Medicine and Health Sciences Commons^™

Effects Of Arginine Supplementation On Hemodynamics And Outcome, J. Reynolds, Jane Gervasio, G. Zaloga, L. Bortenschlager

Jane M. Gervasio

Abstract from the ASHP Midyear Clinical Meeting, New Orleans, LA, December 7-11, 2003.

Small Bowel Necrosis As A Result Of Enteral Nutrition In Critically Ill Patients, J. Reynolds, Jane Gervasio, G. Zaloga

Jane M. Gervasio

Abstract from the ASHP Midyear Clinical Meeting, New Orleans, LA, December 7-11, 2003.

Emg Remains Fractionated In Parkinson's Disease, Despite Practice-Related Improvements In Performance, D. Flament, D. Vaillancourt, T. Kempf, K. Shannon, D. Cross

Timothy Kempf

Objective: We studied the ability of patients with Parkinson's disease to improve their performance in a motor task requiring both speed and accuracy in the execution of elbow flexion movements. Our goal was to investigate the changes in electromyographic activity associated with the changes in movement performance.

Methods: Eleven patients on anti-Parkinsonian medication were tested. The patients were selected for being bradykinetic, having little or no resting tremor or dyskinesias, and being in stages II or III of the Hoehn and Yahr rating scale.

Results: The untrained patients displayed multiple bursts of agonist activity, characteristic of Parkinsonian EMG recordings. All …

Patterns Of Breast Recurrence In A Pilot Study Of Brachytherapy Confined To The Lumpectomy Site For Early Breast Cancer With Six Years' Minimum Follow-Up, Francisco Perera, Edward Yu, Jay Engel, Ronald Holliday, Leslie Scott, Frank Chisela, Varagur Venkatesan

Edward Yu

PURPOSE: In this pilot study of high-dose-rate brachytherapy to the lumpectomy site as the sole radiation, ipsilateral and contralateral breast recurrences are documented with specific attention to the location of recurrence relative to the lumpectomy site. METHODS: Between March 1992 and January 1996, 39 patients with T1 (32 patients) and T2 breast cancers received 37.2 Gy in 10 fractions (b.i.d.) over 1 week prescribed to a volume encompassing the surgical clips. Thirteen received adjuvant tamoxifen, and 4 received chemotherapy. Follow-up included annual bilateral mammograms and clinical breast examination every 3 to 6 months. Whereas 13 patients had intraoperative implantation of …

Modeling The Optimum Duration Of Antibiotic Prophylaxis In An Anthrax Outbreak, Ron Brookmeyer, Elizabeth Johnson, Robert Bollinger

Ron Brookmeyer

A critical consideration in effective and measured public health responses to an outbreak of inhalational anthrax is the optimum duration of antibiotic prophylaxis. We develop a competing-risks model to address the duration of antibiotic prophylaxis and the incubation period that accounts for the risks of spore germination and spore clearance. The model predicts the incubation period distribution, which is confirmed by empirical data. The optimum duration of antibiotic prophylaxis depends critically on the dose of inhaled spores. At high doses, we show that exposed persons would need to remain on antibiotic prophylaxis for at least 4 months, and considerable morbidity …

Statistical Models And Bioterrorism: Application To The U.S. Anthrax Outbreak, Ron Brookmeyer, Natalie Blades

Ron Brookmeyer

In the fall of 2001 an outbreak of inhalational anthrax occurred in the United States that was the result of bioterrorism. Letters contaminated with anthrax spores were sent through the postal system. In response to the outbreak, public health officials treated over 10,000 persons with antibiotic prophylaxis in the hopes of preventing further morbidity and mortality. No persons receiving the antibiotics subsequently developed disease. The question arises as to how many cases of disease may actually have been prevented by the public health intervention of antibiotic prophylaxis. A statistical model is developed to answer this question by relating to the …

Will The Real Charles Fried Please Stand Up?, Paul Miller, Charles Weijer

Charles Weijer

In response to the preceding commentary by Jerry Menikoff in this issue of the Journal, the authors argue that Fried's central concern is not that randomized clinical trials (RCTs) are conducted without consent, but rather that various aspects of the design and conduct of RCTs are in tension with physicians' duties of personal care to their patients. Although Fried does argue that the existence of equipoise cannot justify failure to obtain consent from research subjects, informed consent by itself does not supplant ill subjects' rights to personalized judgment and care embodied in Fried's equipoise.

Importance Of Informed Consent In Offering To Return Research Results To Research Participants, Conrad Fernandez, Eric Kodish, Charles Weijer

Charles Weijer

No abstract provided.

Amygdala Hyperreactivity In Borderline Personality Disorder: Implications For Emotional Dysregulation, Nelson H. Donegan, Charles A. Sanislow, Hilary P. Blumberg, Robert K. Fulbright, Cheryl Lacadie, Pawel Skudlarski, John C. Gore, Ingrid R. Olson, Thomas H. Mcglashan, Bruce E. Wexler

Charles A. Sanislow, Ph.D.

BACKGROUND: Disturbed interpersonal relations and emotional dysregulation are fundamental aspects of borderline personality disorder (BPD). The amygdala plays important roles in modulating vigilance and generating negative emotional states and is often abnormally reactive in disorders of mood and emotion. The aim of this study was to assess amygdala reactivity in BPD patients relative to normal control subjects. We hypothesized that amygdala hyperreactivity contributes to hypervigilance, emotional dysregulation, and disturbed interpersonal relations in BPD.

METHODS: Using functional magnetic resonance imaging, we examined neural responses to 20-sec blocks of neutral, happy, sad, and fearful facial expression (or a fixation point) in 15 …

Quantitative And Qualitative Changes In Gene Expression Patterns Characterize The Activity Of Plaques In Multiple Sclerosis, Lotti Tajouri, Albert Mellick, Kevin Ashton, Anthony Tannenberg, Rashed Nagra, Wallace Tourtellotte, Lyn Griffiths

Lotti Tajouri

Multiple sclerosis (MS) is a complex autoimmune disorder of the CNS with both genetic and environmental contributing factors. Clinical symptoms are broadly characterized by initial onset, and progressive debilitating neurological impairment. In this study, RNA from MS chronic active and MS acute lesions was extracted, and compared with patient matched normal white matter by fluorescent cDNA microarray hybridization analysis. This resulted in the identification of 139 genes that were differentially regulated in MS plaque tissue compared to normal tissue. Of these, 69 genes showed a common pattern of expression in the chronic active and acute plaque tissues investigated (P value<0.0001, ρ=0.73, by Spearman's ρ analysis); while 70 transcripts were uniquely differentially expressed (≥1.5-fold) in either acute or chronic active tissues. These results included known markers of MS such as the myelin basic protein (MBP) and glutathione S-transferase (GST) M1, nerve growth factors, such as nerve injury-induced protein 1 (NINJ1), X-ray and excision DNA repair factors (XRCC9 and ERCC5) and X-linked genes such as the ribosomal protein, RPS4X. Primers were then designed for seven array-selected genes, including transferrin (TF), superoxide dismutase 1 (SOD1), glutathione peroxidase 1 (GPX1), GSTP1, crystallin, alpha-B (CRYAB), phosphomannomutase 1 (PMM1) and tubulin β-5 (TBB5), and real time quantitative (Q)-PCR analysis was performed. The results of comparative Q-PCR analysis correlated significantly with those obtained by array analysis (r=0.75, P value<0.01, by Pearson's bivariate correlation). Both chronic active and acute plaques shared the majority of factors identified suggesting that quantitative, rather than gross qualitative differences in gene expression pattern may define the progression from acute to chronic active plaques in MS.

Marketing Lifestyles: The Gravity Games And Generation Y., Anthony Lachowetz, G. Bennet

Anthony J Lachowetz

No abstract provided.

Critical Care Nurses Be Aware: Lemierre's Syndrome Is On The Rise, Roseanne Jane, Patricia Johnson

Patricia Johnson

Lemierre's syndrome (LS) typically occurs in previously healthy young adolescents and young adults who become acutely ill following an attack of pharyngotonsillitis. Also known as post anginal sepsis, those afflicted develop pyrexia, rigours and multiple metastatic abscesses that lead to septic thrombophlebitis of the internal jugular vein. In the pre-antibiotic era this particularly virulent syndrome had a mortality rate in excess of 90%, but since the introduction of antibiotics and the widespread treatment of throat infections, it has became almost unknown. However, due to a number of factors, including a reduction in the use of antibiotics for the treatment of …

Shifting From Hypofractionated To "Conventionally" Fractionated Thoracic Radiotherapy: A Single Institution's 10-Year Experience In The Management Of Limited-Stage Small-Cell Lung Cancer Using Concurrent Chemoradiation, Gregory Videtic, Pauline Truong, A. Dar, Edward Yu, Larry Stitt

Edward Yu

PURPOSE: To perform a retrospective review of a single institution's 10-year experience in treating limited-stage small-cell lung cancer (LS-SCLC) with a concurrent chemoradiation regimen modeled after the experimental arm of a randomized National Cancer Institute of Canada trial in which hypofractionated radiotherapy started with cycle 2 of chemotherapy. We then looked at the impact on patient outcomes of changing the RT during the course of the decade to a "conventionally" (2 Gy) fractionated regimen, with a focus on toxicity and survival rates. METHODS AND MATERIALS: Between 1989 and 1999, 215 LS-SCLC patients received six cycles of chemotherapy consisting of cyclophosphamide, …

The Efficacy Of A Work-Station Intervention Program To Improve Functional Ability And Flexibility In Ageing Clients With Cerebral Palsy: A Pilot Study, Nancy Low Choy, Rosemary Isles, Ruth Barker, Jennifer Nitz

Nancy Low Choy

Purpose:
Health care workers associated with the long-term care of ageing clients with Cerebral Palsy have reported on the adverse effects of less active daily activity programmes with resultant decreased functional mobility. While the negative effects of ageing have been reported in these clients, programmes have not been implemented to determine whether these adverse changes can be reversed or prevented. The efficacy of a work-station intervention programme to improve functional ability and flexibility in ageing clients with cerebral palsy was investigated.

Method:
A clinical intervention study using repeated measures (pre/post-intervention and at follow-up) to evaluate efficacy was undertaken. Twenty-two clients …

The Natural Course Of Bulimia Nervosa And Eating Disorder Not Otherwise Specified Is Not Influenced By Personality Disorders, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, Robert L. Stout, Maria E. Pagano, Shirley Yen, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) and to test the effects of personality disorder (PD) comorbidity on the outcomes.

Method: Ninety-two female patients with current BN (N ¼ 23) or EDNOS (N ¼ 69) were evaluated at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study (CLPS). Eating disorders (EDs) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders. Personality disorders (PDs) were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV). The course of BN and EDNOS was assessed with the Longitudinal Interval Follow-up …

Clinical Features And Impairment In Women With Borderline Personality Disorder (Bpd) With Post-Traumatic Stress Disorder (Ptsd), Bpd Without Ptsd, And Other Personality Disorders With Ptsd, Caron Zlotnick, Dawn M. Johnson, Shirley Yen, Cynthia Battle, Charles A. Sanislow, Andrew E. Skodol, Carlos M. Grilo, Thomas H. Mcglashan, John G. Gunderson, Donna S. Bender, Mary C. Zanarini, M. Tracie Shea

Charles A. Sanislow, Ph.D.

The aims of this study were to examine differences in clinical features, impairment, and types of childhood traumas among women with borderline personality disorder (BPD), women with BPD and posttraumatic stress disorder (PTSD), and those with other personality disorders and PTSD. Using baseline data from the Collaborative Longitudinal Study of Personality Disorders, 186 women were divided into 3 groups (BPD+PTSD, BPD, PTSD), based on structured diagnostic interviews for Axis I and Axis II disorders and compared on selected clinical variables. The additional diagnosis of PTSD in borderline women did not significantly increase the degree of borderline pathology and psychiatric morbidity …

Comparative Analysis And Expression Of Clul1, A Cone Photoreceptor-Specific Gene, Qi Zhang, William A. Beltran, Zuohua Mao, Kui Li, Jennifer L. Johnson, Gregory M. Acland, Gustavo D. Aguirre

Gustavo D. Aguirre, VMD, PhD

High-Field 19.6 T 27Al Solid-State Mas Nmr Of In Vitro Aluminated Brain Tissue, Pamela L. Bryant, Walter J. Lukiw, Zhehong Gan, Randall W. Hall, Leslie G. Butler

Randall W. Hall

Obat Telinga Gatal Karena Jamur, Obatgatal Seluruhtubuh

obatgatal seluruhtubuh

Cara Mengatasi Gatal Pada Selakangan, Obatgataldi Selangkangantradisional

obatgataldi selangkangantradisional

Offering To Return Results To Research Participants: Attitudes And Needs Of Principal Investigators In The Children's Oncology Group, Conrad Fernandez, Eric Kodish, Susan Shurin, Charles Weijer

Charles Weijer

PURPOSE: The offer to return a summary of results to participants after the conclusion of clinical research has many potential benefits. The authors determined current practice and attitudes and needs of researchers in establishing programs to return results to research participants.

METHODS: An Internet survey of all 236 principal investigators (PIs) of the Children's Oncology Group in May 2002 recorded PI and institutional demographics, current practice, and perceived barriers to and needs of PIs for the creation of research results programs.

RESULTS: One hundred fifty (63.8%) PIs responded. Few institutions (n = 5) had established, comprehensive programs to offer the …

Understanding Novel Therapeutic Agents For Multiple Myeloma, Joseph D. Tariman Phd

Joseph D Tariman PhD, RN, ANP-BC, FAAN

No abstract provided.

The Representation Of Four Personality Disorders By The Schedule For Nonadaptive And Adaptive Personality Dimensional Model Of Personality, Leslie C. Morey, Megan B. Warner, M. Tracie Shea, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study examined the relationships of the Schedule for Nonadaptive and Adaptive Personality (SNAP) model of personality to 4 targeted personality disorders (PDs) in a large multisite sample of patients. Data were examined from 529 patients, who were assigned 1 of 5 primary diagnoses: borderline, schizotypal, avoidant, and obsessive–compulsive PDs and major depression without PD. Patients were administered the SNAP questionnaire and results were compared among diagnostic groups and between patient groups and nonclinical norms. Results indicated that the dimensions of the model appear to have considerable promise in differentiating normal from abnormal personality, particularly in the propensity of individuals …

Implementing Library Service Agreements: The Experience Of Australian Health Libraries, Lindsay Harris, Susan J. Rockliff

Susan J Rockliff

There is little in the published literature on creating and implementing service agreements in libraries as distinct from reports on the outsourcing and contracting out of discrete functions or entire services. This paper examines the role of service agreements in Australian health libraries and their operation in libraries. Aspects considered are the definition of service agreements, what they are and are not, how they are developed, the scope and contents of such agreements and areas likely to cause difficulties. The experiences of Australian health libraries in the implementation of service agreements and key features in their success or failure are …

Diagnosing Patients With Tiredness In General Practice, Jenny Doust

Jenny Doust

Trying to sort out which patients have a relatively simple problem that will resolve spontaneously from those that require medical treatment and those that require urgent attention is one of the aspects of general practice that makes it interesting and challenging. Patients who present with tiredness in general practice can have any of a long list of diagnoses ranging from the trivial to the life threatening, and knowing how to determine who has which is an essential skill for competent practice.

Bioethics In Social Context, Edited By Barry Hoffmaster, Charles Weijer

Charles Weijer

No abstract provided.

Interdisciplinary Team Collaboration, Laura Greiss Hess, Kerrie Lemons, Lesley Deprey, Cynthia Winn

Laura Greiss Hess

Axis I And Ii Disorders As Predictors Of Prospective Suicide Attempts: Findings From The Collaborative Longitudinal Personality Disorders Study, Shirley Yen, M. Tracie Shea, Maria Pagano, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Andrew E. Skodol, Donna S. Bender, Mary C. Zanarini, John G. Gunderson, Leslie C. Morey

Charles A. Sanislow, Ph.D.

This study examined diagnostic predictors of prospectively observed suicide attempts in a personality disorder (PD) sample. During 2 years of follow-up, 58 participants (9%) reported at least 1 definitive suicide attempt. Predictors that were examined include 4 PD diagnoses and selected Axis I diagnoses (baseline and course). Multivariate logistic regression analyses indicated that baseline borderline personality disorder (BPD) and drug use disorders significantly predicted prospective suicide attempts. Controlling for baseline BPD diagnosis, proportional hazards analyses showed that worsening in the course of major depressive disorder (MDD) and of substance use disorders in the month preceding the attempt were also significant …

Cara Menghilangkan Gatal Di Selakangan, Caramenyembuhkan Gatalgataldiselangkangan

caramenyembuhkan gatalgataldiselangkangan

Medial-Lateral Postural Stability And Balance In Community Dwelling Women Over 40 Years Of Age, Jennifer Nitz, Nancy Low Choy, Rosemary Isles

Nancy Low Choy

Objective:
To document the change in medial–lateral balance in women aged between 40 and 80 years.

Design:
A cross-sectional study of six measures of medial–lateral balance was undertaken.

Setting:
The Betty Byrne Henderson Centre for Women and Ageing, Royal Women's Hospital, Australia.

Subjects:
Five hundred and three community-dwelling women between 40 and 80 years of age were randomly recruited from a large metropolitan region with 366 subjects admitted after applying exclusion criteria.

Measurements:
The clinical measurements included the lateral reach and step tests while laboratory measurements were gathered from the Balance Master software programs for unilateral stance and limits of …