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Biomedical subjects

L Halstead

Publications and source records attributed to L Halstead.

18 recordsLinked to original sources
PubMed1999

Idiopathic thrombocytopenic purpura presenting as postmyringotomy hemorrhage.

Acute idiopathic thrombocytopenic purpura has an annual incidence of about 4 per 100000 children and usually presents after a viral illness with new-onset petechiae, easy bruisability, and, occasionally, mucosal bleeding. It usually follows an uneventful course en route to a spontaneous recovery. We describe a patient with chronic otitis media who developed idiopathic thrombocytopenic purpura as a postmyringotomy complication.

Child, Preschool↗
PubMed1997

An intact N terminus is required for the anabolic action of parathyroid hormone on adult female rats.

Intermittent administration of parathyroid hormone (PTH) peptides increases bone density in animal and human models of osteoporosis. In vitro studies have demonstrated that PTH analogs lacking the first two amino acids can stimulate cell proliferation in certain cell systems, whereas fragments with an intact N terminus can be antimitogenic. We have tested whether the truncated PTH(3-38) fragment may be a better "anabolic analog" than PTH(1-38) by monitoring bone density and biomechanical properties of the femur in 6-month-old ovariectomized (OVX) rats. Either PTH fragment was administered subcutaneously (8 micrograms/100 g of body weight) 5 days/week, for 4 weeks, starting 1 week after surgery. During the entire study, untreated OVX rats lost 12.1 +/- 4.4% of their initial bone density. PTH(1-38) reversed the initial bone loss, leading to complete restoration of presurgery values after 4 weeks of treatment. Conversely, administration of PTH(3-38) resulted in 13.2 +/- 5.8% bone loss, while continuous estrogen infusion (10 micrograms/kg/day) prevented bone loss but did not reverse it. Sham-operated animals also experienced significant bone loss in the vehicle and PTH(3-38)-treated groups (-4.5 +/- 6.7%, and -7.6 +/- 2.8%, respectively), whereas a significant gain in bone density (+4.4 +/- 5.6%) was observed in the rats treated with PTH(1-38). A bone quality factor (index of strain energy loss) and the impact strength (resistance to fracture) were 25% and 44% lower in femurs explanted from OVX animals treated with either vehicle or PTH(3-38), compared with sham-operated animals. On the contrary, no difference was observed between OVX and control animals after treatment with PTH(1-38), indicating a preservation of the capacity to withstand mechanical stress. Thus, PTH(1-38) counteracts estrogen-dependent loss of mineral density and bone biomechanical properties and increases bone density in estrogen-replete animals. An intact N terminus sequence is necessary for this anabolic action of PTH.

Amino Acid Sequence↗
PubMed1995

X-linked hypophosphatemic rickets and the murine Hyp homologue.

Recent studies have reported the cloning of several sodium-dependent phosphate cotransport proteins from the apical membrane of proximal tubules of several species. The human proximal tubule apical sodium-phosphate cotransport protein maps to chromosome 5 in the 5q35 region, indicating that this gene is not a candidate for the genetic defect leading to X-linked hypophosphatemia (XLH). Studies in what is thought to be the murine XLH homologue, Hyp, also indicate that the proximal tubular phosphate cotransporter gene does not map to the X chromosome. In Hyp, message levels for the apical membrane sodium cotransport protein are reduced by approximately 50%, similar to the reductions in the apical membrane protein levels of the transporter. This indicates a potential transcriptional defect in Hyp, leading to underexpression of the sodium-dependent phosphate transport protein. Recent studies in the Hyp osteoblast have characterized the intrinsic abnormalities of the cell leading to the osteomalacia characteristic of both Hyp and XLH. These studies demonstrate that the Hyp osteoblast expresses normal rates of phosphate transport, but altered gluconeogenesis similar to the proximal tubule, and that there is an underphosphorylation of an important matrix protein, osteopontin. Since osteopontin is involved in matrix mineralization, defective posttranslational modification of the protein could be a factor in producing the osteomalacia of the Hyp. Other recent studies have demonstrated improved modalities of treatment for Hyp and potentially for XLH. These involve the use of phosphate and nonhypercalcemic analogues of 1 alpha,25-dihydroxyvitamin D3. Thus, although the detection of the genetic defect producing XLH and Hyp is awaited, significant advances in the characterization of the phenotype and the bone abnormalities continue.

Animals↗
PubMed1995

Evaluation of bone resorption: a common problem during impaired mobility.

Osteoporosis, the result of an imbalance between bone resorption and bone formation, is a potential problem for the individual with a spinal cord injury because of the immobility commonly associated with this impairment. This study was performed to determine the diagnostic value of a new assay for urinary Pyridinium crosslink (UPyr). Assays were performed on 62 first morning voided and 50 24-hour urine specimens from clients in a bone health clinic. Higher than normal levels of UPyr were observed in females with osteoporosis. UPyr correlated well with urinary hydroxyproline (r = 0.429, p = 0.005; conversely, there was an inverse relationship between bone density and UPyr (r = -0.489, p = 0.01), positive correlation (r = 0.43, p = 0.011) between the 24-hour UPyr and a serum marker of bone resorption. The study confirms that UPyr has the ability to identify states of high bone resorption. This assay should be a welcome addition to the bone health assessment of individuals with risk factors such as impaired physical mobility.

Adult↗
PubMed1993

Spiritual needs and interventions: comparing the views of patients, nurses, and chaplains.

Because of the current trend to use the term spiritual in a broad context that includes religious aspects as a component, along with others such as transcendence and relational aspects, it is essential to clarify what people mean when they use the term. The researchers designed a descriptive (qualitative) study to collect interview data to determine how patients, nurses, and chaplains currently are defining the phrases spiritual needs and spiritual interventions. The researcher interviewed and recorded the responses of 19 surgical patients, 12 nurses, and 7 chaplains to identify their definitions and the specific interventions they thought nurses and chaplains should use to meet spiritual needs. The interviews were analyzed and definitions of spiritual needs were classified according to six categories: religious, values, relationships, transcendence, affective feeling, and communication. Respondents identified five common nursing interventions: prayer, scripture, presence, listening, and referral.

Adult↗
PubMed1990

Subglottic stenosis in Wegener's granulomatosis: development during cyclophosphamide treatment with response to carbon dioxide laser therapy.

A patient with Wegener's granulomatosis rapidly developed a circumferential subglottic stenosis while on a cyclophosphamide regimen that had caused resolution of systemic symptoms and pulmonary infiltrates. The stenosis developed in the area of previously noted tracheal ulceration and responded satisfactorily to carbon dioxide laser therapy.

Adult↗
PubMed1988

Does interleukin-1 affect intracellular calcium in osteoblast-like cells (UMR-106)?

Interleukin-1 (IL-1) enhances bone resorption and formation in vitro, presumably through a primary action on osteoblasts, but the mechanism by which IL-1 activates bone cells is unknown. We investigated the possibility that the effect of IL-1 on osteoblasts is mediated through an increase in intracellular calcium [Ca++]i by studying the effects of purified human monocyte-derived IL-1 (hIL-1) and recombinant human IL-1 alpha (rhIL alpha) and beta (rhIL-1 beta) on [Ca++]i in the rat osteogenic sarcoma cell line UMR 106 using indo-1, a new-generation fluorescent Ca++-sensitive probe. hIL-1 (1 U/ml) resulted in an 85.5% rise in [Ca++]i over baseline that reached a peak after 30 seconds and returned to basal levels within 60 seconds. A similar transient rise in calcium was obtained upon exposure of the UMR cells to both the hIL-1 suspension buffer and to the concentration of fetal bovine serum present in the hIL-1 buffer. This effect was not abolished either by heat inactivation of both hIL-1 and serum or by pretreatment of hIL-1 with specific rabbit antihuman-IL-1 antibody. Moreover, exposure of the UMR cells to either rhIL-1 alpha or rhIL-1 beta or to a mixture of both at concentrations of 1 to 100 U/ml was not followed by any change in [Ca++]i. Our data do not support the idea that IL-1 can stimulate osteoblasts through a calcium-mediated pathway.

Animals↗
PubMed1987

Comparative study of electrophrenic nerve stimulation and mechanical ventilatory support in traumatic spinal cord injury.

Over the past two decades, the number of surviving apneic spinal cord injured patients has been increasing. Mechanical ventilation for home maintenance has been supplemented by electrophrenic respiration (EPR) since 1970. Nineteen patients who were totally mechanical ventilator dependent at discharge from rehabilitation in a spinal cord centre are compared with 18 patients discharged on EPR. There were more young males in the EPR group while the overall average ages were approximately the same. The mortality rates were approximately equal although the mechanical ventilator dependent patients expired earlier than the EPR group. Survivors on mechanical ventilation lived longer on an average and the vast majority of both groups were discharged to their home. There needs to be the establishment of a ventilatory dependent registry for spinal cord injury.

Adult↗
PubMed1975

Time care profile: an evaluation of a new method of assessing ADL dependence.

Valid and reliable measures of dependency in activities of daily living (ADL) remain a critical area in rehabilitation medicine for determining the patient's progress and assessing program effectiveness. This paper describes a new approach to ADL evaluation which utilizes a diary method to record the amount of time the patient receives assistance during the course of a normal day as an index of dependency. Results from a validity study using this approach on hospitalized patients in which staff members made on-the-spot time recordings of assistance provided suggest the following conclusions: (1) a diary-type record of information indicating the length of time (time measurements) an activity lasted is relatively inaccurate; and (2) the same kind of diary approach provides a highly accurate record of the number of times (frequency measurements) an activity occurred and the distribution of assistance throughout the day. In five of six activities studied, frequency measurements recorded by staff members agreed with those of an independent observer 84 percent or more of the time. Frequency measurements in a diary format appear to represent a feasible and useful method for quantifying and evaluating patient performance in nontest situations.

Activities of Daily Living↗
PubMedDate not supplied

Use of a faculty investment model to attain the goals of a college of nursing.

Driven by demands for fiscal prudence, new services, and an orderly transition as aging faculty approach retirement, a new model for administrative planning and decision making was tested. In its first year of using an investment model, a private, 600+ student, College of Nursing was able to achieve a labor savings of 10 percent, an enhancement of revenue of 3 percent, and a human capital pool equal to 12 percent of total full-time faculty equivalents. The model, which includes the integration of strategic planning, benchmarking, continuous quality improvement, and management by objectives, was accomplished by taking three investment steps. The steps included goal determination, market understanding, and resource allocation. Investment activity distribution and work determination frameworks were developed as a result of the commitment to the investment process. Suggestions for the future include the need to continue to reorient administrative and faculty thinking as definitions of the educational enterprise evolve.

Chicago↗
PubMedDate not supplied

Child bereavement after paternal suicide.

BACKGROUND: Studies of child suicide survivors are rare and often these studies have not included direct interviews with children. OBJECTIVES: To describe the bereavement process in a sample of prepubertal children whose fathers died by suicide within the previous three years. METHODS: Sixteen prepubertal children, their mothers, and a relative or caretaker were interviewed to examine grief, trauma, and behavior within 25 months of paternal suicide. RESULTS: Reminiscing was the most frequently endorsed grief behavior. Males were more likely than females to score above the standard means for CBCL scores. PTSD scores were significantly related to parental threats of divorce and exposure to death by discovery of the body. CONCLUSIONS: The concept of grief and trauma as separate and overlapping phenomena is supported by the study findings.

Bereavement↗
PubMedDate not supplied

The experience of terminating an abusive relationship from an Anglo and African American perspective: a qualitative descriptive study.

A common question asked about abused women is, "Why don't they leave?" This qualitative study explored the experiences of 15 African American and 15 Anglo American women who had terminated abusive relationships. The constant comparative method of analysis of audiotaped interviews revealed a 3-phase process of leaving: being in, getting out, and going on. Participants endured abuse until they could relinquish the fantasy of a happy relationship. Differences in relationship power and public response to abuse distinguished the experiences of Anglo and African American participants. Findings support the notion of leaving as a social process with similarities across both groups. However, critical differences in responses suggest that leaving is a culture-bound experience.

Adult↗
PubMedDate not supplied

The postpartum experience of low-risk women: a time of adjustment and change.

To describe the postpartal experiences of low-risk women after discharge from the hospital, 50 puerperal women were interviewed in their homes within 2 weeks after discharge from the hospital. Fatigue was identified as an underlying factor for many issues during this time period, including physical complications, emotional changes, and changes in relationships. Several women commented that their short hospital stays left them with too little time to recuperate before they were discharged from the hospital. Caregivers of childbearing women need to be cognizant of the needs and concerns of contemporary low-risk puerperal women to provide adequate education, guidance, and support.

Adaptation, Psychological↗