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Biomedical subjects

V Wolfe

Publications and source records attributed to V Wolfe.

At least 19 recordsLinked to original sources
PubMed2001

Functional magnetic stimulation of the colon in persons with spinal cord injury.

OBJECTIVE: To evaluate the usefulness of functional magnetic stimulation (FMS) as a noninvasive method to stimulate the colon in individuals with spinal cord injury (SCI). DESIGN: A prospective before-after trial consisting of 2 protocols. SETTING: FMS laboratories of 2 SCI centers. PARTICIPANTS: Two able-bodied men and 13 men with SCI levels ranging from C3 to L1. Protocol 1 consisted of 9 subjects, 2 of whom were excluded from the analysis. Protocol 2 consisted of 4 subjects. INTERVENTION: Commercially available magnetic stimulators with round magnetic coils (MCs) were used. Protocol 1 measured the effects of FMS on rectal pressure by placing the MC on the transabdominal and lumbosacral regions. Protocol 2 consisted of a 5-week stimulation period to investigate the effects of FMS on total and segmental colonic transit times (CTTs). MAIN OUTCOME MEASURE: An increase in rectal pressure and a decrease in CTT by magnetic stimulation. RESULTS: Data were averaged and the standard error of the mean was calculated. Statistically significant changes in rectal pressure and CTT were also measured. Rectal pressures increased from 26.7 +/- 7.44cmH(2)O to 48.0 +/- 9.91cmH(2)O, p =.0037, with lumbosacral stimulation, and from 30.0 +/- 6.35cmH(2)O to 42.7 +/- 7.95cmH(2)O, p =.0015, with transabdominal stimulation. With FMS, the mean CTT decreased from 105.2 to 89.4 hours, p =.02. CONCLUSION: FMS is able to stimulate the colon and reduce CTT. FMS is a noninvasive, technological advancement for managing neurogenic bowel in patients with SCI.

Adult↗
PubMed1999

Methicillin-resistant Staphylococcus aureus in patients with spinal cord injury.

During the past decade, methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of nosocomial and community-acquired infections in the United States. A retrospective chart review of MRSA-positive cases from January 1990 to December 1994 was done to assess the extent of the problem, the factors associated with MRSA acquisition, and the effectiveness of a Center for Disease Control (CDC) protocol to treat MRSA infection in a population with spinal cord injury (SCI). Seventy-four percent of the patients acquired MRSA during their hospitalization. Urine was the most common site of colonization, and 73 percent of the patients with positive urine cultures managed their bladders with indwelling catheters. Implementation of the CDC protocol in 1991 was associated with a decrease in the MRSA incidence rate in subsequent years. Other simple methods of treatment, such as bladder irrigation, were also effective. To control the spread of MRSA, a continual concerted effort by hospital staff through education and implementation of the MRSA protocol is necessary.

Adult↗
PubMed1998

Voice problems and risk factors among aerobics instructors.

Fifty female and four male aerobics instructors completed a questionnaire pertaining to vocal problems and variables that could indicate an increased risk for developing problems. The questions concerned teaching experience, physical data regarding instructional facilities, method of voice projection, music volume, history of illness, allergies, voice loss, hoarseness, smoking habits, and knowledge of vocal hygiene. The results showed that a significant number of instructors experienced partial or complete voice loss (44%) during and after instructing, as well as increased episodes of voice loss, hoarseness, and sore throat unrelated to illness since they began instructing. Significant variables associated with voice problems included sore throat and hoarseness following instruction, and shouting to cue the participants. It was also found that very few instructors in this study had any knowledge of vocal hygiene techniques.

Adult↗
PubMed1997

Micturition by functional magnetic stimulation.

Effectiveness of functional magnetic stimulation (FMS) technology on bladder contraction and bladder emptying was evaluated in twenty-two spinal cord injured subjects. FMS of the bladder was performed by stimulating the sacral nerves or the suprapubic region using a commercially available magnetic stimulator with a round coli. With sacral stimulation, the mean change in bladder pressure (Pves) was 24.4 +/- 4.88 cm H2O; with suprapubic stimulation, the mean change in Pves was 16.5 +/- 4.44 cm H2O. The change in Pves with sacral stimulation was higher than with suprapubic stimulation (p < .01). Seventeen subjects demonstrated voiding, either with sacral or suprapubic stimulation. Using a water-cooled coli, one subject demonstrated complete bladder emptying. FMS of the bladder has the potential to be a useful non-invasive technology for bladder emptying and bladder training in patients with neurogenic bladders.

Adult↗
PubMed1997

Acoustic measures of dysphonic severity across and within voice types.

The purpose of the study was to explore an interaction between pathologic voice type and the acoustic prediction of dysphonic severity. One hundred and two phonatory samples, representing a wide range of laryngeal conditions, were categorized by listeners into three voice types: breathy, rough, and hoarse. A second group of trained listeners rated the severity of the samples on a 7-point scale. Twenty-five frequency- and time-domain measures were used to predict perceptual severity. Multiple regression analyses showed that the most useful measure for the prediction of severity across voice types was noise-to-harmonic ratio (NHR). The severity of individual voice types was predicted with differential results on the basis of both short- and long-term measures of perturbation.

Adolescent↗
PubMed1995

Asymmetrical visual-spatial attentional performance in ADHD: evidence for a right hemispheric deficit.

This study was designed to confirm the presence of a lateralizing deficit in visual-spatial attention in children with ADHD, to further characterize the nature of this deficit and to specify the likely hemispheric locus of dysfunction. Two versions of the covert orienting of attention procedure which evaluated separately endogenous and exogenous cuing effects were administered to 20 unmedicated children aged 9-12 with ADHD and 20 matched controls. Both groups also underwent thorough psychiatric assessment and testing using the TOVA and the Wisconsin Card Sorting Task (WCST). Children with ADHD showed an asymmetrical performance deficit characterized by a loss of costs on controlled (endogenous) attentional orienting to invalidly cured left visual field targets. The degree of cost asymmetry correlated negatively with the number of categories sorted on the WCST. It was concluded that unmedicated children with ADHD show an asymmetrical performance deficit on the covert orienting procedure characterized by a disruption of right hemispheric attentional mechanisms. This deficit may be related to diminished right hemispheric frontal-striatal catecholamine activity.

Attention↗
PubMed1995

Abnormal processing of irrelevant information in attention deficit hyperactivity disorder.

The presence of a selective attention deficit in children with attention deficit hyperactivity disorder (ADHD) was investigated by administering a trial-by-trial version of the Stroop Color-Naming Task to children, aged 9-12, with ADHD (n = 19) and age-matched normal control children (n = 19). Performance was evaluated on both interference and facilitation components of the task. On the standard version of the task, with equal numbers of color words and neutral words, children with ADHD showed increased Stroop interference (prolongation of color-naming times by color-incongruent stimuli) but normal amounts of facilitation (speeding of color naming by color-congruent stimuli). This finding suggests that children with ADHD show increased disruption of color-naming performance by task-irrelevant information, probably secondary to decreased attentional control over the interference process. In contrast to findings of studies in adults, both groups of children failed to use an attentional strategy to reduce interference when they were administered blocks of trials that varied their expectancy for color word trials. This precluded a direct test of the diminished control hypothesis. There were no significant correlations between abnormal Stroop performance and impairment on the Continuous Performance Test or the Wisconsin Card Sorting Test or measures of IQ or reading performance. The implications of these findings for our understanding of information-processing deficits in children with ADHD and of the neurobiological underpinnings of these deficits are discussed.

Attention↗
PubMed1995

Sentence/vowel correlation in the evaluation of dysphonia.

Considering the widespread use of the sustained vowel in the evaluation of voice disorders, our objective was to study the degree to which the vowel is representative of voice in continuous speech. Phonatory samples were recorded from 20 normal subjects and 60 patients representing commonly occurring voice problems (nodules, unilateral paralysis, and functional). The phonatory samples were evaluated by 25 listeners on the basis of 12 bipolar, semantic differential scales. Factor analysis produced two perceptual dimensions with similar loadings for both vowels and sentences. A correlation of 0.78 was obtained between vowels and sentences on factor 1 scores, "vocal severity," and a correlation of 0.77 was obtained between vowels and sentences on factor 2 scores, "pitch/quality." Six of the 80 pairs of sentences and vowels differed by two scale points or more on vocal severity. Results suggest that although a relatively strong relationship exists between the two measures, sustained vowel sounds may not be an adequate clinical index to the dysphonic severity of continuous speech.

Adult↗
PubMed1995

Acoustic prediction of severity in commonly occurring voice problems.

The relative effectiveness of three acoustic measures (jitter, shimmer, and harmonic/noise ratio) in predicting the dysphonic severity of a diverse clinical population singly and together was investigated. Phonatory samples were recorded from 20 normal subjects and 60 patients representing 3 laryngeal groups (nodules, paralysis, and functional). The phonatory samples were evaluated by 22 listeners using a 7-point equal-appearing interval scale. Shimmer produced a bivariate correlation of 0.54 with dysphonic severity; harmonic/noise ratio correlated -0.32 with dysphonic severity; and jitter produced no significant correlation with severity. The combination of acoustic variables through multiple regression analysis produced a correlation of 0.56, with only shimmer and average F0 contributing to the correlation. For this particular clinical population, therefore, findings indicated that (a) none of the variables was strongly correlated with dysphonia ratings, and (b) a combination of acoustic predictors was no more successful than a single predictor of dysphonic severity, namely, shimmer.

Adolescent↗
PubMed1995

Pathologic voice type and the acoustic prediction of severity.

We hypothesized that acoustic measures would predict dysphonic severity with differential results for pathological voice types. An instructional program based upon synthesized voice signals was developed to facilitate an awareness of prototypical voice types. Eighty phonatory samples representing normal subjects as well as patients with unilateral vocal fold paralysis, vocal nodules, and functional dysphonia were analyzed acoustically on the basis of four measures: average fundamental frequency (F0), jitter, shimmer, and harmonic/noise ratio (H/N ratio). Following training, 29 listeners classified 62% of the phonatory samples on the basis of breathy, hoarse, rough, and normal. Dysphonic severity of rough voices was predicted more successfully by H/N ratio (r2 = .73) than by shimmer (r2 = .43). Dysphonic severity of breathy voices was predicted only by the combined features of less jitter, more shimmer, and lower H/N ratio (r2 = .74). No combination of acoustic variables was successful in the prediction of the hoarse voice type.

Adolescent↗
PubMed1995

Comparative study of laser versus electrocautery prostatic resection: 18-month followup with complex urodynamic assessment.

A total of 25 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia was entered into a prospective, randomized trial comparing prostatectomy done with the Urolase right angle firing neodymium:YAG laser fiber and standard transurethral electroresection of the prostate. Efficacy of treatment, as assessed by standardized American Urological Association symptom scores, patient assessment of symptom improvement, peak urinary flow rates, post-void residual urine volumes and complex urodynamic evaluation, including assessment of opening pressure and maximum detrusor voiding pressure, was equivalent for the 2 treatment groups through 1 year. Ultrasonic assessment of prostatic volumes at 1 year showed a mean decrease in total volume of 59% for standard electrocautery resection compared to 28% for laser prostatectomy. Symptom scores and peak urinary flow rates remained equivalent for both groups through 18 months.

Aged↗
PubMed1993

Incidence and management of autonomic dysreflexia and other intraoperative problems encountered in spinal cord injury patients undergoing extracorporeal shock wave lithotripsy without anesthesia on a second generation lithotriptor.

Spinal cord injury patients are at increased risk for urolithiasis and many will require treatment, most commonly with extracorporeal shock wave lithotripsy. New, second generation lithotripsy devices allow treatment without tub immersion, and without general or regional anesthesia for most patients. Spinal cord injury patients, with loss of sensation below the level of injury, would seem to be ideal candidates for such treatment. We present our experience with 20 consecutive spinal cord injury patients treated without anesthesia on the Medstone STS second generation lithotriptor. All patients were awake and experienced no direct sensation from the shock waves. All but 1 patient (T12 level), however, experienced autonomic dysreflexia, with significant elevations in systolic blood pressure (mean increase 44 mm. Hg, maximum 74) and diastolic blood pressure (mean increase 24 mm. Hg, maximum 61), with reflex bradycardia (mean decrease -22 beats per minute). Autonomic dysreflexia was successfully treated in this setting with short-acting sublingual nifedipine. Associated bradycardia was treated with atropine in 6 patients. Preoperative bowel preparation proved to be useful in spinal cord injury patients to maximize stone imaging and may decrease autonomic dysreflexia if this is caused by shock waves impacting on the distended bowel. Other problems included uncontrolled skeletal muscle spasms elicited by shock waves, which proved to be troublesome in maintaining patient position and stone localization. Muscle spasms were decreased with benzodiazepines. Care was also observed in spinal cord injury patients to pad all pressure points on the hard, dry treatment surfaces associated with second generation lithotriptors and, thus, prevent skin breakdown.

Adult↗
PubMed1992

Use of penile prostheses to maintain external condom catheter drainage in spinal cord injury patients.

This is a retrospective analysis of 79 spinal cord injury patients who have had penile implants from one to 14 years. The primary indication for implants was the loss of condom catheter with a small retractile penis. Mean period after injury to when the implants were placed was 8.24 years (range 1-21 years). Mean total length of time the implants have been followed was 7.08 years (1-14 years). Sixty patients responded to our detailed questionnaire and they have been subjected to further analysis: prior to the implant 46 patients (77%) frequently lost their condoms. Fourteen of the patients (23%) had indwelling catheters, and 3 (5%) had a suprapubic cystostomy since they could not retain an external condom for urinary drainage because of retraction of a small penis. Post implant, 81% of patients had no accidents involving condom loss, while 19% still lost condoms. All indwelling catheters could be removed except for one patient who continued with a suprapubic catheter following transurethral sphincterotomy (TURS) and a penile implant. Sixty-eight percent used the implant for sex and felt their wives were satisfied. Patient satisfaction survey showed a markedly increased self esteem, increased mobility without fear of condom loss, and an improved sex life. Overall, the long term prosthesis failure rate was 8%. The specific infection complication rate was less than 2%. The Flexirod semirigid, hinged prosthesis proved ideal in meeting the requirements for these patients.

Adult↗
PubMed1991

Acoustic correlates of pathologic voice types.

Listeners classified 49 samples of vowels /a/ and /i/ on the basis of four voice types: hoarse, breathy, strained, and normal. The vowels were analyzed acoustically for mean harmonic/noise differences in four spectral regions, average fundamental frequency, natural logarithm of fundamental frequency, and jitter. Discriminant analysis showed that classifications of voice type were made with 80% accuracy using three acoustic parameters: (a) mean harmonic/noise difference factor (1-3.5 kHz), (b) natural log of fundamental frequency, and (c) vowel type. The significance of these particular acoustic parameters for the perception and classification of voice types is discussed.

Discriminant Analysis↗
PubMed1982

Motor speech deficit following carotid endarterectomy.

Stroke as a complication of carotid endarterectomy has been extensively reviewed. Considerably less attention has been directed to local injuries of the cranial nerves and their branches. Verta, Hertzer, Imparato, DeWeese, and Matsumoto have reported experience with these injuries. DeWeese found a 9.7% rate of cranial nerve injury, while in Hertzer's series, 15% of patients had nerve dysfunction in the early postendarterectomy period. In 1980, Liapis in a preliminary report found that when postoperative examination was supplemented by detailed evaluation by speech pathologists, the incidence of early abnormalities reached 27%. The purpose of this study was to expand upon Liapis' early observation and to clarify the contribution of the speech pathologists in identifying cranial nerve dysfunctions, specifically those resulting in motor speech abnormalities, following carotid endarterectomy.

Adult↗
PubMed1970

Winter vomiting disease in Florida students.

On 14 November 1967 an investigation was begun at the University of South Florida to determine the cause of an increased number of gastrointestinal illnesses on campus. An estimated 300 students suddenly became ill with nausea, vomiting, abdominal pain, and diarrhoea. While at first food poisoning was suspected, no common food, water, or toxic exposure could be found. The data collected were most consistent with Winter Vomiting Disease. This entity is characterized by acute gastrointestinal illnesses which may occur in epidemic form in residential schools between September and March. Most investigators suspect that a viral agent is responsible for the illnesses, though attempts to isolate a virus have been unsuccessful. The incubation period in the University outbreak was estimated at 28 hr., and contact was the most likely mode of transmission. The outbreak illustrated that Winter Vomiting Disease in residential institutions may be an accentuation of the gastrointestinal illnesses occurring simultaneously in the community at large.

Communicable Diseases↗