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Biomedical subjects

S Brown

Publications and source records attributed to S Brown.

At least 613 records · Page 34Linked to original sources

Twenty-four hour reality orientation: changes for staff and patients.

A 24-hour reality orientation programme was initiated in a long-stay geriatric ward. Nursing and occupational therapy routines were changed specifically to meet the needs of the 20 patients participating in the programme. The assessments included the Clifton Assessment Procedures for the Elderly, the Holden Communication Scale, the Holden Orientation Facilities Scale, and the Oberleder Scale (adapted by Holden et al.). These scales were administered before, during and after completion of a study lasting 4 months. The CAPE scales showed no significant results. However, the Holden Communication Scale indicated that there were significant differences for certain groups of patients. Those patients with high scores initially tended to continue to have high scores and showed no real change. However, patients who had scores in the medium range initially, showed improvement. This finding indicated that severity at onset of the experiment was an important variable when considering outcome of treatment. Expectations regarding the future of the very elderly must be realistic, and to anticipate a return to previous vitality and total independence should not be expected. However, to find a means by which functional levels can be maintained, and even slightly improved, is desirable. It would seem that the 24-hour reality orientation programme achieved this goal.

Aged↗

Suppression of post-vasectomy cytotoxic sperm antibody formation in rats by a short-term pretreatment with cyclosporine.

The effect of a short pulse therapy with cyclosporine on the production of vasectomy-induced cytotoxic sperm antibodies was studied in Lewis rats. Cyclosporine at a dose of 10 mg/kg was administered once daily for 7 days before and 7 days after vasectomy (group A), for 7 days before vasectomy (group B), and for 7 days after vasectomy (group C). Ten rats were studied in each group for a period of 5 weeks. Ten rats were vasectomized and untreated with cyclosporine (group U). All animals in this group developed high titers of cytotoxic sperm antibodies at the end of the first week after vasectomy (primary antibody response). In contrast, all the treated rats of groups A, B, and C had a normal range of sperm antibody titers. By the third week, six of nine rats in the post-treated group C had significant cytotoxic sperm antibody titers, while the other groups had normal antibody titers. In the fourth week, all the rats of groups A and B continued to have normal sperm antibody titers of less than or equal to 16, while most animals in groups C (78%) and U (63%) had significant cytotoxic sperm antibody titers. It is concluded that prevasectomy treatment with cyclosporine may significantly reduce or delay the production of cytotoxic sperm antibodies in Lewis rats.

Animals↗

Diagnosis of B cell lymphoma by analysis of immunoglobulin gene rearrangements in biopsy specimens obtained by fine needle aspiration.

Histologic diagnosis of lymphoma is far more difficult in the disaggregated cells obtained by percutaneous aspiration of lymph nodes than in tissue sections prepared from excisional biopsy specimens. However, the simplicity, economy, and safety of aspiration biopsy makes this an attractive diagnostic option in certain situations. In the present study, we demonstrate that lymph node aspirates provide material that is both suitable and sufficient for accurately detecting clonal proliferations of B cells by analysis of immunoglobulin gene rearrangements. The rearrangements detected in aspirated tissue serve as clonal markers that can be directly compared with the rearrangements found in histologically confirmed lymphoma removed by open biopsy. The application of gene rearrangements to aspirated material therefore offers a useful method of diagnosing lymphoma, particularly for the purposes of more thorough staging at initial presentation or the evaluation of tissues for possible relapse.

B-Lymphocytes↗

Ethiodized oil emulsion enhanced computerized tomography in the preoperative assessment of metastases to the liver from the colon and rectum.

Selective reticuloendothelial (RE) cell uptake of ethiodized oil emulsion 13 (EOE-13), an emulsion of Ethiodol (ethiodized oil) roentgenographic contrast material in a phosphate buffer, permits detection of small metastatic lesions of the liver and spleen through enhancement of roentgenographic density differences on computerized tomography (CT) between tissues containing and not containing RE cells. To determine the efficacy of this contrast material in the assessment of patients with metastatic disease of the liver, routine CT and emulsion enhanced tomography (EOE) were performed in a series of 15 patients prior to surgical exploration for treatment of carcinoma of the colon and rectum. All patients were suspected of harboring hepatic metastasis on the basis of clinical examination, liver function tests or radionuclide scans. EOE consistently demonstrated the nature and location of hepatic defects. Surgical exploration failed to locate one metastasis that was judged to be real because of progressive enlargement on EOE and CT over a period of two years. CT scans detected metastases in three patients subsequently shown to have normal livers and failed to detect disease in one patient subsequently shown to have metastases. EOE contrast material provides a more sensitive and accurate picture of metastatic liver involvement from carcinoma of the colon and rectum than is available on routine CT. The information provided by the results of this test can be useful in preoperative planning when treatment of disease of the liver is considerable feasible.

Adenocarcinoma↗

Female sterilization: can the woman who will seek reversal be identified prospectively?

Demographic socio-economic and decision-making aspects of sterilization and reversal of sterilization were compared in a group of 103 women requesting reversal (RR) and 117 women about to undergo sterilization (S), to determine the practicality of identifying in advance the woman likely to request reversal. The willingness of patients to pay for these procedures and the ethical implications of these decisions were also examined. RR were younger at the first relationship, birth of first child and birth of last child. There were no differences (RR vs S) between the number of full-term pregnancies, living children and therapeutic abortions. The timing of sterilization (puerperal versus interval) did not influence the decision to be reversed. The level of education, partner's level of education and mean family income were lower in the group requesting reversal. Multiple regression analysis revealed three characteristics which were most discriminatory: youth at first birth; lack of spousal support; and failure to choose 'family complete' as a reason for sterilization. The predictability was not strong enough to provide an accurate assessment of the individual woman. RR were of significantly lower socio-economic standing but were more likely to be prepared to pay a large sum of money for the reversal. The ethical implications of this finding are discussed.

Adult↗

Absorption of aluminum from aceglutamide aluminum in healthy adult males.

The absorption of aluminum was studied in twelve healthy male volunteers over a period of fourteen days in a placebo-controlled, double blind study. All subjects were institutionalized during the study. Eight subjects (treated group) received ascending doses of aceglutamide aluminum (N-acetyl-L-glutamine aluminum complex) administered in multiple daily doses. The remaining four subjects (untreated group) received placebo. Systemic absorption and excretion of aluminum were evaluated by measuring aluminum concentrations in serum, urine and fecal samples. Aluminum concentrations were determined by electrothermal atomic absorption spectrometry. All serum aluminum concentrations were less than 16 micrograms/L for both groups. The mean urinary and fecal aluminum concentrations in the aluminum-treated group were significantly higher than in the untreated group during the study days the drug was administered. The total amount of aluminum (as aceglutamide aluminum) given to each treated subject during the 14 day study period as 3290 mg. The mean total fecal aluminum concentration was 3318 mg for the treated group and 269 mg for the untreated group during the study period. These findings are consistent with the view that some aluminum absorption from the gastrointestinal tract occurred following the administration of the drug. The absorbed aluminum appears to have been rapidly excreted in the urine and the feces.

Adolescent↗

Effect of smoking on human natural killer cell activity.

Natural killer (NK) cells play a central role in immune surveillance against tumors and viral infections. NK activity is depressed in patients who have a wide range of carcinomas, including carcinomas of the lung. Peripheral blood NK activity was measured in 22 nonsmokers, 15 light/moderate smokers, 12 heavy smokers, and 19 patients with carcinoma of the lung. Patients with carcinoma of the lung had marked depression in NK activity compared with nonsmokers. Light/moderate smokers had NK activity comparable to that of nonsmokers, whereas heavy smokers had marked depression in NK activity that was comparable to that of patients with carcinoma of the lung. These results suggest that smoking-induced alterations in NK activity may have a role in the pathogenesis of smoking-associated carcinoma of the lung.

Cells, Cultured↗

Effective patient education. A quasi-experiment comparing an individualized strategy with a routinized strategy.

A quasi-experiment was conducted on 127 hospitalized rheumatoid arthritis patients to determine the relative success of 3 patient teaching strategies--an individualized program, a routinized program, and a no-planned-instruction program--on patients' knowledge of their disease and treatment. Data analysis revealed that the individualized program produced a 100% greater learning gain than the routinized program in patients who had low pretest scores. The results suggest that maximum patient learning occurs when the teaching process accommodates important patient differences.

Arthritis, Rheumatoid↗

Initial agonist burst duration changes with movement amplitude in a deafferented patient.

Changes in the duration of the initial agonist burst were studied in a deafferented human. The patient had been functionally deafferented for five years, having no touch, vibration, pressure or kinesthetic sensation nor any tendon reflexes in the four limbs. Pain and temperature sensation were intact and motor fibres were unaffected. The subject made visually guided step-tracking movements using flexion/extension movements about the elbow. Initial agonist burst duration increased with movement amplitude. Burst duration was approximately 65 ms in small movements (6-12 deg) increasing to 136 ms in intermediate (36 deg) and 200 ms in large (54 and 60 deg) movements. Similar changes in initial burst duration with movement amplitude were seen when the subject made non-visually guided movements. It is concluded that the duration of the initial agonist burst is centrally determined.

Adult↗