Biomedical subjects
J Ashford
Publications and source records attributed to J Ashford.
Comparing treatment intensities of tactile-thermal application.
The purpose of this study was to investigate the relationships of four intensities of tactile-thermal application (TTA) to changes in duration of stage transition (DST) and performance on a newly designed scale of penetration and aspiration by groups of patients made dysphagic by stroke. Patients were randomly assigned to receive 150, 300, 450, or 600 trials of TTA during each of 2 weeks. Data on the time required to provide such treatment, the actual number of trials clinicians were able to provide, and on the influence of the four intensities are provided. No single intensity emerged as the most therapeutic. It is suggested that subsequent studies with larger groups include intensities between 300 and 550.
Effects of fluvoxamine and dothiepin on psychomotor abilities in healthy volunteers.
We gave 12 healthy male volunteers single doses of 50 mg fluvoxamine, 100 mg fluvoxamine, 75 mg dothiepin, and placebo in a double-blind crossover study. Subjects completed a test battery that was sensitive to the behaviourally toxic effects of psychoactive drugs prior to dosing, and then at 1, 2, 3, 4, and 6 h after dose. The test battery included tasks of choice reaction time, tracking, critical flicker fusion threshold, and memory scanning. Subjective feelings were assessed using the line analogue rating scales and the Milford-Epworth sleepiness scale. Daytime activity was recorded by means of wrist actigraphy. The results show that the positive internal control (dothiepin) had a sedative effect in that it impaired performance in the majority of the tests and also reduced daytime activity. Both doses of fluvoxamine remained relatively neutral throughout and did not impair psychomotor performance or cognitive ability in any of the tests. These results indicate that fluvoxamine may be a safe and efficacious antidepressant for outpatients who wish to carry on with the tasks of everyday life without being sedated.
Longitudinal assessment of the components of energy balance in well-nourished lactating women.
The mechanisms by which well-nourished women meet the additional energy costs of lactation were studied by measuring energy intake (EI), basal metabolic rate (BMR), total energy expenditure by doubly labeled water (TEE), physical activity plus thermogenesis (TEE-BMR), changes in body fat stores, and milk energy transfer. Ten women were studied at 36 wk gestation; 4, 8, and 12 wk lactation (L4, L8, L12); and when nonpregnant and nonlactating (NPNL) after weaning. At L4, L8, and L12 the energy transferred in milk averaged 2245, 2225, and 2217 kJ/d with an additional 445 kj/d (106 kcal/d) estimated as being necessary for synthesis. EI was 1360, 1740, and 1275 kJ/d higher than the NPNL values, representing 56% of the costs of lactation. The remaining 44% was met by a reduction in TEE (-945, -688, and -826 kJ/d vs NPNL) caused largely by a reduction in physical activity because BMR was essentially unchanged (+29, -12, and -218 kJ/d). The energy-balancing strategies adopted by different women varied markedly.
Energy expenditure of Gambian women during peak agricultural activity measured by the doubly-labelled water method.
The doubly-labelled water (2H218O) method was used to measure total energy expenditure (TEE) in ten non-pregnant, non-lactating (NPNL), six pregnant (P) and fourteen lactating (L) women in a rural Gambian community. Measurements were made on free-living subjects at a period of peak energetic stress when high agricultural work loads coincided with a hungary season to induce moderately severe negative energy balance. TEE averaged 10.42 (SD 2.08) MJ/d, equivalent to 1.95 (SD 0.38) times resting metabolic rate (RMR). The energy cost of physical activity plus thermogenesis, derived as TEE-RMR, averaged 4.94 (SD 1.96) MJ/d. Expressed per kg body-weight (103 kJ/kg per d) this component of expenditure was 2.5 times greater than comparative values from inactive, affluent women studied previously (39 kJ/kg per d). Estimated energy intake (EI) in a subset of the women (n 13) was only 4.80 (SD 1.58) MJ/d, yielding an apparent deficit of 6.08 MJ/d between EI and TEE. Weight changes suggested that endogenous fat oxidation accounted for only about 0.85 MJ/d, leaving an unexplained difference of over 5 MJ/d. Critical analysis of possible errors suggests that the new doubly-labelled water method has provided the most reliable estimates and that the estimates of EI were substantially in error. This finding has important consequences for other food intake studies.
Silicone oil as a reservoir for nosocomial infection.
Two episodes of infection with epidemic methicillin-resistant Staphylococcus aureus (EMRSA) associated with silicone oil baths are described. In vitro studies indicated that certain organisms, including EMRSA, can survive in silicone oil for several days. We conclude that the oil acted as a reservoir for continuing infection in our patients. We suggest routine care of silicone oil baths in order to prevent cross infection.
[Body weight at birth and neonatal mortality in Palermo for the years 1971, 1977, 1982].
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High levels of energy expenditure in obese women.
Total free living energy expenditure was compared in lean and obese women by the new doubly labelled water method and partitioned into basal metabolism and thermogenesis plus activity by whole body calorimetry. Average energy expenditure was significantly higher in the obese group (10.22 versus 7.99 MJ/day (2445 versus 1911 kcal/day); p less than 0.001) resulting from an increase in the energy cost of both basal metabolism and physical activity. Self recorded energy intakes were accurate in the lean subjects but underestimated expenditure by 3.5 MJ/day (837 kcal/day) in the obese group. Basal metabolic rate and energy expenditure on thermogenesis plus activity were identical in the two groups when corrected for differences in fat free mass and total body mass. In the obese women in this series there was no evidence that their obesity was caused by a metabolic or behavioural defect resulting in reduced energy expenditure.
Adenocarcinoma of the tongue complicated by a hemimandibulectomy: soft tissue support for a tongue prosthesis in an edentulous glossectomy patient.
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Nulliparity in women with double primary cancers in both breast and endometrium.
A hospital-based diagnostic index revealed 340 women with endometrial carcinoma diagnosed over the 5-year period 1974 to 1979. On later review, 12 had histological evidence of a separate primary in the breast, developing either prior or subsequent to the endometrial primary. Fifty-eight per cent (n = 7) of these women were nulliparous, which was significantly greater than the nulliparity rate of 23% observed in a sample of the remaining women with endometrial cancer. The results from this small study suggest that the association of nulliparity with double primary cancers is greater than with endometrial cancer alone, though the findings need confirmation from the study of a larger series of such patients.
Unexpectedly low levels of energy expenditure in healthy women.
A new method for measuring total energy expenditure (TEE) with stable isotopically labelled water (2H218O) was used to measure average daily energy expenditure over 14-21 day periods in 12 healthy women following their normal activity patterns. TEE expressed as a multiple of basal metabolic rate (TEE/BMR) averaged only 1 X 38 +/- 0 X 04. This result is at variance with the widely held assumption that minimum maintenance requirements are 1 X 5 times BMR.
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Constipation in long-stay elderly patients: its treatment and prevention by lactulose, poloxalkol-dihydroxyanthroquinolone and phosphate enemas.
37 long-stay geriatric patients were studied. All had 80% transit time (TT) in excess of 6 days. Only an average of 23% of markers were passed by day 6 and 30% of patients still had markers in situ after 2 weeks. Three daily enemas had no effect on TT and three daily enemas together with a laxative for 6 days normalized TT in 40% only. A further 3 weeks of laxatives did not prevent constipation from getting worse. The effectiveness of lactulose and poloxalkol-dihydroxyanthroquinolone, respectively, were the same and better than no treatment.
The effects of intra-amygdaloid injections of 6-hydroxy-dopamine on avoidance responding in rats.
1 The effects of bilateral intra-amygdaloid injections of 6-hydroxydopamine (6-OHDA) on shuttle box avoidance acquisition, retention, and extinction, and passive avoidance acquisition were examined in rats. 2 Intra amygdaloid 6-OHDA injections produced catecholamine depletion in and around the amygdalae but failed to reduce striatal dopamine concentrations. 3 Conditioned avoidance acquisition was markedly inhibited in 6-OHDA-treated rats whereas retention and extinction were only slightly impaired. 4 Passive avoidance acquisition was slightly but significantly improved in rats with amygdaloid 6-OHDA lesions. 5 Treated rats showed no motor abnormalities, they were not hypoactive in a photocell activity cage and they performed as well as controls on a rotating rod. 6 It is suggested that the conditioned avoidance acquisition deficit in rats with amygdaloid 6-OHDA lesions may be related to an impairment of associative learning rather than to perceptual or motor disturbances.
[Cross-sectional epidemiological study of the development and dental status of school-age subjects in Palermo. A comparative analysis with Swedish and English data].
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Education. Guiding rights.
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