Search PubMed⌕ Search

Biomedical subjects

D Roberts

Publications and source records attributed to D Roberts.

483 records · Page 27Linked to original sources

Transdermal drug delivery using iontophoresis and phonophoresis.

Introducing medicines into the human body by way of the skin is an ancient practice, and transdermal delivery has long been a standard for administering medications such as nitroglycerin and scopalamine. Phoresis, another method of transdermal drug delivery, is now being ordered for an increasing number of orthopaedic patients who suffer from inflammation, strains, or sprains. In phoretic drug delivery, enhancers such as electricity or ultrasound are used to stimulate drug absorption in the treatment area. To guide their patients to explore a variety of treatment options, orthopaedic nurses need a greater understanding of these phoretic modalities.

Administration, Cutaneous↗

Respiratory syncytial virus and ribavirin therapy: winter 1987-spring 1988. A report of 74 cases treated at Providence Hospital, Anchorage, Alaska.

Seventy-four pediatric cases of Respiratory Syncytial Virus lower respiratory tract infection were treated at Providence Hospital, Anchorage, Alaska between September 1, 1987 and April 30, 1988. These patients are described with illustrative case reports. Twenty-one patients were treated with Ribavirin and these patients are further analyzed as a special interest group. A disproportionate number of the Ribavirin treated group were Alaskan Natives. In the discussion we address concerns of possible toxicity of Ribavirin and current recommendations for patient selection for treatment with Ribavirin.

Adolescent↗

Models for assessing the effect of toxicants on immunocompetence in mice. II. Effect of cyclophosphamide on the antibody responses to type III pneumococcal polysaccharide and tetanus toxoid in BALB/c female mice.

A mixture of antigens was used to detect alterations in immunocompetence. Type III pneumococcal polysaccharide (S3) and tetanus toxoid (TT) stimulate different cellular components, and can therefore be used to assess different compartments of the immune mechanism. Cyclophosphamide (CP), a known immunosuppressant, had a potent effect upon the antibody responses to both S3 and tetanus toxoid. All doses of CP administered within 2 days of priming with S3 resulted in a dose-related immunosuppressive action which persisted even after reinjection of S3. 300 mg/kg of CP given up to 14 days prior to or following primary immunization resulted in a marked suppression of antibodies to S3. Doses of S3 which were partially tolerogenic were made even more so by injections of CP. The effect persisted over a 96 day experimental period. CP also suppressed the formation a memory cells necessary for induction of a secondary-type IgG response to TT. The time of injection for maximum suppression was days 10 to 14 after priming. Therefore, the suppression must involve cellular mechanisms different from those responsible for S3 antibody suppression. In addition, there was a difference in the degree and persistence of the suppressive effect, since the suppressed animals were able to mount an immune response to subsequent injections of TT. Double injections of a high dose (300 mg/kg) of CP 4 weeks after priming completely suppressed the acquired immunity to both S3 and TT. Low and moderate doses of CP appeared to induce a mild augmentation of S3 antibody response when given 4 weeks after priming. However, an immunosuppressive effect occurred if the primed animals were reinjected with S3 or challenged with TT within a period of 2 days prior to or after receiving the CP treatment. Doses of CP, injected prior to challenge and resulting in suppressed tetanus antitoxin production, elevated the titers of specific IgE antibody. This class of antibody is associated with adverse hypersensitivity reactions. These data provided background for the development of models to assess immunocompetence in mice, based on a study of immune profiles following exposure to selected T-dependent and T-independent antigens. Such models may be used to detect potentially hazardous chemicals found in the environment of incorporated into foods, drugs, or cosmetics.

Animals↗

Reduced per- and postoperative mortality following the use of urea during elective cardiopulmonary bypass. A proposed treatment for the prevention of reduced red cell deformability during open heart surgery.

The vital micro-rheological function of the red cells to deform was monitored during extracorporeal circulation in 75 patients undergoing open heart surgery. Red cell deformability was assessed in vitro by estimating red cell filtration rate (RFR). Urea was given to 32 patients during surgery and the remaining 43 acted as controls. After one hour on cardiopulmonary bypass (CPB) all patients showed a significant reduction of red cell filtration rate which continually worsened. In control patients where the RFR was severely altered there appeared to be more morbidity and mortality (11.6%). Using this simple method it is possible for the perfusionist to assess blood damage rapidly and possibly anticipate a difficult postoperative recovery. Urea administered during CPB reduced the decrease in RFR by a significant extent and in these patients the postoperative course was relatively uneventful and all survived.

Coronary Artery Bypass↗

Radiologic techniques used to evaluate the temporomandibular joint; I. Conventional methods.

Symptoms of temporomandibular joint pathology are present in a relatively high proportion of the population. Conventional radiographic techniques used to evaluate the morphology of the joint provide data which may be difficult to interpret. These techniques are reviewed briefly and their interpretational shortcomings are noted. Computed tomography is currently being used by some clinicians to evaluate the joint. This technique may also yield data which are difficult to interpret. Extended processing of CT data to provide three-dimensional images of the joint enhances the technique as a means of diagnosing hard tissue pathology, but despite reports in the literature detailing its use in diagnosing soft tissue pathology, CT is not optimal for this purpose. The introduction of nuclear magnetic resonance imaging provides a means of examining the soft tissues of the joint in either two- or three-dimensional images and has the advantage over all previous techniques in that the patient is not subjected to ionizing radiation during the scan process.

Humans↗

Assessment of myocardial damage by circulating cardiac myosin light chain I after heart transplantation.

The purpose of this study was to evaluate the cardiac damage by cardiac myosin light chain I after transplantation. This study included 30 patients who underwent cardiac operations and who were divided into three groups. These groups consisted of (1) control group, 15 valvular patients without coronary disease (no electrocardiography changes and creatine kinase MB isoenzyme of 100 micrograms/L or less); (2) infarction group, eight patients (six coronary bypass and two valvular patients with perioperative infarction pattern in the electrocardiography and creatine kinase MB isoenzyme of 100 micrograms/L or more; and (3) transplantation group, seven transplant patients (six heart and one heart-lung). The peak cardiac myosin light chain I value in the transplantation group (32.9 +/- 3.4 micrograms/L) was comparable to the infarction group (27.6 +/- 2.6 micrograms/L), and both of them were significantly higher than the control group (9.2 +/- 0.9 micrograms/L) (p < 0.01). Peak cardiac myosin light chain I levels in the control and transplantation groups correlated with the ischemic time (r = 0.48, p < 0.05 and r = 0.67, p < 0.05, respectively). The total dose of dopamine in the transplantation group correlated with the peak cardiac myosin light chain I (r = 0.67, p < 0.05), and with the cardiac myosin light chain I value on day 7 (r = 0.88, p < 0.01). This study suggests that circulating cardiac myosin light chain I estimations are useful to evaluate myocardial damage after transplantation during postoperative week 1.

Aged↗

Hypoprolactinemia does not prevent restoration of normal spermatogenesis in gonadotropin-suppressed, testosterone-replaced rats.

We have previously shown that suppression of gonadotropins and spermatogenesis can be produced in rats by immunization against gonadotropin releasing hormone (GnRH). Administration of testosterone (T) alone is effective in restoring complete spermatogenesis in these rats, although it is not effective in doing so in chronically treated hypophysectomized rats. This suggests that a pituitary factor(s) other than luteinizing hormone (LH) and follicle-stimulating hormone (FSH) is required to restore normal spermatogenesis. The studies described herein test the hypothesis that prolactin (PRL) is the additional requirement for complete restoration of spermatogenesis. Twenty rats were immunized against GnRH, and four groups of five each received either 1) 24-cm T-filled Silastic implant (TSl), 2) TSl plus bromocriptine pellet (B), 3) B plus empty Silastic implant (Sl), or 4) Sl alone. Five nonimmunized rats received Sl alone and served as controls. All rats were sacrificed 2 months after treatment. GnRH immunization and B administration suppressed gonadotropins and PRL levels, respectively, and advanced spermatids were not detectable in these rats. Testis weight was suppressed to about 19% of controls. The number of advanced spermatids in control rats was 220 +/- 23 x 10(6). TSl administration restored advanced spermatids to numbers comparable to controls in GnRH-immunized rats whether the rat received B (191 +/- 17 x 106) or not (217 +/- 18 x 10(6)). Additionally, we determined mRNA levels for PRL and FSH beta subunit (FSH beta) in the pituitary by Northern blot and densitometric scanning. The mRNA levels of PRL mirrored serum PRL levels, and the same was true for FSH beta subunits and serum FSH levels. These data show that suppression of PRL has no effect on the ability of T to restore complete spermatogenesis in GnRH-immunized rats. This observation mitigates against the hypothesis that PRL is the pituitary factor required to allow complete restoration of spermatogenesis to occur.

Age Factors↗

Association between the severity of chronic lung disease and first-year outcomes of very low birth weight infants.

OBJECTIVE: The objective of this study was to determine if there is an association between the severity of chronic lung disease in very low birth weight infants (as assessed by the duration of supplemental oxygen requirements in the neonatal period) and first-year neurodevelopmental, sensory, and growth outcomes as well as duration of neonatal hospitalization and first-year hospital readmissions. STUDY DESIGN: Retrospective chart review with matched subject groups. METHODS: The subjects of this study were very low birth weight infants born between 1987 and 1991 in a 17-county perinatal region of North Carolina. Infants were categorized into one of three groups on the basis of duration of supplemental oxygen requirements. Infants who were breathing room air by 28 days were classified as having no chronic lung disease; infants who required supplemental oxygen at 28 days but not at 36 weeks postmenstrual age were classified as having mild chronic lung disease; and infants who required supplemental oxygen at 36 weeks postmenstrual age were classified as having severe chronic lung disease. Infants were matched for birth weight, sex, and race. The matched groups (n = 174) were compared with respect to the incidence of first year adverse neurodevelopmental and sensory outcomes, growth patterns, and hospital readmissions during the first year. Results were analyzed with general linear models and logistic regression analyses. RESULTS: The incidence of any adverse neurodevelopmental or sensory outcome increased as severity of chronic lung disease increased from none (3.6%) to mild (21.4%) to severe (31.6%, p < 0.001). Growth patterns were similar in infants with no and mild chronic lung disease, but infants with severe chronic lung disease were significantly lighter (p < 0.01) and shorter (p < 0.005) at 40 weeks postmenstrual age and significantly lighter at 1 year adjusted age (p < 0.05). The duration of the initial hospitalization increased with chronic lung disease severity (p < 0.001). Infants with severe chronic lung disease were readmitted to the hospital significantly more often (p < 0.005) than infants with no chronic lung disease or mild chronic lung disease. CONCLUSIONS: Very low birth weight infants who required supplemental oxygen at or beyond 28 days were at increased risk for adverse neurodevelopmental and sensory outcomes, but only those infants who continued to require supplemental oxygen at 36 weeks were at increased risk for poor growth and readmission to the hospital.

Case-Control Studies↗

Relationship between soil and dust lead in a lead mining area and blood lead levels.

UNLABELLED: The relationship between lead mining waste and childhood lead poisoning is poorly understood. This study evaluates the contribution of soil lead to blood lead levels. METHODS: 125 children between 6 and 71 months of age living in a lead mining area of southwestern Missouri were evaluated for blood lead and their homes tested for lead in soil, dust, and paint. These results were compared to 26 control children. RESULTS: Homes in the lead mining area had significantly increased soil and dust lead levels and significantly higher blood lead levels. The primary source of dust lead was soil lead. There was a strong relationship between blood lead levels and dust, soil, and paint lead. CONCLUSION: Soil lead related to mining operations plays a significant role in contributing to blood lead levels in children.

Child, Preschool↗

Nurses' perceptions of the role of liaison mental health nurse.

A focus group interview was carried out with a group of nurses to evaluate a liaison mental health nursing role. This work carried out by a liaison mental health nurse (LMHN), had been in operation for several years in a haematology unit. The views of nurses using the service were positive. The LMHN role was valued for its availability and visibility, objectivity and mental health expertise.

Attitude of Health Personnel↗