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Biomedical subjects

D Salmon

Publications and source records attributed to D Salmon.

At least 37 records · Page 2Linked to original sources
PubMed2001

Detection of mild cognitive deficits in Parkinson's disease patients with the WAIS-R NI.

The relative insensitivity of traditional IQ tests to mild cognitive deficits has led investigators to develop a version of the widely used Wechsler intelligence scales that allows quantitative analysis of underlying qualitative responses. This instrument, the Wechsler Adult Intelligence Scale-Revised as a Neuropsychological Instrument (WAIS-R NI) was administered to 16 Parkinson's disease (PD) patients and 30 normal controls (NC). The 2 groups did not differ significantly in mean age or education, or on their mean Mattis Dementia Rating Scale score. Relative to NC participants, PD patients showed decreased visual attention span, longer response latencies, slower visuomotor processing, and more stimulus-bound errors. Many of the WAIS-R NI measures were able to detect cognitive impairment in a greater percentage of patients than the traditional WAIS-R measures, making it easier to identify deficits that could affect quality of life early in the course of the disease.

Adult↗
PubMed2001

Shaping the interprofessional agenda: a study examining qualified nurses' perceptions of learning with others.

This paper presents the findings of a survey of post-qualified nursing students undertaking an interprofessional studies programme in a higher education institution. The total population of students surveyed included nurses, midwives, social workers and youth and community workers. However, the findings presented here centre on the data generated from the nurses. The participants made a retrospective evaluation of their educational experiences through focus groups and the use of a semi-structured questionnaire. Out of a potential 36 nurses, 32 (88%) participated in the evaluation. Overall, the nurses appraised their learning positively, although the qualitative data highlighted the complexity of the experience and the importance of skillful facilitation. Learning to work collaboratively entails more than learning about the practical roles of other occupations; it includes an understanding of the knowledge bases, aspirations and values that underpin those roles. The paper contributes to current debates about the most effective ways to prepare nursing students to work interprofessionally. It highlights the importance of evaluating the experiences of those taking part in interprofessional initiatives. This is a distinctive departure from much nursing research in the field in that it gives a voice to participants and identifies how their voice may shape interprofessional policy agendas.

Attitude of Health Personnel↗
PubMed2001

Do subgroups of patients with Alzheimer's disease exhibit asymmetric deficits on memory tests?

Several studies have reported asymmetric cognitive profiles in patients with Alzheimer's disease (AD), but these results have almost exclusively been found using non-memory cognitive instruments. The present study investigated whether AD patients who display lateralized profiles on non-memory cognitive instruments also exhibit asymmetric deficits on verbal versus spatial memory tests. Sixty-eight AD patients participated in the study: 36 with a "High Verbal" cognitive profile, and 32 with a "High Spatial" profile. The results indicated that the High Verbal AD patients performed significantly better than the High Spatial AD patients on verbal memory tests, but the two subgroups failed to differ on spatial memory tests. Implications of these findings for understanding the heterogeneous nature of cognitive profiles in AD patients are discussed.

Aged↗
PubMed2001

The practitioner as policy analyst: a study of student reflections of an interprofessional course in higher education.

Health and welfare practitioners in the United Kingdom have experienced and continue to experience considerable turbulence as services and occupational boundaries undergo restructuring. To a significant extent such turbulence is driven by policies that promote interprofessional agendas. This paper reports on an evaluation of a higher education programme that adopted a social policy approach to the analysis of interprofessional working. The retrospective views were sought of nursing, midwifery, social work and community and youth work post-qualifying students with use of semi-structured questionnaires and focus groups. Although difficulties were encountered with the political science focus to the programme, overall the participants very positively evaluated the opportunity to engage in policy analysis in a shared learning environment. Given the highly politicised, complex and shifting environment of interprofessional working, it is suggested that the study lends support to the argument that 'policy acumen' is a central skill for contemporary health and welfare practitioners. The paper, therefore, starts to explore issues of particular relevance for educationalists involved in developing frameworks for interprofessional programmes particularly in higher education.

Education, Continuing↗
PubMed2001

Rate of cognitive change in Alzheimer's disease: methodological approaches using random effects models.

Subtraction of serial scores, Least Squares Estimators, and Best Linear Unbiased Predictors (BLUPs) were compared for estimating rates of cognitive change for Mini-Mental State Exam (MMSE) and Dementia Rating Scale (DRS) scores for 299 probable Alzheimer's disease patients. The BLUPs provided cleaner group estimates of subjects' intercepts and slopes and are preferred. Regression analysis of the BLUP estimates of rate of change indicated that steeper declines were associated with higher levels of education and older age at onset. These effects were much smaller than those due to estimated initial cognitive test score. Differences in longitudinal metric characteristics of the MMSE and DRS were found, with the DRS yielding more precise change estimates. We discuss modeling these longitudinal data, and discuss use of the estimates of rate of change and intercept as data in their own right.

Aged↗
PubMed2001

Music therapy as psychospiritual process in palliative care.

This paper proposes a theoretical framework for understanding how music therapy elicits and supports depth experiences in palliative care. The author explores music therapy as a containing or sacred space in which ventures into the realm of psychospiritual awareness may safely occur. The ultimate goal is to facilitate the process of connecting to that which is psychologically and spiritually significant for the patient, thereby transforming experiences of suffering into those of meaning.

Female↗
PubMed2000

Induction and maintenance therapy of cytomegalovirus central nervous system infection in HIV-infected patients.

OBJECTIVE: To evaluate the efficacy and safety of the foscarnet-ganciclovir combination in induction therapy (IT) and maintenance therapy (MT) for cytomegalovirus (CMV) central neurological disorders in HIV-infected patients. DESIGN: An open pilot non-comparative multicentre study. METHODS: Thirty-one patients with acute CMV encephalitis (CMVe) (n = 17) or CMV myelitis (CMVm) (n = 14) during the era before highly active antiretroviral therapy (HAART) received intravenous IT with foscarnet 90 mg/kg plus ganciclovir 5 mg/kg twice a day followed by MT. The primary endpoint was clinical efficacy, assessed at the end of the induction phase. RESULTS: The foscarnet-ganciclovir combination in IT resulted in a 74% (23 out of 31 patients) clinical improvement or stabilization. Eight patients did not respond clinically. Side-effects leading to drug discontinuation occurred in 10 patients during IT. Among the 23 patients who qualified for the maintenance phase, CMV disease progressed in 10, with a median time to the first relapse of 126 days (range 64-264 days). Overall, the median survival time was 3 months [95% confidence interval (CI), 2-4 months]. CONCLUSION: The combination of foscarnet and ganciclovir can safely be used for CMV central nervous system (CNS) infection, with an improvement or stabilization in 74% of patients. Life-long MT with this combination is recommended as long as the immune system is profoundly impaired.

AIDS-Related Opportunistic Infections↗
PubMed2000

Lesbian, gay and bisexual experiences within critical care nursing, 1988-1998: a survey of the literature.

The aim of this paper is to provide an analysis of the extent to which gay, lesbian and bisexual service user experiences are represented within the critical care literature. A survey of five well established critical care journals, covering the period 1988-1998, was conducted in order to reveal the range of themes addressed within them. The findings suggest that these groups are invisible in this field of practice and consequently their particular concerns have remained marginalised. The implications of this absence are far reaching, potentially inhibiting nurses from establishing effective caring relationships with either lesbians, gays or bisexuals and from identifying and developing appropriate interventions for the care of these patients and their families.

Bibliometrics↗
PubMed2000

Pneumonia due to Scedosporium apiospermum in a patient with HIV infection.

A 29-y-old woman from Congo Democratic Republic was admitted to hospital with dyspnoea of 5-months duration. Chest X-ray showed left white lung and infiltrates of the right superior lobe. The patient underwent left pneumonectomy. Histopathological examination showed pulmonary cavitary lesions and bronchectasis full of branching septated fungi. Cultures yielded Scedosperium apiospermum.

Adult↗
PubMed2000

Sarcoidosis in a patient with acquired immunodeficiency syndrome treated with interleukin-2.

Concomitant human immunodeficiency virus (HIV) infection and sarcoidosis is rare. Sarcoidlike reactions could belong to the "highly active antiretroviral therapy (HAART)-induced immune restitution syndrome." We report a case of sarcoidosis beginning after 2 months of interleukin-2 (IL-2) therapy in a patient with HIV who had undetectable plasmatic viral load under HAART and we discuss possible mechanisms.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Detection and quantification of HIV-1 in semen: identification of a subpopulation of men at high potential risk of viral sexual transmission.

BACKGROUND: To assess HIV burden in both acellular and cellular fractions of semen in men with different levels of blood plasma HIV RNA by a cross-sectional study. PATIENTS: Fifty-two HIV-1-seropositive men (21 receiving antiretroviral therapy) with CD4 cell counts ranging from 1 to 1170 x 10(6)/l. METHODS: Semen was separated into seminal plasma and fractions enriched in motile spermatozoa or non-spermatozoal cells. HIV RNA was quantified by the HIV-Monitor technique (Roche) in blood plasma, seminal plasma and spermatozoa fractions. HIV DNA or infectious virions in cellular fractions were detected by either PCR or qualitative viral culture. RESULTS: HIV RNA was detected in 86.5% of seminal plasma specimens and in 14.6% of spermatozoa fractions; HIV DNA was detected in 57.1% of non-spermatozoal cell fractions. HIV RNA levels in blood plasma and seminal plasma were correlated (r5 = 0.56, P < 0.0001, Spearman's rank test). A majority of men had lower levels in seminal plasma than in blood plasma: one-third had HIV-positive seminal cell fractions. However, 20 men (38.5%) with HIV RNA levels in seminal plasma (median: 4.65 log10 copies/ml) comparable to or higher than those in blood plasma had all HIV-positive non-spermatozoal cells or spermatozoa fractions with a high frequency of positive cultures. CONCLUSION: A high frequency of men had detectable HIV in semen. We identified a subpopulation demonstrating high levels of HIV RNA in seminal plasma, comparable to or higher than those in blood plasma, frequently associated with a substantial viral shedding in seminal cells, raising the possibility of viral production within the genital tract and suggesting heterogeneity in the potential of HIV sexual transmission among infected men.

Adult↗
PubMed1999

Distribution of human herpesvirus-8 latently infected cells in Kaposi's sarcoma, multicentric Castleman's disease, and primary effusion lymphoma.

Human herpesvirus 8 (HHV-8, also called KSHV) is linked to the etiopathogenesis of Kaposi's sarcoma (KS), multicentric Castleman's disease (MCD), and primary effusion lymphoma (PEL). The universal presence of HHV-8 in early KS has not yet been shown. We used a mAb (LN53) against latent nuclear antigen-1 (LNA-1) of HHV-8 encoded by ORF73 to study the distribution of the cell types latently infected by HHV-8 in patch, plaque, and nodular KS, MCD, and PEL. In early KS, HHV-8 is present in <10% of cells forming the walls of ectatic vessels. In nodular KS, HHV-8 is present in cells surrounding slit-like vessels and in >90% of spindle cells, but not in normal vascular endothelium. In addition, HHV-8 colocalizes with vascular endothelial growth factor receptor-3 (VEGFR-3), a marker of lymphatic and precursor endothelium. In early KS lesions, VEGFR-3 is more extensively expressed than LNA-1, indicating that HHV-8 is not inducing the proliferation of VEGFR-3-positive endothelium directly. In MCD, HHV-8 is present in mantle zone large immunoblastic B cells. No staining for LNA-1 is seen in samples from multiple myeloma, prostate cancer, and angiosarcoma, supporting the absence of any etiological link between these diseases and HHV-8.

Antigens, CD↗
PubMed1999

A field study of the ecotoxicology of copper to bryophytes.

The impact of particulate copper, emitted from a copper rod-rolling plant, on the distribution of common grassland bryophytes has been investigated. Several areas of managed grassland, differing in total and water-extractable soil copper content, surrounding the factory were surveyed to establish species composition and distribution of the bryophyte flora. Clear differences emerged in the distribution patterns of the main acrocarpous (upright/tufted growth form) and pleurocarpous (horizontal/spreading growth form) species present, with some species being more or less confined to soils with elevated copper (Pohlia nutans), whilst others were absent from such sites. The distribution of acrocarpous species was not related to increasing soil copper concentrations, whereas pleurocarpous species showed considerable sensitivity. This may not be a simple reflection of sensitivity to copper; ecological factors such as differences in patterns of water and soluble copper uptake between the different growth forms may be significant factors, as may be changes in the vascular plant flora giving rise to differences in population densities of potential competitors between sites. Pleurocarpous species are absent from grassland where total soil copper >550 microg g(-1) dry weight, whilst the less sensitive acrocarpous species occur at total soil copper levels in excess of 2000 microg g(-1) dry weight.

Journal Article↗
PubMed1999

A feminist analysis of women's experiences of perineal trauma in the immediate post-delivery period.

OBJECTIVE: To provide an account of women's experiences of perineal trauma in the immediate post-delivery period. DESIGN: Qualitative, using unstructured interviews with broad questions about experiences of childbirth and perineal trauma. SETTING: The South Wales. PARTICIPANTS: A snowball technique was employed to recruit six participants, all of whom were between 25 and 40 years of age, white, British and had had access to further education. FINDINGS: The women identified several factors which informed their experience. Of significance to midwives are the following: the doctor--'patient' relationship, particularly in relation to gender, not feeling heard, the expression of feelings; and a lack of available information and advice. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The study identified some of the reasons why women sufferers find it difficult to get these issues on the health-care agendae and the need for more research. Improvements in care are necessary in the areas of interpersonal skills and perineal suturing. Listening to women is the key to responsive care.

Adaptation, Psychological↗
PubMed1999

Broad, intense anti-human immunodeficiency virus (HIV) ex vivo CD8(+) responses in HIV type 1-infected patients: comparison with anti-Epstein-Barr virus responses and changes during antiretroviral therapy.

The ex vivo antiviral CD8(+) repertoires of 34 human immunodeficiency virus (HIV)-seropositive patients with various CD4(+) T-cell counts and virus loads were analyzed by gamma interferon enzyme-linked immunospot assay, using peptides derived from HIV type 1 and Epstein-Barr virus (EBV). Most patients recognized many HIV peptides, with markedly high frequencies, in association with all the HLA class I molecules tested. We found no correlation between the intensity of anti-HIV CD8(+) responses and the CD4(+) counts or virus load. In contrast, the polyclonality of anti-HIV CD8(+) responses was positively correlated with the CD4(+) counts. The anti-EBV responses were significantly less intense than the anti-HIV responses and were positively correlated with the CD4(+) counts. Longitudinal follow-up of several patients revealed the remarkable stability of the anti-HIV and anti-EBV CD8(+) responses in two patients with stable CD4(+) counts, while both antiviral responses decreased in two patients with obvious progression toward disease. Last, highly active antiretroviral therapy induced marked decreases in the number of anti-HIV CD8(+) T cells, while the anti-EBV responses increased. These findings emphasize the magnitude of the ex vivo HIV-specific CD8(+) responses at all stages of HIV infection and suggest that the CD8(+) hyperlymphocytosis commonly observed in HIV infection is driven mainly by virus replication, through intense, continuous activation of HIV-specific CD8(+) T cells until ultimate progression toward disease. Nevertheless, highly polyclonal anti-HIV CD8(+) responses may be associated with a better clinical status. Our data also suggest that a decrease of anti-EBV CD8(+) responses may occur with depletion of CD4(+) T cells, but this could be restored by highly active antiretroviral treatment.

Antiviral Agents↗