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Biomedical subjects

R Cole

Publications and source records attributed to R Cole.

At least 55 records · Page 3Linked to original sources
PubMed1995

Double-blind trial of botulinum toxin for treatment of focal hand dystonia.

Ten patients with focal dystonia of the hand, all of whom had benefited in an open-label study of botulinum toxin, were treated with botulinum toxin-A in a double-blind study. Response was assessed by three measures: (a) subjective rating, provided by patients' reports of the effect of the injections on the dystonia; (b) objective testing, consisting of manual muscle testing (MRC scale) to measure muscle strength in all patients, timing of a writing sample and counting the number of errors of writing off-the-line in six patients with writer's cramp, counting the number of errors on a standard test of transcription in two patients with stenographer's cramp, and rating by professional musicians of the performances of two patients with musician's cramp; and (c) physicians' rating, provided by a review of the patients' videotaped performance by neurologists who were unaware of which treatment was administered. Eight of the 10 patients had greater subjective improvement with botulinum toxin than with placebo, and this impression was verified by at least one objective test in six patients. Two patients failed to have a better response to botulinum toxin than to placebo, and their reports were verified by the objective tests. This study confirms the efficacy of botulinum toxin in many patients with focal hand dystonia.

Botulinum Toxins↗
PubMed1995

Propagation of local motion correspondence.

We examined how the direction of apparent motion in one part of a scene can propagate and constrain motion direction in another part. The stimulus scene consisted of an array of dots all moving in the same physical direction at the same time. According to the proximity rule, the dots in the interior of the array should appear to move rightward and the dots at the edges should appear to oscillate horizontally. However, we found that: (1) with long frame durations, the interior dots also appeared to oscillate; (2) with shorter frame durations, the likelihood that the subjects perceived rightward motion at the center of the array increased; (3) oscillation was observed at the edges regardless of frame duration; (4) when opaque objects were placed on both the left and right sides of the array as occluders, only rightward motion was observed both in the center and at the edges of the occluders independent of frame duration; (5) in all cases, similar results were obtained with both foveal and peripheral viewing of either the center or the edge; and (6) with longer frame durations, the interior area within which oscillations were observed became larger. These findings suggest that signals for motion correspondence (oscillation) can gradually propagate to distant units (roughly 30 deg/sec). This can be explained by a locally-connected iterative network model.

Female↗
PubMed1995

Student health services at four rural colleges: implications for healthcare reform.

This study investigated services available at health centers at four rural colleges. It also investigated the healthcare accessible to students at those institutions if college health services were unavailable. The authors used a survey and interview procedure to establish the existence of healthcare resources in two adjacent communities and to identify barriers to student use. Findings from the study indicate that, for many students attending rural colleges, the student health center may be the only source of primary healthcare available. The data support the need to include student health centers at rural colleges in the national healthcare reform agenda because closing any one of these schools' health centers could result in a healthcare disaster for some students.

Community Health Services↗
PubMed1995

Protective efficacy of nonneutralizing monoclonal antibodies in acute infection with murine leukemia virus.

We have used an experimental retrovirus infection to study the roles played by different antibodies in resistance to both infection and disease. A molecularly cloned chimeric murine leukemia virus was used to induce acute lethal neurological disease in neonatal mice. A panel of monoclonal antibodies directed against the Gag and Env proteins was tested for protective efficacy. In vitro neutralization assays demonstrated that anti-Env antibodies gave different degrees of neutralization, while no anti-Gag neutralized the virus. In vivo experimental endpoints were onset of clinical signs and premoribund condition. As expected, different anti-Env antibodies demonstrated different degrees of protection which correlated with their neutralizing abilities. Surprisingly, anti-Gag antibodies directed against both p15 (MA protein) and p30 (CA protein) were also protective, significantly delaying the onset of disease. No protection was seen with either of two control antibodies. The protection with anti-Gag was dose related and time dependent and was also produced with Fab fragments. Treatment with anti-Gag did not prevent viremia but resulted in a slight slowing in viremia kinetics and decreased levels of virus in the central nervous systems of mice protected from disease. These data indicate that nonneutralizing antiretroviral antibodies can influence the outcome of retroviral disease. The data also suggest a functional role for cell surface expression of Gag proteins on murine leukemia virus-infected cells.

Animals↗
PubMed1995

Effects of prenatal and infancy nurse home visitation on surveillance of child maltreatment.

OBJECTIVE: To examine the effects of prenatal and infancy nurse home visitation on the surveillance of child abuse and neglect by examining differences in the health, living conditions, and maltreatment characteristics of nurse-visited and comparison children who had been identified as maltreated in the first 4 years of life. DESIGN: Randomized controlled trial. SETTING: Carried out in a semirural community in upstate, New York. Families dispersed throughout 14 other states during 2-year period after children's second birthdays. PARTICIPANTS: 400 primiparous women registered before 30th week of pregnancy, 85% of whom were either teenaged (< 18 years at registration), unmarried, or from Hollingshead social class IV or V. Maltreated subsample consisted of 56 families in which children had a state-verified report of child abuse or neglect during the first 4 years of the children's life. INTERVENTION: Nurse home visitation from pregnancy through the second year of the child's life. MAIN RESULTS: During the two-year period after the program ended, nurse-visited maltreated children lived in homes with fewer observed safety hazards for children; their homes contained more intellectually stimulating toys, games, and reading materials; their mothers were less controlling; and the children paid 87% fewer visits to the physician for injuries or ingestions, and 38% fewer visits to the emergency department. CONCLUSIONS: Children who were identified as maltreated and who were visited by nurses during pregnancy and the first two years of life had less serious expressions of caregiving dysfunction. This is likely to be a reflection, in part, of earlier and more comprehensive detection of child maltreatment on the part of nurse-visited families.

Adolescent↗
PubMed1994

Anaphase onset in vertebrate somatic cells is controlled by a checkpoint that monitors sister kinetochore attachment to the spindle.

To test the popular but unproven assumption that the metaphase-anaphase transition in vertebrate somatic cells is subject to a checkpoint that monitors chromosome (i.e., kinetochore) attachment to the spindle, we filmed mitosis in 126 PtK1 cells. We found that the time from nuclear envelope breakdown to anaphase onset is linearly related (r2 = 0.85) to the duration the cell has unattached kinetochores, and that even a single unattached kinetochore delays anaphase onset. We also found that anaphase is initiated at a relatively constant 23-min average interval after the last kinetochore attaches, regardless of how long the cell possessed unattached kinetochores. From these results we conclude that vertebrate somatic cells possess a metaphase-anaphase checkpoint control that monitors sister kinetochore attachment to the spindle. We also found that some cells treated with 0.3-0.75 nM Taxol, after the last kinetochore attached to the spindle, entered anaphase and completed normal poleward chromosome motion (anaphase A) up to 3 h after the treatment--well beyond the 9-48-min range exhibited by untreated cells. The fact that spindle bipolarity and the metaphase alignment of kinetochores are maintained in these cells, and that the chromosomes move poleward during anaphase, suggests that the checkpoint monitors more than just the attachment of microtubules at sister kinetochores or the metaphase alignment of chromosomes. Our data are most consistent with the hypothesis that the checkpoint monitors an increase in tension between kinetochores and their associated microtubules as biorientation occurs.

Anaphase↗
PubMed1994

Detection of small airway dysfunction in asymptomatic smokers using aerosol bolus behavior.

Tests using inhaled particles assess ventilatory nonuniformities and may be sensitive to early changes in the small airways of cigarette smokers. We measured aerosol bolus behavior in 20 asymptomatic smokers and 20 age- and sex-matched nonsmokers for comparison with pulmonary function parameters including the single-breath nitrogen test. Narrow boluses containing 1-micron particles were introduced into 1-I breaths and inhaled to varying lung depths. We examined changes in bolus shape between inhalation and exhalation using plots of aerosol concentration versus respired volume for measurement of bolus dispersion, volumetric change in mean location (mean shift), and quantitative particle deposition. We found exhaled bolus dispersion to be significantly increased in smokers compared with nonsmokers. Volumetric mean shift was significantly different in smokers at shallow lung depths, with the center of bolus mass occurring later in exhalation. FEV1/FVC in smokers was significantly inversely correlated with dispersion at deeper lung depths and with mean shift at all lung depths. Smokers with abnormal spirometry (n = 4) or an abnormal single-breath nitrogen test (n = 7) had significantly increased dispersion compared with smokers with normal pulmonary function tests. We conclude that aerosol bolus dispersion is a useful tool for examination of small airway function in asymptomatic smokers.

Adult↗
PubMed1994

Down's syndrome.

Explore the source record for details and available documents.

Child↗
PubMed1994

HIV-related training programs for health care professionals: findings from a collaborative assessment.

Seeking to avoid duplication of effort, evaluators from twelve separate HIV-related training programs worked together to share information, assessment tools, measurement instruments, and preliminary findings across programs. Each training program focused on preparing health care professionals to meet the growing demands of the AIDS epidemic and specifically address psychosocial issues of care. The collaborative effort of program evaluators included an examination of experiences across programs and yielded recommendations for needs assessments, process evaluation procedures, and outcome measures. This paper focuses on the findings from an analysis of needs assessments and process evaluations across twelve HIV-related training programs in eleven areas of the country.

Forecasting↗
PubMed1993

Lack of agreement between measurement of ejection fraction by impedance cardiography versus radionuclide ventriculography.

OBJECTIVE: To determine the limits of agreement between left ventricular ejection fraction estimated using systolic time intervals from impedance cardiography and left ventricular ejection fraction estimated by radionuclide ventriculography. DESIGN: A prospective study for diagnostic tests using radionuclide ventriculography as the criterion standard. SETTING: A large military teaching hospital. PATIENTS: Twenty ambulatory adults scheduled for radionuclide ventriculography. MEASUREMENTS AND MAIN RESULTS: A regression equation to estimate ejection fraction from systolic time intervals is available in a widely used impedance-based cardiac monitoring device. The estimated ejection fraction is then used in an equation with stroke volume estimated by the same device to calculate an end-diastolic volume. We studied the agreement of the ejection fraction as estimated by this device with the ejection fraction estimated by radionuclide ventriculography by obtaining simultaneous estimates of ejection fraction over a broad range of adult patients. Twenty ejection fraction pairs were analyzed. The correlation of ejection fraction by impedance cardiography to ejection fraction by radionuclide ventriculography was significant (r2 = .55; p < .002). However, the mean difference between the technologies was -8.85%, with a standard deviation of the differences of 7.15%, resulting in a 95% confidence range for agreement of -23.2% to +5.5%. CONCLUSIONS: The 95% confidence range defining the limits of agreement between ejection fraction by impedance cardiography and ejection fraction by radionuclide ventriculography is not clinically acceptable. In the opinion of the authors impedance cardiography should not be used in place of radionuclide ventriculography for the assessment of ejection fraction at this time.

Adult↗
PubMed1993

Diagnostic and substance specificity of carbon-dioxide-induced panic.

OBJECTIVE: The authors assessed the substance and diagnostic specificity of carbon-dioxide-induced panic since, in addition to the specific biochemical effects of inhaled carbon dioxide (CO2), simple physiologic distress is also frequently implicated as a panicogenic factor during respiratory challenge studies with CO2 in patients with anxiety disorders. METHOD: Eighteen patients with panic disorder, 20 with social phobia, and 23 psychiatrically normal subjects inhaled a mixture of 35% CO2 and 65% O2 for 30 seconds through a face mask. They also breathed for 30 seconds through a valve reducing the diameter of the airway. A double-blind, counterbalanced, randomized design was used. RESULTS: In spite of important similarities between the two interventions, including the induction of equal amounts of subjective respiratory distress, carbon dioxide inhalation was significantly more potent than increased airway resistance in provoking panic in the anxiety disorder patients. The patients with panic disorder were significantly more sensitive to CO2 than were the patients with social phobia or the normal subjects. CONCLUSIONS: Carbon dioxide inhalation appears to have a specific panicogenic effect in panic patients that goes beyond simple breathlessness.

Administration, Inhalation↗
PubMed1993

Bereavement support: evaluation of a palliative care memorial service.

A memorial service providing bereavement support in a palliative care unit is evaluated. Results indicate that respondents found it to be a positive experience, particularly in relation to its formality and content. One-fifth of respondents experienced distress during the service, but this was evaluated as appropriate, being related to personal thoughts, feelings of loss and sadness, and remembrance.

Bereavement↗
PubMed1992

Conservative treatment of deep partial thickness hand burns--a long term audit of outcome.

Fourteen patients with 23 burned hands assessed as deep partial thickness were studied. Fourteen (61%) hands re-epithelialised within 3 weeks. A detailed hand assessment at a mean of 19 months post-injury was carried out. The functional outcome compared favourably with a group of matched normal controls. There was no statistically significant functional difference between the 7 late grafted hands and the 16 spontaneously healed hands except for total passive motion. Seventeen (74%) hands were considered by the patients to be functionally as good as before the injury.

Adult↗