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Biomedical subjects

J Lambert

Publications and source records attributed to J Lambert.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Effects of probucol on vascular remodeling after coronary angioplasty. Multivitamins and Protocol Study Group.

BACKGROUND: We have shown that probucol reduces restenosis after balloon angioplasty. Whether probucol acted via prevention of neointimal formation or improvement in vascular remodeling could not be addressed by angiography and required the use of intravascular ultrasound (IVUS). METHODS AND RESULTS: Beginning 30 days before angioplasty, 317 patients were randomly assigned to receive probucol, multivitamins, combined treatment, or placebo. Patients were then treated for 6 months after angioplasty. IVUS examination was performed immediately after angioplasty and at follow-up in 94 patients (111 segments). The cross section selected for serial analysis was the one at the angioplasty site with the smallest lumen area at follow-up. In the placebo group, lumen area decreased by -1. 21+/-1.88 mm2 at follow-up, and wall area and external elastic membrane (EEM) area increased by 1.50+/-2.50 and 0.29+/-2.93 mm2, respectively. Change in lumen area, however, correlated more strongly with the change in EEM area (r=0.53, P=0.002) than with the change in wall area (r=-0.13, P=0.49). Lumen loss was -1.21+/-1.88 mm2 for placebo, -0.83+/-1.22 mm2 for vitamins, -0.25+/-1.17 mm2 for combined treatment, and -0.15+/-1.70 mm2 for probucol alone (P=0.002 for probucol, P=0.84 for vitamins). Change in wall area was similar for all groups. EEM area increased by 0.29+/-2.93 mm2 for placebo, 0. 09+/-2.33 mm2 for vitamins only, 1.17+/-1.61 mm2 for combined treatment, and 1.74+/-1.80 mm2 for probucol only (P=0.005 for probucol). CONCLUSIONS: Lumen loss after balloon angioplasty is due to inadequate vessel remodeling in response to neointimal formation. Probucol exerts its antirestenotic effects by improving vascular remodeling after angioplasty.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Long-term use of silver containing nose-drops resulting in systemic argyria.

Generalized argyria is a silver intoxication that results in pigmentation due to deposition of silver in the skin and mucous membranes. Compared to several decades ago, argyria is now relatively rare. We report a case of generalized argyria after continous use of argyrophedrine nosedrops in the last ten years. Argyria should be taken into consideration when a patient presents with a blue-grey discoloration of the skin, particulary in areas exposed to the sun.

Argyria↗
PubMedDate not supplied

Twice-daily mixed regular and NPH insulin injections with new jet injector versus conventional syringes: pharmacokinetics of insulin absorption.

The purpose of the present study was to evaluate the feasibility of using a jet injector in a split and mixed regular and NPH insulin regimen and to compare serum glucose and free-insulin profiles obtained with the injector and the conventional syringe and needle. Twelve insulin-dependent diabetic patients were hospitalized for 5 days. After a stabilization day, six patients received their insulin injection with the injector for 2 days and with the syringe and needle for the following 2 days; the regimen was reversed for the other six patients. Diet, exercise, and insulin dosage remained constant. The serum glucose levels with the injector were consistently lower than those obtained with the syringe at all times of the day except at 5:00 a.m. and 7:30 a.m., when mean values were similar for both treatments. Free-insulin levels were higher with the injector from 10:30 a.m. to 4:30 p.m. These findings suggest that insulin absorption is faster and possibly greater with the injector than with the syringe. When switching from a syringe to an injector insulin program, insulin dose adjustment may be necessary.

Adult↗
PubMedDate not supplied

Development of new jet injector for insulin therapy.

To improve diabetic patients' compliance to multiple injection protocols, we developed and tested a new insulin jet injector, the Preci-Jet 50. The prototype has the following features: small size (14 X 2 cm) and weight (160 g), capability of mixing two types of insulin, accuracy and reliability of the ejected volume (dose), ease of use and sterilization, simplicity of design, and capacity of adjusting jet pressure to individual skin resistance. The ejected volume, evaluated by gravimetry, was more accurate and more reliable with the injectors (N = 18) than with 0.5-cc disposable plastic syringes (N = 18). The dead space of the injectors (N = 16), as evaluated by isotopic recuperation of radioactive insulin, was minimal, allowing mixed insulin injections. The human-device interface evaluation demonstrated that diabetic patients (N = 13) learned easily to manipulate the injector and that their ability to use it properly improved after 1 mo of use. We conclude that this injector may be a practical tool for insulin-dependent diabetic patients.

Adult↗
PubMedDate not supplied

Prediction of motor status 3 and 6 months post severe traumatic brain injury: a preliminary study.

The prediction of outcome following severe traumatic brain injury has received considerable attention in recent years. Previous prediction studies have focused on a long-term follow-up or prediction period. The reported outcome measures generally adopted a global approach (e.g. independent living) in terms of the prediction of physical function. The objective of the present study was to construct clinically useful predictive equations of motor system status, as represented by selected postural reactions (indicators of central nervous system function). Specifically, these equations would serve to predict the recovery of equilibrium and protective reactions both at 3 and 6 months post-injury, respectively. A stepwise multiple logistic regression analysis was performed, where nine predictive variables were considered using a multivariate approach. The results indicate that coma duration followed by age contribute significantly to the predictive capability of the models at both 3 and 6 months post-injury. Specifically, at 3 months, the predictive variables 'coma duration' and 'age' enabled an 84.62% correct prediction rate, whereas, at 6 months, 'coma duration' and 'age' enabled a 79.49% correct prediction rate. In addition, the exact probabilities (for given sample ages and coma durations) and associated 95% confidence intervals were calculated based on the predictive models obtained. The theoretical framework underlying these predictive models can form the basis for further studies. Furthermore, these preliminary predictive models have potential implications for early treatment planning and patient management.

Adult↗
PubMedDate not supplied

An evaluation of the hemiplegic patient based on the Bobath approach: a reliability study.

The intra- and inter-rater reliability of a motor function evaluation of stroke patients, based on the Bobath approach, was studied. The intraclass correlation coefficient (ICC) was used to determine the degree of agreement between repeated measurements on the same patient taken by the same rater and between measurements taken by three raters on the same patient. In the intra-rater study, each of 19 patients was evaluated in three different sessions by one of 19 raters. In the inter-rater study 18 patients were each evaluated by three different raters. The intra-rater data were highly reliable, with ICCs of 0.95 and 0.97 for the upper and lower limbs respectively. For the inter-rater study, the ICCs were 0.79 and 0.77 for the upper and lower limbs respectively. It can therefore be concluded that this instrument, previously demonstrated to quantify patient progress, is also reliable both in intra- and inter-rater dimensions.

Cerebrovascular Disorders↗
PubMedDate not supplied

Melanocyte biology and its implications for the clinician.

Epidermal and follicular melanocytes are neural crest derived cells that are in close contact with surrounding keratinocytes. By producing melanin in specialized organelles, the melanosomes, and transferring it to the keratinocytes, human skin becomes pigmented. Establishment of cultures of human melanocytes and an increasing interest in photo-carcinogenesis/photoaging have led to an explosion of knowledge concerning the biology of melanocytes.

Albinism, Oculocutaneous↗
PubMedDate not supplied

Evaluation of therapeutic ultrasound devices: performance stability over 44 weeks of clinical use.

The aim of this study is to establish at what time intervals regular checks of therapeutic ultrasound devices (TUSD) should be made to verify power output, timer accuracy, and ultrasonic frequency. Twenty-nine TUSDs from physiotherapy departments of 11 hospitals affiliated with the University of Montreal were retained for the study. The make, model, date of purchase, and other pertinent data of the TUSDs were determined from a questionnaire completed by each participating hospital. Power output, timer accuracy, and ultrasonic frequency of the TUSDs were verified every 4 weeks during a 20-week period with 2 further verification visits at 12-week intervals to complete the study. Data collected included the duration, intensity, and frequency of use of the TUSDs. The humidity and ambient temperature of the treatment locales were also recorded. At the initial verification, 66 percent of the TUSDs were found to be outside of tolerance limits for ultrasound intensity and 35 percent had inaccurate timers. For the duration of the study (44 weeks), 62 percent (18) of the TUSDs had to be calibrated at least twice, 38 percent (11) three times, and 31 percent (9) needed to be calibrated at least four times. Statistical analysis of the data failed to identify which factor or factors caused the deterioration in calibration of these TUSDs. Among the suggestions for improving the accuracy and safety of ultrasound treatments is that calibration verification should be made every 4 weeks and at even shorter intervals for some units. The authors suggest a follow-up study to determine the results of weekly verification.

Calibration↗
PubMedDate not supplied

Update on the safety of itraconazole pulse therapy in onychomycosis and dermatomycoses.

As the use of newer antifungal agents becomes more widespread, safety issues surrounding their use have become more important. To date, the safety profile of itraconazole has been well defined by its worldwide use in 50 million patients over the past 13 years. Data from clinical practice and clinical trials indicate that the 1-week pulse regimen of itraconazole is well tolerated and associated with a favourable safety profile. Adverse events are generally mild and transient. Furthermore, a dose increase to 400 mg in the pulse regimen has had no adverse impact on safety.

Antifungal Agents↗
PubMedDate not supplied

[Stress and social support in relation to psychological distress in community-residing elderly persons in Montreal].

Our aim was to quantify the degree of association that selected psycho-social and health variables have with psychological distress in the elderly. In order to estimate the level of association, data previously obtained from the "Enquêre Santé Québec" (1987) were entered into a multiple regression analysis with psychological distress as the dependent variable. The independent variables retained were: age, sex, language, physical health, functional health, health status perception, social integration, perceived social support and stress. The scores contained in the data bank were from a representative sample of subjects (n = 361, age = 72.7 +/- 6.3) living in the Montreal area. The results of the regression analysis indicated that psychological distress is significantly related (adjusted R2 = 0.256; p = .000) to the following variables: the interaction "stress events X perceived social support", physical health, functional health and sex. The results of the present study consequently support previous reports relating psychological distress to physical health, social support, stress and sex with a predominant effect on women. Finally, the results give further support to the "buffering effect" of social support on stress.

Aged↗
PubMedDate not supplied

Predicting and reinforcing children's intentions to wear protective helmets while bicycling.

The researchers undertook to identify the factors that are most likely to influence children's intentions to use bicycle helmets. To determine the most important intention influencing factors, a random sample of 797 students in grades 4 through 6 completed a self-administered questionnaire concerning their beliefs about helmet use. They were asked about their perceptions of the risk of riding bicycles unprotected, the severity of possible head injuries, and about other bicycle-safety related behaviors. Factors that best predicted the student's intentions to use bicycle helmets involved both behavioral beliefs and normative beliefs. Analysis of factors influencing those with low intentions to use helmets, compared to those with high intentions, suggests the most effective messages that health planners can provide preadolescents to influence them to use helmets. They are that helmet use is fun and attractive, helmets provide a new look and a sporting image, and friends approve of and value this behavior. Parents, and particularly mothers, can reinforce their children's intentions to use helmets and their involvement should be encouraged.

Bicycling↗