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Biomedical subjects

Pamela Thompson

Publications and source records attributed to Pamela Thompson.

11 recordsLinked to original sources
PubMed2006

Predicting memory decline following epilepsy surgery: a multivariate approach.

BACKGROUND: While some patients experience a decline in memory function following an anterior temporal lobe resection, there is considerable individual variation in the extent, nature, and direction of postoperative memory change. Patients with surgically remediable temporal lobe epilepsy differ in etiology, the extent and type of underlying pathology, and on demographic and epilepsy-related variables, all of which may have an impact on their pre- and postoperative neuropsychological functioning. This study examined the relationship between these variables and postoperative memory decline. METHODS: Logistic regression was used to examine the effects of age, laterality of surgery, age of onset of epilepsy, underlying pathology and preoperative level of memory function on postoperative verbal learning in 288 patients who had undergone an anterior temporal lobe resection. One hundred twenty-five patients underwent a right temporal lobe resection (RTL), 163 patients underwent a left temporal lobe resection (LTL). RESULTS: In the group as a whole, 25% of the patients demonstrated a significant postoperative deterioration in verbal learning. Postoperative deterioration in verbal learning was significantly associated with higher levels of preoperative function in both the RTL and LTL groups. Older age at the time of the operation and a lower verbal IQ were additional significant predictors for the RTL group. The presence of cortical dysgenesis was a significant predictor of postoperative decline in the LTL group. The logistic regression models accurately identified 3/4 of those who experienced a postoperative decline in memory, using a cutoff of 0.25 or above to identify high risk. CONCLUSIONS: Our analyses suggest that the majority of patients with a high risk of significant postoperative memory decline can be reliably identified preoperatively. These models are valuable tools helping patients make an informed decision regarding surgery.

Epilepsy↗
PubMed2005

GTF2IRD1 in craniofacial development of humans and mice.

Craniofacial abnormalities account for about one-third of all human congenital defects, but our understanding of the genetic mechanisms governing craniofacial development is incomplete. We show that GTF2IRD1 is a genetic determinant of mammalian craniofacial and cognitive development, and we implicate another member of the TFII-I transcription factor family, GTF2I, in both aspects. Gtf2ird1-null mice exhibit phenotypic abnormalities reminiscent of the human microdeletion disorder Williams-Beuren syndrome (WBS); craniofacial imaging reveals abnormalities in both skull and jaws that may arise through misregulation of goosecoid, a downstream target of Gtf2ird1. In humans, a rare WBS individual with an atypical deletion, including GTF2IRD1, shows facial dysmorphism and cognitive deficits that differ from those of classic WBS cases. We propose a mechanism of cumulative dosage effects of duplicated and diverged genes applicable to other human chromosomal disorders.

Adolescent↗
PubMed2005

SOX2 anophthalmia syndrome.

Heterozygous, de novo, loss-of-function mutations in SOX2 have been shown to cause bilateral anophthalmia. Here we provide a detailed description of the clinical features associated with SOX2 mutations in the five individuals with reported mutations and four newly identified cases (including the first reported SOX2 missense mutation). The SOX2-associated ocular malformations are variable in type, but most often bilateral and severe. Of the nine patients, six had bilateral anophthalmia and two had anophthalmia with contralateral microphthalmia with sclerocornea. The remaining case had anophthalmia with contralateral microphthalmia, posterior cortical cataract and a dysplastic optic disc, and was the only patient to have measurable visual acuity. The relatively consistent extraocular phenotype observed includes: learning disability, seizures, brain malformation, specific motor abnormalities, male genital tract malformations, mild facial dysmorphism, and postnatal growth failure. Identifying SOX2 mutations from large cohorts of patients with structural eye defects has delineated a new, clinically-recognizable, multisystem disorder and has provided important insight into the developmental pathways critical for morphogenesis of the eye, brain, and male genital tract.

Adolescent↗
PubMed2005

Measurement of glut-1 expression using tissue microarrays to determine a race specific prognostic marker for breast cancer.

BACKGROUND: African-American women (AAW) have more adverse tumor characteristics than non-African American women (non-AAW) and there is a need for a specific predictive marker for AAW recurrence. Tumors with higher grade and proliferative activity are associated with overexpression of the glucose transporter (Glut-1). An examination of Glut-1 expression relative to recurrence and no recurrence was conducted on both groups to determine if it predicts prognosis and could predict a race specific prognosis. METHODS: A breast cancer data set containing clinical information including race and biological characteristics was generated between 1991 and 1996. Tissue samples were selected from this group with similar characteristics in both racial groups for a retrospective analysis of Glut-1 expression using tissue microarrays (TMAs). Mean Glut-1 expression for intensity and percent of tumor cells staining was determined using standard immunohistochemistry. RESULTS: Clinical and biological differences were noted in the original data set between AAW and non-AAW. No significant difference between races was noted in mean Glut-1 values using a subset which had similar characteristics. The mean Glut-1 did not predict recurrence but a rounded score did indicate that higher levels of Glut-1 expression was indicative of a lower disease free survival (p = 0.063). The actual average mean for AAW with no recurrence was significantly lower than any other group (p = 0.04). Conclusions. TMA analysis for Glut-1 expression may be useful to predict disease free survival but it does not predict race specific recurrence.

Black or African American↗
PubMed2005

Defining meaningful postoperative change in epilepsy surgery patients: measuring the unmeasurable?

Two hundred and ninety epilepsy surgery patients completed the Hospital Anxiety and Depression Scale and were assessed on a list learning task preoperatively and 1 year postoperatively. Deterioration and improvement in verbal memory were determined using reliable change indices (RCIs) at 80 and 90% confidence limits. Almost one third of patients (27%) experienced a deterioration in verbal learning. The number of left temporal lobectomy patients who had deteriorated outnumbered the right temporal lobectomy patients by 2:1. Significant improvements in verbal learning were seen in 21% of the right temporal lobectomy group and 10% of the left temporal lobectomy group. Patients who were seizure-free postoperatively were not more likely to experience a postoperative deterioration or improvement in memory than those who continued to experience seizures. No significant relationships were found between subjective ratings of postoperative memory function and objective indices of change. Reliable, objective indices of postoperative deterioration in memory function may bear little relation to the patient's subjective experience. This should be considered when statistical predictions are used as the basis of preoperative counseling.

Adult↗
PubMed2005

Policy perspectives of major nursing organizations, part II. Interview by David M Keepnews.

Understanding the roles of interest groups is an important element of examining policy change. There are a number of interest groups that affect the policy environment for nursing and that shape the profession's impact on health policy. This article, the second of a two-part series, presents interviews with executive directors and chief executive officers of major nursing organizations about their organizations' policy priorities and policy-related activities. Included in this article are the American Organization of Nurse Executives, the National League for Nursing, Sigma Theta Tau International, and the National Black Nurses Association.

Health Policy↗
PubMed2004

Testing of a dual-mode microwave care regimen for hydrogel lenses.

PURPOSE: To test the design of a patient care regimen for soft lenses that aims to provide the highest standards of disinfecting through use of domestic microwave cookers, while also providing storage equipment and solution that enable patients to follow a conventional cold disinfecting regimen when traveling. The cleaning efficacy of surfactant agents during microwave treatment was also considered. METHODS: The microbiologic performance of the regimen and its disinfecting apparatus was tested according to the Food and Drug Administration (FDA) protocols for contact lens heat disinfectors. Subsequently, a prospective pilot clinical trial of the regimen involving 15 subjects was carried out to the protocols of the FDA and International Standards Organization 11,980:1997. RESULTS: Lenses inoculated with 10(7) colony-forming units (cfu) of Enterococcus faecalis were disinfected to 0 cfu by a 12-s irradiation of a compact disinfecting case that held the lenses suspended in 12 ml saline. A proof of operation indicator performed correctly for all 10 cases tested. No adverse reactions were found in the pilot patient trial, using Renu multipurpose (Bausch and Lomb, Rochester, NY) as the test solution, and no statistically significant difference was found between test and control groups in respect of any sign. However, the greater incidence of edema, palpebral hyperemia, and lens front-surface deposition in the microwave test group may be clinically significant. CONCLUSIONS: The design of the test care regimen proved easy for patients to follow in either hot or cold disinfecting mode. The greater incidence of certain signs in the microwave test group suggests the need to continue using a rub and rinse step for the microwave mode and for additional investigation into the choice of an appropriate multipurpose solution formulation for this proposed regimen, preferably one that does not use a block copolymer-type surfactant agent.

Contact Lens Solutions↗
PubMed2004

Guiding principles.

Uncertainty about the future does not justify delaying action. It's time to redefine work roles and competencies needed to deliver quality care.

Delivery of Health Care↗
PubMed2003

Topiramate and word-finding difficulties in patients with epilepsy.

OBJECTIVE: To evaluate the prevalence of word-finding difficulties as a treatment-emergent adverse event in patients with epilepsy taking topiramate and to identify a clinical phenotype at risk. METHODS: The authors investigated the relationship of word-finding difficulties to topiramate titration schedule, seizure frequency and pattern, and EEG and neuroradiologic findings in 431 consecutively and prospectively collected patients taking topiramate. RESULTS: Thirty-one patients (7.2%) developed word-finding difficulties. Presence of simple partial seizures (OR = 6.7 p = 0.007) and a left temporal EEG epileptic focus (OR = 5.2 p = 0.021) were significantly associated with word-finding difficulties. CONCLUSIONS: The presence of word-finding difficulties seems to be a titration schedule independent phenomenon that occurs in a subgroup of patients with a specific biologic vulnerability.

Adult↗
PubMedDate not supplied

Comparison of cytology proficiency testing: glass slides vs. virtual slides.

OBJECTIVE: To compare proficiency testing in gynecologic cytology using glass slides vs. virtual slides. STUDY DESIGN: To compare performance, a sample of 111 individuals (pathologists = 52, cytotechnologists = 59) from participating in-state laboratories were administered 2 proficiency tests. The annual test of the Maryland Cytology Proficiency Testing Program (MCPTP) was administered to individuals in their laboratories following normal work practice (i.e., using microscopes and equipment with which they were familiar). The other test was CytoView II (Centers for Disease Control and Prevention, Atlanta, Georgia, U.S.A.), a computer-based test composed of virtual slides captured from the MCPTP's glass slides, which test administration personnel transported to the individual's laboratory and administered using 1 of 2 laptop computers. ANOVA was used to compare the performance on the 2 tests and the effect of various potential confounding variables. The slides were evaluated by comparing the performance average for each glass slide to that of the matching virtual slides. All data analysis was performed at the 95% confidence interval. RESULTS: The mean score of the individuals (n = 111) on the MCPTP test was 99.2% (SD = 2.2, range = 90-100%). The mean score of the individuals (n = 111) on CytoView II was 96.8% (SD = 5.8, range = 70-100%). No individual scored < 90% on the glass slide test (pass rate = 100%). Eight individuals (pathologists = 3, cytotechnologists = 5) scored < 90% on the CytoView II (pass rate = 93.8%). Comparison of an individual's performance on the 2 tests demonstrated a significant difference. When virtual slides that did not attain a 90% consensus were excluded from the scoring, a comparison of individual pass rate for the glass slide test (100%) and computer-based test (99.1%) did not demonstrate significant difference. CONCLUSION: Each slide (glass or virtual) must be field validated by cytotechnologists and pathologists. If field validation and Clinical Laboratory Improvement Amendment referencing of virtual slides are comparable to those of glass slides, computer-based testing can be equivalent.

Cell Biology↗