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Biomedical subjects

T Moore

Publications and source records attributed to T Moore.

At least 37 records · Page 2Linked to original sources

Exercise-training protocols for astronauts in microgravity.

The question of the composition of exercise protocols for use by astronauts in microgravity is unresolved. Based on our knowledge of physical working requirements for astronauts during intra- and extravehicular activity and on the findings from bed-rest studies that utilized exercise training as a countermeasure for the reduction of aerobic power, deterioration of muscular strength and endurance, decrements in mood and cognitive performance, and possibly for bone loss, two exercise protocols are proposed. One assumes that, during microgravity, astronaut exercise physiological functions should be maintained at 100% of ground-based levels; the other assumes that maximal aerobic power in flight can be reduced by 10% of the ground-based level. A recommended prescription for in-flight prevention or partial suppression of calcium (bone) loss cannot be written until further research findings are obtained that elucidate the site, the magnitude, and the mechanism of the changes. Hopefully these proposed exercise prescriptions will stimulate further research and discussion resulting in even more efficient protocols that will help ensure the optimal health and well-being of our astronauts.

Exercise

Multifocal glioblastoma with liver metastases in the absence of surgery. Case report.

A patient with two intracerebral glioblastomas of differing histology with metastases to the liver in the absence of surgery is reported. The gliomatous nature of the lesions was confirmed by staining for glial fibrillary acidic protein. Histological and immunohistochemical evidence suggests that the metastases arose from the more poorly differentiated of the intracerebral tumors. One of the intracerebral tumors had enhanced expression of the ras p21 oncogene as compared to the other tumors and as compared to nonmalignant brain tissue from this patient.

Aged

Employee assistance program evaluation. Employee perceptions, awareness, and utilization.

Periodic evaluation is necessary to maintain a quality employee assistance program. This survey was undertaken to determine employee awareness of the existing EAP and their satisfaction with the program. Likewise, the survey allowed for employee input on areas of the program they had concerns with that may have caused hesitancy in further use of the program. The survey not only documents to management that the program is of value to employees and identifies areas where changes may be focused in the future to meet employee needs, but actually serves as a communication tool in itself as a reminder of the availability of the Employee Assistance Program.

Adult

Predictors of survival in patients undergoing dialysis.

Survival and risk analyses were performed on all 532 patients in whom long-term dialysis was started from 1970 through 1985. During this 16-year period, starting age increased from 47 to 60 years (p less than 0.001), and the incidence of diabetes mellitus and renal vascular disease increased. Survival analysis showed age, renal diagnosis, type of dialysis, and year starting dialysis to be important predictors of survival. There was a fourfold rise in the risk ratio as starting age increased from 25 to 65 years. The risk was 1.5 times higher for those patients who did not start dialysis in 1978 through 1981 than for those who did. Risk decreased fivefold for patients choosing home hemodialysis. Home hemodialysis patients survived longer compared with patients utilizing other dialysis modalities, possibly because of a younger average age and a lower incidence of diabetes mellitus and renal vascular disease. There was greater than a threefold rise in risk ratio with the diagnosis of diabetes mellitus compared with either chronic glomerulonephritis or polycystic kidney disease. Older patients and those with diabetes mellitus formed the high-risk group; these two characteristics have been increasing during the last eight years of the study. It is concluded that although patients with high risk have an increased and a high mortality, overall survival has improved.

Actuarial Analysis

Closure of defects from pressure sores requiring proximal femoral resection.

Proximal femoral resection (i.e., modified Girdlestone procedure) is often required in the paraplegic with an infection or dislocation of the hip joint. A philosophy and technique for dealing with this difficult problem are presented. The technique involves using an external osseous fixator to stabilize the femur and allow healing of the flap used to fill the defect.

Adult

Sepsis of the hip in paraplegic patients.

For the treatment of chronic sepsis of the hip in paraplegic patients, we adopted three measures: (1) a Girdlestone procedure, (2) transposition of the vastus lateralis muscle into the void that was left by the removal of the femoral head and neck and the acetabular wall, and (3) external fixation to prevent unrestrained motion of the femoral shaft, which might damage the transposed muscle. The hip joint was spanned by a posterior pelvic-femoral skeletal external fixator. Nine patients, all of whom had thoracic-level paraplegia, were treated in this manner. The fixator was kept in place for three to six weeks while the patients were cared for in the prone position. All of the infections were fully healed by twelve weeks postoperatively. In two patients, the wound drained at the edge of the flap for a short time.

Adult

Human-immunodeficiency-virus infections in infants negative for anti-HIV by enzyme-linked immunoassay.

Of 85 children with human-immuno-deficiency-virus (HIV) infection based on clinical (opportunistic infection), epidemiological (mother a drug addict or known to be HIV infected), and immunological (helper-T-cell deficiency and impaired proliferative response to pokeweed mitogen) features, 9 were found to lack antibody to HIV as measured by a commercial enzyme-linked immunoassay (ELISA). All 9 children had detectable levels of HIV antigen in simultaneous plasma specimens, measured by a sensitive antigen-capture ELISA. The use of the western blot assay and an ELISA with recombinant HIV antigens was able to identify HIV infection in 4 of the 9 children.

Acquired Immunodeficiency Syndrome

Reflectance photoplethysmography as an adjunct to assessment of gravitational acceleration tolerance: preliminary findings.

We have examined the feasibility of using reflectance photoplethysmography to assess Gz acceleration tolerance. Reflectance plethysmograms recorded using a sensor placed on the region of the superficial temporal artery were analysed along with the mean value and the pulsatile component of the Doppler velocity recorded from the opposite temporal artery. The photoplethysmogram signal and pulsatile and mean Doppler velocities were examined as predictors of impending peripheral light loss (PLL) during the experiments. Photoplethysmography correctly predicted a large percentage of the PLL runs (80.5%) and non-PLL runs (98.3%). Mean Doppler velocity predicted a higher percentage of PLL runs (88.1%), but with an unacceptably low rate of non-PLL runs (77.2%). The pulsatile Doppler velocity yielded only 50.7% correct prediction of PLL runs. The results of this preliminary study indicate that, with an improved design of the sensor and the electronics, it may be possible to use reflectance photoplethysmography in acceleration tolerance experiments as a reliable predictor of impending peripheral light loss.

Acceleration

Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly.

To promote early full weight-bearing and rapid rehabilitation, 20 elderly patients (average age, 82.2 years) with unstable intertrochanteric hip fractures were treated with a bipolar head-neck replacement. Seventeen patients had the prosthesis inserted as primary fracture management, and three, for salvage of failed internal fixation. The patients were ambulating with unrestricted weight-bearing at an average of 5.5 days after the operation. The bipolar design may permit conversion to a total hip arthroplasty without removal of the femoral component, and may reduce the risk of acetabular cartilage damage. By using the greater trochanter as a landmark for precise placement of the femoral head, correct limb length was restored.

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