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Biomedical subjects

L Hughes

Publications and source records attributed to L Hughes.

At least 55 records · Page 3Linked to original sources
PubMed1992

The syndrome of senile gait.

Infrared computed stroboscopic photometry was used to quantify the kinematic profiles of walking in 10 elderly patients with symmetrical neurological disturbances of gait and in 19 age-matched neurologically healthy people. Clinical examination of the patients revealed similar profiles of walking even though their diagnoses were vascular dementia (2), normal pressure hydrocephalus (2), Alzheimer dementia with possible normal pressure hydrocephalus (2), mixed Alzheimer and vascular dementia (1), peripheral neuropathy (1), Alzheimer dementia with parkinsonian features (1), and undetermined (1). Quantitatively, the patients' gait kinematics deviated greatly from control values, but these deviations were statistically attributable to reductions in stride. We suggest that many gait disturbances in elderly people are similar, regardless of etiology, because the characteristics of these gait disturbances are heavily veiled by nonspecific stride-dependent changes that comprise the syndrome of senile gait.

Aged↗
PubMed1992

Phase resetting and frequency entrainment of essential tremor.

Step and sinusoidal forcings were delivered to the wrists of 10 patients with advanced essential tremor using a computer-controlled torque motor. Consistent (type 0) phase resetting was produced in only 5 patients, whereas all 10 patients exhibited harmonic and 2:1 subharmonic entrainment of essential tremor. These results indicate that the oscillator of essential tremor is coupled to the stretch-reflex arc. Irregularity in the tremor rhythm and postperturbation mechanical-reflex oscillations obscured the phase of essential tremor, thereby impeding the computation of phase resetting curves. Sinusoidal forcings circumvented these problems, but frequency entrainment was produced only by forcings at frequencies within +/- 1 Hz of the tremor frequency and its second harmonic. Resonance accompanied frequency entrainment and probably plays a role in the clinical expression of tremor.

Adult↗
PubMed1992

Faculty-student interactions and the student-perceived climate for caring.

The identification of caring as a core value for nursing practice elaborates the need to investigate the educational processes through which caring can be learned by those who will assume primary caregiver roles. Using qualitative inquiry, this study was conducted to describe a climate for caring as perceived by 10 junior nursing students and to identify faculty behaviors and faculty-student interactional episodes through which these students experience a climate for caring. Consistent with one researcher's conceptualization of the components of a moral education, the findings from this study suggest that modeling, dialogue, practice, and confirmation are the faculty-student interactional processes through which these students experienced a climate for caring.

Adult↗
PubMed1992

Longitudinal study of essential tremor.

We measured wrist tremor and forearm EMG in 18 patients with essential tremor on two occasions separated by periods of 4 to 8 years. The frequency of tremor decreased 0.28 Hz to 3.21 Hz in 10 patients and changed less than 0.25 Hz in the remaining eight patients. Thus, the frequency of essential tremor may decrease over time.

Adult↗
PubMed1992

Discrimination between forms of vitamin E by humans with and without genetic abnormalities of lipoprotein metabolism.

To study the mechanisms of discrimination between various forms of vitamin E, four normal subjects, one patient with lipoprotein lipase deficiency, and three patients with abnormal apolipoprotein B-100 production were given an oral dose containing three tocopherols labeled with differing amounts of deuterium (2R,4'R,8'R-alpha-(5,7-(C2H3)2)tocopheryl acetate (d6-RRR-alpha-tocopheryl acetate), 2S,4'R,8'R-alpha-5-(C2H3)tocopheryl acetate (d3-SRR-alpha-tocopheryl acetate), and 2R,4'R,8'R-gamma-(3,4-2H)tocopherol (d2-RRR-gamma-tocopherol). The tocopherol contents of plasma, red cells, and lipoproteins were measured up to 76 h after the dose. In normal subjects all three tocopherols were absorbed and secreted in chylomicrons with equal efficiencies. Both d2-gamma- and d3-SRR-alpha-tocopherols peaked at similar concentrations in the other lipoprotein fractions, then decreased similarly, but 2-4 times more rapidly than did d6-RRR-alpha-tocopherol. A lipoprotein lipase-deficient patient and a patient with prolonged production of chylomicrons with absent apolipoprotein B-100 also demonstrated the lack of discrimination between tocopherols during absorption. Despite abnormal apolipoprotein B-100 production in two patients, the "VLDL" was preferentially enriched in d6-RRR-alpha-tocopherol. Our results show that there is no discrimination between the three tocopherols during absorption and secretion in chylomicrons, but subsequently there is a preferential enrichment of very low density lipoprotein (VLDL) with RRR-alpha-tocopherol. Catabolism of this VLDL results in the maintenance of plasma RRR-alpha-tocopherol concentrations.

Administration, Oral↗
PubMed1991

Impairment, disability, handicap and medical expenses of persons aging with spinal cord injury.

Data from 205 Craig Hospital patients with spinal cord injuries (SCI) were analysed with regard to level of injury, age, length of time since SCI, disability (as measured by the Functional Independence Measure), handicap (as measured by the Craig Handicap Assessment and Reporting Technique), and average annual costs for services relating to the SCI. Differences in disability, handicap, and costs of care were analysed by chronological age and length of time since injury. Older individuals showed significant increases in disability and handicap. When chronological age was added to the number of years post-injury, significant increases in disability, handicap, and costs of care were noted at all neurological levels.

Adolescent↗
PubMed1990

Further studies of a new vitamin E analogue more active than alpha-tocopherol in the rat curative myopathy bioassay.

The bioactivities of the acetates of 2R,4'R,8'R- and 2S,4'R,8'R-2,4,6,7-tetramethyl-2-(4',8',12'-trimethyltridecyl)-5-h ydroxy-3,4- dihydrobenzofuran (RRR- and SRR-1-Ac) have been measured in the rat curative myopathy bioassay and compared with the RRR and SRR stereoisomers of alpha-tocopheryl acetate (RRR- and SRR-2-Ac). Each stereoisomer of 1 is only slightly more active than the corresponding stereoisomer of 2(RRR-1-Ac/RRR-2-Ac = 1.10; SRR-1-Ac/SRR-2-Ac = 1.16). This finding contrasts with our earlier finding [(1986) FEBS Lett. 205, 117-120], confirmed in the present study, that all-rac-1-Ac is 1.5-1.9 as active as all-rac-2-Ac. We suggest that the stereochemistry (S vs R) at the 4' and 8' tail carbons is of less biological importance in 1 than in 2.

Animals↗
PubMed1990

Comparison of prednisolone and placebo in subfertile men with antibodies to spermatozoa.

43 subfertile men with circulating antibodies to spermatozoa entered a double-blind crossover trial and received soluble prednisolone (20 mg twice daily on days 1-10 of the female partner's menstrual cycle, followed by 5 mg on days 11 and 12) or matching placebo tablets for 9 months each. 9 pregnancies were produced by men during prednisolone treatment, compared with 2 by men randomised to placebo (although only 1 was actually taking the placebo). No serious complications were produced, although 60% of those receiving prednisolone experienced mild side-effects.

Agglutination Tests↗
PubMed1990

Fibrinogen, factor VII clotting activity and coronary artery disease severity.

To asses the relationship between fibrinogen, factor VII coagulant (VIIc) activity and extent of coronary artery disease, we studied 43 white males shown to have greater than 50% stenosis of at least one major coronary artery. Thirty six had a definite history of myocardial infarction at least 3 months earlier and were classified as having 1, 2 or 3 vessel disease while 7 had 2 or 3 vessel disease, but no prior infarction. Groups were similar with regard to age, body mass index and blood pressure. In those with documented prior infarction, there was a significant relationship between the extent of atheroma and coagulation variables factor VIIc and fibrinogen. However, given a similar degree of atheroma, patients with prior infarction had significantly higher levels of factor VIIc activity compared with patients without such a history. These results corroborate those from prospective studies confirming a significant role for the coagulation system in the clinical manifestation of coronary artery disease.

Cholesterol↗
PubMed1990

Sequestrated meningoceles of scalp: extracranial meningeal heterotopia.

Sequestrated meningocele of the scalp has seldom been reported and is difficult to diagnose. Clinically it resembles dermoid cyst, hemangioma, or alopecia; radiographs and computed tomographic scans reveal no cranial bone defect, and surgery discloses no communication with the cranial cavity. Histologically, the lesion is characterized by a loose arrangement of connective tissue in dermis and subcutis, associated with flattened cells around collagen fibers (meningothelial cells). Most examples are very vascular, sometimes mimicking angioma, and about one third contain small necrotic foci. The meningothelial nature of the lesion is shown by its architectural similarity to communicating meningocele, and its identical immunoperoxidase reactions with vimentin and epithelial membrane antigen. In the 12 cases reported herein, most lesions were small (1 to 1.5 cm), and all but one were noted at birth but usually not resected until the patient had reached age 1 to 4, and one not until the patient was 31 years of age. Five lesions were not midline. We have been unable on histologic grounds to determine whether meningoceles are communicating or sequestrated. Compared with 20 communicating meningoceles, the sequestrated lesions were usually smaller, found in slightly older patients, and much less likely to be associated with hydrocephalus. The local excision of scalp lesions in children should include a search for a small intracranial connection.

Adult↗
PubMed1990

Is methyl-branching in alpha-tocopherol's "tail" important for its in vivo activity? Rat curative myopathy bioassay measurements of the vitamin E activity of three 2RS-n-alkyl-2,5,7,8-tetramethyl-6-hydroxychromans.

The vitamin E activity of the acetates of three 2RS-n-alkyl-2,5,7,8-tetramethyl-6-hydroxychroman analogs of alpha-tocopherol have been measured and compared directly with all-rac-alpha-tocopheryl acetate, or indirectly via 2R,4'R,8'R-alpha-tocopheryl acetate, using the rat curative myopathy, plasma pyruvate kinase assay. The analogs with alkyl chain lengths of 11 and 13 carbons have activities which not only do not differ significantly (p greater than 0.05) from each other but also do not differ from that of all-rac-alpha-tocopheryl acetate. This finding indicates that methyl branching in the phytyl tail at the 4', 8', and 12' positions has little if any influence upon vitamin E activity. Thus physical interactions involving the methyl branches of the phytyl tail and the polyunsaturated moieties of membrane phospholipids are unimportant in vivo, insofar as this bioassay is concerned. However, the length of the hydrocarbon tail is important. This is indicated by the result obtained with the acetate of the analog with an alkyl chain length of 15 carbon atoms which had only 15% of the activity of 2R,4'R,8'R-alpha-tocopheryl acetate, i.e., 22% of the activity of all-rac-alpha-tocopheryl acetate since this form is 1.47 times less active than 2R,4'R,8'R-alpha-tocopheryl acetate in the curative myopathy bioassay (Weiser, Vecchi, & Schlachter, Internat. J. Vit. Nutr. Res. 55:149-158, 1985).

Acetates↗
PubMed1990

A survey of the ultrastructural defects associated with absent or impaired human sperm motility.

The sperm tails of 400 patients having absent or impaired sperm motility were examined by electron microscopy. A wide variety of fine-structural defects were observed although all of the patients fell into clearly defined groups. Total or partial dynein arm deficiency was observed in 12 patients (3%). Ninety-one patients (23%) had sperm with a spectrum of fine-structural defects, whereas 90 patients (23%) were necrospermic. Subjects with low motility, but with at least a few tails of normal structure, had a 5% pregnancy rate, whereas those patients with similar overall motility, but in whom no normal sperm were seen, produced no pregnancies. The results confirm the importance of making an electron microscopical examination of the sperm of patients with asthenozoospermia.

Humans↗
PubMed1990

Professionalizing domesticity: a synthesis of selected nursing historiography.

The 19th century consolidation of the ideology of domesticity and the ideology of professionalism paralleled the evolution of nursing as a formal occupation for women. Efforts to combine these ideologies, which are based on markedly different foundational assumptions, have been central to the history of American nursing. A meaningful understanding of nursing's history necessitates a synthesis of the interpretations generated by individual historians who have studied similar events in nursing's past. Three feminist historians have studied the professionalizing process in nursing. Generated from diverse perspectives and source materials, the work of these historians illuminates the tensions resulting from nursing's efforts to blend the ideologies of domesticity and professionalism and provides insight into the lessons that can be learned from history.

Female↗
PubMed1990

Assessing organizational culture: strategies for the external consultant.

Organizational culture provides a mechanism for controlling the actions of the members of the organization by informally approving or prohibiting certain behaviors. Additionally, it serves an integrative function by generating commitment to the goals of the organization and by providing a framework for shared understanding of the meaning of events that occur within the organization (Smircich, 1983). Organizational theorists suggest that culture plays a particularly important role in those organizations that operate under conditions of high uncertainty and complexity and that strive to achieve outcomes that are difficult to measure (Bolman & Deal, 1984; Wilkins & Ouchi, 1983). Today's healthcare delivery agencies clearly fit this category of organizations. By taking the culture of these organizations into consideration when making recommendations, the nurse consultant can minimize the potential for resistance to the consultation process and maximize the potential for successful consultative outcomes.

Health Services Administration↗