Search PubMed⌕ Search

Biomedical subjects

C Smith

Publications and source records attributed to C Smith.

At least 1,189 records · Page 66Linked to original sources
PubMedDate not supplied

Nurses' attitudes toward emotional, sexual, and physical abusers of children with disabilities.

Some studies have linked birth defects, disability, and chronic illness with an increased incidence of child abuse. Nurses who are involved with disabled children face a challenge in preventing child abuse and intervening in cases in which abuse has occurred. Nurse must become aware of the risk factors and signs of abuse, understand the role of their personal attitudes toward abuse and abusers, and develop the skills to intervene effectively and deal with abusers. Thus, the authors of this article undertook a study to ascertain nurses' attitudes about emotional, sexual, and physical abuse of children with disabilities and to determine if nurses' anticipated level of comfort differed when dealing with abusers of children with disabilities in contrast to abusers of children without disabilities.

Adolescent↗
PubMedDate not supplied

Compliance measurement in respiratory distress syndrome: the prediction of outcome.

Dynamic compliance (Cdyn) measurements within the first three days of life predicted survival in 60 preterm infants suffering from respiratory distress syndrome. Cdyn was measured in 47 survivors at 2.3 +/- 1.4 days of life and in 13 nonsurvivors on 2.7 +/- 1.7 days. All nonsurvivors died from respiratory failure within the first two weeks of life. Mean Cdyn of the survivors was 0.83 +/- 0.33 ml/cm H2O and of the nonsurvivors 0.35 +/- 0.19 ml/cm H2O (p less than 0.001). Cdyn values below 0.45 ml/cm H2O predicted 11 of 13 deaths in infants, and Cdyn measurements above this value predicted 45 of 47 survivals, with a specificity of 81% and a sensitivity of 89%. Eleven of the survivors, who subsequently developed bronchopulmonary dysplasia (BPD), had a mean Cdyn of 0.56 +/- 0.23 ml/cm H2O. When these infants were matched with infants of comparable weight without evidence of BPD, the BPD group had a significantly lower Cdyn (p less than 0.05). Cdyn measurements during the first three days of life are useful in predicting outcome of respiratory failure secondary to respiratory distress syndrome.

Airway Resistance↗
PubMedDate not supplied

Measurement of phosphatidylserine exposure in leukocytes and platelets by whole-blood flow cytometry with annexin V.

Phosphatidylserine (PS) exposure serves as a procoagulant stimulus and a signal for phagocytic clearance of apoptotic cells. In order to measure PS exposure in blood cells, we developed a flow-cytometric procedure to measure annexin V binding to leukocytes and platelets in whole-blood samples. Leukocytes were identified by CD45 and side-scatter gating, and platelets by CD6 1 and side-scatter gating. The absolute number of annexin V molecules bound per cell was determined from an independent calibration procedure. Normal populations had the following levels of annexin V binding (in molecules per cell): lymphocytes, 0.53 x 10(3) neutrophils, 1.75 x 10(3) monocytes, 2.45 x 10(3) platelets, 0.14 x 10(3). These levels represent </= 0.1% of the values obtained after maximal stimulation of PS exposure with calcium ionophore, confirming that virtually all PS is intracellular in normal circulating leukocytes and platelets. Pretreatment of whole-blood samples with ammonium chloride to lyse erythrocytes caused a 9- to 300-fold increase in annexin V binding to leukocytes, indicating that analysis of unlysed whole-blood samples is essential to avoid artifactual increases in annexin V binding to leukocytes. Comparison of annexin V with two other markers of platelet activation, CD62P and the activation-dependent epitope of glycoprotein IIb/IIIa detected by the PAC I antibody, indicated that platelets from normal donors showed the least amount of activation with the annexin V marker. Whole-blood flow cytometry with annexin V can reliably measure the state of PS exposure in platelets and leukocytes, and the results confirm that these cell

Annexin A5↗
PubMedDate not supplied

Intake of nutrients related to cardiovascular disease risk among three groups of American Indians: the Strong Heart Dietary Study.

BACKGROUND: Although diet is implicated in the elevated rate of cardiovascular disease among some American Indian tribes, the dietary intakes of these individuals have not been described. The Strong Heart Dietary Study compared diets of 10 tribes in Arizona, Oklahoma, and the Dakotas to examine the possible contribution of diet to cardiovascular and other chronic diseases. METHODS: During 1988-1991, 892 people responded to a 24 hr diet recall questionnaire. Nutrient intake by study area, sex, and age group were compared by analysis of variance, and intakes were compared with nutrient intakes reported by participants in Phase 1 of the Third National Health and Nutrition Examination Survey and with dietary recommendations of the National Research Council, the American Heart Association, and the Healthy People 2000 objectives. RESULTS: The intake of energy and nutrients varied significantly by sex and age. Men consumed more energy, macronutrients, and sodium than did women (P < or = 0.001). Women's diets were denser in carbohydrate, beta-carotene, vitamin C, and vitamin E than were men's diets (P < or = 0.001). Younger participants consumed more energy, macronutrients, vitamin E, and sodium than did older participants (P < or = 0.001). Older participants had diets denser in protein and beta-carotene than did younger participants (P < or = 0.001). Energy intake did not differ significantly by study area, but men in Arizona consumed more energy from carbohydrate and less energy from total fat than did men elsewhere (P < or = 0.01). Men and women in Arizona consumed more cholesterol and fiber than did other participants (P < or = 0.01) and less of the antioxidant vitamins (P < or = 0.01). Participants in the Strong Heart Diet Study reported diets higher in fats and cholesterol than did participants in Phase 1 of the Third National Health and Nutrition Examination Survey. Few Strong Heart participants achieved dietary recommendations for the reduction of risk of chronic disease. CONCLUSIONS: Area differences in nutrient intake were observed, but most participants consumed diets associated with increased risk of heart disease and other chronic diseases. Women and older participants in general reported healthier nutrient intakes. Dietary intervention programs should educate American Indians about dietary modifications to reduce the risk of cardiovascular and other nutrition-related disorders.

Age Distribution↗
PubMedDate not supplied

Attending rounds: a survey of physician attitudes.

To determine attitudes regarding attending rounds, the authors surveyed all internal medicine residents and attending physicians at the eight Army teaching hospitals. The response rate was 86%, including 166 (76%) of 217 residents and 246 (93%) of 264 attendings. Of 12 educational activities, attending rounds were ranked seventh by residents in their perceived value. Both residents and attendings favored sessions that lasted 90 minutes or less and were held three to four times per week. Most respondents felt case presentations should take 5 minutes or less and be delivered away from the patient's bedside. On average, residents preferred less time at the bedside than did attendings (25% vs. 34% of attending round time). Residents desired substantial control of the agenda for rounds and also wanted to be responsible for one-third of the teaching. The attending-physician attributes that residents valued most highly were fund of knowledge, availability, and relating well to housestaff. Since residents' and attending physicians' attitudes may differ, expectations regarding attending rounds should be clarified at the beginning of a ward rotation so that mutually acceptable goals can be established.

Adult↗
PubMedDate not supplied

Sleep states and memory processes.

Evidence for the involvement of rapid eye movement (REM) sleep or paradoxical sleep (PS) with memory processing continues to accumulate. In animals, there is continuing evidence of relatively small, vulnerable paradoxical sleep windows (PSWs) following successful acquisition. These PSWs, which manifest as increases in PS over normal levels, appear to exhibit shorter latencies to onset when the amount of material presented during acquisition is increased. Prevention of the PSW results in memory deficits. In humans, there is now evidence that different types of tasks are differentially sensitive to rapid eye movement sleep deprivation (REMD). Memory for declarative or explicit types of tasks appear not to be affected by REM sleep loss, while memory for cognitive procedural or implicit types of material are impaired by REMD. Using post training auditory stimulation during REM sleep, memory enhancement of the procedural material is also possible. The memory for a fine motor task appears to be sensitive to post training stage 2 sleep loss. The important neural structures are generally not yet identifiable, although the hippocampus would appear to be important for place learning in the Morris water maze.

Animals↗
PubMedDate not supplied

Systematic studies on synthesis, structural elucidation, and biological evaluation of A-ring diastereomers of 2-methyl-1alpha,25-dihydroxyvitamin D(3) and 20-epi-2-methyl-1alpha,25-dihydroxyvitamin D(3).

All possible A-ring diastereomers of 2-methyl-1alpha,25-dihydroxyvitamin D(3) (2) and 20-epi-2-methyl-1alpha,25-dihydroxyvitamin D(3) (3) were synthesized by palladium-catalyzed coupling reaction of A-ring 'enyne' synthons with CD-ring portions. The A-ring synthons were rationally synthesized via a novel and practical route, starting with methyl (R)-(+)- and (S)-(-)-3-hydroxy-2-methyl-propionate, in good yields. X-ray crystallographic analysis of 2alpha-methyl-1alpha,25-dihydroxyvitamin D(3) (2b) and conformational analysis of the A-ring of 2alpha-methyl-(2b) and 2beta-methyl-1alpha,25-dihydroxyvitamin D(3) (2f) were carried out, and the results are described. All A-ring diastereomers (2 and 3), thus synthesized, were biologically evaluated both in vitro and in vivo. The biologic potency was highly dependent on the stereochemistry of the A-ring substituents. In particular, 2b showed 4-fold higher vitamin D receptor [VDR] binding activity than the natural hormone, and its 20-epimer (3b) exhibited exceptionally high activity, 12-fold more potent in VDR binding, 7-fold in calcium mobilization, and 590-fold in induction of human promyelocytic leukemia (HL-60) cell differentiation as compared with the natural hormone. Further, the 20-epi-2beta-Me-1beta, 3alpha(OH)(2) isomer (3g) had significant biologic potencies compared to the natural hormone despite having 1beta-OH configuration. The transcriptional activities on human osteocalcin gene promoter, including VDRE in transfected mammalian cells, were also evaluated. Finally, there was a clear contrast between the effects of the 2-methyl group on the HL-60 cell differentiation- and apoptosis-inducing activities of 2 and 3.

Animals↗
PubMedDate not supplied

Early- versus late-onset dythymic disorder: comparison in out-patients with superimposed major depressive episodes.

BACKGROUND: This study examined the validity of the early-late onset subtyping distinction in dysthymic disorder. METHODS: Participants were 340 out-patients meeting DSM-III-R criteria for dysthymia and a concurrent major depressive episode (MDE). The sample was drawn from a 12-site double-blind randomized parallel group trial comparing the efficacy of sertraline and imipramine in the treatment of chronic depression. All patients received comprehensive evaluations using semi-structured interviews and rating scales. RESULTS: 73% of the sample met criteria for the early-onset, and 27% for the late-onset, subtype. The early-onset patients had a significantly longer index MDE, significantly higher rates of personality disorders and lifetime substance use disorders, and a significantly greater proportion had a family history of mood disorder. The subgroups did not differ in symptom severity or functional impairment at baseline, nor in response to a 12-week trial of antidepressants. LIMITATIONS: Further work is needed to extend these findings to dysthymic disorder without superimposed MDEs. CONCLUSIONS: These results support the distinction between early-onset and late-onset dysthymic disorder.

Adult↗
PubMedDate not supplied

Disseminated coccidioidomycosis with rapid progression to effusive-constrictive pericarditis.

This case reports coccidiomycosis presenting as pericarditis with tamponade rapidly progressing to effusive-constrictive pericarditis and death over 72 hours. Coccidiomycosis pericarditis is a rapidly progressing disease requiring early and complete pericardiectomy to avoid the hemodynamics of constriction. We illustrate the use of echocardiography in this case and demonstrate the histopathology. We review the literature and discuss therapy and management. Coccidiomycosis is often clinically unsuspected and unrecognized by the health care worker unfamiliar with the disease process.

Adult↗
PubMedDate not supplied

Prompt gamma neutron activation analysis method and instrumentation for copper grade estimation in large diameter blast holes.

A spectrometric prompt gamma neutron activation analysis logging system and a method of data handling and interpretation have been developed at CSIRO, Exploration and Mining for copper grade estimation in large diameter blast holes of the Chuquicamata open-cut copper mine in Chile. Since the development, the logging system has been extensively tested at a number of open-cut and underground copper mines and has proven its viability for quantitative copper grade estimation in boreholes.

Journal Article↗
PubMedDate not supplied

Mass gathering medicine: a predictive model for patient presentation and transport rates.

INTRODUCTION: This paper reports on research into the influence of environmental factors (including crowd size, temperature, humidity, and venue type) on the number of patients and the patient problems presenting to first-aid services at large, public events in Australia. Regression models were developed to predict rates of patient presentation and of transportation-to-a-hospital for future mass gatherings. OBJECTIVE: To develop a data set and predictive model that can be applied across venues and types of mass gathering events that is not venue or event specific. Data collected will allow informed event planning for future mass gatherings for which health care services are required. METHODS: Mass gatherings were defined as public events attended by in excess of 25,000 people. Over a period of 12 months, 201 mass gatherings attended by a combined audience in excess of 12 million people were surveyed throughout Australia. The survey was undertaken by St. John Ambulance Australia personnel. The researchers collected data on the incidence and type of patients presenting for treatment and on the environmental factors that may influence these presentations. A standard reporting format and definition of event geography was employed to overcome the event-specific nature of many previous surveys. RESULTS: There are 11,956 patients in the sample. The patient presentation rate across all event types was 0.992/1,000 attendees, and the transportation-to-hospital rate was 0.027/1,000 persons in attendance. The rates of patient presentations declined slightly as crowd sizes increased. The weather (particularly the relative humidity) was related positively to an increase in the rates of presentations. Other factors that influenced the number and type of patients presenting were the mobility of the crowd, the availability of alcohol, the event being enclosed by a boundary, and the number of patient-care personnel on duty. Three regression models were developed to predict presentation rates at future events. CONCLUSIONS: Several features of the event environment influence patient presentation rates, and that the prediction of patient load at these events is complex and multifactorial. The use of regression modeling and close attention to existing historical data for an event can improve planning and the provision of health care services at mass gatherings.

Anniversaries and Special Events↗
PubMedDate not supplied

A radiation hybrid mapping panel for the rhesus macaque.

The genomes of nonhuman primates have recently become highly visible candidates for full genome analysis, as they provide powerful models of human disease and a better understanding of the evolution of the human genome. We describe the creation of a 5000 rad radiation hybrid (RH) mapping panel for the rhesus macaque. Duplicate genotypes of 84 microsatellite and coding gene sequence tagged sites from six macaque chromosomes produced an estimated whole genome retention frequency of 0.33. To test the mapping ability of the panel, we constructed RH maps for macaque chromosomes 7 and 9 and compared them to orthologous locus orders in existing human and baboon maps derived from different methodologies. Concordant marker order between all three species maps suggests that the current panel represents a powerful mapping resource for generating high-density comparative maps of the rhesus macaque and other species genomes.

Animals↗
PubMedDate not supplied

Endoscopic ultrasonography (EUS) and EUS-guided fine needle aspiration for accurate staging of rectal cancer: explanation of tumor staging and a case report.

This article describes the diagnosis, staging, and therapeutic options for rectal cancer and the importance of endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (FNA) as a relatively new diagnostic modality. A case study is presented from initial diagnosis through surgery to illustrate how EUS and EUS-guided FNA influenced the treatment plan. Discussion focuses on rectal cancer and the importance of early detection through routine screening. The internationally accepted Tumor Node Metastasis (TNM) staging classification system for rectal cancer is included, followed by a description of EUS and EUS-guided FNA with regard to accuracy in staging. In conclusion, the various stage-dependent treatment options available for rectal cancer that can be individualized based on the patient's medical problems and preferences are discussed.

Adult↗