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Biomedical subjects

S Long

Publications and source records attributed to S Long.

At least 37 records · Page 2Linked to original sources

Long-term outcome of brain manganese deposition in patients on home parenteral nutrition.

Manganese intoxication has been described in children on long term parenteral nutrition presenting with liver and nervous system disorders. Cases are reported of a brother and sister on long term parenteral nutrition with hypermanganesaemia and basal ganglia manganese deposition, detected by magnetic resonance imaging (MRI), without overt neurological signs. Following reduction of manganese intake, basal ganglia manganese was monitored by repeated MRI, and neurological and developmental examinations. An MRI intensity index of the globus pallidus declined over a three year period from 0.318 and 0.385 to 0.205 and 0.134 with concomitant falls in whole blood manganese from 323 and 516 to 226 and 209 nmol/l (normal range, 73-210 nmol/l). Unlike adult experience these children developed normally without neurological signs. In conclusion, deposited manganese is removed from neural tissue over time and the prognosis is good when neurological manifestations and liver disease are absent.

Basal Ganglia↗

Expression of biologically active human insulin-like growth factor-I following intramuscular injection of a formulated plasmid in rats.

Recent evidence has shown that insulin-like growth factor-I (IGF-I) plays an important role in the development, maintenance, and regeneration of peripheral nerves and skeletal muscle. IGF-I offers the potential to treat neuromuscular diseases in humans. We have developed a nonviral gene therapy method to express and produce localized and sustained therapeutic levels of IGF-I within target muscles by intramuscular injection of formulated plasmids. The purpose of the present study was to demonstrate that intramuscular injection of a plasmid encoding human IGF-I (hIGF-I) and engineered to restrict expression to skeletal muscle produces sustained local concentrations of biologically active hIGF-I. Normal rats received a single intramuscular injection of plasmids formulated as a complex with polyvinylpyrrolidone (PVP). Results show that hIGF-I mRNA and hIGF-I protein were detectable in the injected muscles for the duration of the study (28 days), whereas the hIGF-I protein was not detected in blood. Biological activity of hIGF-I was determined by immunodetection of a nerve-specific growth-associated protein, GAP-43, an indicator of motor neuron sprouting. Placement of human growth hormone (hGH) 3' untranslated region enhanced GAP-43 staining, probably due to improved secretion of hIGF-I. Enhanced immunoreactivity of GAP-43 was observed in muscles injected with the formulated hIGF-I plasmid when compared to controls. These results demonstrate that intramuscular injection of hIGF-I plasmid formulated as a complex with PVP produces a localized and sustained level of biologically active hIGF-I.

Animals↗

Counting the cost: hospital versus home central venous catheter survival.

We compared catheter survival and sepsis rates in a tertiary paediatric gastroenterology centre with those at home in the same patients. We examined whether there were differences in the safety in the two locations, and estimated the financial and opportunity cost implications of any difference. We used survival analysis to analyse differences. Surgical records were audited to determine venous access workload, and to estimate cost implications. Twenty patients with chronic intestinal failure but stable parenteral nutrition requirements, ranging from 0.04-15.83 years of age were studied. The duration of line survival and sepsis-free intervals and rates of re-operation for venous access were determined to estimate morbidity and costs. The study encompassed 28 patient-years in hospital and 48 patient-years at home. There was a significant reduction in the rate of sepsis at home compared with hospital (Z = 4.30, P < 0.00001), and a similar improvement in line survival (Z = 4.36, P < 0.00001). Line insertions accounted for 21% of minor surgery in our hospital, one third being reinsertions. We conclude that central venous catheter sepsis rates are greatly improved at home. If home results could be achieved in the hospital setting, considerable cost savings would be made.

Adolescent↗

National survey of the impact of low vision device use among veterans.

BACKGROUND: This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through he Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs. METHODS: Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Factor analyses were used to describe prescription and use patterns. RESULTS: Most (85.4%) of the devices were still in use. Having a helper in the home was a demographic variable related to continued use. Neither age, acuity, nor etiology were related to continued use. Strong prescription and use patterns emerged. Most veterans reported receiving > 20 h of training and > 20 h of practice in the use of their LVDs. CONCLUSIONS: Most veterans who receive LVDs through the service delivery system of the Department of Veterans Affairs appear to use them for a wide variety of daily tasks and reported that they obtain a great deal of benefit from their use.

Adult↗

Veterans' use of low vision devices for reading.

BACKGROUND: This report presents the results of a 2-year study of veterans' use of low vision devices (LVDs) which were prescribed and dispensed through the Blind Rehabilitation Centers (BRCs) and Visual Impairment Centers to Optimize Remaining Sight (VICTORS) of the Department of Veterans Affairs. METHODS: Two-hundred veterans using 740 LVDs were surveyed by telephone 12 to 24 months after the prescription/dispensing of the devices. Reliability (test-retest) and validity (content, criterion-related, and construct) were established for the survey. Primary analysis of the data was accomplished through tabular presentations. Because most devices were used for reading, an exploratory data analysis was completed to further investigate successful use of LVDs for this task. Relationships of 21 variables with a definition of highly successful use, use and nonuse of LVDs for reading were evaluated. RESULTS: Only visual acuity provided a statistically significant predictor of use of LVDs for reading. LVDs in the lowest visual acuity grouping tend to be used either highly successfully, or fall into the nonuse category. The highly successful LVDs are primarily video magnifiers; the nonused LVDs tended to be spectacle magnifiers. CONCLUSIONS: This population is using devices extensively for reading, reporting frequencies of use of several times per day.

Health Surveys↗

Being together as a family.

The mothers and fathers of six newborn infants, hospitalised for gastro-intestinal surgery were interviewed about their needs. Parental needs were categorised into the theoretical concepts of 'coming to terms', 'developing understanding' and 'achieving contact' with the dominant theme for parents being that of 'seeking to be together as a family unit'. Nursing interventions in this context should be aimed at addressing these needs.

Adult↗

[Effect of levodopa on visual evoked potential in amblyopia].

PURPOSE: To evaluate the efficacy of levodpa treatment for amblyopia. METHODS: The patients with amblyopin were given a single dose of levodopa, and the normal control group was established with the other normal eye in unilateral amblyopia. Their pattern visual evoked potential(PVEP) were tested before and after taking levodopa. RESULTS: After taking a single dose of levodopa, the PVEP in the normal eyes showed that the N1P1 amplitudes evoked by middle spatial frequency stimuli and the P1N2 amplitudes evoked by high spatial frequency stimuli increased, however, in the amblyopic eyes showed that the N1 latency evoked by low spatial frequency stimuli and P1 latency evoked by middle spatial frequency decreased. CONCLUSION: A single dose of levodopa administration can induce improvement of PVEP in the amblyopic eyes, and levodopa may be efficacious in the amblyopic therapy.

Adolescent↗

[Study of the relationship between human quality and reliability].

To clarify the relationship between human quality and reliability, 1925 experiments in 20 subjects were carried out to study the relationship between disposition character, digital memory, graphic memory, multi-reaction time and education level and simulated aircraft operation. Meanwhile, effects of task difficulty and enviromental factor on human reliability were also studied. The results showed that human quality can be predicted and evaluated through experimental methods. The better the human quality, the higher the human reliability.

Aviation↗

Report on the progress of standardization of the G-banded canine (Canis familiaris) karyotype. Committee for the Standardized Karyotype of the Dog (Canis familiaris).

Karyotyping of dog chromosomes is a difficult task owing to the high diploid number of chromosomes (2n = 78) and the similar morphology of autosomes, all of which are acrocentrics. In this report 22 of the 39 G-banded chromosome pairs and their corresponding ideograms have been standardized. The ideogram comprises altogether 235 bands. The need for the introduction of molecular techniques such as chromosome painting and physical mapping of genetic markers for the identification of small acrocentrics is discussed.

Animals↗

Cancer and comorbidity in older patients: a descriptive profile.

In 1992, the National Institute on Aging (NIA) and the National Cancer Institute (NCI) initiated a study to assess the prevalence of comorbid conditions in elderly patients with cancer. Seven cancer sites were selected for the study: breast, cervix, ovary, prostate, colon, stomach, and urinary bladder. This report on approximately 7600 patients in the study sample describes the NIA/NCI approach to developing information on comorbidity in elderly patients and addresses the chronic disease burden (i.e., comorbidity) and severity for six particular conditions: arthritis, chronic obstructive pulmonary disease (COPD), diabetes, gastrointestinal problems, heart-related conditions, and hypertension. Data on comorbidity were collected by abstracting information from hospital medical records. Patients were registered in six geographic areas of the NCI Surveillance, Epidemiology, and End Results (SEER) Program. A stratified random sample of patients aged 55 to 64, 65 to 74, and 75 years or older-with the index cancers were selected. Comorbidity data were matched with data from the conventional SEER monitoring system. Analyses showed that hypertension is the most prevalent condition and is also much more common as a current management problem rather than as history for the NIA/NCI SEER Study patients. Heart conditions varied slightly in the percentage of severity reported, but percentages for all tumors remained within a range of 13 to 26% for current and past categories. A similar range was observed for arthritis, with the higher percentage seen in the current problem category. For episodic complaints (e.g., gastrointestinal problems), a medical history was more common, except for cancers that involve complaints associated with the malignancy (e.g., colon and stomach cancers and, to a lesser extent, ovarian cancer). COPD and diabetes were less prevalent. Analyses currently under way will determine the impact of a patient's comorbidity burden on the cancer care continuum of diagnosis, treatment, and survival. The broad and independent effects of chronic conditions, singly and in combination, are being examined.

Age Distribution↗

Primary health care team workshop: team members' perspectives.

This study explored members' perceptions of teamwork in two primary health care teams (PHCTs). It also examined the effect of a team-building intervention on members' perceptions centred around five topics: the PHCT, role perception, communication, leadership and conflict. The study used a qualitative approach with semistructured interviews before and after the intervention. It was found that members perceived each other's roles only in the light of their interactions with each other. Issues of hierarchy in leadership and interpersonal conflicts were raised. It is concluded that the team-building intervention had some positive effects on team members' perceptions and behaviour. However, further research is needed into management structures and conflict resolution in the PHCT.

Communication↗

Evaluation of a self-medication program.

OBJECTIVE: To determine the effect of an inpatient self-medication program (SMP) on the ability to self-medicate, patient medication knowledge, compliance, and patient morale. DESIGN: Randomized controlled clinical trial. POPULATION: One hundred seven consecutive patients admitted to a geriatric assessment and rehabilitation program were randomized to either participate in the SMP or to receive standard care. INTERVENTION: The SMP was a three-stage program in which patients were given increasing responsibility for the administration of their own medications. MEASUREMENTS: Ability to self-medicate on discharge from hospital; medication compliance at 1 month; patient medication knowledge; Philadelphia Morale Scale. MAIN RESULTS: Participation in the self-medication program did not increase the proportion of patients who were able to self-medicate on discharge from hospital. Compliance was improved by the program. On a proportional basis, the self-medication group made significantly fewer medication errors than the control group at 1-month follow-up (0.045 vs 0.086, P < .001). There were no significant differences in morale or medication knowledge between the SMP and control groups, although both groups made significant gains in knowledge about the names, administration times, and purposes of their medications from admission to follow-up (P < .001). CONCLUSIONS: A SMP can improve compliance in geriatric patients who are discharged to the community. Participation in a SMP does not improve patients' morale nor does it improve their medication knowledge more than pharmacy counselling alone. Participation in a SMP is unlikely to increase the probability that patients will be able to self-medicate on discharge. Cognitive factors limit patients' ability to self-medicate.

Aged↗

Unintended pregnancies and use, misuse and discontinuation of oral contraceptives.

Unintended pregnancies are a recognized occurrence among women using oral contraceptives (OCs) as a consequence of both user and method failure. However, OCs also influence the occurrence of unintended pregnancies through an additional, poorly recognized, route: cessation of OC use by women who do not wish to become pregnant but stop using OCs because of side effects or other reasons. Many such women fail to immediately substitute a new contraceptive and/or adopt a less reliable contraceptive. This is a particularly important consideration for the approximately 3.7 million women who begin taking OCs in the United States each year since this group commonly experiences side effects and has a high discontinuation rate. Using a decision tree to follow a cohort of OC users over one year, we estimate that over 1 million unintended pregnancies are related to OC use, misuse or discontinuation. The greatest proportion of these, 61%, occur in women who discontinue OCs; of these, 66.6% occur in women who fail to immediately substitute other contraceptives and 33.3% because of the adoption of less reliable contraceptive methods. Of continuing OC users, the majority, exhibiting good compliance, contribute 24% of pregnancies because of their large numbers. Continuing OC users who are poor compliers, though many fewer, are responsible for 15% due to their high pregnancy rate. Unintended pregnancies in women who discontinue OCs account for approximately 20% of the 3.5 million annual unintended pregnancies in the United States, incurring costs of nearly +2.6 billion.(ABSTRACT TRUNCATED AT 250 WORDS)

Contraception Behavior↗