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Biomedical subjects

A Campbell

Publications and source records attributed to A Campbell.

At least 73 records · Page 4Linked to original sources
PubMed1999

Improvement of patient care through a collaborative approach to patient education and triage.

Educating and triaging new patients into the End-Stage Renal Disease care system are a challenge for all renal providers. This review describes the role of a renal patient educator, the goals of education, and ways in which an educator collaborates with multiple renal team members to assure optional treatment decision-making by patients and a smooth transition to treatments and care facilities. A case study is provided to show the collaborative role and benefits to both patients and facilities. Examples of team collaboration for delivery of education and care and requirements for successful teamwork and communication are provided. Results of this approach are improved continuity of care and coordination of patients, enhanced satisfaction of both patients and providers, and cost savings when appropriate financial and treatment decisions are in place.

Aged↗
PubMed1999

Staying alive: evolution, culture, and women's intrasexual aggression.

Females' tendency to place a high value on protecting their own lives enhanced their reproductive success in the environment of evolutionary adaptation because infant survival depended more upon maternal than on paternal care and defence. The evolved mechanism by which the costs of aggression (and other forms of risk taking) are weighted more heavily for females may be a lower threshold for fear in situations which pose a direct threat of bodily injury. Females' concern with personal survival also has implications for sex differences in dominance hierarchies because the risks associated with hierarchy formation in nonbonded exogamous females are not offset by increased reproductive success. Hence among females, disputes do not carry implications for status with them as they do among males, but are chiefly connected with the acquisition and defence of scarce resources. Consequently, female competition is more likely to take the form of indirect aggression or low-level direct combat than among males. Under patriarchy, men have held the power to propagate images and attributions which are favourable to the continuance of their control. Women's aggression has been viewed as a gender-incongruent aberration or dismissed as evidence of irrationality. These cultural interpretations have "enhanced" evolutionarily based sex differences by a process of imposition which stigmatises the expression of aggression by females and causes women to offer exculpatory (rather than justificatory) accounts of their own aggression.

Aggression↗
PubMed1999

Experimental models in rhinitis.

Nasal challenge with allergen or mediators is a useful model to understand the pathophysiology of allergic rhinitis. Some mechanisms have thereby been clearly clarified. Different methods have been proposed to mimic the natural allergen exposure and to measure the clinical and biological responses. Nasal challenges can also be used in clinical practice, mainly when there is a discrepancy between results of skin tests and in vitro or when occupational allergens are involved. Nasal challenges are also valuable to assess the efficacy of specific immunotherapy or some drugs.

Animals↗
PubMed1998

Short-term outcome of chronic immunosuppression on the development of breast lesions in premenopausal heart and lung transplant patients.

The risk of development of breast lesions in patients on chronic immunosuppression is unknown. In order to assess this risk, a retrospective review was performed of the records of 87 women between the ages of 12 and 47 years who received thoracic organ transplant from 1987 to 1996 at our institution. Inclusion criteria consisted of patients who were premenopausal, had no previous history of breast disease, and survived for at least 1 year posttransplantation. All patients were on a triple immunosuppressive regimen consisting of cyclosporine, steroids, and azathioprine. Mean follow-up was 4 +/- 1.2 years with a range of 1-6 years. During this period, 21 patients (24%) with a mean age of 38 +/- 10 years had screening or diagnostic mammography. The remainder of patients with a mean age of 24 +/- 9 years were followed clinically. Overall, 10 patients (11%) developed a total of 17 palpable, solid lesions at 33 to 72 months posttransplantation. Fifteen of these lesions were surgically excised. Five of the patients had multiple lesions. Pathological examination of the specimens revealed fibroadenoma in nine, fibrocystic disease in four, low grade phylloides tumor in one, and T-cell lymphoma in one case. None of the patients have developed primary breast cancer during follow-up. In conclusion, short-term immunosuppression does not increase the risk of the development of benign breast lesions in young women after thoracic organ transplantation, but rather the distribution of benign lesions is similar in an age-matched population. There were several cases of multiple fibroadenomas in the transplant population, but mammography revealed no malignant disease in this age group and does not need to be utilized in this population beyond what is considered standard for immunocompetent patients. The long-term effect ofimmunosuppressive therapy on the developmentof breast cancer in this group remains to be defined.

Adolescent↗
PubMed1998

Effects of hippocampal lesions on striatolimbic ionotropic glutamatergic receptors.

Changes in ionotropic N-methyl-D-aspartate (NMDA), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and kainate glutamatergic (Glu) receptor binding in rat caudate putamen (CPu) and nucleus accumbens (NAc) and hippocampal CA1 and CA3 regions were examined after unilateral injections of kainic acid (KA) into hippocampus to degenerate local intrinsic neurons and remove the glutamatergic afferents projecting to CPu and NAc. KA injections produced large losses of NMDA, AMPA and kainate receptors in hippocampal CA1 and CA3 regions. In addition, NMDA and kainate, but not AMPA, receptors were significantly reduced in NAc and CPu. These results suggest that a large proportion of NMDA, AMPA and kainate receptors in rat hippocampus arise on intrinsic postsynaptic neurons, and that some NMDA and kainate, but not AMPA, receptors also occur on presynaptic terminals of hippocampostriatal afferents innervating the CPu and NAc.

Animals↗
PubMed1998

Progressive accumbens degeneration after neonatal striatal 6-hydroxydopamine in rats.

Parkinson's disease is associated with progressive loss of nigrostriatal dopamine (DA). Models of the disorder, produced with neurotoxins (N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine or 6-hydroxydopamine) that selectively lesion DA neurons, are characterized by acute removal and gradual recovery of DA. We report slowly progressive loss of DA in ipsilateral nucleus accumbens following profound (>90%) acute unilateral depletion of DA in the caudate-putamen of neonatal rats, from 50% at age 27 days to 94% by 100 days. Metabolic turnover of DA markedly increased in ipsilateral accumbens, and may yield tissue-damaging neurotoxic by-products. This paradigm may help in elucidating mechanisms responsible for gradual degeneration of DA neurons and for screening potential neuroprotective agents.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1998

Localization of ionotropic glutamate receptors in caudate-putamen and nucleus accumbens septi of rat brain: comparison of NMDA, AMPA, and kainate receptors.

Changes in binding of selective radioligands at NMDA ([3H]MK-801), AMPA ([3H]CNQX), and kainate ([3H]kainic acid) glutamate (GLU) ionotropic receptors in rat caudate-putamen (CPu) and nucleus accumbens (NAc) were examined by quantitative autoradiography following: 1) unilateral surgical ablation of frontal cerebral cortex to remove descending corticostriatal GLU projections, 2) unilateral injection of kainic acid (KA) into CPu or NAc to degenerate local intrinsic neurons, or 3) unilateral injections of 6-hydroxydopamine (6-OH-DA) into substantia nigra to degenerate ascending nigrostriatal dopamine (DA) projections. Cortical ablation significantly decreased NMDA receptor binding in ipsilateral medial CPu (20%), and NAc (16%), similar to previously reported losses of DA D4 receptors. KA lesions produced large losses of NMDA receptor labeling in CPu and NAc (both by 52%), AMPA (41% and 45%, respectively), and kainate receptors (40% and 45%, respectively) that were similar to the loss of D2 receptors in CPu and NAc after KA injections. Nigral 6-OH-DA lesions yielded smaller but significant losses in NMDA (17%), AMPA (12%), and kainate (11%) receptor binding in CPu. The results indicate that most NMDA, AMPA, and kainate receptors in rat CPu and NAc occur on intrinsic postsynaptic neurons. Also, some NMDA, but not AMPA or kainate, receptors are also found on corticostriatal projections in association with D4 receptors; these may, respectively, represent excitatory presynaptic NMDA autoreceptors and inhibitory D4 heteroceptors that regulate GLU release from corticostriatal axons in medial CPu and NAc. Conversely, the loss of all three GLU receptor subtypes after lesioning DA neurons supports their role as excitatory heteroceptors promoting DA release from nigrostriatal neurons.

Animals↗
PubMed1998

Localization of dopamine receptor subtypes in corpus striatum and nucleus accumbens septi of rat brain: comparison of D1-, D2-, and D4-like receptors.

Changes in D1-, D2- and D4-like dopamine receptor binding in rat brain were examined by quantitative autoradiography following: (i) unilateral surgical ablation of frontal cerebral cortex to remove descending projections to corpus striatum and nucleus accumbens, (ii) unilateral injections of kainic acid into corpus striatum or nucleus accumbens to degenerate local intrinsic neurons, (iii) unilateral injections of 6-hydroxydopamine into substantia nigra to degenerate ascending dopamine projections. Rats were killed one week after lesioning, with contralateral tissue controls. Radioligands were: [3H]SCH-23390 for D1-like (D1/D5) receptors, [3H]nemonapride alone for D2-like (D2/D3/D4) receptors, and [3H]nemonapride with 300 nM S[-]-raclopride and other masking agents for D4-like receptors (identified by blockade with D4 selective L-745,870). Frontal cerebral cortex ablation did not alter D1- or D2-like receptor density, but D4-like binding decreased significantly in both corpus striatum (18%) and nucleus accumbens (23%). Kainic acid markedly reduced D1-like (75% and 84%) and D2-like binding (44% and 52%), with smaller D4-like losses (28% and 27%) in corpus striatum and nucleus accumbens, respectively. Nigral 6-hydroxydopamine lesions (verified by autoradiographic loss of dopamine transporters labelled with [3H]GBR-12935) did not significantly change D1-, D2-, or D4-like binding in the corpus striatum. These results suggest that the majority of D1-, and D2-like, and a smaller portion of D4-like receptors in corpus striatum and nucleus accumbens arise on intrinsic postsynaptic neurons, and that some D4-like, but neither D1- nor D2-like, receptors are found on presynaptic corticostriatal afferents.

Animals↗
PubMed1998

Effects of hippocampal kainic acid lesions on striatolimbic dopamine D1-, D2-, and D4-like receptors.

Changes in D1-, D2- and D4-like dopamine receptor binding in rat caudate-putamen, nucleus accumbens and hippocampus were examined by quantitative in vitro receptor autoradiography after unilateral injections of kainic acid into hippocampus to degenerate local intrinsic neurons and remove hippocampal-striatal projections. Radioligands were: [3H]SCH-23390 for D1-like (D1/D5) receptors, [3H]nemonapride alone for D2-like (D2/D3/D4) receptors and with 300 nM S[-]-raclopride and other masking agents for D4-like receptors. Kainic acid injections produced massive local hippocampal losses of D1-like (75%), D2-like (77%) and D4-like (79%) receptor binding but did not significantly alter D1-, D2- or D4-like receptor density in caudate-putamen or nucleus accumbens. Most D1-, D2- and D4-like receptors in rat hippocampus evidently arise on intrinsic postsynaptic neurons whereas none was detected on presynaptic terminals of hippocampal-striatal afferents innervating the striatal complex.

Animals↗
PubMed1998

Diagnosis and follow-up of Chlamydia trachomatis infections in the ED.

The purpose of this study was to determine the impact on patient care and the cost effectiveness of testing for chlamydial infection in the emergency department. All patients tested for chlamydial infection in three emergency departments between October 1, 1993 and January 31, 1994 were retrospectively reviewed for charges and adequacy of therapy. In one hospital, the effectiveness of a call-back system to enhance proper therapy of inadequately treated patients was evaluated. Of 2,416 test results, 249 were positive, and 197 of these charts were available for review. All 16 male patients were treated appropriately at the initial visit; 105 of 181 female patients were inadequately treated at the initial visit. The charge to identify each patient inadequately treated was $981.22 ($103,000 for 105). Of the 28 inadequately treated patients receiving a follow-up call, 20 sought treatment. The high cost of testing patients cannot be justified without an adequate surveillance system to enhance proper follow-up treatment.

Abdominal Pain↗
PubMed1998

Improvements in forehead flap design for nasal reconstruction.

Joseph Carpue introduced us to the use of the forehead flap for nasal reconstruction in 1814 after he read an account of its use in India. The forehead flap was the first pedicled flap to be described in European literature and it set off an immediate search for similar flaps elsewhere on the body. In fact, this initial use of the forehead flap was so inspirational that it has been given credit for the rise of plastic surgery as a specialty. The forehead flap is well situated to replace missing nasal skin due to its excellent vascularity, close proximity, and similar histologic qualities. In fact, it is safe to say the forehead flap is the first choice for reconstruction of nasal defects larger than 2.0 cm in diameter. Over the last 180 years there has been considerable refinement in the under stage and standardization of forehead flap design. This short monograph is intended to provide refinements in forehead flap design which, in these authors' opinion, provide superior nasal reconstruction results while minimizing donor site morbidity. Some of these modifications are fairly subtle while others fundamentally affect the design of a forehead flap. Incorporating these modifications will advance the sophistication of the reconstructive surgeon and improve results.

Forehead↗
PubMed1998

Alfred D. Hershey.

Explore the source record for details and available documents.

Bacteriophage lambda↗
PubMed1998

Neuropsychological functioning in HIV-positive African-American women with a history of drug use.

This preliminary investigation examined neuropsychological performance in a sample of human immunodeficiency virus (HIV)-positive and HIV-negative African-American women with a history of drug use. The study population was comprised of 10 HIV-negative, 9 asymptomatic HIV-positive, 13 symptomatic HIV-positive, and 10 acquired immunodeficiency virus (AIDS) patients. A neuropsychological battery designed to assess attention, psychomotor processing, verbal memory, and visual memory was administered to participants. No evidence of HIV-related cognitive impairment was found in patients in the early stages of HIV infection. Multivariate analyses of variance revealed significant deficits in psychomotor processing and verbal recall in persons with AIDS. These individuals showed greater difficulty in tasks requiring maintained attention and performed poorly on measures of immediate and delayed verbal recall. In contrast, HIV status was not related to visual memory, verbal recognition, or the number of errors made during a verbal recall task. The pattern of cognitive deficits observed in persons with AIDS resembles that commonly associated with subcortical pathology. The cognitive deficits observed were not related to depression or recentness of drug use.

Adult↗
PubMed1997

Mapping of locomotor behavioral arousal induced by microinjections of dopamine within nucleus accumbens septi of rat forebrain.

Dopamine (DA) at ca. ED50 (16 microg) or saline was stereotaxically microinjected unilaterally 2 h after pretreatment with an MAO inhibitor into left or right nucleus accumbens septi of 697 freely moving rats (1394 injections) to define subregions involved in DA-induced behavioral arousal throughout the anatomical extent of the accumbens. Locomotion was quantified electronically and behavioral responses were assigned to histologically verified injection sites; postural or stereotyped behaviors characteristic of DA injections in caudate-putamen did not occur. Screening with 60 injections across mid-accumbens (2.2-3.2 mm rostral to bregma) indicated that locomotion was elicited non-homogeneously, and was particularly intense dorsomedially. Sites yielding intense arousal and their inactive surround were mapped along the rostrocaudal axis (1.4-4.2 mm anterior to bregma) in coronal sections. Responses to DA showed lateral symmetry and were similar across rostrocaudal levels, with intense responses in dorsomedial accumbens along its border with the caudate-putamen. This functional localization does not coincide closely with reported distributions of DA or its receptors, nor with histologically or histochemically defined core-shell regions of this limbic structure. Nucleus accumbens in rat brain thus appears to be organized functionally into distinct subregions differing markedly in ability to produce locomotor hyperactivity in response to exogenous DA.

Animals↗