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Biomedical subjects

J Armstrong

Publications and source records attributed to J Armstrong.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Evaluation of alternative computer input devices used by people with disabilities.

The aim of this study was to evaluate a range of alternative computer input devices suitable for people with disabilities and to provide comparative data that will enable health care professionals and users to make informed choices when selecting products. Our focus was on the potential advantages and disadvantages of individual product features as they related to the abilities and needs of different users. A sample of 14 alternative keyboards and pointing devices commonly used by people with disabilities were appraised by 35 disabled adults. A multi-disciplinary panel of independent assessors also appraised the products. We identified key factors regarding the set-up, personal acceptability, ease of use, design features, compatibility and potential limitations of each device. We found that difficulties in accessing computers could sometimes be reduced or overcome by adjusting the existing workstation and customizing computer settings rather than through additional technology. However, successful computer access often requires a combined approach, as a single piece of equipment will rarely provide a complete solution. If alternative computer input devices are necessary, it is likely that the hardware settings will need customizing.

Adult↗
PubMedDate not supplied

Antibiotic-associated colitis: effects of antibiotics on Clostridium difficile and the disease in hamsters.

Fifteen isolates of Clostridium difficile from hamsters and human patients were inhibited or killed by low concentrations of metronidazole, vancomycin, penicillin, and ampicillin; the isolates were often reesistant to tetracycline, cephalosporins, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, and aminoglycosides. Antibiotics to which C. difficile was susceptible were able to prevent or postpone the colitis caused by clindamycin in hamsters. Colitis could be produced by treatment of hamsters with any one of these antibiotics. Production of colitis not only involved selection of resistant variants, but in some instances seemed to result from the acquisition of organisms after treatment, their persistence despite treatment, or from subinhibitory cecal concentrations of antibiotic (explainable by either pharmacologic factors or enzymatic inactivation). As in humans, no organisms other than C. difficile have been implicated conclusively as etiologic agents of colitis in hamsters. Our results suggest it may be wise to use isolation precautions for patients with colitis caused by C. difficile.

Animals↗
PubMedDate not supplied

Surface texturing and coating of biomaterial implants: effects on tissue integration and fibrosis.

To determine whether texturing and coating have additive effects in promoting tissue integration and inhibiting fibrosis, we evaluated smooth silicone rubber (SSR), textured silicone rubber (TSR), porous silicone rubber (PSR), expanded polytetrafluoroethylene (ePTFE), and porous polyurethane (PPU) subcutaneous implants in eight minipigs. Some of the implants were coated with type IV collagen (Col) and/or fibronectin (Fn). At 6 months, we removed the implants and examined them microscopically. Texturing was more important than Col and Fn in reducing fibrosis and inflammation. The PSR yielded the best response, including reduced fibrosis and inflammation, satisfactory adherence, and no dystrophic mineralization.

Animals↗
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Inspiratory lung volume achieved on routine chest films.

Posteroanterior and lateral chest radiographs were obtained in 19 healthy subjects after routine instruction. Immediately afterwards, repeat films were obtained with the subjects vigorously coaxed to maximal inhalation. Total lung capacity was measured from both sets of radiographs. Normal subjects inhale to 95.5% +/- 3.8% (SD) of total lung capacity during routine chest radiography. Routine chest radiographs will provide useful total lung capacity measurements. Old chest radiographs, in addition to frequently being a mandatory part of the clinical evaluation of patients with chest problems, may provide the only antecedent information about lung function (total lung capacity).

Humans↗
PubMedDate not supplied

Outbreak of Clostridium difficile-associated disease in a small animal veterinary teaching hospital.

An apparent outbreak of enteric disease occurred in dogs and cats at a veterinary teaching hospital. Clostridium difficile Toxin A or B or both were identified in 1 or more fecal samples from 48 of 93 (52%) dogs over a 5-month period, 30 of which were identified in the 1st 26 days, after which strict infection control measures, including closure to elective cases, were implemented. Affected animals included in-patients, out-patients that were housed temporarily in the wards, and resident blood donor dogs. Infection control measures, including partial depopulation, isolation, hospital and yard cleaning, and barrier precautions, were instituted, after which, the incidence of nosocomial diarrhea decreased from 19 cases per 1,000 admissions to 2.5 cases per 1,000 admissions (P < 0.001).

Animals↗
PubMedDate not supplied

Prenatal diagnosis in Rett syndrome.

BACKGROUND/AIM: Rett syndrome (RTT) is an X-linked neurodevelopmental dominant disorder that affects almost exclusively girls. The disease is mainly sporadic, caused by de novo mutations at MECP2 gene (Xq28), but a low percentage of familial cases have been reported. We present the results of RTT prenatal diagnosis in three families and discuss the usefulness of such analyses in diseases caused mainly by de novo mutations. METHODS: For adult individuals, DNA was extracted from peripheral lymphocytes; for fetus analysis it was obtained from cultured amniotic fluid or from chorionic biopsy specimens. Mutation detection at MECP2 gene was first carried out in the patients by SSCP/HD analysis and subsequent sequencing. Family studies and prenatal diagnoses were done by direct analysis of previously characterized patients' mutations using SSCP/HD or restriction analysis. RESULTS: Heterozygous mutations identified in the 3 patients were: 1061del96bp, 473C-->T, and 763C-->T, respectively. Mutations were not present in the mothers' DNAs obtained from peripheral lymphocytes. None of the 3 fetuses analyzed carried the mutation of the affected sister. CONCLUSIONS: Recurrence within RTT families can be due to asymptomatic nonpenetrant carrier mothers or to parental germinal mosaicism for the MECP2 mutation. Since germline mosaicism can neither be predicted nor detected, families with 1 affected patient whose RTT-causing mutation has been previously identified can benefit from prenatal diagnosis which contributes to a decrease in the recurrence risk in a new pregnancy comparable to that of the normal population.

Chromosomal Proteins, Non-Histone↗
PubMedDate not supplied

Prazosin plasma concentration and blood pressure reduction.

Prazosin was administered to 16 patients with essential hypertension in an initial dose of 0.5 mg, after which the blood pressure (BP), pulse, and plasma concentrations of prazosin were measured at 0, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, and 24 hours. The dose of prazosin was then increased over 16 to 20 weeks, and similar sequences of measurements were obtained twice. Eleven patients completed the 20-week course. All patients did not respond in a similar way; two distinct patterns of BP and pulse response emerged, although there was no significant difference in the pharmacokinetic parameters, namely, absorption rate constant (Ka), maximum plasma concentration (Cpmax), time to reach the maximum concentration (Tmax), prazosin plasma half-life (T 1/2), elimination rate constant (kel), prazosin plasma concentration-time curve (AUC), and clearance. Patients in Group 1 had a marked reduction (52/30 mm Hg) of BP after the first dose of prazosin, no pulse increase, and needed a small dose of prazosin to maintain an adequate BP response. Patients in Group 3 had a minimal reduction in BP (14/13 mm Hg) after a first dose, a significant pulse increase, and needed a high dose of prazosin to control their BP. We conclude that this effect might be due to a different drug-receptor interaction, and the BP response and dose could be predicted from the response of the first dose of prazosin.

Blood Pressure↗
PubMedDate not supplied

Metabolic and hormonal alterations in cats with hepatic lipidosis.

Hepatic lipidosis in cats is a commonly diagnosed hepatobiliary disease of unknown cause. The purpose of this prospective study was to characterize the blood hormone and lipid status of cats with hepatic lipidosis, and to compare this status to that of cats with other types of liver disease and to control cats. Twenty-three cats with hepatic disease were assigned to 1 of 2 groups on the basis of cytopathologic or histopathologic examination of the liver: group 1, hepatic lipidosis (n = 18); or group 2, cholangiohepatitis (n = 5). Ten healthy young adult cats were used as controls. Food was withheld from control animals for 24 hours before blood collection. Concentrations of plasma glucagon and serum insulin, cortisol, thyroxine, triglycerides, cholesterol, phospholipids, and nonesterified fatty acids (NEFAs) were determined in all cats, in addition to routine hematologic and serum biochemical testing. Cats with hepatic lipidosis had higher serum NEFA concentrations than cats with cholangiohepatitis or control cats (P < .05). Cats with cholangiohepatitis had higher serum cholesterol and phospholipid concentrations than those of cats with lipidosis or control cats (P < .05); their plasma glucagon concentrations were higher than those of control cats (P < .05), but were not different from those of cats with hepatic lipidosis. Serum insulin concentrations were significantly higher in control cats than in diseased cats (P < .05), but neither serum insulin nor the insulin to glucagon ratio was significantly different among the cats with hepatic disease. The high concentration of NEFAs in cats with hepatic lipidosis suggests that at least 1 factor in the pathogenesis of this syndrome may involve the regulation of hormone-sensitive lipase.

Animals↗
PubMedDate not supplied

Final report of the 70.2-Gy and 75.6-Gy dose levels of a phase I dose escalation study using three-dimensional conformal radiotherapy in the treatment of inoperable non-small cell lung cancer.

PURPOSE AND OBJECTIVE: Three-dimensional conformal radiotherapy (3D-CRT) is a mode of high-precision radiotherapy designed to increase the tumor dose and decrease the dose to normal tissues. This study reports the final results of the first two dose levels (70.2 Gy and 75.6 Gy) of a phase I dose-escalation study using 3D-CRT for the treatment of non-small cell lung cancer. PATIENTS AND METHODS: Fifty-two patients were treated with 3D-CRT without chemotherapy. The median age was 67 years (range, 39-82 years). The majority of patients had locally advanced cancer. Tumor was staged as I/II in 10%, IIIA in 40%, and IIIB in 50%. Radiation was delivered in daily fractions of 1.8 Gy, 5 days a week. A radiation dose level was considered complete when 10 patients received the intended dose without unacceptable acute morbidity. Toxicity was scored according to the Radiation Therapy Oncology Group grading scheme. RESULTS: Twenty patients were initially assigned to the 70.2-Gy level; 14 of them received the intended dose. Three patients experienced severe acute toxicity, two with grade 3 (requiring steroids or oxygen) and a third with grade 5 (fatal) acute radiation pneumonitis. Because of the grade 5 pulmonary toxicity, the protocol was modified, and only patients with a calculated risk of normal tissue complication of less than 25% were eligible for dose escalation. Patients who had a normal tissue complication probability (NTCP) of greater than 25% received a lower dose of radiation. An additional 18 patients were entered on the modified study; 11 of them received 70.2 Gy. One patient experienced grade 3 acute pneumonitis. Despite dose reduction in four patients because of an unacceptably high NTCP, two additional patients developed grade 3 pulmonary toxicity. Fourteen patients were accrued to the 75.6-Gy dose level, and 10 received the intended dose. One of the 10 patients experienced grade 3 pulmonary toxicity and one developed grade 3 esophageal toxicity. Three patients were treated to lower doses as a result of their calculated NTCP without toxicity, and one patient refused treatment. The 2-year local control, disease-free survival, and overall survival rates were 37%, 12%, and 24%, respectively. The median survival time was 11 months. DISCUSSION: Treatment to 70.2 Gy and 75.6 Gy using 3D-CRT was delivered with acceptable morbidity when NTCP constraints were observed. Local control was encouraging in these patients with locally advanced disease. Patients are currently being accrued to the 81-Gy level of the study.

Adult↗
PubMedDate not supplied

Teaching pathophysiology to diverse students using an online discussion board.

Communication on the internet offers teachers a unique method for promoting learning among students who are challenged by numerous factors such as linguistic and cultural considerations. This article describes the use of out-of-class online discussions to promote active student learning among a diverse group of baccalaureate nursing students enrolled in a large lecture class. Student-to-student and teacher-to-student asynchronous threaded discussions occurred out of class. Students earned class points by posting and responding to classroom topics. By the end of the 15-week semester, there were approximately 790 messages on the bulletin board. Eighty-five percent of the 64 students participated in this assignment. Of the 64 students, approximately 50% were moderate to high users of the activity and 14% did not participate at all. There were no statistical differences between native English-speaking and non-native English-speaking students and their preference for study partners, interest, or experience with the internet. These initial results suggest that this assignment, based on electronic discussions, promoted greater participation and feedback among this diverse nursing student population. Despite the potential isolation of internet and e-mail-based communications, this computer-based technology may, ironically, facilitate an important shift from teacher-orchestrated to student-centered learning.

California↗
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Impact of HIV infection/AIDS on social service agencies serving children and youth in Toronto.

There are few data on how HIV infection/AIDS affects social service agencies serving children and youth. We conducted a survey of 24 provincially funded agencies in the Metro Toronto area and discovered that 36 clients and 9 staff members were HIV-infected. Our data strongly suggest that these agencies were ill equipped to cope with issues surrounding HIV infection/AIDS. Inadequacy or absence of policy and procedures resulted in confusion regarding issues such as HIV testing, need to know, confidentiality, duty to warn, staff and client education, and universal precautions for infection control. In order to effectively deal with the psychosocial, legal, ethical and education needs of clients and staff, agencies must be pro-active in developing policy and procedure.

AIDS Serodiagnosis↗
PubMedDate not supplied

Lending an ear.

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Adult↗