Beyond mechanical nursing care.
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Allied Health Personnel↗
Biomedical subjects
A Hunt
Publications and source records attributed to A Hunt.
Nursing student speaks out.
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Clinical Competence↗
Characterizing the outlines of degraded fine-particles by fractal dimension.
Fractal dimension has been used extensively as a descriptor of the rugged outlines of fine-particles. Potentially, it may be a useful parameter for characterizing the outlines of fine-particles which have been subjected to some form of chemical degradation. Here, fractal dimension values have been computed for the outlines of microscopic lead fine-particles both before and after weak hydrochloric acid dissolution experiments. Values obtained for the post-dissolution rugged profiles were greater than those of the pristine fracture grains which had a Euclidean form. The profiles of the degraded fine-particles could be characterized by a single fractal dimension value, or they exhibited multifractal behavior. Data from profiles of fine-particles lead from the natural environment of the soil suggest that fractal dimension calculations may provide a useful descriptor for particles which have undergone chemical dissolution and transformation in such an environment.
Environmental Pollutants↗
Comment on "Correlation functions for ionic motion from NMR relaxation and electrical conductivity in the glassy fast-ion conductor (Li2S)0.56(SiS2)0.44"
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Journal Article↗
Speech dysfunction in early Parkinson's disease.
The purpose of this study is to determine if subjects in the early stages of untreated Parkinson's disease (PD) or PD treated with deprenyl alone suffer from motor speech abnormalities. Speech defects are common in advanced PD, including disturbances of respiration, phonation, and articulation. We studied 12 subjects with early PD (Hoehn and Yahr stage < or = 2, mean duration disease 3.2 years) who were not taking symptomatic therapy and tested them under two conditions: on and off deprenyl. None of the subjects was depressed or demented (Mini Mental Status mean 29.9/30; Hamilton Depression Rating mean 2.7/52). All functioned independently (Schwab and England Activities of Daily Living mean 93.1/100). Acoustic and speech productions were assessed using the DSP Sona-Graph 5500 and an evaluation of dysarthria. All 12 had at least two characteristics of dysarthria on examination, although 8 were not aware of it. Vocal tremor was identified on narrow band spectrogram for four subjects. Deprenyl did not have a consistent effect on speech. Ten subjects had no detectable change in speech on deprenyl, one was worse, and one was improved.
Adult↗
Environmental contamination by cobalt in the vicinity of a cemented tungsten carbide tool grinding plant.
Surface soil and dust samples have been collected from the vicinity of a hard metal (cemented tungsten carbide) tool grinding factory. As a result of poor waste management practices, dusts generated by the grinding operation were, for the most part, swept from the interior of the building onto open ground at the rear of the plant. The potential for contamination of the local environment with cobalt, tungsten, and other metals as a result of dust being either resuspended from the resulting uncontrolled mound of debris or emitted from the factory vents was considerable. Levels of cobalt in local soils were found to be as high as 12,700 mg kg-1; almost 2000 times higher than the average value for in the United States. Scanning electron microscopy and energy dispersive X-ray micro-analysis examination of the waste dust particles revealed that the individual particles were, in general, composites containing variable quantities of tungsten, cobalt, calcium, titanium, and iron. Individual particles in soil samples collected at some distance from the plant were less heterogeneous, and fewer particles contained detectable quantities of cobalt. This would suggest that a degree of disassociation had occurred in the soil environment resulting in a mobilization of the cobalt.
Air Pollutants, Occupational↗
Effects of protein kinase C modulation on NMDA receptor mediated regulation of neurotransmitter enzyme and c-fos protein in cultured neurons.
The role of protein kinase C (PKC) in N-methyl-D-aspartate (NMDA) receptor-mediated biochemical differentiation and c-fos protein expression was investigated in cultured cerebellar granule neurons. The biochemical differentiation of glutamatergic granule cells was studied in terms of the specific activity of phosphate-activated glutaminase, an enzyme treatment in the synthesis of the putative neurotransmitter pool of glutamate. When the partially depolarized cells were treated with NMDA for the last 1 to 3 days (between 2 and 5 days in vitro), it elevated the specific activity of glutaminase. In contrast, NMDA had little effect on the activity of aspartate aminotransferase or of lactate dehydrogenase. Treatment of 10-day old granule neurons with NMDA also resulted in a marked increase in the immunocytochemically measured expression of c-fos protein. The increases in both the activity of glutaminase and the steady state level of c-fos protein were specific to the activation of NMDA receptors, as they were completely blocked by D,L-2-amino-5-phosphonovaleric acid. The specific stimulation of NMDA receptors in PKC-depleted granule neurons or in the presence of reasonably specific PKC inhibitors also produced significant elevation in the activity of glutaminase and the expression of c-fos protein. These increases were similar in magnitude to those observed in the granule neurons of the respective control groups. Our findings demonstrate that PKC is not directly involved in the NMDA receptor-mediated signal transduction processes associated with biochemical differentiation and c-fos induction in cerebellar granule neurons.
Animals↗
Medical and nursing problems of children with neurodegenerative disease.
Little is written on the management of problems encountered by children with neurodegenerative disease. Whilst the conditions are individually rare, as a group of diseases they pose a considerable burden on the child, the family and the community. This study describes the 127 children with neurodegenerative disease who were admitted to Helen House, a hospice for children, from the time of opening in November 1982 until the end of 1993. The great majority of the conditions were genetic in origin and nearly one-third of the families had had two or more children with the same disease. Seventy-four (58%) of the children have died, with nearly half dying at home. The course of the disease was in many cases chronic and these children presented with multiple medical and nursing problems. Examination of the problems recorded in 1993 revealed that nearly all the children had no speech, or speech was impaired. Most were either totally immobile or had considerably reduced mobility. Seventy per cent of the children had feeding problems and one-quarter were fed through a nasogastric tube or gastrostomy. Thirty-five per cent of the children suffered pain on occasions, with muscle spasm being the main identifiable source of pain. Practical suggestions are made for the management of these children.
Adolescent↗
Coagulation monitoring during extracorporeal membrane oxygenation: the role of thrombelastography.
Patients undergoing extracorporeal membrane oxygenation (ECMO) are at an increased risk for developing coagulopathies due to the adverse effects of extracorporeal circulation on the hemostatic mechanism. Methods of determining causative factors of bleeding diathesis are often inconsistent and non-specific. ECMO patients require aggressive transfusion therapy with autogenic blood products to stabilize and maintain hemostasis. The present study evaluated the coagulation status of newborn patients undergoing ECMO therapy, using a viscoelastic monitor (Thrombelastograph -TEG) that measures functional aspects of clot development and stabilization. Seventeen neonatal patients undergoing ECMO for severe respiratory dysfunction were entered into this study. Serial blood samples were obtained and routine coagulation assessment including fibrinogen concentration, platelet count and ionized calcium was performed. In addition, fibrin(ogen) degradation products (FDP), d-Dimers, antithrombin III and plasma free hemoglobin were measured. Transfusion indicators were established and total transfusion requirements recorded. TEG profiles were determined with the use of heparinase, an enzyme that degrades heparin but has little effect on other coagulation factors. The most commonly encountered complication was hemorrhaging which was diagnosed by laboratory and clinical assessment in 11 of 17 patients. Transfusion requirements (measured in ml/kg/ECMO hour) were the following: packed red blood cells--1.34 +/- 0.5; platelets--0.71 +/- 0.57; fresh frozen plasma--0.09 +/- 0.12; cryoprecipitate 0.05 +/- 0.05. Thrombelastograph profiles reflected hemostatic conditions that ranged from severe coagulopathies (DIC) to hypercoagulability. Interpretation of TEG profiles identified hemostatic abnormalities in 57 of 101 profiles (46.5%), with the most common etiology related to platelet dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)
Blood Coagulation Disorders↗
Computer music in the service of music therapy: the MIDIGRID and MIDICREATOR systems.
The paper describes the use of the MIDIGRID and MIDICREATOR systems with a range of transducers and interface devices in music therapy. This opens up new possibilities, as well as new challenges in the way in which such technology may be used in therapy. The paper includes a discussion of the role of music therapy, together with some case histories involving the use of these systems.
Adolescent↗
Physiological costs of reciprocal gait in FES assisted walking.
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Electric Stimulation Therapy↗
Sleep disorder and epilepsy in children with tuberous sclerosis: a questionnaire-based study.
Sleep disorders were investigated in 40 children with tuberous sclerosis (TS) and compared with those found in non-disabled children and those reported in a mixed group with learning disabilities. Significantly higher levels of sleep disturbance were found in the TS group compared with both other groups. Within the TS group, current epilepsy and a high level of daytime behavioural disturbance were significantly associated with sleep disturbance, but pervasive developmental delay and high parental stress levels were not. Detailed study of the relationship between seizure activity and sleep disturbance in tuberous sclerosis is needed.
Adolescent↗
Apportioning the sources of lead in house dusts in the London borough of Richmond, England.
The sources of particulate lead in houses in the London Borough of Richmond, England have been investigated using automated scanning electron microscopy in conjunction with energy dispersive X-ray spectroscopy. Compositional and size information was collected on lead-bearing particles from density and size fractionated floor dusts from 16 residences of various ages. A classification scheme based on the analysis of different types of lead source particles was used to categorize the house dust particles as either auto exhaust, road dust, garden soil, paint, high temperature process emissions, lead of common origin or miscellaneous lead-bearing. Classification results based on both populations of particles and estimated particle volumes suggest that paint, road dust and garden soil are the major contributors of particulate lead to the Richmond households. The primary contributing source in the 64-1000-microm size range of the house dusts appears to be paint. In the 0-64-microm size fraction of the dusts paint, road dust and garden soil all make significant contributions. Variations in the contributions made by the major sources appear to be unrelated to the age of the homes.
Dust↗
Effects of the glucocorticoid agonist, RU28362, and the antagonist RU486 on lung phosphatidylcholine and antioxidant enzyme development in the genetically obese Zucker rat.
The biochemical maturation of the lung in late gestation and in the young animal is regulated by glucocorticoids. The present study was aimed at dissociating the different glucocorticoid receptor sites involved in these regulatory functions. The obese Zucker rat was selected as a model for this study as it exhibits hypersensitivity to glucocorticoid hormone action by virtue of its elevated receptor numbers and activity. Two synthetic steroid analogues were administered to obese animals; RU28362, a specific type II receptor agonist, and the type II antagonist RU486. RU28362 promoted a strong catabolic effect, which was associated with reduced food intake and the abolition of growth in the rats. The agonist, RU28362, attenuated developmental increases in antioxidant enzyme activities, and altered the growth of the tissue. At the age studied, development of the lung phosphatidylcholine (PC) system was almost complete, but RU28362 increased disaturated PC 16:0/16:0 concentrations by almost 2-fold, and altered the molecular composition of total pulmonary PC. RU486 attenuated the growth of the rats and reduced their food intake. Treatment with the type II antagonist attenuated lung growth and increased the activities of pulmonary copper zinc (Cu/Zn) and manganese (Mn) superoxide dismutases. RU486 had no effect on lung PC concentrations and molecular composition. The data suggest a role for type I glucocorticoid receptors in the regulation of the antioxidant enzyme system in the lung, as type II antagonism will channel endogenous glucocorticoid binding to the type I site. Type II receptor binding would appear to play a role in regulating the lung PC content.
Androstanols↗
Positron emission tomographic findings in Filipino X-linked dystonia-parkinsonism.
Regional and global metabolic rates for glucose (rCMRGlc and GMR) were estimated using [18F]fluorodeoxyglucose and positron emission tomography in 3 patients with Filipino X-linked dystonia-parkinsonism (lubag). In all 3 patients a selective reduction in normalized striatal glucose metabolism (rCMRGlc/GMR) was observed compared with 15 normal volunteer subjects. Presynaptic nigrostriatal function was assessed in these patients using [18F]fluorodopa and positron emission tomography. Striatal rate constants for [18F]flurodopa uptake were found to be in the normal range in all 3 patients with lubag. These findings suggest that the extrapyramidal manifestations of lubag are metabolically localized to the striatum and that clinical parkinsonism in these patients may be secondary to extranigral factors.
Adult↗
A prevalence study of autism in tuberous sclerosis.
An estimate of the prevalence of autism in tuberous sclerosis (TSC) was made by interviewing the parents of 21 children between ages 3 and 11 ascertained during a previous population study of the condition in the West of Scotland. Five of the children (24%) were rated autistic and a further four (19%), all of whom were girls, had socially impaired behavior categorized as pervasive developmental disorder, without fulfilling all the DSM-III-R criteria for autism. One further boy had disruptive attention-seeking behavior that had excluded him from his normal school. The estimated prevalence from this study of autism in TSC is 1 in 4 children in general, and 1 in 2 of those with mental retardation. Tuberous sclerosis could be a significant cause of autism and pervasive developmental disorders, particularly in girls.
Autistic Disorder↗
Relationships between insulin-like growth factor-1 levels and growth hormone concentrations during diurnal profiles and following oral glucose in acromegaly.
OBJECTIVE: The aim of this study was to refine the biochemical definition of disease activity in acromegaly by comparing serum growth hormone (GH) measurements during a 10-hour day profile with serum GH values during an oral glucose tolerance test. DESIGN: Using plasma insulin-like growth factor-1 (IGF-1) levels as a measure of disease activity, serum GH data from a day profile and from an oral glucose tolerance test were compared. PATIENTS: Thirty-five acromegalic patients were studied, 13 of whom had serum GH measured during a day profile and 22 during an oral glucose tolerance test. In addition, basal plasma IGF-1 levels were estimated in all acromegalic patients, and in 24 normal subjects. MEASUREMENTS: Following acid-ethanol extraction of the plasma samples, IGF-1 levels were measured by radioimmunoassay using a polyclonal antibody. In a day profile, six to eight blood samples for serum GH estimation were taken at hourly intervals during the day; during an oral glucose tolerance test samples for serum GH estimation were taken in the fasting state and every 30 minutes for 2 hours and measured by a two-site IRMA for GH. RESULTS: Ninety-four per cent of acromegalic patients with raised plasma IGF-1 levels had serum GH concentrations > 10 mU/l whilst 98% of acromegalic patients with plasma IGF-1 levels in the normal range had serum GH concentrations < 6 mU/l. A highly significant positive correlation was found between the mean serum GH concentrations (r = 0.67), the minimum serum GH concentration (r = 0.65) and the area under the GH curve (r = 0.66) estimated during an oral glucose tolerance test and plasma IGF-1 concentrations. The relations between identical indices of serum GH concentration measured during a day profile and plasma IGF-1 levels, although significant, show a less powerful correlation. The relation between serum GH and plasma IGF-1 levels describes a curvilinear model, plasma IGF-1 levels exhibiting a plateau at serum GH concentrations > 40 mU/l but maintaining a linear relationship with serum GH levels < 20 mU/l. CONCLUSIONS: A highly significant correlation exists between plasma IGF-1 levels and various parameters of serum GH levels in acromegalic patients. Hormonal assessment of disease activity in acromegaly is more accurately reflected by the serum GH concentration during an oral glucose tolerance test rather than by the serum GH level during a day profile. Normalization of plasma IGF-1 levels is rarely achieved unless the mean serum GH level is reduced to < 6 mU/l.
Acromegaly↗
Development, behaviour and seizures in 300 cases of tuberous sclerosis.
Three hundred cases of tuberous sclerosis were surveyed by postal questionnaire, including 240 cases with learning difficulties. People who have tuberous sclerosis and severe learning disabilities also have a higher frequency of epileptic seizures than people with learning difficulties from all causes. Pervasive developmental disorder and hyperactive behaviour are behavioural features of the disorder. Sleep problems and the level of vigilant care required because of seizures or behaviour have implications on the level of service needed to support people with tuberous sclerosis in the community.
Adolescent↗