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Biomedical subjects

S Nelson

Publications and source records attributed to S Nelson.

At least 37 records · Page 2Linked to original sources
PubMed2001

From salvation to civics: service to the sick in nursing discourse.

This paper explores the emergence of civics discourse in early 20th-century nursing. It foregrounds this discussion with an analysis of the attempt to secularise nursing that occurred in 1789 during the French Revolution. It then examines the discursive displacement of religious vocational fervour by civic and patriotic imperatives during the first two decades of the 20th century. Contemporary scholars have portrayed nursing's professional development as characterised by tension between the professional elitist agenda of the nursing leadership, and the rank and file positioning of nursing as a female occupation. By contrast, this paper focuses on the porosity of nursing to broader trends such as civic discourse, the labour movement, feminism and socialism, and works to shift our understanding of nursing's professional history from a dialectical model (professional versus industrial), to one of multiplicity in political and ethical values. It argues that civic and patriotic discourse provided the framing for the secular nurse's subjectivity and the mechanism by which nurses negotiated the moral dangers of care of the sick and male bodies without the protection of vow or veil.

Christianity↗
PubMed2001

Three-dimensional magnetic resonance spectroscopic imaging of histologically confirmed brain tumors.

The goal of this study was to determine whether presurgical metabolite levels measured by 3D MR Spectroscopic Imaging (MRSI) can accurately detect viable cancer within human brain tumor masses. A total of 31 patients (33 exams, 39 pathology correlations) with brain tumors were studied prior to surgical biopsy and/or resection. The 3D MRSI was obtained with a spatial resolution of 0.2 to 1 cc throughout the majority of the mass and adjacent brain tissue using PRESS-CSI localization. Levels of choline, creatine and NAA were estimated from the locations of the resected tissue and normalized to normal appearing brain tissue. The data were correlated with subsequent histologic analysis of the biopsy tissue samples. Although there were large variations in the metabolite ratios, all regions of confirmed cancer demonstrated significant choline levels and a mean choline/NAA ratio of 5.84 + 2.58 with the lowest value being 1.3. This lowest value is greater than 4 standard deviations above the mean (0.52 +/- 0.13) found in 8 normal volunteers. The choline signal intensities in confirmed cancers were significantly elevated compared to normal appearing brain tissue with a mean ratio of 1.71 +/- 0.69. Spectra with no significant metabolite levels were observed in the non-enhancing necrotic core of the tumor masses. The results of this study indicate that 3D MRSI of brain tumors can detect abnormal metabolite levels in regions of viable cancer and grades and can differentiate cancer from necrosis and/or normal brain tissue.

Biomarkers, Tumor↗
PubMed2001

Measuring and improving patients' and families' perceptions of care in a system of pediatric hospitals.

BACKGROUND: Shriners Hospitals for Children (SHC) is a network of 22 pediatric specialty hospitals that provide medical care free of charge to children up to 18 years of age and that serve as referral centers for children with complex orthopedic and burn problems. In 1998 the SHC system began using The Picker Institute's Patient and Family Perception of Care inpatient survey throughout its hospitals. SYSTEMWIDE IMPLEMENTATION: A broad-based implementation plan was developed to promote acceptance of the perception of care topic and provide education on performance improvement. In 1999 a work group was formed to prioritize areas for improvement, survey benchmark hospitals, and identify best practices in benchmark hospitals. This work group first focused on the dimensions of Partnership Between Families and Clinicians and Information and Education to the Child. In May 1999 the work group began the task of identifying best practices in these two priority dimensions from the SHC benchmark hospitals. Surveys were submitted to those hospitals, asking what they perceived as being the reasons they scored well in those areas. The results of these surveys were used to identify key practices in these benchmark hospitals that are of significant importance in patient and family perceptions of quality care. NEXT STEPS: The challenge is to facilitate cross-facility interactions to understand and adopt best practices. Focus groups will be conducted to further delineate the dimensions with higher problem scores. The SHC system plans to expand the patient surveys to outpatients, to allow for the evaluation of the full complement of hospital patients.

Burn Units↗
PubMed2001

Hairdressing and nursing: presentation of self and professional formation in colonial Australia.

When Lucy Osburn led her team of Nightingale sisters to the Sydney Infirmary in 1868 she knew that a challenge awaited her. Her goal was to transform the colony's only public hospital into a respectable, ordered environment where, according to the Sanitarian view of the universe espoused by Miss Nightingale, the patient would find the resources to heal himself (sic). The prime difficulty was not the filth and disorder of the institution, it was the calibre of the nurses. This paper offers a case study into the issues of presentation of self, institutional shaping and the professional formation of nurses in the late nineteenth and early twentieth century. The aesthetics of bodily grooming and the class and ethnic issues embedded in the professionalisation of nursing will be discussed. The story of nursing provides an exemplar of the disaggregation of a domain of female expertise. The translation of this expertise to a mass occupation embodied significant difficulties. Not the least of these difficulties was the problem nursing leaders encountered when attempting to instil certain personal attributes and vocational values in non pious common women. It will be argued here that it was the inculcation of a specific set of attributes that created the nurse. It is this persona of the nurse, and the challenge that it presented for colonial nurses in the late nineteenth and early twentieth centuries, that this paper explores.

Australia↗
PubMed2001

The psychosocial impact of cancer and lupus: a cross validation study that extends the generality of "benefit-finding" in patients with chronic disease.

Mohr et al. (1999) described the psychosocial effects of multiple sclerosis (MS) from the patient's perspective. Three factors emerged: demoralization, benefit-finding, and deteriorated relationships. The benefit-finding factor suggested that some patients with MS benefited from their illness. We investigated the generalizability of these results by replicating the Mohr et al. study using patients with two diseases, cancer (N = 56) and lupus (N = 31). All participants completed the questionnaire developed by Mohr et al. along with the Profile of Mood States. When the data were analyzed, results showed a three-factor solution very similar to the one reported by Mohr et al. Scores on the demoralization factor were positively related to total mood disturbance and average pain ratings and inversely related to benefit-finding. Conversely, patients who perceived more benefits from their illness suffered less. We conclude that benefit-finding is not unique to patients with MS but occurs in patients with other chronic diseases.

Adaptation, Psychological↗
PubMed2001

Cytokine treatment of bacterial pneumonia.

The lungs represent the largest epithelial surface area of the body and are repeatedly exposed to a variety of potential pathogens. The respiratory system has, therefore, developed an elaborate system of defense mechanisms to maintain the sterility of the lower airways. In the event of a defect, either developmental or acquired of any component of these defenses, the host is rendered susceptible to infection of the respiratory tract. Conventional therapy primarily focuses on the selection of appropriate antibiotic therapy and institution of supportive measures. In this article, we discuss emerging immune-based strategies in the treatment of pneumonia that are primarily focused on amplification of the host defense system through the administration of cytokines.

Animals↗
PubMed2001

CD4+ lymphocyte responses to pulmonary infection with Mycobacterium tuberculosis in naïve and vaccinated BALB/c mice.

The Biostack experiments I and II were flown on board the Apollo 16 and 17 command modules in order to obtain information on the biological damage produced by the bombardment of heavy high-energy (HZE) particles of cosmic radiation during spaceflight. Such data are required for estimating radiation hazards in manned spaceflight. Seven biological systems in resting state (Bacillus subtilis spores, Colpoda cucullus cysts, Arabidopsis thaliana seeds, and eggs of Artemia salina, Tribolium castaneum and of Carausius morosus) were accommodated in the two Biostacks. By using a special sandwich construction of visual track detectors and layers of biological objects, identification of each hit biological object was achieved and the possible biological damage correlated with the physical features of the responsible HZE-particle. In the different systems the degree of damage depended on whether the hit cell was replaceable or not. A high sensitivity to HZE-particle bombardment was observed on Artemia salina eggs; 90% of the embryos, which were induced to develop from hit eggs, died at different developmental stages. Malformations of the abdomen or the extremities of the nauplius were frequently induced. In contrast, the growth of hit Vicia faba radiculae and the germination of hit Arabidopsis thaliana seeds and hit Bacillus subtilis spores were not influenced remarkably. But there was an increase in multicaulous plants and a reduction in the outgrowth of the bacteria] spores. In addition, information was obtained on the fluence of the HZE-particles, on their spectrum of charge and energy loss, and on the absorption by the Apollo spacecraft and the Biostack material itself. This will help to improve knowledge concerning radiation conditions inside of spacecrafts, necessary to secure a The Biostack experiments I and II were flown on board the Apollo 16 and 17 command modules in order to obtain information on the biological damage produced by the bombardment of heavy high-energy (HZE) particles of cosmic radiation during spaceflight. Such data are required for estimating radiation hazards in manned spaceflight. Seven biological systems in resting state (Bacillus subtilis spores, Colpoda cucullus cysts, Arabidopsis thaliana seeds, and eggs of Artemia salina, Tribolium castaneum and of Carausius morosus) were accommodated in the two Biostacks. By using a special sandwich construction of visual track detectors and layers of biological objects, identification of each hit biological object was achieved and the possible biological damage correlated with the physical features of the responsible HZE-particle. In the different systems the degree of damage depended on whether the hit cell was replaceable or not. A high sensitivity to HZE-particle bombardment was observed on Artemia salina eggs; 90% of the embryos, which were induced to develop from hit eggs, died at different developmental stages. Malformations of the abdomen or the extremities of the nauplius were frequently induced. In contrast, the growth of hit Vicia faba radiculae and the germination of hit Arabidopsis thaliana seeds and hit Bacillus subtilis spores were not influenced remarkably. But there was an increase in multicaulous plants and a reduction in the outgrowth of the bacteria] spores. In addition, information was obtained on the fluence of the HZE-particles, on their spectrum of charge and energy loss, and on the absorption by the Apollo spacecraft and the Biostack material itself. This will help to improve knowledge concerning radiation conditions inside of spacecrafts, necessary to secure a The Biostack experiments I and II were flown on board the Apollo 16 and 17 command modules in order to obtain information on the biological damage produced by the bombardment of heavy high-energy (HZE) particles of cosmic radiation during spaceflight. Such data are required for estimating radiation hazards in manned spaceflight. Seven biological systems in resting state (Bacillus subtilis spores, Colpoda cucullus cysts, Arabidopsis thaliana seeds, and eggs of Artemia salina, Tribolium castaneum and of Carausius morosus) were accommodated in the two Biostacks. By using a special sandwich construction of visual track detectors and layers of biological objects, identification of each hit biological object was achieved and the possible biological damage correlated with the physical features of the responsible HZE-particle. In the different systems the degree of damage depended on whether the hit cell was replaceable or not. A high sensitivity to HZE-particle bombardment was observed on Artemia salina eggs; 90% of the embryos, which were induced to develop from hit eggs, died at different developmental stages. Malformations of the abdomen or the extremities of the nauplius were frequently induced. In contrast, the growth of hit Vicia faba radiculae and the germination of hit Arabidopsis thaliana seeds and hit Bacillus subtilis spores were not influenced remarkably. But there was an increase in multicaulous plants and a reduction in the outgrowth of the bacteria] spores. In addition, information was obtained on the fluence of the HZE-particles, on their spectrum of charge and energy loss, and on the absorption by the Apollo spacecraft and the Biostack material itself. This will help to improve knowledge concerning radiation conditions inside of spacecrafts, necessary to secure a maximum possible protection to the astronauts.

Animals↗
PubMed2001

Oral jaw behaviors in TMD and bruxism: a comparison study by severity of bruxism.

The purpose of this study was to document the prevalence of oral jaw behaviors concomitant to bruxism in TMD+bruxing behavior patients and in nonbruxer controls. Clinical examination, questionnaires, and specific criteria to allocate patients to mild, moderate, and severe groups of TMD and bruxers were used. The sample consisted of 274 TMD+bruxing behavior patients and 52 control non-bruxing behavior groups evaluated at the Center for the Study of TMD. The mean age of the TMD+bruxing behavior group was about 33.11 years old (range 16.66, SD = 11.52) as compared to 34.90 years old (range 17-67, SD = 14.26) in the control group. Oral jaw behaviors were assessed in the mild, moderate, and severe TMD+bruxing groups, and in the corresponding control group. It was found that the prevalence of oral jaw behaviors was higher in the TMD+bruxing behavior group as compared to the control. Hence, concomitant oral jaw behaviors predominated in bruxers and increased with its severity. The data reinforce the need to assess TMD patients in terms of the presence of bruxism, its severity, and concomitant oral jaw habits. Such approach will enable the clinician to have better understanding about the role of these behaviors in TMD. Epidemiological data was also provided regarding jutting the jaw forward (a rarely-described oral jaw habit) in a relatively large sample of TMD+bruxing patients, suggesting a more clinical intervention in children and adolescents. This study is the first to document the prevalence of specific oral jaw habits in a relatively large sample of TMD+bruxing behavior classified by degree of severity. Results suggest that TMD+bruxing patients may present many other additional oral jaw habits which may concur to increase masticatory muscle activity thus leading to TMD signs and symptoms. Factors responsible for the increased frequency of oral jaw habits with the severity of bruxism behavior remain unknown and therefore further studies are needed.

Adolescent↗
PubMed2001

Intimate partner violence, dependence symptoms and social consequences from drinking among white, black and Hispanic couples in the United States.

This study estimates the association of intimate partner violence (IPV) and alcohol-dependence symptoms, social consequences from drinking, and drug use among white, black, and Hispanic couples. A probability sample of 555 white, 358 black, and 527 Hispanic couples in the U.S. household population was interviewed in 1995. The response rate was 85%. Bivariate analysis indicates that most problem status variables are associated with increased rates of male-to-female (MFPV) and female-to-male (FMPV) partner violence. Logistic regression analyses showed that predictors of MFPV and FMPV vary by ethnicity.

Adult↗
PubMed2001

Keratinocyte growth factor attenuates hydrostatic pulmonary edema in an isolated, perfused rat lung model.

Hydrostatic pulmonary edema is a common complication of congestive heart failure, resulting in substantial morbidity and mortality. Keratinocyte growth factor (KGF) is a mitogen for type II alveolar epithelial and microvascular cells. We utilized the isolated perfused rat lung model to produce hydrostatic pulmonary edema by varying the left atrial and pulmonary capillary pressure. Pretreatment with KGF attenuated hydrostatic edema formation. This was demonstrated by lower wet-to-dry lung weight ratios, histological evidence of less alveolar edema formation, and reduced alveolar accumulation of intravascularly administered FITC-labeled large-molecular-weight dextran in rats pretreated with KGF. Thus KGF attenuates injury in this ex vivo model of hydrostatic pulmonary edema via mechanisms that prevent increases in alveolar-capillary permeability.

Animals↗
PubMed2001

Interleukin-17 and lung host defense against Klebsiella pneumoniae infection.

Bacterial pneumonia remains an important cause of morbidity and mortality worldwide, especially in immune-compromised patients. Cytokines and chemokines are critical molecules expressed in response to invading pathogens and are necessary for normal lung bacterial host defenses. Here we show that interleukin (IL)-17, a novel cytokine produced largely by CD4+ T cells, is produced in a compartmentalized fashion in the lung after challenge with Klebsiella pneumoniae. Moreover, overexpression of IL-17 in the pulmonary compartment using a recombinant adenovirus encoding murine IL-17 (AdIL-17) resulted in the local induction of tumor necrosis factor-alpha, IL-1beta, macrophage inflammatory protein-2, and granulocyte colony-stimulating factor (G-CSF); augmented polymorphonuclear leukocyte recruitment; and enhanced bacterial clearance and survival after challenge with K. pneumoniae. However, simultaneous treatment with AdIL-17 provided no survival benefit after intranasal K. pneumoniae challenge. These data show that IL-17 may have a role in priming for enhanced chemokine and G-CSF production in the context of lung infection and that optimally timed gene therapy with IL-17 may augment host defense against bacterial pneumonia.

Animals↗
PubMed2001

Filgrastim in patients with pneumonia and severe sepsis or septic shock.

STUDY OBJECTIVES: Evaluate the safety of filgrastim (recombinant methionyl human granulocyte colony-stimulating factor) administration, combined with standard therapy, in patients with pneumonia and either septic shock or severe sepsis who were receiving mechanical ventilation. DESIGN: Multicenter, double-blind, randomized, placebo-controlled study. SETTING: ICU, multicenter. PATIENTS: Eighteen patients with pneumonia and hypotension, or in the absence of shock, two or more end-organ dysfunctions, were enrolled and treated. Baseline acute physiology and chronic health evaluation II scores and median age for the filgrastim (n = 12) and placebo (n = 6) groups were 25.0 and 49.5 years and 31.5 and 56.5 years, respectively. INTERVENTION: Filgrastim (300 microg) or placebo was administered IV daily for up to 5 days. MEASUREMENTS AND RESULTS: Study end points included safety; biological response, including endogenous cytokine levels, endotoxin levels, and neutrophil counts; and mortality. Cytokine and endotoxin levels were highly variable in both groups. By day 29, 3 of 12 filgrastim-treated patients and 4 of 6 placebo-treated patients had died. There were no differences in types and occurrences of adverse events, including ARDS, or in outcome between the two groups. Three of four placebo-treated patients had persistent bacterial growth on bronchoscopy repeated after 48 h compared with 2 of 10 filgrastim-treated patients. CONCLUSION: Filgrastim appeared to be well tolerated in this population of patients with pneumonia and severe sepsis or septic shock. Larger studies to determine the benefit of filgrastim in patients with pneumonia and sepsis or organ dysfunction are warranted.

Adult↗
PubMed2001

Novel nonantibiotic therapies for pneumonia: cytokines and host defense.

Effective host defense against bacterial infection is dependent on the activation and recruitment of phagocytic cells. The initiation, maintenance, and resolution of this inflammatory response in the setting of bacterial pneumonia is dependent on the expression of cytokines. As the complexities of the host-pathogen interaction are further dissected and unraveled, immunologic manipulation of cytokine expression will likely become an important adjuvant therapy in the treatment of serious lung infections.

Animals↗
PubMed2001

Inhibition of hematopoietic progenitor cell proliferation by ethanol in human immunodeficiency virus type 1 tat-expressing transgenic mice.

BACKGROUND: A number of hematological abnormalities are associated with both human immunodeficiency virus type 1 (HIV-1) infection and alcohol abuse. There is little information on how alcohol abuse might further influence the survival and growth of hematopoietic progenitors in HIV-infected individuals in the presence of immune system abnormalities and anti-HIV drugs. Because there is evidence that viral transactivator Tat itself can induce hematopoietic suppression, in this study we examined the role of ethanol as a cofactor in transgenic mice that expressed HIV-1 Tat protein. METHODS: Tat transgenic mice and nontransgenic littermates were given ethanol (20% v/v) and the anti-HIV drug 3'-azido-3'-deoxythymidine (AZT; 1 mg/ml) in drinking water. Immunosuppression in mice was induced by weekly intraperitoneal injections of anti-CD4 antibody. Hematopoiesis was examined by erythroid colony forming unit (CFU-E) and granulocyte/macrophage colony-forming unit (CFU-GM) assays of the bone marrow progenitor cells. RESULTS: Administration of ethanol for 7 weeks resulted in a 50% decrease in the proliferative capacity of CFU-E- and CFU-GM-derived progenitors from transgenic mice compared with that of ethanol-treated nontransgenic controls. Similar decreases also were observed in transgenic mice treated with AZT or a combination of AZT and ethanol. Furthermore, ethanol and AZT were significantly more toxic to the granulopoietic progenitors (40-50% inhibition) than to the erythropoietic progenitors (10-20% inhibition) in Tat transgenic mice. Although a 10 day exposure of Tat transgenic and nontransgenic mice to a combination of ethanol and AZT had no suppressive effect on the erythropoietic and granulopoietic progenitor cells, there was a marked decrease (40-60%) in CFU-GM in mice made immunodeficient by CD4+ T-lymphocyte depletion. The ethanol-treated Tat transgenic mice but not the nontransgenic litter-mates also showed a significant decrease (25%) in CFU-GM. CONCLUSION: Our in vivo study strongly suggests that ethanol ingestion in HIV-1-infected individuals, particularly those on antiretroviral drugs, might increase bone marrow toxicity and contribute to HIV-1-associated hematopoietic impairment.

Animals↗
PubMed2001

Implications for dental education of a dental school-initiated practice research network.

The Case Western Reserve University (CWRU) School of Dentistry has organized a research network of 210 general dentists in northern Ohio. Seventeen of these dentists have volunteered to serve on a steering committee, for the purpose of generating research questions and helping with network organization. To enable the practitioners to investigate questions of interest in their practices, faculty in the CWRU schools of Dentistry and Medicine provide consultation to network dentists, as needed, with regard to research design, implementation, and analysis. In turn, the network serves as a resource for the dental school, facilitating faculty development, encouraging the development of new research programs, and providing an opportunity for students throughout the university to become involved in dental practice research. To date, faculty members have initiated studies of dental practice that include a survey of dentists' attitudes toward tobacco, a weekly return caries study, and a direct observation study of general dental practice. The network provides a research "laboratory" for the dental school, enabling clinical faculty to participate in research concerning dental practice. It has also stimulated a major re-examination of several curriculum elements in the school.

Adult↗
PubMed2000

A randomized controlled trial of filgrastim for the treatment of hospitalized patients with multilobar pneumonia.

This study assessed the safety and efficacy of filgrastim (r-metHuG-CSF [recombinant human methionine granulocyte colony-stimulating factor]), when combined with intravenous (IV) antibiotics, in the treatment of hospitalized adult patients with multilobar community-acquired pneumonia (CAP). Four hundred eighty patients were randomized to receive placebo (n=243) or filgrastim 300 microg/day (n=237), in addition to standard therapy. Treatment with study drug was continued for 10 days, until the peak white blood cell (WBC) count reached 75x109/L, until discharge from the hospital, until death, or until IV antibiotics were discontinued. Study-related observations continued through day 29. Filgrastim increased WBC counts (baseline median, 13.3x109/L; median peak, 43. 8x109/L). The 2 treatment groups were not statistically different with respect to the study end points; however, there was a trend toward reduction of mortality in patients with pneumococcal bacteremia. Although further studies will be required to validate this observation, filgrastim was safe and well tolerated when administered to patients with multilobar CAP.

Adult↗