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Biomedical subjects

J L Anderson

Publications and source records attributed to J L Anderson.

At least 307 records · Page 17Linked to original sources
PubMed1983

Observed differences between direct, indirect, and direct/indirect videotaped supervisory conferences.

The purpose of the study was to determine whether supervisors and supervisees were able to observe differences in supervisory styles and whether or not the subjects' experience levels were related to the differences they observed. It investigated whether speech-language pathology supervisors, graduate student clinicians, and undergraduates rated differently their observations of direct, indirect, and direct/indirect supervisory behaviors in videotaped supervisory conferences. A modification of Smith's Individual Supervisory Conference Rating Scale served as the dependent measure. Under counterbalanced conditions, 30 supervisors, 30 graduates, and 30 undergraduates from six different universities each viewed one of the three videotapes and rated the level of occurrence of direct and indirect supervisory behaviors. Factor analysis results indicated that 14 of the 18 rating scale items could be used reliably to assess direct and indirect supervisory behaviors in the videotaped conferences. ANOVA results demonstrated that regardless of level of experience, subjects did observe differences between the direct, indirect, and direct/indirect conferences. Results of Tukey tests demonstrated that the direct conference observers' mean score accounted for the significant conference-style main effect 75% of the time.

Audiology↗
PubMed1983

Profound arterial hypotension in dogs: brain electrical activity and organ integrity.

To determine whether non-invasive measurement of brain electrical activity can predict ischemic brain damage, we recorded the electroencephalogram (EEG) and somatosensory- (SEP) and auditory- (AEP) evoked potentials before, during, and after trimethaphan-induced profound arterial hypotension in dogs. The authors set out to compare the change in electrical activity with the degree of brain damage, as determined by microscopic examination. Dogs were anesthetized with halothane (1.4 vol % inspired), maintained horizontal (head at the level of the heart), and ventilated mechanically (FIO2 0.50); deviations from normal acid-base status were corrected. Twenty animals received a 1.5-mg/kg intravenous bolus of trimethaphan. Three animals were resistant to the drug. The remaining animals had profound hypotension [mean arterial blood pressure (MABP) at some steady level between 12 and 25 mmHg] for 1 h. Eight of these animals died during or soon after the hypotensive period as a consequence of cardiac arrest (three), intestinal bleeding (three) or unknown causes (two). In all survivors, EEG intensity and the amplitude of the SEP decreased during hypotension; both variables recovered with restoration of MABP. All nine animals surviving hypotension had no apparent neurologic or behavioral deficit nor any histologic evidence of ischemic brain cell injury. We were thus unable to find a MABP threshold for brain with minimal brain injury. Our findings suggest, under the conditions of our experiments, a great margin of tolerance for profound hypotension by the brain in this species. Other organ systems--the heart, gastrointestinal tract, and liver--proved to be more susceptible to ischemic damage. Eight of the nine surviving animals had elevations in serum alanine transaminase (SGPT), aspartate transaminase (SGOT), and alkaline phosphatase. Animals with the greatest increases in these enzymes showed centrilobular hepatocyte degeneration.

Animals↗
PubMed1982

Deficient natural killer cell activity in patients with idiopathic dilated cardiomyopathy.

Dilated (congestive) cardiomyopathy is a disease of uncertain aetiology in which viral and immune factors are postulated to be of importance. Natural killer cells mediate natural resistance to viral infections and certain tumours. To evaluate natural killer (NK) activity in patients with cardiomyopathy, circulating peripheral blood mononuclear cells were obtained from 16 patients, from 54 normal blood donors, and from 14 patients with heart failure due to other causes (primarily coronary disease). NK activity was assessed as a lymphocyte to target cell ratio causing 50% killing (L/T50). L/T50 in normals was 17.2 +/- 11.4. A normal L/T50 distribution was also noted in heart failure controls (L/T50 = 19.6 +/- 9.9) and 8/16 cardiomyopathy patients (L/T50 = 17.5 +/- 9.5). NK activity was deficient (L/T50 greater than or equal to 50) in 8/16 patients with cardiomyopathy but in only 2/54 normals (p less than 0.001) and 0/14 heart failure controls (p less than 0.01). Of the several clinical and laboratory variables examined, only the frequency of the HLA-A3 tissue type was associated with NK deficiency. NK deficiency is an independent disease marker in about 50% of patients with cardiomyopathy and should be evaluated for a possible role in its pathogenesis.

Adult↗
PubMed1982

Long-term intravenous infusion of antiarrhythmic drugs using a totally implanted drug delivery system.

In vitro and in vivo testing was performed to establish the feasibility of a totally implantable pump system to deliver antiarrhythmic agents. In vitro flow characteristics suggested predictable day to day delivery with acceptably small variations in flow with changes in reservoir volume or temperature. During 3 months of in vitro testing, procainamide and bretylium were found suitable for long-term delivery. Delivery of lidocaine was limited by high viscosity and corrosion of steel elements within the pump. The pump was implanted in a subcutaneous pocket in four dogs. Procainamide (0.5 g/ml), delivered at 4 ml/day (70 mg/kg body weight per day), provided a mean steady state drug concentration of 5.3 micrograms/ml. Bretylium (50 mg/ml), delivered at 8 ml/day (13 mg/kg per day), provided a steady state concentration of 0.8 micrograms/ml (range 0.4 to 1.4). Long-term intravenous administration of therapeutic doses of bretylium and procainamide with this delivery system has been demonstrated in dogs and appears to be feasible in human subjects.

Animals↗
PubMed1982

Development and validation of an individual supervisory conference rating scale for use in speech-language pathology.

An Individual Supervisory Conference Rating Scale (ISCRS) was developed and validated to provide a conference rating instrument for researchers, supervisors, and supervisees in speech-language pathology. Procedures to determine both reliability and validity of the scale were implemented throughout the development process. Direct and indirect supervisory behaviors were identified as factors indicative of effective individual supervisory conferences by experts, trained raters, supervisors, and supervisees. Though these two major factors perceived as indicators of effectiveness remained consistent across groups rating the conferences, perceptions of those factors varied depending on the group rating the conference interactions. Ratings of the factors were strongly related for experts and trained raters; however, ratings for supervisees showed little or no relationship to the ratings of any of the other three groups. The Individual Supervisory Conference Rating Scale is suggested for use in research, supervisor self-analysis, and supervisor/supervisee joint analyses to measure perceptions of conference interactions and to determine perceived effectiveness.

Attitude of Health Personnel↗
PubMed1982

Relationship of perceived effectiveness to verbal interaction/content variables in supervisory conferences in speech-language pathology.

This study investigated the individual supervisory conference in speech-language pathology. The purpose was to determine the relationship between those factors in conference behavior perceived to be effective and the verbal interaction/content variables of the conference, isolating the variables most important for further conference analysis and research. An Individual Supervisory Conference Rating Scale (ISCRS) and portions of Weller's MOSAICS analysis system were used in conference analysis. Factors in conferences which were consistently perceived to be indicators of effectiveness by supervisor-supervisee pairs and trained raters who had completed the ISCRS were direct and indirect behaviors. These two factors correlated frequently and significantly to 21 of the 42 conference verbal interaction/content variables coded using portions of Weller's MOSAICS. Verbal interaction/content variables of particular importance were the sequence of questions and answers; discussion of ideas expressed in both the cognitive and affective domain; and whether discussion focused on analyzing, evaluating, diagnosing, and prescribing behavior. The use of complex or simple statements and questions also was related to perceived effectiveness. The two perceived effectiveness factors identified, as well as the verbal interaction/content variables isolated, appear to be the most critical variables to investigate or manipulate in future supervisory conference research.

Affect↗
PubMed1982

Evaluation of a practical approach to teaching about communication with terminal cancer patients.

Teaching about communication between doctors and terminal cancer patients is problematic. A practical model that requires individual student problem-solving and group discussion with minimal staff involvement has been described. An evaluation showed that this model was effective in exposing students to different points of view, could result in changes in behaviour and was found to be interesting by the majority of students.

Behavioral Sciences↗
PubMed1982

High-dose doxorubicin: an exploration of the dose-response curve in human neoplasia.

Twenty-seven patients with advanced solid tumors (ten with lung cancer, eight with sarcoma, five with melanoma, four with miscellaneous tumors) were treated with high-dose doxorubicin (120 mg/m2) every 3 weeks for a total of 75 courses. As expected, marked myelosuppression was observed, with all patients having a granulocyte count nadir of less than 500 cells/mm3. The median platelet count nadir was 91 X 10(3)/mm3 following the first cycle and 50 X 10(3)/mm3 following the fourth cycle. Moderate or severe stomatitis was seen with 65% of the courses, and 46% of the courses were complicated by fever greater than 101 degrees F. Congestive heart failure was observed in only one patient after five cycles (600 mg/m2) of high-dose therapy. This patient has received 540 mg/m2 of doxorubicin 2 years previously. Radionuclide ventriculography (MUGA) performed serially in 12 patients (eight of whom received 480 mg/m2) and clinical evaluation did not suggest an increased risk of cardiotoxicity at this dose rate. Overall, 11 of 24 (46%) evaluable patients responded (58% if patients with malignant melanoma are excluded). Responses included one complete and three partial responses in eight evaluable patients with lung cancer, one complete and two partial responses in seven evaluable patients with sarcoma, and no objective responses in five patients with malignant melanoma. With appropriate supportive care, repetitive courses of doxorubicin at a dose of 120 mg/m2 can be given to patients of good performance status without a major increase in cardiotoxicity. However, the low complete remission rate, considering the observed toxicity, does not justify routine use of this regimen in patients with solid tumors.

Adult↗
PubMed1981

Oral flecainide acetate for the treatment of ventricular arrhythmias.

The antiarrhythmic efficacy and safety of oral flecainide acetate were assessed during a controlled, short-term dosage-maintenance study. Thirteen patients with chronic ventricular ectopy entered a placebo control period, and 11 with persistent, frequent (greater than 600 per 12 hours) premature ventricular complexes (PVCs) advanced to drug therapy. Of 10 patients completing a trial of different doses, nine responded completely, with a mean PVC suppression of 98,3 per cent. Repetitive PVCs were eliminated. The mean effective dose was 189 mg per 12 hours, and the effective plasma concentration before administration of a dose averaged 635 ng per milliliter. One patient responded partially (68 per cent of PVCs suppressed). Flecainide continued to be effective and well tolerated at the end of a two-week outpatient trial in the nine complete responders, maintaining an average PVC suppression of 94.6 per cent. The PR and QRS intervals were mildly prolonged. The echocardiographic ejection fraction was unchanged during treatment. The elimination half-life was long - 18.8 +/- 3.8 hours. Flecainide thus appears to be a highly effective and well-tolerated antiarrhythmic agent with favorable pharmacokinetics.

Administration, Oral↗
PubMed1981

Aminoglutethimide therapy in advanced breast cancer.

Aminoglutethimide inhibited adrenal steroid synthesis, as assessed by serial estimations of plasma dehydroepiandrosterone sulphate in ten patients with advanced breast cancer. There was a favourable response in seven out of the ten patients, and in four there was an objective remission using UICC criteria. Favourable responses were more common in patients who had shown similar responses to previous endocrine therapy, especially a response to tamoxifen. Side effects were mild: two patients exhibited a drug sensitivity reaction, but neither required cessation of therapy. Adrenal suppression by aminoglutethimide is effective and well tolerated, and is therefore preferable to surgical adrenalectomy in the treatment of advanced breast cancer.

Adult↗
PubMed1981

Laparoscopy in the diagnosis of acute lower abdominal pain.

Laparoscopy was performed on twenty-seven hospital inpatients presenting with acute lower abdominal pain. Nineteen of the twenty-seven were admitted with a provisional diagnosis of appendicitis. Following laparoscopy, nine patients underwent appendicectomy, and a further three underwent laparotomy. Fifteen patients had a laparoscopy as the sole procedure, and all were discharged from hospital without need for further surgery. Of those patients in the operative group, five had their proposed incisions modified as the result of the laparoscopic findings. The only complications attributable to laparoscopy was one small wound haematoma.

Abdomen↗
PubMed1981

Evaluation of suppressor immune regulatory function in idiopathic congestive cardiomyopathy and rheumatic heart disease.

Several diseases with autoimmune features have recently been shown to be characterised by defects in suppressor cell immune regulation. Aberrant immune mechanisms of primary importance have been sought but not yet demonstrated for idiopathic congestive cardiomyopathy and rheumatic heart disease. We tested whether defective immunoregulatory function might explain certain features of these diseases. Peripheral blood mononuclear cells from patients with both diseases showed normal proliferative responses in the mixed leucocyte reaction. Concanavalin A induced similar suppressor activity, quantified in mixed leucocyte reaction as a suppression index, among control subjects, patients with rheumatic heart disease, and patients with idiopathic congestive cardiomyopathy. Similarly, patient serum supported induction of suppressor activity in normal leucocytes equal to that of control serum. A chronic immunoregulatory defect thus does not appear necessary for the development of idiopathic congestive cardiomyopathy or rheumatic heart disease.

Adolescent↗