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Biomedical subjects

D B Miller

Publications and source records attributed to D B Miller.

161 records · Page 9Linked to original sources
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Women and long term nursing care.

Women have played a significant role in long term care: formerly as volunteer caregivers and presently as volunteer and paid caretakers, as professionals working in the field and increasingly as old, old residents in nursing homes. The goal in long term care is helping people to function to their maximal level; it is based on a philosophy of care not cure. Family-patient relationships influence quality in long term facilities where nursing is the matrix of professional services. Respite care is designed to provide relief to family caretakers for time limited periods and long term home health care is a non-institutional alternative where the nursing home therapeutic regimen is brought into the patients' own home. Whatever the model, the female influence is pervasive.

Accreditation↗
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The "missing link" in the origin of trigeminal neuralgia: a new theory and case report.

Tic Douloureux (Trigeminal Neuralgia) has afflicted mankind for centuries, perhaps for all time. This sharp stabbing paroxysm of pain along the branches of the trigeminal nerve is described as "...one of the most painful problems that plagues mankind." Many theories about the cause of trigeminal neuralgia have been previously presented. Often these theories build on the previous foundations when new research presents itself. The complete picture still eludes researchers today. Much of the mechanism has been proposed, but researchers lacked one essential component. There has never been an answer to why these pains only occur in cranial segments and why, thankfully, TN is rare. What sets the stage for the development of TN? The unique neurophysiology of the trigeminal nerve and the accompanying ability of the Temporomandibular Joints to create a sensitized neural system are the last piece of the puzzle. This central sensitization of the Trigeminal Nerve allows the development of a small cluster of neurons that act as a central trigger for the paroxysmal pain. The role of the TMJ in trigeminal neuralgia is illustrated by this case report.

Afferent Pathways↗
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Clinical management of chronic TMD pain.

Chronic Pain extracts a "penalty" on society now estimated to be well in excess of $100 million per year. The "penalty" that Chronic Pain extracts from its victims is incalculable. Chronic Pain is a major component of Temporomandibular Disorders. The current neurological theory of the mechanism of chronic TMD pain is explored along with the current modes of treatment. Pharmacological management of Chronic Pain in a clinical setting is outlined. Dentists are involved in pain management on a daily basis. Dentists treat pain both prophylacticly and in response to specific patient symptoms. Most dental treatment involves some type of pain management. We, dentists, have become very adept at managing acute pain. We have much greater difficulty managing chronic pain. The word "pain" derives from the Greek word for penalty, and appeared to them to be a "penalty" inflicted by the gods. In 1984, Bonica estimated that one-third of all Americans suffered from some kind of chronic pain at a "penalty" to society of $65 Billion annually in medical expenses and lost wages and productivity. This figure is certainly much greater now. Chronic pain can be a very complex problem that can require a multidisciplinary approach to treatment. Chronic pain in the dental setting is most frequetly caused by prolonged Temporomandibular Disorders.

Antidepressive Agents↗
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Interoceptive conditioning through repeated suppression of morphine-abstinence. I. Basis for conditioning: once-daily vs. continuous intravenous morphine infusion.

Experimental evaluation of Wikler's interoceptive conditioning hypothesis of relapse to opioid use in ex-addicts requires a preliminary study of the degree of physical dependence produced by two methods of drug administration. Wistar rats were made physically dependent on morphine by single daily intravenous injections or by a continuous i.v. infusion. Rats received the same total daily dose regardless of administration schedule. The initial daily morphine dose was 20 mg/kg, and was increased every fourth day by 20 mg/kg, until a dose of 200 mg/kg per day was reached. The rats were maintained at the highest dose level for 18 days, at which time morphine was discontinued. Body weight and water intake were the primary variables measured during addiction, maintenance, and abstinence phases of the study. Equivalent and parallel changes in mean weight and water intake in injection and infusion rats indicate equivalent degrees of physical dependence were developed. This finding allows separation of the contribution of conditioning factors and of protracted abstinence in facilitating opioid self-administration in formerly-dependent organisms.

Animals↗
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Neurotoxicity of the pesticidal carbamates.

The carbamates, stabilized derivatives of carbamic acid, are potent biological agents used extensively in applications ranging from agriculture to medicine and industry. This review covers the two major classes of pesticidal carbamates: (1) cholinesterase-inhibiting carbamates which include monomethyl- and dimethylcarbamates (used primarily as insecticides); and (2) non-cholinesterase inhibiting, sulfur containing carbamates, the dithiocarbamates (used primarily as fungicides and herbicides). The dithiocarbamates include four major classes; (a) methyldithiocarbamates, (b) dimethyldithiocarbamates, (c) diethyldithio carbamates, (d) ethylenebisdithiocarbamates. For the purposes of this review neurotoxicity is defined as any unwanted change in the functional status of the organism which can be characterized in terms of behavioral, neurochemical, electrophysiological, or neuropathological indices. Neurotoxicity associated with methyl- and dimethylcarbamates has been characterized in terms of their reversible cholinesterase-inhibiting properties. The dithiocarbamates can have neurotoxic effects. However, a complete characterization of the neurotoxicity of these compounds has not been attempted. The neurotoxic actions of the dithiocarbamates may be related to their metal-chelating and enzyme-inhibiting properties.

Aging↗
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Trimethyltin, a selective limbic system neurotoxicant, impairs radial-arm maze performance.

Rats were trained for fifteen sessions in an automated eight arm radial maze prior to treatment with 6 mg/kg trimethyltin chloride. This compound is a neurotoxicant which primarily damages the limbic system, in particular pyramidal cells in the CA3 region of the hippocampus. Following treatment the animals exhibited a marked and persistent impairment of maze performance characterized by decreased selection accuracy and an altered spatial pattern of responding within the maze. These results offered additional evidence that CA3 pyramidal neurons or their connections play an important, if not essential, role in radial-arm maze performance. It was suggested that trimethyltin might be a useful tool for elucidating the neural substrates of both radial maze performance and learning and memory processes.

Analysis of Variance↗
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Chronic neonatal organotin exposure alters radial-arm maze performance in adult rats.

Long-Evans rats were intubated with 0.3 or 1.0 mg/kg of triethyltin sulfate (TET) or 0.3 mg/kg of trimethyltin hydroxide (TMT) from postnatal day 3-29. 1.0 mg/kg of TMT was given on alternate days beginning on postnatal day 3. Learning and memory were assessed in an automated radial-arm maze when the rats were 180-200 days old. With this maze accuracy and activity data can be collected simultaneously. TET or TMT treatment resulted in an increase in the number of days required to adequately perform and radial-arm maze task, and a transient deficit in accuracy. However, the most pronounced effect in both TET and TMT-treated animals was hyperactivity which became manifest on the second day of testing and persisted throughout the remainder of testing.

Analysis of Variance↗
PubMedDate not supplied

Eagle's syndrome and the trauma patient. Significance of an elongated styloid process and/or ossified stylohyoid ligament.

The elongated styloid process has been noted in medical literature for hundreds of years and is commonly referred to as Eagle's Syndrome. The presence of anomalous structures is always a concern to therapists and surgeons. The anatomy, embryology, etiology, plus treatment risks are reviewed. The affects of hyperflexion/hyperextension (whiplash) injuries are exacerbated in the presence of this unexpected calcified structure. The clinical significance of Eagle's Syndrome in the treatment of the trauma patient is explored.

Deglutition Disorders↗