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At least 613 records · Page 34Linked to original sources
PubMed1995

Computer-assisted three-dimensional reconstruction of human dermal dendrocytes.

We attempted to characterize the three-dimensional structure of dermal dendrocytes and to clarify the spatial relationships between dermal dendrocytes and mast cells, macrophages, and nerves. Normal human adult skin (breast, n = 2) was routinely processed for electron microscopy. Every other section (about 50 per data set) was collected at 80-nm intervals traversing about 8 microns of tissue. Grids showing the same cells were photographed by electron microscopy at a magnification of 4000x. Based on the 10-20 photographs per data set, cell outlines were digitized into the reconstruction program at appropriate layers and aligned. Thin, elongated cytoplasmic "dendrites" of dermal dendrocytes in two-dimensional micrographs proved to be thin, membrane-bound flaps in three-dimensional reconstruction. For dermal dendrocytes concentrated about superficial vessels (perivascular dendrocytes), the flaps enshrouded the vessel wall, and for dermal dendrocytes directly beneath the epidermis (subepidermal dendrocytes), these flaps were aligned parallel to the dermal-epidermal junction. The three-dimensional feature of dermal dendrocytes (perivascular and subepidermal) is quite similar to that of perivascular adventitial veil cells, suggesting ultrastructurally identified perivascular dendrocytes and veil cells must be identical cells. In conventional ultrathin sections, 20-40% of perivascular dendrocytes and occasional subepidermal dendrocytes were closely associated with mast cells. When viewed by computer-assisted three-dimensional reconstruction, membrane flaps of dermal dendrocytes consistently shrouded mast cell membranes for 50-90% of their perimeter; mast cells resembled a ball in a baseball glove (dermal dendrocytes). Occasional dermal dendrocytes surrounded non-myelinated nerves in the superficial dermis. Membrane flaps also enabled dermal dendrocytes to present extensive areas to the plasma membranes of adjacent monocyte/macrophages. These findings indicate that dermal dendrocytes are non-dendritic cells that are spatially related to mast cells, monocyte/macrophages, microvessels, and nerves by their membranous flaps. This suggests the need for further study of functional interactions between these cells.

Adult↗
PubMed2004

Framework for evaluation of physiologically-based pharmacokinetic models for use in safety or risk assessment.

Proposed applications of increasingly sophisticated biologically-based computational models, such as physiologically-based pharmacokinetic models, raise the issue of how to evaluate whether the models are adequate for proposed uses, including safety or risk assessment. A six-step process for model evaluation is described. It relies on multidisciplinary expertise to address the biological, toxicological, mathematical, statistical, and risk assessment aspects of the modeling and its application. The first step is to have a clear definition of the purpose(s) of the model in the particular assessment; this provides critical perspectives on all subsequent steps. The second step is to evaluate the biological characterization described by the model structure based on the intended uses of the model and available information on the compound being modeled or related compounds. The next two steps review the mathematical equations used to describe the biology and their implementation in an appropriate computer program. At this point, the values selected for the model parameters (i.e., model calibration) must be evaluated. Thus, the fifth step is a combination of evaluating the model parameterization and calibration against data and evaluating the uncertainty in the model outputs. The final step is to evaluate specialized analyses that were done using the model, such as modeling of population distributions of parameters leading to population estimates for model outcomes or inclusion of early pharmacodynamic events. The process also helps to define the kinds of documentation that would be needed for a model to facilitate its evaluation and implementation.

2-Propanol↗
PubMed1990

Screening system for asymptomatic renal disease in children in Japan.

The introduction in Japan of routine urinalysis for pre-school and school age children has greatly facilitated the discovery of renal disease in asymptomatic children. Over the past 8 years at Kitasato University Hospital, we have studied 113 cases of chronic progressive renal disease based on renal biopsy. Thirty-one of these 113 patients were found by routine urinalysis at area schools. It is note-worthy that many of the asymptomatic children were found to have renal diseases such as MPGN, FGS, and IgA nephropathy. Although it is difficult to decide whether or not medical management is required for asymptomatic children, the histological findings may give pertinent guidance for planning an appropriate therapeutic program in the early stages of various types of renal disease. This early detection may enable us to observe these potentially progressive renal diseases from the early phase and to provide clues for the investigation of the pathogenesis of these renal diseases.

Child↗
PubMed1989

Coronary risk factor outcomes following coronary artery bypass surgery.

The coronary risk factor status of patients prior to and following coronary artery bypass surgery (CABG) has been poorly investigated. Two consecutive series of CABG patients were surveyed following CABG. One hundred and thirty patients were assessed immediately following CABG and 530 patients were assessed 12-30 months following CABG. For the long-term post-CABG group, over 80% of those who had ever smoked had ceased. Sixty-four per cent of these males and 50% of females were classified as being overweight. Twenty-five per cent of males and 34% of females reportedly had high serum cholesterol (i.e. greater than or equal to 6.5 mmol/L). Comparing these CABG data with age-adjusted National Heart Foundation Risk Factor Prevalence Survey data, there was a higher prevalence of ex-smokers, overweight, hypertension, and elevated cholesterol. It was concluded that on most coronary risk factors, except for smoking, these CABG patients had a worse profile than the general Australian community. This problem warrants further research and the development of appropriate treatment programs.

Adult↗
PubMed2003

Improving access to cardiac rehabilitation for remote Indigenous clients.

OBJECTIVE: To identify barriers to Indigenous patients taking up a rural general practice-based cardiac rehabilitation program. We investigated the accessibility and appropriateness of the program and the role of Indigenous health workers (IHWs) in caring for Indigenous cardiac patients. METHODS: A cross-sectional survey of knowledge and views relating to cardiac rehabilitation was undertaken with 47 Indigenous cardiac patients and 41 health professionals in remote Queensland. RESULTS: Only three patients were fully engaged in the program. Reasons for non-participation included: lack of knowledge about rehabilitation, low income, and having a large extended family. Although the program incorporated a training component for IHWs covering prevention and follow-up, most did not monitor patients specifically for their heart problems and thought they did not have adequate skills. Shared care was occurring in some settings but without the participation of IHWs. CONCLUSIONS: There was general agreement that IHWs do have a role in cardiac rehabilitation. There is a need for ongoing in-service education or inclusion in training programs. Lack of understanding of the role of IHWs is a barrier to shared care. Cardiovascular disease needs to be addressed as part of the raft of chronic illnesses. IMPLICATIONS: Training about chronic illnesses and their management needs to be linked to structural adaptations in the delivery of health services to allow efficient use of each professional's skills. Clear role delineation needs to be negotiated to allow all health professionals to carry out their job effectively.

Cardiac Rehabilitation↗
PubMed2006

Gender disparities in mental health service use of Puerto Rican children and adolescents.

BACKGROUND: Differences in service utilization indicating that boys use more mental health services than girls were analyzed to see if they could be explained by known correlates of service use. These correlates were arranged into individual (severe emotional disturbance, level of impairment and externalizing disorders), family (parental education, psychopathology and parental concern) and school factors (difficulties with school work). The objectives were to understand and identify the factors accounting for gender differences in mental health service utilization in order to develop alternatives to promote equity in service delivery. METHODS: A representative sample of 1,896 children 4 to 17 years of age and their primary caretakers were interviewed for this study. Reports of service use were obtained using the Service Assessment for Children and Adolescents. Logistic regression was used to assess the relationship between gender and service use, adjusting for known correlates. RESULTS: Our results showed that, except for impairment, other individual, family and school factors did not explain gender differences in service utilization. Males with impairment were 2.87 times more likely to receive services than impaired females (p <or= .01), and this result continued to hold true for impaired undiagnosed boys compared to impaired diagnoses-free girls (p <or= .001). CONCLUSIONS: Our findings showed a service disparity between impaired boys and girls who did not meet criteria for a DSM IV diagnosis, but no observed differences in service use between boys and girls who met criteria for severe emotional disturbance (SED). Continued investigations are necessary to analyze, assess and understand the different circumstances that bring boys and girls into treatment, followed by the development of appropriate intervention programs at the school and community levels.

Adolescent↗
PubMed1978

Stability of intelligence in the fetal alcohol syndrome: a preliminary report.

A clinical sample of 17 patients with fetal alcohol syndrome was given follow-up IQ testing 1-4 yr after an initial evaluation. Although 77% of the patients had a retest IQ that was within 1 SD of their initial IQ, some individual children did manifest considerable change in scores on retest. Repeated psychologic evaluation at regular intervals is recommended for children with fetal alcohol syndrome so that appropriate educational programming can be maintained in order to promote maximum development in each child.

Adolescent↗
PubMed1988

Rate dependent depression of subsidiary ventricular impulse formation--cause of Stokes-Adams attacks in a patient with rate modulated pacing.

Following His bundle ablation and implantation of a rate adaptive pacemaker (Vitatron TX 911) a 52-year-old gentleman experienced several presyncopal attacks while driving a car. On examination pectoralis muscle contraction caused temporary pacemaker inhibition. Incremental overdrive stimulation demonstrated progressive depression idioventricular automaticity and was associated with similar symptoms following overdrive at high pacing rates. Following appropriate pacemaker programming the patient remained symptom free.

Adams-Stokes Syndrome↗
PubMed1988

Techniques and methods for catheter endocardial fulguration.

Fulguration is a new and promising technique for the treatment of cardiac arrhythmias. This paper discusses the methods and equipment used at Jean Rostand Hospital for invasive experimental research related to fulguration. The importance of catheter testing and selection is demonstrated. The most important features of the measurement techniques for both His bundle and ventricular tachycardia recordings are described. The main components of the protocols for fulguration and early post-operative surveillance are reported. The ODAM Fulgucor is used, augmented by the incorporation of additional pieces of equipment to allow monitoring of current and voltage curves. An electromechanical relay allows for automatic switching from the recording amplifier to the energy source. The video system used includes recording of the image of the last fluoroscopic event with a character generator and an electronic pointer superimposed (when necessary). Computer programs for appropriate timing of predominant events have been developed.

Arrhythmias, Cardiac↗
PubMed1995

Benefits and potential risks of atrial antitachycardia pacing after repair of congenital heart disease.

UNLABELLED: Atrial reentry tachycardia is common after surgical repair of congenital heart disease. The arrhythmia is often difficult to treat and is occasionally life-threatening. This study reports experience with atrial antitachycardia (AAIT mode) pacing for the management of atrial reentry tachycardia, with emphasis on the risks and benefits of automatic pacing therapy. Eighteen patients (2-32 years of age) with a variety of congenital heart lesions underwent atrial antitachycardia pacemaker placement for recurrent atrial tachycardia that was amenable to pace termination prior to the implantation procedure. An appropriate antitachycardia program was determined by repeated induction and termination of atrial tachycardia using the noninvasive programmed stimulation mode of the pacemaker. Over 4-30 months of follow-up, 6 patients had 189 episodes of tachycardia successfully converted with AAI-T pacing, 4 patients had 8 episodes of tachycardia detected but not successfully converted, and 8 patients had no episodes of tachycardia with antibradycardia pacing alone. The number of patients receiving pharmacological therapy other than digoxin or beta blockade fell from 12 to 6. Two subjects died suddenly, 1 while wearing a Holter monitor. In both, tachycardia was detected and pace cardioversion attempted. CONCLUSIONS: Atrial antitachycardia pacing is a useful tool in the management of patients with congenital heart disease and atrial arrhythmias; however, in selected cases, it may not prevent and may even exacerbate the lethal complications of the tachycardia. Antitachycardia function evaluation is recommended under varying levels of autonomic stress prior to institution of automatic therapy.

Adolescent↗
PubMed1996

Electrophysiological characteristics of bipolar membrane carbon leads with and without steroid elution compared with a conventional carbon and a steroid-eluting platinum lead.

In a controlled study, the following four bipolar leads with passive fixation were implanted in 46 patients with the Siemens-Multilog-VVI or Sensolog-VVIR-pacemakers: membrane covered activated porous carbon with steroid elution (Siemens 1402 T, 11 patients) and without (Siemens 1403 T, 15 patients); activated carbon (Siemens 1010 T, 10 patients); and platinum with steroid elution (Medtronic Cap-Sure 5026, 10 patients). Stimulation threshold (STH) (assessed by a vario-test), impedance (IMP), and the intracardial R wave potential (IRW) (both gauged by a telemetric method) were measured 1, 5, and 10 days as well as 3 and 6 months after implantation during unipolar and bipolar stimulation, chronaxie rheobase product (CRP) and energy consumption (EC) were systematically determined. Differing insignificantly at the first day after implantation, STH is significantly lower for the 1402 T and CapSure 5026 leads at the tenth day. However, the 1402 T lead shows a significant increase of STH in the follow-up, in contrast to the other leads. The lowest chronic STH was found in the CapSure 5026 lead (CRP is significantly lower in all other leads, too). IMP is significantly lower in the CapSure 5026 lead compared to 1010 T lead. EC does not differ significantly during chronic stimulation in spite of the best possible programming of pulse amplitude and duration. No significant changes of IRW were observed. Unipolar versus bipolar stimulation shows significantly lower STH, CRP, and IMP, differences of EC and IRW were insignificant. In conclusion, the addition of steroid in membrane covered carbon leads protracts the increase of STH, but does not prevent it. The CapSure 5026 lead shows advantageous stimulation characteristics, but energy consumption is not significantly reduced because of low impedance and impossibility of programming an appropriate low output in Multilog pacemakers.

Aged↗
PubMed2006

Multilevel assessment of determinants of dental caries experience in Brazil.

OBJECTIVE: To examine contextual and individual determinants of dental caries experience, documenting levels of the disease in Brazil. METHODS: The dental status of 34 550 12-year-old schoolchildren was informed by a country-wide survey of oral health comprising 250 towns and performed in 2002-2003. Indices assessing dental caries experience were compared by sociodemographic characteristics of examined children (gender, ethnic group, localization and type of school), and geographic characteristics of participating towns [the human development index (HDI), and access to fluoridated tap water]. A multilevel model fitted the adjustment of untreated caries to individual and contextual covariates. RESULTS: Better-off Brazilian regions presented an improved profile of dental health, besides having a less unequal distribution of restorative dental treatments between blacks and whites, rural and urban areas, and public and private schools. Girls [odds ratio (OR)=1.1; 95% confidence interval (CI): 1.0-1.1], blacks (OR=1.6; 95% CI: 1.5-1.7), and children studying in rural areas (OR=1.9; 95% CI: 1.7-2.0) and public schools (OR=1.7; 95% CI: 1.6-1.9) presented higher odds of having untreated decayed teeth. The multilevel model identified the fluoride status of tap water (beta=-0.3), the proportion of households linked to the water network (beta=-0.3), and the HDI (beta=-0.2), as town-level variables associated with caries levels. CONCLUSION: Dental caries experience is prone to sociodemographic and geographic inequalities. The monitoring of contrasts in dental health outcomes is relevant for programming socially appropriate interventions aimed both at overall improvements and at the targeting of resources for groups of population presenting higher levels of needs.

Black People↗
PubMed1980

Psychosocial assessment of the handicapped.

Assessment of the child with a handicap is in a state of flux due to new constraints regarding the use of tests which label and shunt children into restrictive environments. The process of identifying and assessing youngsters is a time-consuming and costly process, particulary when what we call "standard practices" are employed. The present flux may, in fact, permit a careful re-evaluation of the role of individualized assessment resulting in positive changes. The trend of the future suggests a shift to a more comprehensive framework for assessment, one that takes into account the behavior of the environment and its influences upon the individual. Assessors will have to be trained to understand and use these methods, particularly as they contribute to the development of educationally relevant data and more appropriate educational programs for handicapped youngsters. Health workers have an important role to play in this shift, for many of them will recognize that, because of economic and practical constraints, a public health orientation may be important and necessary as we seek to provide a free, publicly supported education to all handicapped children and youth.

Affective Symptoms↗
PubMed1980

Adapted physical education--perspective on systematic implementation.

Much has been written concerning special education legislation and resulting efforts to initiate appropriate educational programs within established guidelines. One of the specific curriculum areas which has been significantly affected is physical education. This article attempts to clarify the new perspective in which physical education is viewed within the educational process of the handicapped child. The role which health-related personnel can play in that process is concurrently discussed.

Child↗
PubMed1994

Understanding ethnicity, identity formation, and risk behavior among adolescents of Mexican descent.

The population of adolescents of Mexican descent is growing rapidly in the United States. However, the health needs of this group are not being adequately addressed by the health care system. Understanding the factors contributing to risk behavior in adolescents of Mexican descent may help improve service delivery and use. This article presents a sociodemographic profile of this group as well as a description of how one's degree of ethnic identification, acculturation, and other risk factors may contribute to problem behavior. Recommendations are provided to increase culturally appropriate prevention programs for youth of Mexican descent.

Acculturation↗
PubMed1991

The Minnesota Heart Health Program. Education for youth and parents.

Within the Minnesota Heart Health Program, all schools have participated in these programs and most have been incorporated as part of the regular school curriculum. The involvement of parents in youth programs has been challenging, but we view it as essential to making significant changes. Further, a program with appropriate underlying behavioral theory and community involvement can be successful. Such efforts seem critical to primary prevention of cardiovascular disease risk and subsequent disease in a culture where these diseases are common.

Adolescent↗
PubMed1993

Controlled studies of multivitamin supplementation on pregnancy outcomes.

The Hungarian Family Planning Program includes a randomized prospective blind study of periconceptional multivitamin and trace element supplementation to test the efficacy of this treatment in the reduction of the first occurrence of neural tube defect. This program is appropriate for the evaluation of pregnancy outcomes in general. Periconceptional multivitamin supplementation had no beneficial effect on fetal death, that is, chemical and ectopic pregnancies, missed miscarriages, miscarriages, and stillbirths. The proportion of low birth weight (5.8%) was higher in the combined vitamin I-II sample than in the combined trace element I-II sample (4.3%), but it was explained by a higher rate of multiple births in the vitamin sample. The estimated rate of monozygotic twins was higher after periconceptional multivitamin supplementation. The number of informative pregnancies using vitamin and trace elements was 2104 and 2052, respectively. The rate of cases with congenital abnormality was significantly higher in the total trace element sample (22.4 per 1000) than in the total vitamin sample (13.3 per 1000).

Adult↗
PubMed2003

Toward an MRI-based method to measure non-uniform cartilage deformation: an MRI-cyclic loading apparatus system and steady-state cyclic displacement of articular cartilage under compressive loading.

Recent magnetic resonance imaging (MRI) techniques have shown potential for measuring non-uniform deformations throughout the volume (i.e. three-dimensional (3D) deformations) in small orthopedic tissues such as articular cartilage. However, to analyze cartilage deformation using MRI techniques, a system is required which can construct images from multiple acquisitions of MRI signals from the cartilage in both the underformed and deformed states. The objectives of the work reported in this article were to 1) design an apparatus that could apply highly repeatable cyclic compressive loads of 400 N and operate in the bore of an MRI scanner, 2) demonstrate that the apparatus and MRI scanner can be successfully integrated to observe 3D deformations in a phantom material, 3) use the apparatus to determine the load cycle necessary to achieve a steady-state deformation response in normal bovine articular cartilage samples using a flat-surfaced and nonporous indentor in unconfined compression. Composed of electronic and pneumatic components, the apparatus regulated pressure to a double-acting pneumatic cylinder so that (1) load-controlled compression cycles were applied to cartilage samples immersed in a saline bath, (2) loading and recovery periods within a cycle varied in time duration, and (3) load magnitude varied so that the stress applied to cartilage samples was within typical physiological ranges. In addition the apparatus allowed gating for MR image acquisition, and operation within the bore of an MRI scanner without creating image artifacts. The apparatus demonstrated high repeatability in load application with a standard deviation of 1.8% of the mean 400 N load applied. When the apparatus was integrated with an MRI scanner programmed with appropriate pulse sequences, images of a phantom material in both the underformed and deformed states were constructed by assembling data acquired through multiple signal acquisitions. Additionally, the number of cycles to reach a steady-state response in normal bovine articular cartilage was 49 for a total cycle duration of 5 seconds, but decreased to 33 and 27 for increasing total cycle durations of 10 and 15 seconds, respectively. Once the steady-state response was achieved, 95% of all displacements were within +/- 7.42 microns of the mean displacement, indicating that the displacement response to the cyclic loads was highly repeatable. With this performance, the MRI-loading apparatus system meets the requirements to create images of articular cartilage from which 3D deformation can be determined.

Adaptation, Physiological↗