Protection of mice against Nematospiroides dubius by subcutaneously administered larval vaccines.
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Animals↗
Biomedical subjects
S Anderson
Publications and source records attributed to S Anderson.
The reversible acid dissociation and hybridization of lactic dehydrogenase.
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Animals↗
Measuring cosmetic facial plastic surgery outcomes: a pilot study.
OBJECTIVE: To test 4 previously published outcomes instruments (the Facelift Outcomes Evaluation, the Rhinoplasty Outcomes Evaluation, the Blepharoplasty Outcomes Evaluation, and the Skin Rejuvenation Outcomes Evaluation) in terms of their reliability and validity in assessing patient-related outcomes of surgical intervention. DESIGN: A prospective pilot study of 78 patients in 3 similar private cosmetic surgery centers undergoing a total of 100 face-lift, rhinoplasty, blepharoplasty, and skin rejuvenation procedures. Patients were evaluated at 2 preoperative and 1 postoperative time points and the instruments were analyzed with regard to their test-retest reliability, internal consistency, and responsiveness to change. RESULTS: All 4 outcomes instruments had excellent reliability, consistency, and validity scores. Test-retest reliability was 0.74 to 0.83 (Pearson correlation coefficients), internal consistency scores were.83 to.88 (Cronbach alpha), and responsiveness to change was statistically significant for each instrument tested (P< or =.001). In addition, patients experienced significant quality of life improvement, with overall satisfaction increasing on average from 37% to more than 84% after these procedures. CONCLUSIONS: These 4 instruments are reliable and valid and can be used to accurately assess patient-related satisfaction in studies of face-lift, rhinoplasty, blepharoplasty, and skin resurfacing outcomes. These brief questionnaires provide the cosmetic surgeon with quantitative tools to evaluate otherwise subjective and purely qualitative outcomes and are recommended for use in future prospective studies.
Blepharoplasty↗
A proposal for interpreting and reporting negative studies.
An issue of continuing interest is the interpretation and reporting of 'negative' studies, namely studies that do not find statistically significant differences. The most common approach is the design-power method which determines, irrespective of the observed difference, what differences the study could have been expected to detect. We propose an alternative approach, the application of equivalence testing methods, where we define equivalence to mean that the actual difference lies within some specified limits. This approach, in contrast to the design-power approach, provides a way of quantifying (with p-values) what was actually determined from the study instead of saying what the study may or may not have accomplished with some degree of certainty (power). For example, a possible outcome of the equivalence testing approach is the conclusion at the 5 per cent level that two means (or proportions) do not differ by more than some specified amount. The equivalence testing approach applies to any study design. We illustrate the method with a cancer clinical trial and an epidemiologic case-control study. In addition, for those studies in which one cannot specify limits a priori, we propose the use of equivalence curves to summarize and present the study results.
Clinical Trials as Topic↗
Conservative surgery for the management of invasive and noninvasive carcinoma of the breast: NSABP trials. National Surgical Adjuvant Breast and Bowel Project.
In 1976 the National Surgical Adjuvant Breast and Bowel Project (NSABP) initiated a randomized trial (B-06) to evaluate the worth of lumpectomy in the treatment of patients with stages I and II breast cancer. This report presents, for the first time, findings from that trial through 10 years of follow-up relative to ipsilateral breast tumor recurrence (IBTR), distant disease-free survival, and survival of patients who were treated by modified radical mastectomy, lumpectomy, or lumpectomy followed by breast irradiation. The report indicates that the incidence of IBTR observed in the B-06 trial is decreased by effective systemic therapy as well. Also commented on are a number of issues regarding the use of lumpectomy that are of concern to clinicians. They relate to the need for tumor specimen margins, the size of tumors amenable to lumpectomy, treatment of breast tumor recurrence, lumpectomy in older women, and other concerns. No patient or tumor characteristics have been identified that preclude the use of lumpectomy and radiation therapy. All evidence continues to justify the use of lumpectomy and breast irradiation for the treatment of invasive breast cancer. In addition, we have noted findings that indicate the propriety of lumpectomy and breast irradiation for treatment of localized ductal carcinoma in situ.
Breast Neoplasms↗
Saccades in pursuit eye tracking reflect motor attention processes.
A dysfunction of pursuit eye tracking in psychiatric patients has been well documented, but its cause has not. Recent speculation implicates a pathological disinhibition of saccades in these patients. However, great variability in tracking performance was found among nine normal subjects, and tracking quality improved in each when asked to perform a simple analysis of the tracking target: saccade counts and amplitudes decreased, as did a root-mean-square (RMS) error measure of overall tracking performance. This improvement was as great at the end as at the beginning of the analysis condition, suggesting that the improvement is not due to increased attention to a novel task, but rather is the preferred mode of tracking automatically, while attending to target analysis. The anticipatory, purposive saccades produced in attending to the act of tracking thus can be studied as involuntary attention effects reflecting frontal lobe function, and used for diagnostic classification of attentional dysfunction.
Adult↗
Is schizophrenia due to excessive synaptic pruning in the prefrontal cortex? The Feinberg hypothesis revisited.
Several lines of evidence support the notion that a substantial reorganization of cortical connections, involving a programmed synaptic pruning, takes place during adolescence in humans. A review of neurobiological abnormalities in schizophrenia indicates that the neurobiological parameters that undergo peripubertal regressive changes may be abnormal in this disorder. An excessive pruning of the prefrontal corticocortical, and corticosubcortical synapses, perhaps involving the excitatory glutamatergic inputs to pyramidal neurons, may underlie schizophrenia. A reciprocal failure of pruning in certain subcortical structures, such as lenticular nuclei, may also occur. Several developmental trajectories, related to early brain insults as well as genetic factors affecting postnatal neurodevelopment, could lead to the illness. These models would have heuristic value and may be consistent with several known facts of the schizophrenic illness, such as its onset in adolescence and the gender differences in its onset and natural course. The relationship between these models and other etiological models of schizophrenia are summarized and approaches to test relevant hypotheses are discussed.
Age of Onset↗
Quantification of the permeability of the blood-CSF barrier to alpha-MSH in the rat.
The ability of alpha-MSH to cross the blood-CSF barrier of the rat was assessed by measurement of the rate of appearance of immunoreactive alpha-MSH in a cerebrospinal fluid (CSF) perfusate following intravenous injection of peptide. Comparisons were made with the rate of appearance of a simultaneously administered dose of 14C-inulin which is poorly permeable at the blood-CSF barrier. Concentrations of drugs measured in plasma were fitted to two-compartment pharmacokinetic models, and those measured in the CSF perfusate to one-compartment open systems receiving an input from the plasma compartment. The rate constant for entry of alpha-MSH into CSF was 0.00087 min-1, which was not significantly different from that for inulin of 0.00055 min-1. As alpha-MSH penetrated into CSF at a rate comparable to inulin, it was concluded that the limited entry of peptide was by aqueous diffusion along with other water-soluble macromolecules.
Animals↗
Role of altered capillary hemodynamics in the initiation and progression of diabetic microangiopathy.
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Capillaries↗
Current concepts of renal hemodynamics in diabetes.
Glomerular hyperfiltration has long been recognized in insulin-dependent diabetes, and has been more recently recognized in patients with non-insulin dependent diabetes mellitus as well. Experimentally, glomerular hyperfiltration has been shown to result from elevations in the glomerular capillary blood flow and the glomerular capillary hydraulic pressure (PGC). Of the hemodynamic determinants of hyperfiltration, it is glomerular hypertension that is most damaging to the glomerulus. Experimental and clinical studies have confirmed that antihypertensive agents that lower PGC more consistently slow the progression of injury than do those that fail to control glomerular hypertension. The pathogenesis of diabetic hyperfiltration is multifactoral. Many mediators have been proposed, including changes due to the altered metabolic milieu, and alterations in endogenous levels of such vasoactive mediators as atrial natriuretic peptide, endothelial-derived relaxing factor, angiotensin II, prostaglandins, thromboxanes, and kinins, among others. It has more recently been suggested that local renal tissue levels, rather than circulating levels, play the more profound role in hemodynamic regulation. For example, the renin-angiotensin system (RAS) appears to be disproportionately active in the renal tissue, potentially explaining the renal vascular responsiveness to angiotensin-converting enzyme inhibition despite absence of systemic RAS activation. Little is yet known of the mechanisms by which glomerular hypertension leads to injury. Innovative new in vitro systems have been developed to address this question. These studies postulate that glomerular hemodynamic factors (shear stress, pulsatile flow) modify the growth and activity of glomerular component cells, inducing the expression of cytokines and other mediators, which then stimulate matrix production and promote structural injury.
Angiotensin II↗
Characteristics of stereotypic movement disorder and self-injurious behavior assessed with the Diagnostic Assessment for the Severely Handicapped (DASH-II).
The first experiment involved 143 individuals with severe and profound mental retardation. Individuals with Stereotypic Movement Disorder, Self-Injurious Behavior (SIB), and Stereotypic movement disorder with self-injurious behavior as assessed by the Diagnostic Assessment for the Severely Handicapped-II DASH-II were validated against Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) criteria. In a second study DASH-II scores for 1480 individuals with severe and profound mental retardation were compared on demographic variables, core and associated features of each disorder. Characteristics of persons in each group were reviewed. Persons with profound mental retardation were more likely to evince stereotypies or self-injury compared to their severely impaired counterparts. Also, those with stereotypies were more likely to present with Pervasive Developmental Disorder (PDD)/autism, organicity, and eating disorders, while persons with SIB were more likely to evince sleep, sexual, and eating disorders.
Adult↗
Determination of radium-226 in environmental and personal monitoring samples.
Radium-226 is a member of the Uranium-238 natural decay series and is the most hazardous radionuclide released to the environment from uranium mining and milling. Due to its long half-life (1600 years) and radiological effects it is one of the most important isotopes to be determined among the naturally occurring nuclides in environmental samples. It is also among the most toxic long-lived alpha-emitters present in environmental samples, as well as one of the most widespread. The requirement for the determination of radium has become a matter of interest in public health due to its hazardous nature with respect to internal exposure. It is concentrated in bones, thus increasing the internal radiation dose of individuals. The methodology developed involves dissolving solid samples by microwave digestion. The radium is then separated from matrix interferents by cation exchange chromatography and subsequently electrodeposited onto a stainless steel disc. Alpha-Spectrometry is employed to determine the activity in the sample. A limit of detection of 20 mBq l(-1) for ground water samples (100 ml) and 20 mBq g(-1) for solid samples (0.1 g) is achievable. The method has been validated via an intercomparison exercise and analysis of a marine sediment reference material. Samples analysed include run off waters from uranium mines, coal and fly ash and also trapping media such as silica gel, charcoal and activated carbon.
Environmental Exposure↗
Close linkage of c-Harvey-ras-1 and the insulin gene to affective disorder is ruled out in three North American pedigrees.
Affective disorder (AD) is one of the major forms of functional psychoses. Although the mode of transmission is uncertain, family, twin and adoption studies strongly suggest a genetic involvement. Because a basic biochemical abnormality is not known, direct analysis of the disease using a probe for the defective gene is not possible. However, a specific locus can be tested for its relevance to the aetiology of AD by genetic linkage, using restriction fragment length polymorphisms (RFLPs). Using probes for the c-Ha-ras-1 oncogene and the insulin gene, Gerhard et al. and Egeland et al. found convincing evidence for close linkage between these markers and a locus for AD in a large Old Order Amish pedigree. In an attempt to confirm this finding, we examined three bipolar pedigrees outside the Amish population. Our results indicate the absence of linkage from 0 to 15% recombination frequency between AD and the insulin gene-HRAS1 region in these pedigrees.
Bipolar Disorder↗
Global overview of HIV/AIDS--a challenge for nurses.
The human immunodeficiency virus (HIV) continues to spread around the world, insinuating itself into communities previously little troubled by the epidemic and strengthening its grip on areas where AIDS is already the leading cause of death in adults. (See global estimates on page 176.) Below, the evolving picture region by region.
Acquired Immunodeficiency Syndrome↗
Role of neuropathy and plasma nitric oxide in recurrent neuropathic and neuroischemic diabetic foot ulcers.
Various factors are associated with foot ulceration, including delayed reporting of ulcers, poor glycemic control, and severity of neuropathy. Several studies have looked at the role of nitric oxide in wound healing. However, no studies have examined its role in the occurrence and recurrence of diabetic foot ulceration. In a cross-sectional study we examined the role of neuropathy, retinopathy, nephropathy, and plasma nitric oxide (estimated from plasma nitrite and nitrate) levels in diabetic patients with recurrent and non-recurrent neuropathic and neuroischemic foot ulcers. Patients with recurrent foot ulcers had higher vibration perception threshold values compared to patients with non-recurrent foot ulcers (47.4 +/- 5.7 volts versus 39.5 +/- 10.3 volts respectively, P < 0.05). In addition, subjects with recurrent foot ulcers had significantly higher plasma nitric oxide compared to subjects with non-recurrent foot ulcers (46.9 +/- 6.3 microm/L versus 30.2 +/- 2.4 microm/L respectively, P < 0.01). Multivariate logistic regression analysis adjusted for age, sex, hemoglobin A1c, presence of retinopathy and nephropathy, vibration perception threshold, plasma creatinine, and total nitric oxide, indicated that only vibration perception threshold was independently associated with the presence of an ulcer [odds ratio: 1.26 (1.10-1.46); P <0.001)] and the recurrence of foot ulcers [odds ratio: 1.13 (1.01-1.27); P =0.04)]. This study has shown that although plasma nitric oxide is higher in patients with recurrent neuropathic and neuroischemic foot ulcers, severity of neuropathy was the most important factor associated with the development and recurrence of foot ulcers in diabetic patients.
Adult↗
Treatment of acute, adverse psychedelic reactions: "I've tripped and I can't get down".
The resurgence of the use of LSD by a young, inexperienced population increases the likelihood of the occurrence of adverse psychedelic reactions. While the treatment of choice remains supportive, nonjudgmental talkdown, intramuscular lorazepam and haloperidol offer invaluable and specific adjuncts to care.
Adolescent↗
The in-home worker: serving the frail elderly.
Little attention has been paid to the special tasks facing the many unskilled in-home workers who serve the frail elderly. With the assistance of the Community Care Training Project at the University of Illinois in Urbana-Champaign, the authors studied the needs in-home workers have for interpersonal skills. A typology of problematic interpersonal situations is presented, along with suggestions for training, assessment, and supervision of clients and workers.
Aged↗
TB of the spine: Pott's disease.
Tuberculosis (TB) has been around since the beginning of time but for the past decade has experienced an increasing prevalence. TB starts in the lungs but can travel to any organ or structure of the body. The vertebrae are the most often afflicted sites of extra-pulmonary lesions. Pott's disease is the name given to TB of the spine. There are interventions that can enable a person with Pott's disease to return to an optimal level of functioning, and nurses have a pivotal role in helping the patient attain that level. A case study with diagnostic findings and interventions is presented in this article.
Adult↗