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Biomedical subjects

R G Harper

Publications and source records attributed to R G Harper.

18 recordsLinked to original sources
PubMed1992

Psychotherapy: past training and current practice.

Our 1988 survey of Texas psychiatrists indicates that hospital work is more common, and long-term psychotherapy less common than it had been in the 1982 APA survey. Almost 85% reported long-term psychotherapy experience as residents. Thirty-nine percent reported multiple patients treated for approximately 2 years. Use of audio techniques by resident and teacher in the post-1970-trained group predicted current long-term therapy activity as did an experience of personal therapy and seeing a patient at least twice weekly in training. Concurrent drug use is widely reported for long-term psychotherapy patients and to a lesser degree in psychoanalysis. Our data suggest a shift to increased hospital work and decreased long-term psychotherapy.

Attitude of Health Personnel↗
PubMed1992

Comparison of two cognitive screening measures for efficacy in differentiating dementia from depression in a geriatric inpatient population.

The Folstein Mini-Mental State Examination (MMSE) and dementia screening measures developed by Benton (temporal orientation, oral word association, and visual reconstruction tasks) were compared for diagnostic efficacy with geriatric inpatients manifesting depression without dementia or mild or moderate dementias complicated by depression. Both instruments showed generally acceptable differentiation between dementia and depression-only cases overall. The MMSE was less sensitive in identifying mild and moderate multi-infarct dementias but showed better specificity than the Benton measures. The degree and type of dementia and the associated risk of classification error were found to be important factors in the choice of screening instruments.

Aged↗
PubMed1991

Observations on the postpartum shivering phenomenon.

Fifty healthy, nonmedicated, laboring women who had normal spontaneous vaginal deliveries were studied to determine the incidence, time of onset, severity, duration, temperature patterns and relationship of various perinatal factors to the postpartum shivering phenomenon. Axillary temperature was recorded on admission, before delivery, at delivery and every 15 minutes postpartum for 75 minutes. The degree and duration of shivering were quantified visually. The environmental temperature was recorded. Of the 50 women, 22 (44%) commenced shivering during delivery or up to 30 minutes postpartum. Shiverers and nonshiverers exhibited a reduction in the mean axillary temperature during labor, with a rise post-partum (P less than .002). The median axillary temperature of the shiverers at all time points was higher than that of the nonshiverers and was statistically significant 30 (P less than .01), 45 (P less than .003), 60 (P less than .004) and 75 minutes (P less than .001) after delivery. The shiverers tended to raise their postdelivery temperature somewhat later than did the nonshiverers. The temperature pattern of both shiverers and nonshiverers fell during labor, and the temperature pattern of the shiverers differed from that of the nonshiverers postpartum. The mean delivery room temperature for shiverers was lower than for nonshiverers (P less than .009), as was the mean recovery room temperature (P less than .03). Environmental temperature may play a heretofore unsuspected role in the postpartum shivering phenomenon.

Adult↗
PubMed1991

Blood pressure values in 500- to 750-gram birthweight infants in the first week of life.

The means and standard deviations for systolic, mean, and diastolic blood pressure were noted in the first week after delivery for 12 hemodynamically stable infants by a retrospective chart review. Blood pressure taken by means of an umbilical artery transducer or an oscillometer were not statistically different. All blood pressure values increased during the first week after birth. A trend was noted toward increasing blood pressure with increasing gestational age for the first week after birth. We conclude that the range of blood pressure in 500- to 750-g birthweight infants is extremely wide and that it may be necessary to use other clinical criteria in conjunction with blood pressure to determine which infants require intervention for hypotension.

Blood Pressure↗
PubMed1979

The response to an oral glucose load during convalescence from hypoxia in newborn infants.

The ability to tolerate an oral glucose load during convalescence from hypoxia was studied in four term and 11 premature appropriate-for-gestational-age infants by sequential measurements of the changes occurring in blood pH, bicarbonate, plasma lactic acid, and plasma glucose following an oral glucose load. All infants developed metabolic acidosis and lactic acidemia after the oral glucose load. The maximum fall in blood bicarbonate occurred at 30 minutes, and the maximum rise in plasma lactic acid concentration was attained at 60 minutes. The metabolic changes were found to be more severe in infants given the oral glucose load early in their convalescence and in those infants less than 10 days of age. The absorption of glucose was also decreased in these infants, as shown by a reduced rise in blood sugar. These observations indicate that newborn infants, term or premature, tolerate glucose loads poorly during convalescence from hypoxia.

Acidosis↗
PubMed1977

Maternal ingested methadone, body fluid methadone, and the neonatal withdrawal syndrome.

The relationship between the quantity of methadone ingested by the pregnant mother, the quantity of methadone in maternal and neonatal body fluids, and the subsequent neonatal withdrawal course was studied. The severity of the neonatal withdrawal syndrome was found to be related to the total dose of methadone ingested by the mother during the last 12 weeks of pregnancy (p less than 0.02), the maternal dose of methadone at delivery (p less than 0.01), and the intrapartum serum methadone levels (p less than 0.01). The cord blood levels of methadone were consistently lower than the maternal serum levels. Amniotic fluid methadone levels were not constantly related to maternal or neonatal serum methadone levels. Concentrations of methadone 10 to 60 times greater than that of cord blood were found in neonatal urine.

Amniotic Fluid↗
PubMed1977

The high-risk perinatal registry. A systematic approach for reducing perinatal mortality.

A systematic and comprehensive review of all 320 perinatal deaths occurring in Nassau County in 1973 reveals that one-quarter of these deaths might have been prevented if modalities of care that were known and available at that time had been utilized appropriately. Preventability--the presence or absence of avoidable factors which might have materially lessened the risk of death --was determined for each perinatal death. Preventable deaths were disproportionately higher among postmature (P less than .01) and large-for-gestational-age (P less than .05) perinatal deaths, neonatal deaths after the first day of life (P less than .05), intrapartum fetal deaths (P less than .01), and perinatal deaths secondary to anoxia and idiopathic respiratory distress syndrome (P less than .01). The study concludes that rigorous application of currently available medical knowledge, the establishment of local perinatal mortality review committees, and vigorous outreach to practitioners are urgently needed to bridge the time gap between the development of new modalities of care and their application.

Adult↗
PubMed1975

Rentrolental fibroplasia in a full-term infant.

A 3,800-g infant, born after 40 weeks' gestation, developed retrolental fibroplasia, documented by indirect ophthalmoscopy. Elevated arterial oxygen tensions may have occurred during brief treatment for two episodes of cyanosis.

Adult↗
PubMed1975

Electroconvulsive therapy and memory.

Recent research on the effects of electroconvulsive therapy (ECT) on memory is critically reviewed. Despite some inconsistent findings, unilateral nondominant ECT appears to affect verbal memory less than bilateral ECT. Adequate research on multiple monitored ECT is lacking. With few exceptions, the research methodologies for assessing memory have been inadequate. Many studies have confounded learning with retention, and only very recently has long term memory been adequately studied. Standardized assessment procedures for short term and long term memory are needed, in addition to more sophisticated assessment of memory processes, the duration of memory loss, and qualitative aspects of memories.

Amnesia↗
PubMed1975

Inguinal hernia: a common problem of premature infants weighing 1,000 grams or less at birth.

Thirty percent of 37 consecutive surviving premature infants weighing 1,000 gm or less at birth were noted to develop inguinal hernias. Incarceration occurred in two infants. One infant suffered a cardiac arrest during repair of the hernia. In view of the increased survival now being reported in these tiny prematures, it is important that physicians recognize the high incidence and potential hazards of this congenital anomaly in surviving premature infants weighing 1,000 gm or less at birth.

Birth Weight↗
PubMedDate not supplied

De Lange syndrome. Clinical, dermatoglyphic and chromosomal findings in nine cases.

Nine cases of the de Lange syndrome are reviewed. Our findings show that the facial characteristics in the present series and in previously reported cases are remarkably similar. Dermatoglyphically, we have documented an increased incidence of tibial loops on the hallucal area and increased incidence of single flexion creases of the digits from this study series. Our study also supports the previous authors who have recorded an increased incidence in radial loops on the second and third digits and increased incidence of simian lines. We have not been able to document a consistent chromosomal defect.

Child, Preschool↗