Biomedical subjects
Publications and source records attributed to M Lyons.
Ethical practice is a necessary component of nursing in today's complex clinical arena. This paper reviews the current status of ethics teaching in nursing education and the role of nurses in ethical decision making in acute care hospitals.
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Persons with disabilities are devalued by society. Occupational therapists may be contributing to this devaluation through their attitudes. This study focused on the attitudes of undergraduate students. From a sample of 223 occupational therapy students and 326 business students at an Australian university, it was found, with the use of the Attitudes Toward Disabled Persons Scale-Form A (Yuker, Block, & Young, 1966), that the attitudes of freshman occupational therapy students did not differ significantly from those of their business-major peers. Furthermore, the occupational therapy students' attitudes did not vary with the years of undergraduate education completed. However, those students who had had contact with persons with disabilities beyond the context of a caregiver-care receiver relationship (i.e., those students who had assumed roles that emphasized valued attributes of the person with a disability) had significantly more positive attitudes than did those students without such contact. Educational curricula must address the issue of students' attitudes and, in particular, the facilitation of valued social role contact with persons with disabilities.
Buschke-Löwenstein tumor is a rare type of anogenital squamous cell carcinoma with a distinctive clinical appearance. We present the case of a thirty-four-year-old man with this tumor, which was excised surgically. Human papillomavirus was detected in formalin-fixed, paraffin-embedded sections with a human papillomavirus 6/11 probe, but not with a human papillomavirus 16 or a human papillomavirus 18 probe.
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A factor analysis of the entire item set of the DSM-III criteria was conducted to determine the extent to which the factors that emerged corresponded to the 11 personality disorders and three clusters included in DSM-III. Data were obtained from 552 patients who completed a self-report personality questionnaire and from 287 psychiatrists who rated their patients. Eleven questionnaire factors emerged that had eigenvalues greater than one, and at least three items emerged with factor loadings greater than 0.40. A correlational and multiple regression analysis of the questionnaire factors and clinicians' ratings showed few strong relationships between the factors and the 11 personality disorders but good correspondence with the three clusters.
The Silicone Study is a multicentered, randomized surgical trial designed to compare the tamponade effectiveness of silicone oil versus long-acting gas in the treatment of proliferative vitreoretinopathy (PVR) by vitrectomy and associated techniques. Fundus photographs are taken to provide documentation of the anatomic status of eyes proposed for entry and are graded at an independent Reading Center. This article describes the protocol for photographic documentation of PVR as a continuum of increasing pathology, in which the pathology may only be present in the anterior retina, and the retina is usually highly elevated. In a validity and reliability study, agreement between photographic and clinical observation within one step was obtained for 88% of the eyes; intra- and inter-observer agreement within one step was 85 and 80%, respectively. Differences between the surgeon's grade and the Reading Center's were caused about equally by disagreement regarding extent of fixed folds and width of the funnel. Rarely did peripheral folds not visible in the photographs appear to be the sole explanation of the disagreement. Differences among readers were concerned mainly with differentiation of true full-thickness fixed folds from folds due to simple redundancy of the detached retina. These results demonstrate that complicated retinal detachment (RD) can be photographically documented and independently assessed.
Previously the authors have observed a reduction of the ventricular fibrillation threshold (VFT) in a mild diabetic model. This investigation examines the role of more severe hyperglycemia in altering the ventricular fibrillation threshold and how the sympathetic nervous system modulates the response. Alloxan diabetes was induced in eight male mongrel dogs 3-5 years of age (Group 2), for comparison with matched controls (Group 1). Hemoglobin A1c rose from 2.9 +/- .4-7.8 +/- .3% and body weight was maintained with daily insulin. After 1 year, anesthesia was induced with chloralose and an electrode catheter placed at the right ventricular apex. VFT was 41.7 +/- 1.8 ma in Group 1 and 27.8 +/- 2.1 ma in the diabetics of Group 2 (p less than .001). There was significantly greater decline of VFT in response to epinephrine infusion in Group 2. The threshold in diabetics rose to normal levels after infusion of the beta-blocking agent, esmolol. Subsequently, the response of the cardiac sympathetic system was assessed during ventricular pacing at 200 beats/minute. Serial paired blood samples were taken from catheters in the aorta and coronary sinus for catecholamine assay by HPLC. Both groups had similar coronary blood flow responses by the thermal method, as well as changes in arterial pressure. While no change occurred in Group 1, a progressive rise of norepinephrine (NE) concentration was observed in coronary venous effluent of Group 2 (p less than .01). The basal arterial-coronary sinus difference was-123 +/- 52 pg/ml, which rose during pacing in Group 2 to a peak of -376 +/- 9.3 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
We examined the influence of diabetes on the severity of coronary atherosclerosis, as judged by coronary morphometric and blood flow studies. Cynomolgus monkeys were fed a coconut-peanut oil mixture plus cholesterol to induce the plaque lesions of atherosclerosis in nondiabetic (group 2) and diabetic monkeys (group 3). Group 1 consisted of chow-fed controls. After 18 months of hypercholesterolemia, the animals were anesthetized to assess myocardial blood flow, by use of radioactive microspheres. Transmural and inner/outer wall flow ratios were normal in the two lipid-fed groups in the basal state. Vasodilation after adenosine (0.45 mg/kg/min IV) elicited a more than threefold rise of transmural blood flow in group 1, and a significantly reduced increment in groups 2 and 3. The blood flow ratio was not different from unity in group 1 but declined to 0.69 +/- 0.03 in group 2 and 0.69 +/- 0.06 in group 3, with similar decrements of heart rate and aortic pressure. In contrast to results in group 1, left ventricular filling pressure rose and velocity of contractile elements declined to a similar extent in groups 2 and 3 after adenosine, consistent with myocardial ischemia. Morphometric measurements as well as chemical analyses were performed on the three major coronary arteries. The degree of intimal thickening and increase of cholesterol and collagen content were comparable in groups 2 and 3. Thus, in this model the plaque lesions of atherosclerosis did not appear to be intensified by diabetes. Moreover, the responses to adenosine in terms of myocardial underperfusion and mechanical dysfunction were comparable in the two experimental groups.
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Infected and noninfected spinal cord-injured (SCI) patients, bilateral amputees (control for mobility), and a control group were compared for immune function. Immune measures involved acute phase reactants (erythrocyte sedimentation rate [ESR], c-reactive protein [CRP], and alpha-1 globulin [A1G], T cell measurements (absolute lymphocyte count [ALC]), and B cell function (gamma globulin [GG]). All subjects were at least three months postinjury, had no history of immune system disease, and were not taking potential immune system altering drugs. There was no T or B cell dysfunction, but acute phase reactants were elevated, even in patients without infection. Criteria for predicting infection included recent injury, few previous infections, and catheters. The best predictor of infection was CRP. Suggestions for further research include investigating nonhospitalized patients, searching for reasons for elevated acute phase reactants, and using the predicting formula on newly injured patients to see if it predicts infectious complications.
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Diisopalmitoylphosphatidylcholine (DIPPC), -phosphatidylethanolamine (DIPPE), and -phosphatidylglycerol (DIPPG) have been synthesized, and the structures of aqueous dispersions of these lipids have been examined by high-sensitivity differential scanning calorimetry, 31P nuclear magnetic resonance, and Raman spectroscopy. DIPPC at temperatures below 23.1 degrees C readily forms a gel phase with the acyl chains packed in an orthorhombic subcell. Above this temperature, this "orthorhombic" phase converts directly to the liquid-crystalline phase. The phase diagram for the system DIPPC--dipalmitoyl-PC (DIPPC-DPPC) shows that the gel phases formed by either lipid can accommodate only limited amounts of the other species and suggests that the low-temperature orthorhombic phase of DIPPC is distinct in its structure from the "subgel" phase of DPPC. DIPPE forms a well-ordered gel phase only in samples that are equilibrated at low temperatures for long times (approximately days to weeks) or at very high lipid concentrations. However, this lipid readily forms an "intermediate" phase with a very disordered acyl chain packing upon cooling from the liquid-crystalline state. Mixtures of DIPPE with DIPPG exhibit similar thermotropic properties. Hydrated DIPPE appears to be stable in the lamellar phase up to at least 98 degrees C, while di-cis- and di-trans-9-hexadecenoyl-PE convert to the hexagonal II phase at 43.5 and 92.5 degrees C, respectively. We discuss the relevance of these results to the structure and stability of bacterial membranes containing branched-chain acyl lipids.
The paper examines the high incidence of birth defects that still occur in the UK and suggests that it might be possible to reduce this by preparing prospective mothers for parenthood prior to conception. One test in particular is suggested as having a part to play in this preconception screening-that being the hair metals analysis. Such a screening test is useful in identifying both excesses of toxic metals and deficiencies of essential metals. The results from our studies seem to indicate a high proportion of potential mothers as having low levels of manganese, iron and possibly zinc in their hair. The significance of these findings is discussed in relation to the possible effect on birth defects and the possible routine use of hair metal testing in the pre-conception situation is suggested.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.