Granulomatous angiitis of the CNS causing spontaneous intracerebral haemorrhage: the importance of leptomeningeal biopsy.
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Arachnoid↗
Biomedical subjects
S Robinson
Publications and source records attributed to S Robinson.
The role of baccalaureate nursing students in the matrix of health promotion.
The Declaration of Alma Ata in 1978 put primary health care into the forefront of government health agendas around the world. The Ottawa Charter followed in 1986, emphasizing the role of health promotion for enhancing the wellness of populations and the potential cost savings related to illness care. The findings from research and evaluation in health promotion indicate that multiple approaches, such as mass media campaigns, school-based education, community education, community development, environmental initiatives, and implementation of legislation, are most likely to bring about sustained change (Garrard, 1990). Health education is a component of health promotion and is directed toward enhancing the skills of individuals, families, and communities to change behavior. Behavior change, however, will not be achieved by isolated health education campaigns but by a combination of strategies, methods, and activities at a local, state, and federal level. The type of campaigns that are implemented by nursing students is one intervention that forms part of the matrix of health promotion. This article describes the experience of a School of Nursing in the application of health education by students in a variety of settings in the community. These campaigns help the students to connect theory to nursing practice in a creative way that provides immediate and long-term benefits and may enhance the health of the community.
Community Health Nursing↗
Dehydroepiandrosterone sulfate does not prevent spontaneous and iodine-induced lymphocytic thyroiditis and diabetes mellitus in the BB/Wor rat.
Chronic feeding of dehydroepiandrosterone (DHEA) and its sulfated metabolite, dehydroepiandrosterone sulfate (DHEAS), has previously been reported to decrease hyperglycemia, obesity, cancer, and autoantibody generation in a number of animal models and to increase muscle mass and physiological and psychological well-being in elderly humans, although these latter studies remain controversial. The present study was carried out to determine whether large amounts of DHEAS given orally would prevent the occurrence of spontaneous and iodine-induced autoimmune lymphocytic thyroiditis (LT) and/or spontaneous insulin-dependent diabetes mellitus (DM) in male and female BB/Wor rats. DHEAS was administered by gavage (44 mg/rat/day) or in the chow (133 mg/rat/day) to LT- and DM-prone rats from 30 to 120 days of life; some of these rats also received iodine in the drinking water to enhance the incidence and intensity of LT. Onset of DM requiring protamine zinc insulin and its maintenance dose were assessed. Rats were killed at 90 or 120 days of age and blood, thyroid, adrenals, pancreases, testes, and ovaries were removed. Serum glucose, DHEA, DHEAS, thyroxine (T4), tri-iodothyronine (T3) and thyrotropin (TSH) concentrations were measured in all rats in both experiments. Serum DHEAS concentrations were 10-fold higher in the rats given the steroid by gavage or in the diet compared with levels in control rats. DHEAS administered over a prolonged period of time had no significant effect on body weight, incidence and severity of DM, incidence and intensity of spontaneous and iodine-induced LT, and thyroid, pancreas and testes weights but did significantly decrease adrenal and ovarian weights. Serum T4, T3, and TSH concentrations were similar in control and DHEAS-treated rats. In conclusion, DHEAS did not prevent the occurrence of iodine-induced or spontaneous autoimmune LT or spontaneous DM in the BB/Wor rat, at variance with its reported immunosuppressive effects in other animal models.
Analysis of Variance↗
Laying down the law: reducing illegal tobacco sales to minors in central Harlem.
OBJECTIVES: This study compared the impact of educational and enforcement interventions on retailers' sale of tobacco to minors in Central Harlem, New York. METHODS: In a randomized trial with repeated measures, 152 stores were randomly divided into control, education, and enforcement groups. RESULTS: Overall tobacco sales to 12- and 13-year-old minors at baseline (98%) were among the highest in the nation. At 6-month and 1-year follow-ups, decreases in rates of tobacco sales to minors were modest among education stores and substantial among enforcement stores. CONCLUSIONS: Effective reduction of tobacco sales to minors may require ongoing enforcement measures, including fines for retailers who violate state and local laws.
Adolescent↗
The effects of metformin on glycemic control and serum lipids in insulin-treated NIDDM patients with suboptimal metabolic control.
OBJECTIVE: To test the hypothesis that metformin therapy, given as an adjunct to insulin therapy, improves metabolic control in insulin-treated NIDDM patients with suboptimal glycemic control. RESEARCH DESIGN AND METHODS: A total of 33 subjects with insulin-treated NIDDM were investigated; all had commenced insulin after secondary failure of antihyperglycemic agents. Two randomized double-blind placebo-controlled crossover studies were run. In study 1 (n = 19), insulin-treated subjects with suboptimal glycemic control received 12 weeks of metformin 1 g b.i.d. and 12 weeks of placebo. In study 2 (n = 14), subjects already established on adjunctive metformin/insulin therapy stopped the metformin component and received 12 weeks of metformin at their baseline dosage (range 1-2.5 g) and 12 weeks of equivalent placebo. Fasting plasma glucose, HbA1c, and serum lipids were measured at baseline and midway through and at the end of each treatment phase. The effect of 12 weeks of metformin treatment was compared with the effect of 12 weeks of placebo in each study and in both studies combined. RESULTS: In study 1, metformin treatment was associated with significant improvements in fasting plasma glucose (mean 12-week difference from placebo [95% CI]: 5.8 mmol/l [3.5-8.1], P < 0.001) and HbA1c (1.6% [0.9-2.4], P < 0.001). In study 2, metformin treatment was associated with significantly lower fasting plasma glucose (5.3 mmol/l [0.6-9.9], P = 0.029) and lower HbA1c (2.4% [1.0-3.8], P = 0.003) compared with those for placebo. Study 2 also showed metformin treatment to be associated with significantly lower total cholesterol than that for placebo (1.0 mmol/l [0.1-1.9], P = 0.032) and lower LDL cholesterol (1.0 mmol/l [0.1-1.9], P = 0.028). This significant difference in serum lipids seen in study 2 was not seen in study 1, but was present when both sets of data were combined (n = 33, mean total cholesterol difference at 12 weeks [95% CI]: 0.6 mmol/l [0.1-1.1], P = 0.015). Metformin had no significant effect on triglyceride, HDL cholesterol, weight, or blood pressure. Two subjects on metformin withdrew because of side effects. CONCLUSIONS: Metformin, when given as adjunctive therapy, was well tolerated and improved glycemic control and lipid concentrations in patients with insulin-treated NIDDM whose diabetes was poorly controlled. These improvements could be maintained over the long term.
Aged↗
Decreased expression of the adenomatous polyposis coli (Apc) and mutated in colorectal cancer (Mcc) genes in mouse lung neoplasia.
A decrease in the intracellular concentrations of the transcripts for some tumor suppressor genes has been found during murine lung tumorigenesis; for p15INK4b and p16INK4a, this was due to homozygous deletions. We report here a decrease in the mRNA levels of the mutated in colorectal cancer (Mcc) and adenomatous polyposis coli (Apc) genes in mouse lung tumors and some neoplastic cell lines. This was assessed both by northern blotting and reverse transcriptase-polymerase chain reaction of RNA isolated from lung tumors that had been induced by urethane, N-nitrosodiethylamine, or 3-methylcholanthrene in (A/J x C57BL/6) F1 or A/J mice. A reduced amount of both Mcc and Apc messages was also seen when two neoplastic cell lines, a spontaneous transformant (E9) and a line derived from a chemically induced solid tumor (82-132), were compared with two independently derived nontumorigenic cell lines (E10 and C10); E9 was derived from E10, and all of these lines are probably of alveolar type 2 cell origin. A cell line derived from a chemically induced papillary lung tumor probably of bronchiolar Clara cell origin (LM2) had Mcc mRNA levels similar to those of C10 and E10 but reduced Apc mRNA levels. A line (p53-823) derived from a papillary tumor that arose in a mouse with a mutated p53 transgene had a reduced amount of the Mcc gene product only. These differential changes in the relative amounts of Apc and Mcc messages in LM2 and p53-823) cells may serve as useful models for studying the regulation of their expression. Both messages had half-lives of 6-9 h in normal E10 and neoplastic E9 cells, so decreased message stability does not account for these reductions. This is the first report of estimated degradation rates of these mRNAs. Apc and Mcc message content did not vary as a function of growth status of the cell lines. Single-strand conformation polymorphism analysis did not reveal mutations in Apc coding regions known to have a high mutation frequency in human colon tumors. Loss of heterozygosity of Apc and Mcc was not found in tumors that developed in the F1 mice, implying a lack of allelic deletions. These changes in tumor suppressor gene expression may contribute to the development and maintenance of neoplasia in lung epithelium.
Animals↗
Lisinopril, an angiotensin I-converting enzyme inhibitor, prevents entry of murine hematopoietic stem cells into the cell cycle after irradiation in vivo.
The hemoregulatory peptide N-Acetyl-Ser-Asp-Lys-Pro (AcSDKP) has been shown in vivo to inhibit the cycling of murine hematopoietic stem cells triggered into S-phase by either cytotoxic drug administration or irradiation. This property, further confirmed using in vitro models, demonstrates that the peptide has an in vivo protective effect on the hematopoietic system. AcSDKP has been shown to be a physiological substrate of angiotensin I-converting enzyme (ACE), which catabolizes the peptide through a dipeptidasic activity. Thus, oral administration of ACE inhibitor to humans has led to an increase in the plasma AcSDKP concentration. In the present paper, we report on the in vivo effect of lisinopril, an ACE inhibitor, on the proliferative status of murine hematopoietic stem cells triggered into S-phase by irradiation. Administration of lisinopril (10 mg/kg) 1 hour after irradiation led to a 90 to 100% inhibition of murine plasma ACE activity as observed during the first 4 hours postirradiation. This inhibition was correlated with a 600% increase in the endogenous plasma AcSDKP level and a total suppression at 24 hours of entry of the hematopoietic stem cell into the cell cycle. We discuss the possible role of ACE in the regulation of hematopoietic stem cell proliferation through control of the AcSDKP concentration.
Angiotensin-Converting Enzyme Inhibitors↗
Dynamics of GABA(A) receptor binding in the ventromedial hypothalamus during postnatal development in the rat.
In vitro quantitative autoradiography of [3H]muscimol binding was used to examine the developmental pattern of GABA(A) receptor expression in the ventromedial hypothalamus (VMN) of Long-Evans rats. Peak levels of [3H]muscimol binding were observed in the VMN on postnatal day 14 (PN14), binding levels were significantly lower in the VMN at earlier (PN0 and PN7) and later (PN70) ages. The developmental pattern of [3H]muscimol binding observed in the VMN differed from that seen in the hippocampus where binding was found to increase progressively from PN0 to PN14 and was maintained at high levels in adulthood. Although the profile of GABA(A) receptor expression in the developing VMN undergoes considerable modification during the critical period for sexual differentiation, no significant differences in [3H]muscimol binding were observed between male and female animals at any developmental age.
Aging↗
Glial cell line-derived neurotrophic factor-dependent RET activation can be mediated by two different cell-surface accessory proteins.
Glial cell line-derived neurotrophic factor (GDNF)-dependent activation of the tyrosine kinase receptor RET is necessary for kidney and enteric neuron development, and mutations in RET are associated with human diseases. Activation of RET by GDNF has been shown to require an accessory component, GDNFR-alpha (RETL1). We report the isolation and characterization of rat and human cDNAs for a novel cell-surface associated accessory protein, RETL2, that shares 49% identity with RETL1. Both RETL1 and RETL2 can mediate GDNF dependent phosphorylation of RET, but they exhibit different patterns of expression in fetal and adult tissues. The most striking differences in expression observed were in the adult central and peripheral nervous systems. In addition, the mechanisms by which the two accessory proteins facilitate the activation of RET by GDNF are quite distinct. In vitro binding experiments with soluble forms of RET, RETL1 and RETL2 demonstrate that while RETL1 binds GDNF tightly to form a membrane-associated complex which can then interact with RET, RETL2 only forms a high affinity complex with GDNF in the presence of RET. This strong RET dependence of the binding of RETL2 to GDNF was confirmed by FACS analysis on RETL1 and RETL2 expressing cells. Together with the recent discovery of a GDNF related protein, neurturin, these data raise the possibility that RETL1 and RETL2 have distinctive roles during development and in the nervous system of the adult. RETL1 and RETL2 represent new candidate susceptibility genes and/or modifier loci for RET-associated diseases.
Amino Acid Sequence↗
The role of neuroendoscopy in the treatment of pineal region tumors.
The authors describe a technique for the initial management of patients with pineal region neoplams and symptomatic hydrocephalus. Endoscopic third ventriculostomy and, if possible, tumor biopsy are performed through a single precoronal burr hole. When indicated, formal tumor resection can be performed nonemergently, without the need for ventricular drainage or shunting.
Adult↗
Dimensional stability of thermosensitive gutta-percha.
The expansion and shrinkage of four commercial brands of endodontic thermosensitive gutta-percha were evaluated. A modified volume dilatometry technique was used; the dilatometric system (DS) consisted of Pyrex glass capillary tubes and a specimen chamber. Each sample was weighed to 10(-4) mg, placed in the specimen chamber, and subjected to vacuum for 45 min to eliminate moisture or gases. The DS was gradually heated from 24 degrees C to 80 degrees C and then cooled to 24 degrees C using a well-agitated temperature-controlled water bath. In a parallel set of experiments, the DS was heated in the same manner but cooled to body temperature (37 degrees C) in the water bath and the temperature kept stable at 37 degrees C for 24 h. The level of the mercury meniscus within the DS was monitored to determine the percent volume change of each sample at 2 degrees C intervals. All samples expanded as the temperature was elevated and shrank during cooling. The percent volume change for each of the four gutta-percha products, as the temperature was raised to 80 degrees C, ranged from an expansion of +11.62 to +12.25. As the temperature was lowered from 80 degrees C to 24 degrees C, the percent volume change representing shrinkage ranged from -2.22 to -3.53. When the temperature was lowered from 80 degrees C to 37 degrees C, the products continued to exhibit shrinkage for a range of time between 45 min and 10 h before stabilizing at a fixed volume. The final percent volume change for each experiment, with each product, was positive, ranging from +5.50 to +7.20, with discernible differences between products.
Drug Stability↗
Understanding the quality challenge for health consumers: the Kaiser/AHCPR Survey.
BACKGROUND AND PURPOSE: "Americans as Health Care Consumers: The Role of Quality Information," a nationally representative telephone survey of 2,006 adults, designed by the Henry J. Kaiser Family Foundation (Kaiser) and the Agency for Health Care Policy and Research (AHCPR) of the U.S. Department of Health and Human Services, was presented at the Kaiser/AHCPR conference "Value and Choice: Providing Consumers with Information on the Quality of Care" in Arlington, Virginia, October 29-30, 1996. The survey was conducted by Princeton Survey Research Associates between July 16 and September 5, 1996, and has a margin of error of plus or minus 3 percentage points. RESULTS: The survey found that Americans value quality but that the use of quality indicators is likely to be only one factor in their decision making, given their reliance on and preference for quality information from their physicians, friends, and family. A plurality (42%) chose having high quality of care as their most important concern, but only 39% reported seeing information comparing health plans, and only about one-third of that group said they used this information themselves to make decisions. The following are possible explanations for why consumers don't use information on quality in making health care decisions: They trust friends, families, and physicians about all other sources for advice; They do not (at the time of the survey) have many health plan choices to make; or They lack familiarity with comparative health care quality information.
Adult↗
Future of education in clinical forensic medicine: summary of multidisciplinary forum.
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Journal Article↗
Dendritic cells: from basic studies to therapeutic applications. Fourth International Symposium on Dendritic cells in Fundamental and Clinical Immunology. Venice, Italy, 5-10 October 1996.
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Antigen Presentation↗
Constructing career pathways in nursing: some issues for research and policy.
Nurses currently construct careers in a climate of continuing occupational and organizational change. A longitudinal project is in progress which is documenting the post-qualification histories of a cohort of registered general nurses, and studying the extent to which their careers represent occupational choice, a response to organizational constraints, or a combination of both. Three elements comprise the core of the research: questions which provide information on the cohort's career plans, charts which document their career histories and questions which explore the relationship between the two. The basis of the design is the first element, and this paper focuses on the problems encountered in designing the questions and routing structures which enabled all cohort members to describe their plans for the future. The importance of extensive pilot work is demonstrated in the development of options tailored for each potential career pathway and to allow expressions of uncertainty to emerge at points when appropriate to respondents. Of the 1164 members of the cohort, 1015 returned the questionnaire; a response rate of 87%. Findings are presented on the cohort's plans at qualification. The majority of respondents (86%) saw themselves as remaining in nursing and in clinical practice in the early post-qualification period. Eighteen per cent said they intended to practise abroad at some point, 30% foresaw a likelihood of working in the private sector, 59% wanted to take one or more English National Board courses and 42% expressed interest in obtaining an undergraduate or postgraduate degree.
Attitude of Health Personnel↗
Developing the nursing contribution to the management of the mental health services.
The importance of management and leadership in mental health nursing has been stressed in an extensive review of the role of the profession in the mental health services. Drawing from a longitudinal study of the careers of a cohort of registered mental nurses, this paper presents data relevant to developing the management capability of the profession. The data were obtained from a questionnaire sent to the cohort at qualification, 80% of whom responded. Findings showed that 14% thought that at some stage they would definitely seek a management post and 19% thought it likely. Only 18% had received information during the course about developing a career in management. Sixty-nine per cent of those who had not received such information would have liked to have had some. Just over half (51%) felt that their course had prepared them well for aspects of ward management and 46% held this view in relation to management of other nursing staff. A statistical modelling approach as used to explore the relationships between these three aspects of management and a range of demographic and course perception variables considered as possible predictors of seeking a post in management. These analyses demonstrated that likelihood of seeking such a post was significantly associated with sex of respondent, with receipt of information about developing a career in management, and with being encouraged by the course to want to work as a psychiatric nurse. Strategies to encourage an early orientation towards management posts are considered in the light of the findings.
Education, Nursing, Continuing↗
Maternal birthweight and diet in pregnancy in relation to the infant's thinness at birth.
OBJECTIVE: To examine how maternal diet in pregnancy and parental body size and birthweight influence an infant's thinness at birth measured by a low ponderal index. DESIGN: An observational study of newborn infants and their parents. SETTING: Southampton, England. POPULATION: Five hundred and thirty-eight infants born at term. MAIN OUTCOME MEASURE: Ponderal index at birth. RESULTS: Women who had a high intake of carbohydrate in early pregnancy and a low intake of dairy protein in late pregnancy tended to have infants that were thin at birth (P = 0.01 and P = 0.03, respectively, in a simultaneous analysis). Women who themselves had a low birthweight also tended to have thin infants, ponderal index falling from 28.3 kg/m3 to 26.2 kg/m3 as the women's birthweights decreased from more than 4.0 kg to 2.5 kg or less (P < 0.0001). Tall fathers had thin infants, but ponderal index was not related to the women's heights or the fathers' birthweights. CONCLUSION: These associations may reflect constraints on placental development imposed by a woman's nutrition in pregnancy and during her own intrauterine life. Effects of the father's height may be mediated through genetic influences on skeletal growth.
Adult↗
Birth weight and body fat distribution in adolescent girls.
OBJECTIVE: To examine the association between birth weight and body fat distribution in a group of adolescent girls. DESIGN: A total of 216 white girls who were born in Southampton had their heights, weights, waist and hip circumferences, and skinfold thicknesses measured when they were aged between 14 and 16 years. RESULTS: The girls who were smallest at birth, but who were fattest at time of measurement were the most centrally obese. In girls whose body mass index was above the median (21 kg/m2), the subscapular to triceps skinfold ratio rose by 9% for every kilogram decrease in birth weight. Among overweight girls, with a body mass index over 25, the ratio rose by 27% for every kilogram decrease in birth weight. CONCLUSION: In adolescent girls, the tendency to store fat on the trunk rather than the limbs, seems to be programmed by growth in fetal life, and is most evident in those who are overweight.
Adipose Tissue↗