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Biomedical subjects

S Isaacs

Publications and source records attributed to S Isaacs.

At least 73 records · Page 4Linked to original sources
PubMed1986

The effects of brain death and 24 hours' storage by hypothermic perfusion on donor heart function in the pig.

The effects on the myocardium of the agonal period and subsequent management have been studied in the pig. Acute ischemia of the brain led to major temporary hemodynamic changes. Brain death, with or without hemodynamic support of the circulation, led to a significant reduction in subsequent myocardial function, associated with some depletion of the myocardial high-energy phosphate and glycogen reserves, although the rate of this depletion was reduced by anaerobic glycolysis. Although 24 hours' storage by continuous hypothermic perfusion of hearts taken from control animals led to only a minimal reduction in myocardial function, storage increased the reduction in function associated with brain death when intravenous fluid and dobutamine support had been given to maintain the brain dead pig in a normotensive state. Storage, however, reduced the anaerobic metabolism seen in hearts functioning in hypotensive brain dead pigs and led to replenishment of the glycogen stores.

Adenosine Triphosphate↗
PubMed1985

Vitamin A therapy in patients with Crohn's disease.

Vitamin A therapy has been claimed in isolated reports to be of benefit to patients with Crohn's disease. To investigate this further, 86 patients were entered into a long-term double-blind study of vitamin A, 50,000 U twice daily, as compared with placebo. After a mean of 14.1 mo of treatment there was no significant difference between the groups as measured by a variety of activity indices (including the National Cooperative Crohn's Disease Activity Index), the number of acute attacks, and the surgical rate. No toxic effects of vitamin A were observed during the study. In this study vitamin A has not been shown to be of benefit to patients with Crohn's disease who are in remission.

Adolescent↗
PubMed1985

The significance of left ventricular volume measurement after heart transplantation using radionuclide techniques.

Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts.

Adolescent↗
PubMed1984

Hemodynamic effects of sublingual nifedipine in acute myocardial infarction.

Twenty-six patients with acute myocardial infarction (mean delay time 6 hours after onset of symptoms) were randomized to control or nifedipine treatment (10 mg sublingually, followed by 10 mg every 6 hours for a total of 24 hours). Nifedipine reduced arterial blood pressure from 127/78 to 115/70 mm Hg at 30 minutes (p less than 0.001) and continued to reduce the blood pressure significantly for 12 to 18 hours. Nifedipine also reduced systemic vascular resistance and the rate-pressure product. Cardiac output increased from 4.9 liters/min before nifedipine to 5.4 liters/min at 60 minutes (p less than 0.05 vs controls). In patients with high initial pulmonary wedge pressures, sublingual nifedipine decreased the wedge pressure (p less than 0.001) more effectively than did 80 mg of furosemide given intravenously. Thus, nifedipine may be useful in patients with early myocardial infarction and left ventricular failure.

Adrenergic beta-Antagonists↗
PubMed1984

Prediction of acute cardiac rejection using radionuclide techniques.

Radionuclide scanning of the donor left ventricle using technetium-99m-labelled red cells was used to monitor acute rejection after heterotopic heart transplantation and compared with histopathological evidence of rejection obtained at examination of an endomyocardial biopsy specimen. The ejection fraction and end-diastolic, end-systolic and stroke volumes were calculated at each examination; an equation was derived from these data to predict the degree of acute rejection, using histopathological examination of endomyocardial biopsy specimens as criteria of the presence and severity of rejection. A highly significant multiple correlation between radionuclide scanning parameters and endomyocardial biopsy was found. The advantages of non-invasive radionuclide scanning over the invasive procedure of endomyocardial biopsy are discussed.

Adolescent↗
PubMed1984

A randomized controlled trial of cervical cerclage in women at high risk of spontaneous preterm delivery.

The effect of cervical suture on pregnancy outcome was studied in 194 women with a high risk (approximately 30%) of having a late abortion or a preterm delivery. The women were randomly allocated either to have a cervical suture inserted (n = 96) or to be managed without a suture (n = 98). There was no evidence that cervical cerclage either prolonged gestation or improved survival. Patients allocated to receive cerclage spent significantly longer in hospital, even when the period of admission for insertion was excluded. The patients in the cerclage group were more likely to receive tocolytic drugs, and more of them experienced puerperal pyrexia, although these differences between the groups were not statistically significant.

Adolescent↗
PubMed1984

A hypermobility study in ballet dancers.

Hypermobility, using Beighton's mobility score, was present in 9.5% of 377 ballet dancers. Females were more mobile than males. A direct relationship was found between forward flexion and both the duration of dance training and age. This suggests that forward flexion is acquired, and unlike generalized hypermobility, which was found among family members of the hypermobile group. None of the hypermobile dancers studied had evidence of mitral valve prolapse but injuries were significantly more common compared to controls (p less than 0.05). We regard hypermobility as a liability to the ballet dancer.

Adolescent↗
PubMedDate not supplied

Public health inspectors in restaurants: what they do and why.

This report identifies strategies used by public health inspectors in the Central West Region of Ontario during restaurant inspections, based on and comparing the perceptions of inspectors, their managers, and restaurant operators. Factors influencing the choice of strategies are reviewed, putting into perspective the importance of manager and policy expectations relative to other influences experienced by inspectors in the field. The need to set pragmatic and reality-tested criteria and objectives for a HACCP-based inspection protocol is discussed.

Facility Regulation and Control↗
PubMedDate not supplied

Follow-up of participants in a preschool hearing screening program in child care centres.

As part of its response to the Ontario Ministry of Health recommendation that communication disorders in preschool children be identified, the Hamilton-Wentworth Department of Public Health Services performed hearing screening tests on all preschool children in child care centres. Parents of children who had failed the hearing screening test were recommended to take their child to their family physician for further assessment. Out of 1,844 children tested between September 1990 and February 1991, 35 children failed the pure-tone audiometry test administered by nurses. A telephone follow-up interview determined that 26 children with screening test failures had received some medical follow-up. Eight children had a confirmed hearing problem; of these, five were newly diagnosed with a hearing problem, all resulting from fluid build-up in the middle ear. Three children were treated, with two having improved hearing. Of the two children not treated, one was reported to have improved hearing. As with other recently reported preschool hearing screening programs, this study raises doubts about the usefulness of such programs.

Audiometry, Pure-Tone↗
PubMedDate not supplied

Marriage law and practice in the Sahel.

The legal systems of Sahelian African countries combine customary law, Islamic law, French colonial law, and civil law introduced since independence in 1960. Utilizing a framework developed by the Faculty of Law, University of Dakar, Senegal, and the Development Law and Policy Program, Center for Population and Family Health, Columbia University, the Sahel Institute undertook a comprehensive study of the legal and social status of women in Burkina Faso, Mali, Niger, and Senegal. Since 1960, Burkina Faso, Mali, and Senegal have replaced French family law with national marriage codes. Niger has not yet adopted a family code; the laws on the family inherited from the French remain in force. The postindependence marriage codes have attempted to give young women more say in choosing a husband, to regulate the practice of bride price, and to limit the practice of polygyny. They have done this by integrating customary law and government-passed civil law. Mali, Niger, and Senegal have repealed provisions in their codes prohibiting the distribution of contraception, based on a 1920 French law. Although it has taken no formal legal action, Burkina Faso has adopted family planning policies that effectively nullify the 1920 law.

Burkina Faso↗
PubMedDate not supplied

Does the electrocardiogram detect early acute heart rejection.

Changes in electrocardiographic parameters, particularly a reduction of the voltage of the QRS complex, have been held to indicate acute rejection of a transplanted heart. In a series of heterotopic heart recipients, changes in electrocardiographic parameters were correlated with histopathological evidence of acute rejection seen on endomyocardial biopsies obtained by the percutaneous transvenous technique. No statistically significant correlation was found between the electrocardiographic changes and the histopathological features. The electrocardiogram appears to be an unreliable predictor of early acute rejection in patients with heterotopic heart transplants.

Adolescent↗
PubMedDate not supplied

1992 Ontario Survey of Public Health Nurses: perceptions of roles and activities.

A survey of public health nurses (PHNs) who work in official public health units in Ontario was undertaken to determine whether their perceptions of their roles and activities concurred with a 1990 Canadian Public Health Association report which describes the roles and qualifications of public health nursing in Canada. The survey questionnaire was completed by 1,849 PHNs in all 42 public health units (response rate = 85%). About one tenth of the PHNs reported no activity as a caregiver/service provider. Most PHNs reported being active in the roles of educator/consultant, social marketer, and facilitator/communicator/collaborator. The community developer, policy formulator, research/evaluator, and resource manager/planner/coordinator roles were less frequently performed, however, increased activities in such roles were expected in the future. Nurses said that they needed further preparation to perform the latter roles. These results have implications for deployment of PHNs as Ontario's health system shifts to community health and health promotion.

Community-Institutional Relations↗
PubMedDate not supplied

Public health nurses' quality of worklife: responses to organizational changes.

The Nursing Division of a local health unit in Ontario reorganized its nursing teams into target population based programs. Nurses involved in this reorganization were asked to report their perceptions of job satisfaction, job design and role stress using standardized instruments before the reorganization and at three points in time after the reorganization. No administratively significant differences in these variables were reported by the nurses through the four time periods. The one exception was an unpredicted decrease in their perception of their task identity, that is, their perception of the significance or importance of their work. Major changes in the organization of a nursing division may be possible with minimal impact on perceptions of job satisfaction, job design and role stress. We caution that further assessment of the measurement tools used in this study should be undertaken.

Humans↗
PubMedDate not supplied

Evaluation of registered nurses follow-up on the reported immunization status of children attending child care centres.

The purpose of this study was to evaluate whether follow-up by nurses increased the reported rate of correctly immunized preschoolers in child care centres (CCCs). Records from 14 randomly selected CCCs from the Hamilton-Wentworth area (n = 514 records) were assessed for the number of correctly immunized preschoolers by two nurses operating in different centres. The nurses advised the centres about all incomplete records and reminded parents to update their child's immunization status. One nurse revisited all her assigned centres two to five weeks later. Both nurses returned to the CCCs to reevaluate the records two to eight months after the initial contact. 382 records were available for the second review (25% drop out rate). The reported rates increased significantly for all immunizations. There was no difference when the follow-up intervention was greater. This study suggests that monitoring records improves the completeness of the records in CCCs; 19.9% of child records were updated (76 of 382). In 3.4% of cases (13 of 382), the children received immunizations that had been previously missed.

Child↗