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Biomedical subjects

J Hayes

Publications and source records attributed to J Hayes.

At least 73 records · Page 4Linked to original sources
PubMed1997

Side effects of adjuvant chemotherapy: perceptions of node-negative breast cancer patients.

Twenty-one node-negative breast cancer patients were interviewed shortly after completing adjuvant chemotherapy and asked about side effects they had experienced, expectation of side effects, and strategies for coping with the side effects. Eighteen of the women were interviewed 6 months later to determine their feelings about the chemotherapy experience and ending treatment and what side effects persisted or developed after chemotherapy. Hair loss, fatigue, treatment-related problems, nausea and infections/low blood counts were the most frequently described problems during the first interviews. Patients used coping strategies suggested by physicians and nurses. Six months later, hair problems, fatigue, weight gain, menopausal problems, emotional problems and nail problems were most often reported. Most patients (16/18) did not expect to be experiencing chemotherapy-related problems 6 months after ending treatment. Fatigue interfered with daily lives and weight gain caused concern. A total of 35% of participants experienced fear or anxiety at the end of chemotherapy, but most (62%) recalled at least some positive feelings 6 months later. Given the same circumstances, all but two would make the same decision to undergo adjuvant chemotherapy. Support groups would be especially useful for patients completing chemotherapy who would lose continued frequent support from clinic personnel.

Adaptation, Psychological↗
PubMed1997

Thermal equipment usage patterns in neonatal intensive care units: interunit variability and intraunit consistency.

We conducted a survey and audit of thermal equipment use in very low-birth-weight infants in five Ohio neonatal intensive care units (NICUs) to document regional practice. The survey indicated a variety of thermal care styles. Two NICUs preferred to admit infants to incubators, the other three favoring radiant warmers. These three NICUs moved infants from radiant warmers into incubators at significantly different mean ages. The audit demonstrated inconsistent use of plastic covers, warming mattresses, and added humidity under radiant warmers, and discrepancies between survey responses and actual use within NICUs. Inter-NICU variability of thermal equipment use may complicate fluid management.

Beds↗
PubMed1997

Assessment of fitness in patients with cystic fibrosis and mild lung disease.

BACKGROUND: Maximal exercise testing is used in patients with cystic fibrosis to assess functional status and prognosis. The lactate threshold is an index of aerobic fitness with significant advantages over maximal exercise tests. This study was undertaken to determine if the lactate threshold might be identified, non-invasively, in adult patients with cystic fibrosis and mild lung disease by measurement of ventilatory and gas exchange parameters. METHODS: Ten subjects with mild cystic fibrosis (forced vital capacity (FVC) > 70% predicted) and 10 healthy controls undertook an incremental exercise test on a bicycle ergometer. Ventilation and gas exchange parameters were measured continually and arterialised venous blood pH, carbon dioxide tension (PCO2), and lactate concentrations were measured at intervals throughout the tests. RESULTS: In subjects with cystic fibrosis there was no significant difference between the mean gas exchange and lactate thresholds (mean difference 1.0 (95% confidence interval (CI) of the mean -1.5 to 3.44) ml/kg/min). In contrast, there was a significant difference between the mean ventilatory and lactate thresholds (3.8 (95% CI 0.9 to 6.7) ml/kg/min). Arterialised venous PCO2 increased significantly during the exercise tests. In healthy subjects the mean differences between these thresholds were not significantly different from zero and PCO2 fell significantly during the tests. CONCLUSIONS: The ventilatory threshold significantly overestimates the lactate threshold in subjects with cystic fibrosis induced lung disease because of impaired carbon dioxide excretion during exercise. However, the gas exchange threshold may be used to determine the lactate threshold in this patient group.

Adult↗
PubMed1997

The checkpoint control for anaphase onset does not monitor excess numbers of spindle poles or bipolar spindle symmetry.

Exit from mitosis in animal cells is substantially delayed when spindle assembly is inhibited, spindle bipolarity is disrupted, or when a monopolar spindle is formed. These observations have led to the proposal that animal cells have a 'spindle assembly' checkpoint for the metaphase-anaphase transition that monitors bipolar spindle organization. However, the existence of such a checkpoint is uncertain because perturbations in spindle organization can produce unattached kinetochores, which by themselves are known to delay anaphase onset. In this study we have tested if cells monitor bipolar spindle organization, independent of kinetochore attachment, by analyzing the duration of mitosis in sea urchin zygotes and vertebrate somatic cells containing multipolar spindles in which all kinetochores are attached to spindle poles. We found that sea urchin zygotes containing tripolar or tetrapolar spindles progressed from nuclear envelope breakdown to anaphase onset with normal timing. We also found that the presence of supernumerary, unpaired spindle poles did not greatly prolong mitosis. Observation of untreated PtK1 cells that formed tripolar or tetrapolar spindles revealed that they progressed through mitosis, on average, at the normal rate. More importantly, the interval between the bipolar attachment of the last monooriented chromosome and anaphase onset was normal. Thus, neither of these cell types can detect the presence of gross aberrations in spindle architecture that inevitably lead to aneuploidy. We conclude that animal cells do not have a checkpoint for the metaphase-anaphase transition that monitors defects in spindle architecture independent of the checkpoint that monitors kinetochore attachment to the spindle. For dividing cells in which spindle microtubule assembly is not experimentally compromised, we propose that the completion of kinetochore attachment is the event which limits the time of the metaphase-anaphase transition.

Anaphase↗
PubMed1997

A protocol for telemedical consultation.

We have developed a protocol for telemedical consultations. This has been used by emergency nurse practitioners to consult doctors in a main hospital accident and emergency department, using videoconferencing at 384 kbit/s. A telemedical consultation should simulate a face-to-face one. The protocol starts with an explanation for the patient of what will happen, followed by the necessary introductions. After relaying the history, the generalist should show the abnormal part to the specialist. Attention should be paid to colour. Depth perception is often enhanced by rotating the camera through 180 degrees. The diagnosis and management, together with their implications, should be discussed with the patient by the specialist. Referral and follow-up should also be discussed. Proper clinical record-keeping is essential. In the first 15 months of using the protocol, we completed more than 300 teleconsultations. An analysis of the first 50 teleconsultations showed that about half were for discussing a radiograph and about half were for examining a patient.

Clinical Protocols↗
PubMed1997

Providing information about breast cancer via public forums.

This study examines whether persons who attended a breast cancer education summit or received written materials (i) exhibited improved knowledge about breast cancer; and (ii) used the information themselves, share it with others, or implemented community education/screening programs. Participants (92 lay persons, 67 health professionals who attended; 44 who did not attend but received written materials) were primarily female, with a mean age of 47. They completed a 10-item knowledge questionnaire on four occasions (pre-conference, immediately post-conference, 9 weeks, 6 months). On the third and fourth occasion, participants also were asked how they had used the information. Paired samples t tests revealed that lay individuals (p < 0.001) and health professionals (p < 0.001) exhibited improved knowledge of breast cancer after attending the conference, used the information in their personal health care, and shared it with others, and some implemented education and screening programs. Of nonattendees, only the health professional group retained knowledge gain over time. A conference can produce increased knowledge about breast cancer and stimulate attendees to use information for themselves and share it with others. For lay persons, conference attendance is superior (p < 0.01) to written materials alone, in achieving long-term gain in knowledge.

Age Factors↗
PubMed1996

An asymmetric model for the nucleosome: a binding site for linker histones inside the DNA gyres.

Histone-DNA contacts within a nucleosome influence the function of trans-acting factors and the molecular machines required to activate the transcription process. The internal architecture of a positioned nucleosome has now been probed with the use of photoactivatable cross-linking reagents to determine the placement of histones along the DNA molecule. A model for the nucleosome is proposed in which the winged-helix domain of the linker histone is asymmetrically located inside the gyres of DNA that also wrap around the core histones. This domain extends the path of the protein superhelix to one side of the core particle.

Animals↗
PubMed1996

Isoetharine versus albuterol for acute asthma: greater immediate effect, but more side effects.

PURPOSE: To compare the magnitudes of the immediate effects of the nebulized beta-agonists isoetharine and albuterol in the treatment of acute severe asthma. PATIENTS AND METHODS: Fifty-one adults presenting with severe asthma exacerbations (forced expiratory volumes in the first second of exhalation [FEV1] <40% of predicted) to the emergency department were randomized (double-blind) to receive hourly inhaled nebulization treatment with either isoetharine (5 mg) or albuterol (2.5 mg). The FEV1 was measured immediately before and after each nebulized treatment. Any side effects were recorded. RESULTS: Immediately after the first nebulized treatment, the isoetharine group improved its mean FEV1 (+/-SEM) by a significantly greater amount than did the albuterol group: 60% +/- 11% versus 39% +/- 5%, respectively (P <0.05). One hour later the mean FEV1 were equivalent. This pattern repeated itself after the second hourly treatment. The two groups did not differ in any outcome parameters (FEV1 at discharge, number of nebulized treatments required, the number of inpatient admissions, number of clinical relapses after discharge). More patients treated with isoetharine had side effects (36% versus 4% for albuterol, P <0.01), 1 of whom required discontinuation from the study. CONCLUSIONS: Both medications were equally effective in alleviating bronchospasm. The immediate effect of isoetharine was significantly greater, but equalized that of albuterol within an hour after treatment. There were more side effects with isoetharine.

Acute Disease↗
PubMed1996

Shunt infections in children: presentation and management.

Since the earliest attempt at surgical management of hydrocephalus, infection has been a significant complication. For better assessment and care the neuroscience nurse needs to be aware of the signs and management of this condition. A retrospective review of 68 infections in 61 children was undertaken. Results showed an increased incidence of infection in the first nine months after surgery. Gram positive organisms (Staphylococcus epidermidis and Staphylococcus aureus) were most frequent; Propionobacter acnes was a significant pathogen in adolescence. Presenting symptoms included fever (26%), abdominal pain (19%), wound changes (22%) and indicators of shunt malfunction (33%). Elevated white blood cells (WBCs) in spinal fluid from shunt tap and positive cultures were most reliable laboratory data. Culturing of causative organism was sometimes difficult. A value regulated system for ventricular drainage which allows greater mobility for the patient is described.

Algorithms↗
PubMed1996

Continuous vs intermittent albuterol, at high and low doses, in the treatment of severe acute asthma in adults.

Adult patients suffering from acute asthma presenting to the Emergency Department with an FEV1 of less than 40% of predicted were randomized into four treatment groups. They were treated with nebulized albuterol at a high (7.5 mg) or standard (2.5 mg) dose given either continuously through 1 h, or intermittently every hour, for 2 h. When the FEV1 improvements for the different groups at 2 h were compared, the groups treated with continuous nebulization had the greatest improvement. The improvements (1.07 L for the high-dose group, and 1.02 L for the standard-dose group) were significantly greater than the improvement seen with standard-dose intermittent treatment (0.72 L; p < 0.05). The improvement in FEV1 of the high-dose, hourly treated group was intermediate in magnitude between these (0.09 L). There was no difference in the improvement seen between the two groups treated with continuous nebulization. The potassium fall, present in all groups, was more pronounced in the groups treated with high doses of albuterol. Only one person (high dose, continuous treatment group) developed hypokalemia of less than 3.0 mmol/L. The high-dose hourly treated group had the highest incidence of side effects, and the standard-dose continuously treated group had the lowest. The standard-dose continuous-treatment regimen had the greatest improvement in FEV1 with the least number of side effects.

Acute Disease↗
PubMed1996

Insecticide susceptibility of Aedes aegypti and Aedes albopictus in the Lower Rio Grande Valley of Texas and Mexico.

In response to a potential dengue fever outbreak in south Texas during 1995, the susceptibilities of Aedes aegypti and Aedes albopictus to commonly used mosquito adulticides were assessed. Larvae collected from the Lower Rio Grande Valley of Texas and Mexico were reared to adults and tested against susceptible laboratory strains at Texas A&M University. Resistance ratios at both the LC50 and LC95 rates were all less than 10, indicating that adult populations of both species are still susceptible to malathion, chlorpyrifos, resmethrin, and permethrin.

Aedes↗
PubMed1995

Vitamin D receptor gene polymorphism, bone mass, body size, and vitamin D receptor density.

We determined vitamin D receptor (VDR) gene alleles (based on the BsmI restriction site polymorphism), duodenal mucosal receptor density, bone mass at spine and total body, and body size in 32 healthy premenopausal females. While we found no relationship between allele and receptor density in duodenal mucosa, bone mineral content (BMC) at both spine and total body was significantly associated with VDR gene alleles. BMC was highest for the bb allele, lowest for BB, and intermediate for Bb. A similar association was noted between allele and body size variables, particularly weight. When BMC was adjusted for body weight, the association with VDR polymorphism disappeared. The VDR gene polymorphism may be affecting bone mass not through classical nutritional mechanisms (e.g., intestinal calcium absorption), but through an influence on body size.

Adult↗
PubMed1995

Nonlinearity of heart rate in the neonate.

The relationship between heart rate variability and level of illness was examined. Fifteen patients (10 male and 5 female), gestational ages 25 to 42 weeks, postnatal ages 1 to 42 days, birthweights 545 to 4375 g receiving care in the neonatal intensive care nursery were randomly selected. Data from each infant was transferred from the bedside physiologic monitor to a microcomputer for analysis. A severity of illness index (the Children's Hospital Illness Score [CHILLS]) correlated with heart rate variability. Four patterns of heart rate variability were identified: (1) infants whose CHILLS score indicated that they were cardiovascularly normal demonstrated a modest amount of variability; (2) infants with a CHILLS score indicating a moderate amount of illness had heart rates and heart rate variability greater than the normal infants; (3) three infants exhibited bimodality (period doubling) in their heart rates; each of these infants had a CHILLS score that indicated that they were less ill than the most critically ill patients, but sicker than those moderately ill infants without period doubling; and (4) heart rate decreased in the most critically ill infants identified by the CHILLS, but it remained above the heart rate of a healthy newborn; heart rate variability collapsed below that of a healthy newborn. Our data suggest that the variability of heart rate may increase as an infant becomes sicker. When the infant becomes critically ill and unstable, heart rate variability is less than the normal infant. Nonlinear dynamics theory may be a potential model for fitting the data.

Birth Weight↗
PubMed1995

Patient satisfaction with teleoncology: a pilot study.

OBJECTIVE: To assess levels of satisfaction among rural cancer patients being seen for clinic visits by their remote university-based oncologist, using interactive videoconferencing (IAVC). METHODS: A 12-item survey instrument assessing satisfaction with the patient-physician clinical interaction was administered to 39 cancer patients who were seen using IAVC. A similar survey, comprised of 9 of the 12 items used in the initial survey, was administered to 21 of these patients after a subsequent on-site clinical interaction. All items were responded to on a five-point Likert scale. Levels of satisfaction with the two consultation modes (IAVC mediated and on-site) were compared. RESULTS: Relatively high levels of patient satisfaction with the telemedicine encounter were recorded both at the time of the initial IAVC-mediated clinical visit, as well at the follow-up on-site visit. With one exception, for each of the survey items, both initially and on follow-up, mean score was above 3.0 (i.e., positive). CONCLUSION: This small pilot study suggests that rural cancer patients may be satisfied with seeing their oncologist via telemedicine, at least on an occasional basis. Although the accrual numbers are too small to allow the results to be generalizable, the results suggest that patient acceptance is high enough to warrant further investigation of this modality in the care of rural cancer patients with limited access to cancer specialists.

Aged↗