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Biomedical subjects

J Roche

Publications and source records attributed to J Roche.

At least 73 records · Page 4Linked to original sources

Creative ritual in a hospice.

St. Peter's Hospice, Albany, NY, is dedicated to meeting the emotional needs of patients, families, and staff. Creative ritual, hospice leaders have found, is a powerful tool that can: Provide an "arena" for healing, affirmation, reconciliation, and celebration Serve as a reminder of the sacred Evoke heartfelt emotion Effect renewal and inspiration Offer an opportunity to cleanse the soul of grief, anger, frustration, or guilt Provide tangible experiences of bonding and interdependence Prevent staff burnout St. Peter's staff show a good deal of imagination and variety in creating rituals. Possible themes include patients' birthdays or wedding anniversaries, religious celebrations, national holidays, and changes of seasons. A lighted candle, bouquet of flowers, or incense burner may be used to give the ritual a focus. Music is often played to help set the tone. Rituals involve a major shift in consciousness. They often allow participants to express feelings it would otherwise be difficult for them to put into words. At St. Peter's, participants may begin to communicate by sharing favorite prayers, poems, photos, or works of art. Or they may make music--the hospice provides the instruments--or pass around a Native American "talking stick." Such methods facilitate the bonding of patients and their families. Particularly important are those rituals which allow patients and estranged family members to reconcile. Others enable patients to acknowledge God-given gifts. Still other rituals are held for staff members, who thereby deal with the anger and sadness their work inevitably brings. For all at St. Peter's Hospice ritual is a source of healing, affirmation, renewal, inspiration, and grace.

Burnout, Professional↗

Application and evaluation of QBC malaria diagnosis in a holoendemic area.

Quantitative Buffy Coat Analysis was used in practical diagnosis situations. In the first place, sensitivity and specificity was measured in an active search survey (720 schoolchildren under 10 years of age, in nine field trips) under unfavourable laboratory conditions (onsite school diagnosis being conducted with electricity supplied by a diesel-powered generator). In this group, the QBC-based study revealed sensitivity and specificity ratings of 99.6% and 81.7% respectively. QBC proved 5.5% more sensitive than the thick-film method, but specificity was greater with the latter. QBC returned good results when used in adverse situations, viz., in the absence of air conditioning and with a diesel generator as the only power supply. QBC was used in a passive search survey (hospital group, 618 children) under good laboratory conditions (air conditioning) with patients enrolled in a trial to measure resistance to antimalarial drugs. In this survey we targeted at assessing the efficacy of chloroquine treatment at dose of 25 mg/kg/3 days. QBC proved more sensitive than the thick-film method, detecting - on day 14 of the in vivo test - low parasitaemias that had gone undetected by thick film. Lastly, this study reports on the conversion of QBC readings (parasitaemia per field) into thick-field terms (number of parasites per microliter of blood), with the aim of measuring the degree of recurring parasitaemia.

Acridine Orange↗

DNase activity of micrococcal endonuclease covalently immobilized on nylon and polystyrene.

Water-insoluble nucleases were prepared by immobilizing the endonuclease from S. aureus onto the surface of nylon-66 and polystyrene spheres. The activation phase of the synthetic supports was optimized to define optimal conditions of pH, temperature, and Ca2+ concentration for using immobilized enzymes. The activity, evaluated by hydrolysis of high-molecular-weight and supercoiled DNA, indicates that both derivatives are highly stable for storage and further use. Immobilization of the enzyme is much more effective when the covalent binding is performed on polystyrene. By using different activation methods with these matrices, a set of immobilized nucleases with various levels of enzymatic activity can be prepared. The possibility of working in a wide range of enzymatic activity and at low temperature and Ca2+ concentrations in different buffers makes these immobilized nucleases very useful for investigating accessible DNA regions in chromatin structure.

Biotechnology↗

Resistance of Plasmodium falciparum to antimalarial drugs in Equatorial Guinea.

One hundred and sixty-six children from Equatorial Guinea, all under 10 years of age and with acute uncomplicated falciparum malaria, were randomly allocated to four groups and treated with one of the following regimens: chloroquine or amodiaquine (25 mg base/kg body weight over 3 days), quinine (8 mg/kg every 8 h for 3 or 5 days), and sulphadoxine-pyrimethamine (25-1.25 mg/kg, in one dose). The parasite clearance rates up to day 14 were 28% with chloroquine, 74% with amodiaquine, and 95% with quinine or sulphadoxine-pyrimethamine. The times required to clear asexual blood forms of Plasmodium falciparum in sensitive cases were 64, 70, 73 and 65 h, respectively. Although quinine and sulphadoxine-pyrimethamine are equally effective, quinine is recommended for treatment of multidrug-resistant malaria in paediatric patients, essentially because of the risk of serious reactions to sulpha drugs. Health providers are, however, encouraged to keep supplies of sulphadoxine-pyrimethamine as an option and to refer patients quickly, if required.

Amodiaquine↗

Baseline entomological data for a pilot malaria control program in Equatorial Guinea.

Entomological studies conducted on the island of Bioko and the mainland province, Río Muni, in Equatorial Guinea provided baseline data for a pilot malaria control program. The main species collected resting in houses at low density were Anopheles gambiae s.l. Giles and Anopheles funestus Giles. An. gambiae s.l. density increased during the rainy season, whereas An. funestus populations remained stable during both dry and wet seasons. Both species tended to be endophilic and were not collected resting or biting outdoors. Overall, delayed sporozoite rates were about 10% for both species and were highest in the dry season. An. gambiae s.l. from the mainland showed resistance to 4% DDT, but the island population was still susceptible. All populations were completely susceptible to 5% malathion and 0.025% deltamethrin.

Animals↗

Rapid direct reversal photography.

This is a description of a method which enables fast, direct-reversal photography of radiological images for slides and was designed to retain: (i) continued use of an existing small darkroom; (ii) use of Kodak Rapid Process copy film; and (iii) use of standard X-ray processors. By adaptation of a commercial photographic flash power pack, a flash head and a reflector it is possible to achieve a somewhat expensive but very successful system which enables the very rapid production of good quality image slides for lectures.

Audiovisual Aids↗

The dense basilar artery as a sign of basilar territory infarction.

Three cases of basilar artery territory infarction, in which a dense basilar artery was noted, are described. The dense basilar artery was recognized on computed tomography (CT) by comparing its density with that of other unaffected intracranial vessels. This sign is thought to represent basilar thrombosis or embolism and has similarities to the dense middle cerebral artery sign. The dense basilar artery is an early sign suggesting basilar territory infarction and its use improves the CT detection of basilar territory infarction.

Aged↗

Vocal granuloma, including sclerosis of the arytenoid cartilage: radiographic findings.

Vocal granulomas are uncommon benign tumors that may not respond readily to medical treatment or surgical removal. Gastroesophageal reflux is said to be a causative factor. Osteosclerosis of the arytenoid cartilage was found on computed tomographic scan in a series of 21 consecutive patients. The relationship of vocal granuloma to so-called contact ulcer (better called contact pachydermia) is discussed. Imaging of the granuloma and the arytenoid has little, if any, place in management, but should be recognized in the differential diagnosis of a vocal cord mass if the mass lies immediately adjacent to a sclerotic arytenoid.

Adult↗

Primary hypothyroidism with pituitary enlargement and a visual field abnormality.

A 23 year old man presented with classical hypothyroidism of 9 years duration. This was associated with pituitary enlargement, documented on magnetic resonance imaging (MRI), and abnormal half-field visual evoked responses (VERs). Following the initiation of thyroxine therapy the pituitary enlargement and the VER abnormalities resolved. The final diagnosis was of primary hypothyroidism with secondary pituitary hyperplasia.

Adult↗

Concurrence of primary aldosteronism and renal artery stenosis.

1. An unusual clinical case is described in which renal artery stenosis (RAS) was found to coexist with adrenocortical hyperplasia, resulting in hypertension. 2. Partial relief of the hypertension was achieved by correction of RAS, and then further relief by extirpation of one adrenal gland affected by unilateral hyperplasia, in interventions 8 months apart. 3. Biochemical features typical of primary hyperaldosteronism were observed both before and after RAS repair but were not present after unilateral adrenalectomy. 4. The association of these two lesions could have occurred by chance, through genetic linkage, or by progression from RAS to tertiary aldosteronism.

Adrenal Cortex↗

Identification of GATA-1 and NF-E2 binding sites in the flanking regions of the human alpha-globin genes.

Some of the elements involved in the erythroid-specific transcriptional regulation of the human gamma- and beta-globin genes and located inside or in the immediate proximity of these genes have been identified as sequences which bind erythroid-specific factors. In the present study, we found two regions located within 1 kb in 5' to the alpha 2- and in 3' to the alpha 1-globin genes which contribute to the induction of human alpha-globin genes following erythroid differentiation in stable MEL transformants. By DNAse I footprinting and gel mobility shift assays, we identified several GATA-1 and one AP-1/NF-E2-binding sites located inside these regions. These results strengthen the idea that, like for all other globin genes, flanking regions contribute in vivo to the regulation of human alpha-globin gene expression.

Animals↗

Spiritual care of the person with AIDS. Literature and art can touch closed hearts.

Spiritual ministers, challenged to find meaningful ways to heal the hearts of persons with AIDS, are turning to some untraditional sources for help. Poetry, art, and stories are among the creative instruments for healing that pastoral ministers are bringing to the bedsides of the terminally ill. The story is the primary tool of spiritual care. Spiritual ministers working with persons with AIDS and their families should elicit and listen to their stories, which serve multiple purposes. Telling the stories is therapeutic for the person with AIDS. For the minister, the stories identify areas that need reconciliation, as well as those which call for celebration. Finally, when the time is right, the minister can tell another story, one that offers consolation and hope to the afflicted. Ritual is another tool of spiritual care. Just as the concrete image symbolizes the spiritual reality, so, too, does ritual facilitate or help celebrate spiritual healing. The Bible is a rich source of ideas for creative ritual. Other effective tools are art, drama, poetry, guided meditations, and dreams. In the hands of sensitive care givers, they are instruments of spiritual healing.

Acquired Immunodeficiency Syndrome↗

Depo-Medrol and myelographic arachnoiditis.

OBJECTIVE: This study was undertaken to see if patients who had a radiological diagnosis of arachnoiditis attributed to methylprednisolone acetate (Depo-Medrol, Upjohn Pty Limited) had the clinical syndrome of arachnoiditis. DESIGN: An attempt was made to review all patients, reported by Roche in 1984 with a radiological diagnosis of corticosteroid-induced arachnoiditis, by taking a detailed history and performing a physical examination. SETTING: The Department of Orthopaedics and Traumatic Surgery, The University of Sydney, The Royal North Shore Hospital, Sydney. RESULTS: Of the 18 patients reported by Roche 15 were located and participated in this study. The clinical syndrome of arachnoiditis was defined as a constant burning pain in the back and legs, impotence, marked limitation of spinal motion, alteration of sensation and power in the legs, and a need for regular analgesia. Three of the 15 patients had the clinical syndrome of arachnoiditis. The grade of radiological change was unrelated to the severity of symptoms. The details of doses and precise sites of administration were unavailable for the severely affected individuals. CONCLUSIONS: The absence of any other apparent cause for their symptoms implies that Depo-Medrol should not be used in or about the thecal sac.

Adult↗

An epidemiological study of malaria in Bioko and Annobón islands (Equatorial Guinea).

A seroparasitological study of malaria was carried out in two of the more important islands of Equatorial Guinea, Bioko (ex Fernando Poo) and Annobón. The study involved a randomly-chosen population of children aged from two to nine years. In Bioko 1130 children were chosen from 29 of the 51 villages on the island; in Annobón 185 children were chosen from the capital town, where all the population lived. Indirect immunofluorescence tests (IFAT) showed a prevalence of malaria infection of 29.8% in Bioko and 55.7% in Annobón. The parasitic prevalence (malaria index) was 26.6% and 55.1% respectively, and the splenic index was 57.0% and 54.6% respectively. The results indicate that this is an area of stable hyperendemic malaria, which may benefit from an antimalarial programme.

Age Factors↗