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Biomedical subjects

M Hayes

Publications and source records attributed to M Hayes.

176 records · Page 10Linked to original sources
PubMedDate not supplied

Midwives and maternal and child health: building resource capacity.

With dramatic changes in health, social services, and welfare systems and escalating pressure to increase clinical productivity, midwives need to enhance their capacity to work with federal, regional, and state partners to promote and protect comprehensive, culturally competent, and community-based quality health care for pregnant women and their families. Information about maternal and child health (MCH) regional and state resources is provided, and strategies for obtaining additional MCH resources are suggested, so that midwives and other women's health care providers can more effectively improve health care programs and systems that benefit women and their families. In addition, ways to work with MCH programs at the regional and state levels are described.

Community Health Planning↗
PubMedDate not supplied

Tubular carcinoma of the breast: a population-based study of nodal metastases at presentation and of patterns of relapse.

Tubular carcinoma of the breast (TCB) is a recognized histologic variant of infiltrating ductal carcinoma (IDC) and has been considered to have a comparatively favorable prognosis. However, previous studies have been based on small numbers of cases, some pure TCB and some mixed histology, or have not employed an appropriate comparison group. In this study 171 pure TCB cases and a comparison group of 386 cases with grade I (well differentiated) IDC were identified in a population-based database maintained by the British Columbia Cancer Agency (BCCA). The proportion of cases with axillary nodal involvement at presentation was lower in TCB cases than in the grade I IDC comparison group (12.9% and 23.9%, respectively; p < 0.05). Low-risk tumors (T1 and without vascular lymphatic or perineural invasion) were more prevalent in the TCB patients than in the grade I IDC patients (66.7% and 60.0%; p < 0.05). Low-risk TCB cases had a significantly lower rate of nodal metastases at presentation than low-risk grade I IDC cases (7.0% and 13.2%; p < 0.05). Kaplan-Meier and log-rank analyses indicated a statistically significantly lower rate of local recurrence in TCB cases than among IDC cases (p < 0.05) and a trend toward a lower rate of systemic relapse in TCB cases (p = 0.07). However, no difference in disease-specific survival was observed between TCB cases and grade I IDC comparisons. We conclude that the biologic behavior of TCB was more favorable than that of a comparison group of IDC cases. In view of the low incidence of axillary node metastases at presentation in the low-risk TCB subset (7%), axillary dissection may be omitted as part of the initial surgical management in these patients.

Adenocarcinoma↗
PubMedDate not supplied

Student placements as a creative solution to the nursing shortage.

This article combines a case presentation of a university affiliation with a home care agency and a study of the perceptions of district nurses in the agency regarding client and student interactions. Overwhelmingly, district nurses found having student placements positive. However, some concerns are expressed.

Community Health Nursing↗
PubMedDate not supplied

Anxiety and endocrine responses to surgery: paradoxical effects of preoperative relaxation training.

It has been argued that surgery is a form of psychological stress, and that the response to it should therefore be modifiable by psychological means. To test this hypothesis, we assessed the effect of preoperative relaxation instructions on endocrine, cardiovascular, and subjective responses in 21 patients undergoing minor abdominal surgery. Controls (N = 19) received general procedural information. In the relaxation group only, there was a significant increase in cortisol and adrenaline concentration from immediately before induction of anesthesia to immediately after surgery. Noradrenaline values were unaffected by relaxation. In contrast, relaxation reduced state-anxiety on the preoperative day and the two postoperative days; maximal peroperative systolic and diastolic blood pressures were also reduced. The results are consistent with previous evidence that adrenaline and cortisol responses to surgery are greater in less anxious patients.

Adaptation, Psychological↗
PubMedDate not supplied

Stress reactions involving the pars interarticularis in young athletes.

A stress reaction involving the pars interarticularis of the lumbar spine was confirmed in seven young athletes with a positive technetium pyrophosphate bone scan. No pars defects were detectable on their lumbosacral roentgenograms, which included oblique views. The return to normal levels of radioactive uptake on repeat bone scans correlated closely with their clinical course. If the bony reaction is recognized early, it may heal at a subroentgenographic level and prevent the development of lumbar spondylolysis. These early lesions usually show unilateral increased uptake at one lumbar level on the bone scan and, initially, the athlete localizes the pain to the corresponding unilateral lumbar paraspinous area. The "one-legged hyperextension test" is positive on the ipsilateral side and aggravates the pain. Treatment consists of avoiding the aggravating activities and resting. The average time for return to pain-free competition was 7.3 months. These developing defects may be the source of considerable prolonged disability in the young athlete, particularly if undiagnosed and untreated.

Adolescent↗
PubMedDate not supplied

Prognostic significance of TGF beta 1 and TGF beta 3 in human breast carcinoma.

Transforming growth factor beta s (TGF beta s) are multifunctional growth factors which show differential expression both temporally and spatially and exert pleiotropic effects during carcinogenesis. Although all three mammalian isoforms of TGF beta share considerable sequence similarity, they appear to have distinct functions in health and disease, such as embryogenesis, wound healing and tumourigenesis. Much of our knowledge about the relationship between TGF beta s and breast cancer is based on publications on TGF beta 1 but the role of TGF beta 3 in the progression of breast cancer has not been well documented. In the present study, the expression of TGF beta 1 and TGF beta 3 was assessed by immunohistochemistry. Of the 153 invasive breast cancer tissues, TGF beta 1 was expressed strongly in 25 and moderately in 98 cases. The immunoreactivity of TGF beta 3 was comparable with TGF beta 1, which was expressed strongly in 21 and moderately in 104 cases. The two isoforms were coexpressed in 111 (72.5%) tumours and were absent in 16 cases (10%). Immunostaining for TGFb3 but not TGF beta 1 was inversely correlated with overall survival (p = 0.0204). When combined with lymph node involvement, TGFb3 became an even more significant prognostic factor for overall survival (p = 0.0003), i.e. patients with node metastasis and positive TGFb3 expression had a worse prognosis: the risk of death for these patients was thirteen-fold greater than those who had no node involvement. The fact that it has been reported previously that high TGF beta 3 plasma levels in patients with untreated early stage breast cancer were correlated with subsequent lymph node metastasis and it was observed in the present study too, that TGF beta 3 expression in breast tumours was an independent predictor of overall survival, led us to suggest that the simultaneous measurement of TGF beta 3 in plasma and its expression in resected tumour tissues in the same cohort of patients may prove to be an important parameter in assessing tumour progression.

Adult↗