Biomedical subjects

K McIntire

Publications and source records attributed to K McIntire.

6 recordsLinked to original sources

PubMed2005

Quantitative assessments of the effect of bilateral subthalamic stimulation on multiple aspects of sensorimotor function for patients with Parkinson's disease.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is effective for the treatment of advanced Parkinson's disease. Most studies have evaluated the effectiveness of DBS of the STN using clinical motor scores or simple timed tests of motor function. There have been few studies that quantitatively assessed the outcome of STN DBS using multiple testing paradigms. In the current study, 11 patients who had bilateral STN DBS were quantitatively evaluated under four conditions using gait, postural control, and gait initiation. The four conditions included the medication on/stimulation on (M_on/S_on), medication on/stimulation off (M_on/S_off), medication off/stimulation on (M_off/S_on), and medication off/stimulation off (M_off/S_off) conditions. DBS of the STN significantly increased walking speed with and without levodopa, but had no influence on the cadence. The addition of levodopa had a minimal additional effect on walking speed. The effect of STN DBS on gait initiation approached the significant level. The mean values of lateral body sway during quiet standing increased moderately with medication and/or DBS, but the changes were not statistically significant. Future studies need to determine whether or not there is a potential negative effect of STN DBS on the postural control.

Adult↗

PubMed2005

Bilateral subthalamic stimulation improves gait initiation in patients with Parkinson's disease.

Impaired gait initiation is one of the typical sign of advanced Parkinson's disease (PD). This is the first study to examine quantitatively the effect of deep brain stimulation of the subthalamic nucleus on the performance of gait initiation for patients with advanced PD. A total of 11 patients after surgery of bilateral deep brain stimulation of the subthalamic nucleus (STN) were tested in both the deep brain stimulation (DBS) ON and OFF conditions and/or in both the medication ON (i.e., with the usual dosage of antiparkinsonian medications administered) and OFF (i.e., with the usual dosage of antiparkinsonian medications withheld) conditions. DBS had no effect on the onset of anticipatory postural adjustment (APA). The effect of DBS approached significant level for the onset of swing foot lifting, but reached significant level for the delay of swing foot lifting. DBS significantly increased the amplitude of the APA, amplitude of reactive shear forces on both feet, and amplitude of COP in both anterior-posterior and medial-lateral directions. It is concluded that DBS significantly improved the performance of patients with advanced PD in gait initiation.

Adult↗

PubMed2004

Live broadcast of laparoscopic surgery to handheld computers.

BACKGROUND: Thanks to advances in computer power and miniaturization technology, portable electronic devices are now being used to assist physicians with various applications that extend far beyond Web browsing or sending e-mail. Handheld computers are used for electronic medical records, billing, coding, and to enable convenient access to electronic journals for reference purposes. The results of diagnostic investigations, such as laboratory results, study reports, and still radiographic pictures, can also be downloaded into portable devices for later view. Handheld computer technology, combined with wireless protocols and streaming video technology, has the added potential to become a powerful educational tool for medical students and residents. The purpose of this study was to assess the feasibility of transferring multimedia data in real time to a handheld computer via a wireless network and displaying them on the computer screens of clients at remote locations. METHODS: A live laparoscopic splenectomy was transmitted live to eight handheld computers simultaneously through our institution's wireless network. RESULTS: All eight viewers were able to view the procedure and to hear the surgeon's comments throughout the entire duration of the operation. CONCLUSION: Handheld computer technology can play a key role in surgical education by delivering information to surgical residents or students when they are geographically distant from the actual event. Validation of this new technology by conducting clinical research is still needed to determine whether resident physicians or medical students can benefit from the use of handheld computers.

Audiovisual Aids↗

PubMed2001

Wireless vital sign telemetry to hand held computers.

Most physicians and other health care providers share/access patient information via hard copy chart records, telephone conversations, or through hospital computer networks. These modalities are cumbersome when physicians are away from the hospital and ground wiring infrastructure is not readily available. In a prior study, we used wireless in-flight telephony and the Internet to transmit vital signs from an airborne Boeing 757 to three remote locations on the ground. However, because all recipient stations relied on an institutional network to receive the information, it was not possible to transfer data to a given location beyond the hospital campus. We now propose an innovative system capable of transmitting telemetry information from any location in the globe to a single portable computer using Wireless Application Protocol (WAP) technology for the Internet. Medical data including blood pressure, pulse, respiratory rate, end tidal CO2, oxygen saturation and EKG tracings were transferred from a G2 (digital cellular) phone linked to a hand held computer to a remote hand held device and were viewed in real time using customized software. Cellular Digital Packet Protocols (CDPD) enabled data transfer speeds up to 19,200 bps. Advances including the Internet and wireless computer technology may revolutionize the way medical information is shared, making it possible for physicians and health allies to directly access patient data from anywhere at any time.

Humans↗

PubMed1998

Differences between self- and peer ratings of interpersonal problems.

Interpersonal problems are frequently a source of distress for individuals and the focus of psychotherapeutic interventions. A self-report circumplex measure, the Inventory of Interpersonal Problems Circumplex (IIP-C), was modified for this investigation to acquire peer report data on interpersonal problems to help assess the validity of self-reported problems. The peer report data replicated the circumplex model of the IIP-C and when general interpersonal distress was removed (by ipsatizing), the data suggested that peers observed more domineering, vindictive, and emotionally cold types of problems than self-report (ipsatized) data. Individuals reported more other-pleasing, overly nurturant types of problems than peers observed. The findings both support the validity of the IIP-C and describe discrepancies in self- versus peer reported interpersonal problems. The results also describe differences in the general interpersonal distress factor accounted for by ipsatizing versus removing the general factor from unipsatized data. The results describe implications for clinicians and others assessing interpersonal problems.

Adult↗

PubMed1983

Temporal control in a complex environment: An analysis of schedule-related behavior.

Three experiments conducted in an automated ten-compartment chamber recorded collateral activities of rats reinforced for lever pressing on differential-reinforcement-of-low-rate schedules. In Experiment 1, the rate of lever pressing increased when stimulus support for collateral activities was removed, thus confirming earlier findings. However, there were no temporal or sequential patterns of collateral activities that predicted operant responding. In Experiment 2, the rate of lever pressing increased only if (a) access to all stimulus support for collateral activities was simultaneously prevented, and (b) the rat was forced to remain in the presence of the lever and food tray. The availability of any of the stimuli related to collateral activity was sufficient to keep lever-pressing rates from increasing. Experiment 3 examined collateral activities under a signaled differential-reinforcement-of-low-rate schedule. Preventing access to stimuli supporting collateral activities had little effect on stable lever pressing when the signal was maintained. When the signal was removed, collateral activities continued, but lever-pressing rates increased in three of the four rats and rates of food presentation declined in all rats. Hypotheses that collateral activities have (a) a timekeeping or discriminative function, or (b) directly inhibit operant responding were not supported. The results suggest that collateral activities may facilitate operant responding by simply removing the subject from the presence of reinforcement-related stimuli.

Journal Article↗