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Biomedical subjects

S M Wright

Publications and source records attributed to S M Wright.

At least 91 records · Page 5Linked to original sources
PubMed1991

Quality assessment in support services: do practitioners concur with expert consensus?

The purpose of this study was to examine the degree of concordance between experts and practitioners as to the importance of quality assessment measures (elements and indicators) in therapeutic recreation (TR) services. Results from a survey of TR practitioners as to actual uses of these quality assessment measures within Veterans Affairs Recreation Services nationwide were compared to expert opinions used in a previous study that identified quality assessment measures for TR. Agreement between expert ratings of importance and frequency of use by practitioners were greatest for the experts' most important elements and indicators and least for the least important. Findings suggest that a select few "important" elements and indicators might be universally required of all quality assessment programs; others might be optional or can be modified to meet the needs of individual settings. Results also demonstrate the need for further study of optimal quality assessment approaches using both expert knowledge and practitioner experience.

Ancillary Services, Hospital↗
PubMed1991

A programmable data acquisition and control system for magnetic resonance imaging: application to mutually coupled surface coil arrays and temperature monitoring.

A programmable data acquisition and control system was developed for use in conjunction with magnetic resonance imaging (MRI). The controller consists of two functional blocks: a host system and a remote system. The remote system resides inside the shielded room housing the magnet. The host, an IBM compatible personal computer, is located at the technician's console. Communication between these devices is implemented over a fiber optic RS-232 data link. This configuration allows experiments to be performed remotely by using a series of keyboard typed commands, by programming the host to send a series of commands, or by directly programming the remote system. As an example of its capabilities, the controller was used to tune and match arrays of receiver coils for localized imaging and to record the rectal temperature of a sedated rat during image acquisition.

Algorithms↗
PubMed1990

Liposome encapsulated MnCl2 as a liver specific contrast agent for magnetic resonance imaging.

We examined the usefulness of MnCl2 entrapped in liposomes as a liver specific contrast agent for magnetic resonance imaging. Toxicity experiments showed that the effective dose for imaging experiments was 7 to 11 times lower than the LD50 of free MnCl2. In rats with implanted liver tumors, liposome encapsulated MnCl2 caused a two- to three-fold increase in the relaxation rate of the liver while having little effect on the relaxation rate of tumor tissue. T1 weighted, magnetic resonance images obtained at 0.5 T of an R3230 adenocarcinoma implanted in the liver showed an increase in the signal intensity of both normal liver and tumor tissue after the injection of free MnCl2 (25 mumole/kg). However, after the injection of liposome encapsulated MnCl2 (40 mumole/kg) the liver exhibited a marked increase in signal intensity with little change in the signal intensity of the tumor tissue. These results suggest that liposome encapsulated MnCl2 has excellent potential as a liver specific contrast agent for the improved detection of liver metastases.

Animals↗
PubMed1990

Pathophysiology of congestive heart failure.

Although the mortality rate for cardiovascular disease is declining, the incidence of congestive heart failure (CHF) is escalating. This article reviews normal cardiovascular physiology and cellular anatomy; defines CHF; explores the etiologies, pathophysiology and clinical presentation of CHF; and briefly discusses diagnostic modalities and prognostic indices.

Heart Failure↗
PubMed1989

Fundamentals of prosthetic practice. Part II--The surgery.

It is important for the smooth running of appointments that everyone, patient, receptionist, dental surgery assistant (DSA), the laboratory and, of course, the dental surgeon should know what is happening. Obviously, they do not all require the same information, but certain points will be essential to each of them for maximum efficiency of treatment.

Consumer Behavior↗
PubMed1989

Fundamentals of prosthetic practice. Part I--The laboratory.

Prosthetic dentistry in general practice produces many challenges for both the newly qualified trainee and the long-standing practitioner. If these challenges are not appreciated, met and dealt with effectively, the dentist may be left disillusioned with his skills and expertise, and stressed at the thought of treating patients requiring dentures. The economic need for rapid treatment while maintaining good standards of work, can result in pressure, and the temptation to 'cut corners' can prove costly. These articles, far from being a definitive text, seek to illuminate some potential problems and to lead the clinician to establish his own solutions in the areas of the laboratory, the prescription, communication and some alternative clinical techniques.

Communication↗
PubMed1989

Bilateral MR imaging with switched mutually coupled receiver coils.

The authors describe a system of bilateral mutually coupled receiver coils and its initial clinical use in magnetic resonance imaging of the knees and temporomandibular joints. Switched mutually coupled coils allow bilateral simultaneous imaging of paired structures without a penalty in signal-to-noise ratio because the coils can be alternated with each section acquisition. With this coil system, there is no restriction on placement or design of coils to prevent interaction. When combined with three-dimensional imaging techniques, switched coils allow simultaneous bilateral acquisition of multiple, contiguous sections through paired anatomic structures in a reasonable amount of imaging time.

Adult↗
PubMed1988

Host immune responsiveness to the chigger, Eutrombicula cinnabaris.

Chigger infestation is often associated with severe cutaneous reactions. Mice were given four infestations with the pest chigger Eutrombicula cinnabaris, and each exposure was separated by a 14-day mite-free period. Mean duration of engorgement was nine to ten days for a first exposure and four to five days for a fourth exposure. An initial exposure did not elicit macroscopic changes at chigger attachment sites, while all third and fourth exposure animals had marked reactions consisting of erythema, epidermal thickening and serous exudation. Approximately 20% of second exposure animals had macroscopic changes at chigger feeding sites, but these reactions were much less intense than the responses of third and fourth infestation hosts. Third and fourth exposure animals had infiltrates of lymphocytes, eosinophils, basophils and neutrophils at attachment sites, with eosinophil influx the most intense. Cutaneous reactivity to chigger feeding was adoptively transferred with lymphocytes from fourth exposure animals. Passive transfer of serum from fourth infestation donors resulted in heightened reactivity to a challenge infestation. Skin testing, after a fourth infestation, with an extract of whole E. cinnabaris larvae provided evidence for Arthus and delayed type hypersensitivity responses to chigger antigens. Chigger-reactive homocytotropic antibody was not detected by skin testing and active cutaneous anaphylaxis.

Anaphylaxis↗
PubMed1987

Biomedical research in the nursing home: methodological issues and subject recruitment results.

Although nursing homes are potentially important sites for geriatric research, previous reports have identified impediments to subject recruitment in this setting. We are conducting five simultaneous clinical studies in a 725-bed nursing home. Utilizing a systematic subject recruitment methodology designed to minimize patient and staff burden, we have recruited over 100 subjects. The average recruitment rate over two years from nursing home residents meeting study entry criteria was 43%. The rate was highest (81%) for a study of urinary incontinence offering direct benefit to participants, and lowest (28% and 14% respectively) for physiologic studies of vasopressin regulation and dermal vitamin D production, offering no direct benefit. Studies of syncope and dementia which benefitted groups affected by these problems but not controls, had intermediate recruitment rates (46 and 44%, respectively, P less than .002 compared to incontinence). Thus, clinically relevant projects, sensitive to the needs of the patient and institution, can recruit subjects from the nursing home.

Aged↗
PubMed1987

The use of therapeutic touch in the management of pain.

Nursing by definition is in part nurturing. It is the care of human beings--people who should be viewed and treated as a unified whole, people who interact with the environment and those around them on many levels. Nursing as a profession offers a unique service to those who are ill and in pain. That service takes form in many ways, among them a deep caring for the patients. The caring component in nursing is one of the most valuable intangibles, and TT is one of the most basic of the caring skills. TT provides the patient with extra care and puts the "art" back in nursing. But TT is also something much more than that. TT is a very personal act of caring, of giving to another person. To the patient with pain, TT affirms that you care and that you are acknowledging their pain. That, in and of itself, can be a source of great comfort to someone with pain. The management of pain is a complex and inexact science at best. The pain experience is a complex and often frustrating one. Patients look to various members of the health care profession for assistance and affirmation of their pain. But there are no "magic bullets" in the treatment of pain; even TT is not a universally effective therapy. There is a great deal to learn about pain, about the treatment of pain, and about TT. The challenge now is to continue the research to better understand pain, to understand the human response to pain, and to explain the phenomenon of TT, one modality in the treatment of pain. In implementing this research effort, it is important to recognize that objective scientific information is a necessary but insufficient component in understanding pain. Subjective information, the pain experience, is just as necessary for fully understanding the problem of pain. Until research provides better approaches, the treatment of the patient with pain, regardless of modality, demands multiple approaches, a commitment to keep trying, engaging the patient in the treatment plan, and moving at the patient's pace, not that of the care giver or health care team.

Acute Disease↗
PubMed1986

Liposome delivery of NMR contrast agents for improved tissue imaging.

Large unilamellar liposomes containing the paramagnetic contrast agent manganese chloride were shown to selectively enhance the intensity of the proton NMR signal from the livers of experimental mice. The kinetics of the observed effect indicate that the liposomes are rapidly removed from the circulation and deposited in high concentration within the liver. This process is known to involve the phagocytic activity of macrophages. These results show that liposomes could provide a useful and efficient vehicle for delivering NMR contrast agents to organs like the liver, spleen, and bone marrow. It may also be possible to use liposomes to selectively deliver contrast agents to tissue regions of developing pathology that are rich in macrophage activity.

Animals↗
PubMed1986

Last days: a study of the quality of life of terminally ill cancer patients.

Behavior of a number of Quality of Life measures gathered from two samples of terminal cancer patients over the last weeks of their lives are reported. Samples represent patients in the 26 hospices participating in a nationwide U.S. demonstration project and patients in the palliative care units of two Montreal hospitals. The U.S. data reported are quality of life measures made by a lay principal care person (PCP) or trained interviewer; the Montreal measures were made by both an attending doctor and an attending nurse. The general finding, as expected, is one of increasing deterioration in quality of life, with accelerated deterioration between 3 and 1 week of death. Pain follows a somewhat different pattern than other measures. More patients are in either of the extreme categories at an earlier point in time than found for other measures, and there are fewer changes as death is approached. Finally, about 20% of the patients do not fall into extremely low quality of life categories, even in the week prior to death.

Activities of Daily Living↗
PubMed1986

Effects of bipolar affective disorder and lithium administration on the cholinergic system in human blood.

Several processes relating to the cholinergic system that are present in human blood were measured in samples obtained from patients with bipolar affective disorder, both before and during treatment with lithium, and from controls. The biochemical measurements include RBC and plasma choline concentrations, the kinetics of RBC choline uptake, plasma non-specific cholinesterase and RBC and plasma acetylcholinesterase. The RBC choline level is increased and the Vmax of the RBC choline uptake system is decreased in samples from lithium-free bipolar patients during manic episodes. There are no differences from control in the plasma choline levels or in the acetylcholinesterase enzyme activities in blood samples from the lithium-free or lithium-treated patients. Plasma non-specific cholinesterase is below control levels in all patients. Lithium treatment increases the RBC choline concentration to more than ten-times control levels and reduces the Vmax and the affinity for choline of the RBC choline transport system. In vitro addition of lithium does not replicate the effects of in vivo administration of lithium. Possible mechanisms for these effects of lithium are discussed.

Acetylcholinesterase↗
PubMed1986

Clinical utility of magnetic resonance imaging in pediatric neurosurgical patients.

The clinical utility of magnetic resonance imaging in pediatric neurosurgical patients was reviewed in a series of 126 scans. MRI was determined to be superior or equivalent to other imaging techniques in the evaluation of intracranial hypertension, developmental abnormalities, or acute conditions involving the spinal cord. In 74% of the scans performed because of these clinical problems, adequate data were obtained for both specific anatomic diagnosis and surgical planning. The scan proved equivalent to CT in the imaging of structural abnormalities associated with seizure disorders or degenerative conditions. In acute head injuries and generalized infections of the central nervous system, MRI offered no advantage in diagnostic specificity, and had significant logistic limitations.

Acute Disease↗
PubMed1985

Biochemical RBC abnormalities in drug-free and lithium-treated manic patients.

RBCs from two lithium-free manic patients displayed lower choline transport and higher choline concentrations and methionine S-adenosyltransferase activity than those of controls. Lithium therapy decreased RBC methionine S-adenosyltransferase activity to normal, decreased choline transport further, and increased choline concentrations further.

Adult↗