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Biomedical subjects

J E Baker

Publications and source records attributed to J E Baker.

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

An evaluation of enhanced self-regulation training in the treatment of childhood obesity.

Obese children (8-13 years old) and at least one of their parents participated in a behaviorally oriented treatment program. Participants in a standard treatment condition experienced a multicomponent intervention in which parents were given primary responsibility for following program prescriptions. An enhanced child involvement condition provided the same basic intervention but with greater emphasis on, and training in, child self-regulation. Children in both conditions achieved a significant reduction in percentage overweight and triceps skin-fold during the 6-month treatment period. Overall, the follow-up period of 3 years was characterized by increases above posttreatment levels. There was, however, some suggestion in the 3-year follow-up results and the long-term patterns over a 6 1/2-year period of the benefits of the enhanced child involvement approach. Findings are discussed in terms of suggestions for reconsideration of treatment goals, improved interventions, and refinements in the assessment of self-regulatory behavior.

Adolescent↗
PubMed1994

Lack of protection of PBN in isolated heart during ischemia and reperfusion: implications for radical scavenging mechanism.

We evaluated the ability of alpha-phenyl-tert-butyl nitrone (PBN) to trap free radicals and to protect the rat myocardium during ischemia and reperfusion. Isolated bicarbonate buffer-perfused hearts (n = 8) were subjected to 20 min global ischemia (37 degrees C) followed by reperfusion with 0.4 to 4.0 mM PBN. Coronary effluent containing the PBN adduct was extracted in toluene. Electron spin resonance analysis of the toluene extract revealed a PBN-hydroxyl adduct. To verify this assignment, a Fenton system was used to generate an authentic PBN-hydroxyl adduct (n = 8), which yielded the same ESR spectra as the reperfusion-derived adduct. The structure of the adduct formed in the Fenton system was confirmed by gas chromatography-mass spectrometry. The ESR parameters of the PBN-hydroxyl adduct were exquisitely sensitive to solvent polarity during extraction of the adduct. Extraction of an authentic PBN-hydroxyl adduct into chloroform, chloroform:methanol, and toluene closely matched the ESR parameters obtained during reperfusion of ischemic myocardium in other animal models. To determine whether PBN could confer any protective effect during ischemia or reperfusion, hearts (n = 8/group) were subjected to 35 min global ischemia at 37 degrees C with the St. Thomas' II cardioplegic solution followed by 30 min reperfusion. Percent recovery (mean +/- SEM) of developed pressure, rate pressure product, and leakage of lactate dehydrogenase during reperfusion in control hearts were 58 +/- 3%, 48 +/- 4% and 3.2 +/- 0.5 IU/15 min/g wet wt. PBN at a concentration of 0.4 mM or 4.0 mM when present either during ischemia alone or reperfusion alone did not exert any effect upon recovery of developed pressure, rate pressure product or post-ischemic enzyme leakage. We conclude that PBN fails to improve contractile recovery and reduce enzyme leakage during reperfusion of myocardium subjected to global ischemia.

Animals↗
PubMed1994

Postural changes can reduce leakage in women with stress urinary incontinence.

OBJECTIVE: To assess the efficacy of postural changes, such as crossing the legs, in reducing urine leakage in women with stress urinary incontinence. METHODS: Sixty-five women with urodynamically proven stress incontinence underwent a series of standing cough stress tests in each of four postures: standing, crossing the legs, bending forward from the hips, and a combination of crossing the legs and bending forward. The bladder volume and strength of coughing were standardized, and the volume of leakage in each test was measured as the change in pad weight. RESULTS: The mean loss was 12.3 g (95% confidence interval [CI] 8.5-16.1) in the standing position; this was significantly reduced to 1.3 g (95% CI 0.5-2.1, P < .001) with crossed legs and to 4.7 g (95% CI 1.4-7.7, P < .01) by the combination of crossing the legs and bending forward. Bending forward alone did not reduce fluid loss (mean loss 10.2 g, 95% CI 6.5-13.9). The mean reduction in fluid loss was -14.7 g (95% CI -21.2 to -8.2) using the best posture compared to the standing position. Seventy-three percent of the subjects became continent using one or more postural changes. CONCLUSION: Postural changes are an effective means of reducing urine leakage in women with stress urinary incontinence and should be an integral part of the management of this condition.

Adolescent↗
PubMed1993

Dietary fish oil reduces microthrombi over atherosclerotic lesions in hyperlipidemic swine even in the absence of plasma cholesterol reduction.

We have investigated in swine the effect of fish oil additives to a butter-cholesterol hyperlipidemic diet (BT) on atherogenesis and thrombogenesis when average plasma cholesterol levels were kept similar in fish oil-treated and untreated BT groups. The studies included evaluation of lesion sizes and cell numbers, counts of adherent monocytes over lesions, and counts of platelet clumps (microthrombi) over lesions either attached directly to endothelium or to adherent monocytes. Anatomic sites studied for lesion development were the left anterior descending coronary artery (LAD), the distal 1/5 of the abdominal aorta, and a proximal portion of the thoracic aorta. Counts of attached monocytes and platelet clumps were made by scanning electron microscopy only for the LAD and expressed per mm2 of surface. The most striking new result was in regard to the platelet clumps. These were reduced by the fish oil from 996 +/- 295/mm2 in the untreated BT group to 313 +/- 59 and 364 +/- 105 in BT+cod liver oil and BT+menhaden oil groups, respectively. Most of the platelet clumps were adherent to attached monocytes in all groups and the number of attached monocytes were greatly reduced by the fish oil additive. Thus there were close relationships among platelet clumps, monocytes, and lesion endothelium. Numbers of attachments over nonlesion endothelium were much less than those over lesions in all dietary groups. The most surprising result was the lack of retardation of lesion growth by the fish oil additives in spite of the reduction in attached monocytes and platelet clumps. In previous studies where the high plasma cholesterol levels in the BT swine had been modestly reduced (about 25%) there had been a marked retardation of lesion growth. The current result suggests that plasma cholesterol is the major factor controlling lesion growth in this model through under milder conditions and longer observation periods other factors might become apparent.

Animals↗
PubMed1993

Age and protection of the ischemic myocardium: is alkaline cardioplegia appropriate?

Hypothermic alkaline pharmacologic cardioplegia used in pediatric cardiac surgery may be less than satisfactory despite its benefits in adults. We determined whether the pH (7.8) of standard St. Thomas' II cardioplegic solution contributes to inadequate protection of the ischemic immature heart and whether the effect is age-related. Modified hypothermic St. Thomas' II solution (pH range, 4.8 to 8.8) was compared with hypothermic bicarbonate buffer alone (pH 7.25) in protecting the ischemic immature (7 to 10 days old) and mature (12 months old) rabbit heart. Isolated hearts (n = 6 per group) were perfused with bicarbonate buffer, and aortic flow was measured before hypothermic (14 degrees C) ischemia (immature hearts: 4 hours; mature hearts: 3 hours). Hearts were reperfused, and enzyme leakage and recovery of function were measured. In the immature heart, a bell-shaped dose-response profile was observed for pH and recovery of aortic flow but not for postischemic creatine kinase leakage. Optimal recovery of aortic flow (98% +/- 3%) occurred at pH 6.8, which was greater than protection with hypothermia alone (82% +/- 4%; p < 0.05) and standard St. Thomas' II solution (72% +/- 2%; p < 0.05). In the mature heart, a bell-shaped dose-response curve existed for recovery of aortic flow and a U-shaped curve existed for creatine kinase leakage. Again, optimal recovery of aortic flow (84% +/- 5%), which was superior to that with standard St. Thomas' II solution (60% +/- 8%; p < 0.05), and minimal enzyme leakage also occurred at pH 6.8, as did the least enzyme leakage (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1993

Vasodilatory and toxic effects of spin traps on aerobic cardiac function.

The objective of this study was to compare the effect of several structurally related nitrone and nitroso spin traps on the function of the isolated bicarbonate-buffer perfused rat heart model. Spin traps investigated were alpha-phenyl-tert-butyl N-nitrone (PBN), alpha-(4-pyridyl-1-oxide)-N-tert-butyl nitrone (POBN), 2-methyl-2-nitroso propane (MNP), 2-hydroxymethyl-2-nitroso propane (MNP/OH), nitrosobenzene (NB), dibromonitrosobenzene-sulfonic acid (DBNBS), and 5,5'-dimethyl-1-pyrroline-N-oxide (DMPO). During perfusion of hearts with increasing concentrations of spin traps, ventricular pressure, coronary flow rate, and heart rate were continuously recorded. The extent of contractile recovery was subsequently measured upon return to spin-trap free perfusion. The percentage of maximum increase in coronary flow with PBN, POBN, MNP, MNP-OH, NB, DBNBS, and DMPO were 11, 40, 45, 66, 28, 28, and 29%, respectively. Thus, all nitroso and nitrone spin traps studied acted as vasodilators. Over the dose range studied, POBN, MNP, MNP/OH, and DMPO did not exert any chronotropic effect. PBN, NB, and DBNBS exerted a negative chronotropic effect at higher concentrations. All spin traps studied, with the exception of DMPO, exerted a negative inotropic effect at the higher concentrations studied. We conclude that all spin traps examined acted as coronary vasodilators. Their negative chronotropic and inotropic effects were minimal in comparison and only manifest at the higher concentrations studied.

Aerobiosis↗
PubMed1993

Working memory in clinical depression: an experimental study.

This study compared clinically depressed subjects with normal controls on a range of working memory tasks. The findings suggested the articulatory loop and visuospatial sketch pad components of working memory to be unimpaired in depression. On a range of clinical tasks likely to involve central executive function, depressed subjects showed impairment only on some tasks.

Adult↗
PubMed1993

Effects of structure and clustering on recall and recognition memory in clinical depression.

The present study compared retrieval of high, medium, and low structured material, using word lists consisting of uncategorized words and categorized words presented in randomized and clustered order. Clinically depressed subjects were found to be significantly impaired relative to controls only on the medium level of structure and the randomized categories list when measured by free recall. There were no effects of group nor any interactions for recognition memory, although there was a main effect for group on d' when signal detection analysis was applied. The implications of the findings for models of memory deficits in depression are discussed.

Adult↗
PubMed1993

Protection of the ischemic immature heart--effect of perfusate reinfusion and composition.

We determined the influence of perfusate composition and reinfusion during ischemia upon myocardial protection in the immature rabbit heart. Isolated "working" hearts (n = 6 per group) from 7-10-day-old New Zealand White rabbits were perfused with Krebs bicarbonate buffer and function measured. Hearts were then arrested with 3 minutes cold (14 degrees C) perfusion with bicarbonate buffer (as hypothermia-alone group) or St. Thomas' II cardioplegic solution (as hypothermia-plus-cardioplegia group). Hearts were then subjected to hypothermic (14 degrees C) global ischemia for 2 or 6 hours, with and without multiple reinfusion of the coronary vasculature. Following 2 hours ischemia impaired recovery of aortic flow occurred after multiple reinfusion in comparison with a single infusion with the cardioplegic solution (64 +/- 3% versus 72 +/- 4%) but not with bicarbonate buffer (79 +/- 3% versus 83 +/- 4%). However after 6 hours ischemia impaired recovery of function occurred after multiple reinfusion in comparison with single infusion both with the cardioplegic solution (60 +/- 3% versus 68 +/- 3%) and with bicarbonate buffer (57 +/- 4% versus 75 +/- 5%). There were no differences in post-ischemic creatine kinase leakage or myocardial water content between groups. These results suggest (i) that reinfusion itself, regardless of the composition of the perfusate, caused decreased recovery of function after an extended period of ischemia, and (ii) protection of the ischemic immature heart with St. Thomas' II solution remains inadequate and requires improvement.

Animals↗
PubMed1993

Intracellular catalase inhibition does not predispose rat heart to ischemia-reperfusion and hydrogen peroxide-induced injuries.

The objective of this study was to determine whether inhibition of intracellular catalase would decrease the tolerance of the heart to ischemia-reperfusion and hydrogen peroxide-induced injuries. Isolated bicarbonate buffer-perfused rat hearts were used in the study. Intracellular catalase was inhibited with 3-amino-1,2,4-triazole (ATZ, 1.5 g/kg body weight, two hours prior to heart perfusion). In the ischemia-reperfusion protocol, hearts were arrested with St. Thomas'II cardioplegic solution, made ischemic for 35 min at 37 degrees C, and reperfused with Krebs-Henseleit buffer for 30 min. The extent of ischemic injury was assessed using postischemic contractile recovery and lactate dehydrogenase (LDH) leakage into reperfusate. In the hydrogen peroxide infusion protocol, hearts were perfused with increasing concentrations of hydrogen peroxide (inflow rates 0.05-1.25 mumol/min). Inhibition of catalase activity (30.4 +/- 1.8 mU/mg protein in control vs 2.4 +/- 0.3 mU/mg in ATZ-treated hearts) affected neither pre-ischemic aerobic cardiac function nor post-ischemic functional recovery and LDH release in hearts subjected to 35 min cardioplegic ischemic arrest. Myocardial contents of lipid hydroperoxides were similar in control and ATZ-treated animals after 20 min aerobic perfusion, ischemia, and ischemia-reperfusion. During hydrogen peroxide perfusion, there was an increase in coronary flow rate followed by an elevation in diastolic pressure and inhibition of contractile function in comparison with control hearts. The functional parameters between control and ATZ-treated groups remained unchanged. The concentrations of myocardial lipid hydroperoxides were the same in both groups. We conclude that inhibition of myocardial catalase activity with ATZ does not predispose the rat heart to ischemia-reperfusion and hydrogen peroxide-induced injury.

Amitrole↗
PubMed1992

Psychological tasks for bereaved children.

The grief process in bereaved children is conceptualized as a series of psychological tasks that must be accomplished over time. Early tasks include understanding and self-protection; middle-phase tasks include acceptance and reworking; late tasks pertain to identification and development. This timing model has practical implications for the conduct of psychotherapy at different times during the grief process.

Adaptation, Psychological↗
PubMed1992

Primary prophylaxis with fluconazole against systemic fungal infections in HIV-positive patients.

OBJECTIVE: To investigate the efficacy of fluconazole prophylaxis against systemic fungal infections in HIV-positive patients. DESIGN: Open label treatment compared with historical controls. SETTING: Patients were seen at the Parkland Memorial Hospital HIV Clinic, Dallas, Texas, USA between 1 March 1990 and 28 February 1991. PATIENTS, PARTICIPANTS: Three hundred and thirty-seven historical controls were followed for 157 patient-years, and 329 fluconazole-treated patients for 145 patient-years. INTERVENTIONS: Fluconazole (100 mg daily) was administered to all patients with CD4 lymphocyte counts less than 68 x 10(6)/l seen at our HIV clinic after 1 March 1990. MAIN OUTCOME MEASURES: Lysis-centrifugation blood cultures were recorded monthly for all patients during both study periods. RESULTS: Twenty infections (16 cryptococcosis, four histoplasmosis) occurred in 337 historical reference control patients (product-limit 1-year incidence, 7.5 +/- 2.0/year). Four infections (one cryptococcosis, three histoplasmosis) occurred in the treated patient group (product-limit 1-year incidence, 1.8 +/- 0.9/year). CONCLUSIONS: Fluconazole warrants further evaluation for prophylaxis against systemic fungal infections in HIV-positive patients.

Adult↗
PubMed1992

Primary, secondary, and tertiary prevention in reducing pesticide-related illness in farmers.

American farmers are a specific population with specific health concerns, and there is little in the literature that addresses nursing care of farmers. The farmer needs to be educated and assessed for the potential of poisoning injury related to pesticide exposure. Studies done by the National Cancer Institute (NCI) and others have shown a somewhat greater risk of specific cancers in farmers using pesticides. Acute exposures and chronic conditions resulting from years of exposure to pesticides are oftentimes not attributed to pesticides. By use of the nursing process, nurses can develop programs at all levels of prevention to deal with this problem. This article describes such programs, as well as providing resources useful in their development.

Agricultural Workers' Diseases↗
PubMed1991

Calcium content of St. Thomas' II cardioplegic solution damages ischemic immature myocardium.

Clinical application of hypothermic pharmacologic cardioplegia in pediatric cardiac surgery is less than satisfactory, despite its well known benefits in adults. Protection of the ischemic immature rabbit heart with hypothermia alone is better than with hypothermic St. Thomas' II cardioplegic solution. Control of cellular calcium is a critical component of cardioplegic protection. We determined whether the existing calcium content of St. Thomas' II solution (1.2 mmol/L) is responsible for suboptimal protection of the ischemic immature rabbit heart. Modified hypothermic St. Thomas' II solutions (calcium content, 0 to 2.4 mmol/L) were compared with hypothermic Krebs bicarbonate buffer in protecting ischemic immature (7- to 10-day-old) hearts. Hearts (n = 6 per group) underwent aerobic "working" perfusion with Krebs buffer, and cardiac function was measured. The hearts were then arrested with a 3-minute infusion of either cold (14 degrees C) Krebs buffer (1.8 mmol calcium/L) as hypothermia alone or cold St. Thomas' II solution before 6 hours of hypothermic (14 degrees C) global ischemia. Hearts were reperfused, and postischemic enzyme leakage and recovery of function were measured. A bell-shaped dose-response profile for calcium was observed for recovery of aortic flow but not for creatine kinase leakage, with improved protection at lower calcium concentrations. Optimal myocardial protection occurred at a calcium content of 0.3 mmol/L, which was better than with hypothermia alone and standard St. Thomas' II solution. We conclude that the existing calcium content of St. Thomas' II solution is responsible, in part, for its damaging effect on the ischemic immature rabbit heart.

Age Factors↗
PubMed1990

On the detection of paramagnetic species in the adriamycin-perfused rat heart: a reappraisal.

Recently, L. Costa et al. reported the direct detection of the superoxide anion and other paramagnetic species in the isolated, adriamycin-perfused rat heart [L. Costa et al. (1988) Biochem. Biophys. Res. Commun. 153, 275-280]. We have reevaluated the results of their study and concluded that the ESR parameters of the spectrum obtained from the adriamycin-perfused heart are consistent with that of the peroxyl radical and not with that of the superoxide anion. In addition, the ESR spectrum of the peroxyl radical is very likely produced as an artifact caused by the grinding of myocardial tissue. This artifact may mask the ESR spectra of the adriamycin-derived semiquinone radical and the iron-sulfur protein components of myocardium.

Animals↗
PubMed1990

Cardioplegia-induced damage to ischemic immature myocardium is independent of oxygen availability.

The known benefits of hypothermic pharmacological cardioplegia in protecting the ischemic adult heart may not extend to children. Protection of the ischemic immature rabbit heart with hypothermic Krebs-Henseleit bicarbonate buffer is better than with hypothermic St. Thomas' II cardioplegic solution. We investigated whether the availability of oxygen in the preischemic perfusate is responsible for the increased tolerance to ischemia of immature (7- to 10-day-old) hearts perfused with Krebs buffer in comparison with St. Thomas' II solution immediately before ischemia. After obtaining preischemic control data in the "working" mode, we perfused hearts (n = 8 per group) for 3 minutes with hypothermic (14 degrees C) Krebs buffer or hypothermic St. Thomas' II solution saturated with 0%, 25%, or 95% oxygen. This was followed by 2 hours of global ischemia at 14 degrees C. Hearts were reperfused for 15 minutes in the Langendorff mode and 35 minutes in the working mode, and recovery of function was measured. For preischemic oxygen concentrations of 0%, 25%, and 95%, recovery of aortic flow in hearts protected by hypothermia alone during ischemia was 74% +/- 9%, 82% +/- 4%, and 99% +/- 2% of preischemic values, respectively. In hearts protected by hypothermia plus cardioplegia, the values were 69% +/- 6%, 72% +/- 3%, and 86% +/- 5%, respectively. Thus, at equal oxygen concentrations, recovery of postischemic function was better in hearts protected by hypothermia alone compared with hypothermia plus cardioplegia. We conclude that factors other than oxygen availability are responsible for the damaging effect of St. Thomas' II solution on the ischemic immature rabbit heart.

Animals↗
PubMed1990

Family adaptation when one member has a head injury.

The Family Adaptation to Medical Stressors (FAMS) model was used to assist in understanding the family's adaptation when a dependent child suffers a head injury. Twenty-six families took part in the study. Fourteen families had a member with a severe head injury; twelve had a member with a mild head injury. Significant correlations were found between the presence of rules in the family which permit emotional expression and depression (r = -.52, p less than .05), assistance the parents felt was available and trust (r = .47, p less than .05), the actual number of people available for assistance outside the nuclear family and illness anxiety (r = -.40, p less than .05), age of the patient and trust (r +/- .55, p less than .05), depression and increased expression of negative emotions (r +/- .52, p less than .05), and role flexibility and depression (r +/- .52, p less than .05). A weak correlation was found between perceived stress of the injury and illness anxiety. No differences were found in stress and adaptation between the groups of families who had a member with a mild head injury and those with a member with severe head injury, suggesting that both mild and severe head injury have similar impact on the family. A needs assessment of these families was also done.

Adaptation, Psychological↗