MDs bill for these routine nursing tasks.
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Abstracting and Indexing↗
Biomedical subjects
N Thomas
Publications and source records attributed to N Thomas.
Fathers and grieving: coping with infant death.
As we have listened to parents who have come to our parent support group during the past 10 years, we have become increasingly aware of the differences in the way fathers and mothers grieve. These differences can lead to misunderstanding and to further hurt and confusion for both parents who are grieving the loss of an infant. Role expectations seem to account for many of these differences. Fathers' responses to infant loss tend to coincide with how they believe they should act as men, rather than how they need to act to confront and resolve grief. We conducted a pilot study of parents' experiences following infant death, and sought more detailed insight from several fathers into their experiences. In this article, we explore some of the differences in the way fathers and mothers grieve and the constraints men experience in resolving grief because of their role expectations.
Adaptation, Psychological↗
Distinction of Becker from limb-girdle muscular dystrophy by means of dystrophin cDNA probes.
The similarity in clinical features of X-linked Becker muscular dystrophy (BMD) and the autosomal recessive limb-girdle (LGD) type of adult muscular dystrophy makes differential diagnosis of the isolated male case difficult. DNA probes complementary (cDNA) to the Duchenne/Becker muscular dystrophy gene product, dystrophin, can detect molecular deletions in 60-70% of affected subjects. Thirty-three patients with BMD or LGD (thirty isolated and three with an affected brother) were screened with a panel of cDNA probes for the whole dystrophin gene. Deletions were found in thirteen of eighteen (72%) patients with a diagnosis of BMD. Deletions were also found in four of the fifteen (27%) patients previously thought to have LGD, who were therefore reclassified as having BMD. All male patients with progressive muscular dystrophy of limb-girdle pattern should be routinely screened with these cDNA probes as a useful adjunct to their clinical diagnosis since the results have important implications for genetic counselling of affected families.
Adult↗
Observation of Brillouin scattering from single muscle fibres.
The propagation of sound waves along relaxed single fibres of glycerinated rabbit psoas muscle has been observed using Brillouin scattering at frequencies up to 1.6 GHz. Two types of waves were observed: one with a velocity of 1508 +/- 7 m s-1, which is attributed to sound waves in intra-cellular saline, the other with a velocity of 912 +/- 25 m s-1, which is attributed to waves propagating along the protein filaments within individual sarcomeres. The latter sound velocity is much higher than that which has been reported by Stienen and Blangé (1985) for 50 microseconds tension transients, and the difference is attributed to the much higher stiffness of the protein filaments compared to the cross-bridges which determine the low-frequency elasticity of muscle fibres.
Acoustics↗
Modulation of gentamicin nephrotoxicity by chronic inhibition of angiotensin-I-converting enzyme in rat.
Perindopril, a new specific and potent inhibitor of angiotensin-I-converting enzyme, was used to evaluate the possible participation of inhibition of the renin-angiotensin system in the development of aminoglycoside-induced renal failure. Kidney function, morphology and biochemistry were evaluated at regular intervals throughout the study. Perindopril was given orally to rats at a daily dose of 2 mg/kg for 15 days prior to and during 15-day gentamicin treatment given intraperitoneally at a daily dose of 50 mg/kg. Perindopril treatment alone induced no modification in renal function or structure. Gentamicin treatment alone induced typical renal lesions which were scored as moderate and a slight but significant decrease in ACE blood levels. Concurrent treatment with perindopril and gentamicin induced a greater drop in ACE blood levels than after the administration of perindopril alone and produced more marked renal impairment than after the administration of gentamicin alone. These observations suggest that the integrity of the renin-angiotensin system may play an important role in limiting kidney injury during aminoglycoside-induced nephrotoxicity.
Acetylglucosamine↗
Imaging of children with urinary tract infection.
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Child↗
Effect of different insulin administration modalities on vitamin D metabolism of insulin-dependent diabetic patients.
The vitamin D status of IDDs was studied in 3 groups of patients who were treated for several months with (i) conventional insulin therapy (group I, n = 17, HbA1 = 10.1 +/- 0.5%); (ii) continuous subcutaneous insulin infusion (CSII, group II, n = 11, HbA1 = 8.9 +/- 0.6%); and (iii) continuous intraperitoneal insulin infusion (CPII, group III, n = 13, HbA1 = 8.0 +/- 0.4%). In all patient groups the plasma concentration of vitamin D metabolites were within normal range. However plasma 25 OH D (ng/ml) was significantly lower in groups I (13.0 +/- 0.8, P less than 0.01) and II (12.5 +/- 1.5, P less than 0.02) than in group III: 22.1 +/- 2.3 (normal range 7-27). Plasma 24,25-(OH)2D (ng/ml) was positively correlated to plasma 25 OH D and was significantly decreased in groups I (1.5 +/- 0.2, P less than 0.05) and II (1.4 +/- 0.2, P less than 0.05) compared with group III: 2.3 +/- 0.3. No significant differences were found in plasma 1,25-(OH)2D between the three groups of diabetics. Plasma PTH was similar in the three groups. The same differences in plasma 25 OH D were observed between the patients treated with CPII and 15 subcutaneously treated patients matched for diabetic control (HbA1 less than 10 per cent). The present results seem to indicate that insulin might have a stimulatory effect on the hepatic 25 hydroxylase activity.
Adult↗
Response to desmopressin in type IID von Willebrand's disease.
Dominant transmission of a variant of von Willebrand's disease (vWD) with aberrant polymerization of von Willebrand factor (vWF) has been identified in a Scottish family. Multimer analysis of plasma vWF from the propositus and her father revealed an identical pattern to that previously reported in families designated as type IID vWD. There is loss of the larger multimers and presence of an intermediate subsidiary band not seen in normal subjects or other vWD variants. Platelet/vWF interaction induced by ristocetin is not enhanced in these cases and the platelet vWF shows the same aberrant multimer pattern as plasma vWF. DDAVP infusion in two affected members of the Scottish family and in one of the index cases produced a rise in plasma vWF antigen and factor VIII. Higher molecular weight vWF multimers appeared transiently after infusion of desmopressin (1-deamino-8-D-arginine vasopressin, abbreviated DDAVP) coincident with shortening of the bleeding time. The platelet counts did not change after the DDAVP infusions. DDAVP should be considered for management of bleeding in this variant of von Willebrand's disease.
Adult↗
Topical application of penetration enhancers to the skin of nude mice: a histopathological study.
Eighteen potential penetration enhancers, some at concentrations that might be used for that purpose, have been examined to evaluate their irritancy potential on nude mouse skin. A biopsy technique was employed followed by histological examination. Up to 50% glycerol, 10% hydroxyethyl lactamide (HELA), 10% oleyl alcohol, 10% Solketal, 10% glycofurol, 100% tetrahydrofurfuryl alcohol (THFA) and 10% urea induced no discernible change in the histological appearance of the skin whereas 100% dimethyl sulphoxide (DMSO), 100% dimethyl formamide (DMF), 100% N-methyl-2-pyrrolidone, 10% Azone, 10% oleic acid, 10% methyl laurate, 10% benzyl alcohol and 10% glycerol formal caused severe skin irritation.
Animals↗
[Treatment with an angiotensin converting enzyme inhibitor may increase the nephrotoxicity of gentamicin in rats].
Perindopril, a new specific and potent inhibitor of angiotensin-I-converting enzyme was used to evaluate the possible participation of the inhibition of the renin-angiotensin system in the development of aminoglycoside-induced renal failure. Kidney function, morphology and biochemistry were evaluated at regular intervals throughout the study. Perindopril was given orally to rats at a daily dose of 2 mg/kg for 15 days prior to and during 15 day gentamicin treatment given intraperitoneally at a daily dose of 50 mg/kg. Perindopril treatment alone induced no modification in renal function or structure. Gentamicin treatment alone induced typical renal lesions which were scored as moderate and a slight but significant decrease in ACE blood levels. Concurrent treatment with perindopril and gentamicin induced a greater drop in ACE blood levels than after the administration of perindopril alone and produced more marked renal impairment than after the administration of gentamicin alone. These observations suggest that the integrity of the renin-angiotensin system may play an important role in limiting kidney injury during aminoglycoside induced nephrotoxicity.
Angiotensin-Converting Enzyme Inhibitors↗
The human gene for von Willebrand factor. Identification of repetitive Alu sequences 5' to the transcription initiation site.
The region at the 5' end of von Willebrand factor gene was cloned by screening genomic libraries with a partial von Willebrand factor cDNA probe and oligonucleotides complementary to areas of von Willebrand factor mRNA at the extreme 5' end of the untranslated region. The sequence 2158 bp upstream of the transcription initiation site, the first exon and first exon-intron junction is reported. The first exon includes the entire 5' untranslated sequence (250 bp) and the translation initiation codon starts the second exon, suggesting an unusual control mechanism for the cell specific expression of von Willebrand factor. An AT-rich region resembling a TATA box is found 32 bp upstream of the transcription initiation site. At -1030 and -1806 nucleotides 5' of the TATA box are two repetitive Alu sequences of approximately 300 bp. Recombinant events at these Alu sequences could result in some clinical forms of von Willebrand disease involving transcriptional defects.
Base Sequence↗
Low volume processing of protein blots in rolling drums.
We have evaluated an improved method for processing protein blots on nitrocellulose or nylon membranes using cylindrical plastic containers. The method, which is directly analogous to the commonly used method of photographic processing in rolling drums, uses small values of reagents which are constantly washed over the blotting membrane by rotating the drum horizontally on a roller mixer. Volumes of reagents used are typically less than one-10th of those required for conventional methods using plastic bags or trays. The efficiency of probing and washing steps are greatly improved, giving an all-round increase in sensitivity, ease of processing, and economy of reagents.
Animals↗
Transcutaneous pacing for cardiac emergencies.
Transcutaneous cardiac pacing using the Pace-Aid (Cardiac Resuscitator Corporation) was assessed in 32 emergency patients presenting with profound bradycardia or asystole who had failed to recover with advanced life support including the use of epinephrine. Pacing stimuli, pulse width 20 ms at 50, 100, or 200 mA, were delivered through two 8 cm gel-pad electrodes placed antero-posteriorly on the chest. By ECG criteria, definite electrical capture was achieved in a total of five patients and possible capture in a further 16. Of the 21 patients presenting in asystole 11 showed possible electrical capture only. No evidence of capture was seen in one third of the patients studied. Use of the Pace-Aid resulted in a palpable pulse in a total of seven patients. Four of the 11 patients with profound bradycardia survived to receive temporary transvenous pacing; two were eventually discharged. None in the asystolic group survived. Difficulties in using the Pace-Aid resulted from electrical overload by the pacing impulse that obscured the evidence for electrical capture, and intense muscle contraction that hindered reliable palpation of the arterial pulse. Transcutaneous pacing can occasionally be of value even at a late stage in the emergency treatment of profound bradycardia but is unlikely to be worthwhile in complete asystole.
Aged↗
[Habekacin: a new aminoglycoside. Study of nephrotoxicity in rats in comparison with gentamicin, netilmicin and amikacin].
Habekacin is a new aminoglycoside antibiotic. In this study we want to know the effect of increasing dose of habekacin on renal function and on renal morphology. We decide to compare the renal alterations induced by habekacin to these provoked by gentamicin, netilmicin and amikacin. Female Wistar rats received intraperitonally a single injection daily of 10, 30, 50, 150 mg/kg of habekacin for seven days. Wistar rats received also 50 mg/kg gentamicin, 50 mg/kg netilmicin and 150 mg/kg amikacin. No mortality was observed in groups treated with 10, 30, 50 mg/kg habekacin but 50 per cent of rats died with 150 mg/kg habekacin. Habekacin--30 mg/kg seven days--induced a decrease of cortical enzymatic activities, an increase of the number of lysosomes, a great accumulation of myeloid bodies, an alteration of lysosomal membranes Habekacin--50 mg/kg seven days and 150 mg/kg--induced a decrease of creatinine clearance and ultrastructural alterations of renal tubular cells. Comparative studies with other aminoglycosides showed that amikacin--150 mg/kg was the lesser nephrotoxic drug. With a same dose of 50 mg/kg, gentamicin appeared lesser nephrotoxic than habekacin and habekacin seemed to induce a same degree of renal modifications than netilmicin. With the dose of 150 mg/kg habekacin this drug was higher nephrotoxic than 50 mg/kg gentamicin. In conclusion, if it could be necessary to use habekacin and to prefer this aminoglycoside to gentamicin from an antibacterial activity point of view it is necessary to keep in mind that this drug is potentially nephrotoxic and that the dosage had to be strictly respected.(ABSTRACT TRUNCATED AT 250 WORDS)
Amikacin↗
[Measurement of jejunal absorption during the postoperative ileus stage with a D-xylose test: consequences for immediate postoperative enteral feeding].
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Adult↗
A comparison of immunocytochemical staining enhancement methods using a rapid microtitre immunocytochemistry assay (MIA).
A method is described which allows rapid and quantitative comparison of immunocytochemical staining procedures. Cells grown and fixed in microtitre plates are probed with increasing dilutions of primary antibody and then stained using the procedures under test; the resulting staining intensities are determined using a microtitre plate reader. The microtitre immunocytochemistry assay (MIA) has been used to compare the sensitivities of enhancement procedures based on immunoperoxidase and immunogold staining. Silver enhancement of DAB staining was found to be the most sensitive technique giving up to 200 fold amplification of the peroxidase staining.
Animals↗
Work site group meetings and the effectiveness of a televised smoking cessation intervention.
At the work site, smoking accounts for increased health care expenses and worker absenteeism due to smoking-related illness and reduced productivity and lost wages. Developing comprehensive and accessible smoking cessation programs at the work site is an important objective for health care professionals. In this study, employees of 43 corporations participated in a televised smoking cessation program accompanied by self-help manuals. The media component involved presenting a smoking cessation program on a network television affiliate station during the 4:30 p.m. and 10:00 p.m. news for 20 days. Employees at half the corporations also had access to semiweekly self-help group meetings. Adding self-help support groups to a program involving self-help manuals and the media reports was found to significantly increase abstinence and its maintenance over time. The implications of using the media, self-help groups, and work site locations in large-scale community-based interventions are discussed.
Adult↗
Effect of labetalol on indices of myocardial necrosis in patients with suspected acute infarction.
The role of combined alpha and beta blockade as a means of limiting infarct size has been studied in a randomised controlled trial using labetalol. Only 166 of 630 (26%) consecutive patients admitted to a cardiac care unit with suspected myocardial infarction were deemed suitable for inclusion; most of the remainder had delayed admission to hospital, were over the age limit of 75, or had complications which precluded the use of labetalol. Those on active treatment received a loading dose followed by a slow intravenous infusion over six hours, and oral therapy for the subsequent five days. Doses were adjusted to maintain systolic pressure in the range 100 to 120 mmHg. The control group received only conventional therapy. Labetalol caused lowering of the blood pressure and heart rate during the phase of intravenous treatment, but little effect occurred subsequently because oral dosage was constrained by low systolic pressures. The group that received active treatment had significantly greater release of CKMB enzyme. Little difference was observed in R wave scores or ejection fraction. Only low doses of labetalol can be used for most patients with acute myocardial infarction. Labetalol cannot be recommended as routine treatment for normotensive patients admitted to hospital with suspected infarction.
Aged↗