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Biomedical subjects

J Thornton

Publications and source records attributed to J Thornton.

At least 127 records · Page 7Linked to original sources

A comparison of sonographic estimation of fetal weight and obstetrically determined gestational age in the prediction of neonatal outcome for the very low-birth weight fetus.

A comparison of sonographic estimation of fetal weight and obstetrically determined gestational age in the prediction of neonatal outcome for the very low-birth weight fetus was conducted in a study population of 122 fetuses. With stepwise logistic regression, obstetric gestational age was found to be the best predictor of neonatal death, while sonographic estimated fetal weight did not add significantly to this prediction. However, both variables were important in the prediction of adverse neonatal outcome (neonatal death together with major neonatal complications of prematurity.

Female↗

Occupational therapy issues in the treatment of the long-term mentally ill.

In this paper, a single case study is used to facilitate discussion of problems encountered by occupational therapists engaged in working with the long-term mentally ill. The achievement of the long-range and multi-faceted approach necessary for the management of this population is a recognized challenge. Some of the paradoxes and dilemmas involved in programming and the measurement of outcome and success are clarified. As well, sources of stress to individuals involved in working with the long-term mentally ill are considered. Issues addressed include: philosophy of approach, professional and personal conflicts patients' wishes and involvement, and the low priority given to working with this group. Two main objectives of the paper are to: bring an appreciation for the complexity of the difficulties presented and demonstrate how occupational therapists can offer valuable contributions in working with the long-term mentally ill.

Chronic Disease↗

Health status of workers with past exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin in the manufacture of 2,4,5-trichlorophenoxyacetic acid: comparison of findings with and without chloracne.

Chloracne was found in 52% of 226 workers in a 1979 cross-sectional survey at a plant where 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) had been manufactured from 1948 to 1969. Mean duration of residual chloracne was 26 years, and in 29 subjects, it had been present for 30 years. A significant increased prevalence of abnormal gamma-glutamyl transpeptidase (GGT) and higher mean GGT were found in those with chloracne, compared to those without. Although mean triglyceride values were higher in those with chloracne, the difference was not statistically significant. Neurological examination showed a statistically significant higher prevalence of abnormal sensory findings in those with chloracne. Increased prevalence of angina and reported myocardial infarction in those with chloracne was not significant when age-adjusted. Increased prevalence of reported sexual dysfunction and decreased libido in those with chloracne compared to those without was statistically significant after age adjustment. No differences were found between those with and without chloracne in serum cholesterol, total urinary porphyrins, or in reproductive outcome.

2,4,5-Trichlorophenoxyacetic Acid↗

The satiating efficiency of foods.

Experiments were undertaken to test the general hypothesis that some foods are more satiating than others, to find a mechanism for their differential satiating efficiencies, and to determine whether certain soups had a high enough satiating efficiency to recommend their addition to a meal as a way of reducing total caloric intake of that meal. In the first experiment it was found that intake of a test meal was lower after a large preload of tomato soup than after a small preload in women, but not in men. However, the total energy intake (soup plus test meal) was no less with meals which included the large soup preload than it was with meals that did not include a preload. Therefore adding a normal portion of tomato soup to a meal would not reduce its total energy intake. We noted the interesting incidental finding that total energy intake (i.e., preload plus test meal) of the meals which contained the larger amount of soup was less than the total energy intake of the meals which contained a combination of crackers , jelly, and juice. In the second experiment we confirmed this finding by showing that when equal weights of tomato soup preloads and a preload of crackers , cheese, and apple juice, which contains more energy, were given, total energy intake was less in meals which included soup. Therefore, substituting tomato soup for a more calorically dense first course could reduce total energy intake of that meal. In the third experiment, the hypothesis suggested by the second was confirmed. Two soups were more satiating than crackers , cheese, and juice. When two calorie levels were used for each preload, it was shown that calorie for calorie, these soups decreased intake of the test meal more than crackers , cheese, and juice. In the fourth experiment we showed that the mechanism for this differential satiating efficiency is not readily attributable to either bulk related factors or fat content. We suggest that the differential satiating efficiencies are related to differences in nutrient dispersion, orosensory cues, or temperature. Finally, reductions in intake were accompanied by reductions in the initial rate of eating and not by increases in the rate of deceleration. This reduction was small but consistent and suggests that foods which are more satiating reduce intake by decreasing desire to eat (i.e., hunger), not by accelerating the onset of meal termination (i.e., satiety). In fact the duration of meals was unaffected by the preloads.

Adolescent↗

Neonatal intensive care. The nurse's role in supporting the family.

In this article we have reviewed the family's response to the crisis of premature birth and the sick newborn infant. We included the structure and availability of perinatal care because many states have alternative programs. The discussion of the nurse's role in supporting families was set in our level III ICN. But it is our belief and hope that nurses can apply the same principles and methods described, in any ICN, regardless of level. The nurse's role we have described clearly demonstrates the value of the continuity the nurses can provide as a basis for supporting families. The extended role of the primary nurse can and does provide support for families to an even greater extent.

Communication↗

VEPs in humans reveal high and low spatial contrast mechanisms.

The effect of contrast on visual evoked potential (VEP) amplitude was examined in nine observers. A 6.0 cycles/deg (cpd) grating was modulated in an "on-off" mode at 7.5 Hz. The VEP response contains significant first and second harmonic components: their growth with contrast is parallel, each function consisting of two limbs. The data are consistent with the hypothesis that the pattern VEP obtained with "on-off" presentation may reflect the contributions of "low" and "high" contrast neuronal populations demonstrated in physiological studies of the primate.

Evoked Potentials, Visual↗

Moderate alcohol intake reduces bile cholesterol saturation and raises HDL cholesterol.

The effect of alcohol on plasma high-density lipoprotein (HDL) cholesterol and on bile cholesterol saturation was measured in 12 healthy volunteers with a very low initial alcohol intake who drank 39 g alcohol daily for six weeks, and then abstained from alcohol for 6 weeks. HDL cholesterol (mean +/- SEM) rose significantly from 1.07 +/- 0.05 to 1.25 +/- 0.08 mmol/l (41.4 +/- 1.9 to 48.3 +/- 3.1 mg/dl) when alcohol was being consumed and fell to 1.04 +/- 0.06 mmol/l (40.2 +/- 2.3 mg/dl) during abstention. Bile cholesterol saturation index fell from 1.31 +/- 0.06 to 1.08 +/- 0.06 during the period of alcohol consumption and rose to 1.27 +/- 0.09 during abstention. There was a significant inverse correlation between bile saturation index and HDL cholesterol (r = -0.56). These data provide further evidence of a biochemical link between cardiovascular disease and cholesterol gallstones and suggest that moderate alcohol intake has some protective effect against both diseases.

Adult↗

Pattern electroretinograms and visual-evoked potentials in glaucoma and multiple sclerosis.

Steady-state visual-evoked potentials and electroretinograms were simultaneously recorded in four patients with glaucoma and in five patients with multiple sclerosis. The stimuli included a homogenous field and a 2.3 cycles per degree sinusoidal grating that were counter-phase modulated at the rate of 7.5 Hz. We used narrow bandwidth spectral analysis to measure the response amplitudes and signal-to-noise ratios. Transient pattern visual-evoked potentials (1 Hz) were also measured for latency in each eye. We found abnormal pattern electroretinograms, based on the absence of a significant second harmonic component, in three of the four glaucomatous eyes although the homogenous field electroretinograms were normal. In the patients with multiple sclerosis, the pattern electroretinograms were abnormal in two eyes, but the transient visual-evoked potential latency had the highest diagnostic yield (seven of ten eyes).

Adult↗

Physician bias in cesarean sections.

Various aspects of physician bias in the decision to perform a cesarean section were investigated by comparing indications for cesarean sections for 1979 and 1980 and investigating the distribution of indications according to the day of the week. The contention that obstetricians may perform cesarean sections on weekends for secondary gain was refuted by showing no difference in the distribution of nonelective cesarean section indications between weekdays and weekends. Statistically significant changes in cesarean section indications were, however, observed between the two investigated years, which may be attributed to an organizational change within the department toward more sophisticated obstetric care. These changes included a significant increase in cesarean sections for dystocia and breech presentation and a decrease for fetal distress and "other" indications. Because the total cesarean section rate did not change during the study periods, it is suggested that modern obstetric practice per se does not increase cesarean section rates, but may shift the distribution of indications for cesarean section.

Attitude of Health Personnel↗

Dopaminergic deficiency and delayed visual evoked potentials in humans.

Abnormal delay in visual evoked potential (VEP) could be normalized in 9 of 14 previously untreated parkinsonian patients under the influence of levodopa/carbidopa therapy. In 6 of 11 previously untreated schizophrenic patients the VEP latency became abnormal following therapy with agents known to cause dopaminergic blockade. Besides defects in retrobulbar conduction secondary to demyelination, synaptic dysfunction due to neurotransmitter deficiency or receptor blockade must also be considered as a mechanism underlying VEP delays in humans.

Adult↗

Body burden of polychlorinated biphenyls among persons employed in capacitor manufacturing.

In an effort to assess exposure among workers engaged in capacitors manufacture, PCB concentration was determined in plasma (290) and adipose tissue (61). In general, males had higher concentrations of PCBs than females. The correlation of plasma concentration (1-546 ppb) of the more highly chlorinated PCBs, which had been used in past, with total duration of employment suggested accumulation over time. The gc-ec pattern of these PCB peaks was, in most cases, characteristic of exposure to a PCB mixture with 54% chlorine. The less highly chlorinated PCBs, di-, tri-, and tetrachlorobiphenyls, were the source of current exposure, and were observed in concentrations of 6-2530 ppb in plasma. Higher exposure occurred among persons with direct contact with PCBs in jobs such as capacitor filling. Adipose tissue concentrations, for both the more highly chlorinated PCBs (1-165 ppm) and lower chlorinated PCBs (0.6-414 ppm), were proportional to those in plasma.

Adipose Tissue↗

C-terminal octapeptide of cholecystokinin decreases food intake in obese men.

Six of eight obese men ate significantly less food during an intravenous infusion of the C-terminal octapeptide of cholecystokinin (CCK-8, 4 ng . kg-1 . min-1) than during a saline infusion in a double blind experimental paradigm. Subjects stopped eating sooner during CCK-8. CCK-8 did not change the rate of eating. No overt side effects were reported or observed. This is the first report of the satiety effect of CCK-8 in obese humans and it suggests that the therapeutic potential of CCK-8 for the treatment of obesity deserves investigation.

Body Weight↗

Studies of carbohydrate metabolism after hemodialysis and hemofiltration in uremic patients.

To assess the effects of dialysis or hemofiltration on carbohydrate metabolism in uremia, we performed intravenous (IV) glucose tolerance tests (IV GTTs) after an overnight fast 48 hours following the last treatment in ten patients with chronic renal failure. Samples were obtained for plasma glucose, insulin, glucagon, and growth hormone levels throughout the GTTs in addition to basal samples for levels of plasma potassium and bicarbonate. The IV GTTs were performed at the end of a four-month period of standard hemodialysis (period 1) and then at the end of a four-month period of hemofiltration (period 2). Patients had mild glucose intolerance that did not change after hemofiltration, although the exaggerated insulin responses to glucose administration did significantly decrease in period 2. The fasting hyperglucagonemia did not decrease after hemofiltration but exhibited normal suppression with IV glucose. Levels of basal plasma bicarbonate and basal plasma potassium did not change significantly in period 2. Further studies investigating the beneficial metabolic effect of hemofiltration would seem to be indicated based on the data reported herein.

Adult↗