Economic sanctions and embargoes.
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Economics↗
Biomedical subjects
L Richards
Publications and source records attributed to L Richards.
Therapeutic interventions to improve upper extremity recovery and function.
In this article, the authors discuss motor control deficits in the upper extremity following stroke that interfere with the ability to perform daily life activities. The authors then review conditions of practice that promote learning of motor skills and how well several current intervention approaches adhere to these practice conditions. For each intervention approach, the authors discuss the evidence for effectiveness of the approach in facilitating motor skill gains.
Activities of Daily Living↗
Vaccination with irradiated autologous melanoma cells engineered to secrete human granulocyte-macrophage colony-stimulating factor generates potent antitumor immunity in patients with metastatic melanoma.
We conducted a Phase I clinical trial investigating the biologic activity of vaccination with irradiated autologous melanoma cells engineered to secrete human granulocyte-macrophage colony-stimulating factor in patients with metastatic melanoma. Immunization sites were intensely infiltrated with T lymphocytes, dendritic cells, macrophages, and eosinophils in all 21 evaluable patients. Although metastatic lesions resected before vaccination were minimally infiltrated with cells of the immune system in all patients, metastatic lesions resected after vaccination were densely infiltrated with T lymphocytes and plasma cells and showed extensive tumor destruction (at least 80%), fibrosis, and edema in 11 of 16 patients examined. Antimelanoma cytotoxic T cell and antibody responses were associated with tumor destruction. These results demonstrate that vaccination with irradiated autologous melanoma cells engineered to secrete granulocyte-macrophage colony-stimulating factor stimulates potent antitumor immunity in humans with metastatic melanoma.
Cancer Vaccines↗
Comparison of exposed dentinal surfaces resulting from abrasion and erosion.
The aim of this study was to compare the shape of exposed dentinal surfaces caused by abrasion and erosion with a view to developing a diagnostic clinical test. The study material consisted of 80 natural teeth and 129 dental models obtained from Australian Aborigines known to display considerable dental abrasion due to their diet, and dental models of 37 Caucasians diagnosed with dental erosion through detailed history and dietary analysis. Polyvinyl siloxane impressions were obtained of all occlusal surfaces with dentinal scooping in both the 'abrasion' and 'erosion' groups. All impressions were sectioned buccolingually through the deepest point of the scooped dentine, and then the profiles were photocopied at x2 magnification. The breadth and depth of dentinal profiles were measured to an accuracy of 0.1 mm, enabling ratios of depth:breadth to be determined, and the position of the deepest part of each scooped surface was recorded. The mean depth:breadth ratio of scooped dentine was significantly greater in the Aboriginal natural teeth (0.19 +/- 0.06, mean +/- SE) than in the Aboriginal dental models (0.15 +/- 0.04). Both Aboriginal natural teeth and models with abrasion showed significantly smaller ratios (p < 0.05) than the Caucasian models showing erosion (0.33 +/- 0.07). Furthermore, in the abrasion samples, the deepest region of the scooped dentine tended to be lingually placed more often in maxillary teeth but buccally placed more often in mandibular teeth (p < 0.05). These results indicate that scooped dentine on abraded occlusal surfaces of teeth displays significant differences in shape compared with that caused mainly by erosion.
Adolescent↗
A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke.
BACKGROUND AND PURPOSE: Many stroke survivors have minimal to moderate neurological deficits but are physically deconditioned and have a high prevalence of cardiovascular problems; all of these are potentially modifiable with exercise. The purposes of this randomized, controlled pilot study were (1) to develop a home-based balance, strength, and endurance program; (2) to evaluate the ability to recruit and retain stroke subjects; and (3) to assess the effects of the interventions used. METHODS: Twenty minimally and moderately impaired stroke patients who had completed inpatient rehabilitation and who were 30 to 90 days after stroke onset were randomized to a control group or to an experimental group that received a therapist-supervised, 8-week, 3-times-per-week, home-based exercise program. The control group received usual care as prescribed by the patients' physicians. Baseline and postintervention assessments included the Fugl-Meyer Motor Assessment, the Barthel Index of Activities of Daily Living (ADL), the Lawton Scale of Instrumental ADL, and the Medical Outcomes Study-36 Health Status Measurement. Functional assessments of balance and gait included a 10-m walk, 6-Minute Walk, and the Berg Balance Scale. Upper extremity function was evaluated by the Jebsen Test of Hand Function. RESULTS: Of 22 patients who met study criteria, 20 completed the study and 2 refused to participate. The experimental group tended to improve more than the control group in motor function (Fugl-Meyer Upper Extremity: mean change in score, 8. 4 versus 2.2; Fugl-Meyer Lower Extremity: 4.7 versus -0.9; gait velocity: median change, 0.25 versus .09 m/s; 6-Minute Walk: 195 versus 114 ft; Berg Balance Score: 7.8 versus 5; and Medical Outcomes Study-36 Health Status Measurement of Physical Function: 15. 5 versus 9). There were no trends in differences in change scores by the Jebsen Test of Hand Function, Barthel Index, and Lawton Instrumental ADL Scale. CONCLUSIONS: This study demonstrated that a randomized, controlled clinical trial of a poststroke exercise program is feasible. Measures of neurological impairments and lower extremity function showed the most benefit. Effects of the intervention on upper extremity dexterity and functional health status were equivocal. The lasting effects of the intervention were not assessed.
Activities of Daily Living↗
Cancrum oris (noma) in a patient with acute lymphoblastic leukaemia. A complication of chemotherapy induced neutropenia.
Cancrum oris (noma) has been most commonly described in malnourished debilitated children with poor oral hygiene following systemic childhood infections such as measles, pertussis or scarlet fever. We describe a patient who developed this condition during a period of profound neutropenia following cytotoxic chemotherapy for acute lymphoblastic leukaemia.
Adult↗
A phase I study of vaccination with autologous, irradiated melanoma cells engineered to secrete human granulocyte-macrophage colony stimulating factor.
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Genetic Engineering↗
Activation without selection: parallel right hemisphere roles in language and intentional movement?
Because language and praxis each require the activation and selection of knowledge structures in long-term memory (MacKay, 1985, 1987), it is reasonable to consider whether hemisphere asymmetries for such processes span both domains. Language and skilled movement are thought to be strongly lateralized to the left hemisphere in most individuals. Yet, although recent evidence suggests that the right hemisphere also contributes to language use in context, few similar arguments have been made for the right hemisphere's involvement in motor planning. In this paper, we review some of the evidence for a right hemisphere role in language and action processing and propose that within each domain the right hemisphere activates a range of relevant knowledge structures without selection.
Affect↗
Palatal rugae patterns in Australian aborigines and Caucasians.
The purpose of this study was to determine whether rugae patterns change with age and to compare the number and pattern of rugae in Australian Aborigines with those of Caucasians. For the longitudinal part of the study, serial dental casts of ten Aborigines, from 6 to 20 years of age, were examined and rugae patterns were recorded. To enable comparisons to be made between different ethnic groups an additional 100 dental casts of Australian Aborigines and 200 casts of caucasians, ranging in age from 13 to 17 years, were examined. Characteristics observed were number, length, shape, direction and unification of rugae. The length of rugae increased significantly with age but the total number of rugae remained constant. Thirty-two per cent of rugae showed changes in shape, while 28 per cent displayed a change in orientation. In contrast to studies suggesting that rugae move forward with age, the majority of Aboriginal rugae that changed direction moved posteriorly. Changes in rugae patterns have been assumed to result from palatal growth but alterations in pattern were observed in the Aboriginal sample even after palatal growth had ceased. The mean number of primary rugae in Aborigines was higher than in Caucasians, although more primary rugae in Caucasians exceeded 10 mm in length than in Aborigines. The most common shapes in both ethnic groups were wavy and curved forms, whereas straight and circular types were least common. There was a statistically significant association between rugae forms and ethnicity, straight forms being more common in Caucasians whereas wavy forms were more common Aborigines.
Adolescent↗
The effect of gender and age at onset of depression on mortality.
BACKGROUND: Depression has a marked negative impact on geriatric patient mortality and morbidity. The risk factors and exact reasons for these effects are not well understood. METHOD: Seeking to better define the factors, we retrospectively analyzed the effects of gender and age at onset of affective disorder in a naturalistic study of 192 geriatric patients consecutively admitted to a large midwestern tertiary care center between 1980 and 1987 for the treatment of unipolar depression. RESULTS: After controlling for age at index admission, patients with an onset of depression before age 40 suffered significantly (p < .05) less mortality in follow-up than those with onset after age 40. When effects of gender are examined, the effects of age at onset are most profound in women, with a threefold increase in the rate of death in the cohort with age at onset of depression after 70 years when compared to those with onset before age 40. CONCLUSION: These results and those of others suggest that depressed elderly women with no previous history of affective disorder are at a markedly increased risk compared with elderly women with a history of affective illness for morbidity and mortality and that a significant proportion of elderly depressed patients are admitted to a psychiatric hospital for a depression that is secondary to serious medical illness.
Age Factors↗
Pulmonary Nocardiosis in a patient with human immunodeficiency virus disease.
Nocardiosis is an uncommon disease which occurs most often in patients with impaired cellular immunity, yet is rarely reported in patients with Human Immunodeficiency Virus Disease. We present the first case of Nocardiosis seen at the University Hospital of the West Indies, occurring in a well-controlled diabetic with Human Immunodeficiency Virus Disease.
AIDS-Related Opportunistic Infections↗
Depth of associated activation in the cerebral hemispheres: mediated versus direct priming.
This study investigated the depth of associative activation in the cerebral hemispheres. Semantic priming was assessed for direct (WATER-DRINK) and indirect (mediated: SOAP-DRINK) associates presented to the left and right visual fields across stimulus-onset-asychronies (SOAs) of 50, 250 and 750 msec. Priming for both the direct and indirect associates was found in both visual fields at all SOAs. Our results imply that activation via associated relations in semantic memory is early and extensive in both hemispheres. We relate our findings to the previous suggestion [5, 9, 14] that meaning activation is more narrow in the left hemisphere (LH) than in the right hemisphere (RH).
Adolescent↗
Activation of lexical codes for simultaneously presented words: modulation by attention and pathway strength.
Horizontal and vertical stings were presented in a "crosswords" format within left or right visual fields. Distractor strings were varied to examine the extent to which prelexical, orthographic-phonological, and semantic codes are activated for words not focally attended. The results supported 2 predictions of the pathway strength model of attentional modulation (JD Cohen, K Dunbar & JL McClelland, 1990). First, distractor influences were greater when participants attended to the weaker (ie, vertical) item and ignored the stronger (ie, horizontal) string, than vice versa. Second, distractors similar to the target facilitated, whereas dissimilar distractors interfered with, pronunciation responses. It is concluded that spatial attention can modulate word recognition processes, and that some interesting questions emerge when one abandons the assumptions of serial, noninteractive word recognition processes.
Analysis of Variance↗
The phagocytosis of mycoplasmas.
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Animals↗
Agenesis of permanent maxillary lateral incisors in South Australian twins.
The frequency of agenesis of maxillary lateral incisors (I2) in a sample of South Australian twins was determined, and associations with gender, zygosity, birthweight and dental crown size were investigated. Ten of the 446 twins examined (2.24 per cent) displayed agenesis of one or both I2, a similar frequency to that reported for Australian singletons. Seven of the ten affected individuals were monozygous female twins, including two pairs, while the three affected dizygous twins were each from different male twin pairs. Five pairs of monozygous twins were identified who displayed varying expressions of normal, small, peg-shaped or missing I2. These twin pairs displayed disparate birthweights suggesting they may have been mono-chorionic. These findings are consistent with a multifactorial threshold model linking size and number of I2 with developmental influences modifying phenotypic expression in those monozygous twins whose genetic predisposition places them near to the threshold for agenesis.
Adolescent↗
Effect of ECT on mortality and clinical outcome in geriatric unipolar depression.
BACKGROUND: Recent reports have called into question the safety and effectiveness of electroconvulsive therapy (ECT). METHOD: To investigate these claims, the effects of ECT on clinical outcomes were examined as part of a retrospective, naturalistic study of 192 geriatric patients consecutively admitted between 1980 and 1987 to a large midwestern tertiary care center for the treatment of depression. Data were analyzed by a variety of parametric and nonparametric methods including ANOVA and survival analysis. RESULTS: Patients who received ECT (N = 108) were more likely to exhibit psychomotor retardation and to have had prior courses of ECT than those who did not receive ECT (N = 84). Furthermore, despite the absence of differences in the overall rate or severity of medical comorbidity, patients receiving ECT were more likely to be alive at follow-up and to demonstrate greater clinical improvement than those treated only with pharmacotherapy. CONCLUSION: These results confirm previous studies demonstrating the superior efficacy of ECT as compared with conventional pharmacotherapy treatment in patients hospitalized with depression and document its safety in long-term follow-up.
Age Factors↗
Case study: antimanic effectiveness of dextroamphetamine in a brain-injured adolescent.
A relatively enduring and counterintuitive antimanic response to dextroamphetamine in a brain-injured adolescent who had failed trials involving divalproex, lithium, haloperidol, and carbamazepine is described. This finding combined with data from previous reports of antimanic effects of test doses of stimulants imply that such a pharmacological probe may prove relevant for the prediction of treatment response of mania to dextroamphetamine and perhaps for subclassification of bipolar disorder.
Adolescent↗
Leukemia inhibitory factor prevents the death of axotomised sensory neurons in the dorsal root ganglia of the neonatal rat.
Leukemia inhibitory factor (LIF) has several characteristics of a neurotrophic factor for sensory neurons. Here we have investigated whether LIF also supports the survival of axotomised sensory neurons in vivo. Newborn rat pups received a unilateral sciatic nerve transection and the injury site was treated with gelfoam soaked in phosphate buffered saline (PBS), nerve growth factor (NGF), or LIF. Neuronal nucleoli in the L5 dorsal root ganglia were counted, appropriate corrections applied, and the resultant neuronal loss expressed as a percentage of the contralateral intact side. In animals where LIF was administered neuronal loss was significantly reduced: 2 days after LIF treatment neuronal loss was 19.5% compared to 43% in PBS-treated animals; 3 days after LIF treatment neuronal loss was 20.4% compared to 40.2% in PBS-treated animals; however, 7 days after LIF treatment there was no significant reduction in the number of neurons lost. The degree of rescue of sensory neurons in vivo by LIF was found to be similar to NGF, which was not surprising as both factors supported the survival of a similar population of sensory neurons in vitro. Rescue was not observed when LIF-containing gelfoam was placed away from the axotomised nerve, suggesting that LIF's action may be associated with its retrograde transport or direct signalling at the site of nerve injury.
Animals↗