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Biomedical subjects

T May

Publications and source records attributed to T May.

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

Lack of aura experience correlates with bitemporal dysfunction in mesial temporal lobe epilepsy.

UNLABELLED: The diagnostic value of lack of aura experience in patients with temporal lobe epilepsy (TLE) is unclear. PURPOSE: To evaluate possible factors of bitemporal dysfunction in patients with mesial TLE who did not experience an aura in electroencephalography EEG/video monitoring for epilepsy surgery. METHODS: Ictal scalp EEG propagation patterns of 347 seizures of 58 patients with mesial temporal lobe sclerosis or non-lesional mesial TLE, interictal epileptiform discharges (IED), presence of unilateral mesial temporal lobe sclerosis in visual magnetic resonance imaging (MRI) analysis, prose memory performance, history or not of an aura, and postictal memory or absence of an aura were analyzed. The ictal EEG was categorized as follows. EEG seizure: (a) remaining regionalized, (b) non-lateralized, (c) showing later switch of lateralization or bitemporal asynchronous ictal patterns. RESULTS: Absent aura in monitoring was significantly correlated with absence of unitemporal MRI sclerosis (P=0.004), bitemporal IED (P=0.008), and propagation of the ictal EEG to the contralateral temporal lobe (P=0.001). Other historical data and interictal prose memory performance were not significantly correlated with absent aura. Ten of 11 patients without aura in monitoring also had absent or rare auras in their history. CONCLUSIONS: Lack of aura experience strongly correlates with indicators of bitemporal dysfunction such as bitemporal interictal sharp waves and bitemporal ictal propagation in scalp EEG, and absence of lateralized MRI sclerosis in patients with mesial TLE. The fact that absent auras are not correlated with episodic memory suggests a transient memory deficit, probably because of rapid propagation to the contralateral mesial temporal lobe.

Adolescent↗
PubMed2001

The breadth of bioethics: core areas of bioethics education for hospital ethics committees.

The multidisciplinary nature of bioethics can result in narrow "sub-specialists" within the field, whose work reflects the issues and concerns most relevant to their "home discipline." This can result in work which is insensitive to the important ways in which particular areas of bioethics are interrelated, and which (while viable in the context of the sub-specialty) is not viable in a broader context. The narrow focus of many healthcare ethics committees on issues directly related to clinical patient care can exacerbate this problem. Increasingly, issues in the clinical care of patients cannot be separated from issues in research, organizational ethics, and public policy. I argue that these problems call for a need to identify "core" areas for bioethics education. This is especially true for education of hospital ethics committees, which increasingly face complex cases involving concerns that fall outside traditional patient care issues. I then consider nine areas examined in detail in A Companion to Bioethics edited by Helga Kuhse and Peter Singer, as potential candidates for "core" areas of bioethics education. At the same time, I evaluate the range of issues examined in each area of the book, in the context of the book's ability to provide an introduction to each area.

Bioethical Issues↗
PubMed2001

Medical malpractice, mistake prevention, and compensation.

Clinicians' fear of malpractice litigation is the most significant obstacle to the open reporting of medical mistakes. Without open reporting of medical mistakes, however, root cause analysis of mistakes cannot be done, thus undermining efforts to implement safeguards to minimize the occurrence of future mistakes. Efforts to prevent medical mistakes, therefore, must first directly address clinicians' fear of malpractice litigation. In this paper, we explore the relationship between the current malpractice system and clinicians' fear of litigation. Ultimately, we argue that both the prevention of medical mistakes and the goals of malpractice litigation itself will be better served if substantial malpractice reform is undertaken.

Attitude of Health Personnel↗
PubMed2000

The effect of a methanogen, Methanobrevibacter smithii, on the growth rate, organic acid production, and specific ATP activity of three predominant ruminal cellulolytic bacteria.

Three predominant ruminal cellulolytic organisms, Fibrobacter succinogenes S85, Ruminococcus albus 8, and R. flavefaciens FD-1, were cultured with a methanogen, Methanobrevibacter smithii. Growth rates, bacterial protein, organic acids, and methane production were measured. When grown in diculture with the methanogen, a fermentative advantage was observed with F. succinogenes S85 as seen by an increase in specific rate of ATP production and organic acid concentration. The introduction of the methanogen did not improve the growth rate, organic acid yield, or specific rate of ATP production for R. albus 8. The growth rate and amount of organic acid end products increased when R. flavefaciens FD-1 was cultured with the methanogen; however, the specific activity of ATP production did not increase.

Adenosine Triphosphate↗
PubMed2000

Persisting consequences of drug intake: towards a memory of addiction.

Long-term intake of a psychoactive drug alters brain signal transduction, emotional and motivational factors and behavioral parameters. Some effects that outlast long periods of abstinence are due to the long-term presence of the drug in the organism (tolerance, physical dependence). Withdrawal symptoms, as a consequence of physical dependence, can be protracted, i.e. they persist after long periods of drug deprivation (e.g. a desensitization of the production of cAMP). Further persisting effects include experience-based learning. At least three distinct processes can be differentiated: a memory of drug effects (reflected by a sensitization to drug effects etc.), a memory of drug use (reflected by controlled drug consumption), and a memory of addiction (reflected by a persisting loss of control over drug intake and correlating changes in striatal dopaminergic neurotransmission). The latter probably consists of two components: a general memory of loss of control and a specific memory of the addictive drug (general principles for the development of addiction, specific of the urge for the addictive drug).

Animals↗
PubMed2000

Occupational exposure to blood: search for a relation between personality and behavior.

OBJECTIVE: To describe the behavior of French nurses after occupational exposure to blood (OEB); to study the reasons for not reporting an OEB to the occupational medicine service or the hospital authorities, and to explore the links between personality traits and both the risk of having an OEB and the likelihood of reporting it. DESIGN: A descriptive and correlational study using a cross-sectional survey for data collection. SETTING: Six nursing schools (four initial training institutes and two specialty training schools, one for surgical nurses and one for nurse anesthetists) and six hospitals in Lorraine. PARTICIPANTS: 942 nurses and 459 nursing students were approached, and 964 (69%) replied to the questionnaire. METHODS: The participants received an anonymous two-part questionnaire. The first part explored the knowledge of the risk and Standard Precautions and collected details of the history of OEB. Reporting of OEB to the occupational medicine service or the hospital authorities and the nature of serological monitoring after OEB also were explored. The second part was composed of the Zuckerman sensation-seeking scale, exploring four areas: disinhibition, danger- and adventure-seeking, seeking new experiences, and susceptibility to boredom. RESULTS: 947 nurses were vaccinated against hepatitis B, but only 528 (56%) had checked that they were effectively immunized. Only 166 respondents (17%) stated they routinely used gloves during all procedures in which they were exposed to blood. There were 505 recorded OEB during the study period (0.24 per person per year). The most frequently reported OEB were those involving hollow needles (57%). Approximately one half (48.5%) of all OEB were reported. "Good local antisepsis immediately after the accident" was the reason most often given to justify nonreporting. Only 57% of OEB victims sought to determine the serological status of the source patient for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus immediately after accident. Only 40% and 31% of OEB victims checked their own HIV and HCV serostatus 3 and 6 months after OEB, respectively. Few staff adopted safer-sex measures after OEB, and some continued to donate blood in subsequent months. Logistic regression identified two variables significantly and independently linked to the risk of having at least one OEB in the 27 months preceding the date on which the questionnaire was completed: having a permanent position and having a higher degree of disinhibition. Taking into account the number of OEB during this period (Poisson regression), four variables were significantly and independently linked to the risk of having a larger number of OEB: having a permanent position; having a higher degree of disinhibition; being more susceptible to boredom; and having less nursing experience. In logistic regression, three variables emerged as being significantly and independently linked to reporting all OEB: younger age; having had at least one percutaneous injury (excluding splashes); and having lower susceptibility to boredom. CONCLUSION: Nursing personnel continue to ignore or be unaware of many factors surrounding OEB, meaning that information and counseling must continue unabated. Knowledge of the risk, of the benefit of respecting Standard Precautions, and of the importance of notification and serological follow-up is still inadequate. Finally, certain personality traits, such as a high level of disinhibition and susceptibility to boredom, appear to be linked to the risk of OEB. Subjects strongly susceptible to boredom are less likely to report such accidents.

Acquired Immunodeficiency Syndrome↗
PubMed2000

14-3-3 proteins form a guidance complex with chloroplast precursor proteins in plants.

Transit sequences of chloroplast-destined precursor proteins are phosphorylated on a serine or threonine residue. The amino acid motif around the phosphorylation site is related to the phosphopeptide binding motif for 14-3-3 proteins. Plant 14-3-3 proteins interact specifically with wheat germ lysate-synthesized chloroplast precursor proteins and require an intact phosphorylation motif within the transit sequence. Chloroplast precursor proteins do not interact with 14-3-3 when synthesized in the heterologous reticulocyte lysate. In contrast, a precursor protein destined for plant mitochondria was found to be associated with 14-3-3 proteins present in the reticulocyte lysate but not with 14-3-3 from wheat germ lysate. This indicates an unrecognized selectivity of 14-3-3 proteins for precursors from mitochondria and plastids in plants in comparison to fungi and animals. The heterooligomeric complex has an apparent size of 200 kD. In addition to the precursor protein, it contains 14-3-3 (probably as a dimer) and a heat shock protein Hsp70 isoform. Dissociation of the precursor complex requires ATP. Protein import experiments of precursor from the oligomeric complex into intact pea chloroplasts reveal three- to fourfold higher translocation rates compared with the free precursor, which is not complexed. We conclude that the 14-3-3-Hsp70-precursor protein complex is a bona fide intermediate in the in vivo protein import pathway in plants.

14-3-3 Proteins↗
PubMed2000

Patients, families, and organ donation: who should decide?

Although 69 to 75 percent of U.S. adults say they would be willing to become organ donors, half of the families that are asked to consider donating the organs of a deceased family member refuse to consent. This discrepancy is most noticeable when the refusal of a family conflicts with the known wishes of a patient. It is the practice of nearly all organ procurement organizations in the United States not to procure organs or tissue when families refuse, even if the patient's wishes have been documented. Recently, the Center for Organ Recovery and Education (CORE) adopted a controversial policy of acting on the documented wishes of individuals to donate, independent of family consent. An examination of the moral and political issues raised by this policy lead to the conclusion that the CORE policy is not only justified, but morally required.

Decision Making↗
PubMed2000

Interictal EEG and ictal scalp EEG propagation are highly predictive of surgical outcome in mesial temporal lobe epilepsy.

PURPOSE: Surgical outcome in patients with mesial temporal lobe sclerosis (MTS) is worse than that in patients with temporal lobe activity (TLE) with tumors. Previous studies of the ictal EEG focused on ictal EEG onset in scalp EEG or ictal EEG propagation in invasive recordings. Ictal EEG propagation with scalp electrodes has not been reported. METHODS: Ictal scalp EEG propagation patterns were studied in 347 seizures of 58 patients with MTS or nonlesional TLE. Interictal epileptiform discharges (IEDs) and the presence of unilateral mesial temporal lobe atrophy in magnetic resonance imaging (MRI) also were studied in these 58 patients. Forty-nine patients were operated on (minimal follow-up of 1 year). RESULTS: Postoperatively, seizure-free outcome was seen in (a) 82.8% of patients with regionalized EEG seizure without contralateral propagation, but in only 45.5% of patients with contralateral propagation (p = 0.007); (b) 84.6% of patients with 100% IED lateralized to one temporal lobe, but in only 52.2% with <100% unitemporal IED (p = 0.015); (c) 88.9% with 100% unitemporal IED and regionalized ictal EEG combined, 73.7% with one of both variables, and only 33.3% with <100% ipsitemporal IED combined with contralateral ictal EEG propagation (p = 0.007). CONCLUSIONS: Switch of lateralization or bitemporal asynchrony in the ictal scalp EEG and bitemporal IED are most probably an index of bitemporal epileptogenicity in MTS and are associated with a worse outcome.

Adolescent↗
PubMed2000

Effect of subacute swainsonine (locoweed; Oxytropis sericea) consumption on immunocompetence and serum constituents of sheep in a nutrient-restricted state.

The subacute dose-response effects of swainsonine (SW) consumption on immunocompetence and serum constituents of sheep in a nutrient-restricted state were investigated. Sheep (23 wethers, 5 ewes) were assigned to 1 of 5 SW treatments (0, 0.2, 0.4, 0.8, or 1.6 mg swainsonine/ kg bw/d). Swainsonine was delivered by feeding locoweed (Oxytropis sericea) with grama grass and alfalfa hays for a 28-d treatment period followed by a 21-d recovery period without locoweed. Body weights were measured weekly and behavioral changes were monitored for clinical signs of SW toxicity. Venous blood was collected weekly for lymphoblastogenesis and serum constituent analyses. Clinical signs (sluggishness, decreased responsiveness) of swainsonine toxicity were observed from d 14 to 35 in the 0.8 and 1.6 mg treatments. Subacute oral exposure did not appear to affect lymphoblastogenic analyses. Acute and subacute alterations in various serum constituents did indicate subclinical effects of SW ingestion. Linear, quadratic and cubic dose-response relationships were detected for some serum constituents (e.g., alkaline phosphatase, aspartate aminotransferase). Subacute SW consumption at the levels investigated does not seem to affect the immunocompetence of nutrient restricted sheep. The lack of change in serum alkaline phosphatase at the 0.2 mg SW/kg bw/d dose indicates the potential for a no adverse effect level of SW consumption in nutrient restricted sheep. In combination with measurable SW in serum, rises in serum alkaline phosphatase and aspartate aminotransferase activities, and declines in serum Fe and cholesterol during subacute exposure to SW establish these markers as potential indicators of subclinical SW toxicosis.

Adjuvants, Immunologic↗