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Biomedical subjects

A Brown

Publications and source records attributed to A Brown.

At least 361 records · Page 20Linked to original sources
PubMed1991

The relationship between neuropsychological measures and self-care skills in patients with cerebrovascular lesions.

The present investigation examined the relationship between performance on the Michigan Neuropsychological Battery (MNB) and selected self-care skills in a group of patients with unilateral cerebrovascular lesions. Among MNB measures, left-sided somatosensory and motor functions were the best predictors of self-care skills, showing that in these stroke patients lower level cerebral functions mediated by the right hemisphere are more strongly related to the self-care skills examined than higher cerebral functions. Also, evidence that patients with cerebrovascular lesions in the left hemisphere performed better than patients with right hemisphere lesions in several self-care categories is further indication that right hemisphere processes have a special role to play in the mediation of these self-care activities. The research and clinical implications of these findings are noted.

Activities of Daily Living↗
PubMed1991

Acute pancreatitis: pathophysiology, nursing diagnoses, and collaborative problems.

Acute pancreatitis affects one per 10,000 people annually. Among the alcoholic population this number rises to one per 100. Etiologic factors are numerous, but the main causative agents are biliary tract disease and excessive alcohol intake. The exact mechanism of injury is unknown, but is believed to be either bile reflux into the pancreatic duct or stricture of the sphincter of Oddi. Through either of these pathways the pancreatic enzymes, normally inactive within the gland, are activated and begin digesting pancreatic tissue. Using the knowledge of major collaborative problems, nursing diagnoses, pathophysiology, appropriate assessment parameters, and nursing interventions discussed above, the nurse can develop an effective plan of care for managing the patient with acute pancreatitis.

Acute Disease↗
PubMed1991

Neuropsychological studies of blacks with cerebrovascular disorders: a preliminary investigation.

Very few studies have been conducted that examine brain behavior functions in blacks and other ethnic minorities. Recognizing that measures of higher cortical functions have cultural, experiential, and organic determinants, the present investigation was designed to ascertain whether findings reported in neuropsychologic studies of white patients with lateralized cerebral lesions are applicable to groups of black patients with lesions in similar locations. Thirty-seven patients with left (n = 15) and right (n = 22) cerebrovascular lesions were administered the Michigan Neuropsychological Battery (MNB). This battery is comprised of a number of objective standardized measures of higher and lower-level cerebral functions. With one exception, the performance of patients in the brain-injured groups was not systematically different on tests of higher brain functions. As expected, tests of lower-level somatosensory and motor functions showed a pattern of greater impairment on the side of the body contralateral to the lesion. But, in contrast to neuropsychological studies of white patients, a pattern of laterality specific deficits on verbal IQ and performance IQ was not observed. Methodological and theoretical implications of these findings are discussed.

Analysis of Variance↗
PubMed1991

Cardiac smokers: beliefs and values about smoking, and attitudes toward the risk of smoking to health.

Many cardiac patients continue to smoke, although this greatly increases their risk of health complications. This study explored cognitive and social factors which may discriminate between cardiac smokers who will be successful in quitting smoking and those who relapse to smoking following hospitalization for a myocardial infarction or coronary artery bypass graft surgery. Patients were interviewed prior to discharge from hospital and when they returned to clinic. Few patients were found to have resumed smoking when they returned to clinic. However, patients who had only recently quit smoking were found to be susceptible to relapse to smoking on the basis of their attitudes towards the risk of smoking to their health and the reduced social pressure from significant others not to smoke. Data suggested that nurses did not take full advantage of opportunities to influence cardiac patients about smoking.

Coronary Disease↗
PubMed1990

Type C Niemann-Pick disease: documentation of abnormal LDL processing in lymphocytes.

Type C Niemann-Pick disease (NPC) is an autosomal recessive neurovisceral storage disorder in which defective intracellular cholesterol processing has been demonstrated in fibroblasts from NPC patients and obligate heterozygotes. In the present paper, the ability to esterify LDL-cholesterol was examined in cultured lymphocytes from 8 NPC patients, 8 obligate heterozygotes and 8 controls. Cholesteryl ester synthesis was 8% (+/- 5%) and 45% (+/- 16%) of controls in homozygous and heterozygous cell lines, respectively. Histochemical and electron microscopic examinations confirmed that this biochemical lesion was associated with abnormal intracellular accumulation of unesterified cholesterol in mutant lymphocytes. These results demonstrate that measurement of cholesterol esterification in cultured lymphocytes offers a quick and reliable means of confirming the diagnosis of NPC and that these cells may be useful for probing the primary molecular lesion of NPC.

Cell Compartmentation↗
PubMed1990

Evaluation of the worth of corynebacterium parvum in conjunction with chemotherapy as adjuvant treatment for primary breast cancer. Eight-year results from the National Surgical Adjuvant Breast and Bowel Project B-10.

During the 1970s, information obtained from animal tumor models and from patients with a spectrum of solid tumors indicated the worth of a variety of immunostimulating agents. These findings provided a biological and clinical rationale for conducting randomized trials to evaluate the worth of those agents. Consequently, in May 1977 the National Surgical Adjuvant Breast and Bowel Project (NSABP) implemented a randomized trial to determine whether Corynebacterium parvum (C. parvum, CP) plus chemotherapy would be more effective than chemotherapy alone in prolonging the disease-free survival (DFS) and survival (S) of patients with primary operable breast cancer and positive axillary nodes. The results of that trial through 8 years of follow-up fail to indicate that treatment with CP used in conjunction with l-phenylalanine mustard (L-PAM) plus 5-fluorouracil (PF) results in a better DFS and S than that observed after chemotherapy alone. Use of the immunomodulator has instead resulted in a poorer, but not statistically significant, outcome. Despite adjustments made to account for any imbalance in distribution of prognostic factors between the two treatment groups and despite considering treatment compliance as a factor, the unfavorable outcome persisted. A high incidence of fever and chills was associated with the administration of CP. The administration of hydrocortisone before each CP treatment reduced the frequency of those and other systemic effects. The failure to demonstrate a benefit from CP is in keeping with the failure of other nonspecific stimulating agents to contribute to the creation of a new paradigm for the treatment of breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Risk of exposure of surgical personnel to patients' blood during surgery at San Francisco General Hospital.

We undertook an observational study of 1307 consecutive surgical procedures at San Francisco General Hospital to record descriptions of intraoperative exposures to blood and other body fluids, determine the factors predictive of these exposures, and identify interventions that might reduce their frequency. During a two-month period, circulating nurses took note of parenteral and cutaneous exposures to blood and recorded information about all procedures. In a follow-up validation study, 50 additional procedures were observed by the study investigators to determine the accuracy of the data collected by the nurses. A total of 960 gloves used by surgical personnel during the validation study were examined to determine the perforation rate. Accidental exposure to blood (parenteral or cutaneous) occurred during 84 procedures (6.4 percent; 95 percent confidence interval, 5.1 to 7.8 percent). Parenteral exposure occurred in 1.7 percent. The risk of exposure was highest when the procedures lasted more than three hours, when blood loss exceeded 300 ml, and when major vascular and intraabdominal gynecologic surgery was involved. Neither knowledge of diagnosed human immunodeficiency virus (HIV) infection nor awareness of a patient's high-risk status for such infection influenced the rate of exposure. Double gloving prevented perforations of the inner glove and cutaneous exposures of the hand. We conclude that all surgical personnel are at risk for intraoperative exposure to blood. Our data support the practice of double gloving and the increased use of water-proof garments and face shields to prevent mucocutaneous exposures to blood. No evidence was found to suggest that preoperative testing for HIV infection would reduce the frequency of accidental exposures to blood.

Accidents, Occupational↗
PubMed1990

Predictability of repeated challenge: effects on cardiovascular activity in the type A (coronary prone) behavior pattern.

Fifty-two healthy young adults classified either as Type A (coronary prone) or Type B were randomly assigned to a vigilance task during which observing responses produced targets according to either a predictable (i.e., fixed-interval 90-sec) or a nonpredictable (i.e., random-interval 90-sec) reinforcement schedule. During the task, blood volume pulse, interbeat interval, masseter (EMG) activity, and blood pressure were monitored. Transient peripheral vasomotor constriction and heart rate increases were initiated within an 8- to 12-sec period following target detection with the predictable schedule, with subjects evincing greater responsivity than their nonpredictable schedule counterparts. Type A subjects assigned to the random-schedule evinced significantly shorter heart rate and blood volume pulse response durations than did Type B subjects. Longer postevent EMG elevations were evidenced by subjects assigned to the predictable schedule. No significant blood pressure differences were found among the groups. The impact of challenge-contingent behavior on cardiovascular responsivity and the relevance of attentional processes to this relationship and to cardiovascular risk are discussed.

Adult↗
PubMed1990

Primary lymphoma of the mandible: report of a case.

A case involving primary lymphoma of the mandible is presented. The difficulties in diagnosis of this particular pathology are highlighted. The features of primary lymphoma of the mandible are described based on a review of the literature. Malignant lymphoma must be considered in the differential diagnosis of unexplained dental pain, swelling, ulceration, and radiographic evidence of rarefaction.

Humans↗
PubMed1990

The complete nucleotide sequence of enterovirus type 70: relationships with other members of the picornaviridae.

Enterovirus type 70 (EV70) is the causative agent of acute haemorrhagic conjunctivitis and may also give rise to a rare neurological complication closely resembling poliomyelitis. The complete nucleotide sequence of the genome of EV70 has been determined from cDNA cloned in Escherichia coli. The genome consists of a 5' non-coding region of 726 nucleotides (nt), a long open reading frame of 6582 nt and a 3' non-coding region of 82 nt prior to the poly(A) tract. Comparison of the nucleotide sequence and the predicted amino acid sequence of the polyprotein with those published for other enteroviruses reveals sufficiently high similarity to predict antigenic regions and polyprotein cleavage sites. The P1 region of EV70 is as similar to those of the entero- as to those of the rhinoviruses, whereas the P2 and P3 regions are more closely related to the coxsackie B and swine vesicular disease viruses than other entero- or rhinoviruses.

Amino Acid Sequence↗
PubMed1990

Chemotaxonomic differentiation of legionellae by detection and characterization of aminodideoxyhexoses and other unique sugars using gas chromatography-mass spectrometry.

Legionellae have been differentiated previously by analyzing their carbohydrate contents by gas chromatography with flame ionization detection. In the present study, total ion mode gas chromatography-mass spectrometry (GC-MS) was used to detect a number of unusual sugars, including one that is structurally related to O-methyldideoxyheptoses. Increased sensitivity and selectivity for carbohydrate detection was achieved by selected ion-monitoring GC-MS. Two of the uncommon sugars previously discovered in the legionellae (X1 and X2) were identified as quinovosamine and fucosamine, respectively. Legionella pneumophila contained rhamnose and quinovosamine but not the quinovosamine isomer fucosamine. Tatlockia micdadei and Legionella maceachernii contained large amounts of rhamnose, fucose, and fucosamine but not quinovosamine. These two species were the only legionellae studied that contained another unusual sugar that is referred to as X3, pending determination of its structure. Fluoribacter dumoffi, Fluoribacter bozemanae, and Legionella anisa were varied in their carbohydrate contents, both within and between species, but could be distinguished from L. pneumophila and the T. micdadei and L. maceachernii group. Fluoribacter gormanii was unique among the legionellae in that it lacked both quinovosamine and fucosamine. Legionella jordanis contained other unusual carbohydrates in addition to quinovosamine. GC-MS may have wide application in the differentiation of bacterial species.

Amino Sugars↗
PubMed1990

A functional vagotomy induced by unilateral forced right nostril breathing decreases intraocular pressure in open and closed angle glaucoma.

There is evidence of the central regulation of intraocular pressure, and it has been suggested that vagal tone might be increased in glaucoma simplex. The nasal cycle, the simultaneous congestion-decongestion response in the nasal cavities, reflects the dynamic lateralisation of the autonomic nervous system. Since this lateralisation presents with sympathetic activity induced by left brain hemisphere stimulation and parasympathetic activity induced by right hemisphere stimulation, it was subsequently demonstrated that forced unilateral nostril breathing induces selective contralateral hemispheric stimulation as measured by relative increases in the electroencephalographic amplitude in the contralateral hemisphere as well as alternating lateralisation of plasma catecholamines. Using this functional vagotomy, we report that left hemispheric stimulation by 20 minutes of forced unilateral right nostril breathing led to a significant bilateral decrease of 4.6 mmHg (25%) in intraocular pressure in 46 patients with open and closed angle glaucoma. However, it significantly increased the IOP in three patients with neovascular, one with juvenile onset, and one with closed angle glaucoma.

Adolescent↗