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Biomedical subjects

C Palmer

Publications and source records attributed to C Palmer.

At least 55 records · Page 3Linked to original sources
PubMed1998

Nutrition and oral health guidelines for pregnant women, infants, and children.

Good oral health care and nutrition during pregnancy, infancy, and childhood are essential but often overlooked factors in the growth and development of the teeth and oral cavity. Pregnant women and parents and caregivers of infants and children often receive little guidance about proper preventive dental and oral health care, including fluoride and dietary measures. Pregnant women can maintain their health through proper diet, good oral hygiene, and appropriate use of fluoride. An adequate diet during gestation is important for optimal oral development of the fetus. To promote good oral health in infancy, caregivers need to provide the infant with appropriate amounts of fluoride in addition to a healthful diet. As the teeth erupt into the mouth, the caregiver needs to clean the teeth thoroughly on a daily basis. When solid foods are introduced in later infancy, it is also important to limit the frequency of caries-promoting fermentable carbohydrates between meals. Good oral hygiene habits and dietary practices that emphasize minimum exposure to retentive, fermentable carbohydrates; use of fluoridated water; and a varied, balanced diet should continue throughout childhood to set the stage for optimal oral health for a lifetime.

Child, Preschool↗
PubMed1998

Health-related quality of life assessment in euthymic and depressed patients with bipolar disorder. Psychometric performance of four self-report measures.

The purpose of this study was to evaluate the psychometric properties of selected health-related quality of life (HRQL) self-report measures in 62 euthymic and depressed patients diagnosed with bipolar disorder. Patients completed the Quality of Life in Depression Scale (QLDS), Mental Health Index-17 (MHI-17), Cognitive Function Scale, and Medical Outcomes Study Short Form-36 (SF-36) at baseline and 8 weeks following treatment. Hamilton and Young Rating Scales were used to assess clinical status and validate the HRQL measures. The MHI-17, Cognitive Function Scale, QLDS, and SF-36 social function, vitality, role limitations-emotional, and mental health scales have good reliability and validity, and are responsive to changes in clinical status in patients with bipolar disorder. Although the small sample size limits generalizablity, euthymic and depressed outpatients with bipolar disorder appear to contribute reliable self reports on selected aspects of their quality of life.

Adult↗
PubMed1998

Effect of preeclampsia on mortality, intraventricular hemorrhage, and need for mechanical ventilation in very low-birth-weight infants.

Infants born to mothers with preeclampsia have been shown to have a reduction in intraventricular hemorrhage (IVH). The objective of this article is to investigate the relationship between preeclampsia, IVH, neonatal mortality, mechanical ventilation, and other potential confounding variables such as neutropenia and magnesium sulfate. Methods of research include review of infants <1500 g admitted to a single level III neonatal intensive care unit (NICU), n=356. Infants born to mothers with preeclampsia were compared to those without maternal preeclampsia by univariate and multivariate analysis. Overall, 52 mothers were diagnosed with preeclampsia. After multivariate modeling, preeclampsia was not associated with a decrease in mechanical ventilation (odds ratio 0.5, 95% CI 0.2-1.3), IVH (odds ratio 0.5, 0.1-1.9) or mortality (odds ratio 0.6, 0.2-1.9). In our population, after controlling for multiple confounding variables, including MgSO4, neutropenia and thrombocytopenia, there was no difference in the odds of mortality, IVH, or requirement for mechanical ventilation in infants born to mothers with preeclampsia as compared to infants born to mothers without preeclampsia.

Case-Control Studies↗
PubMed1998

Managing oral health related nutrition issues of high risk infants and children.

Dental professionals are in an ideal position to recognize children at high nutritional and oral health risk and provide early intervention. Some of the children at highest risk for nutritional and oral health problems include those born prematurely, children with failure to thrive, those on multiple medications, special needs children with developmental delays, children with gastroesophageal reflux, and those with lactose intolerance. Nutrition and oral health guidelines are provided to aid the dental practitioner in providing preventive nutrition intervention to these high risk children.

Child↗
PubMed1998

Hospice-at-home.

Explore the source record for details and available documents.

Aged↗
PubMed1997

Monitoring and planning capacities in the acquisition of music performance skills.

We investigate changes in cognitive capacities that occur as musicians acquire performance skills. Previous studies suggest that skilled behaviour is characterized by advanced abilities to monitor one's own performance or to plan upcoming events. We first report a study of child pianists (aged 6-14 years old) of beginning and intermediate skill levels who performed well-learned musical pieces. Computer-detected pitch errors in the performances provided evidence for skill-related increases in both monitoring and planning: Children with more musical training showed quicker detection and correction of errors, more anticipatory and less perseveratory behavior, and larger range of planning than children with less training. Next we report a study of adult musicians' advanced performances, which showed heightened sensitivity to melody and repeated pitch structures. Planning and monitoring capacities increased most during initial stages of musical skill acquisition, whereas sensitivity to musical structure increased across all skill levels.

Adolescent↗
PubMed1997

Association of combined MRI, interictal EEG, and ictal EEG results with outcome and pathology after temporal lobectomy.

PURPOSE: Magnetic resonance imaging, interictal scalp EEG, and ictal scalp EEG each have been shown to localize the primary epileptic region in most patients with mesial-basal temporal lobe epilepsy (MBTLE), but the association of surgical outcome and pathology with each combination of these test results is not known. METHODS: We reviewed the MRI, interictal scalp EEG, and ictal scalp EEG results of 90 consecutive patients with MBTLE. Twelve patients were excluded from the analysis because inconclusive bitemporal intracranial EEG results precluded anterior temporal lobectomy (ATL); none had concordant MRI and interictal scalp EEG results. We compared all combinations of presurgical MRI, interictal EEG, and ictal EEG results to seizure outcome and tissue pathology in the 78 patients who underwent an ATL. RESULTS: Forty-eight (61%) patients had concordant lateralized MRI and interictal EEG temporal lobe abnormalities, with no discordant ictal EEG results; 77% of these patients were seizure-free after ATL. Concordance of MRI and interictal EEG abnormalities correlated with seizure cessation (p < 0.05), compared to all combinations with discordant or nonlateralizing MRI and interictal EEG results. Mesial temporal sclerosis (MTS) was confirmed pathologically in about 80% of both groups (p = 0.5). Outcome in patients with concordant MRI and ictal EEG with nonlateralizing interictal EEG was significantly worse than combinations with concordant MRI and interictal EEG (p < 0.02). CONCLUSIONS: Compared to other combinations of test results, concordance of MRI and interictal EEG is most closely associated with surgical outcome in MBTLE. However, most selected patients have pathologic confirmation of MTS regardless of test results or outcome. This information may be useful for planning the presurgical evaluation of patients with medically intractable MBTLE.

Adolescent↗
PubMed1997

Occipital lobe developmental malformations and epilepsy: clinical spectrum, treatment, and outcome.

PURPOSE: Cortical developmental malformations (CDM) are increasingly recognized in association with epilepsy. We describe 10 patients (age range 14-35 years) with symptomatic occipital lobe epilepsy and CDM. METHODS: Neurologic, neuroophthalmologic and electrophysiologic studies were performed. Patients had MRI, SPECT, and in some cases intracranial EEG investigators. RESULTS: Mean age of seizure onset was 8 years. We noted strong correlations between the presence of visual auras, the scalp EEG pattern, and the subtype of underlying pathology. Magnetic resonance imaging (MRI) showed CDM in all patients, with polymicrogyria and focal dysplasia being the most frequent malformations. Despite the presence of occipital lobe structural malformations in all patients, visual field deficits were present in only 2. Those who underwent cortical resections were seizure-free or showed major improvement at a mean follow-up of 3.5 years. CONCLUSIONS: Intracranial stimulation studies and the low frequency of pre- and postoperative deficits suggest that some degree of cortical visual reorganization may occur in patients with occipital lobe malformations. Occipital lobe CDM should be sought as a cause of symptomatic occipital lobe epilepsy even though they may become symptomatic after childhood.

Adolescent↗
PubMed1997

Identification of a recombination event narrowing the Lafora disease gene region.

Patients affected with progressive myoclonus epilepsy of the Lafora type present during late adolescence with a characteristic EEG pattern and Lafora bodies seen on skin biopsy. The critical region for the Lafora gene has been localised to chromosome 6q24 flanked by the dinucleotide repeat markers D6S292 and D6S420. This study for linkage of markers from the candidate gene region was performed in a previously unpublished family affected with Lafora disease. EEG and skin biopsy evaluation for Lafora bodies were performed on five of eight family members followed for seizure activity. Haplotype and linkage analysis of DNA from five family members were carried out using the nine dinucleotide repeat markers reported in the common region of homozygosity by Serratosa et al in 1995. The present study of an additional family affected by Lafora disease has narrowed the 17 cM critical region for the Lafora disease gene on chromosome 6q24 to a 4 cM region flanked by markers D6S308 and D6S311.

Chromosome Banding↗
PubMed1997

Music performance.

Music performance provides a rich domain for study of both cognitive and motor skills. Empirical research in music performance is summarized, with particular emphasis on factors that contribute to the formation of conceptual interpretations, retrieval from memory of musical structures, and transformation into appropriate motor actions. For example, structural and emotional factors that contribute to performers' conceptual interpretations are considered. Research on the planning of musical sequences for production is reviewed, including hierarchical and associative retrieval influences, style-specific syntactic influences, and constraints on the range of planning. The fine motor control evidenced in music performance is discussed in terms of internal timekeeper models, motor programs, and kinematic models. The perceptual consequences of music performance are highlighted, including the successful communication of interpretations, resolution of structural ambiguities, and concordance with listeners' expectations. Parallels with other domains support the conclusion that music performance is not unique in its underlying cognitive mechanisms.

Attention↗
PubMed1997

The role of neutrophils in the production of hypoxic-ischemic brain injury in the neonatal rat.

Neutrophils contribute to ischemic brain injury in adult animals. The role of neutrophils in perinatal hypoxic-ischemic (HI) brain injury is unknown. Allopurinol reduces neutrophil accumulation after tissue ischemia and is protective against HI brain injury. This study was designed to investigate how neutrophils contribute to perinatal hypoxic ischemic brain injury and how neutropenia compared with allopurinol in its neuroprotective effects. A HI insult was produced in the right cerebral hemisphere of 7-d-old rats by right common carotid artery ligation and systemic hypoxia. Half the rats were rendered neutropenic with an anti-neutrophil serum (ANS). At 15 min of recovery from hypoxia, half the neutropenic and nonneutropenic rats received allopurinol (135 mg/kg, s.c.). The protective effect of the four treatment combinations was determined on brain swelling at 42 h of recovery. Neutropenia reduced brain swelling by about 70%, p < 0.01. Allopurinol alone produced similar protection so that the relatively small number of animals studied did not permit assessment of an additive effect. Neutrophil accumulation in cerebral hemispheres was measured by myeloperoxidase (MPO) activity assay and by neutrophil counts in 6-microm sections stained by MPO and ANS immunostaining. MPO activity peaked between 4 and 8 h of recovery in both hemispheres. Hemispheric neutrophil counts peaked at the end of the HI insult and again at 18 h of recovery. Neutrophils were stained within blood vessels and did not infiltrate the injured brain before infarction had occurred. We conclude that neutrophils contribute to HI brain injury in the neonate and that neutrophil depletion before the insult is neuroprotective.

Allopurinol↗
PubMed1997

Proton spectroscopic imaging at 4.1 tesla in patients with malformations of cortical development and epilepsy.

We used proton magnetic resonance spectroscopic imaging (MRSI) at 4.1 tesla in patients with malformations of cortical development (MCDs) and epilepsy. We compared the spectroscopic results with normative data using 2 SDs (95% confidence) above normal values for detection of significant abnormalities for creatine-N-acetylated compounds (Cr/NA) ratio and choline-N-acetylated compounds (Cho/NA). The results were correlated with clinical, EEG, and histologic findings. Patients with focal cortical dysplasia showed significant metabolic abnormalities in correspondence with the structural lesions, whereas patients with heterotopia and polymicrogyria demonstrated no subcortical MRSI abnormalities. Significant correlations were found between the metabolic abnormalities and the frequency of seizures but not with the degree of interictal EEG discharges. Quantitative neuronal and glial cell counts revealed no statistically significant correlation between cell loss and the abnormal metabolic ratios in those who underwent surgery. These preliminary findings suggest that MRSI-based metabolic abnormalities in patients with MCDs are variable and are likely to be associated with complex cellular mechanisms involving the regulation of NA, total Cr content, and Cho.

Acetylation↗
PubMed1997

Multimodality MRI in mesial temporal sclerosis: relative sensitivity and specificity.

Our objectives were to determine the relative sensitivity and specificity of different MRI sequences and analysis techniques for the detection of mesial temporal sclerosis (MTS). Mesial temporal sclerosis is the most common pathologic finding in patients undergoing temporal lobe epilepsy surgery. Magnetic resonance imaging is the most reliable preoperative imaging technique for the detection of MTS. We analyzed the abnormalities in preoperative MRIs of 44 consecutive patients who had undergone temporal lobectomy and who had pathologic confirmation of MTS. Techniques included inversion recovery (IR); T1-weighted, volume-acquired images; hippocampal T2 relaxometry (HT2); volumetric assessment; and visual analysis. Sensitivity was 86% with IR, 90% with T1-weighted qualitative visual analysis, and 97% with quantitative volumetry. Pathologic prolongation of HT2 (> 2 SD of normal) was present in 79%. Analysis of variance showed statistically significant differences in sensitivity between HT2, volumetric measurements (p < 0.01), and qualitative visual atrophy (p < 0.05). Concordance between all MRI modalities was 68%. Inversion recovery and qualitative analysis lateralized the side of surgery in 93%. The combination of IR and T1-weighted images correctly identify MTS in most patients. Hippocampal volumetry provided localization in an additional small number of patients.

Adolescent↗
PubMed1997

Effect of a bicultural community health worker on completion of diabetes education in a Hispanic population.

OBJECTIVE: To determine the effect of a bicultural community health worker (CHW) on completion of diabetes education in an inner-city Hispanic patient population and to evaluate the impact of completion of the education program on patient knowledge, self-care behaviors, and glycemic control. RESEARCH DESIGN AND METHODS: Patients were randomized into CHW intervention and non-CHW intervention groups. All patients received individualized, comprehensive diabetes education from a certified diabetes nurse educator after baseline demographic information, diabetes knowledge, diabetes self-care practices, and glycohemoglobin levels were assessed. Rates of education program completion were determined. Diabetes knowledge, self-care practices, and glycohemoglobin levels were reassessed at program completion and at a later postprogram follow-up medical appointment and compared to baseline. Logistic regression analysis and the Mantel-Haenszel chi 2 statistic were used to determine the effect of the CHW assignment on program completion. Analyses of covariance were performed with end-of-treatment behavior scores, knowledge scores, and glycohemoglobin levels as outcome variables, controlling for baseline values and testing for the effect of CHW assignment. RESULTS: Of 64 patients enrolled in the study, 40 (63%) completed and 24 (37%) dropped out before completing the diabetes education program. Of the patients having CHW intervention, 80% completed the education program, compared with 47% of patients without CHW intervention (P = 0.01). "Dropouts" were younger (age 47.5 +/- 12.5 years [mean +/- SD]) compared with patients who completed the program (55.9 +/- 9.9 years) (P = 0.004). Dropout status showed no significant relationship to educational level achieved or literacy level. For the program "completers," knowledge levels and selected self-care practices significantly improved, and glycohemoglobin levels improved from a baseline level of 11.7% to 9.9% at program completion (P = 0.004) and 9.5% at the postprogram follow-up (P < 0.001). The effect of the CHW assignment on program completion, controlling for financial status and language spoken, was extremely robust (P = 0.007). The effect of the CHW on knowledge, self-care behavior, or glycohemoglobin outcome variables was not statistically significant. CONCLUSIONS: These findings suggest that intervention with a bicultural CHW improved rates of completion of a diabetes education program in an inner-city Hispanic patient population irrespective of literacy or educational levels attained. Our data further suggests that completion of individualized diabetes educational strategies leads to improved patient knowledge, self-care behaviors, and glycemic control.

Adult↗