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Biomedical subjects

J Reed

Publications and source records attributed to J Reed.

At least 199 records · Page 11Linked to original sources
PubMed1975

Knowledge, power, man and justice: ethical problems in biomedical research.

This essay attempts to raise some ethical problems related to biomedical research as they revolve around the issues of knowledge, power, man and justice. The arguments connected with such matters will not provide answers, but rather soundings for unchartered waters. Much more can and needs to be developed about the nature of knowledge and the politics of its use and abuse. A more detailed analysis and critique of man's nature might be engaged in to determine many concerns, not least of which is whether we can even talk about human nature. The idea of justice is elusive at the best of times and is particularly complicated at a time in history when social and economic interpretation is so complex. Much more must be debated before we can produce a detailed map. Fundamental to all of this, though, hopefully will be a dialogue among the many disciplines concerned with human research. We can not afford to work in isolation. The consequences of our decisions are too great.

Bioethical Issues↗
PubMed1969

Mite infestation.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

Does centralized monitoring affect perinatal outcome?

A retrospective study was performed comparing centralized monitoring to noncentralized monitoring in regard to perinatal outcome. The study was conducted at Lehigh Valley Hospital (Allentown, PA) between August 1994 and February 1995. All deliveries during a 28-week-period were studied retrospectively. The study was designed such that for 14 weeks all patients were centrally monitored (Group A). During the following 14 weeks, no patients were centrally monitored (Group B). Patients not requiring monitoring, such as elective cesarean sections, were excluded from the study. The variables that were studied were the 5-minute Apgar, cord blood pH, perinatal mortality, admissions to the neonatal intensive care unit (NICU), spontaneous vaginal deliveries, cesarean sections, and operative vaginal deliveries. A total of 1,622 deliveries occurred during the 28 weeks of antenatal care. Group A consisted of 805 centralized monitored patients and Group B had 817 noncentralized monitored patients. There was no statistical difference in the 5-minute Apgar, umbilical artery pH, perinatal mortality, or the NICU admissions between the two groups. However, there was a significant statistical difference in the percent of cesarean sections performed for nonreassuring fetal heart rate tracings (Group A, 17.89% vs. Group B, 12.16%; P = 0.02). The overall cesarean section rate was increased in the centrally monitored group (Group A, 23.6% vs. Group B, 18.1%; P = 0.01). There were also statistically significant differences in operative vaginal deliveries (forceps and vacuum) for fetal heart rate abnormalities between Group A, 0.52% vs. Group B, .39% (P = 0.05). Centralized monitoring may be associated with an increase in the overall cesarean section rate. In addition, the rate of operative vaginal and abdominal deliveries appears to be increased for the indication of nonreassuring fetal heart rate tracings with the use of centralized monitoring.

Apgar Score↗
PubMedDate not supplied

Epidural opioids during laminectomy surgery for postoperative pain.

STUDY OBJECTIVE: To determine whether morphine applied directly to the dura during laminectomy surgery provides superior postoperative analgesia during the first 24 hours. DESIGN: Randomized, double-blind study. SETTING: A university-affiliated hospital. PATIENTS: Twenty ASA physical status I and II patients ages 18 to 60 years. INTERVENTIONS: Simultaneous topical dural application and intramuscular (IM) injection of unknown solutions of saline and morphine 3 mg. MEASUREMENTS AND MAIN RESULTS: Postoperative analgesia was assessed using the visual analog scale (VAS), a modified McGill-Melzack pain questionnaire, subjective nursing evaluations, and the amount of supplemental analgesic medication used. Patients were observed for complications and side effects. Compared with the patients who received epidural saline and IM morphine, the patients who received epidural morphine and IM saline had less postoperative pain as determined by VAS scores, nursing evaluations, and amount of supplemental opioid analgesic doses (1.6 +/- 1.2 vs. 4.1 +/- 1.2 analgesic doses per patient; p less than 0.05) required in the first 24 hours. Minor side effects were similar for the two groups. No patient developed respiratory depression. CONCLUSIONS: Morphine 3 mg applied topically to the dura at the end of laminectomy surgery is a simple, safe, and effective way of providing improved postoperative analgesia.

Adolescent↗
PubMedDate not supplied

Parallel pathways, noise masking and glaucoma detection: behavioral and electrophysiological measures.

PURPOSE: We tested the hypothesis that because of their reduced neural efficiency, glaucoma patients should have increasingly impaired thresholds as external noise is added to a stimulus. METHOD: We compared the performance of 20 normals (mean age = 39 years) with that of 15 patients with early glaucoma or at very high risk for glaucoma (mean age 45 years). All patients had normal visual acuity. Contrast thresholds were measured on two sets of tasks: (1) behavioral and (2) sweep visually evoked potentials (VEPs). Two stimuli were used (a) 7.5 Hz reversing gratings of 0.69 cpd, and (b) 5.5 cpd gratings. Noise was binary and contrast varied from 0 to 80%. Psychophysical thresholds were determined using a staircase which employed a spatial four alternative forced choice procedure (4AFC) and converged on 50% correct. Sweep VEP thresholds were determined by extrapolation to zero volts as a function of log contrast. RESULTS: Differences between normal subjects and patients with early glaucoma were not significant without noise. Both the absolute size of the difference and its significance increased as noise level increased. For the behavioral thresholds these trends were clearer with the 5.5 cpd grating, while for the sweep VEPs they were more clear for the 0.69 cpd grating. CONCLUSION: The performance deficit of glaucoma patients which may be minimal under normal testing conditions is magnified when external noise is added to the stimulus. VEPs and psychophysical thresholds show interesting differences in their sensitivity to this effect. Implications for the early detection of glaucoma are discussed.

Adult↗
PubMedDate not supplied

Portage guide to early intervention: cross-cultural aspects and intra-cultural variability.

The issues arising from implementing an early intervention service, developed in the rural United States in the late 1960s in a range of different cultural contexts over a period of a quarter of a century, are explained. Services from India, Bangladesh, Jamaica and the United Kingdom are compared. As well as considering cross-cultural aspects of Portage, variability within one country, the United Kingdom, is considered by comparing one service in an inner-city area and one in a rural area.

Acculturation↗
PubMedDate not supplied

Assessing the written information given to families prior to their attendance at a child development centre.

This paper describes an analysis of the written information given to parents of pre-school children with developmental delay prior to their attendance at a Child Development Centre. Texts were analysed for their readability and human interest, and the usefulness of the information was assessed through consultation with parent consumers. The discussion of the results includes suggestions for staff who are involved in the development of client leaflets and booklets.

Child Day Care Centers↗
PubMedDate not supplied

Intrapericardial cysts in the dog.

Intrapericardial cysts were identified as the cause of impaired cardiac filling in six young dogs. Pneumopericardiography and two-dimensional echocardiography showed the cysts in 2 of 2 dogs and in 4 of 4 dogs, respectively. One dog, which was also infected with heartworms, died before surgical excision of the cyst could be performed. In the remaining dogs, surgical excision of the cysts and subtotal pericardiectomy was successfully accomplished. Histologic examination of the excised tissue from one dog suggested that it was a pericardial coelomic cyst. The gross and histologic characteristics of the cysts removed from the other five dogs resembled those of acquired cystic hematomas. The etiopathogenesis of these cysts was uncertain, but all cysts were connected to a fatty pedicle of tissue. In one dog, a stalk of tissue was observed to enter the pericardium through a small peritoneopericardial diaphragmatic hernia. In four dogs, the stalk of tissue was adhered to the apex of the parietal pericardium. These observations suggested that intrapericardial cysts, in some dogs, develop in association with, and possibly as a result of, congenital herniation and entrapment of omentum or a portion of the falciform ligament into the pericardial sac.

Animals↗
PubMedDate not supplied

Subunit delta of chloroplast F0F1-ATPase and OSCP of mitochondrial F0F1-ATPase: a comparison by CD-spectroscopy.

CD spectra have been recorded with subunit delta from chloroplast CF0CF1 and with OSCP from mitochondrial MF0MF1. These subunits are supposed to act similarly at the interface between proton transport through the F0-portion and ATP-synthesis in the F1-portion of their respective F0F1-ATPase. Evaluation of the data for both proteins revealed a very high alpha-helix content of approximately 85% and practically no beta-sheets. Despite their low homology on the primary structure level (23% identity) and their different electrostatic properties (pI-values differ by 3 units), spinach delta and porcine OSCP are indistinguishable with respect to their secondary structure as measured by CD. Prediction and analysis of consensual alpha-helices even in poorly conserved regions indicate a high degree of structural similarity between chloroplast delta and OSCP. In view of the topology and function of delta and OSCP in intact F0F1 these findings are interpreted to indicate the dominance of secondary and tertiary structure over the primary structure in their supposed function between proton flow and ATP-synthesis.

Adenosine Triphosphatases↗