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Biomedical subjects

C Nelson

Publications and source records attributed to C Nelson.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Will outpatients complete living wills? A comparison of two interventions.

OBJECTIVE: To test the efficacy of two intervention methods that aimed to increase the percentage of adult clinic patients who completed living wills and placed them on file with their physicians within a four-month period. DESIGN: There were one control and two intervention groups. Surveys were separated by age and gender categories and randomly selected for the final sample. SETTING: The internal medicine outpatient clinic of a large tertiary hospital. PARTICIPANTS: All patients who visited the clinic were asked whether they would be willing to fill out a survey. The final sample included 167 adult patients who comprised three study groups. INTERVENTIONS: The first intervention relied solely on a booklet that described the Minnesota Living Will Act, general information concerning advance directives, and medical interventions that could be considered extraordinary if used for a patient in a terminal condition. The second intervention relied on both the booklet and repeated physician-initiated discussions with the patient about the probable value of a living will. MAIN RESULTS: The booklet/physician intervention was found to be significantly more effective than either the booklet-only intervention or no intervention (p less than 0.05 and 0.01, respectively). CONCLUSIONS: The physician intervention used in this population could be undertaken in any primary care clinic. Time spent in discussion before a crisis may be significantly shorter and qualitatively better than time spent in discussion with families who must make decisions during a crisis.

Adult↗
PubMedDate not supplied

Discrete cis-active genomic sequences dictate the pituitary cell type-specific expression of rat prolactin and growth hormone genes.

The anterior pituitary gland, which is derived from a common primordium originating in Rathke's pouch, contains phenotypically distinct cell types, each of which express discrete trophic hormones: adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), prolactin, growth hormone, and follicle stimulating hormone (FSH)/luteinizing hormone (LH). The structurally related prolactin and growth hormone genes, which are evolutionarily derived from a single primordial gene, are expressed in discrete cell types--lactotrophs and somatotrophs, respectively--with their expression virtually limited to the pituitary gland. The pituitary hormones exhibit a temporal pattern of developmental expression with rat growth hormone and prolactin characteristically being the last hormones expressed. The reported co-expression of these two structurally related neuroendocrine genes within single cells prior to the appearance of mature lactotrophs, in a subpopulation of mature anterior pituitary cells, and in many pituitary adenomas raises the possibility that the prolactin and growth hormone genes are developmentally controlled by a common factor(s). We now report the identification and characterization of nucleotide sequences in the 5'-flanking regions of the rat prolactin and growth hormone genes, respectively, which act in a position- and orientation-independent fashion to transfer cell-specific expression to heterologous genes. At least one putative trans-acting factor required for the growth hormone genomic sequence to exert its effects is apparently different from those modulating the corresponding enhancer element(s) of the prolactin gene because a pituitary 'lactotroph' cell line producing prolactin but not growth hormone selectively fails to express fusion genes containing the growth hormone enhancer sequence.

Animals↗
PubMedDate not supplied

A method to help new fathers develop parenting skills.

Interaction of parent and infant birth is important to the process of bonding and attachment. Much of this very early interaction is physical handling and care. New fathers may tend to feel uncomfortable and awkward with this handling due to lack of prior experience. A class was developed, in a private Midwestern hospital, to offer opportunities for fathers to gain knowledge, skill, and practice to make them feel more comfortable with this interaction and facilitate attachment. Response from participating fathers indicated that the classes were effective.

Education↗
PubMedDate not supplied

Thermodynamic considerations of acrylic cement implant at the site of giant cell tumors of the bone.

A discussion of the thermodynamic aspects of a relatively new treatment method for giant cell tumors of the bone is presented in this paper. The advantages of implanting methylmethacrylate acrylic bone cement into a curetted tumor site are briefly discussed and placed in perspective relative to more prevalent surgical treatments. As the bone cement self-heats while curing, the possibility of heat necrosis in the bone exists. However, the damage due to heat may be beneficial in reducing the rate of tumor recurrence. A thermodynamic consideration of the treatment situation appears to be warranted. After a general introduction and a brief literature review, the theoretical thermodynamic equations are developed. Once the basic equations for the heat transfer from the cement or the bone are derived, there is then a discussion of the various characteristics of bone and methylmethacrylate crucial to the analysis, such as, thermal conductivity, specific heat, density, and heat generation parameters. Finally, in order to reduce the theory to a form which may be used practically, the equations derived are written in terms of finite-difference equations, which approximate them numerically. Different equations are written for each type of heat transfer condition encountered in the cement-bone system as spacial variances in material and geometry occur. The equations derived may be used to model the system allowing one to predict the time-dependent temperature distribution in bone during the curing of acrylic cement. Using computer techniques to reduce the equations obtained from this analysis, and knowing the temperature at which adjacent cells die, a zone of necrosis may be mapped surrounding the acrylic impact.

Bone Neoplasms↗
PubMedDate not supplied

Median nerve F wave conduction in healthy subjects over age sixty-five.

Parameters of the median nerve F wave and peripheral motor nerve conduction in 51 healthy male and female human subjects 67 to 89 years of age are described. F wave responses were elicited by stimulation of the nerve at the wrist. Motor nerve conduction velocity (MNCV) was determined for the forearm segment. Major results of this study of an older group of subjects demonstrate that: 1) the shortest F wave latency (SFWL) and the MNCV were slower in our older subjects than values in younger subjects; 2) there was no significant correlation between SFWL and age within the age group examined; 3) distal motor conduction latency was significantly slower in subjects age 75-89 years than in those age 67-74 years; 4) SFWL and MNCV of females were significantly faster than that of males; 5) a positive correlation was found between SFWL and arm length and a predictive formula is derived. An upper limit of normal F wave wrist latency of 31 msec for females and 34.4 msec for males over 65 years of age is proposed as a guideline.

Aged↗
PubMedDate not supplied

A Christmas miracle.

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Child, Preschool↗