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PubMed1995

Orthographic effects on phoneme monitoring.

A widely used task in the research on spoken word recognition is phoneme monitoring, in which subjects have to detect phonemes in spoken words. It is generally assumed that this task is performed using phonetic or phonological representations of words only. To test whether an orthographic representation of the words is employed as well, an experiment was conducted in which Dutch subjects monitored for phonemes with either a primary or secondary spelling in phonologically matched spoken words and nonwords. Phoneme monitoring times were slower when the phoneme had a secondary spelling than when it had a primary spelling. The effect was greater after than before the uniqueness point of the word, and monitoring times were faster for words than for nonwords. These findings indicate that an orthographic representation of words is engaged in phoneme monitoring.

Humans↗

PubMed2000

Onset and duration of action of rocuronium in children receiving chronic anticonvulsant therapy.

The onset and time course of action of rocuronium in normal children and children receiving anticonvulsant drugs for prolonged periods was characterized. A single bolus dose of 0.6 mg.kg-1 rocuronium was administered i.v. to seven nonepileptic patients on no medication, and eight patients on chronic anticonvulsant therapy consisting of either phenytoin, carbamazepine, or both who were age and weight matched. Neuromuscular transmission was monitored by the evoked compound electromyography of the thenar muscles using train of four stimulation every 20 s. Recovery times of the first twitch to 10%, 25%, 50%, 75% and 100% of baseline values and recovery index were obtained. The onset times were 1.05+/-0.5 and 1.41+/-0.5 min for the control and anticonvulsant groups respectively and were not significantly different. Children receiving chronic anticonvulsant therapy had significantly shorter recovery index than the control group (control 10.4+/-5.1 min, anticonvulsant 4.8+/-1.7 min, P<0.05). Furthermore, the duration of recovery to 10%, 50%, 75% and 100% of baseline T1 values was less in the anticonvulsant drug group. Our data confirm resistance to rocuronium in children on chronic anticonvulsant drugs.

Analysis of Variance↗

PubMed2006

Water and electrolyte needs for football training and match-play.

The high metabolic rates sustained by soccer players during training and match-play cause sweat to be produced in both warm and temperate environments. There is limited published information available on the effects of this sweat loss on performance in soccer. However, this limited information, together with knowledge of the effects of sweat loss in other sports with skill components as well as endurance and sprint components, suggests that the effects of sweating will be similar to the effects in these other activities. Therefore, the generalization that a body mass reduction equivalent to 2% should be the acceptable limit of sweat losses seems reasonable. This amount, or more, of sweat loss reflected in body mass loss is a common experience for some players. Sodium is the main electrolyte lost in sweat and the available data indicate considerable variability in sodium losses between players due to differences in sweating rate and sweat electrolyte concentration. Additionally, the extent of sodium loss is such that its replacement will be warranted for some of these players during training sessions and matches. Although soccer is a team sport, the great individual variability in sweat and electrolyte losses of players in the same training session or match dictates that individual monitoring to determine individual water and electrolyte requirements should be an essential part of a player's nutritional strategy.

Adolescent↗

PubMed1995

A clinician's workstation for improving laboratory use. Integrated display of laboratory results.

Physicians are often forced to make decisions about the use of laboratory resources without adequate access to earlier results and related supporting information. Less than optimal use of the laboratory may result. The authors developed and deployed a clinical workstation meant to provide ready access to laboratory information that is presented in a format well-matched to the patient monitoring task. The workstation was one element of a multifaceted effort to improve blood component use in adult and pediatric bone marrow transplantation units. It was the sole intervention focused on improving laboratory testing. In the 2 years since the introduction of the workstation, median charges of bone marrow transplantation cases for laboratory test fell by 32%. This reduction in charges has been maintained for 2 years. Better informed physicians appear to use laboratory resources more sparingly.

Clinical Laboratory Information Systems↗

PubMed2006

Social inclusion in workplaces where people with intellectual disabilities are employed: implications for supported employment professionals.

This research investigated elements of workplace culture across eight New Zealand workplaces where people with intellectual disability were employed. Using a semi-structured interview format, eight employers were surveyed, and variations in job entry procedures, orientation and training, company policies, job design, customs and practice, and social opportunities were examined. Factors influencing inclusion in the workplace culture of a total of 16 employees, eight supported employees and eight co-workers without disabilities, were identified and compared. The findings indicated that supported workers had a lower level of inclusion than co-workers. Several factors influencing inclusion of employees in the workplace culture were identified; full-time vs. part-time, level of employment support, limiting expectations and employer/co-worker attitudes. The use of a workplace culture survey by supported employment professionals has several benefits, including the identification of potentially inclusive workplaces, the facilitation of a good person and workplace environment match, the possibility of monitoring inclusion levels, encouragement of full work shift placements, and the provision of effective support on the job.

Humans↗

PubMed1990

Altered generation of interleukin 1 in chronic human schistosomiasis mansoni.

Chronic schistosomiasis mansoni is associated with impaired cell-mediated immune responsiveness (CMI). To assess co-stimulatory factors essential in the induction phase of CMI, interleukin 1 (IL-1) concentration was determined in the sera and cell culture supernatants of Schistosoma mansoni-infected patients, and circulating monocytes were phenotyped, labelling membrane IL-1 and HLA-DP. In addition, adherent cell oxidative-burst capacity was investigated. Since involvement of IL-1 beta in the pathogenesis of severe granulomatous lesions could not be ruled out, 17 patients with intestinal schistosomiasis and 17 patients with hepatosplenic schistosomiasis were matched for intensity of infection and monitored 3-6 months after praziquantel therapy. Seventeen age- and sex-matched uninfected residents of the study area in Alagoas, Brazil, acted as controls. Whereas schistosomiasis patients and controls did not differ in the expression of monocyte surface antigens and the capacity of adherent cells to generate H2O2, IL-1 beta release by monocytes in vitro was significantly reduced in both intestinal and hepatosplenic patients. Low concentrations of circulating IL-1 beta were detected in comparable frequencies in untreated patients and controls. Three months after therapy, IL-1 beta was detectable in serum in an increased proportion of intestinal schistosomiasis patients. IL-1 release in vitro gradually increased in all patients and reached control values 6 months after therapy.

Adolescent↗

PubMed1992

Spontaneously hypertensive rat: lymphoid depression is age dependent and mediated via a mononuclear cell subpopulation.

Immune dysfunction has been reported in spontaneously hypertensive rats (SHR), particularly in mature animals with established hypertension. The current study examined the time course of development of immune dysfunction and defined its cellular basis in male SHR and control normotensive Wistar-Kyoto rats (WKY). Mitogen-induced proliferative responses in lymphoid cells obtained from induced proliferative responses in lymphoid cells obtained from SHR thymus and spleen before (age 4 wk) and during the development of (ages 8 and 12 wk) hypertension and in age-matched normotensive WKY were monitored. A 50% reduction in concanavalin A (Con A)-induced proliferative responses was seen in SHR thymocytes compared with those of WKY at 12 wk only, suggesting differences in immature T-cell populations. Con A-induced T-cell proliferative responses in splenocytes also differed between strains: greatest (as much as 8-fold) decreases were found in 12-wk-old SHR. Similar findings were obtained in splenocytes stimulated with lipopolysaccharide (LPS), indicating differences in B-cell function. Mononuclear cells depleted of their adherent cell population were prepared from SHR and WKY at 12+ wk of age and assayed for their proliferative responses to LPS and Con A. The remaining nonadherent mononuclear cells of SHR had proliferative responses equal to or greater than those of WKY. Further, when SHR splenic mononuclear cells were allowed to adhere to plastic, and the adherent fraction was co-cultured with either SHR G-10 nonadherent or unfractionated SHR splenic mononuclear cells, proliferative responses were suppressed by as much as 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

PubMed2006

Monitoring of alcohol and drugs under scrutiny: output and shortcomings.

A major focus of Dutch addiction policy is to improve the monitoring of substance use and addiction - which surveys and registrations are important for the monitoring of alcohol and drugs problems, and what information is generated or needs to be generated by these monitors? Three methods were used: an inventorisation of existing monitoring projects, a survey among experts in the field of alcohol and drugs to study the information needs, and a study on the output and shortcomings of the existing monitors. Sixty monitors and 13 'umbrella' monitors were found. Experts formulated the needs of 11 topics which were matched with the output of the monitors. Coverage of the nature and extent of use in general is good. Shortcomings apply to the use and accessibility of the monitors, as well as to their completeness, standardisation and content. Especially questions with respect to problem use, treatment demand/need of help and user careers cannot be answered sufficiently with the existing information.

Humans↗

PubMed1998

Defective motor control of coughing in Parkinson's disease.

The high incidence of serious chest infections in patients with Parkinson's disease is unexplained, but an impairment in cough reflex may have a role. Maximal voluntary cough (MVC) and reflex cough (RC) to inhalation of ultrasonically nebulized distilled water were analyzed in patients with Parkinson's disease and age-matched control subjects by monitoring the integrated electromyographic activity (IEMG) of abdominal muscles. The peak amplitude of IEMG activity (IEMGP) was expressed as a fraction of the highest IEMGP value observed during MVC corrected to account for possible losses in abdominal muscle force due to reduced central muscle activation. Cough intensity was indexed in terms of both the IEMGP and the ratio of IEMGP to the duration of the expiratory ramp (TEC), i.e., the rate of rise of IEMG activity. Cough threshold was slightly higher in patients than in control subjects, but the difference failed to reach statistical significance. Compared with control subjects, patients displayed a lower IEMGP during maximal expiratory pressure maneuvers (PEmax), MVC, and RC (p always < 0.01); TEC during RC was longer (p < 0.01) than in controls. Consequently, the rate of rise of IEMG activity during cough was always lower in patients (p < 0. 01), especially during RC. Finally, PEmax, and both the peak and rate of rise of IEMG activity during RC were inversely related to the level of clinical disability (Spearman rank correlation coefficient, rs = -0.88, -0.86, and -0.85, respectively, p always < 0.01). The results indicate that the central neural mechanisms subserving the recruitment of motor units and/or the increase in their frequency of discharge during voluntary and, even more markedly, RC are impaired in patients with Parkinson's disease.

Abdominal Muscles↗

PubMed1981

Deleterious influence of hypothyroidism on evolving myocardial infarction in conscious dogs.

To study the influence of hypometabolism on evolving myocardial infarction in a model with intact autoregulation, we investigated 53 awake dogs after coronary artery occlusion. Severe hypothyroidism was induced by the intravenous administration of 131I. Animals were instrumented to obtain hemodynamic measurements, and regional myocardial blood flow was measured with radioactive microspheres. Infarct size was determined by the creatine kinase depletion method, and dysrhythmia analysis was performed from 24-h Holter monitor tapes in animals matched for infarct size. The microarchitecture of hypothyroid myocardium was determined by the electron microscope. Before coronary occlusion, mean systemic pressure in hypothyroid dogs was reduced by 14% and cardiac output reduced by 32%, with no change in left ventricular end-diastolic pressure, first derivative of left ventricular pressure rise, (dP/dt), or heart rate. After coronary occlusion, there was deterioration in hemodynamic measurements in both groups, with lower absolute levels of mean systemic blood pressure and cardiac output obtained in hypothyroid dogs. Hypothyroidism was detrimental to evolving infarction with a 36% increase in infarct size present in hypothyroid dogs (30 +/- 2%) compared to euthyroid controls (22 +/- 3%), P less than 0.05. Dysrhythmias were more severe in hypothyroid dogs. There were no changes in the relationship between regional myocardial blood flow and the extent of infarction after coronary occlusion. Abnormalities in microarchitecture were present in hypothyroid dog myocardium. Severe hypometabolism in this model was associated with alterations in hemodynamics, more severe dysrhythmias and changes in microarchitecture. The combined effect of these alterations resulted in an overall detrimental influence of hypothyroidism on evolving myocardial necrosis in this model.

Animals↗

PubMed2002

Optimizing the availability of 'stat' laboratory tests using Shewhart 'C' control charts.

BACKGROUND: We describe a general strategy for optimizing the availability of 'stat' out-of-hours laboratory tests to the particular clinical needs of health care institutions. METHODS: We initially introduced a consensus menu of 'stat' tests and prospectively monitored for 5 years all additional requests for 'stat' clinical biochemistry tests in a metropolitan tertiary referral university teaching hospital. Laboratory staff triaged 'stat' requests, and clinical biochemistry consultants reviewed requests not already performed routinely. The frequency of these requests was monitored on a Shewhart 'c' control chart. A quality system certified to ISO 9001 was used to assure laboratory compliance with procedures. Various interventions were tested using the Shewhart 'c' control chart to monitor their effectiveness. RESULTS: Matching the timing of analytical assays with the time of sample collection had no significant effect on the number of 'stat' requests. Implementation of a hospital-wide laboratory information system also had no significant effect on the number of 'stat' requests. The most effective strategy consisted of optimization of the test menu to match request patterns, combined with the introduction of a laboratory quality system. CONCLUSIONS: Within our institution, this strategy resulted in a sevenfold reduction in 'stat' requests, from one per 2,200 specimens to fewer than one per 32,000 specimens.

Blood Chemical Analysis↗

PubMed2001

Pancreas after kidney transplants in posturemic patients with type I diabetes mellitus.

Pancreas after previous kidney (PAK) transplants are an attractive option for type 1 diabetic patients because of the short waiting time and use of living kidney donors. Factors associated with the increased success rate of PAK transplants in four immunosuppressive eras were analyzed. Between July 1, 1978, and April 30, 2000, 406 PAK transplants were performed in posturemic patients. Four immunosuppressive eras were analyzed: (1) the precyclosporine era, era 1 (n = 65; 16%); (2) the cyclosporine era, era 2 (n = 109; 27%); (3) the tacrolimus era with monoclonal or polyclonal antibody induction therapy, era 3 (n = 104; 26%); and (4) the tacrolimus era with monoclonal and polyclonal antibody induction therapy, era 4 (n = 128; 31%). Patient and graft survival, rejection, and technical failure rates were calculated. Patient survival rates have remained high over time, from 91% (era 1) to 96% (era 4) at 1 yr posttransplant. Pancreas graft survival rates with primary cadaver transplants have significantly increased, from 17% (era 1) to 81% (era 4) at 1 yr. The rate of graft loss from rejection has significantly decreased, from 78% (era 1) to 9% (era 4) at 1 yr. Results were best when donors and recipients were matched for at least one antigen per HLA locus. Kidney graft survival was higher in PAK transplant recipients compared with diabetic recipients of kidney transplants alone from the time of the kidney as well as the pancreas transplants. PAK recipients now enjoy >80% graft survival at 1 yr. This improvement in outcome results from better immunosuppression, good matching, and close posttransplant monitoring for rejection.

Adult↗

PubMed1998

Is greater than normal nocturnal heart rate in children with renal scars a predictor of reflux nephropathy?

BACKGROUND: The existence of renal scars constitutes the major etiologic factor for the development of hypertension during childhood. Elevated blood pressure in this setting can be considered a secondary form of hypertension. Certain forms of secondary hypertension have been associated with a lower than normal nocturnal fall in blood pressure. Resting heart rate per se has recently been reported to be an independent predictor of risk for cardiovascular mortality irrespective of age and the presence or lack of hypertension. OBJECTIVE: To ascertain the responses of heart rate and blood pressure in normotensive children with renal scars without, however, proteinuria and renal failure. METHODS: Ten children with renal scars documented by a 99Tc dimercaptosuccinic acid (DMSA) scan were subjected to ambulatory blood pressure monitoring. Ten age-matched and sex-matched healthy children served as the control group. Serum urea and creatinine levels, calculated rate of clearance of creatinine, microalbuminuria, plasma renin activity, and levels of aldosterone and catecholamines were determined for each subject. RESULTS: Average daytime and night-time systolic and diastolic blood pressures for the two groups did not differ. Subjects in both groups demonstrated the physiologic decrease in blood pressure during sleep (normal 'dipper' response), which was of equal magnitude for these two groups. Mean daytime heart rates were 92+/- 13 beats/min in children with renal scars versus 80+/-11 beats/min in controls (NS). Mean and minimal heart rates during night-time in children with renal scars were found to be significantly greater [79+/-6 versus 65+/-5 beats/min (mean) and 61+/-10 versus 56+/-7 beats/min (minimal), P < 0.01]. Parameters of renal function, plasma renin activity, and levels of aldosterone and catecholamines were similar for these two groups. CONCLUSION: Despite their having an equivalent physiologic dip in blood pressure during night-time, normotensive children with renal scars have a significantly greater nocturnal heart rate than do control subjects.

Child↗

PubMed2002

[The application of transcranial Doppler in detecting diabetic cerebral macroangiopathy and microangiopathy].

OBJECTIVE: To evaluate the application of transcranial Doppler (TCD) in the detection of cerebral hemodynamic changes in diabetic macroangiopathy and microangiopathy. METHODS: 81 of diabetic patients and 62 age-, gender- matched healthy controls were monitored with TCD in this study. The pulsatility index (PI) and mean flow velocities (Vm) between the patients and healthy controls, between the patients with microangiopathic complications and patients without complication, were analyzed respectively. RESULTS: The PIs of arteries and Vms of the extracranial internal carotid artery (ICA), middle cerebral artery (MCA) and basilar artery (BA) were significantly higher in diabetic patients than those in healthy controls (P < 0.001), while PIs of ICA and MCA but not BA were significantly increased in patients with complications than those in noncomplicated patients (P < 0.001). CONCLUSIONS: It indicated that PI and Vm might be two useful markers for the detection of diabetic cerebrovascular changes. Marked increase of PIs of ICA and MCA might reflect the microangiopathic changes of cerebral vessels in diabetic patients.

Anterior Cerebral Artery↗

PubMed1978

Twenty-four-hour recording in REM-narcoleptics with special reference to nocturnal sleep disruption.

Twenty narcoleptic patients and ten age-matched normals were polygraphically monitored for 58 consecutive hours. All subjects were on regimented sleep (hours between 2230 and 0700). Group A (11 patients and 10 normals) had enforced wakefulness during the day whereas Group B (9 patients) were permitted to sleep (mean = 2 1/2 hr.). On day 2, all subjects were permitted to sleep for 15-min periods every 2 hr. In narcoloptics, sleep recordings demonstrated a reduction of sleep latency, an increase of stage 1, and a decrease in stages 3 and 4 compared to normals, but total REM time and percentage of REM sleep were similar. Groups A and B showed no difference in the incidence of nocturnal awakenings. REM cyclic periodicity was larger in narcoleptics who also demonstrated a REM-sleep fragmentation. This fragmentation became more pronounced as time passed, with several shifts from REM to wakefulness and stage 1. Narcoleptics present REM onset sleep period but also show an inability to remain in REM sleep.

Adult↗

PubMed1987

CNS cancers and radiation exposure: a case-control study among workers at two nuclear facilities.

A nested case-control study was conducted among workers employed in two nuclear facilities to investigate the possible association of primary CNS cancers with occupational exposure to radiation from external and internal sources. External radiation monitoring data from film badges were available for 27 cases and 90 matched controls. The radiation dose to the lung from internally deposited uranium was estimated for 47 cases and 120 matched controls from area and personnel monitoring data and was used in analyses in lieu of the brain dose. No association was observed between deaths from CNS cancers and exposure to ionizing radiation from external or internal sources. However, due to the small number of monitored subjects and low doses, a modest association could not be ruled out.

Adult↗

PubMed1977

Reversal of central anticholinergic syndrome by galanthamine.

Ten volunteers were given 2 mg scopolamine intravenously (IV) to produce substantial drowsiness and sleepiness. Galanthamine, 0.5 mg/kg IV, effectively reversed the central anticholinergic syndrome produced by scopolamine. Electroencephalographic monitoring of two subjects matched the observed changes of consciousness: scopolamine replaced the dominant awake alpha rhythm with a disorganized, slow, 4- to 6-Hz activity. Galanthamine promptly returned to EEG pattern to the control, awake state. Galanthamine produces effective, safe, and long-lasting reversal of the central anticholinergic syndrome in man.

Blood-Brain Barrier↗

PubMed1981

T and B lymphocyte levels in the peripheral blood of dogs affected with cyclic neutropenia.

Canine cyclic neutropenia (CN), a heritable disease of Collie dogs, is characterized by the periodic cycling of formed elements of blood and the near disappearance of neutrophils every 11-12 days. Studies suggest that lymphocyte activity and regulatory mechanisms may be abnormal in CN. In this study, an immunofluorescence in the peripheral blood of normal CN Collies. Normal Collie dogs (N = 10) had 73.0 +/- 2.4% T-lymphocytes, whereas CN dogs (N = 4) had only 63.2 +/- 1.9% similar cells among peripheral blood lymphocytes (P less than 0.005). Studies on B-lymphocytes showed that normal Collie dogs (N = 10) had 17.8 +/- 2.0%, whereas CN dogs (N = 4) had 29.6 +/- 3.3% B-lymphocytes (P less than 0.005). Absolute counts for B-lymphocyte levels for 2 CN Collie dogs (N = 10) had 17.8 +/- 2.0%, whereas CN dogs (N = 4) had 29.6 +/- 3.3% B-lymphocytes (P less than 0.005). Absolute counts for B-lymphocytes were also increased in CN dogs. In a related study, daily changes in T- and B-lymphocyte levels for 2 CN Collies and 1 age-and-sex matched normal Collie were monitored over the course of a 2-week hematopoietic cycle. Similar differences in peripheral blood T- and B-lymphocyte levels, as mentioned above, were found between the CN Collies and the normal Collie. The absolute B-lymphocyte counts for CN Collies also showed a statistically significant increase (P less than 0.005) over counts for the normal Collie, and daily changes in both B- and T-lymphocyte counts were always greater for CN Collies than for normal Collies.

Agranulocytosis↗