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Biomedical subjects

C Beck

Publications and source records attributed to C Beck.

At least 109 records · Page 6Linked to original sources

Caring for the cognitively impaired. Reconceptualizing disability and rehabilitation.

Rehabilitative interventions must be based on remaining cognitive and physical abilities while recognizing the presence of disabilities. Rehabilitation goals should be to provide the least restrictive environment using the least restrictive intervention, thus promoting independence. The use of behavioral strategies that support remaining abilities and compensate for cognitive deficits is recommended as a rehabilitative approach. The behavioral approach requires an assessment of the ADL steps, the range of activities a person is able to complete, and the kinds of caregiver assistance needed.

Activities of Daily Living↗

Dressing for success. Promoting independence among cognitively impaired elderly.

In demented persons, activities of daily living skills may deteriorate more quickly than their cognitive decline warrants because caregivers do not allow them to perform ADLs to the full extent of their abilities. Caregiver actions that promote independent behaviors were used with subjects in home and nursing home settings. Four of five home subjects showed decreased caregiver assistance and increased ability to dress more independently. Although nursing home subjects did not show a decrease in caregiver assistance, observation showed that some nursing home caregivers did incorporate behavioral strategies, suggesting potential clinical efficacy of the strategies.

Activities of Daily Living↗

Urinary incontinence volume measurement in elderly male inpatients.

Urinary incontinence is a debilitating disease in the elderly and is a leading cause of nursing home placement for aged patients in our society. Accurate measurement of urinary incontinence in elderly inpatients is necessary to determine the severity of the disease and to evaluate the efficacy of any treatment methods being investigated. The technique required for evaluation of elderly chronic care inpatients is different from methods that can be used in patients who do not have the ambulatory and cortical impairment that is common among chronic care inpatients. Since chronic care nursing staff involvement is necessary for accurate measurement and recording of incontinence episodes, a procedure for measurement must be well defined and clearly outlined in a sequence that can be followed easily. This study provides a method of incontinence volume assessment for elderly inpatients that can be performed by inpatient nursing staff to provide accurate incontinence volume measurements. Quantitative urinary incontinence volume measurements were done over ten days in 42 elderly men. Urinary incontinence presented as a significant problem in these patients over a wide range of both frequency and volume of urinary incontinence episodes. The volume measurement technique described allowed the nursing staff to identify, measure, and record incontinence severity over a wide range of frequency and volume while monitoring multiple patients simultaneously.

Aged↗

The influence of portocaval shunting on inner ear structures.

In rats with a portocaval shunt the cells of the inner ear were examined in an ultrastructural study. In 15 rats a porto-caval shunt (PCS) was constructed. Control rats underwent identical procedures but no anastomosis was produced (SOP). The control rats were pair-feeded. PCS rats developed an increased urinary zinc excretion associated with weight loss, alopecia, lethargy and atrophy of the testes. The serum zinc concentration in PCS rats was significantly reduced. In the inner ear we found ultrastructurally an increasing number of lysosomes and a severe damage of the myelin sheath of the granular ganglion cells. The myelin sheath was split and filled with great myelin figures. In the outer hair cells resulted in an increasing number of lysosomes. In the stria vascularis and in Reissner's membrane a vacuolization of the tissue appeared. The results of this study show that rats with a porto-caval anastomosis serve as a pathophysiological model of zinc impoverishment like porto-caval shunting in patients with liver cirrhosis.

Animals↗

Quantitative analysis of MDR1 (multidrug resistance) gene expression in human tumors by polymerase chain reaction.

The resistance of tumor cells to chemotherapeutic drugs is a major obstacle to successful cancer chemotherapy. In human cells, expression of the MDR1 gene, encoding a transmembrane efflux pump (P-glycoprotein), leads to decreased intracellular accumulation and resistance to a variety of lipophilic drugs (multidrug resistance; MDR). The levels of MDR in cell lines selected in vitro have been shown to correlate with the steady-state levels of MDR1 mRNA and P-glycoprotein. In cells with a severalfold increase in cellular drug resistance, MDR1 expression levels are close to the limits of detection by conventional assays. MDR1 expression has been frequently observed in human tumors after chemotherapy and in some but not all types of clinically refractory tumors untreated with chemotherapeutic drugs. We have devised a highly sensitive, specific, and quantitative protocol for measuring the levels of MDR1 mRNA in clinical samples, based on the polymerase chain reaction. We have used this assay to measure MDR1 gene expression in MDR cell lines and greater than 300 normal tissues, tumor-derived cell lines, and clinical specimens of untreated tumors of the types in which MDR1 expression was rarely observed by standard assays. Low levels of MDR1 expression were found by polymerase chain reaction in most solid tumors and leukemias tested. The frequency of samples without detectable MDR1 expression varied among different types of tumors; MDR1-negative samples were most common among tumor types known to be relatively responsive to chemotherapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Caregivers' perception of aggressive behavior in cognitively impaired nursing home residents.

Aggressive behaviors of nursing home residents represent a significant problem for caregivers and families. A guided interview format was used to collect data from 21 nurses and 20 nursing assistants in order to gather information on the characteristics of aggressive behavior and how it is managed in cognitively impaired nursing home residents. Sixty-eight percent of the caregivers stated the residents were physically aggressive, while 95% cited verbal aggression. Aggression occurred most commonly in the mornings while the caregiver was dressing the resident. Inadequate staffing and new staff were both seen as problems by the caregivers. Talking soothingly and assuring the resident were techniques initially used to comfort the residents. Reasoning with the resident was the most common follow-up procedure used by the caregivers.

Aggression↗

Serial incontinence assessment in elderly inpatient men.

Urinary incontinence is a major problem for elderly chronic care patients. As a consequence, a high level of nursing care is required for patient management. Because incontinence rehabilitation programs are usually implemented during the day shift, the incidence of incontinence according to time of day has major implications regarding patient management. Although treatment is usually based on severity, assessment of incontinence severity in elderly chronic care inpatients is difficult. In this study, a telemetric incontinence detection system was developed to identify incontinence episodes. An absorbent pad exchange technique was used for incontinence volume measurement. The study group, 66 chronic care inpatient men over 65 years old, were subject to incontinence measurements over 10 days during all nursing shifts using the telemetric incontinence detection system. The results showed a significantly high incidence of incontinence episodes during the evening nursing shift. The volume of involuntary urine loss was significantly higher during the night nursing shift. Thus, the highest level of incontinence severity occurred during the time of day when nursing staff on chronic care units is usually the lowest.

Aged↗

[Employment of a dental hygienist in Germany. 2. The cooperation between dentist and dental hygienist in day to day practice].

The comprehensive range of functions in a dental practice with special emphasis on periodontal cure requires cooperation amongst highly qualified personnel. The dental hygienist has a special standing and is responsible for as well as in charge of important treatment stages, as much as the dentist himself. The treatment stages are of greater relevance to long-lasting therapeutic achievements.

Adult↗

[The superior vena cava syndrome as an emergency in radiotherapy].

Between 1983 and 1988 90 patients with bronchial neoplasms needed emergency irradiation to treat superior vena cava syndrome. Pathohistologically verified were 30 cases with squamous cell carcinoma, twelve with adenocarcinoma, five cases with large cell carcinoma, 30 with a small cell carcinoma, and non-differentiated in five others. No histological examination was carried out in eight cases. Im 30 patients distant metastases were evident at the initial diagnosis. The average duration of follow-up was 118 days. The survival course proved to be independent of histopathological grading, previous treatment, and age. Similarly no influence of the fractionation employed could be seen. Very important to the prognosis however, were the stage of disease, the Karnofsky index, and dependent on that, the total reference dose applied. Patients with a Karnofsky index of 50% or lower survived on average only 17 days.

Adenocarcinoma↗

Ultracytochemical localization of Ca2(+)-ATPase activity in the middle ear mucosa of the guinea pig.

Ca2(+)-ATPase activity was studied ultra-cytochemically in the middle ear mucosa of the guinea pig. On electron microscopic examination, the most intense reaction was found on the microvilli. Reaction products were also observed on the cilia and around and between the secretory granules on the apical side of the cells in their secretory phase. The basolateral membranes contained few reaction products, while very little or no activity was found on the basal membrane.

Animals↗

Characterization of potassium channels in respiratory cells. I. General properties.

Potassium channels present in the basolateral membrane of respiratory epithelial cells play an important role in the process of chloride secretion. Utilizing the patch clamp technique, we examined human cultured respiratory epithelial cells derived from patients with cystic fibrosis (CF) and normals individual (N) for the existence of and for the properties of K+ channels. We obtained qualitatively and quantitatively identical results for both preparations (CF and N). K+ channels were spontaneously present in cell attached patches. The channels showed burst appearance with rapid flickering within the bursts. When the pipette was filled with 145 mmol/l KCl, a mean conductance of 131 +/- 25 pS (n = 15) was read from the I/V-curve at a clamp voltage (Vc) of 0 mV. After excision, the conductance read from the I/V-curve at Vc = 0 mV was 212 +/- 11 pS (Pipette: 145 mmol/l KCl, bath: 145 mmol/l NaCl) (n = 61). With NaCl in the pipette and KCl in the bath, a similar conductance was obtained (g = 210 pS; n = 2). When both, pipette and bath contained KCl, the conductance was increased to 302 +/- 19 (n = 7). The channel was highly selective for potassium over sodium: PK + /PNa + greater than 40. The channel open probability was only slightly voltage dependent i.e. the open probability increased slightly with depolarisation. For most of the channels one open time constant (to = 6.3 +/- 1.6 ms; n = 22) and one closed time constant (tc = 1.8 +/- 0.3 ms; n = 21) was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Membrane↗

[Use of glass ionomer cement in surgery of the incus-stapedial joint. An initial report of experiences].

Chronic inflammations of the middle ear are characterised by perforation of the tympanic membrane as well as hearing loss, due to disintegration in the incudostapedial joint. Usually the perforation is easily restored by means of available modern procedures; on the other hand, failure of the reconstruction of the ossicular chain, especially of the incudostapedial joint, is not uncommon. Hence, the improvement of hearing capacity is transitory, since later, due to scars, graft lateralisation results in a dislocation of the primarily reconstructed ossicular chain. The patient's hearing capacity is then as poor as it has been before surgery. The aim of this study is to demonstrate the ways of satisfactory reconstruction of the incudostapedial joint by means of glass-ionomer cement: 1. Scar tissue connecting the ossicles in slight defects of the incudostapedial joint can be stabilised by glass-ionomer cement leading to a reasonable sound transmission. 2. If the incus has to be removed in case of a more serious defect, the columella can be properly fixed to the stapes by means of glass-ionomer cement without the risk of scar-induced lateralisation. 3. The fixation of the stapes prosthesis' wire loop to the incus can be effectively achieved by glass-ionomer cement.

Audiometry, Pure-Tone↗