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Biomedical subjects

J Robertson

Publications and source records attributed to J Robertson.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

BRCA1 screening in a woman with breast cancer: a patient's perspective with commentary.

Genetic screening for breast cancer and other diseases poses major personal and psychological challenges for persons facing the prospect of testing. The personal report of those dilemmas by a woman considering BRCA1 screening who had had a lumpectomy for breast cancer and whose mother had died from that disease is presented here. Commentaries by a bioethicist and a genetics counselor show further complexities in the testing experience which persons considering testing and those providing them will need to confront.

Bioethics↗
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The transfer and persistence of automotive carpet fibres on shoe soles.

The transfer and persistence of automotive carpet fibres to shoe soles was investigated. It was found that fibres were transferred with the normal activity of a car passenger. Carpet type and shoe sole parameters were significant determinants in the number of fibres that transferred. The average number of fibres was between about one and 33 per sole. Fibres that had been transferred after normal activity only persisted for a few minutes after walking. A survey of the shoe soles of people about to leave their car showed that fibres were usually present. The majority of shoe soles surveyed had less than five fibres with the greatest number of fibres found being 14. The likelihood of finding a large number of fibres on such soles is rare. Fibre composition of automotive carpets showed a high degree of variation. Grey was seen to be a common colour irrespective of the colour of the vehicle body.

Automobiles↗
PubMedDate not supplied

The effect of implanting gentamicin-impregnated polymethylmethacrylate beads in the tarsocrural joint of the horse.

OBJECTIVE: To determine the effect of intra-articular gentamicin-impregnated polymethylmethacrylate (PMMA) beads inserted in the equine tarsocrural joint on the synovial fluid, synovial lining, and cartilage, and to determine the peak and sustainable gentamicin concentrations in synovial fluid and plasma. STUDY DESIGN: Pharmacokinetic, cytologic, and histologic study of the effect of gentamicin-impregnated PMMA on normal equine tarsocrural joints. ANIMALS: Five healthy adult horses. METHODS: Gentamicin-impregnated PMMA bead strands (3 strands each of 40 beads, with each strand containing 100 mg gentamicin) were surgically inserted into one radiographically normal tarsocrural joint in 5 horses. Each horse had both joints flushed with 1 L of lactated Ringer's solution before bead administration. Synovial fluid total protein concentration, white blood cell (WBC) count, gentamicin concentration, synovial histology, cartilage integrity, and cartilage glycosaminoglycan (GAG) concentrations were determined. RESULTS: Gentamicin concentration (mean +/- SEM peak concentration, 27.9 +/- 2.27 microg/mL) occurred in the first 24 hours and remained above 2 microg/mL for 9 days. Gentamicin concentrations in control joints and the plasma remained below detectable levels. The synovial fluid WBC count for treated joints was increased compared with control joints for 72 hours, but was similar at day 6. The synovial protein concentration in gentamicin-treated joints remained increased for 21 days. Synovium in treated joints had diffuse synovitis, whereas control joints had less fibrovascular proliferation. Superficial cartilage erosion was present in all treated joints. There was no difference in the GAG content of treated and control joint cartilage. CONCLUSIONS: Short-term implantation of gentamicin (300 mg)-impregnated PMMA beads can provide therapeutic levels of gentamicin (>2 microg/mL) in the normal tarsocrural joint for 9 days; however, gentamicin-impregnated PMMA beads induce synovitis and superficial cartilage erosion. CLINICAL RELEVANCE: Temporary intra-articular administration of antibiotic-impregnated PMMA may be an effective way to treat septic joints that require constant high concentrations of antibiotics.

Absorbable Implants↗
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Toxicosis associated with dual oral exposure of rats to lead and trichloroethylene.

To determine if additive or synergistic toxic effects would occur, adult male rats were exposed orally to lead carbonate (2,000 mg/kg) for 9 days before trichloroethylene (TCE), 2,000 mg/kg, was given concurrently for an additional 7 days. Comparisons were made with groups of vehicle-treated rats and rats given only lead or only TCE. Potential neurotoxicity was evaluated by using the Functional Observational Battery (FOB) recommended for neurotoxicity screening. Rats were sacrificed on day 16, and brain, testes, spleen, kidney/adrenals, heart, and liver weighed and observed for pathological changes. Results of the FOB indicated that lead carbonate was more responsible than TCE for changes observed. Additive or synergistic neurotoxicities were not noted. Histological examination of the kidney from lead-treated rats revealed inclusions, an increased incidence of coagulated proteins, and tubular dilation that was generally more severe in the medullary segments. Gastric and testicular necrosis were found in rats given lead carbonate both with and without TCE (15/20 and 6/20 treated, respectively). The results suggest that, even when given concurrently, the toxicities of lead carbonate and TCE are expressed only as though one toxicant was given.

Administration, Oral↗
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Growing older with cystic fibrosis: psychologic adjustment of patients more than 16 years old.

The 79 female and 147 male patients constituting the population with cystic fibrosis (CF) aged 16 years and older attending The Hospital for Sick Children were asked to complete the Cornell Medical Index (CMI) and Tennessee Self-Concept Scale (TSCS); 64 female (81%) and 112 male (76%) subjects participated. Analysis of CMI results showed 43% of female subjects to have moderate to severe emotional disturbance compared to 19% of male subjects. This female : male ratio for severity of emotional disturbance is found in ostensibly healthy groups, but the percentages of disturbance approach values for medical patient populations. The frequency of emotional disability is greater in those more than 20 than in those 16-19 years old. The TSCS results portray a generally normal self-concept except for scores of positive physical self and psychosis for patients aged 20 years and older; these scores approach psychiatric values, suggesting that some reality distortion facilitates emotional adjustment to adult life with CF. The TSCS and CMI results correlate significantly, indicating a connection between self-concept and emotional status. However, TSCS and CMI scores do not correlate with measures of disease severity except for correlations between lung function and physical self-concept in older male patients. These results suggest that psychologic functioning is independent of the degree of physical impairment in older patients with CF, with the long-surviving male patients more realistically appraising the limitations their disease imposes and utilizing denial and minimization to a lesser degree. Demographic data on the clinic population reveal that most patients aged 16 years and older cope with their intellectual, developmental, and socioeconomic tasks commensurate with normal age expectations.

Adolescent↗
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Emotional adjustment of early adolescents with cystic fibrosis.

Eighty-five 12- to 15-year-old adolescents regularly attending the cystic fibrosis (CF) clinic of The Hospital for Sick Children were asked to complete the Children's Health Locus of Control and the Tennessee Self Concept Scale. Their parents were requested to complete the Child Behavior Checklist. Thirty-four males (72%) and 28 females (74%) participated in the study. This study found that adolescents with CF are able to maintain a good self concept, be socially competent, and perceive that they are in control of their health while showing an increase in behavior problems. Females rely heavily on denial and are more behaviorally compliant, whereas boys use less denial but show more behavior problems. Males appear to integrate having a physical disorder into their self concept, whereas females do not. The findings demonstrate a difference in mechanisms of coping with cystic fibrosis between male and female adolescents with CF, which may contribute to the decline in physical status in females and better survival of males.

Adolescent↗
PubMedDate not supplied

Behavioral adjustment of latency age children with cystic fibrosis.

One hundred and twenty-six 6 to 11-year-old latency age children with Cystic Fibrosis regularly attending the CF clinic of the Hospital for Sick Children were asked to complete the Piers-Harris Self-Concept Scale and the Children's Health Locus of Control. Their parents were requested to complete the Child Behavior Checklist and the Family Assessment Measure. One hundred and eight (86%) participated in the study. Twenty-three percent of the children were found to have sufficient behavior problems to indicate a significant degree of maladjustment. Latency-age CF children show an increase in problems compared to a pre-school group, suggesting that leaving the protection of the family is problematic for a child with a chronic physical disorder. Males show more behavior problems than females. Males' behavior is characterized by somatic complaint profile. In spite of difficulties, CF latency children are able to maintain good social competence and self-concept suggesting compensatory mechanisms. These mechanisms are different for males and females. Females' self-concept and social competence are supportive of each other, whereas for males, this is not the case. Similarly, female behavior is relevant to family functioning. Males and females adjust to difficulty as indicated by differences in behavior profiles.

Adaptation, Psychological↗
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Intravascular leukostasis and systemic aspergillosis in a horse with subleukemic acute myelomonocytic leukemia.

Leukemia is a neoplastic disease of one or more of the cell types of the hemopoietic system and is rarely diagnosed in the horse. This report describes a case of subleukemic acute myelomonocytic leukemia in an 11-year-old gelding. Preliminary cytological diagnosis was supported by two types of laboratory investigations. Cytochemical characterization of blood and bone marrow neoplastic cells was consistent with a myelomonocytic origin. Neoplastic blast cells in peripheral blood were labeled by monoclonal antibodies specific for cell surface molecules of horse granulocytes, but they were not labeled by antibodies to T- or B-lymphocytes or macrophages. Treatment was attempted but was unsuccessful. At necropsy, intravascular leukostasis was present in all tissues examined. Fungal hyphae were also found in lung interstitium and colonic submucosa, suggesting the presence of a systemic mycosis. Nucleated cells were isolated from peripheral blood and cultured in vitro; they survived for up to 2 weeks and had evidence of cell division that was not sustained. Frozen-thawed cells stored in liquid nitrogen were also successfully cultured in vitro, but no permanent cell lines could be established.

Animals↗
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Phosphorylation of tau by cyclic-AMP-dependent protein kinase.

Alzheimer's disease paired helical filaments contain abnormally phosphorylated tau (PHF-tau) which has reduced electrophoretic mobility on sodium dodecyl sulphate polyacrylamide electrophoresis. We have investigated the effects of cyclic-AMP-dependent protein kinase (PKA) on recombinant human tau isoforms and two recombinant tau fragments. PKA phosphorylated tau and reduced its electrophoretic mobility, phosphorylation towards the C-terminus of tau having a major influence on this property. Substitution of serine396 (phosphorylated in PHF-tau) or serine416 (phosphorylated by calcium/calmodulin kinase II) by alanine demonstrated that these are not major sites for PKA phosphorylation. Although the phosphorylated forms of tau generated by PKA are not identical to those of PHF-tau, PKA may be involved in the generation of PHF-tau in Alzheimer's disease via phosphorylation of additional, as yet unidentified, sites on tau.

Alzheimer Disease↗
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Traumatic innominate pseudoaneurysm rupture during laryngeal dilatation.

Endotracheal hemorrhage from the innominate artery is, fortunately, a rare problem encountered by the otolaryngologist. We present a patient with a tracheal-innominate artery fistula secondary to delayed rupture of a traumatic innominate artery aneurysm. The differential diagnosis of innominate artery hemorrhage is discussed, as is the management of this potentially lethal event. We propose, as the treatment of choice, cessation of hemorrhage through the use of a cuffed endotracheal tube, followed by ligation of the innominate artery using cardiopulmonary bypass. These techniques were used in this patient with a successful outcome.

Adult↗
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Neuropsychological intervention in dyslexia: two studies on British pupils.

The theoretical context of this research is developmental neuropsychology--in particular, the educational implications for the classification of and intervention in specific developmental dyslexia (SDD). Controlled and validated research can help identify optimal teaching methods for groups and individuals. Within this framework, neuropsychological theory can be explored as a medium for improving intervention for pupils with SDD. Neuropsychological stimulation cannot change the macro aspects of the brain but can change its "finetuning" and its response to written text. Within the psycho-neurological approaches, Bakker (1979, 1990, 1998) developed both a diagnostic procedure and empirically investigated intervention procedures. The theory rests on the Balance Model of learning to read, in which differential hemisphere involvement is implicated in beginning and advanced reading. Intervention can take place via hemisphere-specific stimulation using visual or tactile stimulation or hemisphere-alluding stimulation using modified text. Two investigations are presented, one experimental and another clinical. The results support the validity of dyslexia subtyping and the effectiveness of the treatment methods.

Adolescent↗
PubMedDate not supplied

Can data collection during the grieving process be justifiable?

Research has shown that there are a number of competing theories regarding the use of bereaved people for research purposes. One view emphasizes their vulnerability, weakness and inability to take part in decision-making. Another is that there is an infringement of rights if people are denied the freedom of choice to take part in research. This article considers issues concerned with data collection from recently bereaved relatives who were at some stage of the grieving process. The participants were interviewed as part of the OXMIS study which aimed to identify the incidence of myocardial infarction in Oxfordshire. A total of 142 interviews took place (59 home visits and 83 telephone interviews). Of the cases not interviewed, sufficient information was gained in 94% from other sources to fulfil the required criteria. The perceived benefit or apparent risk of vulnerable groups participating in research is discussed in light of the study results.

Bereavement↗
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Partial splenectomy in the dog: a comparison of stapling and ligation techniques.

Partial splenectomy was performed in 17 adult dogs by using either surgical stapling instrumentation or conventional suturing techniques. Blood loss was minimal as determined by clinical observation and comparison of packed cell volumes and total protein levels before and after surgery. Surgical stapling instrumentation or suturing techniques may be used safely for partial splenectomy in the dog; however, the stapling technique significantly decreases operative time.

Animals↗
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The facet syndrome.

Injection of irritant fluid precisely into the facet joint causes referred pain patterns indistinguishable from the pain complaints frequently associated with the "disk syndrome." Even straight leg raising and diminished reflex signs can be obliterated by precise local anesthetic injection into the facet joint. The use of radiographically localized injection of steroids and local anesthetic into the facet joint has been presented as a diagnostic-therapeutic procedure. Clinical experience with a group of 100 consecutive patients suggests that this treatment alone can achieve long-term relief in one-fifth of the patients with lumbago and sciatica and partial relief in another one-third of these patients. This information suggests that the structures related to the facet joint can be a persistent contributor to the chronic pain complaints of individuals with low back and leg pain.

Adult↗
PubMedDate not supplied

A Delphi survey of clinical nursing research priorities in Western Australia.

In 1989-1990 an investigation was undertaken to ascertain which problems WA nurses considered required researching. A modified Delphi technique was employed to obtain data from nurses in hospitals and health care agencies throughout the metropolitan and rural regions in the state. Participants worked in areas of acute care, mental health, paediatrics, gerontology, community health and domiciliary services and addictions. Problems identified were categorised into three streams; clinical, management and staff development. Respondents were required to assign a value to items according to their importance to nurses and to patients. They were also asked to indicate whether they considered there was an adequate research base relevant to each item. Results reported here are based on the 10 priority items identified in the clinical stream.

Clinical Nursing Research↗