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Biomedical subjects

M Nelson

Publications and source records attributed to M Nelson.

At least 235 records · Page 13Linked to original sources

Translocation (X;18) in primary synovial sarcoma of the lung.

Primary sarcomas of the lung are extremely rare. Among the most common to occur in this location are leiomyosarcoma, fibrosarcoma, and hemangiopericytoma. Many difficulties are encountered when establishing these sarcoma diagnoses, or one of another pathologic type, because of overlapping histologic features and morphologic similarities between primary and metastatic lesions. In this study, the diagnosis of a primary monophasic synovial sarcoma of the lung was aided by the observation of the X;18 translocation characteristic of this neoplasm. To the best of our knowledge, this is the first cytogenetic report of a primary pulmonary synovial sarcoma.

Chromosomes, Human, Pair 18↗

Chromosomal anomalies exclusive of telomeric associations in giant cell tumor of bone.

The occurrence of telomeric associations in giant cell tumor of bone is well recognized. However, there has been little emphasis on clonal structural abnormalities that may be seen in addition to or in the absence of telomeric associations. Two cases of giant cell tumor of bone are presented in this study demonstrating clonal karyotypic anomalies other than telomeric association with a review of previously reported cases showing similar findings.

Adult↗

Food production and nutrition in Biosphere 2: results from the first mission September 1991 to September 1993.

The initial test of the Biosphere 2 agricultural system was to provide a nutritionally adequate diet for eight crew members during a two year closure experiment, 1991-1993. The overall results of that trial are presented in this paper. The 2000 m2 cropping area provided about 80 percent of overall nutritional needs during the two years. Adaptation of the crew to the diet which averaged 2200 calories, 73 g. of protein and 32 g. of fat per person over the course of the two years. The diet was primarily vegetarian, with only small amounts of milk, meat and eggs from the system's domestic animals. The crew experienced 10-20 percent weight loss, most of which occurred in the first six months of the closure reflecting adaptation to the diet and lower caloric intake during that period. Since Biosphere 2 is a tightly sealed system, non-toxic methods of pest and disease control were employed and inedible plant material, domestic animal wastes and human waste-water were processed and nutrients returned to the soil. Crop pests and diseases, especially broad mites and rootknot nematode, reduced yields, and forced the use of alternative crops. Outstanding crops included rice, sweet potato, beets, banana, and papaya. The African pygmy goats were the most productive of the domestic animals. Overall, the agriculture and food processing required some 45% of the crew time.

Adaptation, Physiological↗

Rapid quantitation of mixed red cell populations using flow cytometry.

Methods are described for the identification and quantitation of mixed red cell populations using flow cytometry. Antibodies specific for a wide range of blood group antigens have been used and examples are given in which these analyses have proved to be of clinical use. These examples include monitoring of erythropoiesis following engraftment in allogeneic bone marrow transplant recipients and the detection of chimaeric states months or years after transplantation. The techniques involved are fast, simple and inexpensive.

Bone Marrow Transplantation↗

Food photography II: use of food photographs for estimating portion size and the nutrient content of meals.

The aim of the present study was to determine the errors in the conceptualization of portion size using photographs. Male and female volunteers aged 18-90 years (n 136) from a wide variety of social and occupational backgrounds completed 602 assessments of portion size in relation to food photographs. Subjects served themselves between four and six foods at one meal (breakfast, lunch or dinner). Portion sizes were weighed by the investigators at the time of serving, and any waste was weighed at the end of the meal. Within 5 min of the end of the meal, subjects were shown photographs depicting each of the foods just consumed. For each food there were eight photographs showing portion sizes in equal increments from the 5th to the 95th centile of the distribution of portion weights observed in The Dietary and Nutritional Survey of British Adults (Gregory et al. 1990). Subjects were asked to indicate on a visual analogue scale the size of the portion consumed in relation to the eight photographs. The nutrient contents of meals were estimated from food composition tables. There were large variations in the estimation of portion sizes from photographs. Butter and margarine portion sizes tended to be substantially overestimated. In general, small portion sizes tended to be overestimated, and large portion sizes underestimated. Older subjects overestimated portion size more often than younger subjects. Excluding butter and margarine, the nutrient content of meals based on estimated portion sizes was on average within +/- 7% of the nutrient content based on the amounts consumed, except for vitamin C (21% overestimate), and for subjects over 65 years (15-20% overestimate for energy and fat). In subjects whose BMI was less than 25 kg/m2, the energy and fat contents of meals calculated from food composition tables and based on estimated portion size (excluding butter and margarine) were 5-10% greater than the nutrient content calculated using actual portion size, but for those with BMI 30 kg/m2 or over, the calculated energy and fat contents were underestimated by 2-5%. The correlation of the nutrient content of meals based on actual or estimated portion sizes ranged from 0-84 to 0-96. For energy and eight nutrients, between 69 and 89% subjects were correctly classified into thirds of the distribution of intake using estimated portion size compared with intakes based on actual portion sizes. When 'average' portion sizes (the average weight of each of the foods which the subjects had served themselves) were used in place of the estimates based on photographs, the number of subjects correctly classified fell to between 60 and 79%. We report for the first time the error associated with conceptualization and the nutrient content of meals when using photographs to estimate food portion size. We conclude that photographs depicting a range of portion sizes are a useful aid to the estimation of portion size. Misclassification of subjects according to their nutrient intake from one meal is reduced when photographs are used to estimate portion size, compared with the use of average portions. Age, sex, BMI and portion size are all potentially important confounders when estimating food consumption or nutrient intake using photographs.

Adult↗

Are people with HIV in London able to die where they plan?

Being able to die where you plan is a measure of quality of life near death, in that it implies awareness of diagnosis and prognosis, adequate symptom control and involvement in decision-making in late-stage HIV disease. This study presents trends in place of death for patients attending a large central London HIV centre and examines whether patients dying over a 6-month period in 1994 were able to die where they planned. Early in the epidemic almost all people with HIV died in hospital, but in the late 1980s there was an increase in death at home and in hospices. Of people attending this hospital in 1994, 46% died in hospital, 31% at home, 20% in hospices and 2% abroad. A total of 59% of deaths were where the dying person had planned. Most unplanned deaths were in hospital, two-thirds being due to an unexpected deterioration which precluded planning. The rest were a mixture of people waiting for discharge to die elsewhere, and people who wished to continue active treatment. This pattern of place of death is unlikely to change in the near future. It is therefore essential that hospitals can provide for the needs of patients dying on acute wards.

Choice Behavior↗

Subcutaneous tissue oxygen pressure: a reliable index of peripheral perfusion in humans after injury.

The usual initial life-threatening effect of injury is hypovolemic shock. In the hierarchical physiologic response to hypovolemia, perfusion of peripheral tissues is sacrificed early and restored late. But the usual hemodynamic and metabolic measurements of blood pressure, urine output, and base deficit are not reliable indices of peripheral perfusion. Although the Clark electrode can quantitate tissue oxygen pressure and thereby serve as an index of perfusion, its use is compromised by several technical deficiencies. Recently, an optical method (optode) using fluorescent technology has been developed for measurement of oxygen tension in subcutaneous tissue (P sgO2). Our studies compared this device with the Clark electrode in the laboratory and tested its value in both animal and clinical studies of hypovolemic shock. The results of these several studies demonstrated that: (1) the new oximeter tracked a rapid fall or rapid rise of oxygen tension between room air (150 mm Hg) and 0 mm Hg ( a glucose oxidase/catalase solution) as well as the Clark electrode without encountering its technical problems; (2) with an acute hemorrhage to 20% of base line, the PsgO2 was found to decline rapidly in parallel with the decline of mean arterial pressure (MAP). Although the MAP rapidly returned to normal after immediate complete return of all shed blood, the PsgO2 did not reach normal levels for at least 2 hours, suggesting persistent peripheral vasoconstriction. (3) Studies in progress suggest that between 35 and 78% of trauma patients (n = 18) adequately resuscitated for hypovolemia b customary criteria have a decreased level of PsgO2 for as long as 60 hours after resuscitation for injury. If care is taken to prevent other causes of catecholamine induced vasoconstriction such as pain, fear, cold, and arterial hypoxia, these several results suggest that a certain number of injured patients are inadequately resuscitated despite the return to normal of conventional hemodynamic measurements. The serial analysis of PsgO2 may assist in managing patients and promote better understanding of the responses to injury.

Animals↗

International population and development: the United Nations' Cairo Action Plan for women's health.

The report of the International Conference on Population and Development (Cairo Action Document) was sponsored by 180 national governments and 1,200 nongovernmental organizations during the United Nations' conference on women, population, and development in Cairo, Egypt 1994. Many international conferences preceded the one in Cairo but it was there that women participated at an unprecedented level in shaping the debate. The resulting document represents a quantum leap for women's health. Nurses can play a major role in using the principles in the Cairo Action Document by empowering women and enhancing their health care. To invite dialogue, the authors provide an analysis of the Cairo Plan from a nursing perspective and identify three paradoxes that may hinder progress: Universal values and local cultures, global policy and local implementation, and national development and women's empowerment. Clinicians, scholars, and members of professional organizations are asked to consider the assumptions that underlie the recommendations for action and to propose ways to resolve the problems that may evolve during implementation.

Egypt↗

Faecal alpha 1 antitrypsin as a marker of gastrointestinal disease in HIV antibody positive individuals.

Hypoalbuminaemia and diarrhoea are common complications of HIV infection and substantial causes of morbidity, but the specific intestinal pathologies that cause enteric protein loss have not been clearly defined. Two hundred and twenty stool samples from patients with a variety of HIV related conditions were analysed for faecal alpha 1 antitrypsin. Patients with intestinal Kaposi's sarcoma had a significantly raised faecal alpha 1 antitrypsin value and hypoalbuminaemia. A faecal alpha 1 antitrypsin value of greater than 0.3 mg/g wet stool has a sensitivity of 94% and a specificity of 76% for the diagnosis of intestinal Kaposi's sarcoma in HIV positive individuals. Patients with cytomegalovirus and bacterial enteritis had raised faecal alpha 1 antitrypsin values but levels were normal for all other intestinal pathologies compared with pathogen negative stool. The combination of faecal alpha 1 antitrypsin concentration greater than 0.2 mg/g, a negative stool culture for enteric bacteria, and the absence of palatal Kaposi's sarcoma has a sensitivity of 55% and specificity of 88% for the diagnosis of enteric cytomegalovirus infection.

AIDS-Related Opportunistic Infections↗

Eliminating the "I hate you" in the supplier-purchasing relationship.

Throughout time there has always been a supplier of some service or goods, and there has always been a purchaser of that service or goods. The one thing that has remained constant throughout that time is that they have an agreement not to like each other. This article will approach the subject in the "today" sense using current practical approaches that are used in all industries and will not deal with the relationships of the future. To cover this complex arena, the article will deal with four areas: (1) where we are now, (2) supplier-based concentration, (3) single sourcing, and (4) transportation techniques.

Consumer Behavior↗

Autologous red cell recovery and relapse of multiple myeloma after bone marrow transplantation: is this a graft-versus-myeloma effect?

We report a patient who, following an allogeneic bone marrow transplant for multiple myeloma, recovered autologous erythropoiesis which was rapidly followed by relapse of her multiple myeloma. We postulate that the loss of the graft (as demonstrated by loss of donor erythropoiesis) and subsequent relapse of the multiple myeloma may be support for the existence of a graft-versus-myeloma effect.

Adult↗

Familial inverted duplication 7p.

A 10-month-old female with developmental delay and failure to thrive was referred for genetic evaluation as part of an adoption assessment. Physical exam showed a mildly beaked nose and clinodactyly, but otherwise nothing remarkable. Chromosome analysis showed an inverted duplication of the p12.2-->p13 portion of chromosome 7[(46,XX, dup(7)(p13p12.2)]. The proposita's older brother, mother, and grandmother were cognitively delayed and had the same chromosome 7 duplication. A review of the literature showed no other cases involving this exact duplication.

Chromosome Inversion↗

Matching versus cultural competence in research: methodological considerations.

Researcher/participant matching has been used in nursing research as a strategy for the development of culturally competent knowledge. In this manuscript, the complexities inherent in matching in nursing research are discussed. In raising and discussing issues and questions related to matching, we argue that although matching may be one of the strategies used to generate culturally competent knowledge, it is frequently too complex for operationalization. Therefore, we propose that researchers reflect on questions related to their knowledge of culture, their cultural sensitivity, and the nature of collaboration during every phase of the research. Reflecting on and responding to these questions in every research project may facilitate the development of more culturally competent knowledge.

Cultural Diversity↗

The effect of rishitin on potato tonoplast vesicle and vacuole proton transport.

Rishitin, a known potato phytoalexin, was tested for its effects on proton transport. Like the pterocarpan phytoalexins, glyceollin and phaseollin, rishitin was found to inhibit proton transport. At 100 microM rishitin, proton transport in potato tonoplast vesicles was inhibited by > 95%. This inhibition appears to be due to an increase in proton conductance and not to inhibition of the tonoplast ATPase. Potato vacuoles were also shown to have increased proton leakage in the presence of rishitin.

Antifungal Agents↗

Randomized double-blind comparison of the analgesic efficacy of intramuscular ketorolac and oral indomethacin in the treatment of acute gouty arthritis.

STUDY OBJECTIVE: To compare the analgesic effect of IM ketorolac tromethamine with that of oral indomethacin in the treatment of acute gouty arthritis. DESIGN: Prospective, randomized, double-blind, controlled, parallel group clinical trial. SETTING: Two urban emergency departments. PARTICIPANTS: Twenty consecutive patients who presented to the ED with acute gout. INTERVENTIONS: Each patient was randomly assigned to receive in the ED (1) 60 mg of IM ketorolac and oral placebo or (2) 50 mg of oral indomethacin and IM placebo. The patients rated the intensity of their pain on a Wong-Baker pain scale (which runs from 0 to 5) before treatment and 30, 60, 90, and 120 minutes after treatment. All the patients were discharged with instructions to take oral indomethacin and to complete pain score cards at home at 6, 12, and 24 hours. RESULTS: The 10 patients in each group were similar with regard to age, sex, race, and initial mean pain score. After 2 hours, the mean pain scores (+/- SD) for the ketorolac group had decreased from 4.5 +/- .71 to 1.4 +/- 1.43 (P < .05), and the mean score for the indomethacin group had decreased from 4.4 +/- .70 to 1.5 +/- 1.18 (P < .05). The difference between the two groups was not significant. At 6 hours, there was some pain rebound in the ketorolac group. CONCLUSION: IM ketorolac and oral indomethacin are similar in the relief of the pain of acute gouty arthritis in the ED.

Administration, Oral↗