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At least 973 records · Page 54Linked to original sources
PubMed2002

Electrocardiographic electrodes provide the same results as expensive special sensors in the routine monitoring of anesthetic depth.

UNLABELLED: The Bispectral Index (BIS) is a mathematically derived electroencephalographic (EEG) derivative that has been introduced to monitor depth of anesthesia (1,2). The A-2000 BIS monitoring system (Aspect Medical Systems, Inc., Newton, MA) is currently the only commercially available system to monitor depth of anesthesia. In several studies, its propensity to optimize the use of hypnotics to maintain and achieve a certain depth of anesthesia has been described (3,4). Some studies have even proposed that the routine use of the monitoring system can decrease awareness (1,5), an increasing factor in malpractice claims. The cost-benefit calculations for BIS monitoring suffer from the fact that like its predecessor, the 1000-A BIS monitor, the A-2000 BIS monitoring system demands the use of expensive, special electrodes (6). Although the application of the single-use BIS sensor is very comfortable and easy to use, its high price of approximately $10-20 US prevents many anesthesiologists from using it. Furthermore, whereas the former model of the monitor (1000-A BIS monitor; Aspect Medical Systems, Inc.) used standardized connectors, which allowed the use of other electrodes such as electrocardiogram (ECG), the new monitoring system makes this very difficult because of special connectors that match the equivalent connector at the proximal BIS sensor site. The purpose of this prospective study was to compare BIS values derived from the original BIS sensor with BIS values derived from commercially available ECG electrodes. This comparison was made possible by designing and manufacturing a connector allowing the use of ECG electrodes. IMPLICATIONS: The Bispectral Index (BIS) monitor adequately monitors depth of anesthesia. The routine use of this monitor has been hampered by the benefit-cost equation because only special expensive electrodes can be used. We examined the agreement of BIS values obtained by original sensor electrodes and commercial electrocardiogram (ECG) electrodes. These ECG electrodes can replace more expensive BIS sensors.

Anesthesia, General↗
PubMed1997

Inflammation and specialized intestinal metaplasia of cardiac mucosa is a manifestation of gastroesophageal reflux disease.

OBJECTIVE: The purpose of the study was to test the hypothesis that cardiac mucosa, carditis, and specialized intestinal metaplasia at an endoscopically normal-appearing cardia are manifestations of gastroesophageal reflux disease. SUMMARY BACKGROUND DATA: In the absence of esophageal mucosal injury, the diagnosis of gastroesophageal reflux disease currently rests on 24-hour pH monitoring. Histologic examination of the esophagus is not useful. The recent identification of specialized intestinal metaplasia at the cardia, along with the observation that it occurs in inflamed cardiac mucosa, led the authors to focus on the type and condition of the mucosa at the gastroesophageal junction and its relation to gastroesophageal reflux disease. METHODS: Three hundred thirty-four consecutive patients with symptoms of foregut disease, no evidence of columnar-lined esophagus, and no history of gastric or esophageal surgery were evaluated by 1) endoscopic biopsies above, at, and below the gastroesophageal junction; 2) esophageal motility; and 3) 24-hour esophageal pH monitoring. The patients were divided into groups depending on the histologic presence of cardiac epithelium with and without inflammation or associated intestinal metaplasia. Markers of gastroesophageal reflux disease were compared between groups (i.e., lower esophageal sphincter characteristics, esophageal acid exposure, the presence of endoscopic erosive esophagitis, and hiatal hernia). RESULTS: When cardiac epithelium was found, it was inflamed in 96% of the patients. The presence of cardiac epithelium and carditis was associated with deterioration of lower esophageal sphincter characteristics and increased esophageal acid exposure. Esophagitis occurred more commonly in patients with carditis whose sphincter, on manometry, was structurally defective. Specialized intestinal metaplasia at the cardia was only seen in inflamed cardiac mucosa, and its prevalence increased both with increasing acid exposure and with the presence of esophagitis. CONCLUSION: The findings of cardiac mucosa, carditis, and intestinal metaplasia in an endoscopically normal-appearing gastroesophageal junction are histologic indicators of gastroesophageal reflux disease. These findings may be among the earliest signs of gastroesophageal reflux and contribute to the authors understanding of the pathophysiology of the disease process.

Adolescent↗
PubMedDate not supplied

Barriers to addressing patient sexuality concerns across five areas of specialization.

PURPOSE AND OBJECTIVES: The aim of this study was to examine the barriers to addressing patient sexuality across areas of specialization. DESIGN: A descriptive correlational design was used in this study. SAMPLE AND SETTING: A convenience sample of nurses (N = 302) was recruited from a large Midwestern medical center. METHOD: In this study, a survey using the Sexuality Attitudes and Beliefs Survey and a demographic questionnaire was conducted. FINDINGS: The number one barrier to addressing patient sexuality concerns across all areas of specialization was the nurses' perceptions that patients do not expect nurses to address their sexuality concerns. Other high-ranking barriers included a lack of comfort and confidence in addressing sexuality and failure to make time to discuss patient sexuality concerns. IMPLICATIONS FOR PRACTICE: Educational programs with both general and specific content are needed to help nurses across areas of specialization overcome barriers to addressing patient sexuality concerns. In addition, clinical nurse specialists are challenged to think of ways in which their practice competencies might be used creatively to overcome barriers to addressing patient sexuality concerns and promote the sexual health of individuals and groups. CONCLUSIONS: Further research is needed to determine whether the assumption that patients do not expect nurses to address sexuality concerns matches the reality of patients' expectations.

Adult↗
PubMed1990

Integrated Broadband Communication (IBC) requirements of people with special needs.

In order to make the benefits of the Integrated Broadband Communication (IBC) services available to the largest possible part of the population, special attention should be given to user groups with special needs, such as elderly and handicapped people. For some of these groups the IBC services will facilitate their members socio-economic integration and offer them the opportunity to satisfy some of their everyday needs (e.g. video-telephony for the inter-personal communication of hearing impaired people). For some other categories (e.g. people with motor or sensory impairment), special design considerations are needed at a very early stage of technical development, in order to ensure that they are not prevented from using future sophisticated telecommunication services (e.g. by incorporating appropriate man-machine interaction techniques in general purpose terminals, adapting the user interface of terminals, etc.). This paper gives an overview of the work that is currently taking place within the framework of the Research and development on Advanced Communication in Europe (RACE) programme.

Communication Devices for People with Disabilities↗
PubMed1995

Children from homeless families describe what is special in their lives.

The purpose of this study was to understand what homeless children regard as special. Jean Watson's conceptualization of human care was the orienting framework used in the development and construction of the study. Twelve children between the ages of 6 and 12 years, living at a public shelter, were the participants. The children were given cameras and asked to take photographs of anything that was special to them. Their descriptions of their photographs were analyzed using Moustakas' heuristic method. Important themes derived from qualitative interviews with the children included having fun, being with special people, feeling cared for, and always being there.

Child↗
PubMed1997

Cardiac surgery in special populations, Part 1: Octogenarians, patients with neuropsychiatric disorders, and blacks.

This is the first of a series of articles that discusses the pertinent issues involved in caring for patients undergoing surgery who belong to special populations. Octogenarians have higher mortality, more comorbidities, and special needs regarding convalescence. Patients with neuropsychiatric disorders may have exacerbations of their mental illness after surgery and require special care and patience by the nurse. Survival after cardiac surgery is similar in black and white patients, but the number of blacks having cardiac surgery is significantly and proportionately lower than whites, suggesting either a referral bias or a problem with access to care. Subsequent articles discuss cardiac surgery in women, during pregnancy, in Jehovah's Witnesses, and in patients with Down's Syndrome.

Aged↗
PubMed2002

Is immunostaining for Helicobacter pylori superior to the special stain thiazine in detecting small numbers of H. pylori in gastric biopsies?

Helicobacter pylori is implicated in the pathogenesis of gastritis and duodenal ulcers, gastric lymphoma of the mucosa-associated lymphoid tissue (MALT) type, and gastric adenocarcinoma. Eradication of H. pylori with antibiotic therapy therefore is essential, not only for the successful treatment of active gastritis, but also for the treatment and prevention of the MALT lymphoma. It has been suggested recently that immunostaining for H. pylori is more sensitive than special stains for the detection of the organism in the gastric biopsies after triple therapy. Fifty-five endoscopic mucosal biopsies from 38 patients, including 18 treated with H. pylori eradication therapy, were selected for immunostaining because they were either negative or contained rare H. pylori organisms by thiazine stain. Formalin-fixed, paraffin-embedded tissue sections were immunostained for H. pylori using a polyclonal antibody using standard immunoperoxidase technique. The results were compared with those obtained with the thiazine stain. Detection of H. pylori by immunostaining was easier and less time-consuming than by thiazine stain. There was complete agreement between immunostaining and thiazine stain in 48 (87%) cases. Of the 7 discordant cases, 3 (42%) were positive for H. pylori with thiazine only and 4 (48%) with immunostaining only. Given the nature of the selection of the study sample (absent to rare by thiazine stain), the discordance most likely represents a sampling error. The authors concluded that immunostaining for H. pylori did not appear to be more sensitive than special stains. Three cases with bacterial clumps were diagnosed previously as positive for H. pylori, but identified correctly as negative using both staining methods. Pathologists, however, should balance the added cost to patients of immunostaining against the time saved by the easier screening of the immunostained slides and the possibility of false positive results when special stains are interpreted by inexperienced pathologists.

Biopsy↗
PubMed2006

The use of routine special stains for upper gastrointestinal biopsies.

Helicobacter pylori and intestinal metaplasia (IM) are readily seen in hematoxylin and eosin-stained slides of gastric and/or esophageal biopsies, yet many pathology laboratories perform routine special stains on all of these biopsies. We wished to determine if special stains are necessary for every single gastric and/or esophageal biopsy. We prospectively studied 613 gastric and/or esophageal biopsies from 494 consecutive patients. The slides were stained with hematoxylin and eosin, toluidine blue (TB) for H. pylori, and Alcian blue (AB) for IM. The hematoxylin and eosin slide was classed as positive or negative for H. pylori and IM. Then it was determined if the case needed a TB or AB stain. A total of 436 cases (71.1%) were identified as H. pylori-negative and not needing a TB stain, and none was TB+. A total of 126 (20.6%) of hematoxylin and eosin slides were inconclusive for H. pylori and were regarded as needing a TB stain. Twenty of these (15.9%) were TB+. Fifty-one biopsies (8.3%) were regarded as H. pylori+ on hematoxylin and eosin; the TB stain was also positive in 49. IM was present in 113 (18.4%) hematoxylin and eosin biopsies. Hematoxylin and eosin slides were IM-negative in 498 cases (81.2%). The AB stain revealed rare goblet cells in 3 of 498 cases (0.6%). Only one of those biopsies was esophageal, and that had one goblet cell that was missed on hematoxylin and eosin. Only 2 (0.3%) were regarded as needing an AB stain. We conclude that routine special stains for all gastric and/or esophageal biopsies are not required, and hematoxylin and eosin assessment combined with selective ordering of these stains will identify virtually all cases of H. pylori gastritis and intestinal metaplasia.

Alcian Blue↗
PubMed2006

Human primary motor cortex shows hemispheric specialization for speech.

Hemispheric specialization is a prominent characteristic of the human brain. Should the 'dominant' hemisphere possess differential neural organization for language production in the 'higher order' cortex, it would be rational to consider that the primary motor cortex may also show similar hemispheric specialization for speech production. In order to test this hypothesis, we investigated the spatial distribution of neural activities associated with phonation (M1p), silent tongue motion (M1t), and vocalization (M1v) within the primary motor cortex, utilizing independent component-cross correlation-sequential epoch analysis of high-field functional magnetic resonance imaging time series. While M1t showed no significant differences between the two hemispheres, M1p and M1v exhibited significant hemispheric differences. The study demonstrated direct evidence that human primary motor cortex possesses clear-cut hemispheric specialization similar to that observed for the higher order cortices.

Adult↗
PubMed2003

Growth trades off with habitat specialization.

How differences in niche breadth evolve and are maintained remains largely unknown. The 'jack of all trades is master of none' model of resource specialization has been widely considered, but, to our knowledge, never before supported empirically. It invokes performance trade-offs associated with specialization. Specialists should outperform generalists on a subset of resources, but be unable to maintain high performance over a broader range of resources. By contrast, generalists should perform less well, on average, using a greater diversity of resources. We report such trade-offs among four coral goby species in the wild. Habitat specialists grew faster than generalists in one of two habitats. Average growth rates of generalists were less than that of specialists, but more consistent between habitats. Performance trade-offs associated with resource specialization could influence the evolution and maintenance of narrow niche breadth.

Adaptation, Biological↗
PubMed2005

A falsification of the thermal specialization paradigm: compensation for elevated temperatures in Antarctic fishes.

Specialization to a particular environment is one of the main factors used to explain species distributions. Antarctic fishes are often cited as a classic example to illustrate the specialization process and are regarded as the archetypal stenotherms. Here we show that the Antarctic fish Pagothenia borchgrevinki has retained the capacity to compensate for chronic temperature change. By displaying astounding plasticity in cardiovascular response and metabolic control, the fishes maintained locomotory performance at elevated temperatures. Our falsification of the specialization paradigm indicates that the effect of climate change on species distribution and extinction may be overestimated by current models of global warming.

Adaptation, Physiological↗
PubMed1993

Comparative evidence indicating neural specialization for predatory behaviour in mammals.

The evolution of cognitive and sensory specializations must involve concomitant modifications of neural substrates. Ecological correlates of species differences in brain structure are intriguing sources of evidence about such evolutionary specialization but, to date, these have been identified only for gross parameters, such as overall brain size and the size of major brain regions. Here we show that a behavioural specialization in mammals, predation, is associated with species differences in the fine structure of a single neural pathway, the tectospinal tract. Both the relative number of neurons in this pathway and the relative size of their cell bodies were greater in more predatory species than in their less predatory counterparts within each of four separate mammalian orders. Expansion of these analyses to consider comparisons between taxa at a variety of taxonomic levels gave further support to the idea of a relation between predatory habits and the evolution of the tectospinal tract. In addition, within the primates, the number of neurons in the tectospinal tract was significantly correlated with the proportion of prey in the diet. These results therefore appear to provide an example of correlated evolution between a specific neural system and behaviour which applies generally within the mammals. They also help to unify findings from physiological and anatomical studies on a wider range of vertebrate taxa, including reptiles and amphibians.

Adaptation, Physiological↗
PubMed1998

Visual specialization and brain evolution in primates.

Several theories have been proposed to explain the evolution of species differences in brain size, but no consensus has emerged. One unresolved question is whether brain size differences are a result of neural specializations or of biological constraints affecting the whole brain. Here I show that, among primates, brain size variation is associated with visual specialization. Primates with large brains for their body size have relatively expanded visual brain areas, including the primary visual cortex and lateral geniculate nucleus. Within the visual system, it is, in particular, one functionally specialized pathway upon which selection has acted: evolutionary changes in the number of neurons in parvocellular, but not magnocellular, layers of the lateral geniculate nucleus are correlated with changes in both brain size and ecological variables (diet and social group size). Given the known functions of the parvocellular pathway, these results suggest that the relatively large brains of frugivorous species are products of selection on the ability to perceive and select fruits using specific visual cues such as colour. The separate correlation between group size and visual brain evolution, on the other hand, may indicate the visual basis of social information processing in the primate brain.

Animals↗
PubMed2000

Origins and ecological consequences of pollen specialization among desert bees.

An understanding of the evolutionary origins of insect foraging specialization is often hindered by a poor biogeographical and palaeoecological record. The historical biogeography (20,000 years before present to the present) of the desert-limited plant, creosote bush (Larrea tridentata), is remarkably complete. This history coupled with the distribution pattern of its bee fauna suggests pollen specialization for creosote bush pollen has evolved repeatedly among bees in the Lower Sonoran and Mojave deserts. In these highly xeric, floristically depauperate environments, species of specialist bees surpass generalist bees in diversity, biomass and abundance. The ability of specialist bees to facultatively remain in diapause through resource-poor years and to emerge synchronously with host plant bloom in resource-rich years probably explains their ecological dominance and persistence in these areas. Repeated origins of pollen specialization to one host plant where bloom occurs least predictably is a counter-example to prevailing theories that postulate such traits originate where the plant grows best and blooms most reliably Host-plant synchronization, a paucity of alternative floral hosts, or flowering attributes of creosote bush alone or in concert may account for the diversity of bee specialists that depend on this plant instead of nutritional factors or chemical coevolution between floral rewards and the pollinators they have evolved to attract.

Animals↗
PubMed2003

Specialized cheating of the ectomycorrhizal symbiosis by an epiparasitic liverwort.

Many non-photosynthetic vascular plants in 10 diverse families obtain all of their carbon from fungi, but in most cases the fungi and the ultimate sources of carbon are unknown. In a few cases, such plants have been shown to be epiparasitic because they obtain carbon from neighbouring green plants through shared mycorrhizal fungi. In all such cases, the epiparasitic plants have been found to specialize upon narrow lineages of ecto- or arbuscular mycorrhizal fungi. Here we show that a non-vascular plant, the non-photosynthetic liverwort Cryptothallus mirabilis, is epiparasitic and is specialized on Tulasnella species that form ectomycorrhizae with surrounding trees at four locations in England, France and Portugal. By using microcosm experiments we show that the interaction with Tulasnella is necessary for growth of Cryptothallus, and by using labelling experiments we show that (14)CO(2) provided to birch seedlings is transferred to Cryptothallus by Tulasnella. This is one of the first documented cases of epiparasitism by a non-vascular plant and of ectomycorrhizal formation by Tulasnella. These results broaden the emerging association between epiparasitism and mycorrhizal specialization into a new class of plants and a new order of fungi.

Carbon↗
PubMed2004

Exploiting a mutualism: parasite specialization on cultivars within the fungus-growing ant symbiosis.

Fungus-growing ants, their cultivated fungi and the cultivar-attacking parasite Escovopsis coevolve as a complex community. Higher-level phylogenetic congruence of the symbionts suggests specialized long-term associations of host-parasite clades but reveals little about parasite specificity at finer scales of species-species and genotype-genotype interactions. By coupling sequence and amplified fragment length polymorphism genotyping analyses with experimental evidence, we examine (i) the host specificity of Escovopsis strains infecting colonies of three closely related ant species in the genus Cyphomyrmex, and (ii) potential mechanisms constraining the Escovopsis host range. Incongruence of cultivar and ant relationships across the three focal Cyphomyrmex spp. allows us to test whether Escovopsis strains track their cultivar or the ant hosts. Phylogenetic analyses demonstrate that the Escovopsis phylogeny matches the cultivar phylogeny but not the ant phylogeny, indicating that the parasites are cultivar specific. Cross-infection experiments establish that ant gardens can be infected by parasite strains with which they are not typically associated in the field, but that infection is more likely when gardens are inoculated with their typical parasite strains. Thus, Escovopsis specialization is shaped by the parasite's ability to overcome only a narrow range of garden-specific defences, but specialization is probably additionally constrained by ecological factors, including the other symbionts (i.e. ants and their antibiotic-producing bacteria) within the coevolved fungus-growing ant symbiosis.

Analysis of Variance↗
PubMed2005

Caste evolution and ecology: a special worker for novel prey.

Individual specialization underpins the division of labour within ant societies, but only in a small minority do morphological specialists, or physical castes, exist in the workforce. The genetic conditions that allow such castes to evolve are well understood, but the ecological pressures that select for them are not. We provide compelling evidence that the task of transporting novel prey selected for an exaggerated transport caste, or 'submajor', in the army ant Eciton burchellii. This species is the only Eciton that preys upon large arthropods as well as ants, the ancestral prey type, and by comparing load-transport among Eciton species and within E. burchellii, we show that this mixed diet significantly constrains transport efficiency. Crucially, however, we also show that E. burchellii submajors are highly specialized on transporting non-ant prey, and we demonstrate experientially that it is specifically this prey type that constrains prey-transport efficiency. Our study also suggests that phylogenetic constraints associated with the Eciton lifestyle intensified selection for the exaggerated submajor of E. burchellii. Thus, we propose that a novel task may only select for a special caste when phylogenetic constraints preclude the evolution of alternative solutions. This identifies a new and potentially general scenario for the evolution of physical castes.

Analysis of Variance↗
PubMed2006

Asymmetries in specialization in ant-plant mutualistic networks.

Mutualistic networks involving plants and their pollinators or frugivores have been shown recently to exhibit a particular asymmetrical organization of interactions among species called nestedness: a core of reciprocal generalists accompanied by specialist species that interact almost exclusively with generalists. This structure contrasts with compartmentalized assemblage structures that have been verified in antagonistic food webs. Here we evaluated whether nestedness is a property of another type of mutualism-the interactions between ants and extrafloral nectary-bearing plants--and whether species richness may lead to differences in degree of nestedness among biological communities. We investigated network structure in four communities in Mexico. Nested patterns in ant-plant networks were very similar to those previously reported for pollination and frugivore systems, indicating that this form of asymmetry in specialization is a common feature of mutualisms between free-living species, but not always present in species-poor systems. Other ecological factors also appeared to contribute to the nested asymmetry in specialization, because some assemblages showed more extreme asymmetry than others even when species richness was held constant. Our results support a promising approach for the development of multispecies coevolutionary theory, leading to the idea that specialization may coevolve in different but simple ways in antagonistic and mutualistic assemblages.

Adaptation, Physiological↗