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Biomedical subjects

M Fisher

Publications and source records attributed to M Fisher.

At least 397 records · Page 22Linked to original sources
PubMed1990

Community health advocacy: primary health care nurse-advocate teams in urban communities.

In summary, our health advocacy program uses PHC teams in urban, underserved communities to deal with the interaction of social and health factors in solving problems related to access to appropriate (as perceived by residents) and affordable health care. This approach encourages grass-roots participation in problem identification and solution, a fundamental ingredient of community empowerment. Further, this program facilitates community identification of nurses as resource persons who encourage collaboration to improve the community's health status and as health providers who enhance the authority and autonomy of community participation in the resolution of health issues.

Community Health Nursing↗
PubMed1990

Burst sheaths.

Explore the source record for details and available documents.

Contraception Behavior↗
PubMed1990

Chronic rejection in single-lung transplantation manifested by obliterative bronchiolitis.

Chronic rejection of the lung in patients with heart-lung transplants has most often been associated with the development of obliterative bronchiolitis. Previously only one patient receiving a single-lung transplant suffered from the development of this problem. We describe a patient whose obliterative bronchiolitis developed 9 months after single-lung transplantation. Progressive deterioration occurred until his death from obliterative bronchiolitis at 21 months after transplantation. The functional and histologic changes are described and the possible mechanisms discussed.

Aged↗
PubMed1990

Marfan syndrome in adolescents and young adults: psychosocial functioning and knowledge.

Twenty-two subjects with Marfan syndrome (age range 11-24 years, mean 15.7 years) were studied to evaluate the impact of Marfan syndrome on their lives, level of psychosocial adaptation, concerns about their disorder, compliance with medical regimens, and knowledge of Marfan syndrome. Subjects were interviewed and then completed the Offer Self-Image Questionnaire and two questionnaires designed for the study. Parents also were interviewed. Subjects demonstrated normal psychosocial adaptation on the Offer Self-Image Questionnaire. Nevertheless, the subjects perceived that their lives would be significantly better without Marfan syndrome, especially in the areas of physical activities and self-image. They expressed concerns about their illness most often to their parents, less frequently to their doctors. Their compliance with medical regimens were suboptimal and similar to the published description of compliance among teenagers with other chronic illnesses. Their knowledge base was weakest in the areas pertaining to future childbearing. Thus, although these subjects showed normal psychosocial adaptation, doctors caring for them may foster better coping with Marfan syndrome by discussing self-image issues and Marfan syndrome-related concerns, and by encouraging compliance and imparting knowledge.

Activities of Daily Living↗
PubMed1989

Amantadine treatment of fatigue associated with multiple sclerosis.

Fatigue is a common symptom of multiple sclerosis (MS) that is without an effective treatment. A double-blind, controlled study of fatigue treatment was conducted to evaluate the efficacy of amantadine hydrochloride in treating MS-associated fatigue. Since fatigue cannot be characterized by a single symptom or behavior, a variety of neuropsychological, behavioral, and self-report measures were used to monitor changes across different systems. According to patients' daily diary ratings, amantadine produced small but statistically significant improvements in fatigue across four of seven dimensions (overall energy level, concentration, problem solving, and sense of well-being). In addition, patients with MS who were taking amantadine performed slightly better on the Stroop Interference Test, an attentional measure of freedom from distracting information. Although retrospective reports by patients with MS did not confirm the degree of improvement recorded on a daily basis, the study's results suggested that amantadine may offer modest benefits in alleviating the day-to-day subjective experience of fatigue.

Adult↗
PubMed1989

The effects of a new tissue plasminogen activator analogue, Fb-Fb-CF, on cerebral reperfusion in a rabbit embolic stroke model.

Early fibrinolytic therapy with full molecular tissue plasminogen activator (t-PA) has been observed to be both angiographically and clinically effective when employed in animal stroke models. Preliminary clinical trials with t-PA are in progress. It is possible to refine t-PA by developing fragments or analogues of the drug. Using recombinant DNA technology in the Escherichia coli system, a t-PA analogue consisting of the catalytic fragment of t-PA and a dimer of the B fragment of staphylococcal protein A (Fb-Fb-CF) has been produced. Because this analogue has a long serum half-life of 90 minutes, we employed Fb-Fb-CF in a rabbit cerebral embolic stroke model to assess its efficacy as a reperfusion agent. When given as a bolus to 10 animals 15 minutes after embolization, Fb-Fb-CF produced angiographic cerebral reperfusion in 48 +/- 21 minutes (+/- SD), while in 8 saline-treated controls, reperfusion was not observed at 180 minutes in any animal (p less than 0.01). In another experiment reperfusion was demonstrated at 66 +/- 32 minutes in 11 animals treated with Fb-Fb-CF 90 minutes after embolization as compared with 100 +/- 25 minutes in 12 saline-treated controls (p less than 0.01). A small macroscopic hemorrhage within an infarct was seen in 1 Fb-Fb-CF-treated animal in the 15-minute experiment and in none of the controls. In the 90-minute experiment, macroscopic hemorrhagic infarction was seen in 4 Fb-Fb-CF-treated animals and in 3 controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Atherosclerosis: current concepts on pathogenesis and interventional therapies.

Atherosclerosis, the primary pathological condition accounting for most stroke syndromes, has been the intense focus of epidemiological, basic, and clinical investigations. Since these studies have direct bearing on the prevention of atherothrombotic brain infarction, this review emphasizes those advances in treatment resulting from their findings. The two most prominent theories on the pathogenesis of atherosclerosis relate to aberrations in lipoprotein metabolism and to enhanced proliferation of smooth muscle cells; likely, the theories are complementary. As a practical guideline for preventive therapy, the importance of using the total cholesterol level is stressed, although finer distinctions must rely on the low-density and high-density lipoprotein concentrations and their normalization. Since prevention of stroke may ultimately be its most effective therapy, consideration of cholesterol level, akin to strategies for preventing coronary heart disease, and efforts to avert platelet adhesion or aggregation and coagulation are warranted.

Arteriosclerosis↗
PubMed1989

Cardiogenic brain embolism and lupus anticoagulant.

The lupus anticoagulant, an acquired immunoglobulin associated with an increased tendency for thrombosis, has been linked to the occurrence of cerebral ischemia presumably related to in situ thrombosis. Cardioembolic cerebral ischemic events have rarely been reported. We encountered 2 patients with focal cerebral ischemia, substantial mitral valvular masses, and a circulating lupus anticoagulant. In each, diagnostic evaluation supported a cardioembolic etiology. These findings illustrate the need for evaluating patients with cerebral ischemic events for a cardioembolic source when a circulating lupus anticoagulant is present.

Adult↗
PubMed1989

Epidermoid splenic cyst detected on a sports physical examination.

A 14-year-old female had a large, nontender abdominal mass on a routine sports physical examination. Following evaluation by ultrasound and computed tomography scan there was an initial attempt at drainage. The mass was subsequently removed. The diagnosis was epidermoid cyst of the spleen. In this report, we discuss the epidemiology and management of a splenic cyst, a rarely encountered diagnosis in adolescents, and emphasize the life-saving potential of the abdominal examination in sports medicine.

Adolescent↗
PubMed1989

Premenstrual symptoms in adolescents.

To assess the prevalence and severity of premenstrual symptoms in adolescents, we administered the Premenstrual Assessment Form, a 95-item instrument previously validated in adults. Adolescent females (n = 207) at a suburban-based adolescent health service completed the form. Subjects had a mean age of 17.6 years, 89% were white, 59% were in high school, 28% were in college. Almost all subjects reported at least one premenstrual change of minimal (96%) or moderate (89%) severity, while many reported changes they considered severe (59%) or extreme (43%). The most commonly reported changes in physical condition were general discomfort and water retention symptoms, fatigue, and autonomic physical changes. The most commonly reported changes in mood and behavior included impaired social function, depressive changes, and impulsive behavior. These changes matched almost exactly those previously reported in adults and were most severe in those adolescents who reported having dysmenorrhea and were not on an oral contraceptive. We believe that clinicians and researchers who evaluate and treat adolescents should view the physical and emotional complaints of teenagers in the context of our findings.

Adolescent↗
PubMed1989

Detection of diabetic macular edema. Ophthalmoscopy versus photography--Early Treatment Diabetic Retinopathy Study Report Number 5. The ETDRS Research Group.

Clinical and photographic methods were used to assess retinopathy during the examinations of diabetic patients enrolled in the Early Treatment Diabetic Retinopathy Study (ETDRS). In analyzing available data from eyes randomly selected for deferral of treatment, the authors compare the clinical detection (including contact lens biomicroscopy) with photographic detection (30 degrees stereoscopic color fundus photographs) of diabetic macular edema. Based on clinical detection, 53% (1778 patients) had hard exudates within 1 disc diameter (DD) of the center of macula, 56% (1868 patients) had retinal thickening within this region, and 31% (1027 patients) had thickening at the center of macula. These analyses show agreements of 83, 78, and 83% between retinal specialists and photographic graders when assessing these three characteristics, respectively. Agreement was 81% in the detection of macular edema for which treatment is indicated (clinically significant macular edema). Each method has its advantages but in general there was close agreement between these methods, particularly for clinically significant macular edema, which supports the reliability of each method.

Diabetic Retinopathy↗
PubMed1989

Brain tumor presenting as an acute pure motor hemiparesis.

Acute pure motor hemiparesis is a clinical syndrome of isolated hemiparesis usually related to lacunar infarction, although other etiologies have been described. We recently encountered three patients with the abrupt onset of pure motor hemiparesis as the initial manifestation of primary or metastatic brain tumor. In each patient, early computed tomography demonstrated a nonhemorrhagic, right frontal, enhancing mass lesion. While the mechanism whereby brain tumor may present abruptly and simulate a stroke remains uncertain, these cases illustrate that pure motor hemiparesis can be the initial symptom of intracranial tumor. Early computed tomography or magnetic resonance imaging is suggested for all patients who present acutely with pure motor hemiparesis.

Acute Disease↗
PubMed1989

Intravenous infusion of apolipoprotein E accelerates clearance of plasma lipoproteins in rabbits.

Plasma cholesterol levels in cholesterol-fed rabbits were markedly reduced by the intravenous infusion or bolus injection of recombinant human apo E or rabbit plasma apo E. Administration of 6-70 mg of apo E resulted in an approximately 20-40% acute reduction in plasma cholesterol levels within 2-3 h. Plasma cholesterol levels remained reduced for 4-8 h after the administration of apo E. Furthermore, the intravenous injection of apo E reduced the plasma cholesterol levels in Watanabe heritable hyperlipidemic rabbits. The addition of apo E to [14C]cholesterol-labeled canine thoracic duct lymph or [14C]cholesterol-labeled chylomicrons resulted in accelerated plasma clearance of these diet-induced lipoproteins in normal rabbits, with the uptake occurring primarily in the liver. This study suggests that the amount or availability of apo E in the plasma of cholesterol-fed rabbits may be rate limiting for the normal clearance of diet-induced remnant lipoproteins.

Animals↗