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Biomedical subjects

S Lewis

Publications and source records attributed to S Lewis.

At least 361 records · Page 20Linked to original sources

Inferring category attributes from exemplar attributes: geometric shapes and social categories.

Three experiments tested the hypothesis that judgments about the attributes of categories are disproportionately based on the characteristics of exemplars that best fit the category. In the first 2 experiments, subjects were presented with good and bad exemplars of categories with defining attributes (rectangles, triangles, pentagons, and ellipses) in which different colors were arbitrarily paired with the good and poor examples. In both experiments, subjects erroneously judged the colors paired with the good exemplars as more frequent than colors paired with the poor exemplars. A third experiment, using social categories, examined whether attributes associated with a single category member were more likely to generalize to the category as a whole for prototypical than for nonprototypical category members. Subjects were presented with information about individual fraternity members who varied in prototypicality, and the tendency to infer a target behavior (liberal vs. conservative voting behavior) from the individual fraternity member to the fraternity as a whole increased with the prototypicality of the category member. Implications for the contact hypothesis, category-exemplar relations, and belief stability are discussed.

Adult↗

Cat allergen content of commercial house dust extracts: comparison with dust extracts from cat-containing environment.

Eighteen lots of house dust extract from nine commercial sources (obtained as weight per volume or protein nitrogen unit per cubic centimeter) were analyzed for cat allergen content by direct quantitative immunoelectrophoresis after concentration. Cat allergen 1 was measurable (greater than 0.3 units) in 11 extracts with a mean (range) of 5.8 (1.3 to 31.0) U/gm of source material. Cat albumin was measurable (greater than 2.4 units) in 12 extracts with a mean (range) of 53.4 (11.5 to 319.7) U/gm. In order to evaluate whether the cat allergen 1 content is a significant contribution to the allergenic activity of the extract, 17 cat-allergic subjects were tested by prick test with a purified preparation of cat allergen 1. The mean (range) concentration that produced a 3 mm wheal was 0.01 (0.0013 to 1.33) U/ml. Therefore, the commercial house dust extracts studied, when these extracts were diluted to a concentration commonly used for prick testing, would frequently contain enough cat allergen 1 to produce strong prick test reactions in cat-allergic subjects. It is difficult to justify the use of such commercial dust extracts as diagnostic reagents. For comparison purposes, nine dust samples from an apartment housing two cats were similarly analyzed. Cat allergen 1 was measurable in seven samples with a mean (range) of 23.8 (1.8 to 64.3) U/gm. Cat albumin could be measured in all nine samples with a mean (range) of 32.3 (0.16 to 70.8) U/gm. The average amount of cat allergen 1 that could be washed off the surface of the cats was 270 units. Large reservoirs of cat allergen 1 were present.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗

Transvenous cardioversion for the management of recurrent ventricular arrhythmias.

The efficacy of transvenous cardioversion and defibrillation for treating life threatening spontaneous ventricular arrhythmias was assessed in a study of 17 patients in a cardiac care unit. Eleven had ventricular tachycardia, five had ventricular fibrillation, and one had both. Transvenous cardioversion successfully terminated tachyarrhythmias on 42 separate occasions in ten patients. Stable electrode positions could not be achieved in two patients, recurrent late displacement occurred in one, and four patients had no further arrhythmias requiring cardioversion once the lead was placed. The energy levels required for successful cardioversion ranged from 0.05 J to 25 J for ventricular tachycardia and from 1 J to 25 J for ventricular fibrillation. The nine successful shocks of 1 J or less did not require sedation or general anaesthesia. High energy (25 J) endocardial shocks were unsuccessful in terminating arrhythmias in two patients, one with ventricular tachycardia and the other with both ventricular tachycardia and fibrillation. Minor unwanted effects of endocardial shocks occurred in five patients. These were acceleration of ventricular tachycardia in two patients and complications of pacing via the special lead in three others: failure of sensing occurred in all three and one patient also had a transient rise in pacing threshold. A postmortem examination in one patient who had received three unsuccessful high energy shocks revealed localised endocardial necrosis at the site of the distal electrode. Transvenous cardioversion offers advantages over external cardioversion but at present practical difficulties limit its application to patients with recurrent ventricular arrhythmias that cannot readily be controlled by conventional methods.

Aged↗

Role of exercise Doppler echocardiography in isolated mitral stenosis.

This study reports the role of Doppler ultrasound during exercise for assessment of patients with mitral stenosis. Doppler echocardiography was performed at rest and during symptom-limited supine bicycle exercise in ten patients with isolated mitral stenosis. The mean mitral valvular gradient was calculated using modified Bernoulli's equation, and the mitral valvular area was estimated from the equation, 220/pressure half-time. During exercise the heart rate increased from 74 +/- 14 beats per minute (mean +/- SD) at rest to 110 +/- 8 beats per minute (p less than 0.001) during exercise. The mean mitral gradient increased from 9 +/- 5 mm Hg at rest to 18 +/- 7 mm Hg (p less than 0.01) during exercise. The mitral pressure half-time decreased from 225 +/- 62 msec at rest to 190 +/- 42 msec during peak exercise (p less than 0.005). This corresponded to a reduction of 15 percent. The estimated mitral valvular area increased from 1.0 +/- 0.4 sq cm at rest to 1.2 +/- 0.3 sq cm at peak exercise (p less than 0.005). In conclusion, Doppler echocardiography can be used to evaluate patients with mitral stenosis, with the response of the mitral valvular gradient being the index of obstruction; however, caution should be used in applying the mitral pressure half-time for estimation of the mitral valvular area at high heart rates and flows.

Adult↗

Effect of heparin and citrate on measured concentrations of various analytes in plasma.

Frequently it is assumed that concentrations of biochemical analytes are similar for serum and plasma, without regard to the anticoagulant. Recently it has been hypothesized that use of certain anticoagulants results in an osmotic redistribution of fluid between blood cells and plasma, causing some dilution of the plasma. We sought to determine the effect of two commonly used anticoagulants, heparin and citrate, on the measured concentrations of 13 clinical-chemical analytes, including selected trace elements, vitamins, lipids, and proteins. The data demonstrate that hyperosmolar citrate causes a significant dilution of all indices measured. In contrast, heparin had no osmotic effect; concentrations of most of the analytes measured in the heparinized plasma were statistically no different from those measured in the corresponding serum. Therefore, anticoagulants must be chosen carefully, especially if concentrations in plasma and serum are to be compared.

Blood Chemical Analysis↗

Björk-Shiley and Carpentier-Edwards valves. A comparative analysis.

Between January 1977 and December 1982, 986 Björk-Shiley and 744 Carpentier-Edwards valves were implanted in 774 and 620 patients, respectively, at the same institution. All Björk-Shiley patients and 57% of patients with a Carpentier-Edwards valve in the mitral position received long-term anticoagulation. Mean follow-up was 3.2 years (range 0 to 8.8) in the Björk-Shiley patients and 3.5 years (range 0 to 8.2) in the Carpentier-Edwards group. There was no significant difference between the two groups in hospital mortality (Björk-Shiley 7.6%; Carpentier-Edwards 6.0%), overall incidence of embolism (Björk-Shiley 1.4 per 100 patient-years; Carpentier-Edwards 1.6% py), endocarditis (Björk-Shiley 0.6% py; Carpentier-Edwards 0.8% py), periporsthetic leak (Björk-Shiley 1.6% py; Carpentier-Edwards 1.4% py), anticoagulant-related complications (Björk-Shiley 0.3% py; Carpentier-Edwards 0.1% py), valve failure (Björk-Shiley 0.78% py; Carpentier-Edwards 0.68% py), reoperation for complication (Björk-Shiley 1.68% py; Carpentier-Edwards 1.22% py), and late mortality (Björk-Shiley 3.1% py; Carpentier-Edwards 3.0% py). Actuarial freedom from valve-related events was similar in the two groups. In the aortic position, freedom from embolism was significantly better in the Björk-Shiley group than the Carpentier-Edwards group (Björk-Shiley 99% at 3 and 5 years; Carpentier-Edwards 96% and 92% at 3 and 5 years; p = 0.023). In the mitral position, the overall incidence of reoperation was higher in the Björk-Shiley group (1.78% py) than in the Carpentier-Edwards group (0.48% py) (p = 0.004). Actuarial analysis shows this difference to be confined to the first 6 years of follow-up. The commonest indication for reoperation was valve failure in both groups. However, when analysis is confined to this indication, the difference between the reoperation incidence in the mitral position becomes insignificant (Björk-Shiley 0.85% py; Carpentier-Edwards 0.29% py; p = 0.085). This study confirms the satisfactory performance of both the Carpentier-Edwards and Björk-Shiley valves in the short and middle term and indicates no clear-cut advantage for either prosthesis.

Anticoagulants↗

Treatment of acute myocardial infarction with anisoylated plasminogen streptokinase activator complex.

A controlled trial in 149 patients admitted to a district hospital with probable myocardial infarction tested the effect of 30 units of anisoylated plasminogen streptokinase activator complex (APSAC) on indices of infarct size. Patients were grouped prospectively according to whether they entered the trial within two and a half hours (early entry) or between two and a half and four hours (late entry) after onset of the symptoms. Sixty seven of 73 patients in the control group showed increased plasma activity of myocardial creatine kinase isoenzyme that was diagnostic of infarction compared with only 60 of 76 who received APSAC. The difference was significant overall but occurred predominantly in the early entry group. The patients who received APSAC had more early ventricular arrhythmias, compatible with reperfusion, and showed greater preservation of R waves during admission to hospital. Unwanted effects were generally minor and more common in the actively managed group than the control group (26% v 3%). After nine to 12 months of follow up 12 patients in the control group had died compared with seven in the actively managed group. The ease of administration and the apparent efficacy of APSAC suggest that it is suitable for use in a district hospital for patients with suspected acute myocardial infarction.

Anistreplase↗

Psychological impact of cancer on adolescents: self-image, locus of control, perception of illness and knowledge of cancer.

Two hundred and three healthy adolescents were compared with 31 adolescent cancer patients on self-image, health locus of control, perception of illness, and knowledge of cancer. No differences were found between the patient and the control groups on self-image. Adolescents with cancer had significantly lower internal orientation scores and higher external health locus of control scores. The adolescent patients also perceived cancer to be significantly less severe and better understood by doctors and they believed that cancer patients had a higher probability of recovery compared with normals. No differences were noted on a knowledge of cancer test between groups. Support was found for the theory that cancer diagnosis does influence health perception but does not contribute to a lower self-image. Increased knowledge of cancer may benefit some patients in coping with their disease.

Adaptation, Psychological↗

Cooperation with treatment in adolescent cancer patients.

Twenty-seven adolescent cancer patients were rated by two pediatric oncology nurses using a ten-item cooperation questionnaire. Cooperation scores were compared with patient ratings of self-image, perception of cancer, health locus of control, and knowledge of cancer. Although all patients were generally cooperative, younger adolescents appeared to be more cooperative than older adolescents. A significant positive relationship was found between cooperation and self-image whereas a negative relationship emerged between cooperation and an external locus of control orientation. Patients rated high in cooperation perceived cancer to be a more life-threatening disease than patients rated low in cooperation.

Adolescent↗

Symptoms and longitudinal changes in lung function in young seasonal grain handlers.

A total of 119 seasonal grain handlers (mean age 23) were assessed before and towards the end (mean work period 18 days) of the 1983 Western Australian grain harvest to determine if respiratory symptoms that occur with exposure to grain dust are associated with changes in ventilatory capacity or non-specific bronchial reactivity to methacholine. Eighteen per cent of subjects had wheeze, breathlessness, or chest tightness and 18% had cough or sputum production at work. Subjects complaining of wheeze, chest tightness, or breathlessness at work had a significantly greater decline in FEV1 than subjects who did not experience these symptoms (p less than 0.05). Symptoms were not associated with changes in bronchial reactivity. In young grain handlers who develop respiratory symptoms on short term exposure to grain dust changes in FEV1 but not in non-specific bronchial reactivity have been demonstrated.

Adolescent↗