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Biomedical subjects

M Schaffer

Publications and source records attributed to M Schaffer.

At least 37 records · Page 2Linked to original sources

Population-based public health nursing interventions: a model from practice.

In a changing and complex health care system, public health nurses face challenges to explain their work and contributions to health outcomes. In response to this need, the Minnesota Department of Health, Section of Public Health Nursing, initiated a process to describe public health nursing interventions. The Public Health Nursing Interventions (PHI) Model was developed through a collaborative process by public health nurses at the state and local levels. The purpose of the model was to define more clearly the practice of public health nursing and to describe better the work of public health nurses at the community and systems levels. The PHI model identifies 17 interventions and provides practice examples at the systems, community and individual/family levels. The model defines a broader view of the mission and scope of public health nursing. Practice examples are given for agency staff, administrators, educators, and policy makers.

Community Health Planning↗

Biomodulative effects induced by 805 nm laser light irradiation of normal and tumor cells.

The influence of light emitted from a diode laser centred at lambda = 805 nm was investigated on murine skeletal myotubes (C2), normal urothelial cells (HCV29), human squamous carcinoma cells of the gingival mucosa (ZMK) and urothelial carcinoma cells (J82) in a computer-controlled irradiation chamber. Cells were treated with varying fluences between 0 and 20 J cm-2. The response was tested by analysis of the mitotic index using single cell counting after Orcein staining and proliferation index based on BrdU incorporation during DNA synthesis. While the mitotic index of C2, HCV29 and J82 cells increased at a fluence of 4 J cm-2, irradiation with fluences of 20 J cm-2 resulted in a slight decrease. ZMK tumor cells showed a decrease of the mitotic index with both fluences. No significant differences could be determined when using irradiances between 10 mW cm-2 and 150 mW cm-2. The BrdU test after irradiation showed no significant effects compared to the controls in each cell line.

Animals↗

A novel DRB1*13 allele (DRB1*1327) on a DR17, DQ2 haplotype with a DRB1*0301 sequence motif in the 2nd hyperpolymorphic region.

In a sample from a Netherlands Caucasian, we found a new DRB1*13 allele (DRB1*1327). The nucleotide sequence of the second exon of the novel allele was identical to DRB1*1301 except for a single productive base substitution changing codon 26 from TTC to TAC, encoding phenylalanine and tyrosine, respectively. The new allele shares sequence with DRB1*03011 from codons 5 to 66. The haplotype carrying the new allele was, from known linkage disequilibria, deduced to be DRB1*1327, DRB3*0101, DQA1*05011, DQB1*0201, i.e. similar to the DR17, DQ2 haplotype, which suggests that the DRB1*1327 allele has arisen by a double recombination event between a DR13 donor haplotype and a DR17, DQ2 recipient haplotype.

Alleles↗

[Prolongation of a bi-amniotic twin pregnancy after premature rupture of fetal membranes and umbilical cord prolapse of the first twin during the 23rd week of pregnancy].

A 41-year old woman had a premature rupture of the membranes of the first twin with prolapse of the umbilical cord and the left foot in the 24th gestational week (23 + 4). The treatment consisted of bed rest in the Trendelenburg position, antibiotic prophylaxis and glucocorticoids for lung maturation. After 7 days the first twin was delivered vaginally from breech position. He died 10 hours later due to intraventricular hemorrhage. Tocolysis was administered and the umbilical cord was ligated and cut as high as possible. Seven days later a premature rupture of the membranes of the second twin and a prolapse of the fetal hand occurred. The second twin (birth weight 750 g) was delivered by cesarean section in the 26th gestational week (25 + 4) and survived without neurologic sequelae. Prolongation of pregnancy after a very premature delivery of the first twin of a biamniotic twin pregnancy can improve the neonatal outcome.

Adult↗

Resolution of cavopulmonary shunt-associated pulmonary arteriovenous malformation after heart transplantation.

A child with heterotaxia, azygous continuation of an interrupted inferior vena cava, single ventricle, and pulmonary atresia underwent the Kawashima modification of the Fontan procedure, which excluded hepatic venous return from the pulmonary blood flow. After the operation, the patient had development of pulmonary arteriovenous malformations, increasing cyanosis, and ventricular dysfunction. He underwent orthotopic heart transplantation at 7 years of age with prompt resolution of the pulmonary arteriovenous malformations.

Arteriovenous Malformations↗

Comparison of the types of child utterances mothers expand in children with language delays and with Down's syndrome.

Sixteen children with language delays and their mothers were studied to identify the types of child utterances mothers were most likely to expand. Eight of these children had Down's syndrome (DS), while the other eight were pairwise-matched for mean length of utterance (MLU) and did not have DS, but were language delayed. Twenty-minute mother-child free-play sessions were videotaped and transcribed. Trained observers coded utterances for child intelligibility, child utterance length, adult expansions and adult non-expansions. Sequential analysis results indicated that mothers of children with DS were more likely to expand partially intelligible multi-word utterances than to expand fully intelligible multi-word utterances. The opposite pattern occurred in the dyads without DS. Single-word utterances were least likely to be expanded in both groups. The implications of the results for language intervention and future research are discussed.

Adult↗

Elevated parathyroid hormone-related peptide levels after human gestation: relationship to changes in bone and mineral metabolism.

PTH-related peptide (PTHrP) can be found in high concentrations in human breast milk and has been implicated in material calcium regulation postpartum. We studied the relationship of plasma PTHrP levels of serum markers of bone turnover and selective cancellous bone density in 35 women (age, 25 +/- 3 yr) 2-3 days postpartum and after 3 and 6 months of lactation. The mean postpartum plasma PTHrP levels measured by immunoradiometric assay was 2.64 +/- 0.19 pmol/L (mean +/- SE) and were elevated compared to that in 35 age- and sex-matched controls (1.34 +/- 0.14; P < 0.0001). PTHrP remained significantly elevated, but decreased during the lactation period of 6 +/- 1 months. Immediately postpartum, serum protein levels were lowest, and serum ionized calcium levels highest. At that time, PTH was suppressed to 50% of control values (P < 0.001). Two or 3 days postpartum, serum ionized calcium was negatively correlated with total serum protein (r = -0.47; P < 0.0001) and positively correlated with plasma PTHrP (r = -0.32; P < 0.008). PTH was inversely correlated with ionized calcium (r = -0.24; P = 0.03) and PTHrP (r = -0.31; P < 0.01). Three and 6 months postpartum, serum protein and PTH levels had returned to normal, and ionized calcium concentrations decreased. There was no indication that PTHrP may have any significant systemic effect after 3 and 6 months of lactation. Long term lactation led to a significant decrease in radial cancellous bone density (-4.5%; P < 0.05) at 6 months and to elevations in serum markers of bone resorption (2- to 3-fold for serum carboxy-terminal telopeptide of type I collagen) and formation (1- to 2-fold for osteocalcin and serum carboxy-terminal propeptide of type I procollagen). Bone turnover balance was clearly negative after 3 months of lactation compared to the control value and indicated net bone loss at a time when estrogen levels were low. With ongoing lactation, estrogen levels increased, and bone turnover balance improved significantly and independently of PTHrP levels. We interpret these results as evidence that PTHrP is elevated during the postgestational period and has a weak and temporary effect on calcium metabolism when serum protein levels are reduced. PTHrP does not seem to participate significantly in the regulation of bone turnover during lactation. Normalization of bone turnover balance at 6 months of lactation suggests that further cancellous bone loss is most likely minimal when breast-feeding is extended beyond that time.

Adult↗

The influence of the post-Chernobyl fallout on birth defects and abortion rates in Austria.

OBJECTIVES: We analyzed the influence of the radioactive fallout after the Chernobyl disaster on the rate and regional distribution of birth defects and abortion rates in southern Austria. STUDY DESIGN: During 1985 to 1989 a total of 66,743 births was monitored. Twelve sources provided data on 1695 cases of birth defects, 1579 of which were suitable for analysis. All cases were analyzed in terms of their calculated conception date and divided into three main groups according to their vulnerable phase of embryogenesis, spermatogenesis, and oogenesis. To study possible regional changes, the findings were plotted in 17 political subdistricts. The overall abortion rate and the counseling frequency at termination clinics was determined. RESULTS: No significant changes in the incidence of birth defects, abortion rate, or counseling rate at pregnancy termination clinics were observed. CONCLUSIONS: Assessing the teratologic potential of low-dose radiation is difficult and requires adequate grouping of birth defects, sufficient baseline data, and highly reliable registries.

Abortion, Induced↗

Quantitative determination of Escherichia coli from coliforms and faecal coliforms in sea water.

Escherichia coli concentration in sea water was determined by the MUG test after primary growth on membrane filters used to determine total coliforms or faecal coliforms. A good correlation (r = 0.86) was found between E. coli obtained from coliforms versus those from faecal coliforms. Verification procedures showed that all the MUG-positive colonies obtained on both media were E. coli. Evaluation of this data and the literature indicated that this technique for estimation of E. coli in sea water is a useful addition to laboratory procedures without generally increasing the time and the expense of the analysis of recreational water.

Enterobacteriaceae↗

Hemolysis due to branch pulmonary stenosis after the arterial switch procedure.

An infant with d-transposition of the great arteries underwent arterial switch operation using the modified Jatene technique. Severe bilateral branch pulmonary artery stenosis and mechanical hemolysis subsequently developed. The hemolysis resolved after surgical repair of the stenotic arteries. Probable causes are discussed.

Anemia, Hemolytic↗

The narcolepsy-associated DRw15,DQw6,Dw2 haplotype has no unique HLA-DQA or -DQB restriction fragments and does not extend to the HLA-DP subregion.

Almost all patients with cataplectic narcolepsy are DR2-positive. It has been suggested that the non-DR2 allele/haplotype might not be neutral with respect to disease susceptibility. It has also been reported that Taq I DQA and Bam HI, Eco RI, Eco RV, and Pst I DQB restriction fragments might differentiate between narcoleptic and healthy DR2-positive individuals. In the present study, HLA class II gene polymorphisms were investigated by restriction fragment length polymorphism (RFLP) analysis in 47 Swedish patients with cataplectic narcolepsy, 100 random controls, and DR2-associated homozygous cell lines. All patients had Taq I DRB-DQA-DQB patterns corresponding to the DRw15,DQw6,Dw2 haplotype. The non-DR2 haplotype was found to be neutral. This genotyped group of patients allows firm rejection of a recessive mode of inheritance and supports a dominant or additive model. No DQA or DQB RFLPs were found that could differentiate between DR2-positive narcoleptics, DRw15,DQw6,Dw2-positive controls, or Dw2-homozygous cell lines. No significant Msp I HLA-DP association was found. No linkage disequilibrium was observed between the DRw15,DQw6,Dw2 haplotype and alleles of the DP subregion in patients or controls. Thus, the HLA-D region-associated narcolepsy susceptibility gene may be located telomeric to the HLA-DP subregion. No RFLPs have been observed that can locate the narcolepsy susceptibility gene closer to the DQ than to the DR subregion.

Genetic Linkage↗

[The value of prenatal ultrasound screening exemplified by abnormalities of the urogenital system. Data from the Styrian malformation register 1985 to 1987].

Over a three-year period (1985 to 1987), the number of fetal malformations was entered into Styrian Malformation Register (SMR). The data were compared with those of the Austrian Ministry of Health. The SMR collected 137 cases of urinary tract malformations, but only six appeared in the Health Ministry statistics. This discrepancy resulted from the different data collection methods. Presently only a small percentage of fetal abnormalities is officially registered. Using the example of urinary tract malformations this paper shows the value of prenatal ultrasound screening. Such infants must be treated soon after delivery to avoid progression of parenchymal damage. Ultrasound examinations should not be restricted to pregnant women at defined risk. Registration of all prenatally diagnosed--or missed--malformations is a quality-control measurement and improves prenatal diagnosis.

Austria↗

A comparison of the age-MLU relation in normal and specifically language-impaired preschool children.

The relation between age and mean length of utterance in morphemes (MLU) was evaluated in a sample of 48 preschool children between 24 and 50 months of age. Twenty-four of these children were diagnosed as having a specific language impairment, and 24 were considered language normal. The groups were matched on age, race, sex, and parental education level. A majority of the children in each group were from lower-middle-class backgrounds. MLU was derived from 20-min mother-child conversations as the dyad engaged in free play. The results showed that (a) age and MLU were significantly correlated in the normal group (r = .75) and in the group of specifically language-impaired children (r = .77), (b) the predicted MLU of the language-impaired group was lower than that of the normal group across the age range, and (c) the rate of MLU change in each group was similar. The age-MLU relation observed in the lower-middle-class normal children compared favorably to that reported previously for middle- to upper-middle-class children (Miller & Chapman, 1981). The finding that MLU changed at a similar rate in the normal and language-impaired groups is evaluated in light of the observation that childhood language disability is usually associated with slower rates of language development.

Age Factors↗