control subjects. These results suggest that peripheral inhibitory noradrenergic responses to clonidine are normal in depressed patients, while plasma MHPG responses to clonidine, which have a limited central contribution, appear to be a weak reflection of central noradrenergic function and appear insufficiently robust for a meaningful evaluation of hypothetical group differences in central inhibitory alpha 2-adrenergic activity in this population.

Acute Disease↗
PubMed1992

Adoption of research-based practice for treatment of pressure ulcers in long-term care.

Implementation of a clinical trial to evaluate the effectiveness of electrotherapy on pressure ulcer healing provided the stimulus for adoption of research-based innovations for pressure ulcer treatment in one long-term care facility. A five-year retrospective study conducted prior to introduction of the clinical trial revealed that 72 different treatments were applied to pressure ulcers. Forty-two percent of the pressure ulcers were left open to the air or covered with a dry gauze dressing and 64% were treated with some type of antiseptic solution. Since implementation of the clinical trial and the accompanying access to wound healing research knowledge it provided in this setting, the prevailing treatment for pressure ulcers has become moist physiologic dressings.

Adult↗
PubMed1991

[Cancer of the ovary after cancer of the breast. 45 cases].

Forty-five patients who had primary cancer of the breast had a laparotomy when a second cancer appeared in the ovaries. There were no other peritoneal metastases to suggest that it was disseminated breast cancer. Twenty-eight had primary ovarian cancer and 17 metastases from breast cancer. The study comparing the two groups shows that: there are few clinical or paraclinical features that make it possible to arrive at a differential diagnosis; ovarian metastases occurring in patients who have primary breast cancer carry a more serious prognosis; if the cancer is a primary ovarian cancer (and not a secondary) the chances of survival are less poor; in primary ovarian cancer the results justify our attitude for carrying out surgery; screening systematically for ovarian involvement by using CA 125 or by routine ultrasound does not seem to us to be effective.

Adult↗
PubMed1991

Effect of vitrectomy on the ocular distribution of gentamicin in the rabbit.

To determine whether vitrectomy affects the ocular distribution of intravitreally injected gentamicin sulfate, 25 pigmented rabbits received an intravitreal injection of gentamicin (control group), and 25 other pigmented rabbits underwent pars plana vitrectomy followed by an intravitreal injection of gentamicin (experimental group). The animals were killed in groups of five 1, 3, 6, 12 and 24 hours after the injection. The mean retinal gentamicin levels 1 and 3 hours after the injection were significantly higher in the experimental group than in the control group (p less than 0.01). The mean gentamicin level in the aqueous humour was significantly lower in the experimental group than in the control group 1 hour (p less than 0.01), 6 hours (p less than 0.01) and 24 hours (p less than 0.001) after the injection. The mean corneal gentamicin level 24 hours after the injection was significantly lower in the experimental group than in the control group (p less than 0.05). There was no significant difference in mean choroidal gentamicin level between the two groups. We conclude that vitrectomy significantly affects the ocular distribution of gentamicin in the rabbit.

Animals↗
PubMed1991

The cost of treating pressure ulcers in a long-term care facility.

Although there is rising concern with the cost of pressure ulcer treatment, actual expenditures have not been quantified in many settings. A retrospective research design was used to describe the costs incurred by an 830-bed long-term care facility to treat 240 pressure ulcers over a five-year period. The total cost was $116,416 for the study period. The mean cost of treatment was $5.35/pressure ulcer/day. These costs are substantially lower than the costs of pressure ulcer treatment in acute care. Further study to compare treatment costs with prevention costs would provide useful information on the cost benefits of prevention.

Adult↗
PubMed1990

Foscarnet therapy of cytomegalovirus retinitis in AIDS.

Cytomegalovirus (CMV) retinitis is the most common cause of blindness in AIDS. Twenty patients were treated with a 21-day course of foscarnet therapy by continuous infusion. Response to therapy was good in eight (47%) of 17 evaluable patients; partial arrest of progression was observed in eight (47%); and no response was obtained in one (6%). Foscarnet therapy did not lead to suppression of urinary excretion of CMV in four of 12 patients who nonetheless had improvement in retinal lesions. Toxic effects, especially reversible renal failure, were common, with blood creatinine increase in 50% and dialysis in two patients. Renal toxicity occurred primarily during the third week of therapy. Anemia (hemoglobin less than 80 g/L) occurred in 10 patients after a mean of 14.5 +/- 5.1 days of therapy and required transfusion. Review of this study and of data from a previous case series, however, was inconclusive regarding the additional benefit of a third week of therapy. Maintenance therapy was given to seven patients. Four had recurrence of CMV retinitis at a mean interval of 62 +/- 52 days. Only one patient has maintained prolonged remission on maintenance (greater than 24 weeks). Toxicity on the maintenance protocol included anemia (two of seven patients) and increased creatinine blood levels (one of seven patients). Zidovudine therapy in six patients did not contribute to increased toxicity of induction or maintenance therapy. Drug levels during continuous infusion were stable for individual patients but showed wide inter-patient variability. Peak levels of post-maintenance infusion varied both within and between patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

A unifying parameter to describe the clinical mechanics of hydrogel contact lenses.

We studied the relation of postlens squeeze pressure to the clinical fit of hydrogel contact lenses. This relation was statistically significant (p less than 0.01) for a variety of contact lenses currently prescribed over a range of thickness, water content, back central optic radius, diameter, and back vertex power. The squeeze pressure provided a useful parameter to describe and compare the clinical fit of hydrogel contact lenses and a model with which the fit of a lens to an eye could be predicted. There was virtually no movement of the contact lenses across the eye when the squeeze pressure was more than -14 mm H2O (-1370 dynes/cm2). However, the mechanics of the lens motion when the squeeze pressure was less than this critical pressure appeared to be related to a more complicated combination of the squeeze pressure and the other forces in the eye-lens system.

Contact Lenses, Hydrophilic↗
PubMed1988

Lymphocyte subpopulation monitoring in cyclosporine-treated patients following heart transplantation.

Circulating lymphocyte subpopulations were studied in 18 consecutive patients treated with cyclosporine-prednisone immunosuppression during the first month following heart transplantation. Eleven patients showed no evidence of graft rejection. There were eight episodes of acute rejection demonstrated at endomyocardial biopsy in 7 patients. Three patients were treated with corticosteroids, 3 were treated with rabbit antithymocyte globulin (RATG), and 1 died before treatment (early mortality: 5.6%). Using the monoclonal antibody technique, 150 determinations of lymphocyte subpopulations were performed and were correlated with 72 endomyocardial biopsy specimens. Cyclosporine immunosuppression caused a significant (p less than 0.05) decrease in total lymphocyte count (38%) and in the number of OKT3 (52%) and OKT4 cells (55%). During acute rejection, total lymphocytes and OKT3, OKT4, and OKT8 cells all increased significantly, but the T4 to T8 ratio did not change significantly. Treatment of rejection with corticosteroids resulted in a moderate but not significant decrease in all T-cell types, whereas RATG caused a marked but not selective decrease in all T-cell groups. In conclusion, T cells decrease with cyclosporine immunosuppression and with treatment of rejection and increase at onset of rejection, but the T4 to T8 ratio has no predictive value for the diagnosis and severity of rejection, and the sensitivity of the method does not permit its use to assess the degree of immunosuppression with cyclosporine following heart transplantation.

Adolescent↗
PubMed1987

Extracorporeal shock wave lithotripsy: impact on a large diagnostic radiology department.

Extracorporeal shock wave lithotripsy is a new therapeutic technology that has received instant and widespread acceptance. The history and technical aspects of the procedure are presented, but most importantly, the authors discuss radiology's role and note the importance of management's awareness of the potential impact on departmental fiscal, equipment and personnel resources.

Hospital Bed Capacity, 500 and over↗
PubMed1987

Human serum albumin as a substitute for foetal calf serum in blast transformation assays and cytogenetic analyses.

Diverse factors in serum produce complex effects on lymphocytes. Indeed, when used as a protein supplement for lymphocyte culture, serum has many disadvantages. A need exists for media in which serum is replaced by purified active serum components. The in vitro effects of human serum albumin (HSA) were evaluated and compared with the widely used foetal calf serum (FCS). Unstimulated and mitogen-activated lymphocyte proliferation was measured by 3H-thymidine incorporation. Phytohaemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM) were used to transform the lymphocytes obtained from 36 healthy adults. Six concentrations of HSA, 0.5, 1, 2.5, 5, 10 and 20%, were studied. The last two concentrations produced an inhibition of lymphocyte proliferation. HSA, which was not itself mitogenic permitted a 4- to 5-fold higher transformation than 10% FCS. Maximum transformation occurred at HSA concentrations between 2.5 and 5% for PHA and PWM, and between 1 and 2.5% for Con A. In whole-blood lymphocyte cultures, the addition of 1% HSA gave a number of mitoses comparable to that obtained with the 10% FCS supplement. HSA is an interesting substitute for FCS: it is chemically well understood and standardized, species specific, readily available, relatively inexpensive, and has a long shelf life. HSA appears to be an excellent protein supplement for support of human lymphocyte proliferation in vitro, and can be recommended for routine use in lymphocyte cultures.

Adult↗
PubMed1986

Positive and negative symptoms in schizophrenia: attentional performance correlates.

Attentional impairment has been hypothesized to be associated with negative symptoms in schizophrenia. The present study examined the relation between attentional performance and positive and negative symptoms in both schizophrenic and manic patients. The results showed that deficits on the distraction conditions of a digit-span task were greatest in positive-symptom schizophrenics. Regression analyses revealed that only certain positive symptoms were related to digit-span scores; specifically, ratings of positive-thought disorder were inversely associated with performance for both schizophrenics and manics. The findings are discussed in light of their implications for conceptualizing the symptom categories and their laboratory correlates.

Attention↗
PubMed1986

[Human papillomaviruses in the epithelial cells of the cervix uteri: frequency of types 16 and 18. Preliminary results of a clinical, cytologic and viral study].

Between April 1 and June 30 1984, cervical scrapes were taken from 381 women attending the Gynecology Department of the Anticancer Center René-Huguenin. The scrapes were examined for the presence of human papillomavirus (HPV) DNA, by a molecular hybridization method, at the Pasteur Institute. The four HPV types involved in genital pathology, HPV 6, HPV 11, HPV 16 and HPV 18, were studied. Twenty four specimens (6.3%) were found positive: 19 for HPV 16, 3 for HPV 18, 2 for HPV 6 or HPV 11. Results of molecular hybridization were compared with cytological findings. HPV 6 or HPV 11 were detected in cases of mild dysplasia. HPV 16 or HPV 18 were mainly detected in cases diagnosed as severe dysplasia or carcinoma in situ (9 out of 14, i.e. 64.3%), and invasive carcinoma (3 out of 5 cases). The results were further confirmed when virological data obtained with cervical scrapes were compared with the histological diagnosis on biopsies: 14 out of 15 cases of severe dysplasia or carcinoma in situ (93%) and 3 out of 6 cases of invasive squamous carcinoma had been found positive for HPV 16 or HPV 18. Interestingly, four "normal" women (1.3%) with a negative cytology were found positive for HPV 16 or HPV 18. The data obtained by this sensitive and reliable method are useful to the clinician to identify women presenting a high risk of subsequent cervical intraepithelial neoplasia or invasive carcinoma, and, thus, to adapt the treatment and the follow-up of these patients.

Adult↗
PubMed1985

Effect of beta-blockers on psychomotor performance in normal volunteers.

The effects of beta-adrenergic receptor antagonists on psychometric tests including vehicle handling, choice reaction time, and kinetic visual acuity (KVA), are reviewed. The beta-blockers had little effect on the performance tests, with the unexplained but reproducible effect of enhanced KVA performance with atenolol. Although the beta-blockers had little effect on performance tests they were shown to have psychotropic effects in normal volunteers. The reasons for the conflicting evidence concerning the effect of these drugs on performance tests is discussed in relation to the present experiments and to variables that may influence response. It is concluded that one should use tests that are as independent as possible from potentially confounding variables. The use of evoked potentials in the electroencephalogram is one such test. A preliminary study is described in which the effects of beta-blockers were detected using visual evoked responses on the electroencephalogram.

Adolescent↗