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Biomedical subjects

M Smith

Publications and source records attributed to M Smith.

At least 1,567 records · Page 87Linked to original sources
PubMedDate not supplied

Magnetic resonance imaging as a sensitive and specific predictor of neoplasms removed for intractable epilepsy.

Twenty-three patients had magnetic resonance imaging (MRI) and computed tomography (CT) of the head prior to surgery for medically intractable epilepsy. Eleven patients had neoplasms, mostly astrocytomas. Six of the 11 tumors were seen on CT. In five of the six cases, the MRI showed a focal area of increased signal on T2-weighted images. All 11 tumors were detected by MRI. None of the non-neoplastic lesions produced an abnormal T2-weighted signal area on MRI. Only one of the non-neoplastic lesions was seen on both CT and on MRI. MRI allowed clear discrimination between tumors and non-neoplastic lesions in patients coming to surgery for intractable epilepsy.

Adult↗
PubMedDate not supplied

A study of miscarriage: development and validation of the Perinatal Grief Intensity Scale.

OBJECTIVE: This article outlines the development of the Perinatal Grief Intensity Scale (PGIS). It is based on a theoretical model developed to predict intensity of grief response to early pregnancy loss. DESIGN: Participants completed the PGIS by mail and made an overall assessment of their grief intensity by completing a single Likert-type item. PARTICIPANTS: A convenience sample of 186 women who had experienced a miscarriage before 16 weeks gestation in the previous 12-18 months. RESULTS: Fourteen items were retained after factor analyses, loading at .4 or greater. The 14 items loaded on a three-factor solution as predicted and accounted for 65% of the variance. Three factors were found to influence intensity of grieving: Reality of the pregnancy and baby within (Reality), congruence between the actual miscarriage experience and the woman's standard of the desirable (Congruence), and the ability of parents to make decisions or act in ways to increase this congruence (Confront Others). Chronbach's alpha for the entire instrument was .82, with subscale reliability scores of .89 (Reality), .84 (Confront Others), and .71 (Congruence). CONCLUSION: The PGIS demonstrates acceptable beginning reliability and validity in predicting grief intensity. Further testing of the instrument is needed with all types of pregnancy losses. The level of score needed to predict intense responses also needs to be determined.

Abortion, Spontaneous↗
PubMedDate not supplied

Comparison of fast spin-echo and conventional spin-echo magnetic resonance spinal imaging techniques in four normal dogs.

Various magnetic resonance (MR) imaging techniques have been used to assess lumbar spinal abnormalities in people. Four, young adult, clinically normal dogs were used to compare images of the spinal cord acquired using conventional spin-echo and rapid acquisition relaxation-enhanced (RARE), commonly called fast spin-echo (FSE), magnetic resonance imaging techniques. Lateral myelograms were made as an anatomic control. The T2-weighted FSE technique was characterized by better image quality than the T2-weighted conventional spin-echo technique. The short acquisition time with the FSE technique allowed increases in the matrix size and number of excitations, thus improving resolution and signal-to-noise ratio. In canine lumbar spinal MR imaging, use of a FSE technique is recommended to reduce the overall time for imaging and to improve image quality.

Animals↗
PubMedDate not supplied

Under assault: the experience of work-related anger in female registered nurses.

This article is Part I of a three part article. Part I describes work-related experiences of anger of female registered professional nurses (N = 9) who participated in phenomenological interviews. Participants ranged in age from 29 to 56 and had practiced nursing for a period of 7 to 34 years. Nurses described being "under assault" in a hostile environment. Military metaphors and similes permeated all the interviews. Subtheme of "under assault" included scapegoating, disrespectful treatment, and lack of support. Anger was a weapon used by the nurse to defend or advocate for patients or self, as well as to attack doctors, peers, patients, and self. Factors within the self such as control versus powerlessness influenced nurses' anger experience and expression. Infighting within the profession prevents mobilization of resources to confront the larger issues of healthcare reform. Nurses must reframe anger as a constructive means of empowerment, rather than a weapon to defend against assault. Part II addresses anger experiences of male registered nurses, and Part III provides recommendations for channeling anger constructively.

Adaptation, Psychological↗
PubMedDate not supplied

A technical analysis of an intraoperative radiation detection probe.

A technical evaluation was made of a commercial intraoperative radiation probe. This device utilizes a CsI (T1) scintillation detector and light pipe arrangement to count gamma radiation in vivo. After determining the optimal window and threshold setting, additional evaluations included linearity, distance response function, detector dead time, counter reproducibility, detector sensitivity, angular resolution, and energy resolution. Detector dead time (21.2 microseconds) was found to be characteristic of a nonparalysable system. Activity response for each radionuclide was linear (R = 0.99) both with and without collimation. Energy resolution, 25% at 210 keV, was not sufficient to separate the two photons (172 and 247 keV) emitted by 111In. Detector sensitivity was 1136 and 626 counts per s per microcurie of 111In and 99mTc, respectively. The mean effective distance from the face of the uncollimated probe to the crystal was determined to be 2.03 cm in air.

Antibodies↗
PubMedDate not supplied

Do animals bite more during a full moon? Retrospective observational analysis.

OBJECTIVE: To test the hypothesis that the incidence of animal bites increases at the time of a full moon. DESIGN: Retrospective observational analysis. SETTING: Accident and emergency department at a general hospital in an English city. SUBJECTS: 1621 consecutive patients, irrespective of age and sex. MAIN OUTCOME MEASURES: Number of patients who attended an accident and emergency department during 1997 to 1999 after being bitten by an animal. The number of bites in each day was compared with the lunar phase in each month. RESULTS: The incidence of animal bites rose significantly at the time of a full moon. With the period of the full moon as the reference period, the incidence rate ratio of the bites for all other periods of the lunar cycle was significantly lower (P <0.001). CONCLUSIONS: The full moon is associated with a significant increase in animal bites to humans.

Animals↗
PubMedDate not supplied

The aging voice: a review, treatment data and familial and genetic perspectives.

This paper will provide a review of aspects of vocal aging within the context of general body aging and describe two data sets related to the aging voice. Data will be presented which document pre- to posttreatment improvement in select voice characteristics (sound pressure level, subglottal air pressure, thyroarytenoid laryngeal muscle activity and voice quality) following application of an intensive voice treatment program (the LSVT) to 3 individuals with aged voice. Additionally, physiological data (forced expiratory volume, visual accommodation, bone density, taste discrimination, white blood count and resting heart rate) and select perceptual (perceived age) and acoustic measures (reflecting both cycle-to-cycle and longer-term intensity and frequency stability) from 67 subjects will be reviewed from the work of Gray and colleagues to document the differential impact of the global aging process across organ systems including the aging voice.

Adolescent↗
PubMedDate not supplied

Pulmonary deposition of calcium phosphate crystals as a complication of home total parenteral nutrition.

A patient on home total parenteral nutrition (TPN) developed a diffuse granulomatous interstitial pneumonitis secondary to calcium phosphate deposition. Calcium and phosphorus concentrations in the TPN formula were not unusually high, indicating that other factors contributed to calcium phosphate crystallization. The effects of duration of storage of the TPN formulation, solution temperature, pH, and magnesium concentration on calcium phosphate precipitation are discussed.

Adult↗
PubMedDate not supplied

Failure of three decision rules to predict the outcome of in-hospital cardiopulmonary resuscitation.

The objective of this study was to evaluate three decision-support tools (the Pre-Arrest Morbidity or PAM score, the Prognosis After Resuscitation or PAR score, and the Acute Physiology and Chronic Health Evaluation or APACHE III score) for their abilities to predict the outcomes of in-hospital cardiopulmonary resuscitation (CPR). The medical records of all 656 adult inpatients undergoing CPR during a two-to-three-year period in three large hospitals were retrospectively reviewed, and demographic and clinical variables were abstracted. Of 656 patients undergoing resuscitation, 248 (37.8%) survived the resuscitation attempt long enough to be stabilized (immediate survival), but only 35 (5.3%) survived to discharge. Only 11 patients had PAM scores higher than 8, none of whom survived to discharge; 131 patients had PAR scores above 8, of whom six survived to discharge. The PAR score and the APACHE III score had the greatest areas under the receiver operating characteristic curves (when predicting the outcome of survival to discharge), although no individual area for either outcome was greater than 0.6. None of the decision-support tools studied was able to effectively discriminate between survivors and non-survivors for the outcomes of immediate survival and survival to discharge following in-hospital CPR. This is consistent with previous work utilizing the APACHE II score, which did not identify a threshold above which patients did not benefit from CPR. The findings for the PAR score and the PAM score stand in contrast to previous studies that found them to be potentially useful decision rules. Further work is needed to develop a decision-support tool that better discriminates between survivors and non-survivors of in-hospital CPR.

APACHE↗
PubMedDate not supplied

Effect of subanesthetic concentration of enflurane and halothane on human behavior.

Ten male volunteers performed 3 tasks before, during, and following administration of 3 levels of alveolar halothane (0.05, 0.1, and 0.2%) for one-half hour each and (on a separate occasion) enflurane (0.15, 0.3, and 0.4%) for one-half hour each. The concentrations of halothane tested representing 7, 13, and 27% of MAC values, respectively; those of enflurane were 9, 18, and 24% of MAC. The tasks were a choice-reaction time test, a digit span test, and a Purdue Pegboard Assembly test. Volunteers also were tested for amnesia with word pairs and a picture. No effects or only slight effects on mental function could be detected at the lowest concentrations of either agent. At higher concentrations both agents impaired function, as indicated by an increase in reaction time, decreased ability to remember numbers, and decreased ability to assemble a simple structural array. Amnesia for word pairs but not pictures occurred at 27% of MAC for halothane and 18% of MAC for enflurane. All test scores reverted to control levels within one-half hour after discontinuing the anesthetic. Our results indicate that subanesthetic but not trace levels of enflurane or halothane can impair mental performance and manual dexterity and produce amnesia. The levels of anesthetic required far exceed those experienced by operating room personnel. However, such levels might be found for several hours in patients following prolonged anesthesia.

Adult↗
PubMedDate not supplied

Nonlinear antagonism of anesthesia in mice by pressure.

Previous studies have shown a rectilinear antagonism by pressure of nitrous oxide or isoflurane anesthesia in mice (pressure reversal). Since a rectilinear pressure reversal is predicted by the critical volume hypothesis for anesthesia, we examined this phenomenon with two other gases. We measured the doses of argon or nitrogen which abolished the righting reflex in 50% of animals (ED50) at various high pressures produced by the addition of helium. The ED50 values of argon and nitrogen alone are 16.7 +/- 1.37 and 38.3 +/- 1.62 atmospheres absolute (ATA). Fifty-five percent more argon and 27% more nitrogen is needed to produce anesthesia at 100 ATA. However the increasing anesthetic requirements with pressure were curvilinearly related to pressure, rising most steeply at pressures near the ED50 without helium. This suggests that the pressure reversal of anesthesia is not simply a reciprocal anesthetic expansion-pressure compression phenomenon as predicted by the critical volume hypothesis. It suggests that anesthetics and pressure act at different sites.

Anesthesia↗
PubMedDate not supplied

Evaluation of a geriatric mental health training program for nursing personnel in rural long-term care facilities.

Although mental illness among elderly living in nursing homes is a substantial and growing concern, the behavioral problems associated with mental illness or threats to mental health are not well understood, tolerated, or effectively managed by nursing home staff. As a result, resident care and quality of life, and staff morale often suffer. The need for geriatric mental health training in long-term care settings has become increasingly apparent. Psychiatric/mental health nurses are in an advantageous position to address this current need and future challenge through the development, implementation, and evaluation of geriatric mental health education and training programs in long-term care settings. This article describes one such innovative training effort, designed to improve the quality of psychosocial care provided by nursing personnel in rural long-term care settings, and highlights evaluation outcomes related to participant satisfaction, staff knowledge, and attitudes.

Aged↗
PubMedDate not supplied

Geropsychiatric nursing consultation as an adjunct to training in long-term care facilities: the indirect approach.

Creative, collaborative approaches between sub-specialties in nursing are needed to improve the quality of care and, hence, the quality of life for mentally ill and behaviorally impaired older adults living in long-term care (LTC) facilities. Results of a consultation survey collected as part of a larger geriatric mental health training project, and described in this article, support the position that consultee-centered geropsychiatric nursing consultation services are an important adjunct to training. However, this indirect approach to service enhancement may not be well understood and, as a result, not well utilized by LTC nurses. Methods to facilitate understanding and utilization of "indirect" mental health assistance to LTC residents and staff are explored within the context of building productive liaisons among nurses.

Aged↗
PubMedDate not supplied

Probable human infection with a newly described virus in the family Paramyxoviridae. The NSW Expert Group.

After an apparently new virus in the family Paramyxoviridae was isolated from pigs in August 1997, an investigation was carried out to assess its risk for humans. More than 250 persons with potential exposure to infected pigs were tested serologically. Two piggery workers with intense occupational exposure had high convalescent-phase antibody titers to this new virus. In early June 1997, both workers had an influenzalike illness with rash; serologic testing showed no alternative cause. Strong evidence indicates that the two men became ill from this new virus, but the mode of transmission from pigs to humans remains unknown.

Agricultural Workers' Diseases↗