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Biomedical subjects

M Shore

Publications and source records attributed to M Shore.

12 recordsLinked to original sources
PubMed2000

Autonomic dysfunction in patients with fibromyalgia: application of power spectral analysis of heart rate variability.

OBJECTIVES: To assess the interaction between the sympathetic and parasympathetic systems in patients with fibromyalgia syndrome (FM), using power spectrum analysis (PSA) of heart rate variability (HRV). In addition, we explored the association between HRV, measures of tenderness, FM symptoms, physical function, psychological well being and quality of life. METHODS: We studied 22 women with FM and 22 age-matched healthy women. Twenty-minute electrocardiogram recordings were obtained in a supine position during complete rest. Spectral analysis of R-R intervals was done by the fast-Fourier transform algorithm. RESULTS: Heart rate was significantly higher in FM patients compared with controls (P < .006). FM patients had significantly lower HRV compared with controls (P= .001), and higher low-frequency (LF) and lower high-frequency (HF) components of PSA than controls (P < .001). Quality of life, physical function, anxiety, depression, and perceived stress were moderately to highly correlated with LF, HF (in normalized units), and LF/HF. No association was observed between HRV parameters and measures of tenderness and FM symptoms. CONCLUSIONS: The basal autonomic state of patients with FM is characterized by increased sympathetic and decreased parasympathetic tones. Autonomic dysregulation may have implications regarding the symptomatology, physical and psychological aspects of health status.

Algorithms↗
PubMed1991

Neurotoxic effects of methylene chloride: are they long lasting in humans?

The neurotoxicity of methylene chloride (MC) is of special interest because of its acute effects on the central nervous system (CNS) and its metabolic conversion to carbon monoxide. A cohort study of retired airline mechanics was conducted to examine the hypothesis that long term exposure to MC results in lasting effects on the CNS. Retirees were studied to eliminate effects of current occupational exposures. The total retiree population (n = 1758) was surveyed to identify mechanics who met specific occupational, demographic, and medical criteria. A group of eligible retirees having long term exposure to MC and another group with low probability of exposure to solvents were given a comprehensive battery of physiological and psychological tests. The exposure groups were similar for all potential confounders that were measured. No statistically significant differences between groups were detected on outcome measures, although subtle differences in attention and memory were identified. Thus no firm evidence was found to support the hypothesis of lasting CNS effects in retired mechanics with long term exposure to MC.

Aged↗
PubMed1990

Neuropsychologic "impairment" in a cohort of hospital workers chronically exposed to ethylene oxide.

Ethylene Oxide is widely used to sterilize heat-sensitive materials. Acute and chronic neurogenic effects to the central and peripheral nervous system in man and animals have been described. To assess the chronic, subtle neuropsychologic effects of ethylene oxide, we performed a cross-sectional study of 25 hospital central supply workers exposed to low levels of ethylene oxide and 24 unexposed control workers. Subjects were tested using a neuropsychological screening battery by examiners blinded to exposure status. Testing results were reviewed independently by two neuropsychologists without knowledge of exposure. Subject status was categorized as normal, "impaired," or disagreement (between the two neuropsychologists). There were significantly more subjects concordantly judged as impaired in the exposed group versus the control group (chi 2 (2) = 6.0861, p less than 0.05). Although limited by the cross-sectional study design and the global categorization, these findings suggest that CNS dysfunction and cognitive impairment may result from chronic ethylene oxide exposure in hospital central supply units.

Adult↗
PubMed1989

A rapid method for teaching severely brain injured adults how to wash and dress.

The use of a rapid method of teaching a severely brain injured patient to wash and dress is described. The patient, who was injured in an automobile accident eight months earlier, remained dependent in self-care after five months in an acute rehabilitation unit. He was then transferred to a Transitional Living Facility where the program was performed. The patient's physical and cognitive status remained unchanged during the program which lasted for 12 treatment days, but he did become independent in washing and dressing. Independence was maintained at six-month follow-up. Issues relating to the individual's severe memory impairment are discussed in terms of the relevance of such impairments to outcome of training techniques.

Activities of Daily Living↗
PubMed1987

A comparative study of transcutaneous electrical nerve stimulation (TENS), entonox, pethidine + promazine and lumbar epidural for pain relief in labor.

Analgesic effect, labor outcome, safety and consumer satisfaction were compared in 170 primigravid women; 50 using TENS initially for pain relief, 20 using entonox, 50 pethidine + promazine and 50 lumbar epidural. 88% choosing epidural related it fully effective. 90% using entonox, 96% using TENS and 54% given pethidine + promazine found partial relief. 82% of patients given TENS and 80% given pethidine + promazine required additional analgesia. This was also needed by one of the 20 patients choosing entonox. Women using entonox alone had the shortest labors and women using lumbar epidural, the longest. Operative delivery was significantly more common in women receiving lumbar epidural. No significant inter-group differences were noted in cord pH or Apgar scores. Parturients and midwives both gave high consumer satisfaction ratings to all methods--except for pethidine + promazine, whose use must therefore be questioned. The analgesic efficacy of lumbar epidural outweighs any possible side effects. Entonox appears suited to those able to cope with the earlier part of labor, drug-free. Realization of the potential of TENS requires the design of machines specifically to cope with the quality of the pain of labor.

Anesthesia, Epidural↗
PubMed1986

Pain relief in labour using transcutaneous electrical nerve stimulation (TENS). A TENS/TENS placebo controlled study in two parity groups.

The analgesic effects of transcutaneous electrical nerve stimulation (TENS) in labour and effects on outcome were investigated in a double-blind TENS/TENS placebo controlled trial in 100 primigravidae and 50 women in their third labour. There were no differences between the TENS and the TENS placebo users in terms of pain concept or relief, and only 12 and 13% of primigravidae and 48 and 39% of the para 2 women completed labour without requiring other analgesia in their respective groups. The primigravidae who used either TENS or TENS placebo alone had shorter labours than those who required further analgesia. Although the outcome of labour for mother and infant were similar in the two groups, there was a higher operative delivery rate in women who also had epidural analgesia. There were highly significant differences between the TENS and the TENS placebo users in terms of favourable and unfavourable comments by the mothers and the midwives at 1 and 24 h after delivery. The evident consumer satisfaction for TENS suggests TENS has a part to play in analgesia in labour but the equivocal findings in terms of factors associated with pain relief points to the need for apparatus more specifically designed to cope with the special characteristics of the pain of labour.

Clinical Trials as Topic↗
PubMed1979

The Kevorkian curette. An appraisal of its effectiveness in endometrial evaluation.

Office endometrial biopsy with the Kevorkian curette was performed in 400 patients presenting with abnormal uterine bleeding or other endometrial cancer-risk indicators. The use of this instrument has proved to be a safe, simple, inexpensive, and highly reliable outpatient procedure with excellent patient acceptance. It has provided tissue for adequate diagnosis in 91.8% of the cases, and the diagnostic accuracy when controlled by D&C and/or total abdominal hysterectomy (TAH) was 96.2%. As a result, 73.5% of the women required no further surgical procedures for either diagnostic or therapeutic purposes. In the postmenopausal age group, adenocarcinoma was diagnosed in 7 of 177 (3.9%) women. This procedure is highly recommended for early office diagnosis of uterine pathology and, in particular, endometrial adenocarcinoma and its presumed precursor lesion, adenomatous hyperplasia.

Adenocarcinoma↗