Biomedical subjects
Publications and source records attributed to J Hendricks.
Continuing from the previous issue, this paper discusses the process of developing the content of new courses under the umbrella of the Graduate Diploma/Masters in Emergency Care Nursing offered at Griffith University Gold Coast, Australia. Part 2 of this paper includes information on course structure, implementation, content, assessing methods and competences and the logistics of the course.
Conceptual development in social gerontology is overdue for infusions of innovative thinking. To date, theorizing has evolved in dialectical fashion from an emphasis on individual adaptation, to structural constraints, to interactive processes. Fruitful as these efforts have been, they have not adequately addressed issues of cross-cultural and subcultural diversity, heterogeneity, and nonlinear change. Also, much of what has been taken to be life-course development may be grounded in occupational trajectories. The discussion here sets the stage for a fuller explication of some of these issues, and, it is hoped, will point the way toward further innovative conceptual development in the field.
Fibro-osseous pseudotumor of the digit is an unusual cutaneous process characterized histologically by a fibroblastic proliferation admixed with reactive/metaplastic osteoid formation. The osteoid formation can be florid and immature, mimicking the appearance of malignant osteoid-forming neoplasms. Fibro-osseous pseudotumor of the digit has histologic and clinical features in common with myositis ossificans. This has led many to consider the two to be synonymous. We studied three cases of fibro-osseous pseudotumor, compared to five cases of myositis ossificans, using routine light microscopy and a battery of immunohistochemical stains. Both entities displayed a "zoning" pattern of immature spindled areas admixed with more mature areas having osteoid metaplasia. This was more pronounced in myositis ossificans. In each lesion, the spindle cells stained positively for vimentin and actin. CD34 and Factor VIII highlighted the vasculature. No stromal staining for MAK-6 (cytokeratin) or S-100 was identified. Ki-67, a proliferation marker, showed positive staining of the stromal cells in both lesions, which was strongest in the immature spindled areas. The immunohistochemical and histologic similarities of the lesions support fibro-osseous pseudotumor of the digit being a cutaneous variant of myositis ossificans.
Epidemiological and experimental evidence indicates a strong relationship between diet and cancer. The purpose of this study was to examine the potential of chlorophyllin (CHL), a food-grade derivative of the ubiquitous green plant pigment chlorophyll, to inhibit experimental carcinogenesis. We report that CHL is a potent, dose-responsive inhibitor of aflatoxin B1 DNA adduction and hepatocarcinogenesis in the rainbow trout model when fed with carcinogen. CHL neither promoted nor suppressed carcinogenesis with chronic postinitiation feeding. By molecular dosimetry analysis, reduced aflatoxin B1-DNA adduction accounted quantitatively for reduced tumor response up to 2000 ppm dietary CHL, but an additional protective mechanism was operative at 4000 ppm CHL. The finding of potent inhibition (up to 77%) at CHL levels well within the chlorophyll content of some green leafy vegetables may have important implications in intervention and dietary management of human cancer risks.
The purposes of this study were to determine: (1) the prevalence of psychoactive medication and alcohol use and (2) the relationship among psychoactive medications, alcohol use, and falls in a sample of 1028 independently living women and men, aged 55 and older. Twenty-six percent of the sample reported falling, 28% were taking one or more psychoactive drugs, and 38% drank alcohol during the past year. Analyses with logistic regression indicate that predictors of falls were psychoactive drug use, age, and number of illnesses. Living alone, frequency of alcohol use, and gender were not significant predictors.
Neutrophil accumulation and free radical release are implicated in the genesis of reperfusion injury. However, little is known about the changes in myocardial lipid peroxidation and antioxidant activity in relation to coronary artery thrombosis and thrombolysis. To investigate this issue, 18 dogs with electrically induced occlusive thrombus in the left anterior descending (LAD) coronary artery were given tissue-type plasminogen activator (TPA). Sustained reflow (lasting > 120 min) occurred in 4 dogs, reocclusion after initial thrombolysis (transient reflow, duration of reflow 5 to 25 min) occurred in 7 dogs, and no reperfusion was evident in 7 dogs. Myocardial neutrophil infiltration was determined by measuring myeloperoxidase (MPO) activity, lipid peroxidation by malondialdehyde (MDA) levels and antioxidant activity by superoxide dismutase (SOD) activity in the myocardial regions supplied by the nonischemic left circumflex (Cx) and the ischemic LAD coronary arteries. In dogs with ischemia alone (no reperfusion), MPO activity and MDA levels in the LAD-supplied myocardium were modestly higher and SOD activity modestly lower than in the corresponding Cx-supplied myocardium. In dogs with sustained reperfusion there was a marked increase in MPO and MDA and a marked reduction in SOD activity in the reperfused myocardium. The MPO and MDA values in the myocardium of dogs with transient reperfusion, although much higher than the corresponding normal myocardial values, were less marked than in the myocardium of dogs with sustained reperfusion, and the SOD activity was preserved in the transiently reperfused regions. Myocardial shortening fraction in the LAD region was worse in dogs with sustained reperfusion than in those with sustained ischemia or transient reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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The term nursing diagnosis is constructed in male, medical language. As such, it is proposed that it has no legitimacy in nursing discourse as it is antithetical to notions claimed foremost in nursing's ontology. It is also posited that the term 'nursing diagnosis', whilst reinforcing biomedicine, has little or no meaning to many nurses, is not understood by patients and has no justifiable place in health care discourse.
BACKGROUND: bcl-2 protein encoded by the proto-oncogene bcl-2 confers to the cell a survival advantage by inhibiting apoptosis. Its aberrant expression has been reported in lymphomas and lung carcinoma. To determine if bcl-2 plays a role in the gastric carcinogenic sequence, the authors studied bcl-2 expression in gastric epithelial dysplasia (GED) and chronic atrophic gastritis with intestinal metaplasia (CAG-IM). METHODS: Immunohistochemical staining using monoclonal bcl-2 protein antibody, clone 124, was performed on archival material. RESULTS: bcl-2 staining was seen in 13 of 16 GEDs (81%). The staining was heterogeneous, suggesting that within the dysplastic epithelium, some cellular clones may have a survival advantage. When noted, the staining in IM was located in the proliferative zone, but some positivity could also be noted higher up along the cellular escalator. Normal gastric mucosa stained in the proliferative zone. CONCLUSIONS: The authors demonstrated that bcl-2 expression is noted in GED as well as in the extended proliferative zone of CAG-IM. This suggests that prolonged cell survival due to inhibition of apoptosis is instrumental in addition to increased cellular proliferation in the altered cellular homeostasis of the gastric carcinogenic sequence. Whether bcl-2 protein aberrant expression is an independent process or inherent to immaturity of the cells produced by the increased proliferation awaits further studies.
OBJECTIVE: Diminished coronary flow reserve and myocardial dysfunction following coronary artery occlusion and reperfusion have been attributed to neutrophil infiltration into the reperfused regions. Release of free radicals and elastase during reperfusion may also contribute to ischaemia-reperfusion induced changes. The aim of this study was to determine the effect of an elastase inhibitor on reperfusion induced attenuated coronary flow reserve and myocardial dysfunction. METHODS: Anaesthetised dogs were subjected to 1 h of left anterior descending coronary artery occlusion and 2 h of reperfusion. Ten minutes before reperfusion, dogs were randomly given saline or the neutrophil elastase inhibitor ICI 200,880 (10 mg.kg-1) and treatment was continued for the next 70 min. While the regional myocardial shortening fraction and coronary blood flow responses to acetylcholine and glyceryl trinitrate were attenuated following coronary reperfusion in saline treated dogs, similar reductions were not observed in the ICI 200,880 treated dogs (p < 0.01). Histopathology showed myocardial injury and extensive neutrophil infiltration in the reperfused regions in saline treated animals. In contrast, neutrophil infiltration was minimal in the ICI 200,880 treated dogs, in spite of myocardial injury. Myeloperoxidase, an index of neutrophil infiltration, was increased (p < 0.02 v control regions) in the reperfused regions in saline treated dogs, but not in the ICI 200,880 treated dogs. Flow cytometry also showed diminished neutrophil infiltration and oxidative burst in reperfused myocardium of ICI 200,880 treated (v saline treated) dogs. CONCLUSIONS: The elastase inhibitor ICI 200,880 protects against ischaemia-reperfusion induced attenuated coronary flow reserve and myocardial dysfunction, and this protective effect is associated with decreased neutrophil infiltration into the reperfused regions.
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Proliferating trichilemmal cyst (PTC) is an uncommon tumor that usually arises on the scalp of elderly women. Its biologic nature is that of a benign lesion with occasional local recurrences. PTC can be confused both grossly and microscopically with squamous cell carcinoma and malignant PTC. Distinction between these lesions has historically been made on a histologic basis. We present four cases of PTC. Histologically, the lesions consisted of lobules of basaloid cells admixed with larger pale-staining cells with abrupt trichilemmal type of keratinization and peripheral palisading embedded in a fibrous stroma. Flow cytometry performed on nuclear extracts of the lesions revealed two of the four lesions to have nondiploid DNA content. Proliferation index, measured by immunohistochemical staining with Ki-67 monoclonal antibody along with mitotic rate count, was higher in the two nondiploid lesions as compared with their diploid counterparts. The results raise the question of the significance of aneuploidy and increased proliferation indices in otherwise benign PTC.
A prospective, randomized trial of inpatient vs. outpatient bowel preparation for elective colorectal surgery was performed in 100 consecutive patients. Bowel preparation was standardized for both groups and consisted of 4 liters of Colyte (Reed & Carnrick, Piscataway, NJ) and oral neomycin and Flagyl (G. D. Searle & Co., Skokie, IL) the day before surgery. Patients were randomized into four subcategories: ileocolostomy, colocolostomy, abdominal perineal resection, and other. Tap water enemas were administered on the morning of surgery to ensure and adequate mechanical preparation. Ninety-six percent of the inpatient group and 97 percent of the outpatient group were able to drink three-fourths or more of the oral lavage preparation (P = 0.789, Fisher's exact text). A mean of 2.26 tap water enemas was required to achieve clear returns for the inpatient group, compared with 2.28 tap water enemas for the outpatient group (P = 0.221, Fisher's exact test). The adequacy of the bowel preparation as graded by the primary surgeon was good (84 percent), fair (12 percent), and poor (4 percent) in the outpatient group (P = 0.673, Fisher's exact test). Wound infection developed in 4 percent of the inpatient group and 4 percent of the outpatient group (P = 1.0, Fisher's exact test). Anastomotic leak of intra-abdominal abscess was seen in one patient in each group (P = 1.0, Fisher's exact test). We conclude that outpatient bowel preparation is as effective as inpatient bowel preparation for elective colorectal surgery and offers the advantage of cost savings and shorter hospitalization.
Rainbow trout respond to a range of natural and synthetic dietary tumor modulators. Observed modulations of final tumor incidence include inhibition, promotion and cocarcinogenesis, depending on modulator, carcinogen, target organ, and relative order of carcinogen and modulator exposure. Despite several obvious limitations (e.g. lung, colon, mammary gland, bladder are not available as target organs), the trout model possesses several important features that have made it valuable for tumor modulation studies. (1) The comparative advantage. Since rodents are not perfect human surrogates, studies with alternative vertebrates such as trout have provided important comparative mechanism information for confident extrapolation of animal studies to humans. For example, beta-naphthoflavone appears to inhibit aflatoxin B1 hepatocarcinogenicity by species-independent mechanisms that readily extrapolate to humans. By contrast other modulators, including butylated hydroxyanisole, inhibit aflatoxin B1 hepatocarcinogenesis in rats by an enabling mechanism shown to be absent in trout, namely the induction of an aflatoxin B1-specific glutathione S-transferase isozyme. Interestingly, evidence is presently lacking that this determinant mechanism would be operative in humans. (2) The sensitivity advantage. Trout sensitivity and small body size at exposure have permitted tumor studies with carcinogens and HPLC-purified anticarcinogen intermediates too scarce to study in rodents. (3) The low cost advantage. The very low cost of trout tumor studies has enabled statistically challenging issues in molecular dosimetry, dose-response, and risk-benefit analysis to be addressed using as many as 9600 animals per tumor study at modest budget. In particular, these designs provide modulator-mediated alterations in precisely determined carcinogen TD50 values, rather than changes in simple tumor incidence, to quantify more rigorously modulator potencies for tumor inhibition or promotion as a function of dietary concentrations.
Acute cholecystitis, morbid obesity, and previous upper abdominal surgery have been reported as relative contraindications to laparoscopic cholecystectomy. An analysis of 706 laparoscopic cholecystectomies performed at our institution was undertaken to determine if these relative contraindications led to increased morbidity, an increased rate of conversion to the open technique, or longer operating time. One hundred ninety-seven patients demonstrated one or more relative contraindications to laparoscopic cholecystectomy. Morbidity was not increased in patients with these risk factors, but conversion to open cholecystectomy was required in a greater percentage of patients with acute cholecystitis. We favor an attempt at laparoscopic cholecystectomy in patients with these risk factors; however, they should be counseled as to the increased risk of conversion to open cholecystectomy in the presence of acute cholecystitis.
The process of theorizing, creating theoretical explanations, and disseminating theoretical perspectives is most frequently discussed in terms of disembodied ideas. A more insightful rendering of how theory is used in the sociology of aging literature would attend to the real individuals who promulgate the ideas. Looking at theorizing as a career-related activity engaged in by scholars who are prone to the same demographic imperatives as other human beings is a way of shedding more light on the many uses of theory. The concept of theoretical generations is utilized as a means of accounting for the succession of models and explanatory frameworks.
A conceptual framework for empowerment of the elderly is proposed, using variations on Gramsci's hegemony and Thompson's moral economy to complement recent political economic and social psychological theories. The political economy and social psychology of aging highlight structural constraints and actors' reactions without articulating a model for empowerment. Gramsci's idea of hegemony as new moral and philosophical leadership calls for principles of social and economic organization deserving assent because they maximize people's chances for a decent life at all ages. Hegemony, as normalizing dominance, reveals ways in which the elderly may be disempowered as well as possibilities for intervention. Underlying diverse forms of hegemony are economic arrangements and an array of cultural norms. In contrast to Thompson, the authors argue that norms implicit in moral economy vary with changes in social context. In the process, two ideal types of moral economy are elaborated, grounded in exchange value and use value, respectively. Empowerment may be found through a moral economy grounded in use value appropriate to advanced industrial society that is consonant with Gramsci's new hegemony. Implications for health and income maintenance policies are explored.