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Biomedical subjects

A Buchanan

Publications and source records attributed to A Buchanan.

At least 55 records · Page 3Linked to original sources
PubMed1991

Ultraviolet versus non-ultraviolet light therapy for seasonal affective disorder.

Although light therapy has been shown to be effective in the treatment of seasonal affective disorder (SAD), little research has been done to determine which light wavelengths affect treatment outcome. In this triple crossover study the authors compared 1 week of light therapy in which bright (2500 lux), full-spectrum fluorescent light, with and without blockade of the ultraviolet (UV) spectrum, was used with a dim (500 lux) light control in 11 SAD patients. The dim light condition had no significant antidepressant effects as measured by the Hamilton Rating Scale for Depression (HAM-D), the Beck Depression Inventory (BDI), and an atypical depressive symptom (ATYP) score. The UV-light condition significantly reduced HAM-D, BDI, and ATYP scores, whereas the UV-blocked condition significantly reduced only the ATYP score. These results suggest that the UV-spectrum in light therapy may have a differential effect on typical and atypical symptoms in SAD.

Depressive Disorder↗
PubMed1990

Glutathione synthesis and glutathione redox pathways in naphthalene cataract of the rat.

This investigation examined many parameters during the course of early development of naphthalene-induced cataract in a time span of 0 to 79 days of treatment. Feeding naphthalene daily to Black-Hooded rats resulted in gradual progressive development of cataract. The first faint opacities were detectable after 7 days. Free soluble total glutathione (oxidized and reduced) of these lenses was shown to gradually decrease to a maximum loss of about 20%, a value reached by day 30 of treatment. No activity loss of either enzyme required for glutathione synthesis (gamma-glutamylcysteine synthetase or glutathione synthetase) was observed in homogenates of naphthalene versus control lenses. There was also neither impairment of [35S]-L-cystine uptake nor of [35S]-glutathione synthetic capacity in lenses cultured from rats after 12, 24 or 36 days of naphthalene feeding when compared to control lenses. Hence, glutathione loss cannot be explained by a damaged glutathione synthesis system. Progressive activity loss of glutathione peroxidase and glutathione reductase was observed. The loss of glutathione peroxidase activity was especially remarkable. Thus, the defense system against oxidative damage is impaired and may be a significant factor in naphthalene-induced cataract of the rat.

Animals↗
PubMed1988

Fine-needle aspiration cytology of breast: its impact on surgical practice with an emphasis on the diagnosis of breast abnormalities in young women.

Fine-needle aspiration cytology (FNAC) of the breast is a minimally invasive yet maximally diagnostic method, often precluding the need of an open biopsy. In young women, in whom breast cancer is a rare disorder, it is also important that carcinoma is recognized without delay so that an appropriate plan of management can be adopted. In this study, we reviewed our experience in a total of 3,226 needle aspirates of breast with particular emphasis on the diagnosis of carcinoma in women under the age of 30.

Adult↗
PubMed1987

Improvement in the quality of gynaecological smears using a cytobrush.

For accurate cervical cytology an adequate sample of cells must be obtained from the squamocolumnar junction. In 100 patients conventional smears were compared with smears and membrane filter preparations made using a cytobrush. A satisfactory cell smear was obtained in 39% of patients using the conventional method and in 97% the cytobrush. When membrane filter preparations were used in conjunction with cytobrush smears, adequate cytological samples were obtained from all patients.

Cervix Uteri↗
PubMed1987

'Barking mad'.

Explore the source record for details and available documents.

Female↗
PubMed1979

Medical paternalism or legal imperialism: not the only alternatives for handling Saikewicz-type cases.

In 1977, the Supreme Judicial Court of Massachusetts held in the Saikewicz case that the probate court is the proper tribunal for making decisions whether to give or withhold "life-prolonging treatment" for terminally ill incompetent patients. This ruling provoked debate in the medical and legal communities. Dr. Arnold Relman, Editor of The New England Journal of Medicine, argues that Saikewicz encroaches on existing sound medical practice and requires decision-making machinery that is impractical and inhumane. Relman contends that treatment decision for terminally ill incompetents in Saikewicz-type cases should be made by the physician in consultation with the patient's family. Law professor Charles Baron, in contrast, defends Saikewicz's judicialization approach, arguing that such decision must bemade in an adversary framework that approximates the ideal of the rule of law. In the present Article, Professor Buchanan argues that Relman's criticism of Saikewicz rests on a defective, medical paternalist view of the physician-patient relationship, and that Baron's support of Saikewicz is based on an unjustifiable, legal imperalist view of decision making for incompetents. In Buchanan's view, Relman's approach fails to distinguish appropriately between the making of medical judgments and the making of moral judgments and wrongly assumes that the patient's family typically cannot understand the elements of the decision, while Baron's approach unjustifiably extends the sphere of the legal process by ignoring the special moral relationship that usually exists between the family and its incompetent member. Buchanan proposes an alternative decision-making approach that he believes incorporates the merits, while remedying the defects, of both Baron's and Relman's approaches. The alternative is based on three propositions. (1) The proper presumption in Saikewicz-type cases is that the family of an incompetent is to make decisions concerning treatment. (2) This presumption of the family's dominant role in decision making is defeasible: protection of the patient's rights requires that decisions be made within a framework that allows vigorous discussion and accoutability through impartial review and that provides for legal intervention when necessary. (3) The institutional framework for implementing the features listed in the preceding proposition will rely heavily upon an ethics committee that is neither an all-medical prognosis committee nor an administrative agency of the hospital. Besides evaluating and responding to the Relman and Baron approaches, Buchanan examines the contribution to the Saikewicz debate made by law-and-medicine professor George Annas. In essence, Buchanan rejects Annas's argument that, taken together, the Saikewicz opinion and the Quinlan opinion of the Supreme Court of New Jersey delineate a proper division of medical and legal decision-making responsibility concerning terminally ill incompetents. Buchanan concludes that, contrary to Annas's view, those two cases are not reconcilable.

Decision Making↗
PubMed1977

Abuse and neglect as a cause of mental retardation: a study of 140 children admitted to subnormality hospitals in Wiltshire.

The survey of 140 children under 16 in two subnormality hospitals showed that 3 per cent of the children had definitely been rendered mentally handicapped as a consequence of violent abuse, and that a possible maximum total of 11 per cent might have been thus rendered mentally handicapped. In 24 per cent of the children, neglect was considered to be a contributory factor in reducing intellectual potential. Impairment of intellect from abuse and neglect, especially in those with 'vulnerable' brains due to pre-existing abnormality, may be much commoner in children than is generally realized.

Adolescent↗
PubMedDate not supplied

Computerised care plans in Tayside.

The development of ward nursing information systems and, in particular, the advent of computerised nursing care plans, have caused some controversy and discomfort in professional circles. This article describes how staff in a large general hospital in Tayside set about refining their information technology base, with particular emphasis on the role of the project nurse who had overall responsibility for the implementation of the programme. Despite cautionary words from some commentators, it appears that the computerised care planning module has been received positively by nursing staff.

Computers↗
PubMedDate not supplied

Infant mortality in a Mexican-American community: Laredo, Texas, 1950-1977.

Published infant mortality rates (IMR's) for Mexican-American populations frequently are lower than expected given the socioeconomic status (SES) of these populations. It has been speculated that this is due to bias or incompleteness in Mexican-American vital statistics. In this paper an extensive genealogical data base constructed from Catholic church records and civil records for the border city of Laredo, Texas is used to study this problem. The infant mortality probabilities (IMP's) since 1950 are compared to conventional IMR's, both based strictly on the population at risk defined by baptisms, in which the deaths are a proper subset of the denominator, and these are compared with IMR's calculated in the usual way from aggregate civil records of births and infant deaths for Laredo. We find that when these data are used, the IMR's for the most recent years are about twice the conventional rates computed from registered vital statistics.

Bias↗