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Biomedical subjects

D Brown

Publications and source records attributed to D Brown.

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

The synergy of health promotion practice/research/education.

Many nurses are concerned about the lack of connection among nursing practice, research and education. However, the assumption that nursing practice, research, and education represent separate domains or activities that need to be linked, may well contravene the relational synergy they share. This paper describes a project that sought to illustrate, and further explore, the synergistic, iterative relationship of health promoting practice/research/education. The project revealed how this synergy lives out within the daily practice of frontline practitioners and how the researched knowledge practitioners bring forth through their practice can transform care.

Asthma↗
PubMedDate not supplied

Quantitation of HCV RNA in liver of patients with chronic hepatitis C.

BACKGROUND/AIMS: Liver HCV RNA has been quantitated in few studies and the feasibility and the role of this parameter in the evaluation of patients with chronic HCV hepatitis still warrant study. Our aim was to determine the concentrations of HCV RNA in the liver of chronic HCV patients and to correlate the results with serum viral load. We also studied the relation of levels of HCV RNA in the liver with serum aminotransferases levels and with the presence of cirrhosis. METHODS: Twenty patients (14 males, aged 28 to 61 years) were studied. Twelve were infected by HCV type 1, six by type 3 and one by type 5. Percutaneous liver biopsy samples were obtained from 14 patients, and the remainder from liver explant in patients undergoing OLT. Twelve had chronic hepatitis and eight cirrhosis. HCV RNA levels were determined by bDNA. RESULTS: HCV RNA levels below the detection limit were found in one liver and in five serum samples. HCV RNA (mean +/- SD) was 2.1 x 10(8) +/- 2.2 x 10(8) Eq/gm in the liver and 94 x 10(5) +/- 93 x 10(5) Eq/mL in serum, with a significant correlation between these values (r = 0.89; P < 0.0001). Serum HCV RNA levels were significantly lower (P = 0.001) in cirrhotic than in chronic hepatitis patients, while the groups did not differ in liver HCV RNA levels. No correlation was observed between liver or serum HCV RNA and serum ALT or AST. CONCLUSIONS: Quantitation of HCV RNA is possible even in small liver samples. Although average levels are more than one log higher than those observed in serum, hepatic concentrations correlate with those observed in serum. The application of this technology to monitoring antiviral therapy and understanding the pathogenesis of the disease remains to be determined.

Adult↗
PubMedDate not supplied

Inhibition of neutrophil adherence and movement by acute cigarette smoke exposure.

Peripheral blood neutrophils were harvested and exposed acutely in vitro to physiologically attainable levels of cigarette smoke. The adherence of radiolabeled neutrophils subsequently to alveolar epithelial cell monolayers was measured. In contrast to control cells, smoke-exposed neutrophils were significantly less adherent and failed to increase their adherence following stimulation with phorbol ester or f-met-leu-phe (fMLP). Flow cytometric analysis of the cell surface adhesion protein CD18 demonstrated no significant change in expression following in vitro smoke exposure and, furthermore, no increase in surface CD18 of smoke-exposed cells following consecutive fMLP stimulation was demonstrated. Acute in vivo cigarette smoking of up to 4 cigarettes also did not alter peripheral blood neutrophil CD18 expression. Cell spreading and chemokinesis, but not chemotaxis, was also impaired following in vitro smoke exposure. These data suggest that acute cigarette smoke may impair the crucial neutrophil functions of adherence and movement. However, the chronic effects of cigarette smoke exposure may clearly differ.

Adult↗
PubMedDate not supplied

Bilateral optic nerve hypoplasia associated with cerebral atrophy.

We present a series of 12 consecutive cases of optic nerve hypoplasia. Eight of these were unassociated with significant CNS malformations; of these, two had tomographic evidence of cerebral atrophy. This represents the first adequately documented cases of isolated cerebral atrophy associated with optic nerve hypoplasia. We discuss the increasing prevalence and marked variability of optic nerve hypoplasia, note the lack of clear distinction between primary failure of differentiation and secondary degeneration of optic pathways, and mention the inadequacy of the classic explanation of primary failure of ganglion cell development as the cause of hypoplastic nerves. The cause of cerebral atrophy are mentioned, and we hypothesize that the wide range of CNS insults resulting in atrophy may be responsible for a correspondingly wide range of abnormalities of the optic nerves. We speculate that cerebral atrophy may result in an inadequate cortical mass for induction of normal optic nerve growth, possibly by decreased retrograde axoplasmic flow and insufficient nerve growth factor. We encourage a complete neurologic evaluation, including CAT scan of the brain, in children with optic nerve hypoplasia.

Adolescent↗
PubMedDate not supplied

Maximizing service delivery: one OR's experience.

Hospitals are being forced to make strategic downsizing decisions at a rapid rate. Surgical services are frequently targeted as much of the related activity is deemed to be controllable. However, strategies that only focus on bed and operating room reductions do not always achieve desired results. This article describes the experience of one community hospital in controlling surgical costs over a five-year period. The keys to its success include evaluating and monitoring the outcome of strategic decisions, identifying and integrating the systems that comprise the surgical process, and ensuring the involvement of users in developing and implementing change.

Appointments and Schedules↗
PubMedDate not supplied

The role of the physician extender in radiology.

This article examines the role of the radiology practitioner assistant (RPA), a physician extender first defined in the 1970s. The purpose of the research was to determine RPAs' accuracy in recognizing abnormal image patterns and their ability to independently perform gastrointestinal fluoroscopic procedures. The results support previous research indicating that technologists with additional education, training and radiologist supervision can detect abnormal image patterns and perform fluoroscopy successfully.

Arthrography↗
PubMedDate not supplied

The use of dental amalgam--an art or a science?

Dental amalgam remains the best material for filling teeth when aesthetics are of secondary importance. Over the last 20 years improvements in the composition have reduced marginal failure due to creep and corrosion, and the use of modern adhesives has lead to an early seal between the tooth and the filling. However, the proper handling by the dentists remains as the cornerstone for fillings that are going to last. This article describes the history, classification, structure and handling variables of dental amalgams. It also discusses the effects of extra elements, bonding agents and the possible hazard of mercury.

Copper↗
PubMedDate not supplied

Gd-DTPA enhancement of the cisternal portion of the oculomotor nerve on MR imaging.

PURPOSE: To describe a radiographic finding--enhancement of the cisternal portion of the third cranial nerve on postcontrast MR--and to correlate it with patients' clinical symptoms and ultimate diagnosis. MATERIALS AND METHODS: Thirteen consecutive patients with enhancement of the cisternal portion of the third cranial nerve on postcontrast MR were retrospectively identified; 50 control patients referred for pituitary microadenomas were also retrospectively reviewed. FINDINGS: The enhancement was bilateral in six patients and unilateral in seven patients. Four of the six patients with bilateral enhancement had unilateral oculomotor nerve palsies; none had bilateral third cranial nerve palsy. Five of the seven patients with unilateral enhancement had ipsilateral third nerve palsies. Of the nine patients with third nerve palsies, the pupil was involved in four patients. Follow-up studies were available in six patients, four of whom had third nerve palsy. Resolution of the enhancement correlated with resolution of the symptoms in two patients. The patients' underlying diagnoses were lymphoma (four), leukemia (one), viral meningitis (one), neurofibromatosis (two), inflammatory polyneuropathy-HIV related (one), ophthalmoplegic migraine (one), Tolosa-Hunt syndrome (one), coccidioidomycosis (one), and diabetes (one). No enhancement was seen in any of the controls. CONCLUSION: Enhancement of the cisternal segment of the third cranial nerve is always abnormal, revealing an underlying inflammatory or neoplastic process. However, it is not always associated with clinically apparent oculomotor nerve dysfunction.

Adult↗
PubMedDate not supplied

Modulation of oncogene expression by epidermal growth factor and gamma-interferon in A431 squamous carcinoma cells.

Epidermal growth factor (EGF) acts, in a dose dependent manner, as both a mitogen and an inhibitor of growth of the A431 squamous carcinoma cell line. gamma-interferon (IFN) also inhibits A431 cell growth. The dual effects of EGF on A431 growth and expression of the oncogenes, EGF receptor (EGFR) and Ha-ras, were evaluated with or without gamma-IFN. A mitogenic level (10pM) of EGF had no effect on expression of EGFR 10 kb mRNA or protein. gamma-IFN combined with 10pM EGF caused an initial drop in EGFR mRNA not reflected at the protein level; at 72 hours, the level of EGFR 10kb mRNA rose and inhibition of cell growth was observed. Treatment with a cytostatic amount (10nM) of EGF resulted in decreased expression of EGFR 10kb mRNA and protein within 24 hours; combined treatment with gamma-IFN caused rapid cell death. Expression of Ha-ras mRNA paralleled that of EGFR mRNA upon treatment with 10pM EGF and/or gamma-IFN, but differed with 10nM EGF.

Blotting, Northern↗