Search PubMed⌕ Search

Biomedical subjects

J Brown

Publications and source records attributed to J Brown.

At least 739 records · Page 41Linked to original sources
PubMed1989

Teaching money skills through stimulus class formation, exclusion, and component matching methods: three case studies.

This paper describes novel methodology for teaching monetary skills to mentally retarded individuals. The goal of the methodology is to generate such skills with relatively little explicit training. To do so, the procedures were designed to produce emergent new behavior through stimulus class formation, exclusion, and matching of stimulus components. Three case studies demonstrate the methods and provide illustrative supporting data.

Adolescent↗
PubMed1989

Scrotal island flap urethroplasty in the management of bulbar urethral strictures.

We describe our experience with 20 patients undergoing 1-stage scrotal island flap urethroplasty for severe bulbomembranous stricture disease. While 16 patients achieved satisfactory results, 4 required revision for recurrent stricture, diverticulum or fistula. Use of hairless skin and aggressive tailoring of the flap are stressed to avoid the common complications of diverticulum, hair ball and stone formation. This highly vascularized pedicle represents a reasonable alternative to staged repair when local tissue scarring is great and free full thickness skin graft viability is questionable.

Adult↗
PubMed1989

Cricothyroidotomy, a useful alternative to tracheostomy in maxillofacial surgery.

Tracheostomy and prolonged intubation are traditionally used in maintaining the airway, particularly after extensive maxillofacial surgery. The literature reports significant morbidity and mortality from both these procedures. Cricothyroidotomy is proposed as a useful alternative in certain circumstances. Recent documentation suggests that traditional fears of subglottic stenosis after cricothyroidotomy are ill-founded. Cricothyroidotomy may also benefit the patient by quicker rehabilitation and in early mobilisation, compared with prolonged intubation. The surgical procedure is quick and easily performed, making it suitable for emergency airway control. Cricothyroidotomy is not appropriate in children or in patients with inflammation to the trachea, since these may predispose to subglottic stenosis.

Cricoid Cartilage↗
PubMed1989

Acute effects of physiological increments of alpha-atrial natriuretic peptide in man.

Seven dehydrated volunteers received three hour infusions of 0.8 pmol kg-1 min-1 of human alpha-atrial natriuretic peptide (h-alpha ANP) or vehicle alone (Ve) in a single-blind, randomized cross-over design. H-alpha ANP infusion increased plasma h-alpha ANP from 4.2 +/- 0.4 to 20.3 +/- 6.4 pm. H-alpha ANP suppressed plasma renin activity from 3.30 +/- 0.48 to 1.37 +/- 0.35 ng ml-1 hr-1 (P less than 0.001 vs. Ve). Plasma aldosterone was unaltered by h-alpha ANP. Fractional excretion of filtered sodium (FENa) changed from 0.92 +/- 0.09 to 1.13 +/- 0.16% with h-alpha ANP, and from 1.02 +/- 0.09 to 0.69 +/- 0.11% with Ve (P less than 0.01 h-alpha ANP vs. Ve). FEK was unchanged. FEpo4 increased from 7.2 +/- 1.2 to 9.2 +/- 1.2% and FELi from 22.1 +/- 1.4 to 24.9 +/- 3.0% with h-alpha ANP (both P less than 0.05 vs. Ve). H-alpha ANP decreased mean urinary osmolality by approximately 150 mOsmol kg-1 compared to Ve (P less than 0.01). GFR, RPF and filtration fraction were unchanged by h-alpha ANP, H-alpha ANP was associated with a significant tachycardia (P less than 0.01 vs. Ve) but with no significant change in arterial pressure. These results suggest that small increments of plasma h-alpha ANP, mimicking physiological changes, are natriuretic at least partly by reducing proximal tubular reabsorption of sodium, and also impair urinary concentration.

Adult↗
PubMed1989

Absence of priming coupled with substantially preserved recognition in lorazepam-induced amnesia.

Two experiments are reported on priming when subjects are in an amnesic state induced by lorazepam. The primed tasks were completion of word-stems and generation of words from specified categories. In both experiments, lorazepam subjects showed no evidence of priming; whereas control subjects showed substantial priming. Recognition by the amnesic subjects of items produced in the priming tests, although impaired, was well above the chance level. These findings contrast with those obtained with organic amnesic subjects, for whom priming is typically normal but recognition is grossly impaired. The theoretical implications of this double dissociation between priming and recognition are discussed.

Adult↗
PubMed1989

In-vitro activity of tigemonam, an oral monobactam, against gram-negative rods, including variants in beta-lactamase-production.

Tigemonam was compared in vitro with other orally active beta-lactams, aztreonam and ciprofloxacin against a selection of Gram-negative clinical isolates and laboratory-derived beta-lactamase-producing variants. Of the orally active beta-lactams, tigemonam was the most potent, with a spectrum of activity similar to that of aztreonam. This included stability to plasmid-mediated beta-lactamases and poor induction of chromosomal beta-lactamases. The susceptibility to Class I enzymes was only clinically significant for derepressed Enterobacter cloacae mutants. Tigemonam may have a valuable role in the management of infection caused by enterobacteria, particularly if bioavailability following oral administration is confirmed in human subjects.

Anti-Bacterial Agents↗
PubMed1989

The renal effects of atrial natriuretic peptide in man are not attenuated by (+)-sulpiride.

1. Human alpha atrial natriuretic peptide (ANP) was infused intravenously for 1 h in eight healthy salt-replete men on two occasions, with and without pretreatment with (+)-sulpiride. 2. ANP increased sodium excretion and urine flow rate but did not alter blood pressure or plasma renin activity. 3. (+)-sulpiride had no significant effect on baseline creatinine clearance, sodium excretion or urine flow rate and did not alter the increases in these parameters with ANP. 4. It is unlikely that the renal effects of ANP are mediated by dopamine DA1-receptors in man.

Adult↗
PubMed1989

Some ethical considerations in defensive psychiatry: a case study.

Involuntary admission of a patient deemed dangerous may be motivated by a wish to protect the patient and others from potential violence-or by a practitioner's wish to limit personal liability. Evidence is offered to suggest that the practice of defensive psychiatry is not uncommon, and a case demonstrating the role of professional self-protection in an involuntary commitment decision is presented. Procedural modifications in the commitment process are proposed as a means of protecting patients' civil liberties.

Aged↗
PubMed1989

Comparison of detomidine, butorphanol, flunixin meglumine and xylazine in clinical cases of equine colic.

Detomidine hydrochloride, butorphanol tartrate, flunixin meglumine and xylazine hydrochloride were evaluated in a blind multi-centre clinical trial in 152 horses with abdominal pain. The drugs were administered as follows: detomidine 20 or 40 micrograms/kg bodyweight (bwt); butorphanol 0.1 mg/kg bwt; flunixin meglumine 1.0 mg/kg bwt; xylazine hydrochloride 0.5 mg/kg bwt. Each centre compared responses to the two doses of detomidine with those to one of the other analgesics. The drugs were administered intravenously (i.v.) after clinical assessment of the degree of sweating, kicking, pawing, head and body movement, attitude, lip curling, stretching to urinate, pulse rate, respiratory rate and rectal temperature. Similar assessments were repeated at 15 min intervals for at least 1 h. The investigators ranked the response to treatment from 'not satisfactory' to 'highly satisfactory'. Significant differences in sweating, kicking, pawing, head and body movement, attitude, pulse rate and respiratory rate were noted between the horses receiving butorphanol and either dose of detomidine. The investigators' subjective evaluation of the analgesic and sedative effects of either dose of detomidine were significantly better than for butorphanol. Analgesia was rated as highly satisfactory or satisfactory in 93.3 per cent and 6.7 per cent of the horses receiving 40 micrograms/kg bwt of detomidine, 73.3 per cent and 26.7 per cent of the horses receiving 20 micrograms/kg bwt of detomidine, and none of the horses receiving butorphanol. There were no differences in the incidence of side effects with the two compounds. Significant differences were noted in kicking, pawing, head and body movement and attitude between the horses receiving flunixin meglumine and either dose of detomidine. Flunixin meglumine provided significantly less analgesia than either dose of detomidine. Analgesia was rated as highly satisfactory or satisfactory in 73.7 per cent and 21.0 per cent of the horses receiving 40 micrograms/kg bwt of detomidine, 42.9 per cent and 21.4 per cent of the horses receiving 20 micrograms/kg bwt of detomidine, and 6.3 per cent and 37.5 per cent of the horses receiving xylazine. Sedation was considered to be at least satisfactory in 84.2 per cent of the horses receiving 40 micrograms/kg of detomidine, 71.5 per cent of the horses receiving 20 micrograms/kg of detomidine and 53.3 per cent of the horses receiving xylazine.

Adrenergic alpha-Agonists↗
PubMed1989

Screening infants for hearing loss.

A computerised child health register was used to study the coverage, referral rate, and false positive rate of the eight month hearing distraction test in a cohort of 1990 births to residents of one district during an eight month period. Coverage by the age of 9 months was under 60% and varied with ethnic group and immunisation record. The true problem rate among those referred was 48%. None of the three children in the cohort who had a sensorineural hearing loss was picked up by screening, although it did identify children with conductive loss. The findings question the value of the distraction test as currently used, and underline the usefulness of computerisation, even if limited to child registration, in the evaluation of screening tests.

Adolescent↗
PubMed1989

Filtration fraction.noninvasive measurement with Tc-99m DTPA and changes induced by angiotensin-converting enzyme inhibition in hypertension.

Using a recently described new technique, individual kidney filtration fraction was measured from the first 3 min of the Tc-99m DTPA renogram in a series of 11 subjects without evidence of renal disease and in 23 patients with hypertension. Fourteen of these hypertensives had angiographic evidence of renal artery stenosis (RAS) but only 2 had proven renovascular hypertension (RVH). In addition, renal blood flow (RBF), expressed as a fraction of cardiac output, was measured from the first pass time activity curves following bolus injection of Tc-99m DTPA, and individual kidney glomerular filtration rate (IKGFR) was measured from the subsequent plasma Tc-99m DTPA clearance and renographic divided function. An estimation of filtration fraction based on these measurements of RBF and IKGFR correlated rather poorly with that directly based on the renogram, although both showed directionally similar changes in the hypertensive patients following inhibition of angiotensin-converting enzyme (ACE) with captopril. Filtration fraction by both estimates fell significantly after ACE inhibition in patients with RAS and essential hypertension, while RBF increased. IKGFR showed no change in essential hypertension or in hypertensive patients with RAS but fell sharply in 3 renal units in 2 patients with RVH. This renographic method for measuring filtration fraction is worthy of further elaboration and might be a simple and useful discriminator of RVH in a hypertensive population.

Adult↗
PubMed1989

A premature acrosome reaction is programmed by mouse t haplotypes during sperm differentiation and could play a role in transmission ratio distortion.

Mouse t haplotypes are variant forms of chromosome 17 that can be transmitted at non-Mendelian ratios by heterozygous +/t males. The accumulated genetic data indicate that '+-sperm' and 't-sperm' are produced in equal numbers but that most '+-sperm' are rendered dysfunctional, so that 't-sperm' have a relative advantage at fertilization. To date, the basis for this t-induced sperm dysfunction has remained unknown. Here we demonstrate that a high proportion of sperm obtained from certain strains of +/t mice undergo a premature acrosome reaction under in vitro capacitation conditions. The simplest interpretation of these data, in conjunction with previous results, is that developing '+-spermatids' are preprogrammed by 't-spermatids' to undergo this premature reaction. Since acrosome-reacted sperm are unable to participate in the process of fertilization, this defect could account for the extreme distortion of transmission ratio observed from mice heterozygous for a class of complete t haplotypes.

Acrosome↗
PubMed1989

Neurogenic pulmonary edema after trigeminal nerve blockade.

Acute neurogenic pulmonary edema developed immediately after injection of bupivacaine hydrochloride into the trigeminal cistern of a 32-year-old man with atypical facial pain and no prior history of cardiopulmonary problems. This complication of trigeminal nerve blockade has not been reported previously, to our knowledge. Associated neurologic deficits suggest a key role for the brain stem in the pathogenesis of this disorder.

Adult↗
PubMed1989

Recruiting and retaining competent clinical nurses. The Clinical Promotion Project Victoria General Hospital, Halifax, Nova Scotia.

A career advancement program for nurses has been developed and implemented at the Victoria General Hospital, Halifax, as part of a manpower planning strategy for recruitment and retention of clinical nurses. A competency based performance appraisal system was developed and implemented as part of the program. This system identifies four levels of clinical expertise. Progression through each level indicates that a nurse has achieved a certain level of skill, knowledge and abilities. Demonstrated competence in one level is a prerequisite to promotion to the next level of practice. Implementation of this system provides clinical career opportunities for nurses in direct patient care. This article will provide the nurse administrator with an insight into the development and implementation of a clinical career advancement program. Future articles will described the research evaluation of the Clinical Performance Appraisal System and clinical nurses' reactions to the new system.

Career Mobility↗
PubMed1989

Nurses' perceptions of their relationships with parents.

Twenty-five children's nurses were interviewed and asked to select and describe two relationships, one satisfying and one dissatisfying, that they had had with parents of hospitalized children. The data were analyzed using interpretive strategies, and five types of parent-nurse relationships were identified: negotiated, reciprocal, adversarial, asynchronous, and ineffective. It seemed that the nurses' relationships with parents were social rather than professional, and that the nurses had difficulty caring for certain parents. The nurses' descriptions indicated that they either did not have knowledge of communication skills, conflict management and family-centered care to provide therapeutic, goal-oriented care for parents, or had difficulty utilizing that knowledge in practice. Various factors in the environment may have contributed to these difficulties. This descriptive study was conducted to provide some understanding of the interpersonal difficulties that often exist in relationships between nurses and the parents of hospitalized children.

Adult↗
PubMed1989

Column chromatographic characterization of cytoplasmic proteins in Eimeria maxima oocysts from chickens.

Cytoplasmic proteins from unsporulated and sporulated Eimeria maxima oocysts were analyzed by gel-filtration column chromatography. Unsporulated oocysts were characterized as having 3 major cytoplasmic proteins and sporulated oocysts as having 5 major cytoplasmic proteins. Molecular weights ranged from 5 x 10(3) to 1.4 x 10(6). Larger molecular weight proteins were detected in sporulated and unsporulated oocysts, but were associated more with sporocysts of sporulated oocysts.

Animals↗