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Biomedical subjects

S Miller

Publications and source records attributed to S Miller.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Treatment of occipital acne keloidalis by excision followed by secondary intention healing.

OBJECTIVE: To demonstrate the principle of excision with healing by secondary intention in the treatment of occipital acne keloidalis, a chronic, inflammatory condition characterized by inflammation and hypertrophic scarring on the posterior aspect of the neck and the occipital aspect of the scalp. SETTING: Academic teaching institution. METHODS: Five consecutive patients with massive (> 10 x 15-cm) occipital keloids, all actively infected and growing, were treated by excision of the lesion deep to the dermis and hair follicles. Aggressive local wound care of the wound followed, with the end point being complete reepithelialization of the region. RESULTS: Complete wound closure took place in all patients within 6 to 10 weeks. No complications or recurrences occurred. Cosmetic results were judged as fair to good. Follow-up ranged from 2 months to 4 years. CONCLUSIONS: Successful treatment of occipital acne keloidalis with direct excision and secondary intention wound healing is demonstrated. While cosmetic results are not optimal, this form of treatment has produced stable scar beds without return of infection or keloids.

Acne Keloid↗
PubMedDate not supplied

Colonoscopic indirect lymphangiography in a canine model.

Colorectal malignancies metastasize most frequently to mesenteric lymph nodes. Preoperative staging of these nodes by current modalities is problematic. This study evaluates the feasibility of indirect mesenteric lymphangiography as a colonoscopic technique in a canine model. Ten mongrel dogs underwent endoscopic submucosal injection of Ethiodol at various sites in the transverse, descending, and rectosigmoid areas. Serial abdominal roentgenograms were obtained up to 2 weeks postinjection. In seven of the animals, demonstration of mesenteric nodal uptake corresponding to the area(s) of injection was radiographically documented. In the remaining animals (early in the series) nodal opacification was inadequate. This lack of nodal uptake appeared to be due to nonsubmucosal contrast injection. No complications were noted. Colonoscopic indirect lymphangiography appears to be a safe and potentially useful modality in the evaluation of mesocolonic lymph nodes. Further studies to refine this technique and investigate its potential to preoperatively delineate abnormal nodal architecture are warranted.

Animals↗
PubMedDate not supplied

Nurse-midwifery in St. Vincent and the Grenadines.

Brain drain, the exodus of highly trained professionals from developing countries to better paying jobs in the developed world, threatens the structure of community health care in those developing countries. In the Caribbean Basin, as in many developing countries, midwives are the primary health care providers for mothers and their children. This paper describes the maternal and child health (MCH) system in the Caribbean island community of St. Vincent and the Grenadines (SVG); compares MCH indicators in SVG with those in developed and developing nations; describes the role of the nurse-midwife in the delivery of MCH services; and examines the growing problem of recruitment and retention (brain drain) of nurse-midwives. Suggestions made by the nurse-midwives of SVG will be used to explore some solutions to this major human resource problem threatening the MCH system and to identify the major obstacles to their implementation.

Delivery of Health Care↗
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Effects of aging and dietary restriction on DNA polymerases: gene expression, enzyme fidelity, and DNA excision repair.

Hepatic DNA polymerases isolated from young and old C57BL/6N mice fed ad libitum or calorically restricted differed in chromatographic characteristics, binding affinity for DNA template-primer, specific activity, and fidelity of synthesis. DNA polymerase alpha total and specific activity declined slightly, while the nucleotide misincorporation frequency increased dramatically, with increased age of the donor animals. A positive correlation was observed between polymerase alpha specific activity and the affinity of enzyme binding to activated DNA template-primer. Both the age-associated decline in enzyme activity and the decrease in fidelity of synthesis were modified by dietary restriction, with higher specific activity levels and lower misincorporation frequencies for DNA polymerases from dietarily restricted animals compared with ad libitum animals of all ages. Fidelity of both DNA polymerase alpha and beta increased following treatment with the phosphoinositide hydrolysis product inositol-1,4-bisphosphate. The data suggest that dietary restriction could play an important role in decreasing the age-associated decline in function of physiological systems sensitive to decreased or defective DNA synthesis.

Aging↗
PubMedDate not supplied

Glimpses of my mentor, Sir Stewart Duke-Elder.

The author writes not as a biographer, but as a longtime colleague and close friend of Sir Stewart Duke-Elder. Unique anecdotes elucidate the personality of this great ophthalmologist, teacher and writer.

History, 20th Century↗
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Certified nurse-midwife and physician collaborative practice. Piloting a survey on the Internet.

This pilot study was designed to describe the clinical areas of collaboration, financial structures, and sources of conflict for certified nurse-midwives (CNMs) involved in nurse-midwife and physician collaborative practice (CP). A questionnaire was posted on an electronic bulletin board maintained by the Community-Based Nurse Midwifery Education Program of the Frontier School of Nursing. The nonrandom, convenience sample consisted of 78 respondents. Their mean age was 42 years; they had been in practice for a mean of 10 years, and 56% had graduate degrees. Eighty-nine percent reported involvement in CP. Eighty-three percent co-managed higher-risk women, and 46% performed vacuum-assisted deliveries or were first assistants at cesarean sections. Forty-eight percent of CNMs did not bill in their own names, and only 12% had full hospital privileges. The most common sources of conflict in CPs were clinical practice issues (100% ever encountered), power inequities (92%), financial issues (66%), and gender relations (58%). Collaborative practice is a common form of practice for CNMs and suggests a model for collaboration in other sectors of the health care system. Future research should explore methods of reducing the potential for conflict between CNMs and physicians.

Adult↗
PubMedDate not supplied

Collaborative practice. A resource guide for midwives.

There is a paucity of literature specifically addressing the efficacy of collaborative practices composed of midwives and physicians. However, the literature documenting the effectiveness of interdisciplinary teams of various health care providers combined with the literature on the effectiveness of midwifery practice presents a compelling argument for midwife-physician collaborative practice. This resource list provides access to literature on interdisciplinary collaboration most relevant to midwives engaged in creating, reestablishing, and researching collaborative practice models.

Female↗
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Recognition specificity of monoclonal antibodies which protect mice against Salmonella typhimurium infection.

We used enzyme-linked immunosorbent assay (ELISA), competitive inhibition ELISA, flow cytometry and western immunoblots to study the antigenic specificity of two monoclonal antibodies (mAbs) raised against the cell surface antigens of Salmonella typhimurium. These mAbs (SH6.11 and WB60.4) protect CAF1 (Ity(r)) mice against endotoxemia and mouse typhoid. We found that SH6.11 and WB60.4 recognize Salmonella serogroup B-specific lipopolysaccharide O4 and O5 factors, respectively. These mAbs did not bind to Salmonella serotypes that belong to serogroup A, D1, E4, G2, or R and did not cross-react with other enteric and nonenteric bacterial species.

Animals↗
PubMedDate not supplied

The accessible surface area and stability of oligomeric proteins.

Protein structures are stabilized by hydrophobic and van der Waals forces, and by hydrogen bonds. The relation between these thermodynamic quantities and the actual three-dimensional structure of proteins can not be calculated precisely. However, certain empirical relations have been discovered. Hydrophobic energy is gained by the reduction of surface in contact with water. For monomeric proteins, the area of the surface accessible to solvent, and of that buried in the interior, is a simple function of molecular weight. Proteins with different shapes and secondary structures, but of the same molecular weight, have the same accessible surface area. It has been argued that there is no similar relationship for large oligomeric proteins. In this paper we show that the surface areas of oligomeric proteins, and the areas of the surface buried within them, are directly related to relative molecular mass. Although oligomers of the same molecular weight bury the same amounts of surface, the proportions buried within and between subunits vary. This has important implications for the role of subunit interfaces in the stability and activity of oligomeric proteins.

Chemical Phenomena↗
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Audio presence intervention for decreasing agitation in people with dementia.

Researchers have demonstrated the utility of various nonpharmacologic interventions in decreasing or preventing agitation in elderly nursing home residents with dementia. Auditory intervention strategies are one behavioral approach. We tested a modified version of simulated presence therapy called audio presence intervention (API). In 28 episodes of agitation among seven residents, API produced a significant decline in agitation level as measured by four items from the Haycox Rating Scale. However, in six episodes (four residents), agitation stayed the same or worsened. The results of this study pose more questions than answers and should stimulate nurse researchers to further investigate auditory intervention for control of agitation elders with dementia.

Aged↗
PubMedDate not supplied

Changing roles of Afghan refugee women in the United States.

Refugee women face many challenges, such as traumatic flight, loss of family members and property, and dramatic cultural differences in the country of resettlement. We examined the adjustment issues and role changes of Afghan women refugees in northern California. Afghans comprise the largest refugee population in the world, and continuing political turmoil prevents most Afghans in the United States from returning home. Data are presented from interviews with 32 Afghan women. These interviews were conducted as part of a larger ethnographic study that included participant observation and interviews with 90 Afghans and the American health and social service providers who worked with them. Although similar issues were expressed by most Afghan women, generation influenced the experience of such issues. The elderly suffer from social isolation and lack of respect; the middle generation shoulders the triple burden of housewife, employee, and mediator between children and spouse; and young and single women face culture conflict and the lack of appropriate mates.

Acculturation↗