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Biomedical subjects

R F Harvey

Publications and source records attributed to R F Harvey.

At least 55 records · Page 3Linked to original sources
PubMed1982

Antidiarrhoeal agents. Clinical pharmacology and therapeutic use.

Diarrhoea is common and may be disabling, and in developed countries is responsible for more days lost from work than more socially acceptable conditions such as heart disease. Acute diarrhoea in the form of infantile gastroenteritis contributes to the deaths of more children than any other single condition in the world. This review describes the pathophysiological mechanisms and the treatments available for the more common types of diarrhoea in developed countries. Proper treatment depends on an understanding of the underlying pathological abnormality.

Acute Disease↗
PubMed1982

Cannabis effect on spasticity in spinal cord injury.

A study was done to examine the perceived effects of cannabis on spasticity of spinal cord injured persons. Data compiled from 43 questionnaires of spinal cord injured persons suggested the following: 1) spinal cord injured persons reported decreased spasticity with marijuana use; 2) present use of marijuana correlated positively with past use; and 3) the person's reference or peer group contributed significantly to current use. The study suggests the need to examine the relationship between measurable and reported changes in spasticity.

Adult↗
PubMed1982

Vocational/educational services in a medical rehabilitation facility: outcomes in spinal cord and brain injured patients.

Records of 86 patients were reviewed to study whether adding on-site professional vocational/educational staff to a multidisciplinary medical rehabilitation program made an impact on vocational/educational outcomes in patients with spinal cord and brain injuries. Differences in such outcomes between the 2 patient groups were also explored. Patients who participated in an inpatient program prior to the addition of on-site vocational/educational staff were compared to those who participated after professional staff were added. Vocational/educational placement rates increased from 19% or lower to as high as 78% in cases where vocational/educational services were appropriate.

Adolescent↗
PubMed1982

Functional abilities and distress levels in brain injured patients at long-term follow-up.

An investigative long-term follow-up study of brain injured individuals who had been inpatients in an interdisciplinary rehabilitation program was conducted by means of a mailed questionnaire. Level of distress, gauged by the Brief Symptom Inventory (BSI), was compared to the level of functional abilities as determined by a shortened self-report version of the Patient Evaluation Conference System (PECS). Functional skills compared included self-care, mobility, living arrangements, communication, recreation/leisure, and education/employment. Significant negative relationships of distress levels to independence in self-care, mobility, living arrangements, and communication were found.

Activities of Daily Living↗
PubMed1982

Catecholamine metabolites in spinal cord injury.

Previous reports of catecholamine metabolism in spinal cord injury (SCI) have found elevated levels of urinary norepinephrine metabolites. These data have been cited as evidence of a sustained increase in peripheral norepinephrine activity in this population. A study was designed to test this hypothesis and to control for the effect of affective disorders on catecholamine metabolism. Determinations were made of the level of urinary 3-methoxy-4-hydroxyphenylethylglycol (MHPG) and vanillylmandelic acid (VMA) in 30 patients with SCI. Urinary MHPG and VMA were not significantly higher than normal in the total sample. However, in spastic quadriplegia, urinary MHPG was lower than normal, and a calculated VMA:MHPG ratio was higher than normal in complete quadriplegia and spastic quadriplegia. This high ratio was due primarily to decreased MHPG. The authors suggest that these changes are due to decreased norepinephrine turnover in the damaged SC and that a VMA:MHPG ratio is the most useful measure of norepinephrine activity in SCI.

Adolescent↗
PubMed1982

Oxygen saturation during sleep in patients with spinal cord injury.

Sleep is associated with moderate or severe arterial desaturation in many disease states. This study was undertaken to evaluate whether hypoxemia during sleep was a significant problem in the spinal cord injured patient. Eleven patients with cervical or thoracic cord injury who had significant respiratory deficiency were evaluated. The mean age was 29.2 +/- 14. Vital capacity (VC) for the group revealed a mean of 43.1 +/- 18.1% of predicted, inspiratory capacity (IC) was 51.6 +/- 20.2% of predicted, and expiratory reserve volume (ERV) was 23.6 +/- 24.7% of predicted. In eight patients blood gases revealed a mean PO2 of 81.5 +/- 8.4 mmHg and PCO2 of 38.9 +/- 3.4 mmHg. Sleep screening studies were done using the Hewlett-Packard ear oximeter. They were studied for a mean of 2.6 +/- 1.1 hours. The initial O2 saturation was 96.6 +/- 1.6% and dropped to a mean of 90.6 +/- 6.4%. Only 1/11 reached saturation to less than 85% and 2/11 reached levels lower than 90%. Only age was significantly correlated with amount of desaturation (p less than .01). The level of the lesion, and % predicted ERV were not. One of the two patients who had hypoxemia with sleep had unilateral diaphragmatic paralysis. It is concluded that young quadriplegic patients with normal diaphragmatic function have no severe desaturation during sleep, but older patients and patients with some diaphragmatic dysfunction should be screened for sleep desaturation.

Adolescent↗
PubMed1981

Psychiatric disorders in patients with spinal cord injuries.

Although previous studies have reported that all patients with spinal cord injuries experience depression, they have not distinguished between despondency and depressive disorder. Of 30 patients with spinal cord lesions and depressive disorders diagnosed using the Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria (RDC). 15 patients had RDC diagnoses before or after their injury. A depressive disorder developed in nine after injury. Eight depressive disorders developed within a month of the injury. Postinjury depressive disorders were more common in patients with complete spinal cord lesions but were divided equally between paraplegics and quadriplegics. Only one patient received antidepressants. The remainder recovered without treatment other than the rehabilitation program. The accident causing the injury seemed related to a psychiatric disorder before injury in six patients (four alcoholics and two hypomanics) and to drinking before the accident in 15 patients.

Accidents↗
PubMed1981

Depression in spinal cord injured patients.

Many regard depression as an inevitable psychological sequela of spinal cord injury. This assumption, if inaccurate, may confound the rehabilitation process. We evaluated 22 patients with recent spinal cord injuries (less than 6 months), using a standardised interview and diagnostic process. Five patients (22 per cent) had diagnosable depressions after their injury. This is higher than the incidence of depression in the general population, but less than anticipated.

Adolescent↗
PubMed1981

Use of fluorescence microscopy for monitoring periodontal disease state.

Samples of subgingival plaque from patients with periodontal disease and control subjects were stained with the Fluoretec Fluorescent test kits (Pfizer Inc., New York) developed for the rapid detection of members of the Bacteroides fragilis and B. melaninogenicus groups of anaerobes. The same fluorescent fields were also examined by dark-field microscopy for the total count of bacteria. Bacteroides fragilis and B. melaninogenicus were found in plaque samples of healthy subjects and periodontally diseased patients with no significant difference in percent of total flora. Oral spirochetes also fluoresced with the antisera used. Samples from healthy sites showed virtually no spirochetes; spirochetes were present in diseased sites. Tests with other antisera also showed that fluorescein-labelled antibodies can be adsorbed nonspecifically to the surface of spirochetes. Such a phenomenon can be used to monitor an individual's periodontal disease state.

Bacteroides↗
PubMed1981

Effect of coffee on human lower oesophageal function.

The effect of coffee on lower oesophageal sphincter pressure (LOSP) and intraoesophageal pH was assessed in 10 healthy volunteers, in the fasting state and after a standard Lundh test meal. LOSP was measured by the rapid pull-through technique. Coffee with or without milk has no significant effect on LOSP in the fasting subject. The Lundh meal alone (mean drop = 2.01 cm H2O), or when coffee with (mean drop = 1.80 cm H2O) or without milk (mean drop = 3.47 cm H2O) was taken after it, produced a significant drop in LOSP. Heartburn following coffee does not appear to be due to an effect of coffee on the lower oesophageal sphincter but is more likely due to the effect of a previous meal on sphincter pressure with associated acid reflux.

Adult↗
PubMed1981

Pain management: long-term follow-up of an inpatient program.

To determine maintenance of lifestyle changes following completion of an inpatient behavioral pain management program, 40 patients were followed up by questionnaire 6 months to 3 years after program completion, with the majority contacted at least 18 months postdischarge. Thirty-two patients completed some portion of the questionnaire. Responders were similar to nonresponders in age, sex, chronicity of pain on admission, and time since discharge. Responses to specific items indicated that patients had increased activity level and employment and had decreased use of pain-related medications. A global measure of success was based on 3 criteria: (1) reported nonuse of narcotic analgesics, muscle relaxants and tranquilizers; (2) status as employed, in training, or running a household or continuation of 50% to 100% of exercises and reported increased recreational activities; and (3) no reported increase in pain. Of the patients providing adequate data for application of these criteria, 37% met all 3 standards at follow-up. Such a multivariate criterion is recommended for assessment of multidisciplinary pain programs. More frequently practices behaviors (ie, nonuse of medications, exercises) appeared better maintained. Thus, increased behavioral practice, particularly in vocational and recreational activities, is recommended.

Activities of Daily Living↗