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Biomedical subjects

J Lord

Publications and source records attributed to J Lord.

At least 55 records · Page 3Linked to original sources
PubMed1993

The Texas Breast Screening Project: Part II. Demographics, risk profiles, and health practices of participants.

More than 36,000 of the 64,459 women who had $50 mammograms after a media campaign in 1987 completed a demographic and risk factor questionnaire. The screened women were young and well educated with high annual incomes. Only 32% had had mammograms before 1987. Most women reported that high cost and lack of referral for mammography by their physicians were their reasons for not being screened previously. Publicity promoting the project and the lower cost for mammography were the features of the project that attracted participants. Population-based telephone surveys before and after the project showed a change in attitudes about breast cancer screening. The model used for recruitment in this project can improve compliance with recommendations for regular mammographic screening if charges for screening are reduced. Additional efforts are needed to attract minorities and poor or elderly women to regular breast screening.

Adult↗
PubMed1993

Practical strategies for implementing continuous quality improvement.

The strategies for implementing these components will vary for individual health care organizations. It should be apparent that implementation of continuous improvement theories is a complex undertaking which requires a long-term effort to be successful and improve performance.

Clinical Protocols↗
PubMed1991

Chemotherapy for glioblastoma multiforme.

Treatment for the patient with a glioblastoma multiforme often includes chemotherapy with many specific nursing implications directly associated with this form of treatment. While the four agents described share some common adverse effects such as nausea and vomiting, even with this relatively common adverse effect, the onset, duration and severity varies. Multiple other adverse effects like nephrotoxicity, ototoxicity, thrombocytopenia and leukocytopenia vary greatly from agent to agent in occurrence and severity. Knowing the mode of action for each agent, which adverse effects to expect, when to expect them and appropriate treatment measures will help the nurse, patient and family to better manage these effects and improve quality of life.

Antineoplastic Agents↗
PubMed1991

Life in the community: four years after the closure of an institution.

Life experiences of 18 people 4 years after deinstitutionalization were examined. The ecological approach included observation in people's homes, interviews with the 18 individuals and people in their social networks, and a survey of other service providers. Because this research was a follow-up to an earlier study of the process of closing an institution, the findings are particularly significant for future institution closures and individual planning practices. Three major implications were noted: (a) the need to treat deinstitutionalization as a process; (b) the need to pursue alternatives to the 4- or 5-bed group home, which currently dominates community residential services; and (c) the need for community-based support services to develop new, more effective approaches to community integration.

Adult↗
PubMed1990

Implications of mainstream classrooms for adolescents with spina bifida.

This study examined the social and academic implications of mainstream, mainstream and special (combined) or special-class education for 31 adolescents with spina bifida, and for their primary caretakers. The Peabody Picture Vocabulary Test and the UCLA Loneliness Scale (adolescents) and the Personality Inventory for Children (caretakers) were administered. Adolescents in mainstream classes had the most normal scores for academic and social skills, those in combined classes had intermediate scores and those in special classes had the lowest scores. Paradoxically, adolescents in combined classes reported the least loneliness. This study suggests that even among students with relatively good social skills, mainstream placement is associated with greater subjective experience of loneliness than is combined placement.

Adolescent↗
PubMed1990

Scoliosis associated with Duchenne muscular dystrophy.

This study evaluated the age-related and ambulation-related incidence of scoliosis among boys with Duchenne muscular dystrophy (DMD) and the relationship between wheelchair dependency and scoliosis. Charts of 88 DMD boys were reviewed retrospectively. The relationships between age and both wheelchair dependency and scoliosis were graphed as cumulative distributions with increasing patient age. The relationship between ambulation status and scoliosis was analyzed with a stepwise series of chi square analyses, assuming increasing time intervals between wheelchair dependency and scoliosis. Wheelchair dependency and scoliosis were both age-related phenomena. The relationship between ambulation status and scoliosis became significant only after 3.5 years of wheelchair dependency. It should be noted that 24% of boys with scoliosis developed their curves before cessation of ambulation. While development of scoliosis among DMD boys is clearly an age-related phenomenon, its previously assumed relationship to ambulation requires reevaluation.

Adolescent↗
PubMed1989

Relationship of manual muscle testing to objective strength measurements.

This study investigates the relationship between manual muscle test scores (MMT) and quantitative isometric strength measurements (QIS). It also evaluates the implications of that relationship for design of therapeutic trials. Extension and flexion strength at the elbows, hips, and knees of 21 neuromuscular disease patients were tested a total of 26 times utilizing both MMT and QIS testing. Paired data were evaluated with Spearman ranked correlation coefficients, and then QIS was predicted from MMT using Lowess, a consistent form of nonparametric regression. Finally, the implications of the Lowess analysis for designing a therapeutic trial were evaluated. MMT and QIS measurements were significantly correlated in all movements tested. Lowess analysis yielded prediction errors ranging from 16 to 24% of QIS range. Analysis of the sample size needed for a therapeutic trial suggested that a protocol measuring MMT would require more subjects for the same level of statistical significance as a protocol measuring QIS. Since it was not possible to reliably predict QIS values from MMT scores, such conversions are not appropriate for clinical use. This inconsistent relationship between MMT and QIS carries major implications for the design of therapeutic trials. Since therapeutic trials are time consuming, expensive, and most centers do not have large numbers of individuals available, using QIS as an outcome measure is a preferable research design.

Humans↗
PubMed1989

The potential of consumer participation: sources of understanding.

The potential of consumer participation in mental health services can be appreciated by drawing upon three "sources of understanding": listening to consumers and their perspectives, gaining insight from partnership models for change, and learning from consumer-directed organizations. Ways of structuring consumer participation to maximize empowerment and equality are noted.

Canada↗
PubMed1987

A monoclonal antibody recognizes a human nuclear protein resembling Xenopus oocyte nucleoplasmin.

The monoclonal antibody 10BG2 (IgG3) was derived from a mouse immunized with human pre B cells. In immunofluorescence studies the antibody revealed a human nuclear-associated determinant, which in interphase cells was entirely restricted to the nucleus. In metaphase cells 10BG2 antigen was detected throughout the cytoplasm with intensified staining at the periphery of chromosomes. 10BG2 antibody stained all human normal and transformed cells tested. In contrast, the antibody did not stain mouse 3T3 cells or Chinese hamster ovary (CHO) cells. Electrophoresis under denaturing and non-denaturing conditions revealed the 10BG2 antigen to be a 130 X 10(3) to 140 X 10(3) Mr protein with a subunit molecular weight of 29.5 X 10(3). This suggests the protein is at least a tetramer. On two-dimensional gels the 10BG2 antigen had a streaked appearance and separated into two isoelectric variants (pI5.2, 5.4). The protein was also shown to be phosphorylated and thermostable, and remained in solution at pH 3.6. 10BG2 antigen was highly soluble in aqueous buffers and co-migrated on non-denaturing gels with the nucleosome-assembly protein, nucleoplasmin, purified from Xenopus oocytes. The similarity of 10BG2 antigen to nucleoplasmin is discussed.

Animals↗
PubMed1986

Graft rejection following HLA matched T-lymphocyte depleted bone marrow transplantation.

Bone marrow graft rejection following HLA-matched bone marrow transplantation (BMT) for leukaemia has been a rare problem. However, with the introduction of T-lymphocyte depleted BMT, graft rejection is recognized as a new complication. At the Royal Free Hospital (RFH) in London T-depletion is achieved using two monoclonal antibodies with complement mediated lysis. The methodology was extended to other centres and in total 56 patients have received T-depleted, HLA matched BMT. Twelve of 56 patients have had graft rejection. At the RFH three of 41 (7%) patients have had rejection whereas at collaborating centres nine of 15 (60%) patients have had rejection. We have investigated these rejections in order to identify factor(s) responsible. Rejection was not restricted by patient or donor characteristics, nor disease status. Patient management, chemotherapy conditioning, efficiency of T-depletion, graft versus host disease (GvHD), and infection post BMT, were not consistently implicated. The major difference between the RFH and all other centres was in the radiotherapy (RT) conditioning: The RFH prescribed a single fraction of 7.5 Gy total body irradiation (TBI) whilst collaborating centres gave 10 or 12 Gy fractionated TBI. We conclude that the different incidence of rejection (7% v. 60%) relates primarily to the RT conditioning although the mechanisms(s) of rejection remain unknown. We conclude that where T-depleted BMT is used, compensation by more intensive RT conditioning is required in order to avert graft rejection.

Adolescent↗
PubMed1985

Differential diagnosis in young women with oligomenorrhea and the pseudo-pseudohypoparathyroidism variant of Albright's hereditary osteodystrophy.

Oligomenorrhea was the reason for consultation in three individuals (two sisters and one unrelated woman) with the pseudo-pseudohypoparathyroidism (PPHP) variant of Albright's hereditary osteodystrophy (AHO). All had short stature, Ullrich-Turner-like signs, acral anomalies typical of AHO/brachydactyly E, and hypogonadism. One of the three individuals also had reduced erythrocyte NS (a membrane nucleotide regulatory protein that is required for functional coupling of stimulatory hormone receptors and catalytic adenylate cyclase) activity as described in the pseudohypoparathyroidism variant of AHO. The differential diagnosis of young women with the PPHP phenotype is discussed with special reference to Ullrich-Turner syndrome, brachydactyly E, the "resistant ovary" syndrome, and acrodysostosis.

Adolescent↗
PubMed1984

[Sterility of immunologic origin].

Antispermatozoal antibodies in the woman, the man, or both, may be the cause of nonorganic infertility in a small number of couples. The antibodies are most often found in the serum or in the genital fluids. Diagnosis is based on the postcoital test and on various laboratory tests to assess sperm-cervical mucous compatibility and to detect antispermatozoal antibodies. In women the strongest relation between results of laboratory tests and infertility is between the presence of serum antispermatozoal antibodies and infertility of more than 3 years' duration. In men there is a relation between high levels of these antibodies in the semen and infertility. Various treatments have been proposed, but further prospective studies are needed. However, promising results have been reported with homologous intrauterine insemination and with immunosuppression in men.

Adult↗
PubMed1984

The concentrations of urinary prostaglandins E and plasma prostaglandins F2 alpha and E during induction of ovulation with human gonadotropins.

Plasma prostaglandins F2 alpha and E (PGF2 alpha, PGE) and urinary PGE were measured in 10 women treated with human gonadotropins (HMG) and subsequently with human chorionic gonadotropins (HCG). Five women became pregnant (6 pregnancies). There was no correlation between concentrations of plasma PGF2 alpha or PGE and plasma estradiol or progesterone. Urinary PGE concentrations showed a positive correlation with estradiol before HCG and a negative correlation with progesterone after HCG, only in women who subsequently became pregnant. Higher urinary PGE concentrations before HCG suggest that either HMG or rising estradiol levels stimulate PGE renal production. The significant negative correlation between urinary PGE and progesterone concentrations, after HCG, in those patients who became pregnant suggests that ovarian production of progesterone may decrease renal production of PGE.

Dinoprost↗
PubMed1984

Cerebral palsy: a clinical approach.

Spastic cerebral palsy remains a therapeutic challenge. Diagnosis, usually possible within the first year of life, is straightforward. However, its uncertain etiology frustrates attempts at prevention and its poorly defined prognosis defies attempts to evaluate therapeutic effectiveness. Treatment must be directed toward both medical and habilitation issues. The syndrome of spastic cerebral palsy includes an increased risk of multiple medical problems. These must be followed and treated as needed. Habilitation needs are more difficult to define, thus demanding open communication between families and physicians for goal setting. Once goals are defined a comprehensive management program must be devised, choosing from several available approaches. No "right" answers exist; the only overriding concern remains to promote optimal independence through the developmental years and on into adulthood.

Biofeedback, Psychology↗
PubMed1983

The expectancy of pregnancy for "normal" infertile couples.

The prognosis of unexplained infertility was studied for 47 couples. The cumulative rate of pregnancy was 65%, with 81% achieving a full-term pregnancy. The type and duration of infertility, the age of the woman, and the previous use of contraceptives did not significantly modify the results. This study indicates that a complete investigative protocol should include laparoscopy. It also suggests caution in the application of untried empirical treatments to normal infertile couples.

Adult↗