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Biomedical subjects

J Goodman

Publications and source records attributed to J Goodman.

At least 19 recordsLinked to original sources
PubMed2006

Deployment and early experience with remote-presence patient care in a community hospital.

BACKGROUND: The introduction of the RP6 (InTouch Health, Santa Barbara, CA, USA) remote-presence "robot" appears to offer a useful telemedicine device. The authors describe the deployment and early experience with the RP6 in a community hospital and provided a live demonstration of the system on April 16, 2005 during the Emerging Technologies Session of the 2005 SAGES Meeting in Fort Lauderdale, Florida. METHODS: The RP6 is a 5-ft 4-in. tall, 215-pound robot that can be remotely controlled from an appropriately configured computer located anywhere on the Internet (i.e., on this planet). The system is composed of a control station (a computer at the central station), a mechanical robot, a wireless network (at the remote facility: the hospital), and a high-speed Internet connection at both the remote (hospital) and central locations. The robot itself houses a rechargeable power supply. Its hardware and software allows communication over the Internet with the central station, interpretation of commands from the central station, and conversion of the commands into mechanical and nonmechanical actions at the remote location, which are communicated back to the central station over the Internet. The RP6 system allows the central party (e.g., physician) to control the movements of the robot itself, see and hear at the remote location (hospital), and be seen and heard at the remote location (hospital) while not physically there. RESULTS: Deployment of the RP6 system at the hospital was accomplished in less than a day. The wireless network at the institution was already in place. The control station setup time ranged from 1 to 4 h and was dependent primarily on the quality of the Internet connection (bandwidth) at the remote locations. Patients who visited with the RP6 on their discharge day could be discharged more than 4 h earlier than with conventional visits, thereby freeing up hospital beds on a busy med-surg floor. Patient visits during "off hours" (nights and weekends) were three times more efficient than conventional visits during these times (20 min per visit vs 40-min round trip travel + 20-min visit). Patients and nursing personnel both expressed tremendous satisfaction with the remote-presence interaction. CONCLUSIONS: The authors' early experience suggests a significant benefit to patients, hospitals, and physicians with the use of RP6. The implications for future development are enormous.

Attitude↗
PubMed2006

Dexamethasone in the treatment of obstetric cholestasis: a case series.

Twelve women with obstetric cholestasis were given dexamethasone after failure to respond to ursodeoxycholic acid. Clinical improvement was achieved in eight cases, without complete resolution of symptoms. Biochemical response was achieved in seven cases. All but two cases had good correlation between clinical and biochemical response. Women of Asian and South American origin were more likely to respond to dexamethasone than Caucasians. There were no reported maternal or fetal side-effects. However, the subsequent consequences of dexamethasone treatment for the mother and fetus have not been thoroughly evaluated. Therefore, even in Asian and South American women, larger studies of dexamethasone are required before this treatment can be recommended as a universally safe and effective treatment for obstetric cholestasis.

Anti-Inflammatory Agents↗
PubMed2006

Radioactive materials in biosolids: dose modeling.

The Interagency Steering Committee on Radiation Standards (ISCORS) has recently completed a study of the occurrence within the United States of radioactive materials in sewage sludge and sewage incineration ash. One component of that effort was an examination of the possible transport of radioactivity from sludge into the local environment and the subsequent exposure of humans. A stochastic environmental pathway model was applied separately to seven hypothetical, generic sludge-release scenarios, leading to the creation of seven tables of Dose-to-Source Ratios (DSR), which can be used in translating from specific activity in sludge into dose to an individual. These DSR values were then combined with the results of an ISCORS survey of sludge and ash at more than 300 publicly owned treatment works, to explore the potential for radiation exposure of sludge workers and members of the public. This paper provides a brief overview of the pathway modeling methodology employed in the exposure and dose assessments and discusses technical aspects of the results obtained.

Environmental Monitoring↗
PubMed2005

fMRI of sensitization to angry faces.

This study examined what is communicated by facial expressions of anger and mapped the neural substrates, evaluating the motivational salience of these stimuli. During functional magnetic resonance imaging, angry and neutral faces were presented to human subjects. Across experimental runs, signal adaptation was observed. Whereas fearful faces have reproducibly evoked response habituation in amygdala and prefrontal cortex, angry faces evoked sensitization in the insula, cingulate, thalamus, basal ganglia, and hippocampus. Complementary offline rating and keypress experiments determined an aversive rank ordering of angry, fearful, neutral, and happy faces and revealed behavioral sensitization to the angry faces. Subjects rated angry faces, in contrast to other face categories such as fear, as significantly more likely to directly inflict harm. Furthermore, they rated angry faces as significantly less likely to produce positive emotional outcomes than the other face categories. Together these data argue that angry faces, a directly aversive stimulus, produce a sensitization response.

Adaptation, Psychological↗
PubMed2003

Immunoregulation of cellular lifespan: physiologic autoantibodies and their peptide antigens.

Physiologic autoantibodies are part of our normal immune repertoire where they function to maintain homeostasis by performing physiologic functions. The role of physiologic autoantibodies in removing senescent and damaged cells is probably the best example of a physiologic autoantibody, complete with well established function. IgG autoantibodies bind to altered band 3 anion exchanger protein on senescent cells and trigger their removal by macrophages. Band 3 isoforms are found in all cells, tissues, and membranes, and in all species examined. In this paper, we discuss the innate immune response to band 3 membrane proteins and their regulation of cellular lifespan. The role of physiologic autoantibodies and their peptide antigens in health and disease, apoptosis, and their therapeutic potential is discussed focusing on the examples of senescence and malaria.

Animals↗
PubMed2001

Streptozocin-induced neuropathy is associated with altered expression of voltage-gated calcium channel subunit mRNAs in rat dorsal root ganglion neurones.

Voltage-gated calcium channels (VGCCs) within sensory neurones are believed to perform an important role in neuropathic pain. In the present study we examine the changes in VGCC mRNA which occur following streptozocin- (STZ) induced diabetic neuropathy using in situ hybridization. STZ caused a significant increase in alpha(2)delta(1), alpha(2)delta(2), and alpha(2)delta(3) mRNA levels in all neuronal cell types. Similarly, mRNA levels of alpha(1F), alpha(1I), and alpha(1S) were increased in all cell types studied whilst alpha(1A) and alpha(1G) mRNAs were specifically upregulated in medium and large diameter neurones. In conclusion, we demonstrate that the induction of diabetic neuropathy is associated with dramatic changes in the expression of VGCCs.

Animals↗
PubMed2001

Expression of voltage-gated calcium channel subunits in rat dorsal root ganglion neurons.

In the present study, we have used in situ hybridisation to examine the distribution of calcium channel subunits in rat dorsal root ganglion (DRG) neurons. Within DRG neurons, the calcium channel alpha subunit mRNAs alpha(1A), alpha(1B), alpha(1C), alpha(1D), alpha(1E), alpha(1I) and alpha(1S) were readily detected in small (<25 microm), medium (25-45 microm) and large (>45 microm) diameter neurons. alpha(1F) was present at very low levels in these neurons whilst alpha(1G) was virtually undetectable. The calcium channel auxiliary subunits alpha(2)delta(1) and alpha(2)delta(2) showed a complementary pattern of distribution to that of alpha(2)delta(3) in DRG neurons. alpha(2)delta(1) and alpha(2)delta(2) transcripts were expressed predominantly in small c-type sensory neurons and were present at lower levels in large Abeta-type sensory neurons. In contrast, alpha(2)delta(3) mRNA was present in high quantities in the large-diameter cells but was expressed at lower levels in small-diameter neurons of the DRG. The present study provides an insight into the molecular profile of calcium channel alpha(1) and alpha(2)delta subunits in the neurons responsible for transmitting sensory information.

Animals↗
PubMed2001

Striatal volume loss in HD as measured by MRI and the influence of CAG repeat.

BACKGROUND: Huntington's disease (HD) is an autosomal dominant neurodegenerative disease that results from the expansion of a trinucleotide (CAG) repeat on chromosome 4. Progressive degeneration of the striatum is the pathologic hallmark of the disease. Little is known about the regional selectivity of the neurodegeneration and its relationship to the genetic expansion. METHODS: The authors used high-resolution MRI to determine the relationship between the genetic expansion and the degree of striatal degeneration. Morphometric analyses of the striatum from high-resolution MR images from 27 subjects with HD were compared with those of 24 healthy control subjects. RESULTS AND CONCLUSIONS: Striatal volumes were reduced in subjects with HD as compared with control subjects, in agreement with previously published reports. Left-sided volumes were smaller than right-sided volumes in subjects with HD; in healthy subjects, right-sided volumes were smaller. Finally, volume loss was significantly correlated with CAG repeat number. These results have potential implications for the design and assessment of therapeutic agents in the future.

Adult↗
PubMed2001

Novel inhibitors of Leishmanial dihydrofolate reductase.

The program DOCK3.5 was used to search the Cambridge Structural Database for novel inhibitors of Leishmanial dihydrofolate reductase. A number of compounds were obtained and screened against the enzyme and against the intact parasite Leishmania donovani and the related organisms Trypanosoma brucei and Trypanosoma cruzi. The compounds screened showed weak activity in both the enzyme assays and the in vitro assays.

Animals↗
PubMed2001

Homing markers for atherosclerosis: applications for drug delivery, gene delivery and vascular imaging.

Endothelial dysfunction plays a major role in the pathogenesis of atherosclerosis. Pro-inflammatory cytokines such as interleukin-1 beta and tumour necrosis factor alpha activate endothelial cells changing their resting phenotype to become pro-adhesive, pro-thrombotic and pro-atherogenic. Phage display in vivo biopanning has been used to identify peptide sequences that home to diseased regions of the vessel wall in low density lipoprotein receptor (LDLr) knockout mice. In LDLr knockout mice, peptide sequence determinants exhibiting organ specificity have been isolated. These sequences have applications for gene delivery, drug delivery and for improving contrast agents for vascular imaging.

Animals↗
PubMed2001

Practice patterns in the diagnosis and treatment of erectile dysfunction among family practice physicians.

OBJECTIVES: To examine the philosophies and practices of the family practitioner (FP) regarding the diagnosis and treatment of erectile dysfunction (ED). METHODS: A prospective study by questionnaire of a group of FPs was performed. The Spearman correlation coefficient and proportional odds regression analysis were used to measure the relationship between the continuous variable and ordinal-scale variables. The Goodman-Kruskal gamma test was used to measure the strength of the association between the ordinal-scale variables. RESULTS: Eighty-five FPs completed the questionnaire. All respondents had at least occasional discussions with their patients about ED. History taking, physical examination, and laboratory data were the most common tools used for diagnosis. Eighty-two percent of the FPs reported being either comfortable or somewhat comfortable in making a diagnosis of ED; 93% believed that only selected patients required more extensive diagnostic workups for ED. Sildenafil was the most commonly used agent. All physicians referred patients with ED to urologists at least occasionally. Most referred only after unsuccessful trials with sildenafil. The relationship between the degree of managed care penetration and the percentage of patients with ED referred for evaluation to a urologist was not statistically significant (P = 0.402). The relationship between the number of years in practice and the percentage of patients referred to a urologist for treatment or evaluation was found to be a negative, but statistically significant, relationship (P = 0.003). CONCLUSIONS: FPs are now diagnosing and treating ED on a routine basis. Referrals to urologists are likely to be made when they are no longer comfortable treating the problem.

Adult↗
PubMed2001

Initial experience with an active-fixation defibrillation electrode and the presence of nonphysiological sensing.

Nonphysiological sensing by a pacing and defibrillation electrode may result in inappropriate defibrillator discharges and/or inhibition of pacing. Active-fixation electrodes may be more likely to sense diaphragmatic myopotentials because of the protrusion of the screw for fixation. In addition, the movement of the fixation screw in an integrated bipolar lead system could also result in inappropriate sensing. This may be increasingly important in patients who are pacemaker dependent because the dynamic range of the autogain feature of these devices is much more narrow. Five of 15 consecutive patients who received a CPI model 0154 or 0155 active-fixation defibrillation electrode with an ICD system (CPI Ventak A V3DR model 1831 or CPI Ventak VR model 1774 defibrillator) are described. In 2 of the 15 patients, nonphysiological sensing appearing to be diaphragmatic myopotentials resulted in inappropriate defibrillator discharges. Both patients were pacemaker dependent. Changes in the sensitivity from nominal to less sensitive prevented inappropriate discharges. In one patient, discreet nonphysiological sensed events with the electrogram suggestive of ventricular activation was noted at the time of implantation. This was completely eliminated by redeployment of the active-fixation lead in the interventricular septum. In two other patients, discreet nonphysiological sensed events resulted in intermittent inhibition of ventricular pacing after implantation. These were still seen in the least sensitive autogain mode for ventricular amplitude. These were not seen on subsequent interrogation 1 month after implantation. Increased awareness of nonphysiological sensing is recommended. The CPI 0154 and 0155 leads seem to be particularly prone to this abnormality. Particular attention should be made when deploying an active-fixation screw for an integrated bipolar lead. This increased awareness is more important when a given individual is pacemaker dependent, which may warrant DFT testing in a least or less sensitive mode in these patients.

Adult↗
PubMed2001

Mycobacterium avium invades the intestinal mucosa primarily by interacting with enterocytes.

Previous studies have demonstrated that Mycobacterium avium can invade intestinal epithelial cells both in vitro and in vivo. When given to mice orally, M. avium preferentially interacts with the intestinal mucosa at the terminal ileum. We evaluated the mechanism(s) of M. avium binding and invasion of the intestinal mucosa using three different systems: (i) electron microscopy following administration of M. avium into an intestinal loop in mice, (ii) quantitative comparison of the bacterial load in Peyer's patch areas of the terminal ileum versus areas that do not contain Peyer's patches, and (iii) investigation of the ability of M. avium to cause disseminated infection following oral administration using B-cell-deficient mice, lacking Peyer's patches, in comparison with C57BL/6 black mice. By all approaches, M. avium was found to invade the intestinal mucosa by interacting primarily with enterocytes and not with M cells.

Animals↗
PubMed2001

Exercise-induced myocardial ischaemia in women: factors affecting prevalence.

Coronary artery disease (CAD) is a major health care challenge, and is the leading cause of death amongst women. Both the delay in the clinical manifestations of CAD and 'atypical' symptomatology in women complicates both diagnosis and treatment strategies in this population. It appears that the age-adjusted prevalence of all-cause angina (effort, unstable, etc.) appears to be greater in women than men, although stenotic lesions are demonstrated less frequently. There are a number of factors that complicates the diagnosis and identification of CAD in women, including more diffuse anginal symptoms, a lower initial detection rate of myocardial ischemia by traditional methods, lower rates of interventional procedures, and lastly, potential differences in the pathophysiology of myocardial ischemia. The lower sensitivity and specificity of many diagnostic techniques including ECG and various imaging technologies contributes significantly to these findings. The increased presence of syndrome X in post-menopausal women may reflect an increased likelihood of microcirculatory disease, where the 'gold standard' angiography fails to detect the presence of disease. Thus nonepicardial coronary stenotic disease may be largely undetected by most studies, rendering many positive ECG stress results unverifiable. The increased co-morbidity seen with CAD in women further complicates diagnosis and interventional results. Combined, these factors act to falsely lower the post-test likelihood of disease in women, adding to the existing gender bias in the diagnosis and referral rates for treatment of CAD in women. The lower precision of disease detection in women contributes to the perception that women have less exertional angina than men, despite evidence to the contrary.

Angina Pectoris↗
PubMed2001

Attachment of bacteria to beef from steam-pasteurized carcasses.

The extent to which a bacterial cocktail containing equal numbers of Pseudomonas fragi NCTC 10689, Listeria monocytogenes BL5/2, Salmonella Typhimurium LT2, and Escherichia coli JM 109 attached to loin surface cuts (7 by 5 cm) derived from steam-pasteurized beef carcasses has been evaluated. The extent of attachment was categorized as loosely attached (removed by rinsing), firmly attached (released by stomaching), and irreversibly bound. No significant difference (P > 0.10) in the attachment of bacteria to steam-pasteurized carcasses was found compared with control loin samples that had received no treatment. No significant difference (P > 0.05) was also found in the attachment strength between the different bacterial species tested. Most bacteria inoculated onto the loin cuts were reversibly bound, since they had been removed by rinsing and stomaching. The irreversible attachment of bacteria to loin cuts was found to vary significantly (P < 0.01) among the different carcass sets used but was independent of whether the carcass had undergone steam pasteurization treatment. Use of a bioluminescent strain of E. coli showed that cells bound preferentially to cut edges and convoluted areas on the loin surface and could not be removed by rinsing. The possible mechanisms of bacterial attachment and the suitability of steam pasteurization to remove contamination incurred during slaughter are discussed.

Animals↗