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Biomedical subjects

J Daly

Publications and source records attributed to J Daly.

At least 73 records · Page 4Linked to original sources
PubMed1994

The impact of posthospital home care on patients with cancer.

Symptom distress, mental health status, enforced social dependency and health perceptions were measured in two groups of cancer patients, one receiving home care services (n = 49) and the other receiving no such services (n = 11). Data were obtained at hospital discharge and 3 months later. Patients receiving home care demonstrated statistically significant improvement on mental health and social dependency; patients not receiving home care did not improve on any variable. After controlling for baseline scores, the home care group had significantly higher mental health status at the second interview than the no home care group.

Aftercare↗
PubMed1994

A method for distinguishing human and mouse cells in solid tumors using in situ hybridization.

A common technique used in the study of human malignancies involves the inoculation of nude mice with human neoplastic cells. It is usually assumed that the tumor arising is composed predominantly of human cells with mouse tissue present only to provide minimal stromal support. Several reports, however, have shown evidence of host cell neoplastic transformation. Therefore, in order to effectively study and characterize such xenografts, it is important to establish the relative involvement of human and mouse cells. In the present study, a method for easily distinguishing human and mouse cells is described. The method involves in situ hybridization of formalin-fixed tissues using DIG-labeled oligomer probes which correspond to species-specific portions of Alu sequences. This method can be applied to archival material either as a means of confirming that the tissue taken from nude mice xenografts is predominantly human or as a vehicle for studying the mechanisms of host cell neoplastic transformation and their relevance to human malignant spread. The proposed technique may also serve as a basis for other in situ applications, particularly those involving formalin-fixed tissues and oligomer probes.

Animals↗
PubMed1994

A six-degree-of-freedom transducer for in vitro measurement of patellofemoral contact forces.

A satisfactory design of the patellar component used in total knee arthroplasty and a general understanding of the effects of orthopedic procedures require, in part, an accurate description of patellofemoral contact forces. Experimental determination of the contact stress distribution requires integration to estimate the contact forces. Due to complex patellar geometry, the determination of the components of the resultant load is difficult. Current techniques for the direct measurement of contact loads either report a single load component or require sequential experiments to fully describe the contact force. The present study describes the development of a six-degree-of-freedom patellofemoral force transducer. This transducer allows the simultaneous determination of the three components of the contact force with an increase in accuracy over available devices. The contact forces components are accurate to 1% of full scale (900 N anterior-posterior, +/- 200 N medial-lateral and inferior-superior). The location on the patella where the resultant force acts is determined to within 1 mm. Relative movement of this point as a function of either normal change in knee flexion angle or as a result of a typical orthopedic procedure is determined to within 0.1 mm. A protocol is presented that allows the contact forces to be determined for either the anatomically normal patella or a patella following total knee arthroplasty.

Calibration↗
PubMed1994

The impact of psychiatric comorbidity on Medicare reimbursement for inpatient medical care.

Funding for psychiatric consultation-liaison (C-L) services has been a difficult problem. It has been suggested that the identification of psychiatric co-morbidities in Medicare patients on medical services could generate incremental hospital revenue by moving patients from a lower to a higher paying Diagnostic Related Group (DRG). This increased revenue could be used as a means of supporting the psychiatric C-L service. This study documents the financial impact of screening for and documenting psychiatric co-morbidities on a general acute medical service. We clinically assessed 100 consecutive Medicare admissions and found 25 psychiatric co-morbidities in 20 patients. In only one case did the psychiatric diagnosis result in moving the case to a higher DRG. However, the need for psychiatric consultation remains evident as there was significant lack of recognition and documentation of the psychiatric diagnoses by the medical team. The authors discuss both the financial and clinical implications of screening medical inpatients for psychiatric co-morbidities and propose directions for further studies in this area.

Aged↗
PubMed1993

The economic impact of infections. An analysis of hospital costs and charges in surgical patients with cancer.

We performed an economic analysis of the care provided to patients undergoing major abdominal surgical procedures to determine the effect of postoperative infection on hospital resource use. Patients' clinical and demographic characteristics and their use of medical care services were determined from a review of hospital bills and medical records. Hospital charges were obtained from the hospital billing system and costs were determined by use of Medicare cost-charge ratios obtained from the hospital's Medicare Cost Report. The care of patients with postoperative infections was significantly more expensive than that of uninfected patients (multivariate analysis indicated that a surgical infection added $12,542 to the cost of patient care). Patients with postoperative fever but without documented infection were also more expensive to care for than afebrile, uninfected patients (fever added $9145 to the cost of care). Increased costs for infected patients were found among microbiology tests, radiology services, pharmaceutical costs, and room costs. For these patients, we found that use of departmental cost-charge ratios, instead of hospital-wide cost-charge ratios, had no substantial impact on comparison of the cost of care for infected and uninfected patients.

Academic Medical Centers↗
PubMed1993

The effect of feeding xanthan gum on colonic function in man: correlation with in vitro determinants of bacterial breakdown.

Xanthan gum (15 g/d) was given for 10 d to eighteen normal volunteers. In vivo measurements of stool output, transit time, frequency of defaecation and flatulence were compared with a preceding control period of 10 d. At the end of the control and test periods fresh faecal homogenate from each subject was anaerobically incubated with xanthan gum and control solutions to assess the ability of the bacteria to break down the gum. Xanthan gum was found to be a highly efficient laxative agent causing significant increases in stool output (P < 0.01), frequency of defaecation (P < 0.05) and flatulence (P < 0.01) whilst having variable effects on transit time. Before feeding xanthan gum, faecal samples from twelve of the eighteen subjects could reduce the viscosity of the gum in vitro. This rose to sixteen of the eighteen with significantly greater amounts (P < 0.05) of hydrogen and short-chain fatty acids also being produced, indicating bacterial adaptation in the presence of the substrate. Correlations between the in vivo and in vitro findings did not substantiate claims that the in vivo effect of a given polysaccharide can be predicted from its fermentation characteristics in vitro.

Adult↗
PubMed1993

Effect of food and anti-cholinergic drugs on the pattern of rectosigmoid contractions.

The colonic response to a meal is often used to test the effect of drugs on colonic motility, but this test is hindered by its inconsistency. This study has used multiple manometric sensors situated in the rectosigmoid region to investigate whether recording of the site and type of contraction offers a clear discrimination of the colonic response to a meal and the effect of drugs. Two studies were carried out on 16 healthy volunteers. Before the meal, rectosigmoid motility consisted mainly of isolated contractions occurring in a single manometric channel. The motility index increased in every subject after the meal (p < 0.05), but this increase entirely consisted of a massive increase in contractions occurring simultaneously in three or more manometric channels (multiple channel contractions), the number increasing from 9 per hour preprandially to 57 per hour (p < 0.01). There was a concomitant decrease in the number of the single channel contractions from 65 to 56 per hour. In a second study an infusion of an antispasmodic drug, mebeverine hydrochloride, into the sigmoid colon of healthy volunteers stopped the postprandial increase in the multiple channel contractions and prevented the significant rise in the motility index. The decrease in single channel contractions was unaffected. These results show that the colonic response to a meal consists of a change in the pattern of rectosigmoid contractions and suggest that multiple channel contractions may be a more sensitive indicator of the effect of a meal on the rectosigmoid colon than the motility index.

Adult↗
PubMed1993

Competency for the endoscopy team.

To ensure the delivery of quality patient care during endoscopic procedures, competency of all the team members must be ensured. The physician community deals with this differently than the other members of the perioperative team. Using questionnaires and skill checklists to conduct thorough assessments is essential. Developing programmed learning tools, levels of competency, and performance standards are some examples described in this article. The issue of competency must be managed on a regular basis to continually ensure that quality care is delivered.

Clinical Competence↗
PubMed1991

Radioimmunoguided surgery using iodine 125 B72.3 in patients with colorectal cancer.

Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4 x 10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure.

Antibodies, Monoclonal↗
PubMed1991

Characteristics of treatment drop-outs among two samples of chronic headache patients.

To examine the psychological characteristics of those who terminate treatment for headaches prematurely, this investigation employed 179 posttraumatic headache patients and 67 nontrauma headache patients who underwent electromyographic (EMG) biofeedback therapy. Dependent variables included the patient's age, socioeconomic status, duration of headache, forehead EMG levels, and MMPI. Multivariate analyses of variance revealed no significant differences between the drop-outs and non-drop-outs among the trauma headache patients, but three MMPI scales (Psychopathic-Deviate, Paranoia, and Mania) were significantly higher among the nontrauma headache patients who dropped out of treatment. These data imply that different characteristics underlie the drop-out behavior for different pain conditions and that efforts to uncover a single drop-out pattern may not be realistic.

Age Factors↗
PubMed1991

Temporal variation in morphological and genetic characteristics within a hybrid population of Culex pipiens (Diptera: Culicidae).

Samples of mosquitoes in the Culex pipiens L. complex from Memphis, Tenn., were collected from June to November 1985 and examined in regard to allozyme frequencies and ratios of the two arms of the phallosome of the male genitalia (DV/D). The dominant allozymes of hexokinase (HkA) and 6-phosphogluconate dehydrogenase (PgdF) significantly increased in frequency during this period as did the mean DV/D ratio. An analysis of gene frequencies by species group designated by DV/D ratios revealed no significant differences among Cx. pipiens, Cx. quinquefasciatus Say, and intermediates. The lack of association of gene frequencies with the taxa determined by the DV/D ratio indicated that although allozyme frequencies were correlated temporally with the DV/D ratio in the population, they were not associated with subspecies. These results are consistent with previous work that has shown latitudinal association and thermal stability differences in the major allozymes of these enzymes in the Cx. pipiens complex.

Animals↗
PubMed1991

Gastrointestinal adaptation to diets of differing fat composition in human volunteers.

The effect of a low fat diet (9 MJ) v a high fat diet (19.26 MJ), each consumed separately for four and 14 days, on gastric emptying and mouth to caecum transit time of a high fat test meal and body weight and satiety were examined in groups of 10 and six normal male volunteers. The half time for gastric emptying (t1/2) and the mouth to caecum transit time of a high fat test meal was significantly faster after the high fat diet than the low fat diet when consumed for 14 days (t1/2=98 (80-116) v 147 (88-206) minutes (median (range)), p less than 0.05; mouth to caecum transit time 240 (130-350) v 360 (200-520) minutes, p less than 0.05), but not when consumed for only four days. The mean (SEM) body weight of all subjects significantly increased during the 14 day high fat diet (74.7 (1.3) v 72.7 (1.6) kg, p less than 0.05) but was not influenced during the consumption of the low fat diet. When subjects were given an appetising meal to consume on the day that they had consumed the transit test meal, they ate similar amounts irrespective of their recent dietary history, though the eating rate was significantly slower after the high fat diet (mean (SEM)) 46.7 (1.9) v 71.3 (14.8)/min, p less than 0.05). Maintaining normal subjects on a high or low fat diet for two weeks resulted in a desensitisation or sensitisation respectively of the mechanisms by which nutrients regulate gastrointestinal transit. These findings emphasise the importance of the recent dietary history in the interpretation of gastric emptying and small bowel transit time data.

Adaptation, Physiological↗
PubMed1991

Rectal carcinoma: staging at MR imaging with endorectal surface coil. Work in progress.

To increase the accuracy of local staging of rectal carcinomas at magnetic resonance (MR) imaging, the authors placed on endorectal coil mounted on a balloon in a position adjacent to the lesion. Use of such a local coil resulted in increased signal-to-noise ratio compared with use of a body coil; higher-resolution images were obtained because the field of view was decreased. The depth of wall invasion by rectal carcinoma was correctly staged with endorectal MR imaging in 11 of 12 patients. In the detection of perirectal adenopathy, use of MR enabled correct identification of positive perirectal nodes in four of seven patients (57%). There were no false-positive diagnoses of perirectal adenopathy at MR. Endorectal MR imaging is an evolving and promising technique for the local staging of rectal carcinomas, but further studies are needed to demonstrate its efficacy.

Female↗
PubMed1991

A comparison of selected demographic characteristics and academic performance of on-campus and satellite-center RNs: implications for the curriculum.

This study compared two groups of RN students and noted that there is a difference between the profile of the on-campus student and the student in satellite areas. The demographic profile differences revealed that the RN students in satellite centers were slightly older, were employed, and worked more hours each week. They tended to work full-time, traveled farther to attend classes, had more children, and projected a longer time necessary to complete the SCN than their campus counterparts. The academic profile differences revealed that the satellite center RN students had higher ACT-PEP mean scores and transfer GPAs than their on-campus peers. On-campus RN students had higher University of Iowa GPAs and higher grades in the Pathology course and Foundations of Nursing Practice course than satellite center RN students.

Career Choice↗
PubMed1991

Effects of flexibility training on enhancing spinal mobility in older women.

The purpose of this study was to examine the extent to which spinal flexion and extension, or spinal mobility, could be improved in a population of older adults participating in a 10 week flexibility training program. Twenty female volunteers, mean age 71.8, were randomly assigned to either the experimental group (flexibility training) or the control group (no training). Prior to the initiation of training, all subjects were tested for total spinal mobility, the combined sum of spinal flexion and extension. Subjects in the experimental group were exposed to a series of flexibility exercises, three times per week, for 20-30 minutes in duration, for a total of 10 weeks. The control group participated in an alternative exercise program with the experimental group, including walking, swimming, dance, and other locomotor activities, however, they did not receive the additional flexibility training. At the conclusion of the 10 week period, all subjects were retested for spinal mobility, using back flexion and extension measures. Results indicated a significant improvement in spinal mobility in the experimental group, and virtually no measurable change in the control group. This study suggests that specialized training in back flexibility for older adults is warranted, and that significant gains in spinal mobility can be obtained, regardless of age.

Aged↗
PubMed1990

Components of energy expenditure in tumor-bearing animals.

Single snapshot measurements of resting energy expenditure (REE) suggest that hypermetabolism contributes to cancer cachexia, but tumor impact on total 24-hr energy expenditure (TEE) is unknown. Automated multicage indirect calorimetry was employed to measure daily energy expenditure in adult Buffalo rats (n = 16) randomized to tumor inoculation or controls. Measurements included baseline REE, activity EE (AEE), thermic response to food (TEF), and TEE. Rats (n = 16) were randomized. Metabolic measurements, tumor size, and body weight were recorded weekly. Animals were sacrificed at Week 5 for analysis of host and tumor composition. Significant depletion of total lean body mass occurred in TB rats (greater than 15% wt loss, ANOVA P less than 0.001) which inversely correlated with tumor growth (r = -0.81, P less than 0.001). REE, TEF, AEE, and TEE did not change in controls (ANOVA P = n.s.). In TB rats, a 19.5% increase in REE occurred (119.4 +/- 3.3 to 138.7 +/- 1.8 kcal/kg LBM/day, P less than 0.01). TEE remained unchanged (157.3 +/- 5.6 vs 152.9 +/- 3.6 kcal/kg LBM/day, P = n.s.) due to a 66% decrease in AEE (32.9 +/- 3.1 to 10.5 +/- 1.7 kcal/kg LBM/day, P = 0.01). TEF did not change (4.7 +/- 0.8 vs 5.0 +/- 0.3 kcal/kg LBM/day, P = n.s.). Both TB and controls demonstrated a decreased REE in response to a 24-hr fast (7.9% vs 4.8%, P = n.s.). Respiratory quotient decreased in both groups when comparing fed to fasted values: TB (0.86 to 0.76) and controls (0.86 to 0.71), but the decline was greater in controls (P = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗