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Biomedical subjects

J Hall

Publications and source records attributed to J Hall.

At least 541 records · Page 30Linked to original sources
PubMedDate not supplied

Antisperm antibodies in human immunodeficiency virus infection: effects on fertilization and embryonic development.

Sera from human immunodeficiency virus (HIV)-infected males (n = 10) and females (n = 5) were analyzed for the presence of antisperm antibodies reacting against sperm-specific antigens. Of the HIV-positive males tested, sera of 40% were positive for human sperm extract (HSE), 70% for protamine, and 70% for fertilization antigen (FA-1) for at least one class of antibodies, compared to sera from HIV-negative males. Of the HIV-positive females tested, sera of 40% were positive for HSE, 30% for protamine, and 30% for FA-1 compared to sera from HIV-negative females. The majority of the sperm antigen-reactive antibodies belonged to the IgG class. The reactions observed with FA-1 were weaker than those with other antigens. Ninety percent of HIV-positive male sera and 80% of the HIV-negative female sera were found to contain immune complexes, 20% of which showed the presence of FA-1. HIV-positive male or female sera did not bind to any specific protein on the Western blot of HSE. The minimal amount of free anti-FA-1 antibodies present in sera did not bind to live sperm in the sperm immobilization technique, sperm agglutination technique, or immunobead binding technique and thus were incapable of affecting human sperm penetration of zona-free hamster ova (SPA). Nor did HIV-positive sera induce any apparent abnormality in the development of 2-cell embryos to blastocysts in vitro in murine bioassay. In conclusion, these results indicate that HIV-infected patients have sperm-specific antibodies in their sera that do not adversely affect SPA and murine embryo bioassay. There was a high incidence of immune complex formation after HIV infection. These data will provide the basis for exploring further the role of sperm antigens in altering the immunoregulatory mechanisms after HIV infection.

Adult↗
PubMedDate not supplied

Comorbidity of central auditory processing disorder and attention-deficit hyperactivity disorder.

UNLABELLED: Research has indicated that children with attention-deficit hyperactivity disorder (ADHD) demonstrate significant difficulty on tasks used to assess central auditory processing skills. These findings have raised the question of whether ADHD and central auditory processing disorder (CAPD) represent a singular disorder. OBJECTIVE: The current study explored the incidence of ADHD in a group of 30 children who met diagnostic criteria for CAPD. METHOD: Consecutive referrals specifically for this project were assessed on a variety of measures. In addition, rating scales were completed by teachers and structured interviews were completed with parents. RESULTS: Results indicate that although the incidence rate of ADHD (50%) in this sample significantly exceeds that found in the normative population (p < .001), not all children with CAPD demonstrated behaviors consistent with diagnostic criteria for ADHD. Furthermore, there was a low incidence of any other behavioral disorder in this sample. In contrast, it was found that the sample as a whole demonstrated impaired language abilities. No significant differences emerged across cognitive, auditory, or language measures. CONCLUSION: This study further supports the need for increased collaboration of those professionals who work with these children given the extent of overlap of language and behavioral difficulties in this sample.

Adolescent↗
PubMedDate not supplied

Salter innominate osteotomies in congenital dislocation of the hip.

Clinical and radiographic data on 29 hips and 24 patients between the ages of 18 months and 5 years with congenital dislocation of the hip (CDH) who underwent Salter innominate osteotomies were reviewed. All patients were examined clinically and radiographically at an average postoperative follow-up of 9 years 3 months (range 3-14 years). All patients had good or excellent radiographic results by Severin classification. The complication rate was low. Three patients required reoperation for failed initial procedures. These three patients had hypertrophic subchondral sclerosis and joint space narrowing at follow-up. Our results indicate that the Salter innominate osteotomy if performed properly, has a high rate of clinical and radiographic success.

Child, Preschool↗
PubMedDate not supplied

Influence of glutamine and branched chain amino acids on the jejunal atrophy associated with parenteral nutrition.

Infusions of conventional parenteral nutrients (CPN) are associated with gut atrophy. This may be due to the absence of glutamine in such solutions. Although glutamine is a preferred gut nutrient, it is excluded from CPN because it is unstable at room temperature. This problem may be circumvented either directly by the infusion of fresh solutions of glutamine, or indirectly by the infusion of branched chain amino acids (BCAA). We evaluated the effect of infusing either glutamine, BCAA, or glutamine plus BCAA-enriched CPN on the rat jejunum. Sixty male Wistar rats were randomized to receive 6 days of either conventional parenteral nutrition (CPN), CPN plus 1.5% glutamine (GLN), CPN plus 2% BCAA (BCAA), CPN plus 0.8% BCAA and 1.0% glutamine (GLN/BCAA), or a normal oral diet (Chow). Standardized segments of jejunum were then removed for assessment. Compared with the CPN group, both the GLN/BCAA and the BCAA groups had greater mucosal weights (P less than 0.05) and mucosal protein concentrations (P less than 0.05), the GLN/BCAA group had greater jejunal weights (P less than 0.05), and the GLN group had an increased jejunal weight (P less than 0.05) and a higher crypt cell production rate (P less than 0.05). We conclude that the infusion of glutamine or BCAA-enriched parenteral nutrition improves jejunal morphology compared with conventional parenteral nutrition.

Amino Acids, Branched-Chain↗
PubMedDate not supplied

Academic underachievement in ADHD subtypes.

Although a relationship between attention-deficit/hyperactivity disorder (ADHD) and academic underachievement has been widely reported, the nature of this relationship has not been specified. The present investigation addresses this relationship directly by comparing 24 students (20 males and 4 females) with ADHD and 20 students (15 males and 5 females) with attention-deficit disorder without hyperactivity (ADD/noH) referred to a university-based diagnostic clinic for comprehensive neuropsychological assessment. The students ranged in age from 6 years 0 months to 12 years 10 months. Consistent with previous reports, this study found that math achievement test scores for students with ADD/noH were significantly lower than those for students with ADHD. These findings support previous research suggesting the ADD/noH may represent a distinct ADD subtype. It is hypothesized that inattention interferes with students' ability to master abstract symbol systems, especially in the acquisition of basic arithmetic skills in the primary grades.

Affective Symptoms↗
PubMedDate not supplied

Effects of glutamine infusion on colonic anastomotic strength in the rat.

Glutamine is one of the primary respiratory fuels of the colon. However, it is not included in commercial preparations of parenteral nutrients because of its short shelf life. It has been suggested that colonic atrophy induced by conventional parenteral nutrition can be reversed by the intravenous infusion of fresh solutions of glutamine. This study evaluated the hypothesis that glutamine-enriched parenteral nutrition would enhance the strength of a standard colonic anastomosis in undernourished rats. After surgery, the rats were randomized to receive 6 days of postoperative support with either rat chow, conventional parenteral nutrition, or parenteral nutrition containing 1.2% glutamine. Measurement of colonic bursting tension failed to demonstrate any significant differences between the groups under study. In conclusion, the administration of 1.2% glutamine-enriched parenteral nutrition failed to influence the healing of colonic anastomoses in undernourished rats.

Amino Acids↗
PubMedDate not supplied

The influence of parenteral glutamine and branched-chain amino acids on total parenteral nutrition-induced atrophy of the gut.

We tested the hypothesis that the provision of glutamine and branched-chain amino acids would reverse the gut atrophy that accompanies parenteral nutrition. Three hundred seventy-five rats were randomized into 15 groups to receive either conventional parenteral nutrition, rat food, glutamine-enriched parenteral nutrition (0.5% to 2.5%), branched-chain amino acid-enriched parenteral nutrition (0.8% to 2.0%), or glutamine plus branched-chain amino acid-enriched parenteral nutrition (0.5%/0.4% to 1.25%/1/0%). When compared with effects of conventional parenteral nutrition, the infusion of either glutamine or branched-chain amino acids partially reversed, in a dose-dependent manner, atrophy of the small bowel as assessed by gut weight (p < .05), mucosal weight (p < .05), villous height (p < .05), crypt cell production rate (p < .05), and mucosal protein concentration (p < .05). There was no effect on the large bowel. These results suggest that the parenteral infusion of either glutamine or branched-chain amino acids partially reverses the small-bowel atrophy that is associated with the infusion of solutions of conventional parenteral nutrients.

Amino Acids, Branched-Chain↗
PubMedDate not supplied

Glutamine and nucleotide metabolism within enterocytes.

Glutamine has an important role as a source of energy for enterocytes. However, it may also have a key role as a source of nitrogen for the synthesis of nucleotides. The relative contribution of de novo synthesis and salvage pathways seems to be affected by the position of enterocytes within the crypt-villus axis as well as the dietary intake of nucleic acids and glutamine. Nucleotides are especially important to enterocytes during intestinal development, maturation, and repair. Hence an understanding of nucleotide metabolism within enterocytes has important implications regarding both the composition and route of administration of nutrient solutions. Many important questions remain unanswered, in particular: Does glutamine stimulate intestinal de novo pyrimidine synthesis via the action of carbamoyl phosphate synthetase I? Can de novo purine synthesis maintain intestinal purine pools in the absence of dietary nucleic acids? And, what are the specific effects of parenterally administered nucleotides on the metabolism and well-being of enterocytes? A greater understanding of these issues will lead to a more rational approach toward the nutritional modulation of gut dysfunction.

Glutamine↗
PubMedDate not supplied

Anesthesia practitioner involvement, invasive treatments, and need in hospice pain management: a survey of patient care coordinators.

Pain management is one of the major concerns for the terminal patient. The hospice care team is a highly trained group of health care providers in the area of symptom control, including pain management, for the dying patient. Anesthesia providers also specialize in pain control. The purposes of this study were to survey hospice patient care coordinators to gain an understanding of anesthesia practitioners' involvement with hospice patients, hospice patients' access to anesthesia pain management services, and hospice patient care coordinators' attitudes toward the necessity of anesthesia pain management services for the hospice community. A questionnaire was developed to assess these issues. In general, the findings reflected minimal anesthesia practitioner involvement in the hospice community. Fifty-two percent reported that patients could benefit from invasive treatments offered by anesthesia practitioners. Forty percent responded that more patients could be considered as candidates for invasive pain management techniques if procedures were performed in the patient's home or hospice. Access to anesthesia pain management services was limited by distance to pain clinics and anesthesia practitioners, and more anesthesia pain management services were needed for hospice patients in smaller communities. Cost of anesthesia pain management was frequently proposed as a prohibitive factor.

Anesthesiology↗
PubMedDate not supplied

The economic evaluation of health care.

Economic evaluation is the comparative analysis of alternative courses of action in terms of both costs and consequences. Economic evaluation can also be called economic appraisal or the cost-benefit approach. The basis of economic evaluation lies in comparing costs and benefits of an intervention, program or service. The most important reasons for undertaking an economic evaluation are that resources (e.g., money, time, staff, equipment) are scarce compared with the demands made on them, and that such resource constraints require choices to be made. In this paper, four types of economic evaluations (cost-minimisation, cost-effectiveness, cost-utility and cost-benefit analyses) are described.

Australia↗
PubMedDate not supplied

Patients with genital warts: how are they managed by general practitioners?

This study was carried out to assess the management by general practitioners of patients with genital warts. An anonymized postal questionnaire was sent to 2060 general practitioners in the north west of England; 1260 (61.2%) completed questionnaires were returned. A total of 76.69% of GPs saw one or more cases per quarter. Of 468 (37.1%) GPs who managed patients in-house, 393 (83.9%) used podophyllin of concentration between 0.5 and 50%; 169 (43%) did not specify the podophyllin concentration and 112(23.9%) used podophyllotoxin. Of 395 GPs (31.3%) prescribing patient self-treatment, 259 (65.6%) prescribed podophyllin, but 60.23% did not specify the concentration; 134(33.9%) prescribed podophyllotoxin. Screening for selected sexually transmitted infections (STIs) was performed by 258/618 (41.7%) GPs. Only 74 (11.97%) screened for Chlamydia trachomatis and Neisseria gonorrhoeae and Trichomonas vaginalis. Partner notification was advised by 1138 (90.3%) and condom use by 1027 (81.5%). Only 333 (26.4%) referred all patients to GUM departments. Many GPs manage patients in-house, most using podophyllin solutions which vary in concentration, are non-standardized and potentially hazardous. Most GPs who instigate patient self-treatment prescribe podophyllin which is not licensed for this usage. Podophyllotoxin 0.5% is a safe, effective alternative. Few non-referring GPs screened for the 3 common STIs, thus putting patients at risk of complications such as pelvic inflammatory disease. Non-referral of patients with genital warts to GUM departments may have costly medical and financial consequences.

Condylomata Acuminata↗
PubMedDate not supplied

Incremental change in the Australian health care system.

Australia is similar to the United States in that it is a federation of states, its medical profession is well organized and politically powerful, and it has a substantial private sector. Unlike the United States, Australia provides universal access to health care and has controlled its total health care spending to around 8.5 percent of gross domestic product (GDP). This paper reviews the role of private health insurance and recent initiatives to support this; the strategies used to control costs in the fee-for-service sector; and the capacity for experimentation in health care financing within a national system that guarantees universal access.

Australia↗
PubMedDate not supplied

Giant lamellar bodies in a pulmonary MALT lymphoma: a case report with ultrastructural and immunohistochemical studies.

A 35-year-old, African-American man presented with a 7-year history of a persistent, enlarging pulmonary infiltrate in the right middle lobe associated with three episodes of right-sided pneumonia, recent 12-lb weight loss, and progressive shortness of breath. The nature of the right middle lobe infiltrate was unclear, but recurrent aspiration pneumonia and carcinoma of lung were important considerations. Exploratory thoracotomy with partial lobectomies revealed a low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). Clusters of giant lamellar bodies were a unique finding in this lymphoma. Results of ultrastructural and immunohistochemical studies gave support to the views that these inclusions were derived from both products of cellular degeneration and surfactant. The pulmonary lymphoma subsequently spread to the gastric mucosa. The patient is alive with lymphoma 5 years after the initial diagnosis was made.

Adult↗
PubMedDate not supplied

Heart rate evaluation of axillary and elbow crutches.

The aim of this study was to compare the possible effect on heart rate in patients with a walking disability using 11 different crutch designs. Eighteen patients, over the age of 18 years, who had used crutches for a minimum of 2 weeks before the study were divided into two groups: elbow and axillary crutch users respectively. The former tested six different designs of elbow crutches and the latter five different pairs of axillary crutches. Heart rate was recorded, using a portable digital pulse monitor during a 5-min walk on the level at self-selected velocities. Walking heart rates increased between 28.6 and 58.8% compared with the resting phase. No differences were found in either heart rate or walking speed between elbow crutches. However, a significant difference (p less than 0.001) in heart rate was noted between elbow crutch users who were non-weight bearing on their injured leg compared with those who were partial-weight bearing. The Canadian axillary crutch showed the lowest increase in heart rate at comparable walking speeds compared with other axillary crutches. Prescribers should be aware that the reduced energy requirements of the Canadian crutch would benefit patients with reduced cardiorespiratory function.

Adult↗
PubMedDate not supplied

Subcutaneous fluid administration and site maintenance.

As nurses working with older patients, the authors noticed a marked increase in the use of subcutaneous fluid administration as an alternative to the more traditional intravenous route, as a means of managing hydration in certain patients.

Aged↗
PubMedDate not supplied

The productive manager. Behaviors that encourage and release competence in the workplace.

Research has shown that three organizational conditions are necessary as environmental support for the encouragement and full release of human competence in the workplace: Collaboration, Commitment, and Creativity. Productive organizations have such supports to a significantly greater degree than do their unproductive matched counterparts. This article reports on the specific managerial behaviors necessary for creating those environmental conditions and the relationship of such managerial practices to both productivity and health in the workplace.

Administrative Personnel↗