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Biomedical subjects

S Richer

Publications and source records attributed to S Richer.

At least 19 recordsLinked to original sources
PubMed2000

Innervation of dromyosuppressin (DMS) immunoreactive processes and effect of DMS and benzethonium chloride on the Phormia regina (Meigen) crop.

Antibody to the dipteran myosuppressin peptide, dromyosuppressin, TDVDHVFLRFamide, stained cells and fibers in the brain, optic lobes, subesophageal ganglion, and thoracico-abdominal ganglion of the blow fly, Phormia regina (Meigen). Dromyosuppressin-like immunoreactive fibers were detected in the cardiac recurrent nerve, hypocerebral ganglion/corpora cardiaca complex, crop duct, and crop. In order to explore the mechanisms involved in regulating crop movement, we established an in vitro bioassay. The basal rate of crop movement was 50.8 +/- 1.5 contractions per minute. Application of 1 microl of saline to the crop did not significantly affect the rate of movement compared to the basal rate (46.1 +/- 1.1 contractions per minute, P < 0.05). Application of 1 microl 10(-6) M dromyosuppressin or 1 microl 10(-3) M benzethonium chloride to the crop slowed the rate to 2.2 +/- 0.2 and 6.1 +/- 0.7 contractions per minute, respectively. Although other data have previously been interpreted to suggest that dipteran crop contractions do not include a neural component, the neuropeptide dromyosuppressin affected P. regina crop motility. Innervation of the crop and crop duct by dromyosuppressin immunoreactive processes that originated in the central nervous system and the effect of dromyosuppressin on crop muscle contractions suggest that dromyosuppressin is released locally to modulate crop contractions and that crop motility is under neural regulation. Myosuppressins isolated from numerous insects have a high degree of structure identity and reduce spontaneous muscle contractions of the hindgut, oviduct, and heart. Benzethonium chloride, previously identified as a myosuppressin agonist on the cockroach hindgut and locust oviduct, mimicked the effect of dromyosuppressin on the crop. This suggests that structural requirements for myosuppressin receptor binding in the cockroach hindgut, locust oviduct, and fruit fly crop are similar.

Animals↗
PubMed2000

Nutritional influences on eye health.

BACKGROUND: As with cardiovascular disease, nutrition and environmental intervention present new clinical practice and research opportunities in eye care. This includes maximizing health potential with food choice, the use of supplementation in high-risk and noncompliant patients, avoiding toxins such as cigarettes, and encouraging exercise. METHOD: The author provides his perspective on viewing biochemical, physiological, and epidemiological research in the context of disease prevention in both common and uncommon applications. In most cases, this approach requires food frequency intake evaluation and application of physiological optics to measure efficacy when there is an alteration in diet and/or addition of supplementation. These are details of ocular integrative medical practice that are ignored or underutilized. RESULTS: There are multiple opportunities for intervention in the age-related diseases of cataract, macular degeneration, and glaucoma. A summary of the application of nutrition to create a model for treatment of age-related macular degeneration is presented. CONCLUSIONS: Economic incentives, now lacking, are required to explore new paradigms in nutritional preventative eye care. Schools and colleges of Optometry could play a vital public health role.

Eye Diseases↗
PubMed1999

A protocol for the evaluation and treatment of atrophic age-related macular degeneration.

BACKGROUND: Age-related macular degeneration (ARMD), the leading cause of vision loss in aging Western societies, is (in part) a nutrition-responsive disease that can be stabilized through environmental intervention. The atrophic form of the disease constitutes nearly 90% of cases, yet a standardized ophthalmic and systemic evaluation protocol does not exist. METHODS: A basic science and epidemiologic rationale for evaluating atrophic ARMD using a standardized low-cost, "low-technology," clinical approach is presented. The protocol is based on optometric physiological optics and ARMD retinal physiology/pathophysiology. RESULTS: The ophthalmic component involves baseline and serial measurements of contrast sensitivity (CSF), low-luminance, low-contrast visual acuity (SKILL), and glare recovery (GR) in each eye. The systemic component includes self-administered evaluation of nutritional status (food and supplement intake), exercise and activities of daily living associated with ARMD (night driving/glare adaptation disturbance and dark green-leafy vegetable/plant food consumption). CONCLUSIONS: The literature supports careful baseline and serial evaluation of high-risk patients using germane parameters of ocular function and systemic health specific to ARMD. This "ARMD workup" is analogous to a glaucoma workup, but involves less equipment and chair time. Any optometrist can obtain these measurements using inexpensive testing protocols. (Part II of this paper presents serial environmental intervention case report data.)

Activities of Daily Living↗
PubMed1999

ARMD--pilot (case series) environmental intervention data.

BACKGROUND: A description and justification for using a standardized clinical low-cost, "low-technology," ocular and systemic "ARMD work-up" protocol was presented in the methods paper (Part I). METHODS: Fourteen male patients (70 +/- 9 years), receiving 0.73 +/- 0.45 portions of dark-green, leafy vegetables/day base intake, were placed on an additional portion of 5 ounces sauted spinach 4 to 7 times per week or lutein-based antioxidant (three patients). Detailed "ARMD work-up" data for six of these patients and summary pilot (case series) environmental intervention data are presented. RESULTS: One, Patients demonstrated short-term positive effects in visual function in one or both eyes with this mild therapeutic approach: Amsler grid (87%); Snellen Acuity (71%); Contrast sensitivity (92%); SKILL (65%); Glare recovery (69%); and Activities of Daily Vision Subscale (60%); Two, There was no obvious correlation between ophthalmoscopic appearance of the retina and visual outcome; and Three, Patient symptoms did not necessarily correlate with observed changes in visual function. CONCLUSIONS: The approach to atrophic ARMD presented here warrants informal practitioner replication and formal randomized prospective clinical case-control evaluation.

Aged↗
PubMed1997

A practical guide for differentiating between iron deficiency anemia and anemia of chronic disease in children and adults.

Anemia is a common disorder that should be diagnosed and managed in a primary care setting. Iron deficiency and chronic disease anemia are two subtypes of insidious anemias that may be difficult to differentiate. There are often excessive laboratory studies performed, patient delays, and increased costs while completing the workup. With the rising cost of health care, a greater emphasis is being placed on managed care. This type of system utilizes its own resources in a cost-effective manner and encourages the investigation to be in the domain of the primary practitioner. As the nation focuses on this type of delivery system, outside referrals will be limited. Primary care providers as well as physicians in these types of settings will need to become well versed in the interpretation of these uncomplicated anemias. With appropriate training and experience in the interpretation of blood studies and peripheral smears, clinicians can effectively differentiate between these two classifications while easing the burden on the health care system.

Adolescent↗
PubMed1996

Multicenter ophthalmic and nutritional age-related macular degeneration study--part 2: antioxidant intervention and conclusions.

BACKGROUND: The experimental design, subjects, procedures and baseline data for the prospective double blind dry ARMD-antioxidant intervention study have been described in Part 1. METHODS: At eight DVA medical centers, 32 patients (group one) were assigned a placebo and 39 patients (group two) a "broad spectrum" antioxidant capsule. Data was collected in five areas: demographic; ophthalmic; dietary analysis of daily food intake; serum analysis; and adverse gastrointestinal symptoms. Data was serially acquired at baseline, 6 months, 12 months and 18 months, and was analyzed by univariate repeated factors ANOVA, p = 0.05. RESULTS: Group two (antioxidant po BID) maintained their distance LogMAR visual acuity (p = 0.03), while there was a trend toward both stabilized near M print (p = 0.07) and 6 cycle/degree contrast sensitivity (p approximately 0.10), in left eyes. However, group two (antioxidant) also had increased cortical opacification of the right lens (p = 0.04), compared to group one (placebo). Self perceived stabilization of vision was reported by subjects in group two and supported the objective data (Pearson chi square; p = 0.05). CONCLUSIONS: A specific 14 component antioxidant capsule taken twice daily stabilized but did not improve dry ARMD over the study period of 1.5 years. The ARMD stabilized eyes had less advanced disease functionally but not by fundus appearance. Decreased intake of cardioprotective nutrients (vitamin E, zinc, magnesium, B6 and folate) in ARMD patients remained constant over the course of the trial.

Aged↗
PubMed1994

Managing expectations between patient and nurse.

With increasing consumer interest in the cost and quality of healthcare, it is imperative that patients' expectations of nursing care be recognized and managed. This concept is critical to the continued viability of any healthcare institution in the current competitive market. The authors describe the process that one hospital undertook in looking at patient satisfaction with nursing care, the modification of a patient satisfaction tool, and the development of a quality model of care.

Humans↗
PubMed1993

Cutaneous and ocular changes associated with the use of chlorpromazine.

A 57-year-old schizoaffective disorder patient was placed on chlorpromazine because of its sedative properties and low profile for extrapyramidal side effects. After two years of treatment, the patient developed photosensitivity and blue-gray pigmentation of the skin of the face, neck and dorsum of hands. Significant pigment deposits were also observed in eye lens and cornea. An oval translucent lesion lateral to the left angle of the mouth was removed and the biopsy showed a basal cell carcinoma. The cutaneous and eye pigmentation were only partially reversible after the discontinuation of chlorpromazine. There has been no recurrence of basal cell carcinoma.

Basal Cell Carcinoma↗
PubMed1991

Specialization in low vision rehabilitation and visual therapy.

A questionnaire was mailed to members of the Low Vision Section (LVS) of the American Optometric Association (AOA) and the Council on Visual Development (COVD) to determine the practice patterns of low vision clinicians, amount and source of specialty training and the extent of dual specialization in both low vision rehabilitation and visual training by members of COVD. Results indicate that 61.1 percent of AOA/LVS members and 20.9 percent of COVD members examine more than four patients per month who require low vision services. Yet, only 2.1 percent of COVD respondents and 32.2 percent of AOA/LVS respondents spend more than 20 percent of their practice time providing low vision services.

Humans↗
PubMed1989

Sixth nerve palsy after lumbar anesthesia.

A middle aged man was referred from orthopedics with the complaint of diplopia, which developed 3 weeks after a lumbar puncture for spinal anesthesia. The practitioner should be aware of this rare effect among other common and not so common causes of 6th nerve paresis/paralysis.

Abducens Nerve↗
PubMed1987

A comparative study of cytologic smears and frozen-tissue sections in the determination of sex steroid receptor status of breast carcinomas.

The estrogen receptor (ER) status of breast cancer is important as an indicator of prognosis and in the selection of patients for endocrine therapy. Biochemical techniques (estrogen receptor analysis [ERA]) are conventionally used to determine ER; however, they have limitations and disadvantages. In this study a monoclonal antibody to ER (estrogen receptor-immunochemical assay [ERICA]) was used to detect the presence of ER on cytologic and frozen tissue specimens of breast cancers and was compared with the dextran-coated charcoal assay. One hundred two breast cancers were studied. Ninety-four specimens were studied by ERA and ERICA; in eight patients in whom tissue was insufficient for ERA, ERICA alone was performed. ERICA correlated remarkably well with ERA: 94% sensitivity, 89% specificity, and 93% accuracy. In the eight patients in whom ERA could not be performed, ERICA was successfully applied to obtain information regarding receptor status. There was uniform agreement between frozen-sectioned tissues and cytologic smears. The results suggest that immunocytochemical determination of ER is a valuable adjunct and/or alternative to the biochemical method for determination of the ER status of breast cancers.

Antibodies, Monoclonal↗
PubMed1984

Development of quantitative tools for filter-aided dichromats.

Historically, there has been little quantitative rationale for the prescription of colored filters for color deficients . A formal prediction of the effects of any filter on dichromat luminance and chromatic discrimination is presented; these predictions were generated by using colorimetric concepts and related derived formulas to create four interactive computer-graphic tools. In addition to predicting performance of presently available commercial filters, such tools can be used to describe, classify, and even design new filters.

Color↗
PubMed1984

An experimental test of filter-aided dichromatic color discrimination.

Using derived formulas for dichromat colorimetry and related computer graphic colorimetric tools, predictions of color discrimination performance are made for a deuteranope and protanope standard observer for each of three commercial color deficiency "treatment" filters. Five deuteranopes and five protanopes then participated in two experiments. They were asked to order the caps of the D-15 test, and in a second experiment arrange color pairs (from the D-15 test) in order of difference. Predictions and subject performance reveal that although X-Chrom aided dichromats gain both luminous and chromatic information, all dichromats used predominantly chromaticity information in discrimination tasks. The colorimetric tools correctly predicted that protanopes would derive less useful luminous information from the X-Chrom filter compared with deuteranopes , and correctly predicted an increase in discrimination of blues and purples for both classes of red-green color deficients .

Adolescent↗