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Biomedical subjects

R Walton

Publications and source records attributed to R Walton.

At least 73 records · Page 4Linked to original sources
PubMed1985

Functional assessment of ray transfer for central digital loss.

Nineteen patients who had ray transposition for central digital loss were evaluated retrospectively with regard to postoperative function and appearance. Pinch and grip recoveries were better in patients with small-to-ring finger transfers than in those with index-to-long finger transfers. Total average pinch recovery measured 83.3% of the nonoperated side. Total grip recovery was 80.2% of the nonoperated side. Average ranges of motion for all transferred digits were 77.6 degrees (metacarpophalangeal joint), 87.6 degrees (proximal interphalangeal joint), and 80.8 degrees (distal interphalangeal joint). Overall results judged by a five-component assessment scale were excellent.

Adolescent↗
PubMed1979

Metabolic studies during normoglycaemic clamping of insulin-dependent diabetics using a glucose-controlled insulin infusion system.

Metabolic rhythms have been studied in six insulin-dependent diabetics during subcutaneous insulin therapy, and during control of blood glucose concentration by a glucose-controlled insulin infusion system (GCIIS). In none of the subjects was blood glucose concentration consistently within the normal range during subcutaneous insulin therapy. In contrast, blood glucose concentration was within the normal range after 3.5 h of insulin delivery by the glucose-controlled insulin infusion system and remained in the normal range for the following 8 h through lunch and dinner. Mean blood glucose concentration during this time ranged from 5.31 to 7.90 mM. Following normalisation of blood glucose concentration, blood lactate and pyruvate were similar with both the GCIIS and subcutaneous insulin therapy. Post-prandial lactate peaks were delayed with the GCIIS. Alanine levels were consistently higher during control with the GCIIS compared with subcutaneous therapy, while blood ketone body and plasma NEFA levels were lower, and the premeal peaks in the lipid metabolites were delayed. It is not possible to conclude that attainment of normoglycaemia with the present generation of glucose-controlled insulin infusion systems in insulin-dependent diabetics is accompanied by total normalisation of intermediary metabolism.

Adult↗
PubMed1978

Blood intermediary metabolite and insulin concentrations after an overnight fast: reference ranges for adults, and interrelations.

Concentrations of several metabolites in deproteinized blood and plasma were determined in 100 subjects after an overnight fast, to establish reference ranges. Blood glycerol, nonesterified fatty acids, and ketone body concentrations and the 3-hydroxybutyrate/acetoacetate ratio increased with age while blood alanine concentrations delined. Serum insulin and blood alanine concentrations were also related to weight. No marked sex-related differences were found, although blood glycerol concentration was slightly higher in women. Distribution of all metabolite concentrations was positively skewed, except for glucose, but skewness could be corrected by logarithmic transformation. Skew was particularly marked for blood ketone body concentrations. Concentrations of all metabolites in plasma exceeded those in whole blood, but this was significant for only lactate and pyruvate when concentrations in plasma were compared with calculated concentrations in erythrocyte water.

Adult↗
PubMed1977

Nerve grafting in the repair of complicated peripheral nerve trauma.

Peripheral nerve trauma has been a challenge to surgeons, with significant advances in the surgery of repair occurring in major wars. The standard method of treatment involving wide mobilization and end-to-end suture to close traumatic gaps in peripheral nerves has not produced consistently acceptable results, particularly with large gaps. However, with the recent development of microsurgical techniques and instrumentation, the method of interfascicular nerve grafting has been applied to selected patients with trauma problems of the peripheral nerve, by resecting and autogenous nerve grafting at staggered levels to distribute scar formation, followed by plaster immobilization for 3 weeks. Ten patients are reported, with motor nerve recovery ranging from M2 to M4 and sensory recovery, S2-S4 (See Table I), based on Seddon's classification (11).

Adolescent↗
PubMedDate not supplied

Deep medical knowledge to design clinical guidelines.

Guideline-based care is becoming increasingly important given the surging costs and requirement for quality assessment of health care, and is likely to be a major application of knowledge-based technology into the health sector. Our preliminary experiences with implementing a paper-based guideline in a computer have shown problems that may prevent the dissemination and use by clinicians of the computer-based guideline. Based on these experiences, we propose that deep knowledge, often implicit in guidelines specification, is explicitly considered to provide more adequate support and thus promote its acceptability by clinicians.

Asthma↗
PubMedDate not supplied

The dopamine D2 receptor C32806T polymorphism (DRD2 Taq1A RFLP) exhibits no association with smoking behaviour in a healthy UK population.

A single nucleotide polymorphism (SNP) in the Taq1A site near the DRD2 gene has been associated in several studies with smoking behaviour. We genotyped 732 current smokers (241 low, one to nine cigarettes a day, 250 mid, 10-19 cigarettes, 241 high, 20+cigarettes) and 243 never-smokers at this site (C32806T), to test for effects on smoking initiation and amount of tobacco consumed. No significant association between minor allele frequency and smoking status was detected. Multiple regression analysis including DRD2 genotype, sex, age and alcohol consumption as predictors showed that level of cigarette consumption was associated with sex (p=0.003) and age (p=0.002) but not with alcohol consumption (p=0.25) or DRD2 genotype (p=0.76).

Adult↗
PubMedDate not supplied

Thrombopathies causing bleeding in a boxer and mixed-breed dog.

Hereditary platelet function disorders are clinically characterized by recurrent surface bleeding and prolonged bleeding time, despite normal platelet count and coagulation tests. The authors describe persistent thrombopathies in two young dogs with increased bleeding tendencies but with normal plasma coagulation times and von Willebrand factor (vWf) concentrations. Buccal mucosal bleeding times were prolonged in both dogs. In aggregation studies, platelets underwent only a shape change or minimal aggregation in response to adenosine diphosphate and collagen. Whole-platelet adenine nucleotide concentrations were normal. Electron microscopic evaluation of fibrinogen and vWf binding to the platelets of case no. 1 demonstrated the presence of glycoprotein IIb/IIIa and Ib receptors. Thus, the intrinsic platelet function defects may be different in these two dogs and may likely represent secretion/signal transduction disorders.

Animals↗
PubMedDate not supplied

Correlates of dysphoria in Canadian seniors: the Canadian Study of Health and Aging.

OBJECTIVE: To examine the correlates of dysphoria in elderly Canadians. METHOD: Randomly sampled elderly underwent screening in 1992 (CSHA-1) and in 1997 (CSHA-2). Community-living subjects without dementia at CSHA-1 were re-interviewed at CSHA-2 (n = 5234). A score < 53 on the mental health component of the Medical Outcomes Study Questionnaire (SF-36) was used to measure dysphoria. Sociodemographic, functional, social support, disease and lifestyle correlates of dysphoria were examined. RESULTS: 4.76% of men, and 8.59% of women were classified as dysphoric. The occurrence declined with age. In multivariate analyses, chronic pain, poor self-rated health, functional dependency and, in men only, being married, were significantly related to dysphoria. Perceived social support remained significant after controlling for sociodemographic, functional and disease variables. CONCLUSION: Dysphoria is common among the elderly, especially elderly women. Given the interrelationships and number of correlates of dysphoria, elderly Canadians require broad programs promoting health and social support as well as functional and economic independence.

Age Factors↗