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Biomedical subjects

J Whyte

Publications and source records attributed to J Whyte.

At least 37 records · Page 2Linked to original sources
PubMed1999

Assessment of command-following in minimally conscious brain injured patients.

OBJECTIVE: To develop a method for establishing the presence of command-following in individuals with traumatic brain injury, based on the principles of single-subject experimental design. DESIGN: A series of single-subject experiments, individualized to the particular command-following question about a particular patient. SETTING: An inpatient rehabilitation hospital with a specialized program for vegetative and minimally conscious brain injured patients. PATIENTS: Eight individuals with serious brain injury of traumatic or nontraumatic origin, presenting in vegetative or minimally conscious states. INTERVENTIONS: The frequency of performance of the behavior in question was assessed in response to commands and in relation to appropriate control conditions. Data were analyzed with chi2 or Fisher's exact test, as well as measures derived from signal detection theory. MAIN OUTCOME MEASURES: The frequency of performance of a specific behavior in the presence of a command and in relevant contrasting conditions. RESULTS: This method identified whether a specific behavior was being performed in response to command and whether the reliability of this behavior was changing over time either spontaneously or in response to treatment. CONCLUSIONS: Quantitative assessment of command-following based on principles of single-subject experimental design can determine whether patients are capable of following commands and whether this ability changes over time or in response to treatment.

Adult↗
PubMed1999

[Effects of experimental vasectomy on testicular structure: ultrastructural study].

We have performed experimental vasectomies in dogs in order to study effects of vas deferens ligature with close technique, on the testicular ultrastructure. We point out the existence of alterations: structural changes of the seminiferous epithelium, great extracellular spaces which are generated for the premature exfoliation of germinal cells, degeneration of the germinal shock cells, the appearance of immature germinal cells and multinucleate spermatids in every stages of the spermatogenesis, the fall of mature spermatozoid number, thickening of basal membrane, relative increase in the Sertoli's cells size as well as their phagocytic function, and existence of spermaphagos unfasted into tubular lumen. The Leydig's interstitial islets show an absolutely normal cellular and vascular configuration.

Animals↗
PubMed1999

An overview of behaviour difficulties found in long-term elderly care settings.

STUDY OBJECTIVE: To provide an understanding of the nature and prevalence of behaviour difficulties in long-term care facilities, to compare care settings and comment on the appropriateness of the need for specialist care. DESIGN: Nurses or carers implemented two rating scales in randomly selected settings. SETTING: Nursing homes, residential homes and NHS elderly long-stay wards. SUBJECTS: Elderly long-stay patients. MAIN RESULTS: NHS and nursing home long-term care facilities show similar behaviour difficulties, with nursing homes experiencing more behaviour manifestations in most cases. Residential facilities have behaviour difficulties to a lesser extent. CONCLUSIONS: Nursing homes have limited formal psychiatric intervention compared to NHS settings. Behaviour difficulties result in increased work for general practitioners and increased hospital referrals. More prospective research is required into the antecedents, effects and treatments of patients with behaviour difficulties in nursing homes. For example, it may be appropriate that specialist input is provided for nursing homes in order to implement behaviour intentions and contribute to the reduction of GP callouts and pharmacological interventions.

Aged↗
PubMed1999

[Experimental vasectomy: comparison of epididymal structure with various surgical techniques].

OBJECTIVE: To analyze the effects of different surgical techniques of vasectomy on the epididymal structure. METHODS: Experimental vasectomies were performed in dogs using the conventional and open-ended techniques. The animals were orchidectomized 1 to 12 months after vasectomy and the epididymal structure was analyzed. RESULTS: The epididymal structure of dogs submitted to the conventional technique showed marked ectasia, reinforced basement membrane, loss of stereocilia in the principal cells, and formation of spermatic granulomas in interstitial tissue. At 12 months the principal cells showed signs of degenerative changes. In the different time periods analyzed in the study, no changes were observed in the epididymal structure of dogs submitted to the open-ended technique. CONCLUSIONS: The changes observed in the principal cells are ascribable to the increased intraluminal pressure produced by ligation of both ends of the vas deferens (conventional technique), since no changes were found in the epididymal structure of dogs submitted to the open-ended technique, at least in the different time periods analyzed in the study.

Animals↗
PubMed1998

The effects of visual distraction following traumatic brain injury.

Clinical assessments of individuals with traumatic brain injury (TBI) typically report attentional difficulties, with distractibility prominent among these complaints. However, laboratory-based measures have often failed to find disproportionate distraction among patients with TBI, as compared to control participants. In this experiment, we tested 21 patients hospitalized for rehabilitation following recent TBI and 21 demographically comparable control subjects on a visual reaction time go-no-go task in which the target was preceded or followed by a brightly colored moving visual stimulus, appearing above the target location. Early distractors actually served as warning stimuli, improving accuracy and speed for both participant groups. Distractors occurring at or shortly after the time of target presentation had no significant impact on accuracy or response bias in either group, but did produce slowing of RT that was significantly greater for patients than for controls. The distractor that produced maximal slowing occurred 100 ms after the presentation of the target or foil. Repeated testing sessions led to reduction in the impact of the distractor and loss of the group difference in RT impact. The degree of RT slowing induced by distraction was modestly related to injury severity, as measured by the current score on the Disability Rating Scale, and the time until the patient first followed verbal commands. There was also a trend of greater RT slowing among individuals with focal orbitofrontal lesions, as assessed on neuroimaging studies. These results document a greater susceptibility to extraneous visual distraction among patients with TBI in comparison to controls. The fact that this difference appears only in the RT domain, and is greatest when the distractor follows the target, suggests that the primary impact of visual distractors is on response preparation and execution rather than target detection.

Adolescent↗
PubMed1998

Differential effect of a dopaminergic agonist on prefrontal function in traumatic brain injury patients.

We examined the effects of low-dose bromocriptine, a D2 dopamine receptor agonist, on processes thought to be subserved by the prefrontal cortex, including working memory and executive function, in individuals with traumatic brain injury. A group of 24 subjects was tested using a double-blind, placebo-controlled crossover trial, counterbalanced for order. Bromocriptine was found to improve performance on some tasks thought to be subserved by prefrontal function, but not others. Specifically, there was improvement in performance on clinical measures of executive function and in dual-task performance, but not measures that tap the ability to maintain information in working memory without significant executive demands. Also, on control tasks not thought to be dependent on the prefrontal cortex, no improvement on bromocriptine was noted. These results demonstrate a selective effect of bromocriptine on cognitive processes which involve executive control, and provide a foundation for potential therapies for patients with prefrontal damage causing dysexecutive syndromes.

Adult↗
PubMed1998

Morphometry of the human splenic artery: muscular columns, morphofunctional aspects and developmental implications.

There is a paucity of studies in the literature concerning the structural characteristics of the arterial wall in the abdominal region using human material and specialized morphometric techniques. In the present study we carry out the morphometric study, describing a series of structural peculiarities in 12 segments of the human splenic artery. Among these the presence of length-wise or spiral-shaped muscular columns in the medial layer which mark and reduce the diameter of the arterial lumen is of major importance. In its underlying intima small localized thickenings appear which, with age may become generalized. We also analyze the different intimal thickenings and such indices as the Intimal Thickening Index, Lumen Reduction Index and Pathologic Thickening Index, with differences among the groups we have considered. The study of elastin in the various parietal structures help us to understand the possible pathogenesis of the thickenings, and to clarify the important morphological-functional correlation for the regulation of blood flow which exists in this arterial region.

Adolescent↗
PubMed1998

[Experimental vasectomy: comparison of the testicular structure with various surgical techniques].

We have performed experimental vasectomies in dog in order to study different repercussions of various surgical techniques on the testicular structure. The closed technique, with ligature of both cut ends of the sectioned vas deferens caused a severe tubular atrophy, which finally destroyed the architecture of the testis with compensating hypertrophy of the intertubular connective tissue. The technique of the "open cut end", leaving the proximal end free and allowing the normal drainage of the vas deferens into the interstitial space of the spermatic cord, had not any influence on the testicular-structure, at least in the studied period of time, now one year. We can't reject any long-term immunological phenomena. The conclusion of this study is that the peculiarities of the surgical techniques of vasectomy have a decisive influence on the preservation of the testicular structure.

Animals↗
PubMed1998

[A morphological and morphometric study of the testicle in the rat vasectomized by electrocautery technics].

OBJECTIVE: To evaluate the influence of vasectomy by different fulguration methods on the rat testicular structure. METHODS: Experimental vasectomy was performed in Wistar rats by means of the Shapiro and Silber, and the Schmidt cauterization techniques. The animals were orchidectomized between 7 days and 9 months following vasectomy. A morphological and morphometric study of the rat testes was performed. RESULTS: We have observed that both cauterization techniques do not produce sequelae in the rat testicular structure and its morphology is compatible with the normal. The morphometric study showed that both techniques produced a significant decrease (p > 0.05) of the area occupied by seminiferous epithelium within one month post-vasectomy; however, these values returned to normal three months thereafter. CONCLUSIONS: Vasectomy by different fulguration methods does not change the rat testicular structure.

Animals↗
PubMed1997

Phasic arousal in response to auditory warnings after traumatic brain injury.

Traumatic brain injury (TBI) is believed to have adverse effects on attention, but because of the multifaceted nature of the arousal and attentional network, the precise impact of TBI on various subcomponents of this network remains controversial. As part of a larger program of research on attention in TBI, we studied the effects of auditory warning signals on accuracy, reaction time, and response bias, as indices of phasic arousal in a visual go/no-go task. Warnings were presented randomly at various pre-stimulus intervals to a sample of recently injured patients and control subjects. For each subject and performance index, we examined the time interval required to reach maximal phasic arousal, the degree of performance change occurring at this maximal point, and the ability to maintain this state of increased arousal over longer warning intervals. After adjustment for baseline differences, there were no significant differences between patients and controls in any aspect of performance. Examination of effect sizes suggested that this was not due to limited statistical power, but that any differences between groups, if present, must have been small. In contrast, in our prior research on sustained attention and observable behaviors related to attention, large group differences have been found. These data suggest that mechanisms responsible for auditorily-induced phasic arousal responses are largely preserved in severe TBI.

Adult↗
PubMed1997

Working memory impairments in traumatic brain injury: evidence from a dual-task paradigm.

Although many individuals with traumatic brain injury (TBI) perform well on standard neuropsychological tests, they often exhibit marked functional difficulties. The functions which are impaired seem to be analogous to the role of the central executive system (CES) in Baddeley's [Working Memory, 1986, Oxford University Press, New York] widely accepted model of working memory. The purpose of this study was to investigate CES function in individuals with TBI with a dual-task paradigm. We studied 25 non-demented persons who were at various stages in their recovery from severe TBI and compared their performance on a dual-task paradigm to a group of age-matched controls. Our dual-task paradigm measured performance on a simple visual reaction time task both alone (baseline) and during concurrent tasks of articulation or digit span. Subjects were also assessed with other neuropsychological tests of executive function. TBI patients had slower reaction times on the primary task when performed alone (P < 0.05) and greater decrements in performance during dual-task conditions (P < 0.01). They also exhibited significantly greater deficits than control subjects on other measures of executive function. Although correlations between dual-task performance and other executive measures were quite low, principle components analysis suggested that a common factor does exist between these measures. These findings support the conclusion that TBI patients have a working memory impairment that is due to dysfunction of the CES and which may be related to executive function deficits as measured by standard neuropsychological testing.

Adolescent↗
PubMed1997

[Contribution to the morphological knowledge of the articulations of the human tympanic ossicular chain].

The structure of human tympanic bones and their articulations was studied. Martin's trichrome stain of serial sections revealed the transmission paths of force lines based on bone lamellae density and acid fuchsin staining, which disclosed functional "critical points" (mechanical solicitation). This study contributed basic knowledge and a morphological and functional classification of the incudomalieotar and incudostapedial joints. The incudomalieolar joint was confirmed as a "riding saddle" but the incudostapedial joint as a "spheroid joint" was questioned. Information on capsule structure the meniscus and articular cartilage of the incudomalleolar joint is given.

Bone Density↗
PubMed1997

[Effects of vasectomy on the testicular structure of the dog].

Study of the effect on testis structure in the dog caused by a vasectomy. Emphasis is made on how in animals undergoing ligature of both ends of the ductus deferens, existence of structural changes, which are consistently present, are proportional to the time elapsed from performance of vasectomy. Such changes are revealed by: degeneration of germinal epithelium, thickening of basal membrane and hypertrophy of interstitial tissue at the expense of unspecific connective tissue. Changes were first seen as from the fourth month, but a full year has to elapse prior to noting a marked germinal hypoplasia. These experimental results cast doubts on the safety of such sterilization approach, although they cannot be entirely extrapolated to humans.

Animals↗