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Biomedical subjects

T Adams

Publications and source records attributed to T Adams.

At least 91 records · Page 5Linked to original sources
PubMed1996

A descriptive study of the work of community psychiatric nurses with elderly demented people.

This study examines the work of community psychiatric nurses (CPNs) with elderly demented people. A total of 14 cases, taken from the caseloads of four CPNs, were examined by direct observation of CPNs' practice and in-depth interviews. The data were analysed using a method suggested by Dey (1993). The validity of the findings was checked internally by means of respondent validation and externally by CPNs from other teams working with elderly demented people. It was found that the CPNs operated two strategies: one directed towards the client and the other towards the family. The process underlying these strategies consisted of five overlapping phases: assessment, planning, intervention, evaluation, and termination. The CPNs' working process was set within a framework containing their understanding of what they understood as 'community', the management style within the team and the quality and availability of clinical supervision. This process is integrated with existing literature on community psychiatric nursing and suggestions are made regarding possible developments within the speciality.

Aged↗
PubMed1995

The cavitation threshold of human tissue exposed to 0.2-MHz pulsed ultrasound: preliminary measurements based on a study of clinical lithotripsy.

Evidence of acoustic cavitation was identified in the form of transient echoes in ultrasound B-scan images of patients receiving extracorporeal shock-wave lithotripsy treatment on a Storz Modulith SL20. This lithotripter generates 10-microseconds duration pulses with a centre frequency of 0.2 MHz at a pulse repetition frequency of 1 Hz. The visual appearance of B-scan images was examined in a total of 30 patients and a quantitative analysis of echogenicity changes was carried out in six cases involving lithotripsy treatment of stones in the renal pelvis. In these patients new echoes were identified in images unaffected by movement artefacts and were found to occur in perinephric fat and adjacent muscle and kidney tissue at positions close to the axis of the shock-wave field between 1 and 2 cm in advance of the indicated beam focus of the lithotripter. The echogenicity within each region increased significantly above the background level when the output of the lithotripter was increased above a threshold value. The acoustic pressures corresponding to this threshold were measured in water using a calibrated PVDF membrane hydrophone. After correction for attenuation in tissue the cavitation thresholds, in terms of the temporal peak negative pressure, are found to lie between 1.5 MPa and 3.5 MPa in all six cases. Interpretation of the measured values in terms of the likely threshold at the higher frequencies used in diagnostic ultrasound is considered using a theoretical model.

Acoustics↗
PubMed1994

Depression, suicidal ideation, and substance use among adolescents. Are athletes at less risk?

OBJECTIVES: To determine the relationship between participation in high school athletic programs and depression, suicidal ideation, and substance use, and to study the high-risk behaviors of suicidal ideation and substance use. DESIGN: Survey. SETTING: A suburban public high school in Kentucky. PARTICIPANTS: We received 823 (80%) responses from 1030 potential respondents. Athletes (ie, participation on a high school athletic team) were compared with non-athletes. MEASURES: Depression was measured by the Children's Depression Inventory by an index of suicidal ideation by an indicator of a past suicide attempt, and by current use of tobacco, alcohol, marijuana, and cocaine. RESULTS: Thirty percent of the sample participate in school athletic teams. Athletes are less depressed, have less suicidal ideation and attempts, and are less likely to currently smoke cigarettes or marijuana. The use of smokeless tobacco and cocaine was not related to athletic participation. After controlling for demographic characteristics, no difference in alcohol use was found between athletes and nonathletes. CONCLUSIONS: Athletic participation is a marker for a decreased likelihood of depression and some high-risk behaviors in adolescents. Future research could help in creating alternative interventions beyond participation in varsity and junior varsity athletic teams.

Adolescent↗
PubMed1994

The emotional experience of caregivers to relatives who are chronically confused--implications for community mental health nursing.

This paper examines the emotional experience of informal caregivers to family members who are chronically confused. Six informal caregivers were taken from the caseloads of community mental health nurses working with elderly people. Data were collected by means of a daily diary and in-depth interviews relating to their emotional experience as caregivers. The data are presented in the form of six vignettes and the implications for theory, practice and research in community mental health nursing are examined.

Aged↗
PubMed1993

Role of cranial bone mobility in cranial compliance.

Increases in intracranial pressure are normally buffered by the displacement of blood and cerebrospinal fluid from the cranium when there is an increase in intracranial volume (ICV). How much pressure increases with an increase in ICV is expressed in the calculation of cranial compliance (delta ICV/delta P, where delta P is change in pressure) and elastance (delta P/delta ICV). Data reported here indicate that the movement of the cranial bones at their sutures is an additional factor defining total cranial compliance. Using controlled bolus injections of artificial cerebrospinal fluid into a lateral cerebral ventricle in anesthetized cats and a newly developed instrument to quantify cranial bone movement at the midline sagittal suture where the bilateral parietal bones meet, we show that these cranial bones move in association with increases in ICV along with corresponding peak intracranial pressures and changes in intracranial pressure. External restraints to the head restrict these movements and reduce the compliance characteristics of the cranium. We propose that total cranial compliance depends on the mobility of intracranial fluid volumes of blood and cerebrospinal fluid when there is an increase in ICV, but it also varies as a function of cranial compliance attributable to the movement of the cranial bones at their sutures. Our data indicate that although the cranial bones move apart even with small (nominally 0.2 ml) increases in ICV, total cranial compliance depends more on fluid migration from the cranium when ICV increases are less than approximately 3% of total cranial volume. Cranial bone mobility plays a progressively larger role in total cranial compliance with larger ICV increases.

Animals↗
PubMed1992

Human HPRT mutant database: software for data entry and retrieval.

We have developed a computer database containing information on over 1,000 human hypoxanthine guanine phosphoribosyl transferase (HPRT) mutants. Both published and unpublished data are present. The database itself is maintained in a dBASE format (.DBF) and we provide a set of programs to examine and extract information from the database. A program to input information into the database is also supplied. The database and programs are available directly from us or via remote FTP (file transfer protocol) using BITNET/INTERNET. All programs require an IBM-compatible computer, the MS-DOS operating system (version 3.3 or greater), and a hard disk with about 5 megabytes of free disk space. The purpose of the database is 1) to allow investigators to contribute their HPRT mutants directly to the database in a standardized fashion, and 2) to allow access to the entire database with a set of programs that allows manipulation and extraction of data. For example, using our programs it is possible to i) order the database by base pair position, ii) examine only information regarding mutagenesis by a particular agent, iii) search for a particular author, iv) create a report which contains selected portions of the database, the report can be printed or saved as a file. The database will be updated every several months and distributed.

Databases, Bibliographic↗
PubMed1992

Analgesia and behavioral responses of dogs given oxymorphone-acepromazine and meperidine-acepromazine after methoxyflurane and halothane anesthesia.

This study was designed to test analgesia, duration, and cardiovascular changes induced by meperidine (MEP) and oxymorphone (OXY) following methoxyflurane (MOF) and halothane (HAL) anesthesia. Eight healthy dogs were given atropine and acepromazine, and anesthesia was induced with thiamylal and maintained with 1.5 minimal alveolar concentration of MOF or HAL for 1 hour during controlled ventilation. Eight treatments were given with each anesthetic: 3 with MEP (0.5, 1.0, and 2.0 mg/kg, IV), 3 with oxymorphone (OXY; 0.05, 0.1, and 0.2 mg/kg, IV), and 2 placebos with sterile water. Test drugs were given at the end of anesthesia when early signs of recovery were evident. Minimal threshold stimulus/response nociception was assessed by use of an inflatable soft plastic colonic balloon. Blood pressures and pulse rate were measured with a noninvasive monitor. Meperidine and OXY were found to be effective analgesics and could be reversed with naloxone. Intravenous administration of 2.0 mg of MEP/kg provided analgesia for 36 +/- 6 minutes and 39 +/- 15 minutes after MOF and HAL, respectively. In contrast, OXY was effective at all 3 doses with effects of IV administration of 0.2 mg of OXY/kg lasting 154 +/- 13 minutes and 152 +/- 12 minutes, after MOF and HAL, respectively. Analgesia could not be demonstrated after anesthesia for acepromazine, MOF, or HAL. Blood pressure was not changed by either anesthetic nor was it influenced by MEP or OXY. Pulse rate was significantly depressed by the higher doses of OXY following HAL, but was not changed by MEP following either anesthetic.(ABSTRACT TRUNCATED AT 250 WORDS)

Acepromazine↗
PubMed1992

Periodic limb movement disorder is associated with normal motor conduction latencies when studied by central magnetic stimulation--successful use of a new technique.

This study prospectively tested the hypothesis that patients with periodic limb movement disorder (PLMD) have longer motor conduction latencies than normals. Six healthy adults, 13 patients with PLMD, and 8 patients with long-term multiple sclerosis (MS) had recordings of motor conduction latencies during wake and sleep. MS subjects were included only to show that we could detect prolongation of central conduction; nonMS subjects were used to test the hypothesis. Subjects had no other medical or sleep problems. A novel magnetic stimulator, the Cadwell MES-10, was discharged over the vertex and the C7 cervical spine. It triggered compound muscle action potentials that were recorded in the abductor digiti minimi in the hand. The conduction latencies were the total conduction time (TCT), measured vertex to hand, and the peripheral conduction time (PCT), measured C7 to hand. The difference was the central conduction time (CCT). Only TCT could be obtained during sleep. Supporting the use of TCT as an indirect measure of central conduction was that, in all waking subjects, TCT correlated with CCT (r = 0.91, p = 0.001) but not with PCT. Reliabilities during wake and sleep were 0.95 or higher for TCT and PCT measurements. Waking CCT was greater in MS subjects (13.77 milliseconds) than those without MS (9.21 milliseconds), p = 0.001. Sleeping TCT was much less impressive in distinguishing MS subjects [27.08 milliseconds in nonrapid eye movement (NREM) sleep; 28.64 milliseconds in rapid eye movement (REM) sleep] from nonMS subjects (24.45 milliseconds in NREM; 24.84 milliseconds for REM), p = 0.07 for NREM and p = 0.04 for REM.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Parietal bone mobility in the anesthetized cat.

To quantify parietal bone motion in reference to the medial sagittal suture, a newly developed instrument was attached to the surgically exposed skull of anesthetized adult cats. The instrument differentiated between lateral and rotational parietal bone movements around the fulcrum of the suture. Bone movement was produced by external forces applied to the skull and by changes in intracranial pressure associated with induced hypercapnia, intravenous injections of norepinephrine, and controlled injections of artificial cerebrospinal fluid into the lateral cerebral ventricle. Responses varied considerably among test animals. Generally, lateral head compression caused sagittal suture closure, small inward rotation of the parietal bones, increased intraventricular pressure, transient apnea, and unstable systemic arterial blood pressure. Graded increases in intracranial volume produced stepped increases in pressure, lateral expansion at the sagittal suture, and outward rotation of the parietal bones. We attribute variations in animal response largely to differences in intracranial and suture compliance among them. Cranial suture compliance may be an important factor in defining total cranial compliance.

Animals↗
PubMed1991

Morphology and projections of myenteric neurons to colonic fiber bundles of the cat.

Regulation of colon function depends on the location of nerve cell bodies and the distribution of intrinsic nerve fibers in the myenteric plexus. The morphology and projections of myenteric neurons through colonic fiber bundles in cat colon were determined using in vivo retrograde transport of HRP and Fast blue. Myenteric neurons were found to project from at least 5 to 59 mm orad (mean: 42 mm) or aborad (mean: 54 mm) through colonic fiber bundles. Approximately 73% of labelled cells were in ganglia within 2.8 mm of colonic fiber bundles in the axis of circular muscle fibers; none was beyond 7.7 mm. There were 2 soma morphologies. One type (Dogiel type I) had a mean soma diameter of 40.5 microns and had a rough somal surface. There were few if any short, broad dendrites, but its one long process extended to a branch point of an adjacent colonic fiber bundle. The other type (Dogiel type III) had a mean soma diameter of 26.4 microns, had a smooth somal surface and had few if any fine dendrites. It also projected a single long axon to colonic fiber bundles. There were twice as many Dogiel type III neurons. We conclude that myenteric neurons in the cat colon project both orad and aborad over relatively long distances through colonic fiber bundles where they form another intrinsic neuronal connection for the myenteric plexus.

Afferent Pathways↗
PubMed1991

The idea of revolution in the development of nursing theory.

This paper examines Thomas Kuhn's notion that theory develops by means of revolution and its pervasion within nursing theory. Initially, the traditional, cumulative model of theory development is examined and then Kuhn's idea is explored. The extent of its pervasion in nursing theory is outlined. Finally, the value of Kuhn's model of theory development in nursing is evaluated. It is argued that while Kuhn's model has set nursing theory free from logical empiricism, it needs to be understood in conjunction with the traditional cumulative model.

Humans↗
PubMed1991

Effects of P. aeruginosa-derived bacterial products on tracheal ciliary function: role of O2 radicals.

The purpose of this investigation was to evaluate the effects of bacterial products derived from Pseudomonas aeruginosa on the function of airway cilia and to assess the role of phagocytes and oxygen radicals in the observed responses. Ciliary beat frequency (CBF) was measured in a perfusion chamber with a microscopic technique using tracheal epithelial cells obtained from normal sheep by brush biopsy (70% epithelial cells, 18% macrophages, 11% neutrophils). Baseline CBF ranged between 678 and 1,126 min-1. After 20 min of perfusion with the cell free supernatant of P. aeruginosa culture (mucoid strain), a concentration-dependent depression of CBF was observed with a 58% inhibition at a 1:1 dilution (P less than 0.05). The P. aeruginosa-derived products pyocyanin and 1-hydroxyphenazine also decreased CBF in a dose-related fashion. The cilion-inhibitory effects of the supernatant and bacterial products were markedly attenuated after centrifugation of the brush preparation (80% epithelial cells, 16.5% macrophages, 3.5% neutrophils). Glucose/glucose oxidase also caused a rapid, concentration-dependent cilioinhibition or ciliostasis. Catalase blocked or attenuated the ciliary effects of the supernatant, bacterial products and glucose/glucose oxidase. Thus bacterial products released from P. aeruginosa impaired ciliary activity by a pathway which involved neutrophils and was mediated by toxic oxygen radicals.

Animals↗
PubMed1991

A phase I clinical, plasma, and cellular pharmacology study of gemcitabine.

A novel deoxycytidine analog, gemcitabine (2',2'-difluorodeoxycytidine [dFdC]), has been studied in a phase I clinical and pharmacology trial. Doses ranging from 10 to 1,000 mg/m2 were administered over 30 minutes weekly times 3 weeks every 4 weeks. The maximum-tolerated dose (MTD) was 790 mg/m2. The dose-limiting toxicity was myelosuppression, with thrombocytopenia and anemia quantitatively more important than granulocytopenia. Nonhematologic toxicity was minimal. Two responses in patients with adenocarcinomas of the colon and lung were documented. The maximum dFdC plasma concentration, reached after 15 minutes of infusion, was proportional to the total dose administered. Elimination, due mainly to deamination, was rapid (terminal half-life [t1/2], 8.0 minutes) and dose independent. The deamination product 2',2'-difluorodeoxyuridine (dFdU) was eliminated with biphasic kinetics characterized by a long terminal phase (t1/2, 14 hours); it was the sole metabolite detected in urine. The concentration of dFdC 5'-triphosphate in circulating mononuclear cells increased in proportion to the dFdC dose at infusions between 35 and 250 mg/m2. No further increment in dFdC 5'-triphosphate (dFdCTP) was observed at higher doses, which resulted in plasma dFdC concentrations greater than 20 mumol/L (350 to 1,000 mg/m2), suggesting saturation of dFdC 5'-phosphate accumulation. The recommended dose for phase II clinical trials in solid tumors is 790 mg/m2/wk.

Adult↗
PubMed1991

Dose-response of intravenous butorphanol to increase visceral nociceptive threshold in dogs.

This study was designed to determine the effective analgesic dose of butorphanol administered intravenously to obtund visceral nociception, as well as to determine duration of this effect. Additionally, cardiovascular changes and sedative effects were defined. Eight healthy dogs were each given five doses of butorphanol (0.025, 0.05, 0.1, 0.2, and 0.4 mg/kg) plus a sterile water placebo intravenously in a randomized blinded format. Antinociception was assessed using an inflatable Silastic balloon inserted into the colon. Blood pressures and pulse rates were measured with a noninvasive monitor. The greatest efficacy and longest duration of antinociception were produced by 0.4 mg/kg of butorphanol, with a duration of 38 +/- 9 min. Arterial blood pressure and pulse rate did not vary at antinociceptive doses. Mild sedation was observed at all doses, which generally lasted longer than the antinociceptive effects. These data suggest that butorphanol can be given alone intravenously to provide visceral antinociception lasting 30-45 min without significant side effects.

Animals↗
PubMed1991

Dose response to butorphanol administered subcutaneously to increase visceral nociceptive threshold in dogs.

Butorphanol (0.025, 0.05, 0.1, 0.2, 0.4, and 0.8 mg/kg of body weight, and placebo) was given SC to 8 healthy unmedicated dogs to determine its efficacy for visceral analgesia, using a colonic balloon for minimal threshold nociceptor stimulation. Degree of sedation; systolic, diastolic, and mean arterial pressure; and pulse rate were recorded. The highest 3 dosages, 0.2, 0.4, and 0.8 mg/kg, were found to be most effective, with 0.8 mg/kg the only dosage that was significantly different from control responses at the 45-minute interval. Duration of analgesia ranged from 23 to 53 minutes for all 6 dosages and dosing durations were not significantly different from one another. Blood pressures did not change, but pulse rate was significantly decreased by 0.8 mg of butorphanol/kg. We concluded that butorphanol is an effective visceral analgesic of relatively short duration in the dog.

Analgesia↗