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Biomedical subjects

J J Downes

Publications and source records attributed to J J Downes.

10 recordsLinked to original sources

Preserved implicit memory for lexical information in Alzheimer's disease.

Recent studies have suggested that there is a specific impairment of implicit memory for lexical priming in Alzheimer's Disease. However, there are problems in accepting data from the word-stem completion paradigm as evidence of pure implicit-memory performance. To assess whether Alzheimer's Disease patients are relatively impaired on implicit memory for lexical information an anagram-solution task was adopted. A group of 16 early stage Alzheimer's Disease patients and a group of 16 normal elderly subjects were presented a list of 40 target words. Subsequent free recall was significantly poorer in the former group, but while both groups were significantly better at solving anagrams for words they had previously seen, there was no difference between the two groups in the amount of priming. The data are consistent with the view that previous reports of an implicit deficit in Alzheimer's Disease may not generalise to implicit tasks independent of explicit-memory performance.

Aged

The historical evolution, current status, and prospective development of pediatric critical care.

This article describes the multiple historic origins of pediatric critical care medicine and the evolution of the subspecialty, from the late 1950s with the first units dedicated to the care of critically ill and injured infants and children, to the present status as a recognized medical subspecialty. Also discussed are current major issues and future challenges that flow from both this historic background and a commitment to critically ill children. Presented are specific considerations for physicians in this subspecialty to address as they plan for the future.

Anesthesiology

Optimum levels of CPAP for tracheal extubation of newborn infants.

Arterial oxygen tension and functional residual capacity were studied in 16 intubated, spontaneously breathing newborn infants recovering from respiratory disease. Studies were made at 2 cm H2O continuous positive airway pressure, at zero end expiratory pressure, and following extubation. The study showed that PaO2 and FRC at 2 cm H2O CPAP were the same as observed following extubation, but that both values were significantly lower at ZEEP.

Humans

The therapeutic application of end-expiratory pressure in the meconium aspiration syndrome.

The effectiveness of end-expiratory pressure (EEP) in relieving hypoxemia in the meconium aspiration syndrome (MAS) was studied in 14 patients with the disorder. These infants demonstrated a direct, mean PO2 response of 12 torr/cm H2O EEP. A maximum PO2 response was observed in an EEP range of 4 to 7 cm H2O. EEP was equally effective whether patients were breathing spontaneously or were being mechanically ventilated. EEP is useful in the treatment of hypoxemia in the infants with meconium aspiration syndrome.

Blood Gas Analysis

The PaO2 response to changes in end expiratory pressure in the newborn respiratory distress syndrome.

To quantitate the effect of changes in end-expiratory pressure (EEP) upon PaO2 in infants with the respiratory distress syndrome, arterial blood gas (ABG) data was reviewed in 28 neonates. A total of 94 ABG specimen pairs were analyzed (specimen I taken before EEP adjustment; specimen II taken after EEP change). An overall change in PaO2 of 15 torr was noted per cm H2O change in EEP. Patients in whom the level of EEP was low (0-3 cm H2O) at the time of Sample I had a greater change in PaO2 (p less than 0.01) than infants whose Sample I ABG was taken at mid-range of EEP (4-6 cm H2O) or at high ranges (7-12 cm H2O). At the high ranges of EEP a minimal and variable PaO2 response was observed. The PaO2 response was not statistically different between neonates on controlled ventilation and those breathing spontaneously. Survivors had a greater PaO2 response than did nonsurvivors, but because of the variables affecting respiratory distress syndrome (RDS) patients, it could not be determined if this PaO2 response had a prognostic value. From this data, the clinician is provided with a guide to the expected PaO2 response when a change in EEP is made.

Humans