Inside the mouse hospital: science, animal welfare and strife in the drive for AAALAC accreditation.
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Accreditation↗
Biomedical subjects
J Davis
Publications and source records attributed to J Davis.
Post-transplant Epstein-Barr virus-associated meningoencephalitis and lymphoid interstitial pneumonitis.
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Bone Marrow Transplantation↗
Genetic linkage of hyper-IgE syndrome to chromosome 4.
The hyper-IgE syndrome (HIES) is a rare primary immunodeficiency characterized by recurrent skin abscesses, pneumonia, and highly elevated levels of serum IgE. HIES is now recognized as a multisystem disorder, with nonimmunologic abnormalities of the dentition, bones, and connective tissue. HIES can be transmitted as an autosomal dominant trait with variable expressivity. Nineteen kindreds with multiple cases of HIES were scored for clinical and laboratory findings and were genotyped with polymorphic markers in a candidate region on human chromosome 4. Linkage analysis showed a maximum two-point LOD score of 3.61 at recombination fraction of 0 with marker D4S428. Multipoint analysis and simulation testing confirmed that the proximal 4q region contains a disease locus for HIES.
Chromosome Deletion↗
Women's knowledge about menopause, hormone replacement therapy (HRT), and interactions with healthcare providers: an exploratory study.
This community mail-based survey received responses from 665 women to questions in three areas: (1) sources of information about menopause, (2) knowledge of health risks associated with menopause, and (3) knowledge about hormone replacement therapy (HRT). Women received information from many sources, including healthcare providers, friends, and mothers, but the number one source of information about menopause was women's magazines (76%). Over half of women surveyed said they had left healthcare appointments with unanswered questions about menopause and HRT. Although women seemed to have a basic understanding of the symptoms of menopause, their knowledge of the long-term health risks affected by menopause was poor. For example, women were much more likely (60%) to know that osteoporosis risk increased with menopause than to know that heart disease risk increased (30%) despite the much higher prevalence and severity of heart disease as a health problem of menopausal women. Many women thought that menopause itself (independent of aging) increased the risk of breast cancer. This finding may help explain the low percentage of women who take HRT for menopause despite proven health benefits. It is clear that better education about menopause needs to be accomplished regarding the long-term risk associated with menopause and the pros and cons of HRT. Strategies for improving education and interactions with healthcare providers are suggested.
Aged↗
Decision-making activity and influence of nurse executives in top management teams.
This study assesses the impact on decision-making when introducing the nurse executive into the top management team (TMT) in Veterans Affairs Medical Centers. Results indicate that nurse executives formally elevated to the TMT were no more likely to perceive greater involvement in decision-making than non-TMT nurse executives or nurses informally appointed to the TMT. However, nurse executives in all categories perceived themselves as more involved in strategic decisions than other TMT members.
Decision Making, Organizational↗
Metabolic responses associated with deer hunting.
PURPOSE: Deer hunting is a popular recreational activity with a high rate of cardiovascular events. Previous studies have demonstrated large HR responses during deer hunting. This study compared the HR and metabolic costs of maximal treadmill (TM) exercise with those of hiking while deer hunting and while dragging a deer. METHODS: Healthy male volunteers (N = 16) performed a maximal TM exercise test, a 0.8-km hiking test, and a 0.4-km dragging test over lightly rolling terrain. VO2 was measured by portable spirometry and HR by radiotelemetry. RESULTS: HR averaged 74.0 +/- 7.0% and 89.1 +/- 4.5% of peak TM HR during the hike and drag, respectively. The peak HR observed during hiking and dragging was 83.2 +/- 6.0% and 94.9 +/- 4.2% of peak TM HR, respectively. VO2 averaged 62.2 +/- 15.8% and achieved a peak of 77.2 +/- 19.0% of TM VO2 while hiking. This corresponded to 86.8 +/- 17.3% and 108.1 +/- 22.3% of ventilatory threshold (VT), respectively. VO2 averaged 72.3 +/- 21.0% and achieved a peak of 91.2 +/- 21.4% of peak TM VO2 while dragging the deer. This corresponded to 101.5 +/- 27.7% and 128.5 +/- 26.8% of VT, respectively. The VO2/HR relationship showed significant (P < 0.05) difference between the dragging test and the TM test with a disproportionately high HR. The VO2/HR relationship between the hiking and TM tests was comparable. CONCLUSION: In part, the previously described large HR responses and high rate of cardiovascular complications associated with deer hunting may attributable to the elevated metabolic costs of associated activities.
Adult↗
Prospective study of outcome in antenatally diagnosed renal pelvis dilatation.
AIMS: To ascertain the outcome associated with antenatal renal pelvis dilatation; to recommend guidelines for postnatal investigation and determine an upper limit of normal for the anterioposterior dimensions of the fetal renal pelvis. METHODS: Infants whose antenatal ultrasound scan showed a fetal renal pelvis of 5 mm or greater were investigated using postnatal renal tract ultrasound and a micturating cystogram. Isotope studies were also performed, where appropriate. RESULTS: Vesicoureteric reflux (VUR), the most common diagnosis, was evident in 23/104 (22%). In 14 infants with VUR the postnatal ultrasound scan was normal. There was no evidence of renal scarring or dysplasia in any of the refluxing kidneys. Other diagnoses were pelviureteric junction obstruction, renal dysplasia, and idiopathic dilatation. Antenatal counselling and parental information facilitated postnatal assessment. CONCLUSIONS: Infants with antenatal renal pelvis measurements of 5 mm or greater should be investigated postnatally, as a significant percentage will have VUR. A normal postnatal ultrasound scan does not preclude the presence of VUR.
Female↗
Docetaxel and cisplatin in combination as first-line chemotherapy for advanced epithelial ovarian cancer. Scottish Gynaecological Cancer Trials Group.
PURPOSE: A prospective, nonrandomized, multicenter, open feasibility study of cisplatin and docetaxel as first-line chemotherapy in International Federation of Gynecology and Obstetrics (FIGO) stage IC-IV epithelial ovarian cancer was conducted. The primary end point was the incidence of severe fluid retention that necessitated treatment withdrawal. PATIENTS AND METHODS: Cisplatin and docetaxel were administered every 3 weeks for six planned cycles, with a 5-day prophylactic dexamethasone regimen (8 mg two times per day). One hundred patients (median age, 53 years; range, 24 to 71 years) received a total of 512 cycles of chemotherapy in two cohorts: cohort 1, 49 patients, 258 cycles (cisplatin 75 mg/m(2) and docetaxel 75 mg/m(2)); cohort 2, 51 patients, 254 cycles (cisplatin 75 mg/m(2) and docetaxel 85 mg/m(2)). RESULTS: No patients were taken off study because of fluid retention. Sixty-six patients completed six cycles of protocol therapy; 16 stopped early because of toxicity (neurotoxicity in six patients, nephrotoxicity in three, neutropenia in two, and hypersensitivity, diarrhea and vomiting, skin rash, clinical deterioration, and patient's wishes in one patient each). Grade 3/4 neutropenia was observed in more than 75% of patients and seemed to be cumulative. Patients in cohort 2 had significantly more severe neutropenia and lethargy than those in cohort 1. In addition, there were five treatment-related deaths in cohort 2 (three neutropenia and two upper gastrointestinal hemorrhage). Neurotoxicity (mainly sensory, > grade 1) was observed in 23 patients. The overall clinical response rate was 69% (complete response, 38%; partial response, 31%); CA-125 response rate was 73%. Median progression-free survival for the group was 12 months. CONCLUSION: Cisplatin and docetaxel can be administered at doses of 75 mg/m(2) and 75 mg/m(2), respectively, every 3 weeks, and the utility of this regimen is not limited by fluid retention. However, 33 of 100 patients were unable to complete the planned six cycles, which may explain, in part, the poor overall progression-free survival. Increasing the docetaxel dose to 85 mg/m(2) adds unacceptable hematologic toxicity and potential risks to the patient.
Antineoplastic Combined Chemotherapy Protocols↗
Mutations of CTSK result in pycnodysostosis via a reduction in cathepsin K protein.
Pycnodyostosis, an autosomal recessive osteosclerosing skeletal disorder, has recently been shown to result from mutations in the cathepsin K gene. Cathepsin K, a lysosomal cysteine protease with an abundant expression in osteoclasts, has been implicated in osteoclast-mediated bone resorption and remodeling. DNA sequence analysis of the cathepsin K gene in a nonconsanguineous family demonstrated compound heterozygozity for mutations in two affected siblings. We have identified a missense mutation with a single base G-->A transition at cDNA nucleotide 236, resulting in conversion of a conserved glycine to a glutamine residue (G79E). The other mutation is an A-->T transition at nucleotide 154, leading to the substitution of a lysine residue by a STOP codon (K52X) predicting premature termination of the precursor cathepsin K polypeptide. Sequencing of genomic and cDNAs from the parents demonstrated that the missense mutation was inherited from the father and the nonsense mutation from the mother. Protein expression in both affected children was virtually absent, while in the parents was reduced by 50-80% compared with controls. The protein studies demonstrate that even significantly reduced cathepsin K levels do not have any phenotypic effect, whereas absent cathepsin K results in pycnodysostosis.
Cathepsin K↗
Pathogenic amyloid beta-protein induces apoptosis in cultured human cerebrovascular smooth muscle cells.
The amyloid beta-protein (A beta) pathologically accumulates in cerebral vascular and senile plaque deposits in the brains of patients with Alzheimer's disease (AD) and related disorders including hereditary cerebral hemorrhage with amyloidosis Dutch type (HCHWA-D). The cerebrovascular deposits are accompanied by degeneration and eventual loss of smooth muscle cells in cerebral vessel wall. Similarly, we have shown that pathogenic forms of A beta cause cell death in cultured human cerebrovascular smooth muscle (HCSM) cells in vitro. Here we show that pathogenic A beta induces a number of structural changes in HCSM cells including shrinkage of cell bodies, retraction of processes, disruption of the intracellular actin network, and nuclear condensation and fragmentation. These changes were accompanied by a number of biochemical alterations in the cells shown by in situ end labeling of nuclear DNA, proteolytic breakdown of smooth muscle cell a actin, and proteolytic activation of the proteinase caspase 3. Together, these characteristics are consistent with an apoptotic mechanism of cell death in HCSM cells in response to pathogenic A beta.
Actins↗
Mental health needs assessment of off-reservation American Indian people in northern Arizona.
Native Americans For Community Action, Inc. (NACA) implemented a community-wide mental health needs assessment in Northern Arizona using bilingual interviewers recruited from the local community. A total of 235 people: 156 adults, 28 adolescents, and parents of 51 children were interviewed. File data from the NACA Family Health Center was also analyzed. Thirty-eight percent (38%) of adults reported problems with depression, 27% reported completed or attempted suicide among family members, 31% had problems with drugs or alcohol, and 25% reported problems with physical abuse. Sixty-five percent (65%) of those surveyed never sought professional help. A majority of respondents said that mental health services were needed in their community.
Adolescent↗
Chromosome abnormalities in ovarian adenocarcinoma: II. Prognostic impact of nonrandom chromosome abnormalities in 244 cases.
In a large series of ovarian carcinomas from 244 patients, 134 cases had chromosome rearrangements. We showed before that the pattern of chromosome breakpoints involved 21 separate chromosome regions nonrandomly and, in 90% of cases with breaks, the breakpoints occurred within 13 commonly involved regions. Log-rank and proportional hazards regression analyses showed that the aggregate presence of a chromosome breakpoint in any of 21 nonrandomly involved regions and breaks in 9 distinct regions (1p1, 1q2, 1p3, 3p1, 6p2, 11p1, 11q1, 12q2, and 13p1) were associated with reduced patient survival. Breakpoints in other areas of the genome, including other nonrandomly involved regions, were not associated with decreased survival. Because many cases had breakpoints in more than one nonrandomly involved region, proportional hazards regression was also used to analyze for effects of each nonrandomly involved region, controlling for effects of other regions. With this approach, only breakpoints within 1p1 and 3p1 retained independent, deleterious effects on survival. Similarly, when nonrandomly involved regions were entered into a proportional hazards model containing clinical variables associated with altered patient survival (tumor grade, tumor stage, and residual disease > 1 cm after resection), only 1p1 (P = 0.007) and 3p1 (P = 0.04) were associated with independent, negative effects on survival. These studies demonstrate that chromosome breakpoints within specific, nonrandomly involved chromosome regions are associated with impaired survival in ovarian cancers. Regions 1p1 and 3p1 are identified as areas of particular significance and are appropriate targets for analytical techniques such as SAGE and microarray analysis.
Adenocarcinoma↗
Collaborations to improve hospital-based student practicums.
Hospital educators who place students from area nursing schools noted that the information provided to students in orientation to the hospital was being repeated at the beginning of every clinical rotation. This was costly for the hospitals, and monotonous and time consuming for students. The hospital educators collaborated to develop a generic orientation to be given annually rather than every 10 weeks. Realizing they could better accomplish their goals with the involvement of the nursing schools, they formed a second collaboration with administrators and faculties of area nursing schools. After identifying problems, specific requirements were developed to ease the process of clinical affiliations. Both hospital educators and nursing school administrators saw only benefits arising from the new processes.
Clinical Clerkship↗
How other members of the top management team see the nurse executive.
This study compared how top-level organizational groups within Veterans Affairs Medical Center (VAMC) top management teams perceived nurse executives' participation in strategic decision making. Nurse executives' perceptions of their own involvement in strategic decision making generally agreed with the views of both chiefs of staff and directors. However, the associate director's perceptions of the nurse executive's involvement often differed significantly with those of the nurse. Nurse executives will be better prepared to function effectively within the top management team if they are aware of patterns in how they are perceived by other members.
Attitude of Health Personnel↗
Mature presacral teratoma in an adult male: a case report.
Presacral teratomas are rare tumors derived from more than one embryonic germ layer and are usually diagnosed in infancy. It has been estimated that the incidence of presacral teratoma in children ranges from 1 in 30,000 to 1 in 43,000 live births. However, the diagnosis of these tumors in adults is extremely rare. H. Head et al. reviewed the world literature in 1975 and found only 71 reported cases. Since that time, an additional 14 cases have been reported, and only one of these was found in the United States. This study reports a case of an adult male who presented with recurrent infected pilonidal cysts that proved to be benign presacral teratoma at biopsy. The patient underwent resection by left hemisacrectomy and primary closure using a posterior approach and, since this procedure, has had no evidence of recurrence. The case is presented along with a review of the relevant literature.
Adult↗
Nursing leadership in the US 1950s-1970s: a discourse analysis.
This paper proposes that the development of nursing leadership and the struggle for professionalisation from the time of the early nineteenth century to the late twentieth century may be conceived as a series of products of constituent discourses. However, particular attention is focused on the concept of leadership as it pertains to the nursing profession in the US between the 1950s-1970s. This time-frame is an important period in the discursive formation of the idea of leadership and professionalisation as the US literature on these subjects in the areas of sociology, psychology, education and business administration exercised a strong influence on the microsocial world of professional nursing practice in the US and, indeed elsewhere, for example, Australia and the UK. The sociological complexity of the concept of leadership ultimately meant that it came to be regarded as a dynamic process pervading the existence of all people; their interrelationships, their morale, their confidence and their capacity to achieve. These features are reflected through the perceptions, beliefs and experiences of the American nursing profession as its constituent discourse appeared during the 1950s-1970s. Thus the paper is a discourse analysis on leadership in nursing with particular attention given to the bureaucratic authority of the hospital, the drive for the creation of a profession and the idea of leadership itself.
History, 20th Century↗
Successive intraocular nocardiosis and cytomegalovirus retinitis after cardiac transplantation.
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Adult↗