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Biomedical subjects

K Wheeler

Publications and source records attributed to K Wheeler.

At least 55 records · Page 3Linked to original sources
PubMed1988

Medical cost of curing childhood acute lymphoblastic leukaemia.

Between 1970 and 1979 acute lymphoblastic leukaemia was diagnosed in 378 children at this hospital. The outcome for the 181 survivors was examined six or more years after diagnosis to assess morbidity in an unselected group of long term survivors. One hundred and thirty seven of the survivors were in first remission and probably cured (group I). Forty four (group II) had had one or more relapses, some of whom, who had isolated extramedullary relapses, also have a good chance of cure. In group I 136 patients had prophylactic cranial or craniospinal irradiation, while patients in group II, in addition to having that treatment, received local testicular (17) or craniospinal radiation (seven) for testicular or central nervous system relapse. Eight had additional prophylactic cranial radiotherapy after bone marrow relapse, and six had total body irradiation before bone marrow transplantation. The incidence of clinically important growth and endocrine morbidity was 20% in group I and 68% in group II. The morbidity in patients in group I was mainly attributable to early pubertal maturation. In group II 30 patients had growth failure, of whom 19 had gonadal failure from testicular or total body irradiation, 14 had growth hormone deficiency after doses of cranial irradiation of over 2400 cGy, and 10 had spinal growth impairment after craniospinal irradiation. Two also had early pubertal maturation. Five out of six patients who received total body irradiation had multiple endocrine deficiency. Neuropsychological sequelae of treatment were seen in 40 (42%) of 96 schoolchildren in group I and in 12 (38%) of 32 schoolchildren in group II. Postinfective sequelae of treatment were found in patients in both groups. These results show that the survivors who were in their first remission had a 42% residual morbidity related to treatment compared with an 82% morbidity in the survivors of one or more relapses who had multiple treatments.

Adolescent↗
PubMed1988

Immunity to varicella zoster virus in children with leukaemia.

A total of 46% (32/70) of children with acute lymphoblastic leukaemia presenting to the Hospital for Sick Children had a past history of chickenpox. When their immunity to varicella zoster virus (VZV) was assessed, 75% (24/32) had a positive lymphocyte transformation response to VZV antigen in tissue culture while 78% (25/32) possessed IgG antibody against VZV. Therefore, at least 22% of the children were probably susceptible to infection with VZV inspite of having a history suggestive of chickenpox. Of those with a negative or uncertain history 34% had a positive lymphocyte transformation response, while 55% (21/38) had IgG antibody against VZV. Therefore, about one in two of those with a negative history to VZV had some form of immunity to VZV. Hence, regardless of their VZV infection history, children with leukaemia would need to undergo both cell mediated and humoral immunity tests before they may be considered for immunisation with the live varicella vaccine. From our studies, 34% (24/70) of our patients did not have any evidence of immunity to VZV by either test method. These would be considered for immunisation with the live varicella vaccine.

Adolescent↗
PubMed1987

Radiological rickets in extremely low birthweight infants.

Forty-eight infants of birthweight less than 1000 g who survived for more than 28 days, had wrist X-rays to prospectively determine the incidence of radiological rickets. Twelve infants (25%) had normal X-rays throughout, 10 infants (21%) showed osteopenia and 26 infants (54%) had classical changes of rickets of which 8 (17% of the total) had spontaneous fractures. There was poor correlation between peak values of serum alkaline phosphatase and the radiological changes.

Alkaline Phosphatase↗
PubMed1987

Treatment approaches in adolescent chemical dependency.

Treatment of the chemically dependent adolescent has recently evolved from the realization that youth also suffer from the primary, progressive, and chronic disease of compulsive addiction. Although based on models known to be effective with adults, treatment of the adolescent recognizes developmental needs and differences. A brief overview of the inpatient, residential, and outpatient approaches to treatment is provided.

Adolescent↗
PubMed1987

Predictive factors in repeated suicide attempts by adolescents.

A significant number of adolescents treated for attempted suicide have made previous attempts and will make subsequent attempts. These youths have a high risk of actually committing suicide. To find predictive factors of suicide risk, the authors compared 43 adolescent patients who had attempted suicide once with 38 who reported multiple attempts. The repeaters were less successful in school, displayed more hostility, reported more dysphoria, and had undergone more long-term stress. The authors believe assessing suicide risk requires evaluating the repeater's internal state of rage and dysphoria; they recommend that future studies look closely at these internal states as well as at external factors.

Achievement↗
PubMed1986

Transcobalamin I as a "marker" for fibrolamellar hepatoma.

A 12 year old girl with a localised fibrolamellar hepatoma had a raised serum unsaturated vitamin B12 binding capacity (UBBC) and transcobalamin I (TCI) prior to complete resection and chemotherapy. Regular clinical and radiological follow-up detected no recurrence of her disease, but the UBBC and TCI slowly rose. Local recurrence and pulmonary metastases became detectable 2 1/2 years after diagnosis, 18 months after the UBBC and TCI level became elevated. Measurement of UBBC and TCI can help in the early detection of recurrence long before there is clinical or radiological evidence of recurrent fibrolamellar hepatoma.

Carcinoma, Hepatocellular↗
PubMed1985

Synthesis and biological activity of pentapeptide analogues of the potent angiotensin converting enzyme inhibitor 5(S)-benzamido-4-oxo-6-phenylhexanoyl-L-proline.

Two pentapeptide analogues of the ketomethylene-containing angiotensin converting enzyme (ACE) inhibitor 5(S)-benzamido-4-oxo-6-phenylhexanoyl-L-proline (1) were synthesized and evaluated as ACE inhibitors and antihypertensive agents. Compounds 14 and 15 were very potent ACE inhibitors with I50 values of 7.0 and 3.0 nM, respectively, compared to an I50 value of 70 nM for 1. Neither 14 nor 15 showed significant blood pressure lowering activity in renal hypertensive rats. Investigations conducted on a tritiated analogue of 14 showed that 70% of an oral dose of this compound is absorbed but is rapidly excreted from the blood with a half life of 24 min. Thin-layer chromatography of bile and urine contents in rats given tritiated 14 orally showed that it is excreted in greater than 90% unchanged form. This implies that a ketomethylene linkage can stabilize peptide amide linkages adjacent to it to peptidase degradation.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1985

Suicidal adolescents: factors in evaluation.

Suicide attempts among adolescents are occurring more frequently and their evaluation is a difficult task. The factors related to suicide attempts in eighty-two adolescents, ages 12 to 18 were examined. They had been admitted to the adolescent unit of a large, urban general hospital for evaluation of self-destructive behavior. A systematic review of the patients' charts was performed to gather information about family structure, functioning in school, suicidal risk, degree of depression, and stressful life events. Although most were moderately depressed, a significant proportion denied having tried to harm themselves. While some repressed their anger, the majority expressed anger openly, tended to feel sad and to carry out premeditated as well as more serious suicide attempts. Most had experienced family disruption, and nearly half were functioning poorly in school. Suicide risk correlated only with current stress, while depression correlated with life-long as well as current stress. Results suggest that identification of the suicide attempt and the contributory factors, especially the degree of overt anger and depression, are crucial in deciding appropriate interventions, providing adequate treatment, and avoiding recurrence.

Adolescent↗
PubMed1984

Hypercalcaemia in extremely low birthweight infants.

We report 10 cases of hypercalcaemia associated with hypophosphataemia in the first two weeks of life in extremely low birthweight infants (birthweight less than 1000 g). At the time of diagnosis, the infants were fed mainly with expressed breast milk but they had also received intravenous nutrition. After treatment with additional phosphate plasma calcium concentrations returned to normal. There was a high incidence of rickets of prematurity in these infants.

Calcium↗
PubMed1984

Predictors of repeat pregnancies among low-income adolescents.

The authors compared a group of 58 adolescent girls who had been pregnant once during a two-year period with an age-matched group of 58 girls who had become pregnant at least twice during the same period. They found that the girls' attitudes toward contraception did not predict contraceptive use. Regular use of contraception was associated with a positive relationship between the girls and their mothers and with the presence of the girls' fathers in the home. The authors suggest that parental support of contraception plays a more important role in preventing repeat pregnancies than does the adolescents' reported attitudes toward contraception.

Abortion, Therapeutic↗
PubMed1976

Use of alkaline sucrose gradients in a zonal rotor to detect integrated and unintegrated avian sarcoma virus-specific DNA in cells.

We have attempted to distinguish integrated and unintegrated forms of avian sarcoma virus-specific DNA in cells by sedimentaton through an alkaline sucrose gradient in a slowly reorienting zonal rotor. Results obtained with this procedure are similar to those obtained by the more convenient analysis of networks of high-molecular-weight cell DNA. Most, if not all, viral DNA appears completely integrated into the host cell genome in an avian sarcoma virus-transformed mammalian cell and in normal chicken cells (in which viral DNA is genetically transmitted). Fully transformed duck cells and duck embryo fibroblasts infected for 20 to 72 h contain both integrated and unintegrated viral DNA; up to one copy per cell is integrated within 20 h after infection, and four to eight copies are integrated in fully transformed cells. The amount of unintegrated DNA varies but may comprise over 75% of the viral DNA in acutely infected cells and from 20 to 70% of the viral DNA in fully transformed cells. The unintegrated DNA in either case consists principally of duplexes with "minus" strands the length of a subunit of the viral genome (2.5 X 10(6) to 3 X 10(6) daltons) and relatively short "plus" strands (0.5 X 10(6) to 1.0 X 10(6) daltons).

Animals↗
PubMedDate not supplied

Review and synthesis of selected nursing studies on teaching empathy and implications for nursing research and education.

The mandate by caring theorists to integrate caring into nursing curricula could be accomplished without major curricula change. The integration of empathy training, with special emphasis on expanding one's awareness of self as well as others, espouses a pedagogical approach to caring. The continuing effort of nurse researchers and educators to clarify how to best teach empathy and to integrate heuristic methods into nursing education and practice settings is imperative to the essence of nursing--caring.

Clinical Competence↗
PubMedDate not supplied

Strategies for teaching research: a survey of baccalaureate programs.

The purpose of this study was to survey educators in National League for Nursing-accredited baccalaureate programs regarding placement and teaching strategies for nursing research and assignments used to integrate research throughout the curriculum. The 25-item survey instrument was sent to 100 randomly selected deans and directors of schools, 67 of whom responded. Demographic and descriptive data are reported. Assignments specific for theory and clinical courses are tabulated. Although a number of variables, such as size of school, region, education of faculty, and presence of a graduate program were analyzed, no significant correlations were found.

Chi-Square Distribution↗