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Biomedical subjects

M Gaskill

Publications and source records attributed to M Gaskill.

At least 19 recordsLinked to original sources
PubMed2001

Temporal changes in brain volume and cognition in a randomized treatment trial of vascular dementia.

OBJECTIVE: To measure changes in brain and ischemic volume over time by magnetic resonance imaging (MRI) as part of a randomized treatment trial of vascular dementia. METHODS: Participants who met criteria for vascular dementia underwent comprehensive neurological and neuropsychological testing on entrance, during, and at completion of the 1-year study. For those centers who had easily available MRI, MRI of the brain was to be performed on entry and completion of the study. Image analysis was performed on all balanced and T2-weighted MR films to determine ventricular, sulcal, ischemic, and hemispheric brain volumes. RESULTS: Of the 105 patients who met the criteria for vascular dementia, 40 had a baseline MRI study that met protocol requirements and was of excellent image quality. The baseline ventricular volume in these 40 patients with high-quality MR correlated with most measures of cognitive and behavioral function, including the total Alzheimer's Disease Assessment Score (ADAS) (r = 0.51, P = .0024), as well as activities of daily living (r = 0.61, P = .0002). The baseline ischemic brain volume correlated well only with the gait and postural stability scale (r = 0.74, P = .009). Of the 40 participants, 25 had MRI studies at baseline and at completion of the study that were comparable and of excellent image quality. For these 25 patients, the mean ventricular volumes increased by 9% over the study year (P = .001) and the mean ischemic brain volume increased by 18% (P = .01). Temporal changes in the sulcal and nonischemic brain volume did not reach significance. None of the 14 clinical score measures changed significantly between baseline and completion of the study in these 25 patients. CONCLUSION: In summary, ventricular volume correlated well with cognitive measures in patients with vascular dementia and was a more sensitive marker for change during the study year than the clinical scales used in this study. This study also points out the practical limitations of brain imaging as a surrogate measure of clinical outcome in multicenter randomized treatment trials of brain disease.

Activities of Daily Living↗
PubMed1996

Volumetric measurement of multifocal brain lesions. Implications for treatment trials of vascular dementia and multiple sclerosis.

This pilot study examined the reproducibility of serial magnetic resonance (MR) measurements of brain, ventricular, sulcal, and lesion volumes in patients with ischemic brain disease using an image analysis protocol designed at the University of Cincinnati. Five patients with a clinical history of brain ischemia had two separate MR brain imaging studies using the standard clinical MR imaging protocol at the University of Cincinnati Medical Center. The MR images on both film and tape were digitized and then analyzed according to the standardized image analysis protocol. Based on tape data, variability in volume measurements between the two MR studies, as measured by the coefficient of variation, ranged from 1% for intracranial volume to 8% for ventricular volume. Variability based on film data was slightly greater, ranging from 2% for intracranial volume to 12% for lesion volume. As part of a multicenter treatment trial of vascular dementia, this method was then used to analyze MR films in 13 patients with vascular dementia who all had an MR study at baseline and at 1 year. The mean annual change in lesion volume was 4 +/- 5 cm3 (a 24% increase from the baseline lesion volume); in ventricular volume, 7 +/- 8 cm3 (a 10% increase from baseline); and in sulcal volume, 13 +/- 25 cm3 (a 5% increase from baseline). This method of image analysis, using MR film or tape-generated data, can provide reproducible serial measurements of brain, ventricular, sulcal, and ischemic lesion volumes. This method, if applied in randomized treatment trials of vascular dementia or multiple sclerosis, can be used to monitor disease progression and to evaluate the effectiveness of a given therapy.

Aspirin↗
PubMed1992

Innovative desktop learning tools. Implications for rural hospitals and physicians.

Innovative methods of providing workplace education for health care professionals may be a key to the survival of rural hospitals in America. Such methods must overcome time, distance, cost and organizational constraints, and take into account the structure of the learning experience. The Texas Hospital Education and Research Foundation has recently been involved in two programs that tested new approaches to worker education using distance-learning strategies. The projects--resource sharing among rural directors of nursing and training for cancer tumor registrars--used computer-conferencing technology. A new model using existing satellite, audio-conferencing, and computer-based instruction augmented by computer conferencing is proposed. The Computer-Related Assisted Distance Learning Enhancement (CRADLE) model integrates existing technologies to provide education to health care workers at their desktop. The Cancer Learning Center (CLC) tested peer collaboration, the primary component of the model. The ultimate goal is to have the system available to all tumor registrars in Texas, and to secure funding to implement rural nursing and rural high-school health occupations education projects. Current projects from set-up through results are presented.

Computer Communication Networks↗
PubMed1992

Emergency care. Texas hospitals to the rescue.

An average of 17 Texans die every day as a result of accidental injuries. Our ability to respond to trauma in Texas will be a high priority issue in the upcoming Legislative session. In the meantime, metropolitan areas and remote rural locations across Texas have had to come up with ways to handle what is often a trauma crisis. Efforts are also underway to reduce the number of accidents and injuries in the first place. This month, HealthTexas takes a look at these trauma issues.

Disaster Planning↗
PubMed1991

Utility audits.

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Electricity↗