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Biomedical subjects

C Parsons

Publications and source records attributed to C Parsons.

At least 19 recordsLinked to original sources
PubMed1998

New combination of the old drugs for elderly patients with small-cell lung cancer: a phase II study of the PAVE regimen.

PURPOSE: A regimen of cisplatin, doxorubicin, vincristine, and etoposide (PAVE) was designed for patients with small-cell lung cancer (SCLC) who were older than 65 years, with the following objectives compared with standard chemotherapy regimens: maintain efficacy, diminish toxicity, enhance compliance, and improve chemotherapy administration convenience at an acceptable cost. PATIENTS AND METHODS: The PAVE regimen consisted of cisplatin 30 mg/m2 intravenously (i.v.) day 1; doxorubicin 40 mg/m2 i.v. day 1; vincristine 1.0 mg/m2 i.v. day 1; and etoposide 100 mg/m2 i.v. day 1 and orally days 3 and 5. Cycles were repeated every 3 weeks for four cycles. Patients with limited-stage disease and selected patients with extensive-stage disease received thoracic irradiation delivered concurrently with etoposide-cisplatin (EP) at the time of the second chemotherapy cycle. RESULTS: Sixty-six eligible patients were treated, which included 25 patients with limited-stage disease and 41 patients with extensive-stage disease. Median survival was 70 weeks and 5-year survival was 25% for limited-stage disease. Median survival was 46 weeks for extensive-stage disease. Only one treatment-related death occurred and severe toxicity was infrequent. The median delivered dose-intensity was according to protocol and the mean delivered total dose was 80% of intended. CONCLUSION: The treatment outcome achieved with PAVE in a phase II study of elderly patients compared favorably with published results of standard regimens in patient populations with better prognostic factors. Because the PAVE regimen can be delivered with good compliance, has acceptable toxicity, and is associated with logistic advantages compared with standard regimens, this protocol is suitable for further investigative trials in elderly patients with SCLC.

Age Factors↗
PubMed1998

Injury and anomie: effects of violence on an inner-city community.

OBJECTIVES: Widespread violence affects individuals but also alters group life. This study was designed to examine the effects of violence on an inner-city community. METHODS: A qualitative study was undertaken that included field observations and semistructured interviews. The study took place in Washington Heights, a New York City neighborhood with a high rate of violence, largely secondary to the drug trade. RESULTS: The 100 people interviewed differed widely in their definitions of violence and in their likelihood of having experienced violent acts in the course of daily life. High, medium, and low violence microenvironments were identified; risk of exposure to violence, but not individual definitions of violence, differed by location. Violence in all parts of the neighborhood inhibited social interactions, but the intensity of this effect differed by microenvironment. CONCLUSIONS: In Washington Heights, violence has injured individuals and fractured social relationships, leading to the state of social disarray referred to as "anomie." The public health response to the violence epidemic should address anomie through community organizing efforts.

Adolescent↗
PubMed1997

The significance of paracardiac lymph node enlargement in ovarian cancer.

The computed tomography (CT) scans of 78 patients with stage II, stage III and relapsed stage I ovarian carcinoma were reviewed in order to identify the incidence of enlarged paracardiac lymph nodes in this disease, recognize their association, if any, with peritoneal metastases and establish whether they had any bearing on progression free interval and survival. Twenty-two patients (28%) were found to have enlarged paracardiac nodes, nine at initial presentation and a further 13 during the course of follow-up. The association between paracardiac node enlargement and peritoneal metastases was found to be highly significant. Thirty per cent of 27 patients with peritoneal metastases at presentation were found to have enlarged paracardiac nodes whereas of the 51 patients without peritoneal dissemination only 2% had enlarged paracardiac nodes (P < 0.001). In order to determine whether paracardiac nodal status had any independent prognostic value, multivariate analysis using Cox's regression was performed. When status at presentation was considered, the presence of enlarged paracardiac lymph nodes was found to be an independent predictor for survival. (Hazard ratio 3.70, 95% confidence interval (1.18-11.6), P < 0.04.) The hazard ratio for paracardiac nodal status with respect to progression free survival was not significant but in the expected direction. (Hazard ratio 1.85 (0.65-5.25).) When time-dependent covariate analysis was applied, paracardiac nodal status and peritoneal metastases status were found to be independent predictors for both progression free survival and overall survival. The presence of peritoneal metastases indicated a poorer prognosis than the presence of paracardiac lymph nodes, the hazards ratios for progression free survival were 12.9 and 2.58, respectively, and those for survival were 20.7 and 3.62, respectively. We have demonstrated that the presence of paracardiac lymph node enlargement is a significant adverse prognostic factor for both progression free interval and survival. The diagnosis of involved paracardiac lymph nodes is important as it can define patients having stage IV as opposed to stage III disease.

Adult↗
PubMed1997

Self-paced resistance training and walking exercise in community-dwelling older adults: effects on neuromotor performance.

BACKGROUND: Resistance-training intervention studies have demonstrated meaningful health benefits in older adults; however, most have used exercises performed at specific intensities on expensive equipment, which limit their widespread applicability. We tested whether two self-paced, less expensive exercise protocols could be effective and safe for modifying neuromotor performance and functional capacity in community-dwelling adults 65-95 years of age. METHODS: One hundred and thirty-one subjects were randomized to a novel resistance training, walking, or control group. Subjects determined their level of resistance or walking intensity (self-paced) on a session-by-session basis. Muscle strength, balance, reaction time, stair climbing speed, and a timed pen pickup task were measured before and after the intervention period. Exercisers met three times per week for 10 months. RESULTS: Significant improvements in tandem stance and single-legged stance with eyes open times and stair climbing speed were seen in both exercise groups. In addition, resistance trainers improved their muscle strength and ability to pick up an object from the floor and reduced the number of missteps taken during tandem walking, and walkers reduced tandem walking time. Controls showed no significant improvement in any variable. CONCLUSIONS: The two self-paced exercise protocols were effective at improving neuromotor performance and functional capacity in the study sample and show promise as a safe, effective, cost-efficient, acceptable exercise model for primary and secondary prevention in the general population of community-dwelling older adults.

Aged↗
PubMed1997

Breaking down language barriers in clinical practice.

Communication is an essential component of skilled nursing-practice. As 20 per cent of Australians are born overseas and come from a non-English speaking background (NESB), effective communication becomes a challenge for nurses who do not share the same language. Nursing use of an interpreter service is an essential component of practice in a multicultural community. This was one of the findings of a two-year participatory action research study which explored the practice of nurses caring for non-English speaking families. The intention of this paper is to explore this crucial aspect of the findings; nursing use of interpreters and the strategies instigated by the nurses to work more effectively with them.

Australia↗
PubMed1996

Studies on the toxic effects of crambe meal and two of its constituents, 1-cyano-2-hydroxy-3-butene (CHB) and epi-progoitrin, in broiler chick diets.

1. Studies were undertaken to determine a safe inclusion rate for crambe (Crambe abyssinica) meal in broiler chick diets, and to determine the mechanism for adverse effects by investigating its constituents; 1-cyano-2-hydroxy-3-butene (CHB) and 3-butenyl glucosinolate (epi-progoitrin, E-PG). 2. Crambe meals were prepared to differ in E-PG (19, 36 and 40 g/kg) and CHB contents (0.1, 0.7 and 1.9 g/kg), and with either active or inactive thioglucosidase. 3. Meals were fed to 7-d-old broiler chicks at 50 or 100 g/kg of the diet for 12 or 13 d. In separate studies, isolated E-PG or CHB were mixed into the diet or administered by gavage to 7-d-old broiler chicks in amounts equivalent to 50 or 100 g/kg crambe meal diets for 10 and 12 d, respectively. 4. Weight gain decreased (P < 0.05) in chicks fed on the high glucosinolate crambe diets or isolated E-PG. Food consumption decreased (P < 0.05) in chicks fed on the diet containing the high E-PG meal with active enzyme. 5. Mild liver lesions and increased serum aspartate aminotransferase were found in chicks fed on the diet containing the high glucosinolate meal with active enzyme. Other organs, including thyroids, were normal. 6. Commercially-processed crambe meal appeared safe at an inclusion rate of 50 or 100 g/kg diet, but could not be recommended at this point for long term feeding.

Alkenes↗
PubMed1996

A controlled trial of general practitioners' attitudes to patients with schizophrenia.

OBJECTIVE: To examine general practitioners' attitudes to patients with schizophrenia. DESIGN: A random sample of primary care physicians were alternately sent a case vignette of a patient with or without schizophrenia, in an otherwise identical clinical abstract, and asked to indicate their level of agreement with fifteen statements based on it. SUBJECTS AND SETTING: A one-in-five sample of general practitioners who were identified from the Primary Care Services Register of Lothian Health Board. RESULTS: The median score for each statement was compared by the two-tailed Wilcoxon rank sum test. Doctors responding to the vignette of the patient with schizophrenia were significantly less willing to have the patient on their practice list, more likely to refer them to a specialist and more likely to think that they would be violent; whereas they did not think that they would take up any more time than the other patient. These impressions were no different between those who had or had not received work training in psychiatry. CONCLUSIONS: This controlled trial of primary care physicians' attitudes towards patients with schizophrenia amounts to an empirical demonstration of medical discrimination against the sufferers of this and potentially of other long term psychiatric disorders. Psychiatrists and general practitioners should share care in the management of schizophrenia and try to overcome the prejudices against such patients in an attempt to improve their overall clinical care.

Attitude of Health Personnel↗
PubMed1995

Variation of electron beam uniformity with beam angulation and scatterer position for total skin irradiation with the Stanford technique.

PURPOSE: The influence of different scatterer-degraders and beam angulations on beam uniformity for total skin electron irradiation using the six dual beam Stanford technique is investigated. METHODS AND MATERIALS: The 6 MeV high dose rate total skin electron irradiation mode on a linear accelerator was used. Beam profiles and percentage depth doses in the patient plane for single, dual, and six dual beams were measured for different dual beam angulations and acrylic scatterer-degraders of different thicknesses mounted on the treatment head or in front of the patient in the treatment plane. RESULTS: It is demonstrated that, with the same electron nominal energy, total skin irradiation techniques with different beam penetrations can be obtained by inserting various beam scatterer-degraders into the beam, either mounted on the accelerator head or close to the patient. For our patient treatment, a beam penetration was selected so that the 80% dose lay at 8-9 mm and the 50% dose at 15-16 mm depth. This was achieved by mounting a 0.32-cm thick acrylic beam scatterer-degrader on the accelerator head. A uniform vertical profile was obtained for gantry angulations of +/- 21 degrees. CONCLUSIONS: To implement a total skin electron irradiation technique using the Stanford method, the required depth of penetration needs to be selected. Based on this, the appropriate combination of scatterer-degraders and dual beam angulations to produce a uniform beam in the treatment plane needs to be determined. Different techniques with different beam penetrations can be developed using the same high dose rate mode on the linear accelerator by a proper choice of scatterer-degraders and beam angulations.

Humans↗
PubMed1995

The impact of postmodernism on research methodology: implications for nursing.

This article considers what have been referred to as the two major crises in research methodology: (i) the crisis of legitimation (to what extent are the notions of reliability and validity still meaningful in the light of a posture that is said to approach an 'anything goes' standpoint); and (ii) the crisis of representation (to what extent is it possible to represent the world view of 'the other' without it being merely a construction of the researcher). These are discussed in order to identify aspects of a continuing debate that is of relevance to nurses for they are integral to graduate research and the ongoing application of research in hospital or community contexts. Educating nurses in research requires that they learn a repertoire of research skills such as literature critiques, developing research questions, interviewing, analysing techniques and computer-assisted analysis. However, postmodern debates can also be beneficial by facilitating their understanding of contemporary research issues so that they can critically integrate such reflexive thinking into their own research practices and go on to explore new ways to undertake research.

Humans↗
PubMed1995

Postnatal back care.

Musculoskeletal damage can be a major postpartum problem, and, if left untreated, may affect a women for the rest of her life. Common problems include: Sacrococcygeal pain Symphysis pubis strain Sacroiliac joint strain Lumbosacral joint strain Cervical and dorsal strain. The author recommends osteopathic care continuing through pregnancy (except during the third month) until six months postpartum.

Back Pain↗
PubMed1994

Modulation of fast excitatory synaptic transmission by cyclothiazide and GYKI 52466 in the rat hippocampus.

The effects of cyclothiazide, a drug which potentiates AMPA receptor-mediated responses and GYKI 52466, a non-competitive AMPA receptor antagonist, were studied on fast glutamatergic transmission in rat hippocampal slices. Cyclothiazide prolonged the decay of AMPA receptor-mediated EPSCs (AMPA-EPSCs) in a concentration-dependent manner. GYKI 52466 reduced the peak amplitude of AMPA-EPSCs and blocked the induction of LTP. When GYKI 52466 was applied in the presence of cyclothiazide it still reduced the peak amplitude of AMPA-EPSCs but was not able to reverse the cyclothiazide induced prolongation of AMPA-EPSC duration. These data suggest that GYKI 52466 and cyclothiazide probably mediate their effects on the AMPA receptor via different binding sites.

2-Amino-5-phosphonovalerate↗
PubMed1994

Efficacy of feeding glucosinolate-extracted crambe meal to broiler chicks.

Glucosinolates and their breakdown products (nitriles) have long been implicated as toxic factors when feeding rapeseed (Brassica napus) meals and crambe (Crambe abyssinica) meals to poultry. Accordingly, various methods have been developed to remove these compounds from the meals to enhance their value as feed supplements. Glucosinolates and nitriles were extracted from commercially processed, defatted crambe meal by washing with water or various solvent-water mixtures: 50% isopropanol, 50% acetone, or 50% ethanol. In addition, crambe seed was extruded and extracted in the laboratory with isopropanol or hexane. Water washing of commercially defatted meal proved to be the most effective method of extraction, removing 95% of the glucosinolates and nitriles. Meals were fed to 7-d-old broiler chicks at 10% of the diet for 14 d. Weight gain decreased (P < .05) in most groups; however a greater decrease (P < .01) was observed in birds fed meals with high glucosinolate content. Feed intake also decreased (P < .05) in most groups; consequently, feed efficiencies were similar for all groups. No changes in serum chemistries, triiodothyronine, thyroxine, or tissue lesions were associated with glucosinolate or nitrile intake. A relationship (P < .05, r = .74) was found between weight gain and glucosinolate intake. No correlation was found between feed intake and meal glucosinolate or nitrile concentrations.

Alkenes↗
PubMed1994

Back care in pregnancy.

Early in pregnancy it is useful to encourage the mother to do some gentle exercise to offset some of the mechanical strain that will arise with postural changes. Manipulation of the lumbar spine and pelvic joints is possible until the sixth month for primigravidae and the fourth or fifth month for multiparae. The joints and soft tissues will respond very readily to gentle stretching techniques because of hormonal changes. It is appropriate for midwives to have a good working knowledge of the mechanical advantages and disadvantages of different maternal positions adopted during labour.

Exercise Therapy↗