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Biomedical subjects

R L Steele

Publications and source records attributed to R L Steele.

15 recordsLinked to original sources
PubMed1997

Hyperintense subcortical brain alterations in anorexia nervosa.

OBJECTIVE: The results of past research have identified changes in brain structure in anorexia nervosa. We observed previously unreported MRI alterations in two cases of anorexia nervosa. METHOD: For both cases, we reviewed the clinical history, MRI scans and conducted a pertinent literature review. RESULTS: The MRI brain scans of two patients with the diagnosis of anorexia nervosa revealed evidence of subcortical hyperintense changes on T2-weighted images. DISCUSSION: No previous reports of these findings have been described in the literature on anorexia nervosa to date. Clinical and pathologic correlates associated with these brain observations in anorexia nervosa are discussed.

Adolescent↗
PubMed1995

Aneurysm of saphenous vein graft to coronary artery presenting as non-Q-wave myocardial infarction secondary to mass effect.

Large aneurysms (> 4 cm) of saphenous vein grafts (SVG) to coronary arteries are a rare complication of coronary artery bypass graft surgery (CABG). A 64-year-old male, status post-CABG 14 years ago, presented with dyspnea and diaphoresis. Pneumonia and non-Q-wave myocardial infarction (MI) were diagnosed. Cardiac catheterization and chest computed tomography demonstrated a 5 x 7-cm aneurysm of a SVG. At the time of surgery, the left internal mammary artery (grafted to the left anterior descending artery) was found to be stretched tautly over the aneurysm, resulting in impaired flow. The aneurysm was successfully resected. This is the first published case implicating a SVG aneurysm as the direct cause of a MI by mass effect.

Coronary Aneurysm↗
PubMed1991

Attitudes about faculty practice, perceptions of role, and role strain.

This study examined the opinions and beliefs of 292 faculty and 53 deans regarding clinical practice of nursing faculty and their perceptions of role and role strain. Research hypotheses were formulated to test for statistically significant differences between practicing and nonpracticing faculty. Respondents ranked their perceptions of the importance of various faculty responsibilities and indicated the degree of difficulty they experienced in fulfilling those obligations. Significant differences appeared. Practicing faculty ranked practice higher in importance than did nonpracticing faculty or deans. They (practicing faculty) believed that being actively involved in the clinical area increased their teaching effectiveness and scholarly productivity. Although the practicing faculty did not rank research as high a priority as did nonpracticing faculty or deans, they reported less role strain and felt more confident in other aspects of the faculty role.

Adult↗
PubMed1990

Augmented myocardial perfusion reserve after coronary angioplasty quantified by positron emission tomography with H2(15)O.

Effects of coronary angioplasty on myocardial flow reserve have been difficult to characterize noninvasively because conventional imaging techniques cannot quantitate blood flow in absolute terms. The effects of coronary angioplasty on myocardial perfusion and perfusion reserve were delineated with positron emission tomography and oxygen-15-labeled water (H2(15)O) in 13 patients before and after single vessel angioplasty. In 11 patients, angioplasty was successful (minimal cross-sectional area increased from 0.60 +/- 0.59 to 3.45 +/- 1.09 mm2, p less than 0.001). In these patients, regional H2(15)O radioactivity (the ratio of nutritional perfusion in regions distal to the stenosis compared with regions supplied by angiographically normal arteries) at rest before angioplasty was 55 +/- 22% of peak myocardial radioactivity and did not increase significantly afterward (70 +/- 16%, p = NS). However, after administration of intravenous dipyridamole, hyperemic perfusion in regions distal to a stenosis averaged only 39 +/- 18% of peak myocardial counts before angioplasty, but increased to 66 +/- 22% after angioplasty (p less than 0.02). Perfusion reserve in the two patients in whom angioplasty was angiographically unsuccessful showed no change. Quantitative estimates of perfusion in absolute rather than relative terms were obtained with positron emission tomographic data from seven of the patients with successful angioplasty. At rest, perfusion in regions distal to a stenosis was not different from the values in regions supplied by normal coronary arteries (1.54 +/- 0.54 compared with 1.46 +/- 0.38 ml/g per min, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1988

Delineation of impaired regional myocardial perfusion by positron emission tomography with H2(15)O.

Positron emission tomography with 15O-labeled water (H2(15)O) can be used to delineate abnormal regional myocardial blood flow in experimental animals. To determine the feasibility of this method in humans, we studied 33 subjects (9 normal volunteers and 24 patients with angiographically documented coronary artery disease) at rest and after myocardial hyperemia induced with intravenous infusion of dipyridamole. At rest, the myocardial region demonstrating the lowest relative H2(15)O activity exhibited 71 +/- 8% of activity in the region with peak activity in control subjects and 62 +/- 17% in patients (p = NS). After the dipyridamole infusion, differences between the two groups were accentuated. In control subjects, activity in the region with lowest relative radioactivity averaged 77 +/- 5% of that in the region with peak activity. In patients, it averaged 55 +/- 22% of activity in the region with peak activity (p less than 0.01). Results in patients with ischemia with or without a history of remote myocardial infarction were not significantly different. In 22 of the 24 patients, the region with lowest relative perfusion corresponded anatomically to the region of myocardium distal to a stenosis. Thus, delineation of regional myocardial perfusion in patients with coronary artery disease is possible with positron emission tomography and H2(15)O. Further studies will be necessary to prospectively determine sensitivity and specificity.

Adult↗
PubMed1986

Prepartum grain feeding and subsequent lactation forage program effects on performance of dairy cows in early lactation.

One hundred fifty-six Holstein cows were balanced prior to drying off to one of three diets offered during the dry period (dry matter basis): A) forage only (50% corn silage:50% alfalfa silage), B) forage as A plus a standard dairy grain mix (1.73% calcium), and C) same as B except a low calcium grain mix (.35% calcium). Grain feeding started 3 wk prepartum. Cows from each dry treatment were assigned to one of two treatments during the first 21 d postpartum: total mixed ration (dry matter basis); 50% grain:50% corn silage; or 50% grain:25% corn silage:25% alfalfa silage. Dry period feeding program had no effect on postpartum dry matter intake, milk yield, or composition. Prepartum grain feeding resulted in increased body weight gain during the last 3 wk of the dry period. Feeding corn silage postpartum as the sole forage resulted in higher dry matter intakes (15.0 vs. 14.1 kg/d), milk production (31.3 vs. 29.7 kg/d), and less body weight loss (36 vs. 58 kg) during the first 21 d postpartum than feeding a 50% corn silage:50% alfalfa silage mixture. However, differences varied depending on dry cow feeding program. All dry cow treatments resulted in a high incidence of milk fever (11.5, 11.5, and 15.5% for A, B, and C, respectively). Dry cow rations containing as little as 50% alfalfa silage appear to predispose cows to increased incidence of milk fever.

Animal Feed↗
PubMed1986

Performance of dairy cows fed forage and grain separately versus a total mixed ration.

Forty multiparous cows beyond peak production were fed forage ad libitum behind Calan doors and grain at 1 kg/2.5 kg milk through a computer controlled feeder, and 40 similar cows were fed a total mixed ration balanced for 32 kg milk behind Calan doors ad libitum. Based on mean milk production from d 16 through 21 of a preliminary period, cows were balanced into two groups within each group of 40 cows. Both groups received the originally assigned ration during d 22 through 49. During d 50 through 77, 20 cows were switched abruptly to the other ration and 20 remained on the original. Cows fed forage and grain separately had milk yields similar to those fed total mixed ration. Dry matter intake was lower for cows fed forage and grain separately from d 22 through 49 due to reduced forage intake and was also lower from d 50 through 77 due to decreased grain intake. Four percent fat-corrected milk production efficiency was higher for cows fed forage and grain separately. Abruptly changing cows from one feeding system to another did not influence milk yield, milk composition, or body weight gain. The computer controlled feeder system is an effective method to allot grain according to milk production requirements in freestall housing.

Analysis of Variance↗
PubMed1976

Humanistic psychology and rehabilitation programs in mental hospitals.

A humanistic growth-oriented theory, specifically Maslow's need-satisfaction theory, was used as a basis for examining the contributions work and employment make toward rehabilitation of the state mental hospital patient. Research literature reviewed indicated that if the rehabilitation program is to be viable and optimally effective, satisfying the belongingness and esteem needs of the patient is important. Research that stresses the therapeutic benefit of work, as well as research that raises the issue of workshops inhibiting independence and fostering dependence are presented. Modifications of rehabilitation programs that resulted in reports of increased program effectiveness are discussed. Fundamental features of these alternative or ancillary programs were: 1. a definite structure that allows various levels of advancement; 2. group participation; 3. patient initiative; 4. an orientation that reflects the competitive nature of employment; and 5. early community involvement. The importance of evaluating each client's needs and planning for growth before his/her job placement is considered vital to the program and to the individual.

Humans↗
PubMedDate not supplied

Staff attitudes toward seclusion and restraint: anything new?

The author claims that involuntary confinement of clients is a problematic and uncomfortable topic for nurses who are involved in such interventions. After reviewing some literature relevant to the topic of seclusion and restraint, she summarizes her findings from a survey regarding staff attitude toward client confinement.

Adult↗
PubMedDate not supplied

Anorexia nervosa: a case study.

D.R., a single 19-year-old female experiencing anorexia nervosa, was admitted to a mental health center inpatient unit weighing 64 lb, approximately 54 lb underweight, with liver, kidney, and pancreas damage. D.R. was hospitalized for 59 days. Treatment consisted of utilizing a hierarchy of reinforcements in the form of privileges mutually agreed upon between patient and therapist, psychodynamic and supportive psychotherapy, and involvement in the ward milieu therapeutic program. All privileges had to be earned. Access to food was controlled by the staff. For pounds gained privileges were granted, for pounds lost privileges were curtailed. Dynamically, D.R.'s eating behavior was viewed as an unconscious spite and revenge reaction toward her parents as well as an attempt to elicit attention. At the time of discharge D.R. weighed 104.5 lb. Prior to discharge D.R. agreed that if her weight dropped below 100 lb she would return for readmission. Five months later D.R.'s weight stabilized between 102 and 104 lb. Two years later, D.R.'s weight remains at that level. The study cautions against using solely a behavior modification approach in the treatment of anorexia nervosa.

Adult↗
PubMedDate not supplied

Diversity in academia: some reflections.

How close does academia come to mirroring America? Like other societal institutions, higher education has overcome obstacles to cultural diversity with varying degrees of success. Changes in faculty composition and development of more inclusive curricula have been slow taking place in some instances, but there is reason to be optimistic. This paper discusses the historical context of racism and prejudice in American society and how institutions of higher education compare with current trends in overcoming obstacles affecting parity.

Humans↗