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Biomedical subjects

J Brown

Publications and source records attributed to J Brown.

At least 379 records · Page 21Linked to original sources
PubMed1997

Teaching about the female condom.

Reality female condoms became available for over-the-counter purchase in the fall of 1994. Because the female condom is a new sexual barrier device, women need to learn how to use it correctly. Health care providers must also be knowledgeable about the correct use of the female condom so that they can teach women how to use it as a barrier method. To facilitate learning about the female condom, a curriculum was developed that included a quiz on knowledge about the female condom. Content validity was established through a content validity index completed by six content experts. This quiz was used to evaluate educational sessions offered to 42 persons in an urban college setting and 18 women in a community setting. The article describes the female condom along with the curriculum that was developed to teach its correct use and the reactions of potential users of the female condom.

Adult↗
PubMed1997

Neonatal transphyseal supracondylar fracture detected by ultrasound.

Fractures in young infants are often difficult to detect on plain radiographs when they involve the cartilaginous growth plate. We report a case of a neonatal transphyseal fracture which was detected by the use of ultrasound and magnetic resonance imaging. With shortened postnatal hospitalization becoming increasingly common, these and other birth injuries are more likely to present for the first time in the emergency department. The authors recommend the use of ultrasound as the screening modality of choice in the emergency department.

Birth Injuries↗
PubMed1997

Hip and ankle range of motion in elite classical ballet dancers and controls.

OBJECTIVE: To report range of motion at the hip and ankle in male and female ballet dancers compared with controls. DESIGN: Cross-sectional cohort study with convenience control sample. SETTING: National classical ballet school in Australia. PARTICIPANTS: Thirty-three female and 30 male full-time ballet students of mean (SD) age 16.9 (0.8) and 18.0 (1.4) years, respectively. Controls were 31 female and 16 male nondancing, normally active university students of average ages 18.8 +/- 0.6 and 18.8 +/- 0.9 years, respectively. MAIN OUTCOME MEASURES: Degrees of range of motion of left and right sides for the following four movements: standing plié in parallel-passive ankle dorsiflexion (DF), standing turnout in the balletic first position-lower limb external rotation (LLER), supine hip external rotation (ER), supine hip internal rotation (IR). Two additional ranges of motion were calculated. External rotation below the hip joint (BHER) was derived by subtracting hip ER from LLER, and total supine hip rotation (Hip IR + ER) was derived by summing hip ER and hip IR. MAIN RESULTS: On both left and right sides, dancers had greater LLER (p < 0.0001) and hip ER (p < 0.0001) but lesser hip IR than the controls (p < 0.0001). Female but not male dancers had greater total supine hip rotation (hip ER+IR) than controls (p < 0.05). There was no difference in either BHER or ankle DF between dancers and controls. Within dancers, females had greater range in both left and right hip IR, LLER, and hip IR + ER. There was no difference in hip ER. Regression analysis revealed that LLER related to hip ER in both males and females. CONCLUSIONS: Elite classical dance students had greater hip external rotation (both ER and LLER) and less hip internal rotation than controls but similar BHER and ankle DF. Since ER below the hip joint and ankle DF do not differ between dancers and controls, despite repeated training of these movements in ballet, there may be anatomical (bony/ligamentous) limitations to these movements.

Ankle Joint↗
PubMed1997

Randomised controlled double blind study of role of recombinant erythropoietin in the prevention of chronic lung disease.

AIM: To evaluate the role of recombinant human erythropoietin (R-HuEpo) in reducing iron infusion, which may exacerbate free radical damage, leading to chronic lung disease. METHODS: A multicentre, randomised, placebo controlled, double blind study was carried out in four neonatal intensive care units in Yorkshire. Infants were randomly allocated and received either R-HuEpo (480 U/kg/wk) or placebo by twice weekly subcutaneous injection. The primary outcome measure was the number of days on respiratory support and a secondary outcome the number of blood transfusions required. RESULTS: Forty two very low birthweight (VLBW) infants were randomly allocated. There was little difference in the need for respiratory support one month after randomisation, but subsequently there was a trend towards a reduction in the proportion requiring respiratory support in the R-HuEpo group (difference at three months -0.50, 95% confidence interval -1.00, 0.17). During stay in hospital, the median number of blood transfusions was lower for infants in the R-HuEpo group (difference in medians -2, 95% CI -4, 0). The study was stopped early because of failure to recruit babies at the expected rate. CONCLUSIONS: R-HuEpo seems to reduce the number of days in oxygen for ill VLBW infants. These data could be used to construct a larger multicentre study to evaluate this effect further.

Blood Transfusion↗
PubMed1997

An autocrine system for C-type natriuretic peptide within rat carotid neointima during arterial repair.

C-type natriuretic peptides (CNPs) are produced by endothelium and inhibit vascular smooth muscle cell (VSMC) proliferation. However, endothelial damage stimulates only transient VSMC proliferation in arteries. Here we report that a new source of CNP develops in rat carotid neointima 14 days after balloon angioplasty, when VSMC replication is subsiding despite continued absence of endothelium. CNP was detected immunohistochemically in neointimal but not medial VSMC. No other natriuretic peptides were detected immunohistochemically. CNP immunoreactivity (0.036 +/- 0.010 fmol/mg wet wt) was found in damaged arteries by radioimmunoassay, but none was detected in normal media. Reverse-phase chromatography suggested that this immunoreactivity consisted of CNP(1-53) and perhaps CNP(1-22). CNP transcript was identified by reverse transcription and polymerase chain reaction in carotid segments that had been stripped of endothelium but only once neointima had formed. Moreover, neointima expressed the NPR-C type of natriuretic peptide receptor at the same time as it synthesized CNP. Thus neointima develops an autocrine system for CNP that could regulate neointimal growth. Furthermore, the findings establish novel phenotypic differences between medial and neointimal VSMC in vivo.

Angioplasty, Balloon↗
PubMed1997

UK breast screening programme: how does it reflect the Forrest recommendations?

OBJECTIVE: To compare the UK breast screening programme with the Forrest Report recommendations of 1986. SETTING: The UK breast screening programme. METHODS: A postal survey of 97 local breast screening programmes in the United Kingdom. The main outcome measures were the frequency of screening, the use of two view screening on incident screens, reading of screening mammograms, assessment procedures and visits, staffing levels, and the use of building and equipment. RESULTS: Eighty two (85%) of the questionnaires were completed and returned. All programmes screen every three years, as Forrest intended, with the exception of one health region which screens more often. The national policy is to use two views on incident screens where there is a clinical indication. None the less, 14% of programmes are using, or intending to use, two views on all women. Double reading of mammograms is not recommended in the United Kingdom outside Scotland, but is used by 88% of programmes. All programmes have access to the equipment required for the assessment techniques recommended by Forrest. Variation exists between programmes in the procedures women can expect to receive at their initial assessment visit and in the total number of assessment visits. Sixty eight per cent of programmes' breast screening budgets cover the staff required for a multidisciplinary team as defined by the Forrest Report. Ninety three per cent of screening programmes are organised around static sites, with 86% of these also using mobile vans. CONCLUSIONS: The national programme is following recommendations about the frequency of screening, but there seems to be some divergence from policy as regards the use of double reading, two views at incident screening, and the multidisciplinary team covered by the programmes' breast screening budget. Further research is needed on the effectiveness and cost effectiveness of two view incidence screening, double reading, and non-radiologists as readers. Investigation is also needed of the costs and effects of the variation between programmes in the number of assessment visits a woman may have.

Breast Neoplasms↗
PubMed1997

Head injuries due to falls caused by seizures: a group at high risk for traumatic intracranial hematomas.

This prospective review of adult patients with head injuries examines the incidence of head injuries due to falls caused by seizures, the incidence and severity of intracranial hematomas, and the morbidity and mortality rates in this patient population. A head injury was attributed to a fall caused by a seizure if the seizure was witnessed to have caused the fall, or the patient had a known seizure history, appeared postictal or was found convulsing after the fall, and no other cause for the fall was evident. A total of 1760 adult head-injured patients were consecutively admitted to the authors' service between 1986 and 1993. Five hundred eighty-two head injuries (33.1%) were due to falls and 22 (3.8%) of these were caused by seizures. Based on the prevalence rates for epilepsy in the general population of 0.5 to 2%, these results indicate that epileptics are several times more likely to suffer a head injury due to a fall. Mass lesions were found in 20 (90.9%) of these 22 patients and the remaining two patients suffered mild diffuse head injuries. There was a high incidence of extraaxial mass lesions: 17 (85%) of the 20 intracranial hematomas were either epidural (five cases) or acute subdural (12 cases) hematomas. Eighteen (81.8%) of the 22 patients required evacuation of a hematoma. Both the incidence of intracranial hematomas (90.9% vs. 39.8%, p < 0.001, chi-square analysis) and the rate of hematoma evacuation (81.8% vs. 32.3%; p < 0.001) was significantly greater in patients injured in falls due to seizures (22 cases) than in the group injured in falls from all other causes (560 cases). The higher incidence of hematomas and the need for evacuation were not explained by differences in age, seventy of head injury, or incidence of alcohol intoxication. Despite the greater incidence of mass lesions and the need for operative treatment in patients injured because of seizures, their mortality rate was similar to that of patients injured in falls from other causes. On the basis of their review of patients admitted to a neurosurgical center with complaints of head injury, the authors conclude that patients with head injuries due to a fall caused by a seizure should undergo computerized tomography scanning early in their management. Until a mass lesion has been excluded, any decrease in level of consciousness or focal neurological deficit should not be attributed to the seizure itself.

Accidental Falls↗
PubMed1997

Host defense responses associated with experimental hemorrhagic disease in white-tailed deer.

Our objectives were to examine the immunity conferred by epizootic hemorrhagic disease virus serotype 2 (EHDV-2) infection in white-tailed deer (Odocoileus virginianus) and determine if this immunity was protective during challenge with homologous (EHDV-2) or heterologous (bluetongue virus serotype 10; BTV-10) virus. Trials were conducted in the fall of 1992 and 1993. In the first experiment, naive white-tailed deer were infected intradermally and subcutaneously with EHDV-2 and monitored via physical examinations, complete blood counts, alpha and beta interferon (IFN) assays, viral isolation, and serology. Infected deer had a wide range of clinical signs in response to infection. Eleven of the 16 deer had body temperature elevations > or = 0.5 C between post-infection day (PID) 4 and 8. Infected deer had decreased lymphocyte counts between PID 6 and 10 that returned to normal levels by PID 17. Severely lymphopenic animals had the most severe clinical signs; five of 10 deer with lymphocyte counts less than 1000 cells/microliters succumbed to the infection. Viremia was detected in all 16 EHDV-2 infected animals by PID 4, and peak viremias occurred between PID 4 and PID 10. Three deer remained viremic until PID 56, the study endpoint. Interferon was first detected between PID 2 and 6. Peak alpha and beta IFN levels coincided with peak viremia in 11 deer. Precipitating and neutralizing antibodies were detected in infected deer by PID 10. In the second experiment, convalescent deer were challenged subcutaneously and intradermally with either EHDV-2 or BTV-10 and similarly monitored. Virus was detected in the blood of all four deer challenged with BTV-10, but viremia was not detected in three EHDV-2-challenged deer. Temperature fluctuations, blood cell parameter changes, and IFN and antibody responses seen in BTV-10-challenged deer were similar to those seen in the initial experiment. Deer challenged with EHDV-2 had mildly increased temperatures, but minimal IFN response and lymphocyte alterations.

Acute Disease↗
PubMed1997

Spectro-temporal mapping of the surface electrocardiogram in clinically normal dogs.

OBJECTIVES: To establish data for selected variables of the signal-averaged ECG and determine whether sedation affects segment lengths and points within the terminal QRS complex where windows began. SAMPLE POPULATION: Overtly healthy dogs with no detected abnormalities. PROCEDURE: Signal-averaged ECG (600 beats) were obtained from dogs in left-lateral recumbency, using X, Y, and Z leads with 26-gauge subdermal platinum electrodes. Frequency-domain analyses were performed by fast Fourier transform (FFT), using a post-processing computer software package. Analyses were extracted from 30-, 40-, and 50-millisecond windowed (Blackman-Harris) segments of the terminal 10 or 20 milliseconds of the QRS complex and ST segment. Correlation ratios were calculated by cross-correlation of frequency spectra of each FFT in the range of 40 to 200 Hz. The reference spectrum was the last FFT (nearest the T wave). Spectro-temporal maps were plotted for each analysis. RESULTS: Noise levels were < 1 microV. Sedation resulted in less noise and slower heart rate, but did not affect results. Correlation ratios were not different among 30-, 40-, and 50-millisecond segments, but were lower when 20 (vs 10) milliseconds of the terminal QRS was included. Spectro-temporal maps were similar in all subjects. CONCLUSIONS: Use of sedation facilitated the procedure without affecting results. Segment lengths of 40 and 50 milliseconds, beginning 10 milliseconds prior to the end of the QRS complex and analyzed in the range of 40 to 200 Hz, yielded correlation ratios > 67%, 95% of the time. CLINICAL RELEVANCE: Spectro-temporal mapping may identify dogs with ventricular late potentials (high-frequency signals commonly associated with myocardial fibrosis) that may be at increased risk of sudden death.

Acepromazine↗
PubMed1997

Trauma to the heart.

Traumatic injury to the heart is no longer a death sentence. Efficient urban transport systems and surgeons who are expert in trauma care combine to achieve meaningful survival rates after both penetrating and blunt violations of the heart. Almost all cases of injury to the heart can be repaired without cardiopulmonary bypass and, therefore, are within the purview of the thoracic surgical trauma specialist.

Heart Injuries↗
PubMed1997

Bropirimine as neoadjuvant therapy decreases residual disease and expression of markers PCNA and TGF-beta 1 in a rat orthotopic prostate adenocarcinoma.

The role of bropirimine in prostate cancer remains unexplored. To address the efficacy of this immune modulator as neoadjuvant therapy we utilized the orthotopic placement of the Dunning AT-3 tumor. 2.4-2.6 x 10(6) Dunning AT-3 cells were injected into the ventral prostates of 50 Copenhagen X Fischer rats. Animals were then divided into 5 groups consisting of: 1) untreated controls; 2) those treated with ventral prostatectomy alone (performed 10-12 days following tumor cell inoculation); 3) those treated with ventral prostatectomy plus bropirimine (10 mg/kg) on postimplantation days 1, 3, 5, 10 and 11; 4) those treated with ventral prostatectomy plus bropirimine (100 mg/kg), at the same schedule; and 5) those treated with ventral prostatectomy plus bropirimine (500 mg/kg), at the same schedule. Animals were sacrificed 10 days after prostatectomy, autopsied, and residual disease was weighed. Prostate weights upon removal following neoadjuvant treatment and residual disease remaining after 20-22 days were expressed in grams (g). Following prostatectomy, mean prostate weights were: Group 2, 0.67 +/- 0.11; Group 3, 0.53 +/- 0.11; Group 4, 0.54 +/- 0.12; Group 5, 0.44 +/- 0.09. The effect of bropirimine was significant (p = 0.0001) by multiple regression analysis. In addition, mean residual tumor weights (expressed in grams) after 20-22 days were: Group 1, 12.7 +/- 1.9; Group 2, 6.7 +/- 4.8; Group 3, 5.2 +/- 5.9; Group 4, 3.8 +/- 3.5; and Group 5, 2.8 +/- 3.5. The effect of bropirimine was not significant (p = 0.07) by multiple regression analysis. However, prostatectomy alone, by Student's test, significantly (p = 0.04) reduced residual mean tumor weights by 47% and the additional effect of bropirimine upon residual disease was significant (p = 0.038) if a Chi-square analysis is applied. Finally, a multivariate analysis of the overall effect of bropirimine in rats treated with prostatectomy was significant (p = 0.002). The effect of bropirimine on expression of proliferating cell nuclear antigen (PCNA) and transforming growth factor beta 1 (TGF-beta 1) was also evaluated immunohistochemically and expression of both tumor markers was significantly reduced (p < 0.05). We conclude that bropirimine may have a role as a neoadjuvant therapy when combined with prostatectomy.

Adenocarcinoma↗
PubMed1997

D2-like dopamine receptor density in Tourette syndrome measured by PET.

UNLABELLED: Tourette syndrome (TS) is a chronic neurologic disorder characterized by the presence of involuntary motor and phonic tics. There is evidence that TS is associated with an abnormality of the dopaminergic system, involving postsynaptic D2 receptors. We tested the hypothesis that D2-like dopamine receptors are elevated in TS. METHODS: Twenty-nine adult patients with TS were studied by PET imaging with [11C]3-N-methylspiperone ([11C]NMSP). Two methods of data analysis were used. The first was a caudate-to-cerebellar ratio, measured at 45 min. The second method, applied in 20 subjects, was a two-PET scan procedure. Both used high specific activity [11C]NMSP, but the second scan was preceded by a dose of unlabeled haloperidol, which partially occupied the D2-like dopamine receptors. This was done to provide an absolute measure of receptor density (Bmax). All patients were compared to age- and sex-matched controls. RESULTS: Neither group showed significant differences from their control group in caudate-to-cerebellar ratio. However, the two-PET scan Bmax measurement demonstrated that 4 of the 20 patients had significantly elevated D2-like receptors. In this group of 20 patients, multiple linear regression analysis revealed a trend between the severity of vocal tics and Bmax values. This Bmax measure also revealed a significant (p < 0.05) association with performance on the Wisconsin Card Sorting Test. CONCLUSION: These findings suggest that not all patients with TS have an abnormality of D2-like receptors, but a subgroup of TS subjects has a significant D2-like dopamine receptor elevation. These findings also support the importance of applying a more quantitative method for Bmax determination to PET imaging analysis. The Bmax findings in the subgroup do not exclude an effect of intrasynaptic dopamine competition, but this effect may be less likely due to the high affinity of [11C]NMSP.

Adult↗