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Biomedical subjects

M Martin

Publications and source records attributed to M Martin.

At least 433 records · Page 24Linked to original sources
PubMed1994

Cognitive function in old and very old residents of a residential facility: relationship to age, education, and dementia.

OBJECTIVE: To determine if age, education, and dementia status affect neuropsychological performance in old and very old frail residential care subjects. DESIGN: Descriptive study of performance at the time of preadmission assessment. SETTING: Jewish Home for the Aging, Reseda, California. PARTICIPANTS: 201 applicants to the Jewish Home for the Aging residential care setting. Mean age was 84.7 years; SD was 5.6. Ninety-five subjects were 84 years of age or younger, while 106 were age 85 and older. There were 141 nondemented, 21 demented, and 39 were possibly demented applicants. Levels of education were as follows: 0-4 years: n = 25; 5-8: n = 69; 9-12: n = 77; and, 13-20: n = 23. MEASUREMENTS: Independent variables were age, education, and dementia status. Outcome measures were Folstein MMSE, Inglis P-A Learning Test, Digit Span, Cube Copying, selected Boston Diagnostic Aphasia Exam subtests. RESULTS: Subjects with 0 to 4 years of education scored more poorly on cognitive tests than other subjects. The very old tended to score more poorly than the old. Neuropsychological tests discriminated between those with normal cognitive function, possible dementia, and established dementia. About one-third of nondemented elderly scored below the traditional impairment cut-off of 24 points on the Mini-Mental State Exam. CONCLUSIONS: Questions are raised about how to interpret the poorer cognitive performance of very old and often frail subjects, especially in long-term-care settings where there are fewer demands upon residents whose impairments might otherwise cause them more functional difficulty.

Activities of Daily Living↗
PubMed1994

Diagnosis of cytomegalovirus infections by shell vial assay and conventional cell culture during antiviral prophylaxis.

A total of 3,552 specimens for conventional cytomegalovirus (CMV) culture and shell vial assay for CMV immediate-early antigen were obtained during a prospective randomized trial for prophylaxis of CMV disease after liver transplantation. Prophylaxis with ganciclovir for 2 weeks and then high-dose acyclovir for 2.5 months was compared with high-dose acyclovir alone for 3 months. During the first 12 weeks after transplantation, when the patients were on prophylaxis, there were significantly more clinical samples positive by the shell vial assay and negative by standard culture in comparison with the number of samples obtained from weeks 13 to 24, after prophylaxis was discontinued, that were positive by the shell vial assay and negative by standard culture. In contrast, significantly fewer samples were positive by both the shell vial assay and standard culture during the first 12 weeks compared with the number obtained 13 to 24 weeks after transplantation that were positive by both methods. Samples positive by the shell vial assay only were obtained significantly more frequently from patients with asymptomatic than symptomatic CMV infections, while samples positive by both methods were obtained significantly more often from patients with symptomatic CMV infection. It was concluded that antiviral prophylaxis with high-dose acyclovir or ganciclovir and then high-dose acyclovir and asymptomatic CMV infection are associated with a decrease in the level of CMV isolation by standard cell culture in comparison with that by the shell vial assay.

Acyclovir↗
PubMed1994

Lysis block treatment: a new form of local thrombolysis.

Lysis block treatment (LBT) is a new form of fibrinolytic therapy for deep vein thrombosis and arterial occlusion in the distal parts of the limbs. Strictly local lysis was achieved by placing a cuff around the thigh or the upper arm, inflating the cuff to a pressure of 500 mmHg ("Bier's blockade"), and giving heparin and tissue plasminogen activator (rt-PA) by intravenous injection into the dorsal pedis or antecubital veins. Occlusion lasted for one hour. This new technique was demonstrated in 22 patients. Six patients presented with popliteal vein thromboses and 1 patient with a distal femoral vein thrombosis. In addition, 15 arterial occlusions were treated comprising 3 calf, 6 popliteal, 3 distal femoral, and 2 digital sites and 1 brachial site. Five of 7 venous and 9 of 15 arterial occlusions were partially or totally removed. The activated partial thromboplastin time remained nearly unchanged during LBT and only a limited and short-term lengthening was recorded after restoration of blood flow. This was of importance for patients with bleeding tendencies, which are normally a contraindication for systemic lysis. LBT may therefore be considered as a useful alternative to systemic fibrinolytic treatment.

Aged↗
PubMed1994

Ezrin has properties to self-associate at the plasma membrane.

Ezrin, a member of a family of proteins involved in the interaction of the microfilament cytoskeleton with the plasma membrane, plays a role in membrane translocation in gastric parietal cells (Hanzel, D., Reggio, H., Bretscher, A., Forte, J. G. and Mangeat, P. (1991). EMBO J. 10, 2363-2373). Human ezrin was expressed in and purified from Escherichia coli. It possesses all the major biophysical, immunological and physiological properties of natural ezrin. Upon microinjection in live gastric HGT-1 cells, ezrin was incorporated into the dorsal microvilli, a site where the endogeneous protein is localized. By coimmunoprecipitation and ezrin-affinity assays, two HGT-1 cell proteins of 77 and 72 kDa behaved as ezrin-binding proteins. In enriched gastric apical membranes, 125I-ezrin labelled proteins of 80, 77 and 72 kDa by overlay assay. The 80 kDa protein was identified as ezrin and the 77 and 72 kDa proteins as gastric forms of proteins structurally related to ezrin, such as radixin and moesin. In insect cells infected with a recombinant baculovirus, one-third of over-expressed ezrin accumulated at the plasma membrane. Ezrin bound a 77 kDa endogenous peripheral membrane protein, behaving as an insect counterpart of the mammalian ezrin family. In addition to the respective role of the amino- and carboxyl-terminal domains of ezrin in linking the membrane and the cytoskeleton (Algrain, M., Turunen, O., Vaheri, A., Louvard, D. and Arpin, M. (1993). J. Cell Biol. 120, 129-139), both domains interacted synergistically in a salt-dependent manner to trigger self-association of ezrin. Ezrin's self-association properties could represent another way of regulating the number of ezrin molecules bound at specific membrane sites.

Animals↗
PubMed1994

Retrosternal goiter associated with chylothorax.

We describe a case of chylothorax in a female patient with a large retrosternal goiter. After subtotal thyroidectomy by means of a Kocher cervicotomy, the chylothorax disappeared in 48 h. At present, 2 years after surgical removal, the patient remains asymptomatic, without recurrent pleural chylous effusion. Until now, to our knowledge, only one such case had been reported.

Aged↗
PubMed1994

Evaluation of a rapid infusion system.

Operative cases where there is a potential for massive blood loss necessitates a system to rapidly warm and transfuse large volumes of blood over short periods of time. An in-house system in which both crystalloid solutions and blood products can be quickly added, warmed and available for infusion was developed to meet this need. The purpose of this study was to evaluate how blood products are affected when warmed and recirculated for an extended period of time. A recirculating rapid infusion system was assembled utilizing two filtered cardiotomy reservoirs, a centrifugal pump, a stainless steel blood heat exchanger, and 1/4 inch tubing, and applied in six adult orthotopic liver transplantations. The system was primed with 2 to 4 units each of fresh frozen plasma and packed red blood cells. The prime was recirculated and warmed to 37 degrees C. Samples for blood gases, oxygen saturation, hematocrit, plasma free hemoglobin, sodium and potassium levels were drawn after initial priming and then every 30 minutes until additional blood products were added. Results show no significant change in pH (6.57 +/- 0.21), pO2 (56 mmHg +/- 23 mmHg), pCO2 (173 mmHg +/- 138 mmHg), hematocrit (27% +/- 8.7%) and plasma free hemoglobin values (125 mg/dl +/- 9.4 mg/dl), following 3 hours of recirculation. However, potassium levels significantly decreased from 11.6 meq/L +/- 2.6 meq/L to 10.0 meq/L +/- 2.3 meq/L (p < 0.05), sodium levels significantly increased from 144 meq/L +/- 5.9 meq/L to 147 meq/L +/- 5.3 meq/L (p < 0.05) and oxygen saturations significantly increased from 59% +/- 9.1% to 70% +/- 16% (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Gas Analysis↗
PubMed1994

Rubber windmill: power to the people.

The fourth Rubber Windmill simulation exercise highlighted some interesting issues--among them that managers will be under more pressure and CHCs should have more power. Margaret Martin, Head of Public Information Services at East Anglian RHA, reports.

Community Participation↗
PubMed1994

Testing the limits of freedom of contract: the commercialization of reproductive materials and services.

This article examines the cases for and against commercializing, or "commodifying," reproductive materials and services. Using a supply/demand third-party framework, three basic scenarios in which commercial-exchange relationships may be possible--exchange of gametes and zygotes, exchange of gestational services, and exchange of fetal material--and the major parties of interest, or stakeholders, are identified. The study sketches the liberal, essentialist, and radical contingency theories that shape the debate over the commercialization of reproductive materials and services. The article then attempts to derive some basic governing principles that reflect as much common ground as possible amongst these various normative perspectives, while recognizing that complete reconciliation is impossible. Taken together, these principles are designed to reflect a strategy of "constrained commodification," where commercialization or commodification, that is, financial remuneration, plays a relatively neutral role in the utilization of reproductive materials and services. In light of these principles, the article concludes by sketching legal and regulatory regimes with respect to the exchange of gametes and zygotes, gestational services, and fetal tissue.

Aborted Fetus↗
PubMed1994

[Early manifestations of schizophrenic psychoses].

Schizophrenic disorders in childhood are rare. Only about 0.5 to 1% of all such disorders have their onset before age 9 and about 4% before age 14. In puberty and early adolescence, however, there is a marked increase in the frequency of such disorders. In childhood more boys seem to be affected, but during adolescence this difference seems to disappear. Possible etiological factors currently under discussion are genetic factors, neurointegrative deficits, attentional deficits, communication deficits and conspicuous premorbid features. With regard to the latter, the authors could show that positive and negative symptoms appear months or even years before the first manifestation of the disorder requiring inpatient treatment. From this perspective schizophrenic disorders in general and those with early onset in particular fit a dimensional model of illness better than a categorical one. In the development of preventive measures more attention to premorbid features is essential.

Adolescent↗
PubMed1994

[Follow-up dynamics of schizophrenic diseases in adolescence].

In the present study the clinical features of the first episode of schizophrenia were investigated retrospectively and the initial symptomatology was compared with follow-up findings. The study group consisted of 40 adolescents with chronic schizophrenia. During a one-year follow-up period positive and negative symptoms of schizophrenia and depressive symptomatology were evaluated every six weeks. When the patients entered the follow-up study the mean duration of their illness was 4.3 years. Our data revealed a close link between positive and negative symptoms during the period studied. Persistent positive symptomatology at the end of the first treatment period was predictive of high scores for positive and negative symptoms during the entire follow-up period. Furthermore, we were able to demonstrate that negative symptoms can be distinguished from depressive symptoms in the context of the schizophrenic symptomatology. Depressive states (Brief Psychiatric Rating Scale, BPRS) were closely related to the positive symptoms (assessed with the Andreasen scale SAPS), and the negative symptoms (SANS) were correlated with the anhedonia score on the BPRS. Our results suggest that productive symptomatology should be treated aggressively both initially and for a prolonged period of time thereafter. Positive and negative symptoms appear to be related to each other longitudinally. Thus we postulate a single disease process rather than two distinct types of adolescent schizophrenia.

Adolescent↗
PubMed1994

User evaluation: PA catheter waveforms troubleshooting system.

This paper reports on a user satisfaction survey of a system for consultation and education in troubleshooting pulmonary artery catheter waveforms. The twelve-item End-User Computing Satisfaction Questionnaire was used to assess users' ratings in four areas. On a scale of 1-5 (with 1 the lowest), the ratings were: Content, 3.5; Accuracy, 4.5; Format, 4.2; Ease of Use, 4.4, and Timeliness, 4.1. Comparison with ratings in a survey that included a variety of applications and settings is provided.

Attitude to Computers↗
PubMed1994

Indexing guidelines: applications in use of pulmonary artery catheters and pressure ulcer prevention.

In a busy clinical environment, access to knowledge must be rapid and specific to the clinical query at hand. This requires indices which support easy navigation within a knowledge source. We have developed a computer-based tool for trouble-shooting pulmonary artery waveforms using a graphical index. Preliminary results of domain knowledge tests for a group of clinicians exposed to the system (N = 33) show a mean improvement on a 30-point test of 5.33 (p < 0.001) compared to a control group (N = 19) improvement of 0.47 (p = 0.61). Survey of the experimental group (N = 25) showed 84% (p = 0.001) found the system easy to use. We discuss lessons learned in indexing this domain area to computer-based indexing of guidelines for pressure ulcer prevention.

Abstracting and Indexing↗