Biomedical subjects
K Andrews
Publications and source records attributed to K Andrews.
The rate of recovery from stroke - and its measurement.
A battery of tests to measure improvement over time in physical recovery of stroke patients - and to compare this with varying levels of disability at onset, is described. Recovery in a series of 135 patients with fresh stroke treated by traditional methods of rehabilitation is principally in the first 3 months - but also continues in the second 3 months, except for muscle power. Recovery after 6 months is least in muscle power and is limited mainly to walking and mobility (e.g. getting out of the house) which in some cases may be due to altered environmental factors. At onset only 62 per cent showed moderate or severe impairment of muscle power compared to 88 per cent with similar impairment in mobility and dependency. By 1 year 30 per cent of survivors remained dependent.
The prognostic value of picture drawings by stroke patients.
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Stroke recovery: he can but does he?
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How much physical therapy for patients with stroke?
The use of physiotherapy, occupational therapy, and speech therapy for patients with stroke was investigated, and the three treatments were compared. Out of 135 patients with stroke surviving at two weeks, 107 received physiotherapy, but only 35 received occupational therapy and 19 speech therapy. Those who received most physiotherapy were the most severely disabled and had the worst prognosis, and, although almost no recovery occurred after six months, 30 patients continued with treatment beyond this time. Stiff and painful shoulders were present in 21 of the patients by two weeks and had developed in a further 37 by one year. Physiotherapy did not prevent this. The objectives of physiotherapy for patients with stroke need careful definition, with emphasis on treatment in the early months. Alternative treatment, possibly carried out by volunteers or more simply trained personnel, merits further consideration.
Why admit stroke patients to hospital?
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Ingestive responses of human newborns to salty, sour, and bitter stimuli.
Human newborns (1-4 days old) were offered two fluids differing in taste for 3 min each. The volumes ingested were measured. Infants offered water and bitter or sour solutions did not ingest them differentially, which corroborated earlier observations with weaker solutions. A sucrose solution was used to raise baseline ingestion above that of water. Infants offered the sucrose solution with and without urea, citric acid, or sodium chloride consumed less of it when citric acid was added. They were indiffferent to the addition of urea or sodium chloride. The failure to observe intakes lower than that of water suggests that newborns maximally inhibit their ingestion of water. The effects of sex, age, birth weight, and individual consistency on intake were assessed.
Technique for processing and staining whole lung sections.
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Guidelines for medical and health information sites on the internet: principles governing AMA web sites. American Medical Association.
Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.
Muramyl peptides and the functions of sleep.
Muramyl peptides (MPs) are bacterially derived sleep factors which stimulate slow wave sleep. In the neonate, MPs are capable of inducing quiet sleep and suppressing active sleep. Given that active sleep is thought to be important for brain development during this period, the possibility that changes in the availability of MPs in the neonate may affect brain development was examined. Rat pups were given muramyl dipeptide (MDP) twice daily for the first 14 days post partum. It was hypothesised that MDP would stimulate quiet sleep at the expense of active sleep as has been shown in the young rabbit. There was no effect on neonatal levels of quiet sleep or active sleep. There was, however, a variety of effects, apparently unrelated to the sleep functions of MDP. These effects were changes in adult learning, serotonin metabolism and brain anatomy. The function of sleep in the mediation of the sleep-independent effects of MPs was examined, in particular the opposite effects of MDP on host immunity depending on the sleepiness of the host. In this light sleep does indeed serve to mediate the effects of MPs and it is speculated that many of the effects observed here may change in response to sleep levels in individuals. The notion that autonomic signalling between brain and spleen is more efficient during sleep is presented as an example of a function of sleep that may modulate the immunological effects of MPs.
Ethanol self-administration in rats following exposure to dietary cadmium.
Rats were maintained on an ad lib diet containing 100 ppm cadmium (Group Cadmium-Diet) or a control diet with no added cadmium (Group Control-Diet). After 55 days of exposure to their respective diets, animals were tested for fluid intake using a nonchoice procedure that presented a 15% ethanol solution in the home cage for 5 days. Subsequently, all animals were offered a 10% ethanol solution or tap water in a 3-bottle, 2-fluid choice test in the home cage. This fluid intake test was conducted for a 5 day baseline period, and then again concurrently with avoidance acquisition (14 days) and extinction (4 days) training on a free operant (Sidman) avoidance task that required animals to lever press to avoid electric footshock. After training was terminated the choice test was continued further in the home cage for a 15 day post-avoidance period. Ethanol intake was greater for animals exposed to cadmium on all tests of fluid consumption, and all animals consumed more ethanol during the periods following termination of the stressor (avoidance extinction, post-avoidance) than during the actual period of stress (avoidance acquisition). Interpretive comments focus on the effects of cadmium on stress reactivity, sensory processing, and metabolism.
Problems in magnetic resonance imaging of patients with severe brain injury and a solution to one of them.
A number of difficulties have been encountered in carrying out MRI scans with severely brain-injured subjects. One of the problems is maintenance of head position for the 30 minutes' duration of the scan. The use of a vacuum cushion has proved a low-cost solution to this problem.
Nurse staffing in geriatric wards.
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We're jumping rope for heart...from the American Heart Association.
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