Search PubMed⌕ Search

Biomedical subjects

C A Robinson

Publications and source records attributed to C A Robinson.

At least 55 records · Page 3Linked to original sources
PubMed1994

A nontraditional approach to family violence.

Family violence has often been conceptualized as a linear phenomenon in which perpetrators commit acts intended to hurt victims. Intervention in these circumstances involves treating the perpetrator and the victim individually. In contrast, this article presents a Systemic Belief Approach to the situation of mutual family violence. A case example illustrates the influence of beliefs on the occurrence of violent acts between family members (in this case, sole-parent mother and adolescent daughter). Family systems nursing interventions such as reflective questions and reflecting teams are used to challenge the family's constraining beliefs, which enables the coevolution of facilitative beliefs that invite healing.

Adolescent↗
PubMed1994

Nursing interventions with families: a demand or an invitation to change?

While nurses are becoming more adept at the assessment of families, intervention with families is an area that requires increased attention. This paper provides a critical analysis of existing nursing literature pertaining to interventions with families who are managing a member's chronic health condition. Three orientations to nursing interventions with families (traditional, transitional and non-traditional) are proposed, based on underlying perspectives regarding objectivity and linear versus systemic thinking. These orientations are further distinguished in relation to beliefs that are reflected in the intervention literature.

Attitude to Health↗
PubMed1993

Death attributed to ethyl chloride.

A young college student was found unresponsive, head down in his pillow with a metal canister containing ethyl chloride in or beside his right hand. Resuscitative efforts failed. Qualitative screening detected ethyl chloride in the vitreous fluid and antemortem and postmortem blood. Quantitation was carried out on available fluids with the following results: hospital blood, 20 mg/dL; postmortem blood, 65 mg/dL; and vitreous fluid, 41.7 mg/dL. No other drugs or volatiles were found. Death was subsequently attributed to an overdose or adverse reaction to this product.

Adult↗
PubMed1993

Case report: alpha G-Philadelphia, beta O-Arab, and beta C globins present in a single patient.

The case of a 7-month-old Nigerian child who presented with anemia and microcytosis is described. Hemoglobin electrophoresis studies revealed a band with pronounced cathodic mobility. This represented a heterohybrid hemoglobin tetramer composed of an alpha-globin mutant, G-Philadelphia (alpha GPhil), and two variant beta-globin chains, beta C and beta O-Arab. The absolute amounts of alpha GPhil found in the propositus were less than expected for an alpha 2-globin gene product. It has not been established whether alpha G-Philadelphia interacting with beta O-Arab and beta C globin chains is the cause of the microcytosis.

Anemia↗
PubMed1993

Managing life with a chronic condition: the story of normalization.

One way that families and individuals manage living with a chronic condition is to construct and live a story of "life as normal." The conceptualization of this process is based on constant comparative analysis of accounts of individuals and family members who are managing chronic conditions. The process begins with construction of the story of life as normal and continues as the story is lived over time. As the story is enacted, persons reauthor their lives. Thus the reciprocal nature of the process becomes evident. Specifically, how individuals and families construct and enact the story is discussed along with the role of health care professionals in the process and associated costs and benefits.

Activities of Daily Living↗
PubMed1992

Microalbuminuria associated with diabetic neuropathy.

OBJECTIVE: To test the hypothesis that microalbuminuria may show an independent statistical association with diabetic neuropathy. RESEARCH DESIGN AND METHODS: An observational study of a prospectively identified cohort was conducted at the University Medical Center. The cohort consisted of 78 consecutive diabetic patients who fulfilled the criteria of having diabetes for greater than 10 yr, a normal serum creatinine, urine negative for macroalbuminuria by a commonly used dipstick method, a blood glucose less than 13.8 mM (less than 250 mg/dl), and an HbA1 less than 11% (normal range 5.5-8.5%). Medical record review established the presence of chronic complications of diabetes. Urine albumin level was measured by radioimmunoassay. Albumin concn greater than or equal to 15 mg/L was used as a cutoff value for microalbuminuria. RESULTS: Twenty-five of 78 patients (32%) showed microalbuminuria. Of these, 51% had neuropathy, 39% had retinopathy, 35% arterial hypertension, 17% peripheral vascular disease, and 15% ischemic heart disease. After adjusting for age, sex, and type and duration of diabetes, diabetic neuropathy and hypertension showed a significant association with microalbuminuria. After adjusting for other diabetic complications, diabetic neuropathy showed a significant association with microalbuminuria. CONCLUSIONS: Microalbuminuria is independently associated with diabetic neuropathy. This association lends support to the theory of a vascular etiology for diabetic distal symmetrical neuropathy.

Albuminuria↗
PubMed1991

Acute tolerance in morphine analgesia: continuous infusion and single injection in rats.

This study aimed to determine whether the decline of the analgesic effect of morphine with a continuous infusion or that after a single injection correlates with the changes in brain concentration of morphine. The analgesic effect of morphine and its brain and serum concentrations were determined with a continuous 8-h infusion at a constant rate and after a single subcutaneous injection of the agent. The analgesic effect was determined by measuring the threshold of motor response to noxious stimulation. Brain and serum concentrations of morphine were detected by radioimmunoassay with the use of 125I-labeled morphine. With the constant-rate (4 mg.kg-1.h-1, intravenous) morphine infusion, the peak of analgesia could not be maintained: the increase in the pain threshold at 2 h was 1,003 g and at 8h was 286 g (a decrease in analgesia by 72%, P less than 0.0002). At the same time, the brain morphine concentration tended to increase, to 278 ng/g at 2 h and 329 ng/g at 8 h. After the single morphine injection (6 mg/kg, subcutaneous), recovery from analgesia occurred at a much faster rate than did the decrease in morphine brain concentration; the decrease in pain threshold was 79% at 90 vs. 30 min after the injection (P less than 0.0001), and the corresponding decrease in brain concentration was 28% (NS). The absence of correlation between analgesia and morphine brain concentration both with the constant-rate morphine infusion and after the single injection suggests the development of acute tolerance, which is pharmacodynamic in nature.

Analgesia↗
PubMed1991

Acute tolerance to the hypnotic effect of morphine in rats.

To demonstrate the development of acute tolerance to the hypnotic effects of morphine, loss and recovery of the righting reflex with a constant-rate morphine infusion was studied in rats. In one group of animals, brain and serum concentrations of morphine were detected (radioimmunoassay) at the time of loss of the righting reflex, and in another group, at the time of the reflex recovery. The morphine infusion at a constant rate of 14 mg.kg-1.h-1 caused a loss of the righting reflex in all animals that was achieved by 2.5 h. However, this level of response could not be maintained, and at 5 h it began to decline. All animals recovered the righting reflex by the ninth hour, despite the continuing morphine infusion. The morphine brain and serum levels at the times of loss and recovery of the righting reflex were not different. The results suggest a development of acute tolerance to the hypnotic effect of morphine, which is determined primarily by pharmacodynamic mechanisms.

Animals↗
PubMed1990

Transfer of human systemic lupus erythematosus in severe combined immunodeficient (SCID) mice.

To study the role of peripheral blood leukocytes (PBL) in the pathogenesis of human systemic lupus erythematosus (SLE), we transferred PBL from 5 SLE patients into 15 severe combined immunodeficiency (SCID) mice. Such reconstituted mice showed long-term presence of auto-antibodies characteristic of the donor in their sera, as well as human immunoglobulin deposition, and in some cases mouse C3, in the renal glomeruli. SCID mice repopulated with PBLs from normal donors do not develop serologic abnormalities or immunodeposits. It is concluded that human SLE serology and some associated renal changes can be reproduced solely by PBL transferred from afflicted patients, and that SCID-human-SLE mice may serve as an in vivo laboratory model for the study of human SLE.

Animals↗
PubMed1990

Screening for slight albuminuria: a comparison of selected commercially available methods.

Slight albuminuria predicts clinically significant nephropathy in patients with insulin-dependent diabetes mellitus (IDDM) and early death in patients with non-insulin-dependent diabetes mellitus (NIDDM). This study compares four commercially available methods for measuring low concentrations of urinary albumin. We tested random spot urine specimens from 50 nondiabetic volunteers and 100 diabetic patients. This specimen was chosen to simplify collection in an outpatient setting. Two screening methods were evaluated for their ability to detect urinary albumin in the range of 15 to 200 mg/L. Sensitivity and specificity were 100% and 54.7%, respectively, for the Ames Micro-Bumintest; and 95.5% and 91.5%, respectively, for the Sclavo Albumin Screen. The high number of false-positive results made the Micro-Bumintest unacceptable. The Albumin Screen yielded fewer false-positive results, but also produced some false-negatives. Two quantitative methods, a radioimmunoassay (RIA) and a turbidimetric assay (the SPQ Microalbumin), yielded results that agreed well with each other.

Albuminuria↗
PubMed1990

Analysis of 8-methoxypsoralen by high-performance liquid chromatography.

We report a simple and rapid procedure for assaying 8-methoxypsoralen (8-MOP) in plasma by high-performance liquid chromatography (HPLC). The standard curve for the assay is linear for 8-MOP from 15 to 500 micrograms/L (y = 0.002x-0.01, r = 0.99) with a lower limit of detection of 1.5 micrograms/L. Intra-assay precision (CV) was 6.0% at the 100 micrograms/L concentration and 10.0% at 50 micrograms/L (n = 30 each). Interassay precision was 6.4% at 100 micrograms/L and 7.0% at 50 micrograms/L (n = 50 each). Extraction recovery of 8-MOP was 98%. Common antiarrhythmics, sedatives, and hypnotics were found not to interfere.

5-Methoxypsoralen↗
PubMed1989

Diazepam--morphine hypnotic synergism in rats.

The effect of diazepam-morphine combination on the righting reflex was studied in rats. Doses of the drugs given alone and in combination that block righting reflex (RR ED50) were determined with a probit procedure. Brain concentrations following equieffective doses of the drugs administered separately and in combination were determined by radioimmunoassay. Equieffective intravenous doses and corresponding brain concentrations for the agents were compared with fractional (algebraic) and isobolographic analyses. Interaction between diazepam and morphine was found to be synergistic. It is not likely to be pharmacokinetic in nature.

Animals↗
PubMed1989

Guarded alliance: health care relationships in chronic illness.

A multiphase, qualitative study of ongoing health care relationships from the perspective of the chronically ill patient and family confirmed that such relationships evolve over time through three predictable stages: naïve trust, disenchantment and guarded alliance. In the final stage, four patterns of health care relationships were identified: hero worship, resignation, consumerism and team playing. The configuration of these relationships in guarded alliance is explained by dimensions of the core variable of reconstructed trust--patients' trust in a health care professional and their trust in their own competence.

Chronic Disease↗
PubMed1988

Health care relationships: the chronic illness perspective.

Most explanations of the relationships between health care providers and health care recipients reflect perspectives and belief systems peculiar to health care professionals. In contrast, this study combined data from two separate qualitative investigations to yield an analysis of these relationships from the perspective of family members involved with chronic illness. Relationships between health care providers and health care recipients are viewed as evolving over time through a process which has identifiable stages. The utility of such a process orientation for nurses and other health care professionals is the insight it provides into the possibilities for negotiating satisfying care.

Adult↗
PubMed1988

Lactate dehydrogenase isolated from human liver mitochondria: its purification and partial biochemical characterization.

We have demonstrated that lactate dehydrogenase is not solely a cytosolic enzyme by the isolation and purification of the enzyme from the mitochondria of human liver. Treatment of the mitochondria with digitonin reveals the LD activity to be associated with the inner membrane-inner matrix and the outer membrane. The mitochondrial LD consists of two fractions separated by ion exchange and affinity chromatography. The first mitochondrial fraction, LD-Mt1, with isoelectric points of 9.8, 9.6, and 4.8, has subunit components of 14500 and 34000 daltons. The second mitochondrial fraction, LD-Mt2, is similar to cytosolic LD-5 with respect to both isoelectric points and subunit molecular weight. The first mitochondrial fraction, LD-Mt1, has physical characteristics previously associated with the isoenzyme LD-6.

Chromatography, High Pressure Liquid↗
PubMed1988

Reciprocal trust in health care relationships.

This paper examines the phenomenon of trust in health care relationships from a new perspective, that of the recipients of care for chronic illness. The authors argue that reciprocal trust is a necessary component of satisfying, effective health care relationships when the illness is of an ongoing nature. From the patient's perspective, reciprocal trust has a significant impact on the experience of being a receiver of health care and on the development of competency with illness management. Because of this, the authors claim that it is imperative for health care professionals to alter their traditional beliefs with regard to sick role and trust. With a new perspective, they may then develop the specific skills necessary to enact the caring aspect of the service they offer. The authors offer a number of suggestions for actualizing this reciprocal trust in clinical practice.

Attitude of Health Personnel↗