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Biomedical subjects

M Martin

Publications and source records attributed to M Martin.

At least 1,117 records · Page 62Linked to original sources
PubMedDate not supplied

[Radiation-induced superficial fibrosis and TGF-alpha 1].

Radiation-induced fibrosis is a late sequela of both therapeutic and accidental irradiations, which has been described in various tissues, including the lung, liver, kidney and skin. This review presents different aspects of superficial radiation-induced fibrosis, such as clinical observations, histological changes, cellular and molecular regulations, and medical management. Recent evidence on the critical role played by TGF-beta 1 in the initiation, development and persistence of fibrosis are discussed, as well as the possibility that this cytokine may constitute a specific target for antifibrotic agents.

Animals↗
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Anti-Ata causing mild hemolytic disease of the newborn.

We report here a case of moderately severe hemolytic disease of the newborn (HDN) due to anti-Ata. The gravida 5 proposita was group A rr and previously was found to have anti-Ata and -D. At the 35-week mark of this pregnancy, her anti-Ata demonstrated a titer of 256, score 79. Fluid obtained by amniocentesis at 36 weeks showed an optical density at 450 nm of 0.08 (midzone). The baby was delivered at 38 weeks by cesarean section. The cord cells were group A rr with a 3+ direct antiglobulin test. The dichloromethane eluate of the infant's cells demonstrated anti-Ata specificity only. At birth, the infant's total bilirubin (TB) was 2.1 mg per dl and the hematocrit level (Hct) was 33.8 percent. Within 8 hours, the TB had risen to 3.8 mg per dl. Phototherapy was initiated at 7-1/2 hours and maintained for 40 hours. The infant's TB rose to a maximum level of 10.5 mg per dl 24 hours after phototherapy was discontinued. At discharge 4 days postpartum, the infant's TB had dropped to 9.2 mg per dl, and the Hct value was 38 percent. On a visit 7 days postpartum, the infant's TB level had fallen to 6.5 mg per dl and the hct value was 38 percent. Transfusions were not necessary.

Adult↗
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Inter- and intra-individual differences in semantic priming among young and older adults.

The influences of inter- and intra-individual differences on context effects for young and older adults were examined. Results of a semantic priming task revealed two subsets of older adults who were markedly different in terms of response latency, consistency of responding, and magnitude of priming. Examination of individual response distributions indicated that (a) age differences in priming were localized to trials representing subjects' slowest responses and were eliminated for their fastest responses and (b) inconsistently responding older individuals contributed disproportionately to age differences in priming. The results are interpreted in terms of an interactive-compensatory model in which the ability to sustain attention is related to both priming and word recognition. It is concluded that the failure to examine individual differences may be contributing to the discrepant results in the literature.

Adult↗
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Temporary DDD pacing: evaluating hemodynamic performance.

Temporary DDD pacing is new technology which requires careful nursing assessment and monitoring of the patient. Although nursing care for temporary DDD pacing patients is similar to permanent DDD pacing, there are some unique aspects related to the temporary nature of this treatment.

Cardiac Pacing, Artificial↗
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Sensorimotor neurotoxicity associated with high-dose deferoxamine treatment.

PURPOSE: We report a reversible sensorimotor neurotixicity that developed in two beta-thalassemic patients treated with high-dose deferoxamine (DFO) for iron overload. METHODS: Two patients were treated with high-dose (120 mg/kg/day) intravenous DFO for iron overload. RESULTS: Sensorimotor toxicity developed after 5 and 6 months of treatment, respectively. The development of the neurotoxicity did not correlate with the serum ferritin or the ratio of DFO dose to serum ferritin. Symptoms resolved in both patients with discontinuation of DFO treatment. In 1 patient, symptoms recurred with resumption of DFO treatment. CONCLUSIONS: These cases demonstrate that a reversible sensorimotor neurotoxicity, a previously unreported toxicity, may complicate DFO therapy, this complements the previously reported auditory and visual neurotoxicity associated with DFO therapy. Discontinuation of therapy at the time of onset of neurotoxicity is recommended, with possible resumption at lower doses.

Adult↗
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Dynamic wedge field techniques through computer-controlled collimator motion and dose delivery.

Clinical treatment planning situations arise which require different wedge angles within segments of a single therapeutic x-ray field. Idealized wedge-shaped dose distributions, including combination of several wedge segments of different angle within a single field, are generated and delivered through computer control of asymmetric collimator motion and dose per field segment. A dual-pass technique is introduced to provide improved adherence to the prescribed isodose distribution. Dynamic wedge distributions are verified by film densitometry and ionization chamber measurement. These results suggest the potential importance of this technique as an added clinical radiotherapy tool.

Humans↗
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Substrate uptake and utilization by the kidney of fed and starved rats in vivo.

In order to obtain information (1) on the quantitative contribution of various circulating substrates to renal metabolism and (2) on the relative importance of net luminal and basolateral transport for substrate uptake, we have precisely quantified the renal blood flow, the urinary flow, and the rates of substrate handling by the kidney of anesthetized fed and 72-hour-starved rats. For this, the concentration of twelve metabolites were simultaneously measured in arterial and venous whole blood and plasma as well as in urine of each rat thanks to the use of microassays based on enzymatic cycling. In fed rats, the main potential energy sources were glucose and lactate followed by fatty acids, ketone bodies, citrate and glycerol. Starvation caused a large increase in renal uptake and metabolism of fatty acids, ketone bodies, glutamine and glycerol, and a large inhibition of lactate utilization. The net peritubular uptake of acetoacetate, citrate, glycerol and free fatty acids demonstrated in both nutritional states was increased by starvation only for glycerol and free fatty acids; net peritubular efflux of both beta-hydroxybutyrate and ammonium ions was stimulated whereas that of glutamine was converted into net peritubular uptake by starvation.

Animals↗
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ECT-induced interictal delirium in patients with a history of a CVA.

Earlier works have documented a high incidence of affective disorders in patients with a history of a cerebrovascular accident (CVA). In general, electroconvulsive therapy (ECT) has been reported to be effective in treating depressed patients with a history of CVA. Recent works have shown that preexisting structural brain changes may predispose patients to develop interictal ECT-induced delirium. However, the incidence of ECT-induced interictal delirium in patients with a history of CVA has not been directly studied. In this pilot study, the authors examined the incidence of ECT-induced interictal delirium in 14 depressed CVA patients compared with 14 elderly depressed controls (without a history of CVA). Interestingly, the overall incidence of delirium was identical in both groups (28.5%). However, consistent with previous works, some patients who had had a recent CVA involving the caudate nucleus appeared more likely to develop delirium. Thirteen of the 14 depressed CVA patients (92%) showed a moderate to significant improvement in their depressive symptoms from ECT. None of the patients developed significant cardiac complications during ECT.

Aged↗
PubMedDate not supplied

Clinical profile of a new monoclonal antibody-based immunoassay for tissue polypeptide antigen.

Our preliminary evaluation of a new monoclonal antibody-based assay for tissue polypeptide antigen (TPA) has shown it to be clinically equivalent to the polyclonal antibody-based assay for TPA. The new assay (TPA-M) employs three monoclonal antibodies to epitopes on cytokeratins 8, 18 and 19. This multicenter, multinational study included 266 patients with newly diagnosed carcinomas of the lung, breast, large bowel and urinary bladder. TPA values from the two assays were compared with three other cytokeratin markers (TPS, CYFRA 21-1 and TPACyk) and with the established reference markers for these malignancies (CEA and NSE for lung, CA 15-3 for breast, CEA and CA 19-9 for colorectal tumors). Analysis of receiver operating characteristic (ROC) curves in lung, colorectal and bladder cancer showed similar sensitivities for the two assays, ranging from 50% to 80% with a specificity of 95%. In breast cancer all the markers studied showed poor sensitivity. However, TPA determination by either method could discriminate advanced stage (stages III and IV) from early stage disease (stages 0 to II). TPA showed similar discriminating ability in bladder cancer. On the basis of the results obtained in our patient series, it seems that of the cytokeratin markers studied, TPA and TPA-M are the most sensitive and offer a wide range of clinical applications.

Antibodies, Monoclonal↗
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Pulmonic stenosis in dogs: balloon dilation improves clinical outcome.

Medical records of 81 dogs with severe pulmonic stenosis from 2 referral centers were examined retrospectively. Forty dogs underwent balloon valvuloplasty (BV), which was performed by 1 operator, whereas 41 did not. The mean age at latest follow-up was 41.5 months. A statistical comparison of the clinical outcome and survival was performed. Dogs revealing clinical signs at presentation showed a 16-fold increase in risk of death compared with asymptomatic dogs (P < .001). Statistical analyses demonstrated that an increase of 1 mm Hg in transstenotic pressure gradient (PG) at presentation was associated with a 3% increase in hazard rate (P < .001). Thirty-seven dogs survived BV with a median reduction in PG of 46%. The median preoperative PG was 120 mm Hg, and median PG 24 hours postoperatively was 55 mm Hg with a median of 55 mm Hg 6 months post-BV. Twenty (49%) of the non-BV (NBV) dogs remained asymptomatic at last follow-up. Fourteen (34%) of the NBV dogs died or were euthanized because of heart disease related to pulmonic stenosis. Twelve of these dogs died suddenly, whereas only 1 of the BV dogs died suddenly. After adjusting for PG, clinical signs at presentation, and age, BV or dilation was associated with a 53% reduction in hazard rate (P = .005). This study indicates that BV, when performed by an experienced operator, appears to be successful both in alleviating clinical signs and in prolonging survival in dogs with severe pulmonic stenosis.

Animals↗
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Characteristics of health promotion programs in Federal worksites: findings from the Federal Employee Worksite Project.

PURPOSE: To describe how well-established health promotion programs at selected federal worksites were designed, organized, and implemented and to identify factors related to employee participation. DESIGN: This descriptive study related characteristics of the health promotion program, worksites, and workforce to employee participation and perceptions of program impacts. SETTING: The study was conducted at 10 established federal worksite health promotion programs in various regions of the country. SUBJECTS: A total of 3403 of 5757 federal employees (59%) sampled completed employee surveys. MEASURES: Study data were collected from on-site observations, interviews, focus groups, and employee surveys. RESULTS: Overall, program participation rates were high, and employees reported positive impacts on their health and attitudes toward the agency. Participation in health screening, perceived program convenience, and perceived support by management and others were important determinants of participation and of perceived work-related outcomes. CONCLUSIONS: Although site selection and response rate limit generalizability, the sites evaluated represent a broad cross-section of different types and sizes of agencies. The findings should be relevant in many other settings. Study programs compare favorably with private sector programs. Employees viewed the programs very positively. The most cogent challenge in justifying these, and perhaps other, worksite programs is that most participants already or simultaneously engage in health promotion activities elsewhere "on their own."

Female↗
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Chromomycosis.

Explore the source record for details and available documents.

Adult↗
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Lowering physician hospital resource consumption using low-cost, low-technology computing.

Anderson Area Medical Center physicians have been provided disease-specific and procedure-specific profiles of their practice experiences for more than 5 years. For 4 years, physicians were provided reports, in a variety of formats, detailing their clinical outcomes and consumption of hospital resources in treating patients with acute myocardial infarction (AMI), pneumonia, cholecystectomy, stroke, congestive heart failure, and total hip replacement. For the past 18 months, physicians have been provided a uniform format of monthly physician-specific reporting for stroke, AMI, pneumonia, diabetes, congestive heart failure, cholecystectomy, total hip replacement, new-born delivery, angina, and hernia repair. Using only a modest PC platform with database, word processing, and graphics programs operating in a DOS environment, an effective disease-reporting and procedure-reporting program is provided to medical staff with 3 person-days of effort per month. Education-based physician-practice reporting is effective in encouraging more resource-efficient decision making on the part of medical staff members. Average length of stay and total charges can be reduced significantly by providing physicians with profiles that show them their relative ranking with peers of several outcome and resource variables. Actual aggregate reductions in average total charges for each of three groups of patients profiled following educational reporting to physicians were $203,680 (AMI), $220,296 (pneumonia), and $146,832 (hip replacement). Total benefit for these three educational reports was $570,808. If educational effects persist for 1 year in the physician groups, the annualized estimate of aggregate charge reductions for 390 AMI patients, 483 pneumonia patients, and 52 hip-replacement patients is $1,568,644. Cost savings to the hospital would be near $706,000.

Cost Savings↗