Intrapelvic donovanosis presenting as a psoas abscess in two patients.
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Adult↗
Biomedical subjects
C Russell
Publications and source records attributed to C Russell.
Exploring the experience of type 2 diabetes in urban aboriginal people.
The experience of diabetes among urban Aboriginal people (status and non-status Indians) was explored through a qualitative study. Because researchers have focused almost exclusively on Aboriginal people living on reserves or in isolated rural communities in Canada, this study conducted face-to-face interviews with participants (n = 20) living in the city of Winnipeg, Manitoba. The data generated 3 themes: diabetes as an omnipresent and uncontrollable disease; beyond high sugar: diabetes revealed in bodily damage; and the good, the bad, and the unhelpful: interactions with health-care providers. Findings from this study and previous research support the existence of a pan-Aboriginal model of diabetes. This contemporary cultural stance appears to transcend geography and has implications for the prevention and treatment approaches used in programs and health services for Aboriginal people living with diabetes.
Adaptation, Psychological↗
Destined for pediatrics.
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Career Choice↗
Mapping HLA for single nucleotide polymorphisms.
Knowledge of DNA sequence variation may help us understand how genetic variability gives rise to functional variability and, in so doing, revolutionize the development of strategies to combat and prevent disease. Single nucleotide polymorphisms (SNPs) are stable, inherited, biallelic, single base pair differences which are present in the human genome at a density of 1 to 10 per 1,000 nucleotides. It is anticipated that SNPs will account for much of the functional heterogeneity in gene expression and protein activity exhibited in the human population. Susceptibility to or protection from a number of diseases, particularly those of autoimmune etiology, has been associated with specific alleles of the human leukocyte antigen (HLA) complex. Interestingly, the precise molecular defects in the HLA genes are unknown and the notion that non-HLA genes, within the same chromosomal region, are involved remains a formal possibility. We have determined the nucleotide sequence of a contiguous 2.2 Mbp segment of chromosome six that includes all of the HLA class I region, and have identified over 10,000 SNPs therein. Because of the derivative knowledge of gene and SNP content and position, the scientific community is now uniquely poised to identify disease-contributory SNPs that lie within the MHC.
HLA Antigens↗
Comprehensive needs assessment of clinical breast evaluation skills of primary care residents.
BACKGROUND: Health care reform places primary care (PC) physicians in an increasingly significant role for breast cancer screening and diagnosis. This study assessed the adequacy of traditional PC resident training to prepare physicians for this front-line role. METHODS: Sixty-eight primary care residents, representing seven training programs, participated in a multidimensional needs assessment study of clinical breast evaluation skills. RESULTS: Performance deficiencies noted in each component were most significant in (1) common breast problem management (problem-solving mean 44.51 +/- 11.01); (2) breast examination skills (mean 49.65 +/- 14.48%); and (3) lump detection sensitivity (mean 40.20 +/- 17.10%). Overall examination reliability was good (alpha = .82). Factorial ANOVA revealed significant performance differences among training programs. Residency programs with higher performance levels reported dedicated breast curricula, and residents rated these programs as providing more adequate training. Programs with poorer performance in breast examination lacked curriculum emphasis, with residents describing training received as poor to fair. CONCLUSION: This study demonstrated performance deficits in the clinical breast evaluation skills of graduating PC residents that have not been captured by traditional evaluation methodologies. This may represent a limitation in the ability of many PC physicians to effectively screen and diagnose patients with breast cancer.
Adult↗
Discriminative stimulus properties of low doses of ethanol in humans.
Discriminative stimulus properties of low doses of ethanol were evaluated in humans using established behavioural drug discrimination procedures. Twenty-five moderate drinkers (12 females and 13 males) were trained to discriminate placebo from 0.2 g/kg ethanol in 200 ml tonic water mixed with Tabasco sauce and drunk in portions of 50 ml every 15 s. Seventeen of the subjects (ten females and seven males) were able to reach criterion performance (at least 80% correct responses). Generalisation responding across ethanol doses of 0 (placebo), 0.025, 0.05, 0.1 and 0.2 g/kg was examined the day after training using a procedure in which subjects reported the extent to which the test stimulus resembled the training dose. At the end of each generalisation session, self ratings of mood changes, physiological responses and performance in a working memory and a time estimation task were evaluated. Subjects were able to distinguish the three higher doses of ethanol from placebo. Self ratings indicated that subjects' ability to distinguish ethanol from placebo was related, at the highest dose, to change of taste, but to feelings of light-headedness at the lower doses. Ethanol administration influenced skin conductance measurements but there was no relationship found between changes in skin conductance and the ethanol discriminative stimulus. These data suggest a difference in the nature of the discriminative stimulus of ethanol between high (training) and low (generalising) doses as indicated in the subjective reports.
Adolescent↗
Effects of acid-etching on the tensile properties of demineralized dentin matrix.
OBJECTIVES: Little research has been done to evaluate the effects of acids commonly used in adhesive dentistry, on the tensile properties of the demineralized dentin matrix. The purpose of this study was to evaluate the effects of a number of acidic conditioners on the ultimate tensile strength (UTS) and modulus of elasticity (E) of human coronal dentin matrix. METHODS: Small hour-glass shaped (for UTS) or l-beam shaped (for determination of E) were prepared from mid-coronal dentin of extracted human third molars. After protecting the ends with varnish, the middle of the specimens was completely demineralized in 0.5 M EDTA (pH 7). UTS was determined by tensile stressing to failure. Modulus of elasticity was calculated from stress strain curves. The results were analyzed by ANOVA and Student-Neuman-Keuls test at the 95% confidence level. RESULTS: Brief (ca. 1-2 min) exposure of demineralized dentin matrix to acids had no measurable effects on its tensile properties. Ten-minute exposures to 2.5% and 17.5% nitric acid lowered (p < 0.05) the UTS compared to phosphate buffered saline (PBS)-exposed controls. Exposure of the decalcified dentin to 10% citric acid containing 3% ferric chloride, 10% citric acid, 37% phosphoric acid or 17.5% nitric acid containing 3% ferric chloride for 10 min had no effect on UTS. None of these acids consistently lowered stiffness. SIGNIFICANCE: The results indicate that relatively long exposures to acids are required to alter the tensile properties of demineralized dentin. It is unlikely that the brief exposures to acids that are used in adhesive dentistry would acutely weaken the physical properties of demineralized dentin. However, long-term studies should be done to determine if such treatment increases the susceptibility of the matrix to hydrolysis.
Acid Etching, Dental↗
The new varicella vaccine: efficacy, safety, and administration.
Since the FDA has given approval for the manufacture of a varicella vaccine (Varivax), nurses are beginning to administer the vaccine to children. Over 11,000 healthy and immunocompromised children have been immunized since 1979. Varivax has been found to be 95% to 100% effective in conferring immunity for at least 10 years, and it appears to be a safe vaccine. This article presents a review of the research literature on clinical trials of Varivax, and the risks, benefits, and projected cost of the vaccine. Precautions, contraindications, and guidelines for administration are tabled and discussed in a sample case using the Health Belief Model as a theoretical framework. The article includes a discussion of areas for further research and implications for nursing.
Chickenpox↗
Dosage-sensitive and complementary functions of roundabout and commissureless control axon crossing of the CNS midline.
commissureless and roundabout lead to complementary mutant phenotypes in which either too few or too many axons cross the midline. The robo;comm double-mutant phenotype is identical to robo alone, suggesting that in the absence of robo, comm is no longer required. Comm is expressed on midline cells; Robo is expressed in a dynamic fashion on growth cones and appears to function as an axon guidance receptor. robo function is dosage-sensitive. Overexpression of comm is also dosage-sensitive and leads to a phenotype identical to robo loss-of-function. Comm controls Robo expression; increasing Comm leads to a reduction of Robo protein. The levels of Comm and Robo appear to be tightly regulated to assure that only certain growth cones cross the midline and that those growth cones that do cross never do so again.
Animals↗
Murine MPS I: insights into the pathogenesis of Hurler syndrome.
Mucopolysaccharidosis type I (MPS I) is an autosomal recessive disease resulting from deficiency of the lysosomal enzyme alpha-L-iduronidase. A murine model which shows complete deficiency in alpha-L-iduronidase activity has been developed and shows phenotypic features similar to severe MPS I in humans. Here we report on the long-term clinical, biochemical, and pathological course of MPS I in mice with emphasis on the skeletal and central nervous system (CNS) manifestations. Affected mice show a progressive clinical course with the development of coarse features, altered growth characteristics and a shortened life span. Progressive lysosomal accumulation is seen in all tissues. Skeletal manifestations represent the earliest clinical finding in MPS I mice with histologic analysis of growth plate and cortical bone revealing evidence that significant early pathology is present. Analysis of the CNS has revealed the novel finding of progressive neuronal loss within the cerebellum. In addition, brain tissue from MPS I mice shows increased levels of GM2 and GM3 gangliosides. This murine model clearly shows phenotypic and pathologic features which mimic those seen in severe human MPS I and should be an invaluable tool for the study of the pathogenesis of generalized storage disorders.
Animals↗
Older people's lives in the inner city: hazardous or rewarding?
An exploratory, qualitative study was used to investigate the social health needs of older residents of a low-income inner-Sydney area characterised by multiple social and environmental hazards. The research was conducted to inform the development by the South Eastern Sydney Area Health Promotion Unit of a strategy to promote the health, wellbeing and independence of older people. As part of a needs assessment process, the investigation focused on specific subgroups of the population believed to be highly disadvantaged and neglected. In-depth interviews were conducted with 40 residents aged 60 to 86 years who were recruited through community centres, service providers and neighbours. The interviews were supplemented by observational field notes. We describe key dimensions of the physical and social environment, the many hazards it presented to vulnerable elderly residents and the practices they adopted in meeting their everyday needs in relation to shopping, meals, mobility outside the home and social participation. The description is from the perspectives of residents themselves. Key factors discussed include the neighbourhood, housing, activities of daily living, safety and security, and social participation. We explore the implications of our findings for the development of effective public health practice. The environmental hazards, such as pedestrian safety and traffic management, affect the whole population and require interventions at government level. Others, such as inadequate hygiene and food storage facilities in rented premises, also require an approach at the level of public policy and environmental change, but need to be carefully targetted and implemented.
Aged↗
Treatment of recurrent malignant glioma with BCNU-fluosol and oxygen inhalation. A phase I-II study.
OBJECTIVES: To evaluate the toxicity and response rate following BCNU with oxygen inhalation and escalating dosages of fluosol administered to patients with radiographic progression of malignant glioma after definitive surgery and radiotherapy. METHOD: This single arm, phase I-II multicenter trial, enrolled 99 patients with malignant gliomas recurrent after definitive surgery and radiotherapy. All patients received a fixed dose (200 mg/m2) of BCNU along with 100% oxygen and fluosol, a perfluorochemical. Fluosol doses were escalated between patients (150, 275, 400 and 600 ml/m2). Treatment was repeated every 6 weeks for a maximum of 6 cycles. Patients were assessed for toxicity at the time of infusion and sequentially thereafter. Response was evaluated clinically and radiologically at least every 6 weeks. RESULTS: Treatment was well tolerated. Dose reductions were required at least once in 18 patients, treatment delays were necessary at least once in 33 patients. Grade 3-4 leukopenia occurred in 6 patients (12 events), grade 3-4 thrombocytopenia in 10 patients (25 events) and grade 3-4 liver enzymes elevations in 18 patients (31 events). Higher fluosol dosages did not produce increases in toxicity or responses. Response or stabilization was seen in 57% (38% were stabilizations) of the patients who entered the trial with progressive disease. The median time to progression was 45 weeks, and median survival was 66 weeks for patients who had response or stabilization. For patients with glioblastoma response/stabilization was seen in 45% with a mean duration of 24 weeks, for patients with anaplastic astrocytoma response/stabilization was seen in 68% with a mean duration of 50 weeks. CONCLUSION: This treatment regimen is well tolerated. Our results suggest fluosol may enhance the effectiveness of BCNU for the treatment of recurrent malignant gliomas. Future studies will be performed using fluosol at the dose of 400 ml/m2.
Adolescent↗
Citric acid demineralization of cementum and dentin: the effect of the storage medium.
The purpose of this study was to see if the root surface topography of teeth, stored in saline and subsequently treated with citric acid, differred from the root surface topography of teeth that were treated immediately upon extraction, 12 freshly extracted adult human permanent teeth, with proximal surfaces free of caries and periodontal disease, were treated in succession. The crowns were removed at the level of periodontal attachment, the teeth sectioned buccal-lingually and a treatment area deligniated on each proximal section. The treatment area of 6 teeth was root planed to expose dentin (D) and scaled to remove adherent tissue and leave a cementum surfaces (C) on the other 6 teeth. A coronal-apical groove down the middle of the treatment area divided it into approximately equal parts or experimental regions. One proximal section of each tooth was placed in physiologic saline (S) and treated after 6 weeks of storage while the other proximal section was freshly treated (F). Treatment consisted of applying a 30% citric acid (CA) solution (pH = 1.60) for 5 min. Cotton pellets soaked in the citric acid solution were placed (P) on one half of the experimental area and heavily burnished (B) on the other half. Treatment areas were subsequently prepared for scanning electron microscopy analysis. Assessment was made of (i) the % of surface area tufted, (ii) fibril tufting depth (0.3) and (iii) fibril tufting density (1.3). Similarities were found in the data for both storage methods (F and S) across each application technique (P or B) and each tooth surface (D or C) with respect to the (i) % area tufted and (ii) frequency distribution of tufting depth scores. As for the application techniques, the data for burnishing was greater than placed across each storage method (F or S) and each tooth surface (D or C) for the same two parameters. The results of the study indicated that 6-week physiologic saline storage does not affect root surface demineralization by citric acid, as assessed by SEM.
Adult↗
Increasing rehab utilization. A CQI approach.
As managed care stresses the bottom line, home care providers feel the pressure to achieve the best, most cost-effective outcomes possible. One provider in Colorado found a way to educate its staff on when it is appropriate to refer patients to rehabilitation specialists so they can recover more quickly and effectively.
Colorado↗
Biological properties of fluoroglutamate-containing analogs of folates and methotrexate with altered capacities to form poly (gamma-glutamate) metabolites.
Fluoroglutamate-containing analogs of folates and methotrexate (MTX) with altered capacities for poly (gamma-glutamate) metabolism were synthesized to probe the biological roles of polyglutamates. Compared to folic acid, DL-e,t-gamma-fluorofolic acid, a compound that is a poor substrate for polyglutamylation, was approximately 25-fold less potent in promoting growth of folate-depleted H35 rat hepatoma cells. DL-beta,beta-Difluorofolic acid, a compound that forms diglutamates more readily than does folic acid, was at least equivalent to folic acid in potency. Leucovorin (LV), a reduced folate, was 30-fold more potent than folic acid in promoting growth, whereas the analogous form of DL-e,t-gamma-fluorofolate, DL-e,t-gamma-fluoroleucovorin (DL-e,t-gamma-FLV) was only 4-fold more potent than folic acid. Both LV and DL-e,t-gamma-FLV protected or "rescued" cells from the growth inhibitory effects of MTX; however a 37- to 46-fold higher concentration of the fluoro analog was required. Folic acid, DL-e,t-gamma-fluorofolic acid, LV, and DL-e,t-gamma-FLV each potentiated the growth inhibitory effect of 5-fluoro-2'-deoxyuridine on CCRF-CEM human leukemia cells; higher concentrations of fluorinated analogs again were required. Stereochemically pure L-t-gamma-fluoromethotrexate (L-t-gamma-FMTX), a poor substrate for polyglutamylation, was evaluated as a cell growth inhibitor. In continuous exposure, L-t-gamma-FMTX), was 7-fold less potent than MTX as an inhibitor of CCRF-CEM growth. Results with these fluorinated folate and MTX analogs offer insight into the importance of polyglutamate metabolism to these biological and pharmacological effects.
Animals↗
Engineering and expression in Drosophila melanogaster of a xanthine dehydrogenase (rosy) variant.
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Animals↗
Measuring management potential.
This article provides a brief introduction to instruments that may be used to measure management potential in persons being considered for administrative positions. Instruments that measure aspects of leadership, power, personality, conflict, and organizational climate are discussed. An overview of each instrument is provided as well as data on the type of test, time to complete, cost, and purchasing information. While objective tests such as these are useful in assessing individual suitability for management positions, we advise that they be used prudently and judiciously.
Administrative Personnel↗
Consensus report on ACE inhibitor renography for detecting renovascular hypertension. Radionuclides in Nephrourology Group. Consensus Group on ACEI Renography.
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Angiotensin-Converting Enzyme Inhibitors↗