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Biomedical subjects

M L Andrews

Publications and source records attributed to M L Andrews.

15 recordsLinked to original sources
PubMed1995

Risk of cardiac events in family members of patients with long QT syndrome.

OBJECTIVES: This study sought to identify risk factors for cardiac events (syncope, aborted cardiac arrest or sudden cardiac death) in family members of patients with the long QT syndrome. BACKGROUND: Patients with the long QT syndrome are known to be at high risk for cardiac events. Whenever the first member of a family is identified as having the long QT syndrome (proband), there is concern regarding the likelihood of cardiac events in other family members. METHODS: A multivariate logistic regression model was used to evaluate the risk of cardiac events in 637 family members who were first- and second-degree relatives of 151 probands with the long QT syndrome and in a subset of 513 family members who were not receiving beta-adrenergic blocking agents. There were 293 first-degree (46%) and 344 second-degree relatives (54%) (293 men [46%], 344 women [54%]). Fifteen percent of the family members had a corrected QT interval (QTc) > 0.44 s, and relative tachycardia and bradycardia were observed in 12% and 25%, respectively. RESULTS: The risk of cardiac events occurring before age 40 in family members not taking beta-blockers was influenced by the QTc interval (odds ratio [OR] 1.18/0.01 increase in QTc value; 95% confidence interval [CI] 1.12 to 1.24), relative tachycardia (OR 2.21, 95% CI 0.97 to 5.02) or bradycardia (OR 2.24, 95% CI 1.10 to 4.56) and an interaction term combining gender and closeness of the relationship to the proband (OR for female first-degree relative 3.23 vs. all second-degree relatives, 95% CI 1.67-6.22). CONCLUSIONS: Female first-degree relatives of patients with the long QT syndrome have a higher risk of cardiac events than male first- or second-degree relatives, independent of recorded electrocardiographic findings. Not only bradycardia, but also tachycardia increases risk of cardiac events in family members of patients with the long QT syndrome.

Adolescent↗
PubMed1993

Consistency in clinicians' and clients' behavior in voice therapy: an exploratory study.

The primary purpose of this study was to investigate consistency in clinicians' behaviors during two voice therapy sessions. The secondary purpose was to examine relationships between ratings of clinicians' and clients' behaviors. Each clinician (n = 7) was observed working with two different clients. Two experienced evaluators, using the Adjective Checklist and five-point semantic differential scales, rated clinicians and clients. Results indicated that 6 of 10 aspects of therapy studied were found to be relatively inconsistent, with the pace of therapy being the least stable. Ratings of individual clinician traits (e.g., favorable, unfavorable, intraception) were the most stable.

Adult↗
PubMed1993

Intervention with young voice users: a clinical perspective.

This diverse group is described in relation to life stage, short- and long-range performance objectives, and lifestyle factors pertinent to vocal health. Physical, behavioral, cognitive, and psychosocial issues relevant to assessment and intervention will be addressed. The possible dissonance between a clinician's developmental perspective and a client's immediate pragmatic concerns is discussed. In addition, the specific challenges of dealing with adolescents (e.g., the influence of the peer group, the emergence of autonomy, the redefinition of relationships with significant adults, and the vulnerability of the mechanism) are related to clinical problem solving.

Child↗
PubMed1992

Subclinical mastitis in ewes and its effect on lamb performance.

Two studies were conducted to 1) assess the effectiveness of the California mastitis test (CMT) relative to direct microscopic somatic cell count (DMSCC) and(or) somatic cell count (SCC) procedures for detecting subclinical mastitis in ewes, 2) determine the incidence of subclinical mastitis based on repeated or single sample measures and organisms associated with the inflammation, and 3) assess the relationship between milk quality measures and lamb performance. The relationship between DMSCC and SCC scores was significant (P less than .01); 90% of the variation in DMSCC scores was accounted for by SCC scores. In contrast, CMT scores accounted for only 26% of the variation in DMSCC and 30 to 34% of the variation in SCC scores. Incidence of inflammation varied from 17 to 50% of ewes tested, depending on the study and the method of assessment. Staphylococcus species were cultured from 14/41 samples tested, with cultures of Streptococcus species (3/41) and Micrococcus species (1/41) also present. The effect of subclinical mastitis in ewes on lamb performance was minimal when assessed by regressing lamb weights on subclinical mastitis and milk quality scores. In conclusion, growth performance of lambs in a management system where they had access to supplemental feed was not influenced by the quality of milk produced by ewes, or by the degree of subclinical mastitic inflammation present when they suckled.

Animals↗
PubMed1988

Occurrence, characteristics and prognostic significance of early postacute myocardial infarction angina pectoris.

To determine the incidence, clinical characteristics and prognostic significance of early spontaneous angina after acute myocardial infarction (AMI), the database involving the 867 participants of the Multicenter Post-AMI Program, who were followed for 1 to 4 years after AMI, was analyzed. Two hundred eighty-six patients (33%) had in-hospital postinfarction angina. During a mean follow-up of 31 months, patients with postinfarction angina were more frequently (p less than 0.001) hospitalized for cardiac causes and underwent coronary artery bypass graft surgery; however, their cardiac mortality rates at 1 year (8.4%) and at 4 years (14.3%) were not significantly different from those among patients without postinfarction angina (7.1 and 12.9%, respectively). The only anginal characteristic found to be associated with increased subsequent cardiac mortality (17.9% at 1 year, 39.2% at total follow-up) was high frequency angina (greater than or equal to 1 daily episodes). High frequency angina occurred in a small subset of 28 patients (3.2% of the study population, 9.8% of patients with postinfarction angina). Clinical variables representing higher grades of mechanical dysfunction and electrical instability after infarction were significantly more common among patients with high frequency angina than among those with low frequency angina. Cox survivorship analysis revealed that high frequency angina made a significant contribution to the risk of post-AMI cardiac death (hazard ratio 2.5, p = 0.01), which was independent of the effect of predischarge reduced radionuclide ejection fraction and Holter-recorded frequent or repetitive ventricular premature complexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Acceptability and intelligibility of tracheoesophageal speech.

The original Blom-Singer voice prosthesis, introduced in 1979, has been recently modified to provide lower airway resistance. A tracheostoma breathing valve, introduced in 1982, permits unrestricted two-way breathing, yet eliminates the need for manual occlusion of the stoma. To date, the acceptability and intelligibility of tracheoesophageal (TE) speakers, using these prostheses, has not been extensively studied. Forty-six naive listeners rated the acceptability and intelligibility of 15 TE speakers, all of whom were wearing the tracheostoma breathing valve and a prototype low-pressure prosthesis. Acceptability was judged on an equal-appearing interval scale. Intelligibility judgments were based on randomized word lists of 50 items. Results suggest a high level of acceptability and intelligibility among both male and female TE speakers.

Evaluation Studies as Topic↗
PubMed1984

Localization of calmodulin in differentiating pulmonary type II epithelial cells.

Pulmonary surfactant is synthesized by alveolar type II pneumonocytes and stored in inclusions called lamellar bodies. In the present study we have investigated the role of the calcium-binding protein, calmodulin, in regulating surfactant secretion in differentiating rat fetal type II pneumonocytes. Lamellar body secretion is stimulated in differentiating type II cells in vitro by the calcium ionophore, A23187. A23187-induced secretion is blocked by the phenothiazine drugs, trifluoperazine and chlorpromazine, but is unaffected by the inactive analogs, trifluoperazine sulfoxide and chlorpromazine sulfoxide. Immunofluorescence studies on cultured type II pneumonocytes show that the percentage of Nomarski-dense intracellular granules, which stain positively with anticalmodulin antibody, increases when the cells are stimulated with the calcium ionophore, A23187. Since these Nomarski-dense granules are positively stained by phosphine-3R, these results indicate that increased amounts of immunoreactive calmodulin appear associated with lamellar body surfaces when the cells are stimulated for secretion. In addition, ultrastructural localization of calmodulin on isolated lamellar bodies using protein A-colloidal gold indicates that calmodulin is present on their outer surfaces. The endogenous calmodulin present on the isolated lamellar bodies is not removed by treatment of the lamellar bodies with ethylene glycol bis(beta-aminoethyl ether)-N,N'-tetraacetic acid. Using the same localization technique, we found that isolated lamellar bodies are capable of binding exogenously added calmodulin in the presence of calcium. Taken together, these results implicate calmodulin in pulmonary surfactant secretion.

Animals↗
PubMed1983

Spastic dysphonia: a perceptual test of recurrent laryngeal nerve section.

An objective test of the efficacy of recurrent nerve section in the treatment of spastic dysphonia was conducted with partially trained observers in a blind rating task. It was found that, although immediate effects of the surgery as measured by a general communication effectiveness instrument could not be established, long-term (1-yr post-surgery) effects did emerge and at a high level of confidence. The results corroborate subjective judgments of the effectiveness of the Dedo procedure.

Adult↗
PubMed1983

Control of erythrocyte shape by calmodulin.

Erythrocytes are deformable cells whose shapes can be altered by treatments with a variety of drugs. The forms the erythrocyte may assume vary continuously from the spiny "echinocytes" or crenated cells at one extreme to highly folded and dented "cupped" cells at the other extreme. Examination of 39 compounds for cup-forming activity revealed a remarkable correlation between their ability to form cupped cells and their inhibitory activity against the calcium regulatory protein, calmodulin. Calmodulin is known to interact with several erythrocyte proteins including spectrin, spectrin kinase, and the Ca++ ATPase calcium pump of the membrane. These proteins regulate the form of the cytoskeleton as well as intracellular calcium and ATP levels. It is proposed that calmodulin is required to maintain normal erythrocyte morphology and that in the presence of calmodulin inhibitors, the cell assumes a cupped shape.

Anesthetics, Local↗
PubMed1977

The assessment of pitch discrimination ability in young children.

This study tested the hypothesis that some tasks used in assessing pitch discrimination ability may instead by assessing children's ability to deal with relational language. Five tasks were given to 36 normal children who were equally divided into three age groups, six to six and one-half years, seven to seven and one-half years, and eight to eight and one-half years of age. Task 1 involved a training procedure to assess the children's ability to hear the differences in the pitch of two tones, which were an octave apart. A simple motor response was required. Task 2 assessed the children's ability to label these tones as high or low. Task 3 assessed their ability to compare two tones and label the second as higher or lower than the first. Task 4 examined their ability to label as high or low the position of a man on a ladder. Task 5 examined their ability to compare the positions of two men on two ladders and say whether the second man was higher or lower than the first. Results indicated that children who make pitch discriminations as demonstrated by nearly perfect scores on Task 1 often fail to demonstrate those discriminations on tasks requiring relational language. A comparison of Tasks 2 and 3 to Tasks 4 and 5 suggests that children in the age range studied are less proficient in applying high-low and higher-lower to pitch than to spatial relations.

Child↗
PubMed1976

Perceptions of auditory components of stuttered speech.

Two student groups, one of speech pathology majors and one a class of mixed background fulfilling a humanities requirement, listened to the same set of sentences spoken first in nonstuttered and then in stuttered form. Subjects rated each replication along a set of 114 semantic differential-type adjectives but on 10-point unipolar scales. These scales had previously been factor analyzed and represented 31 positive and 29 negative perceptual factors. The results indicate that all college students react favorably to stuttered speech. However, six factor differences significant at the 0.05 level or above emerged between the two groups when evaluating the stuttered version. These results suggest that pathology students do not perceive stuttered speech as do nonpathology students; they are more favorably disposed on every dimemsion.

Auditory Perception↗