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Biomedical subjects

C Anderson

Publications and source records attributed to C Anderson.

At least 145 records · Page 8Linked to original sources
PubMed1996

Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients.

BACKGROUND AND PURPOSE: Few studies have examined the utility of a new generic health status measure, the Short Form 36 health survey questionnaire (SF-36), in stroke patients. Our aim was to test the internal consistency and validity of the SF-36 in a cohort of long-term stroke survivors. METHODS: The Australian version of the SF-36 was tested in 90 consecutive 1-year stroke survivors (mean age, 72 years) identified from our hospital discharge data. The instrument was administered by personal interview. Validity was assessed by comparing patients' scores on the SF-36 with those obtained for the Barthel Index, the 28-item General Health Questionnaire, and the Adelaide Activities Profile, an instrument developed from the Frenchay Activities Index. RESULTS: The SF-36 was relatively quick and easy to use and had satisfactory internal consistency (Cronbach's alpha > 0.7). For all eight SF-36 health scales, the mean scores for patients dependent in self care and with mental ill health were significantly different from patients without these disabilities, but the strength of the differences varied in a predictable manner. However, the SF-36 social functioning scale did not provide a valid measure of everyday activities relevant to many elderly patients as measured by the Adelaide Activities Profile. CONCLUSIONS: The SF-36 avoids the "ceiling effect" of most disability scales and provides a valid measure of physical and mental health after stroke, but it does not appear to characterize well social functioning. Thus, the instrument may need to be supplemented by other measures for a comprehensive assessment of stroke outcome.

Adult↗
PubMed1996

Follow-up of renal and mesenteric artery revascularization with duplex ultrasonography.

OBJECTIVE: To evaluate the long-term results of renal revascularization procedures using duplex ultrasonography: DESIGN: A case series. SETTING: A university-affiliated hospital. PATIENTS: Twenty-five patients who had undergone renal percutaneous transluminal angioplasty (PTA) (18 arteries), renal bypass (10 arteries) and mesenteric bypass (6 arteries). The mean follow-up was 22 months (range from 3 to 48 months) for those who underwent renal PTA, 23 months (range from 1.5 to 70 months) for those who underwent renal bypass and 34 months (range from 8 to 144 months) for those who underwent mesenteric bypass. MAIN OUTCOME MEASURES: Patency rates for the three procedures as assessed by duplex ultrasonography. RESULTS: Duplex ultrasonography demonstrated patency without stenosis after renal and mesenteric artery revascularization in 14 arteries subjected to renal PTA, 9 arteries subjected to renal bypass and 6 arteries subjected to mesenteric bypass. Three arteries that had renal PTA had recurrent vessel stenosis and one had occlusion. One artery that had renal bypass showed occlusion. CONCLUSIONS: Renal PTA, renal bypass and mesenteric bypass are durable procedures at 2 years of follow-up, and duplex ultrasonography is a valuable method for assessing the patency of arteries after renal and mesenteric revascularization.

Angioplasty, Balloon↗
PubMed1996

Von Willebrand's disease in the Western Cape.

OBJECTIVE: To establish the prevalence of the various subtypes of Von Willebrand's disease (VWD) among patients with bleeding disorders in the Western Cape and to review appropriate treatment strategies. DESIGN: A systematic clinical and laboratory study. SETTING: Haemophilia clinics at two tertiary referral hospitals (Groote Schuur Hospital and Red Cross War Memorial Children's Hospital) in the Western Cape. PATIENTS: Twenty-two patients (14 females, 8 males; ages 3 - 55 years) were studied. Those studied were selected for reasons of convenience, as they were compliant and regular attenders at the clinics. MAIN OUTCOME MEASURES: History of a bleeding tendency; bleeding time measurements; factor VIII assays, von Willebrand factor (VWF) antigen assays; ristocetin co-factor assays and VWF multimer analysis. RESULTS: Fourteen patients had typical type I VWD; 2 had type II and 5 had type III variants, and there was 1 unclassifiable variant. Analysis of local factor VIII concentrates showed the presence of high-molecular-weight VWF multimers. CONCLUSION: The results are similar to patterns reported elsewhere in the world. Locally produced factor VIII concentrates, unlike a number of commercially produced concentrates, contain sufficient multimers for use as appropriate replacement therapy.

Adolescent↗
PubMed1995

Metabolic requirements for induction of contact hypersensitivity to immunotoxic polyaromatic hydrocarbons.

Experiments were performed to define the metabolic requirements for induction of contact hypersensitivity to polyaromatic hydrocarbons (PAHs), environmental xenobiotics that are both immunotoxic and carcinogenic. Evidence that conversion of the parent compound to a reactive metabolite was necessary for the development of contact hypersensitivity included the fact 1) that contact hypersensitivity to the polyaromatic hydrocarbon dimethylbenz(a)anthracene (DMBA) only occurred in strains of mice that could metabolize the compound, 2) that among the PAHs, only those that could induce aryl hydrocarbon hydroxylase, the rate-limiting enzyme in the PAH metabolic pathway, were immunogenic, and 3) that inhibitors of PAH metabolism reduced DMBA contact hypersensitivity. Cells from the XS52 Langerhans cell-like dendritic cell line were able to metabolize the PAH benzo(a)pyrene to its diol, quinone, and phenol metabolites. GM-CSF augmented benzo(a)pyrene metabolism in XS52 cells. Finally, in vivo depletion of CD8+, but not CD4+, T cell populations inhibited contact hypersensitivity to DMBA. The implications of these experiments are that at least for some contact allergens, the metabolic status of the host is a key determinant of individual susceptibility to the development of allergic contact dermatitis, and the metabolic pathway of an individual hapten may have ramifications for the T cell subpopulation-CD4 or CD8-that is activated.

Animals↗
PubMed1995

Nerves containing nitric oxide synthase and their possible function in the control of catecholamine secretion in the bovine adrenal medulla.

NADPH-diaphorase reactivity and neuronal nitric oxide synthase (nNOS) immunostaining have been localised in sections of bovine adrenal glands. Both were present in nerve fibres and terminals in the subcapsular region and running between zona glomerulosa cells, amongst the medullary chromaffin cells, between large ganglion cells in rare encapsulated medullary ganglia and in large nerve bundles running through the cortex. Occasional isolated fibres were stained in deeper cortical layers. Both NADPH-diaphorase reactivity and nNOS immunoreactivity were present in a population of ganglion cells located individually or in small groups at the medullary-cortical boundary. NADPH-diaphorase reactivity was also found in all cortical cells (zona glomerulosa cells being more densely stained than other cortical cells) and in large fibrous structures in large nerve bundles (tentatively identified as glial cells): these structures were not stained with antisera to nNOS. Chromaffin cells were not stained with either technique. The possible role of neurally-released nitric oxide in the regulation of nerve-induced catecholamine secretion from chromaffin cells was investigated in isolated, perfused, bovine adrenal glands. The secretion of both adrenaline and noradrenaline in response to field stimulation of adrenal nerves at either 2 Hz or 10 Hz was unaffected by the presence of N omega-nitro-L-arginine (30 microM), sodium nitroprusside (10 microM) or L-arginine (100 microM) in the perfusing solution. It is concluded that, although nitric oxide may be generated and released from adrenal medullary nerves innervating chromaffin cells, it does not play a direct role in the acute regulation of adrenal catecholamine secretion.

Adrenal Glands↗
PubMed1995

The accuracy of death certificates in identifying work-related fatal injuries.

Three national US agencies report on work-related fatal injuries, and one uses the "injury at work" designation on the death certificate to identify and characterize these fatalities. The accuracy of the "injury at work" notation has not been validated. The authors used selected external causes of death (from the International Classification of Diseases, Ninth Revision, Clinical Modification) that are highly likely to be work-related or not work-related as a standard to compare with the California death certificate "at work" designation for the years 1979-1989. Data from the National Center for Health Statistics for the years 1979-1984 were used to measure prevalence for purposes of determining the predictive value of a positive or negative work-related notation on the death certificate. The sensitivity of the "at work" designation was 77.6%, with a specificity of over 99%. Sensitivity but not specificity varied by age, sex, and specific external cause of death. The predictive value positive of the "at work" designation was about 60%, which suggests caution in using it for some epidemiologic purposes.

Accidents, Occupational↗
PubMed1995

The amino acid sequence GPLY is not necessary for normal endocytosis of the human insulin receptor B isoform.

The human insulin receptor (hIR) cytoplasmic juxtamembrane domain contains two tyrosine (Y) residues which exist in GPLY and NPEY motifs that have been implicated in endocytic function. We have previously shown that the NPEY motif is not necessary for endocytosis of the B isoform (exon 11+) of hIR. To examine the role of the GPLY sequence in transmembrane insulin signaling and endocytic functions of hIR-B, we constructed a mutant receptor, hIR delta GPLY, that lacks the GPLY sequence (residues 962-965), and stably expressed it in CHO cells. When compared to wild type hIR-B (hIR-WT) similarly expressed in CHO cells, the hIR delta GPLY mutant exhibited higher insulin binding affinity (EC50 of 1.0 vs 3.5 nM) and normal insulin-stimulated receptor tyrosine autophosphorylation and kinase activity towards the endogenous 185 kDa insulin receptor substrate. The hIR delta GPLY receptor also exhibited normal endocytic functions as hIR-WT in that: a) the internalization of surface photoaffinity labeled hIR delta GPLY was similar to that of hIR-WT, and b) the rate and extent of 125I-insulin internalization and degradation at 37 degrees C were also unimpaired. Therefore, these results demonstrate that the GPLY sequence is not necessary for transmembrane insulin signaling and endocytic functions of the hIR-B isoform.

Amino Acid Sequence↗
PubMed1995

Prospective evaluation of associations between hearing sensitivity and selected cardiovascular risk factors.

The prospective decline of hearing sensitivity was evaluated in an occupational cohort of university blue collar workers in relation to age, gender, occupational and nonoccupational noise exposure, smoking, blood pressure, and cholesterol. Each of these were associated with loss of hearing sensitivity univariately. When controlling for age and historical noise exposure in a multiple regression model, systolic blood pressure and cholesterol level were independently associated with decline in auditory sensitivity.

Cardiovascular Diseases↗
PubMed1995

Living with chronic mental illness: understanding the role of work.

This paper is based upon an exploratory study designed to examine the role of work within the lives of those with severe, persistent mental illness (SPMI). In-depth, open ended interviews were conducted with a small number of consumers (n = 10) who attend a clubhouse for those with SPMI where emphasis is placed upon preparation for work. Given that little is known about how work impinges upon or enriches the lives of consumers we asked consumers about their experience of mental illness and work throughout their life trajectories. This paper describes these work experiences, the effect of mental illness and treatment compliance upon their ability to work, and the relationship of work to stress. We found that in general some kind of meaningful activity was important to these consumers, but many had found work experiences to be stressful and were cautious about their subsequent abilities to sustain meaningful employment. We suggest that subsequent research needs to examine the nature of the work environment, and that work environments may be usefully distinguished in terms of level of expressed emotion.

Adult↗
PubMed1995

Double-blind, parallel-group comparison of terbinafine and griseofulvin in the treatment of toenail onychomycosis.

BACKGROUND: Griseofulvin has been used in the treatment of toenail onychomycosis with limited success. Evidence suggests that terbinafine may be more effective. OBJECTIVE: In a double-blind, parallel-group study we compared 250 mg/day terbinafine for 16 weeks with 500 mg/day griseofulvin for 52 weeks (or for shorter periods in cured patients) in patients with toenail onychomycosis. METHODS: Eighty-nine patients with culture-proved tinea unguium were included, and 43 in the terbinafine group and 41 in the griseofulvin group were assessable for efficacy. Patients who had not improved after 16 weeks were entered into an open study and were given 250 mg/day terbinafine for 16 weeks with the study code still blinded and were then followed up for 20 weeks. RESULTS: Terbinafine was significantly more effective than griseofulvin, with 42% being completely cured and 84% mycologically cured compared with only 2% with total cure and 45% with mycologic cure in the griseofulvin-treated group. The number of side effects was significantly lower in the terbinafine group (11%) compared with the griseofulvin group (29%). CONCLUSION: Terbinafine is significantly more effective than griseofulvin in the treatment of toenail onychomycosis.

Adolescent↗
PubMed1995

Echocardiographic-morphologic correlations in tricuspid atresia.

OBJECTIVES: Our aim was to clarify the anatomic substrate in hearts diagnosed as having tricuspid atresia by studying autopsy specimens and comparing the findings with those in two-dimensional echocardiograms. BACKGROUND: Traditionally, tricuspid atresia was thought, and is still believed by some, to be due to an imperforate valvular membrane interposed between the floor of the blind-ending right atrium and the hypoplastic right ventricle. Others argued that the dimple, when present, pointed to the outflow tract of the left ventricle rather than to the right ventricle, making the lesion more akin to double-inlet left ventricle. METHODS: We examined 39 autopsy specimens catalogued as having tricuspid atresia. We then studied 24 two-dimensional echocardiograms from patients with a primary diagnosis of tricuspid atresia. RESULTS: Of the 39 specimens, 37 had a completely muscular floor to the right atrium (absent right atrioventricular [AV] connection). The dimple, when identified, was (except in one case) directed to the left ventricular outflow tract. Only two hearts had an imperforate tricuspid valve. Two-dimensional echocardiograms in all cases showed an echo-dense band, produced by the fibrofatty tissue of the AV groove and representing absence of the right AV connection, between the muscular floor of the morphologically right atrium and the ventricular mass. CONCLUSIONS: Tricuspid atresia is usually, but not always, due to morphologic absence of one AV connection. In most cases, the ventricular mass then comprises a dominant left ventricle together with a rudimentary and incomplete right ventricle.

Echocardiography↗
PubMed1995

Infrainguinal bypass in patients with end-stage renal disease.

BACKGROUND: This study was undertaken to evaluate the outcome of infrainguinal arterial reconstruction in a high-risk subset of patients with end-stage renal disease. METHODS: We reviewed the medical records of 44 patients requiring maintenance dialysis and undergoing 57 infrainguinal bypass procedures for limb salvage from 1986 to 1992. These included 16 (28%) femoropopliteal and 41 (72%) tibial or pedal bypasses with autogenous (82%), prosthetic (12%), or composite (6%) graft materials. The principal indications for operation were ischemic ulceration or gangrene (79%) and rest pain (21%). Angiographic evaluation most frequently showed single-vessel runoff (56%). Risk factors included age (mean, 63 years), diabetes (75%), hypertension (93%), coronary artery disease (52%), smoking (39%), previous myocardial infarction (20%), and contralateral amputation (18%). Infection was present in 22 limbs (39%). RESULTS: Early (30-day) surgical morbidity rate was 39%, including wound breakdown (19%), graft thrombosis (9%), and major amputation (4%). Perioperative mortality rate was 9%. Cumulative primary graft patency rates were 71% and 63%, secondary patency rates were 80% and 66%, and limb salvage rates were 70% and 52% at 1 and 2 years, respectively. Limb loss correlated most highly with the presence of preoperative infection (p = 0.036; log-rank method). Patient survival rate was 52% at 2 years. CONCLUSIONS: Life-table analysis confirms a poor life expectancy for this population but indicates that an acceptable level of limb salvage may be achieved with arterial reconstruction in properly selected patients.

Adult↗
PubMed1995

Childhood sexually transmitted diseases: one consequence of sexual abuse.

Numerous sexually transmitted diseases (STDs) of both viral and bacterial origin exist. Nursing and medical literature typically focuses on adults with STD, with vague regard for the epidemiology of STD among prepubertal children. This article focuses on childhood sexually transmitted disease as a consequence of sexual abuse. Nurses are encouraged, however, to assess both for STDs among child victims of sexual abuse and for sexual abuse among child victims of STDs. Some of the more common sexually transmitted diseases among adults, such as Neisseria gonorrhoeae, Chlamydia trachmatis, Treponema pallidum, genital herpes simplex Virus, human papillomavirus and HIV/AIDS are discussed as they occur in children between the ages of 1 and 12 years. Suggestions are provided for nurses regarding assessment and protocols (interviews and examinations) and interventions.

Child↗
PubMed1995

Neisseria meningitidis with decreased susceptibility to penicillin in Saskatchewan, Canada.

Moderately penicillin-resistant Neisseria meningitidis is rare in North America. We report an outbreak of meningococcal disease in Saskatoon, Saskatchewan, Canada, with serogroup C N. meningitidis. The MICs of penicillin ranged from 0.12 to 0.25 micrograms/ml, and all isolates showing decreased susceptibility had identical genomic fingerprints when they were compared by pulsed-field gel electrophoresis. Our data indicate that N. meningitidis that is moderately resistant to penicillin is prevalent in Saskatchewan, Canada.

Adolescent↗
PubMed1995

Diode laser treatment for retinopathy of prematurity: structural and functional outcome.

AIMS: The anatomical and functional outcome of 13 babies with retinopathy of prematurity (ROP) treated with binocular indirect ophthalmoscope diode laser photocoagulation was assessed. METHODS: Thirteen babies (25 eyes) at median postmenstrual age (PMA) 25.5 weeks and median birth weight 725 g were treated with binocular indirect ophthalmoscope (BIO) diode laser photocoagulation when threshold retinopathy of prematurity (ROP) was detected at median PMA 35 weeks. Retinopathy was more severe in the nasal retina in 15 eyes. The median severity of retinopathy was 6 clock hours grade 3 disease. All babies were treated under general anaesthetic with no significant ocular or systemic complications during treatment. The median number of burns was 1200. RESULTS: Resolution of active retinopathy occurred 1-2 weeks following treatment in all but one baby. All eyes had favourable anatomical and functional outcome as defined by the Cryo-ROP study group at a median age of 19.5 months of follow up. CONCLUSION: BIO diode laser treatment is as effective as cryotherapy with less morbidity.

Female↗
PubMed1995

In situ biodegradation of poly(3-hydroxybutyrate) and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) in natural waters.

The biodegradation of samples of poly(3-hydroxybutyrate)(P(3HB)), poly(3-hydroxybutyrate-co-10%-3-hydroxyvalerate)(P(3HB-co-10 %-3HV)), and poly 3-hydroxybutyrate-co-20%-3-hydroxyvalerate)(P(3HB-co-20%- 3HV)) was investigated in situ in natural waters. The degradation was studied by decrease in mass, molecular weight, and tensile strength. In two freshwater ponds the polymers were slowly degraded. After half a year of submersion the mass loss was less than 7%. After 358 days in a freshwater canal, 34% mass loss was recorded for the homopolymer, and 77% for the P(3HB-co-10%-3-HV) samples, while the P(3HB-co-20%-3HV) samples had completely disappeared. In seawater in the harbour of Zeebrugge, P(3HB) samples lost 31% of their initial mass, and the copolymers 49-52%, within 270 days. In all of these environments, the degradation rate was faster during the summer, when the temperature of the water was higher. No relevant changes in molecular weight could be detected, indicating that the degradation took place only at the surface of the samples. The degradation resulted in considerable loss of tensile strength of the copolymer samples. Ninety-two microorganisms, mainly bacteria, able to degrade P(3HB) in polymer overlayer plates, were isolated and identified by fatty acid analysis. The isolates from one freshwater pond belonged mainly to the bacterial genus Acidovorax, while the microorganisms from the other freshwater pond belonged to various bacterial genera, to Streptomyces, and to the mould genus Penicillium. Most of the 31 bacterial isolates from seawater were identified as Alteromonas haloplanktis. The results demonstrate that P(3HB) and P(3HB-co-3HV) samples are effectively biodegradable in natural waters under real-life conditions and reveal the biodiversity of the microflora responsible for this biodegradation.

Bacteria↗
PubMed1995

Comparison of sputum induction with fiber-optic bronchoscopy in the diagnosis of tuberculosis.

Microbiologic confirmation of pulmonary tuberculosis among patients whose sputum smear is negative is increasingly important because of greater incidence among immunocompromised hosts and emergence of drug-resistant strains. We prospectively compared sputum induction to fiber-optic bronchoscopy in the diagnosis of such patients. Consecutive patients referred for investigation of possible active pulmonary tuberculosis underwent sputum induction with hypertonic saline delivered by an ultrasonic nebulizer between 2 and 48 h before transnasal fiber-optic bronchoscopy. All specimens were examined for acid-fast bacilli with fluorescent microscopy and cultured for mycobacteria. Clinical information was abstracted from patient records, and X-rays were reviewed by two blinded readers. Among 101 participants, sputum induction was well-tolerated without complications and provided adequate samples in 93. Sensitivity of direct acid-fast bacilli smear of specimens from both techniques was low. Sensitivity and negative predictive value of culture from bronchoscopy specimens was 73% and 91% compared with 87% and 96%, respectively, for sputum induction when a specimen was obtained. Direct costs for bronchoscopy totaled Canadian $187.60 compared with Canadian $22.22 for sputum induction. Sputum induction was well-tolerated, low-cost, and provided the same, if not better, diagnostic yield compared with bronchoscopy in the diagnosis of smear-negative pulmonary tuberculosis.

Adult↗