Search PubMed⌕ Search

Biomedical subjects

G Smith

Publications and source records attributed to G Smith.

At least 109 records · Page 6Linked to original sources

Collaborating for social change: the black psychologist and the black community.

Several prominent Black scholars have argued that the predicament of Black intellectuals is inseparable from that of Black communities (C. West, 1994), and that Black psychologists should be at the forefront in developing culturally relevant psychological interventions (J. A. Baldwin, 1989). Yet, for Black psychologists there are a number of challenges to conducting successful interventions in Black communities, including historical abuses of Black communities by the "helping" professions and divergences in values, goals, and behaviors of professionals as compared to community members. In order for community psychologists to design interventions that are respectful of the cultural traditions and norms of Black communities, these obstacles to collaboration need to be addressed. This paper outlines some of the challenges faced by Black community psychologists, as well as the unique strengths they can mobilize when collaborating on research and interventions in Black communities. The paper also addresses methods of empowering Black communities and improving the training of community psychologists.

Adolescent↗

Buscopan for the treatment of pain after laparoscopic sterilisation.

We investigated the effect of Buscopan 20 mg, given at the end of surgery, on analgesic requirements in 44 ASA I and II patients presenting as day cases for laparoscopic sterilisation using Filshie clips. Patients were randomly allocated to receive either intravenous Buscopan 20 mg or saline placebo at the end of surgery. There was no significant difference in pain scores, analgesic requirements or the incidence of nausea and vomiting between the two groups. We conclude that intravenous Buscopan 20 mg was not effective for pain relief following laparoscopic sterilisation.

Adult↗

Provision of platelet support for fetuses and neonates affected by severe fetomaternal alloimmune thrombocytopenia.

Severe fetomaternal alloimmune thrombocytopenia requires urgent treatment with compatible platelet concentrates. As prompt treatment is sometimes delayed owing to the unavailability of compatible platelets, we established an accredited platelet donor panel to provide effective and timely transfusion support for fetal and neonatal therapy. After a mass screening programme of over 60,000 blood donations, 45 HPA-1a-negative donors with no antibodies to HPA, HLA, red cell antigens and granulocytes/lymphocytes, and with low titre anti-A and/or -B were accredited. All accredited donors were fully genotyped for HPA-1, -2, -3 and -5 by PCR-SSP. Ninety-one per cent of the accredited donors were also negative for HPA-5b.

Antigens, Human Platelet↗

Detection of cytochrome P450 mRNA transcripts in prostate samples by RT-PCR.

BACKGROUND: The expression of cytochrome P450 (CYP)-dependent mono-oxygenases in the prostate is important, as it will determine the rate of activation of potential carcinogens as well as the metabolism of hormones with implications in diseases of the prostate. In addition, the levels of cytochromes P450 in prostatic tumours may well be determinants of the outcome of therapy involving P450 substrates such as anti-androgens. METHODS: The gene expression of 12 different CYP genes was measured by reverse transcription-polymerase chain reaction (RT-PCR) in a total of 28 human prostatic tumour and nontumour samples. RESULTS: Intriguingly, a large number of CYP mRNAs were detected in the prostate samples, including CYP1A2, -1B1, -2C19, -2D6, -3A4, -3A5, -3A7 and -4B1. CYP1B1 was consistently expressed and CYP3A5 and CYP4B1 were expressed in a majority of the samples tested. CONCLUSIONS: These data demonstrate a wide range of CYP genes being expressed in the prostate. The relative importance of these enzymes in the pathogenesis and treatment of prostatic disease remains an important theme for further study.

Aged↗

Artificial saliva substitutes and mineral dissolution.

The erosive potentials of a number of commercially available artificial saliva substitutes have been investigated using an in vitro hydroxyapatite powder dissolution assay. Most of the saliva substitutes examined did not show any appreciable erosive potential, although one product resulted in greater mineral dissolution levels. There appeared to be little correlation between pH and mineral dissolution levels for the different saliva substitutes examined. Whilst saliva substitutes may be of assistance in maintaining some physiological function in patients with impaired salivary flow, it is important to choose a product with low erosive potential where the natural dentition is present.

Aerosols↗

The gradient index and spherical aberration of the lens of the human eye.

We present equations for analysing the primary spherical aberration of the crystalline lens, both as a whole and of its contributing parts. We apply these equations to two examples of gradient index lenses. The spherical aberration of one lens is well outside that expected for real lenses, but that of the other is within this range. We assess the sensitivity of the aberration to changes in surface shape and gradient index distribution. The process is applicable to other models of the gradient index of the lens.

Adolescent↗

A 20 year audit of nose-tip symmetry in patients with unilateral cleft lip and palate.

The purpose of this study was to audit the process and outcome in terms of nasal-tip symmetry of the first 20 patients with unilateral complete cleft lip and palate treated by the Pigott alar leapfrog primary nasal correction in the early 1970s and followed for 20 years. Symmetry was assessed using the Coghlan computer-based analysis of frontal and basal views to determine the stability of the correction. The Abyholm technique of alveolar bone grafting was performed in 12 of the 20 patients. Various other secondary procedures have been performed on the nose tip and septum to improve the airway or appearance. Photographs were taken within one year of ages 5, 10, 15 and 20 years, and the lower border of the nose, the alar domes and the nostrils were assessed. To assess the overall change from 5 years to 20 years, both views were available for 17 patients. No significant change was found in the lower border or nostril symmetry, but significant deterioration at the P< 0.01 level was found on the basal view. We assessed the 10, 15 and 20 year views of all 12 patients who had undergone alveolar bone grafting to determine early and late changes. No significant benefit was found from alveolar bone grafting or minor secondary procedures for appearance. Consequently, our criteria for undertaking minor adjustments to improve appearance have become more stringent. We consider that objective reporting of appearance should become essential in peer-reviewed journals.

Adolescent↗

Comparing sports injuries in men and women.

OBJECTIVE: To compare the pattern of injury between men and women in seven collegiate sports to determine if gender-specific factors exist which could be modified to reduce the risk of injury to female athletes. DESIGN: Retrospective cohort study of injury reports compiled by certified athletic trainers between Fall 1980 and Spring 1995. SETTING: An NCAA division III College. PARTICIPANTS: Eighteen to 22 year-old male and female college athletes competing in seven like sports (basketball, cross-country running, soccer, swimming, tennis, track and water polo) at the intercollegiate level, playing similar number of contests and using the same facilities. MAIN OUTCOME MEASURES: Analyses of injury patterns, classified by sport and anatomic location, for men and women in seven like sports. RESULTS: A total of 3,767 participants were included in the study, with 1874 sports-related injuries reported among the men and women's teams. Of these injuries, 856 (45.7%) were sustained by female and 1018 (54.3%) by male athletes. Overall, no statistically significant gender difference was found for injuries per 100 participant-years (52.5 for female athlete versus 47.7 for males). A statistically significant gender difference in injury incidence (p < 0.001) was seen for two sports: swimming and water polo. Female swimmers reported more back/neck, shoulder, hip, knee and foot injuries: and female water polo players reported more shoulder injuries. When evaluating all sports concurrently, female athletes reported a higher rate of hip, lower-leg and shoulder injuries, while male athletes reported a higher rate of thigh injuries. CONCLUSION: Except for some minor gender differences in total injuries for two sports and several differences in total injuries by anatomic location, our data suggest very little difference in the pattern of injury between men and women competing in comparable sports. The increased rate of shoulder injury among female swimmers probably resulted from the more rigorous training philosophy of their coach. Thus, no gender-specific recommendations can be suggested for decreasing the incidence of injury to female athletes competing in these sports.

Adolescent↗

Footedness in world soccer: an analysis of France '98.

Most football players and coaches agree that players are capable of learning to use both feet with equal frequency and efficiency--that is, become 'two-footed'. There is also some consensus that two-footed play is associated with skill in individual players. If these assumptions are true, then the world's elite football players should be substantially less 'one-footed' than the rest of the population. To examine this issue, we quantified the pattern of foot use in a sample of 236 players from 16 teams in the 1998 World Cup (France '98). Our findings indicate that World Cup players are as right-footed as the general population (approximately 79%). The remaining players were largely left-footed and as biased towards the use of their preferred foot as their right-footed counterparts. Very few players used each foot with equal frequency. Remarkably, both left- and right-footed players were as skilled, on average, with their non-preferred foot as they were with their preferred foot, on the rare occasions when they used it. Therefore, it is unlikely that infrequent use of one foot compared to the other foot can be accounted for by skill differences between the feet. Players were most asymmetrical for set pieces; nevertheless, first touches, passes, dribbles and tackles were rarely performed with the non-preferred foot as well. Our results support a biological model of foot preference and performance, as well as demonstrating the usefulness of soccer for studies of lateral asymmetries.

Adult↗

Echocardiographic left ventricular geometry in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE Study.

AIM: To assess the prevalence of echocardiographic left ventricular hypertrophy (LVH) and concentric remodeling in hypertensive patients with electrocardiographic (ECG)-LVH and to estimate the cost-effectiveness of echocardiography and ECG for detection of LVH. DESIGN: Echocardiographic LV measurements and the prevalence of abnormal LV geometric patterns were compared between 964 hypertensive patients with ECG-LVH (Cornell voltage-duration product > 2440 and/or SV1 +/- RV5-6 > 38 mm) participating in the LIFE trial and groups of 282 employed hypertensives and 366 apparently normal adults. RESULTS: Among both women and men, stepwise increases from reference subjects to employed hypertensives to LIFE patients were observed for LV wall thicknesses, chamber size and mass. Mean LV mass/body surface area (BSA) and LV mass/height(2.7) were substantially larger in LIFE patients than normal adults among women (113 vs 69 g/m2 and 55 vs 32 g/m(2.7), p <0.001) and men (127 vs 83 g/m2 and 55 vs 36 g/m(2.7), p < 0.001), with intermediate values in employed hypertensives. Compared to the latter group, LIFE patients had higher prevalences of concentric LVH (25-29% vs 3-4%) and eccentric LVH (45-51% vs 13-17%) but not concentric LV remodeling (8-11% vs 12-14%). LVH was present in 70% of LIFE patients by LV mass/BSA criteria and 76% by LV mass/height(2.7) criteria (odds ratios = 11.4 and 13.5 vs employed hypertensives). CONCLUSIONS: The ECG criteria used in LIFE identify hypertensive patients with a >70% prevalence of anatomic LVH, allowing accurate identification of high-risk status by this commonly used technique.

Aged↗

Spousal bereavement--implications for health.

BACKGROUND: Bereavement is a potential medical problem as it has implications for health through possible associations with morbidity and mortality. OBJECTIVE: The aim of the present study was to ascertain if spousal bereavement is associated with physical and psychological parameters of illness. METHODS: A spousal bereavement register was created at a village general practice in the West Midlands of 122 spouses (4.9% of the practice population). After exclusion of 22, a sample of 100 had their medical records analysed for the periods of 12 months before and after bereavement. RESULTS: Between these two periods, the average number of consultations increased from 5.99 to 7.60 (P = 0.01), where the vast majority were for physical illness. Mean number of prescriptions increased from 8.54 to 9.15 per patient (P = 0.8) for physical illness and from 0.76 to 1.34 (P = 0.09) for psychological illness. CONCLUSION: Bereavement can be viewed as a medical problem, but this is not borne out in prescribing and so care should be taken not to over-medicalize grief.

Adaptation, Psychological↗

Risk factors for lyme disease in Chester County, Pennsylvania.

OBJECTIVE: To identify factors associated with increased or decreased risk of infection for Lyme disease in Chester County, Pennyslvania. METHODS: The authors designed an unmatched case-control study involving 294 incident cases reported to the Chester County Health Department in 1998 and 449 controls selected by random digit dialing. All case and control participants were interviewed by telephone. RESULTS: Age is a risk factor for Lyme disease for groups aged 10-19 years old and 50 years or older. Sex was not a risk factor. Incidence of Lyme disease in a rural setting was three times the incidence in an urban setting. Increased risk also was associated with living in single family homes, homes with yards or attached land, woods on the land, signs of tick hosts seen on the land, and homes within 100 feet of woodland. Gardening for more than four hours per week was also a risk factor, but most other outdoor activities were not. Twice as many participants took protective measures against tick bites before outdoor employment than those who merely ventured into the yard or land associated with the home. Only checking for ticks during outdoor activity and the use of repellents prior to outdoor activities outside the yard were unequivocally associated with a reduced risk of Lyme disease. CONCLUSIONS: It is important to increase public awareness about the risk of acquiring Lyme disease from ticks in the immediate environment of the home.

Adolescent↗

Expressed sequence tags for the chicken genome from a normalized, ten-day-old white leghorn whole embryo cDNA library. 2. Comparative DNA sequence analysis of guinea fowl, quail, and turkey genomes.

Accelerated efforts to develop a high-utility chicken genome map have resulted in the development of resources that may be useful for genetic analysis in other economically important poultry species. Here we describe a total of 26 comparative genomic DNA sequences (CGS) for the guinea fowl, Japanese quail, and domestic turkey developed using 10 primer pairs specific for 10 previously reported, unique, chicken expressed sequence tags (EST). The total length of CGS developed for each of the three species was 4,193, 4,597, and 6,057 bp in quail, turkey, and guinea fowl, respectively. About 70% of the CGS showed significant sequence similarity to reference database sequences, including the reference chicken EST and other avian and nonavian genes. A majority of the between-species comparisons of the CGS from all but two primer pairs were significant and ranged from 81 to 99%. The percentage similarity of the CGS appears to be a function of phylogenetic relatedness and was generally higher for comparisons between the chicken, quail, and turkey and lower between the guinea fowl and chicken, quail, or turkey. Maximum likelihood estimation of the phylogenetic relationships using CGS from two primer pairs also showed a closer relationship, as expected, among chicken, quail, and turkey than between guinea fowl and either chicken, quail, or turkey. Within the guinea fowl, quail, and turkey CGS developed, the total number of single nucleotide polymorphisms detected was 28, 17, and 14, respectively. Together, these resources represent tools that will facilitate genetic analysis of species that have been studied very little and our understanding of their genomes and genome evolution.

Animals↗

Gastroesophageal reflux and aspiration of gastric contents in anesthetic practice.

General anesthesia may predispose patients to aspiration of gastroesophageal contents because of depression of protective reflexes during loss of consciousness. In addition, some patients may be at increased risk of pulmonary aspiration because of retention of gastric contents caused by pain, inadequate starvation, or gastrointestinal pathology resulting in reduced gastric emptying and gastroesophageal reflux. Despite increasing knowledge of the problems associated with aspiration, the relatively small incidence and associated mortality rates in the perioperative period do not appear to have changed markedly over the last few decades. In this review article, the physiological factors associated with an increased risk of gastroesophageal reflux and aspiration are considered together with some of the methods that are used to prevent aspiration. In particular, preoperative starvation, the use of drugs designed to increase gastric pH, recent developments in airway devices, and appropriate application of cricoid pressure are critically appraised.

Anesthesia↗

Efficiency and cost saving of 7 day per week exercise testing utilizing all electrocardiography technologists.

BACKGROUND: In most centers, exercise testing (ET) is performed by one or two trained technologists during the weekdays (0800 hours-1600 hours), leaving a void during evenings and weekends. This leads to unnecessary increased costs due to delays in management of patients. Electrocardiography technologists (ECGT) are often available for extended hours. This project was undertaken to improve the efficiency of the ET laboratory by using ECGT to perform ET during these extended hours. METHODS: Clinical utility and cost saving of a 7 day per week ET for management of patients with suspected and/or known coronary artery disease utilizing ECGT was assessed after adequate training. Of 4099 patients undergoing ET between January 1995 and December 1997, 810 tests performed by ECGT were reviewed retrospectively. RESULTS: Of the 810 patients (age mean 58.4 +/- 0.44 yrs; range 16-88; males: 508, females: 302), 806 (99.5%) underwent the Bruce protocol. The indications were: diagnostic, 61.3%, predischarge acute myocardial infarction (AMI), 17.7%, evaluation of angina, 19.6%, other, 1.4%. Only 8 (0.1%) patients had complications (prolonged chest pain, 6; nonsustained ventricular tachycardia, 2) with no AMIs or deaths. This strategy resulted in a savings of 158 bed days (Can189,600 dollars) on inpatients and 15 bed days (Can18,000 dollars) on those presenting to the emergency department. CONCLUSIONS: This study demonstrates the feasibility and safety of utilizing ECGT for ET thus extending the hours of service. This resulted in efficient patient management, with a considerable cost-saving to the hospital.

Adolescent↗

The psychotic phenomenon in probable Alzheimer's disease: a positron emission tomography study.

Positron emission tomography was used to examine the mechanisms of the psychotic phenomenon in Alzheimer's disease (AD). Data from 2 patients with delusions and 2 with hallucinations were compared with those of 5 AD patients without psychosis. The patients with paranoid delusions had diminished relative regional cerebral blood flow (rel-CBF) in the left dorsolateral prefrontal and left medial temporal cortices. The patients with visual hallucinations showed diminished rel-CBF in the right parietal, left medial temporal, and left dorsolateral prefrontal cortices. These findings support the hypothesis that a frontal-temporal abnormality is associated with paranoid delusions in AD. By contrast, visual hallucinations are associated with parietal as well as frontal and temporal lobe dysfunction. In these patients, a left prefrontal-temporal cortex dysfunction appears to be a common denominator for the development of the psychotic phenomenon in AD.

Aged↗

Psychiatric symptoms associated with cortical-subcortical dysfunction in Alzheimer's disease.

Positron emission tomography was used to evaluate 3 Alzheimer's disease (AD) patients: 1 with major depression, 1 with emotional lability, and 1 with apathy. Compared with 5 non-mood-disordered AD patients, the patient with depression had diminished relative regional cerebral blood flow (rel-CBF) in the anterior cingulate and superior temporal cortices, bilaterally. This patient also showed diminished rel-CBF in the left dorsolateral prefrontal and right medial temporal and parietal cortices. The patient with emotional lability had diminished rel-CBF in the anterior cingulate and dorsolateral prefrontal cortices, bilaterally, and left basal ganglia. The patient with apathy had diminished rel-CBF in the basal ganglia and dorsolateral prefrontal cortex, bilaterally. Results are consistent with the hypothesis of a common frontal-temporal-subcortical substrate (e.g., involving aminergic nuclei) in the etiology of depression in AD. Frontal-subcortical dysfunction may also be associated with emotional lability and apathy in AD, although these may be related to a greater involvement of frontal-basal ganglia circuits.

Affect↗