A programmed reaction timer for psychological research

A versatile timer has been developed for use in psychological research which can be used to measure a subject's reaction times in response to sequences of visual or auditory stimuli. The timer is programmed by a twenty channel punched tape programmer and the subject's reaction times are displayed in digital form. The time units can be varied by decades over the range 1 msec-1 sec and each measured reaction time is continuously displayed until just before a new stimulus is presented. Two applications for which the unit can be used are (1) the determination of paced serial reaction time using a multiple choice visual display combined with visual and audio distractors and (2) a modification of the Stroop Colour-Word Test. Any error in response is indicated by the illumination of a red light mounted close to the digital display.     

Bone health in women with early-stage breast cancer

Bone health is an increasingly important concern in breast cancer survivors because in postmenopausal women, bone-sparing tamoxifen is being replaced by aromatase inhibitors, whereas in premenopausal women, ovarian suppression is playing an increasing role in adjuvant management. Estrogen reduction resulting from aromatase inhibition and ovarian suppression are associated with loss in bone mineral density (BMD) and an increase in fracture risk. These side effects must be placed in context of the overall risks and benefits seen with these interventions. The American Society of Clinical Oncology has outlined a management strategy for bone health maintenance in breast cancer survivors with early-stage disease that incorporates baseline and ongoing screening for BMD and treatment based on BMD results. Limited but consistent data suggest bisphosphonate therapy represents a treatment option for this condition. A variety of interventions to maintain bone health in breast cancer survivors are undergoing clinical evaluation and include the oral bisphosphonates risedronate and clodronate, the intravenous bisphosphonate zoledronic acid, the receptor activator of nuclear factor-kB ligand inhibitor AMG-162, and the hormonal agent tibolone. Current information suggests bone loss associated with estrogen reduction in breast cancer survivors may represent a preventable and treatable condition. Ongoing clinical trials will definitively evaluate this hypothesis.     

Removable rigid dressings versus soft dressings: a randomized, controlled study with dysvascular, trans-tibial amputees

This study compares a standard soft dressing (SSD) with a removable rigid dressing (RRD) in a randomized, controlled trial using 50 dysvascular trans-tibial amputees. Both dressing types were applied immediately post-operatively and were only removed for wound dressing changes. Half the subjects were allocated prospectively by ballot to either the RRD group or the SSD group. There was a strong trend indicating that primary wound healing of the stump occurred almost 2 weeks earlier in subjects using the RRD (RRD = 51.2 days +/- 19.4; SSD = 64.7 days +/- 29.5; P= 0.07; RRD: n =17; SSD: n = 14.) There were no significant differences between the other parameters measured which included time to prosthetic fitting, length of hospital stay, incidence of stump breakdown, and time taken for stump volume to stabilize. The incidence of stump damage due to falls was also recorded, the results indicating that RRDs may protect the new stump from trauma.     

Depressive symptoms have an independent, gradient risk for coronary heart disease incidence in a random, population-based sample

PURPOSE: Depression is a risk factor for incident coronary heart disease (CHD), and predicts poor prognosis for patients post-myocardial infarction (MI). Few population-based, prospective studies have tested a gradient risk for depressive symptoms on CHD incidence. METHODS: The sample (n=1302) was derived from the Nova Scotia Health Survey-1995 (NSHS95), an age- and sex-stratified, random, population-based health survey. All subjects were 45 years or older, free of overt CHD at baseline, and completed the Center for Epidemiological Studies-Depression (CES-D) scale. Covariates included age, sex, body mass index, physical activity level, family history of premature CHD, diastolic blood pressure, lipids, smoking, alcohol use, diabetes, and education level. For the 4 years following NSHS95, MI-related hospitalizations (ICD-9-CM code 410) and CHD-related deaths (ICD-9-CM codes 410-414) were extracted from the provincial, universal healthcare registry. RESULTS: Fifty-two participants experienced a CHD event. A one standard-deviation increase in CES-D score was associated with a 1.32 hazard risk (confidence interval, 1.01-1.71) of CHD events, controlling for established CHD risk factors. CONCLUSIONS: An independent, gradient association between depression and incident CHD was detected in a population-based sample with complete 4-year CHD data. This evidence supports the value of investigating mechanisms linking depression and CHD.     

Detection of urine loss using the Exeter recording nappy and other similar devices.

A technical evaluation of the Exeter recording nappy has been carried out with particular reference to (a) linearity, (b) reproducibility of calibration, (c) the effect of variation in the position of moistened zones produced by consecutive leakages and (d) the effect of variation in the electrical conductivity of the liquid detected. The clinical use of the nappy is also discussed. A miniature alarm coupled to a similar pad arrangement has been developed as a training system for the geriatric incontinent patient and patients with neurogenic bladders. A 'pad and pant' version of an enuresis alarm has also been designed which had advantages over the conventional under-sheet type.     

Beta-amyloid inhibition of long-term potentiation is mediated via tumor necrosis factor

A number of recent studies have shown that beta-amyloid (Abeta) inhibits the induction of long-term potentiation (LTP) in the hippocampus. However, little is known about the mechanisms underlying such inhibition of LTP. In the present study, we present evidence that the cytokine tumor necrosis factor (TNF) alpha has a key role in the Abeta inhibition of LTP. The suppression of LTP by Abeta was absent in mutant mice null for TNF receptor type 1 (TNF-R1) and was prevented by the inhibitors of TNFalpha, infliximab and TNF peptide antagonist, and by the inhibitor of TNFalpha production, thalidomide. In addition, exogenous TNFalpha inhibited LTP induction, an action mediated via TNF-R1 as such inhibition was absent in mutant mice null for TNF-R1. The inhibition of LTP by TNFalpha involved activation of group I metabotropic glutamate receptor and p38 MAP kinase, identical to that for the Abeta-mediated inhibition of LTP induction.     

Is early enteral feeding safe in patients who have suffered spinal cord injury?

OBJECTIVE: To examine whether enteral feeding is a safe technique to use in the acute stage of spinal cord injury. METHODS: We searched the departmental computerised patient database and clinical records for all patients with spinal cord injuries admitted to the Auckland Hospital Intensive Care Unit (ICU), known as the Department of Critical Care Medicine (DCCM), between January 1988 and December 2000. Patients were included in the study if they had suffered complete spinal cord transection resulting in either paraplegia or quadriplegia. Data was collected for the following variables: length of time to commence enteral feeding, type of enteral feeding, duration of enteral feeding and reasons for interrupting the feed. RESULTS: Thirty-three patients were found and were included in the study. Twenty-seven (82%) of the patients commenced enteral feeding in the DCCM, 25 by nasogastric (NG) and 2 by nasojejunal (NJ) tube. Feeding was commenced a median of 2 days after admission and the median length of enteral feeding was 7.7 days. The main feeding complications that resulted in interrupting the feed were high gastric aspirates. One patient commenced on enteral feeding developed medical complications that prevented continuation. Two patients on NG feeding converted to NJ feeding. CONCLUSION: No major complications associated with enteral feeding were seen in this study. This would indicate that enteral feeding can be safely administered in the acute stage of spinal cord injury provided complications are monitored for daily.