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Biomedical subjects

C Forrest

Publications and source records attributed to C Forrest.

At least 19 recordsLinked to original sources
PubMed2001

Elementary school-aged children's reports of their health: a cognitive interviewing study.

There are no standard methods for assessing the quality of young children's perceptions of their health and well-being and their ability to comprehend the tasks involved in reporting their health. This research involved three cross-sectional studies using cognitive interviews of 5-11-year-old children (N = 114) to determine their ability to respond to various presentations of pictorially illustrated questions about their health. The samples had a predominance of children in the 5-7-year-old range and families of lower and middle socio-economic status. The research questions in Study 1 involved children's ability to convert their health experiences into scaled responses and relate them to illustrated items (n = 35); Study 2 focused on the type of response format most effectively used by children (n = 19); and Study 3 involved testing children's understanding of health-related terms and use of a specific recall period (n = 60). The results of Study 1 showed that children identified with the cartoon drawing of a child depicted in the illustrated items, typically responding that the child was at or near their own age and of the same gender, with no differences related to race. Study 2 results indicated that children responded effectively to circles of graduated sizes to indicate their response and preferred them to same-size circles or a visual analogue scale. Tests of three-, four-, and five-point response formats demonstrated that children could use them all without confusion. In Study 3, expected age-related differences in understanding were obtained. In fact, the 5-year-old children were unable to understand a sufficient number of items to adequately describe their health. Virtually all children 8 years of age and older were able to fully understand the key terms and presentation of items, used the full five-point range of response options, and accurately used a 4-week recall period. Six- and seven-year-olds were more likely than older children to use only the extreme and middle responses on a five-point scale. No pattern of gender differences in understanding or in use of response options was found. We conclude that children as young as eight are able to report on all aspects of their health experiences and can use a five-point response format. Children aged 6-7 had difficulty with some health-related terms and tended to use extreme responses, but they understood the basic task requirements and were able to report on their health experiences. These results provide the guidance needed to develop and test a pediatric health status questionnaire for children 6-11 years old.

Analysis of Variance↗
PubMed2000

Diagnosis and treatment of erectile dysfunction: the process of care model.

The new era of erectile dysfunction (ED) medicine ushered in by the availability of an effective and safe oral medication paves the way toward managing ED in a primary care setting. The Process of Care Model for the Evaluation and Treatment of Erectile Dysfunction was developed to advance new guidelines for the diagnosis and management of ED. This paper discusses these guidelines.

Erectile Dysfunction↗
PubMed1999

2-Tetradecylglycidic acid, an inhibitor of carnitine palmitoyltransferase-1, induces myocardial hypertrophy via the AT1 receptor.

Activation of the antiogensin II, type 1 (AT1) receptor mediates the myocardial response to numerous hypertrophic stimuli. This study tested the hypothesis that 2-tetradecylglycidic acid (TDGA), an oxirane carboxylate inhibitor of mitochondrial carnitine plamitoyltransferase-1, induces myocardial hypertrophy via the AT1 receptor system. Male Sprague-Dawley rats treated with 10 mg TDGA/kg/day for 7 days had a heart wet weight:body weight ratio of 3. 58+/-0.16 mg/g compared with a ratio of 2.79+/-0.07 for rats treated with vehicle (P<0.05). The plasma level of antiogensin II was 117. 75+/-17.39 pg/ml in rats treated with 10 mg TDGA/kg/day compared with 54.0+/-11.38 pg/ml for rats treated with vehicle (P<0.05). The plasma level of angiotensin I in these two groups of rats was not different statistically. Rats treated with TDGA and given drinking water containing 1 mg losartan/ml had a heart wet weight:body weight ratio of 2.84+/-0.05 mg/g. This value was not statistically different from the value measured in rats given drinking water containing 1 mg losartan/ml and treated with vehicle alone. No significant difference in the heart wet weight:dry weight ratio occurred among these groups of rats. Finally, treating rats with TDGA or giving rats drinking water that contained 1 mg losartan/ml altered neither their heart rate nor their mean arterial blood pressure when compared with untreated rats. This data, therefore, suggests that oxirane carboxylates induce myocardial hypertrophy by activating the AT1 receptor independent of changes in systemic hemodynamics.

Animals↗
PubMed1997

Comparison of secondary ischemic tolerance between pedicled and free island buttock skin flaps in the pig.

We compared the secondary ischemic tolerance of 8 x 12 cm surgically denervated pedicled island skin flaps and skin free flaps raised contralaterally on the buttocks of 50 pigs. The pedicled flaps and free flaps were subjected to 2 hours of primary warm global ischemia followed by 12 hours of reperfusion and 0, 2, 4, 6, or 10 hours of secondary warm global ischemia (n = 10 flaps). Skin necrosis was assessed 7 days after secondary ischemia. Pedicled skin flaps tolerated up to 10 hours of secondary ischemia without skin necrosis. However, incidences of skin necrosis (partial and total) in free flaps subjected to 0, 2, 4, 6, or 10 hours of secondary ischemia were 0, 10, 50, 80, and 100 percent, respectively. In a separate experiment, skin blood flow and hematology were studied in contralateral pedicled flaps and free flaps (n = 20) subjected to 4 hours of secondary ischemia. The skin blood flow measured by 15-micron microspheres at 1.5 hours of reperfusion was significantly higher (p < 0.01, n = 20) in pedicled skin flaps than in skin free flaps (1.91 +/- 0.35 versus 0.67 +/- 0.53 ml/min/100 gm). Under an operating microscope, microthrombi were observed near the arterial and/or venous anastomoses in 8 of 20 skin free flaps but none in the pedicled skin flaps. We obtained venous blood samples by cannulation of the major venae comitantes in 12 of the 20 skin free flaps in which there was no thrombosis in the vascular pedicle for hematologic studies. The venous plasma level of thromboxane B2 was significantly higher (p < 0.05) in the skin free flaps than in their contralateral pedicled skin flaps (195 +/- 49 versus 124 +/- 30 pg/ml). In addition, venous hematocrit, hemoglobin concentration, and white blood cell count also were significantly (p < 0.05) higher in skin free flaps compared with their contralateral pedicled skin flaps. Taken together, these observations were interpreted to indicate that buttock skin free flaps in the pig were less tolerant of secondary ischemia compared with their contralateral pedicled skin flaps subjected to the same ischemic protocol, and this reduced ischemic tolerance in skin free flaps was associated with compromised skin blood flow, hemoconcentration, and thrombosis in the vascular pedicle.

Animals↗
PubMed1995

Transport of the critically ill patient: an example of an integrated model.

AIMS: To demonstrate a model for the transport of critically ill patients between hospitals, and the aiding of primary emergency responses (A-Zeros). METHOD: A review of a model based on Waikato Hospital is carried out. RESULTS: Categories of transport, modes of transport, standards, and the funding model are described. The total Waikato experience includes over 2500 patients transported between hospitals and 325 A-Zeros. A detailed analysis of cases between 1988-94 is presented. CONCLUSIONS: The Waikato model has worked well. A formal system needs to be instituted in New Zealand to handle interhospital transport of the critically ill and also to provide medical help at the scene of emergencies based on advanced trauma and intensive care centres.

Adolescent↗
PubMed1992

Preconditioning: a new technique for improved muscle flap survival.

Musculocutaneous regional and distal flaps have become an important tool available to the head and neck surgeon. Vascularized autogenous muscle transplants allow single-stage reconstruction of complex defects. Ischemic muscle necrosis is a well-recognized complication with serious potential morbidity. It has been shown that myocardial muscle is protected from ischemic damage by brief periods of coronary artery occlusion and reperfusion subsequent to prolonged ischemia. This is called preconditioning. To our knowledge, this technique has never been extrapolated to skeletal muscle. This article presents a discussion of preconditioning and the potential benefits of this new technique as a means to enhance skeletal muscle survival to sustained normothermic global ischemia. Theories behind ischemic muscle injury are presented. A review of the development of preconditioning in myocardial muscle is discussed. Experimental models used to investigate this phenomenon are also presented. In addition, results of our laboratory investigations using the latissimus dorsi porcine model are discussed. Preconditioning is a new, nonpharmacologic means to improve muscle flap survival. This simple technique may have great clinical application in reducing ischemic muscle necrosis in regional and distal muscle transplantation.

Animals↗
PubMed1992

Augmentation of skeletal muscle survival in the latissimus dorsi porcine model using acute ischemic preconditioning.

Reconstruction of head and neck defects commonly involve local and distal muscle transplants. Ischemic flap necrosis is a well recognized complication of autogenous muscle transplants. Research in the field of myocardial survival has recently shown that repeated brief periods of ischemia followed by reperfusion result in improve muscle survival when the cardiac muscle is subsequently subjected to prolonged ischemia. This is called preconditioning and the mechanism is unknown. The concept is discussed in this paper and presented as a potential new, non-pharmacological strategy to reduce skeletal muscle ischemic necrosis. A review of the development and application of preconditioning in myocardial muscle survival is presented, and causes of ischemic muscle necrosis are discussed. Potential mechanisms of preconditioning in muscle are also presented. The extrapolation of the concept of preconditioning is discussed with an examination of a potential experimental model to test this concept: the latissimus dorsi flap in the pig. The results of our investigations into the effect of preconditioning on skeletal muscle and its possible mechanism are discussed. Preconditioning may prove to be a useful method to improve skeletal muscle tolerance to sustained normothermic global ischemia. This may have important clinical benefits in muscle transplantation. To our knowledge, this is the first publication to discuss the application of preconditioning in skeletal muscle.

Animals↗
PubMed1980

Prevention of spinal osteoporosis in oophorectomised women.

100 women who had taken part in a prospective controlled trial of oestrogen therapy for prevention of post-oophorectomy bone loss were reviewed after a median follow-up period of nine years. A significant reduction in height occurred among the placebo-treated group, but not in the group treated with mestranol (mean 23 x 3 micrograms/day). The placebo-treated group had a higher spine score, lower central vertebral height, and larger wedge-angle than the oestrogen group. Within each group none of these spinal morphometric changes correlated with changes in mineral content of metacarpal or radial bones as measured by photon absorptiometry or X-ray densitometry, although both peripheral and central measurements showed highly significant differences between groups. Oestrogen treatment, therefore, prevents against central, as well as peripheral, bone loss, and reduces the incidence of vertebral compression.

Body Height↗
PubMed1980

Effect of a natural and artificial menopause on serum, urinary and erythrocyte magnesium.

1. Serum, urinary and erythrocyte magnesium concentrations were measured in groups of premenopausal, postmenopausal and oophorectomized women. 2. Serum and urinary magnesium were both significantly higher in postmenopausal and oophorectomized women than in the premenopausal group. 3. Oestrogen therapy reduced both serum and urinary magnesium values in oophorectomized women to premenopausal concentrations. 4. Erythrocyte magnesium concentrations were not affected by menstrual status or oestrogen therapy.

Castration↗
PubMed1971

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Gastroenterology↗
PubMedDate not supplied

The free vascularised iliac crest tissue transfer: donor site complications associated with eighty-two cases.

Seventy-eight patients who had undergone a total of 82 free vascularised iliac crest tissue transfers were reviewed to determine the incidence of donor site complications. The most frequent problems encountered were early postoperative pain and long term sensory changes. Major complications such as femoral neuropathy and incisional hernia formation were encountered infrequently. More serious potential complications are discussed. In general, the functional loss associated with the free vascularised iliac crest tissue transfer was found to be acceptable, but the inclusion of a skin paddle was noted to be associated with a greater incidence of sensory changes, hernia formation and contour abnormalities.

Adolescent↗