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Biomedical subjects

J Farmer

Publications and source records attributed to J Farmer.

At least 37 records · Page 2Linked to original sources
PubMed1999

Exploring family relationships in cancer risk counseling using the genogram.

OBJECTIVES: The genogram is a tool that has facilitated counseling in family therapy and social work for many years. It is hypothesized that genograms may also be useful in genetic counseling, because they help the counselor to acquire more objective and consistent information from the client, as well as to incorporate family dynamics and psychosocial issues into the counseling approach. MATERIALS AND METHODS: A pilot study of genograms used as an adjunct to genetic counseling was performed at Fox Chase Cancer Center's Family Risk Assessment Program. A questionnaire was developed to elicit genograms from 38 women at risk for familial breast and/or ovarian cancer. After standard pedigree expansion, a series of questions was asked about the consultand's relationship with other family members, communication patterns within the family, attitudes toward genetic testing, family reactions to cancer, roles individuals play in the family, and significant historical or anniversary events. Relationships were defined by the consultand as close, very close, conflictual, fused and conflictual, distant, or estranged. RESULTS: The majority of relationship types reported by 38 individuals was "very close" or "close." Eighty-one % reported having close/very close relationships with their spouses, 83% reported close/very close relationships with their mothers, and 70% reported close/very close relationships with their fathers. The degree of familial cohesion as depicted by the genogram correlates positively with scores obtained on the standardized Social Adjustment Scale Self-Report (P = 0.01). CONCLUSIONS: Given the family-wide implications of genetic testing, the genogram may offer important guidance in family-targeted interventions.

Adult↗
PubMed1998

Introduction to special section: early Mars.

Ongoing studies of the evolution of the Martian cratered highlands, the nature of the planet's early climate, and the recent announcement of possible evidence of ancient life in the ALH 84001 meteorite have reinvigorated interest in the conditions that prevailed on Mars during its first billion years of geologic history. To address this interest and assess our current understanding of these issues, the Lunar and Planetary Institute hosted a 4-day Conference on Early Mars in Houston in April of 1997. The papers contained in this special section are a product of that meeting. The purpose of the conference was twofold: (1) to consider how impacts, volcanism, and the presence of abundant water affected the physical and chemical environment that existed on Mars 4 Gyr ago, particularly as it related to the nature of the global climate, the origin of the valley networks, the geologic and mineralogic evolution of the surface, the aqueous geochemistry of groundwater, and the existence of local environments that may have been conducive to the development of indigenous life and the preservation of its signature in the geologic record; and (2) to discuss what observations or experiments might he included in future spacecraft missions to test the ideas and expectations arising from purpose 1. While pertinent issues of early atmospheric and solar evolution were also addressed, the primary discussion at the conference focused on the evidence and constraints provided by the geologic records of Earth, the Moon, and Mars and analysis of the SNC meteorites. The papers contained in this special section span the full range of these topics, including the stability of the early atmosphere to erosion by the solar wind, the geologic environment from which the SNC meteorites originated, geomorphic evidence regarding the nature of the early Martian climate and hydrologic cycle, the potential impact of the past and present environment on the preserved signature of ancient life, and a discussion of the capabilities of a lander-based X ray diffraction and fluorescence instrument to assess the potential for past fossilization from the mineralogy of the current local surface environment. The issues raised at the conference, and by the papers included in this special section, will be the focus of ongoing attention as the intensity and scope of Mars exploration increases over the next decade.

Evolution, Planetary↗
PubMed1998

A second-generation screen of the human genome for susceptibility to insulin-dependent diabetes mellitus.

During the past decade, the genetics of type 1 (insulin-dependent) diabetes mellitus (IDDM) has been studied extensively and the disorder has become a paradigm for genetically complex diseases. Previous genome screens and studies focused on candidate genes have provided evidence for genetic linkage between polymorphic DNA markers and 15 putative IDDM susceptibility loci, designated IDDM1-IDDM15. We have carried out a second-generation screen of the genome for linkage and analysed the data by multipoint linkage methods. An initial panel of 212 affected sibpairs (ASPs) was genotyped for 438 markers spanning all autosomes, and an additional 467 ASPs were used for follow-up genotyping. Other than the well-established linkage with the HLA region at chromosome 6p21.3, there was only one region, located on chromosome 1q and not previously reported, where the log likelihood ratio (lod) was greater than 3. Lods between 1.0 and 1.8 were found in six other regions, three of which have been reported in other studies. Another reported region, on chromosome 6q and loosely linked to HLA, also had an elevated lod. Little or no support was found for most reported IDDM loci (lods were less than 1), despite larger sample sizes in the present study.

Chromosome Mapping↗
PubMed1998

Attitudes to LIS education and academic-practitioner liaison: results of a survey of members of the Library Association Health Libraries Group.

A questionnaire survey was conducted by the Library Association Health Libraries Group in October-December 1996. Information practitioners in the health care sector were asked what they considered were the education and research needs of the profession, their opinion of Library and Information Sciences education, and their views on practitioner input to education and research. They were also asked whether they would be prepared to give talks to students and to offer student placements. The results show that there is still a considerable gulf between academics and practitioners, and that although practitioners are enthusiastic about getting more involved in liaison, they are constrained by lack of time and resources. Practical solutions need to be found to encourage greater understanding and closer working relationships, to achieve the benefits of academic-practitioner liaison.

Adult↗
PubMed1998

Anti-infective efficacy of antiseptic-coated intramedullary nails.

The coating of medical devices with antimicrobial agents has recently emerged as a potentially effective method for the prevention of device-related infections. We examined the anti-infective efficacy of intramedullary nails coated with an antiseptic combination of chlorhexidine and chloroxylenol in a rabbit model of device-related infection after fixation of an open tibial fracture. The rabbits were randomized to receive 2.8-by-100-millimeter stainless-steel tibial intramedullary nails that either were uncoated or were coated with antiseptic. After administration of anesthesia and preoperative antibiotic prophylaxis, a tibial fracture was created and then reduced with insertion of the intramedullary nail. A bacterial inoculum of 10(6) colony-forming units of Staphylococcus aureus was injected into the intramedullary canal, and the wound was sutured. Radiographs of the tibiae were made postoperatively, and the rabbits were monitored daily. They were killed at six weeks, or earlier if there was dehiscence of the wound, the fracture became grossly unstable, or the rabbit failed to thrive. The use of the antiseptic-coated nails was associated with a significantly lower rate of device-related osteomyelitis (two of twenty-two; 9 per cent) than the use of the uncoated nails (thirteen of twenty-one; 62 per cent) (p = 0.0003). The radiographic and histopathological findings were generally similar in the two groups of rabbits. Antiseptic agents were not detected in serum. The results suggest that antiseptic-coated fracture-fixation devices provide significant local protection against Staphylococcus aureus, which is the most common cause of infections related to orthopaedic devices.

Animals↗
PubMed1998

Neurologic deterioration after cervical spinal cord injury.

Neurologic deterioration after cervical spinal cord injury (SCI) at a regional spinal cord center was examined. This study examined the incidence of neurologic deterioration as well as associated risk factors in our patient population. Up to 5.8% of cervical SCI patients have been noted to deteriorate neurologically after admission. Risk factors have been early surgery, halo application, traction, and Stryker frame rotation. All cervical SCI patients admitted between 1978 and 1993 who had neurologic deterioration were studied for characteristics of their event, operative status, risk factors, mortality, and neurologic return at 1 year postinjury. Patients were divided into minor and major groups based on the degree of neurologic loss. Nineteen of 1,031 patients were identified as neurologically deteriorated (1.84%). There were 8 major and 11 minor group patients. The average time from injury to deterioration was 3.95 days. Of 10 patients undergoing surgery at < or =5 days, 8 deteriorated postoperatively. Potential risk factors were ankylosing spondylitis (three patients), sepsis (four patients), and intubation (four patients). Neurologic recovery at 1 year showed that 11 of 12 patients were improved. Neurologic deterioration occurred in 1.84% of our patients. Deteriorations were associated with surgery at <5 days after injury, ankylosing spondylitis, sepsis, and intubation.

Adult↗
PubMed1998

Foraminal pressure changes during intervertebral distraction simulating anterior cervical discectomy.

Distraction of the disc space over baseline height has been shown to increase foraminal size. The purpose of this procedure is to determine pressure changes, with disc space distraction simulating an anterior cervical discectomy and fusion (ACDF). An analysis of pressure changes during disc space distraction at C5-C6 was performed. Data were analyzed for maximal pressure observed and for pressure change with prolonged distraction. Five cadaveric specimens underwent a discectomy at the C5-C6 level. Distraction of the disc space was performed and pressure measurements were obtained from within the foramen. Measurements were made for maximal pressure with an intact posterior longitudinal ligament (PLL), divided PLL, and with the nerve root removed from within the foramen. Pressures were also recorded with prolonged distraction until a steady state was achieved. Incremental distraction of +2, +4, and +6 mm resulted in pressure increases within the foramen. Sectioning of the PLL did not affect these increases. Removal of the nerve root from the foramen resulted in pressure increases; however, these were not significantly different from baseline. Prolonged distraction produced an initial increase and a gradual return toward baseline. Final pressures still differed significantly from baseline. Increase intraforaminal pressures can be seen with increasing disc space distraction such as occurs during an ACDF. This suggests that either the foramen narrows in at least one dimension and/or soft-tissue attachments to the nerve produce a tensile force in the nerve as they tighten. The pressure increases relax over time.

Aged↗
PubMed1997

Biotherapeutic effects of probiotic bacteria on candidiasis in immunodeficient mice.

Four species of probiotic bacteria were assessed for their capacities to protect athymic bg/bg-nu/nu and euthymic bg/bg-nu/+ mice from mucosal and systemic candidiasis. Each bacterial species and Candida albicans colonized the gastrointestinal tracts of both strains of mice. The presence of probiotic bacteria (Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus casei GG, or Bifidobacterium animalis) in the gastrointestinal tracts prolonged the survival of adult and neonatal bg/bg-nu/nu mice compared to that of isogenic mice colonized with C. albicans alone. The incidence of systemic candidiasis in bg/bg-nu/nu mice was significantly reduced by each of the four probiotic bacterial species. The numbers of C. albicans present in the alimentary tracts of euthymic bg/bg-nu/+ mice were significantly reduced by L. casei GG and B. animalis. None of the probiotic bacteria species completely prevented mucosal candidiasis, but B. animalis reduced its incidence and severity. Probiotic bacteria also modulated antibody- and cell-mediated immune responses to C. albicans. The prolonged survival of mice, decreased severity of mucosal and systemic candidiasis, modulation of immune responses, decreased number of C. albicans in the alimentary tract, and reduced numbers of orogastric infections demonstrated not only that probiotic bacteria have biotherapeutic potential for prophylaxis against and therapy of this fungal disease but also that probiotic bacteria protect mice from candidiasis by a variety of immunologic (thymic and extrathymic) and nonimmunologic mechanisms in this model.

Adjuvants, Immunologic↗
PubMed1997

Colonization of congenitally immunodeficient mice with probiotic bacteria.

We assessed the capacity of four probiotic bacteria (Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus casei GG, and Bifidobacterium animalis) to colonize, infect, stimulate immune responses in, and affect the growth and survival of congenitally immunodeficient gnotobiotic beige-athymic (bg/bg-nu/nu) and beige-euthymic (bg/bg-nu/+) mice. The bacteria colonized and persisted, in pure culture, in the alimentary tracts of both mouse strains for the entire study period (12 weeks). Although all adult and neonatal beige-euthymic mice survived probiotic colonization, some infant mortality occurred in beige-athymic pups born to mothers colonized with pure cultures of L. reuteri or L. casei GG. The probiotic bacteria manifested different capacities to adhere to epithelial surfaces, disseminate to internal organs, affect the body weight of adult mice and the growth of neonatal mice, and stimulate immune responses. Although the probiotic species were innocuous for adults, these results suggest that caution and further studies to assess the safety of probiotic bacteria for immunodeficient hosts, especially neonates, are required.

Animals↗
PubMed1997

Lung immunopathology in cases of sudden asthma death.

The histopathology of airway inflammation in rare cases of sudden asphyxic asthma death (SAAD) is unclear. This study examines, for the first time, the relative disposition of lymphocyte and macrophage subsets and eosinophils in proximal and distal tissues of such cases. Multiple resection specimens from five cases of SAAD were studied. Tissue blocks were obtained at necroscopy and immediately frozen in liquid nitrogen within 18 hours of death (death occurring within 1 h of the onset of an unprovoked asphyxic asthma attack). After immunohistological staining, frozen sections underwent semi-quantitative analysis (cell counts per unit area) for T-cells, macrophages and eosinophils using computerized imaging systems. Subsets of T-cells and macrophages were estimated using double immunofluorescence techniques. Variability within samples, between samples and between cases was compared. These cases of fatal asthma showed infiltrates of T-cells, macrophages and eosinophils within peribronchial tissues. Distinct from stable asthma, a CD8+ T-cell dominance was found. A high proportion of eosinophils were activated (EG2+), whereas the relative proportion of antigen-presenting cells (RFD1+) did not seem to be abnormal, although numbers of these cells were high. These features were seen both in proximal and distal tissues. The variability of these parameters within an individual was 9.4-15.2%, however, the variability between individual cases was greater. Sudden asphyxic asthma is associated with inflammatory infiltrates both of proximal and distal lung tissues. In contrast to stable asthma, this infiltrate contains large numbers of CD8+ T-cells, suggesting distinct qualitative as well as quantitative characteristics in the immunopathology of sudden asthma death.

Acute Disease↗
PubMed1997

Information for trained nurses in remote areas: do electronically networked resources provide an answer?

This paper reports on a research project which examined the potential of the Internet, and other networked information resources, to improve access to information for trained nurses working in remote areas. This paper provides a review of current literature in the field. It describes the research carried out, presents a summary of the research findings and discusses the implications of these findings. The paper concludes that the Internet and networked resources do have considerable potential to improve access to information for nurses working in remote and rural areas. However, information skills, along with professional guidance, are also required.

Community Health Services↗
PubMed1996

Health check-ups in general practice: a patient perspective.

One of the strategies identified by the NHS to achieve improvements in the health status of the Scottish population is to implement health promotion programmes through the general medical practitioner service. Grampian Local Health Council undertook a survey of Grampian residents to identify factors which might encourage greater public participation in such programmes. The results which are analysed and discussed in this paper show that factors identified by the public include: a preference for doctors to carry out health checks; the need for public education on the roles of different health professionals; the need for information on health checks and their benefits to be supplied in advance; a choice of appointment times and the offer of a follow-up appointment to discuss test results. These results are of interest to health professionals as they are likely to contribute to higher levels of patient involvement in health promotion programmes.

Adult↗