Search PubMed⌕ Search

Biomedical subjects

B Allen

Publications and source records attributed to B Allen.

At least 37 records · Page 2Linked to original sources
PubMed1998

Effectiveness of physicians-in-training counseling for smoking cessation in African Americans.

This study examined the effectiveness of smoking cessation counseling by physicians-in-training (residents) with African-American patients. One hundred fifty-eight family and internal medicine residents at a large urban public general hospital participated in the study; two thirds of the residents underwent a 2-hour smoking cessation training program. Ninety-two of the trained physicians counseled from 1 to 18 patients. The majority of physicians were male, with 8% being current smokers. Over a 26-month period, 1086 patients were randomly assigned to intervention and control (usual care) groups. Mean patient age was 44 years, mean years smoking was 25, and mean number of cigarettes smoked per day was 14. There were no differences in biochemically validated smoking cessation rates between the intervention and control groups at 3 or 12 months postenrollment (2% versus 1.8% and 2.2% versus 2.8%, respectively). Losses to follow-up were high at both 3 and 12 months (38% and 40% respectively). Implications for future trials in minority populations are discussed. A brief physician-based smoking cessation message does not appear to be an effective strategy for use with African-American smokers in a large urban public general hospital.

Black or African American↗
PubMed1997

Are Melnick-Needles syndrome and oto-palato-digital syndrome type II allelic? Observations in a four-generation kindred.

Melnick-Needles syndrome (MNS) is a female-limited skeletal dysplasia inherited in a X-linked dominant pattern. Males born to women with MNS may exhibit lethal multiple congenital anomalies, but recurrence of this phenotype within one family has not been reported. Males with oto-palato-digital syndrome type II (OPD II) also demonstrate a multiple congenital anomalies phenotype that includes skeletal dysplasia but the maternal phenotype includes only mild craniofacial anomalies. These two syndromes have been suggested as being allelic despite differences in the described maternal phenotypes. We present a four-generation kindred in which four males had a consistent multiple congenital anomalies phenotype. The females in this family have skeletal changes characteristic of MNS but have only mild craniofacial anomalies and also deafness attributable to ossicular deformity, traits more commonly found in OPD II. The expression of manifestations of MNS and OPD II in males and females in this kindred further suggest that these syndromes are allelic.

Abnormalities, Multiple↗
PubMed1997

Task performance of black and white children across levels of presentation variability.

This study is an examination of the task performance patterns of Black and White, working and middle-class American children across a nonvaried and a varied presentation format condition: the relation of such patterns to activity levels in the home and to standardized achievement was also examined. Performance was better under the varied than the nonvaried format condition. This pattern held for all ethnic group/class combinations with the exception of Black middle-class children, for whom performance under the two conditions was virtually identical. Moreover, Black children, especially Black working-class children, reported greater home activity levels than did their White counterparts. Neither home activity level nor achievement was functionally related to patterns of performance.

Achievement↗
PubMed1997

Risk factors for coronary heart disease among Navajo Indians: findings from the Navajo Health and Nutrition Survey.

Coronary heart disease was uncommon among the Navajo in the past, but appears to have increased substantially over the last few decades. The 1991-1992 Navajo Health and Nutrition Survey, which included interviews and examinations of 303 men and 485 women between the ages of 20 and 91 y, is the first population-based examination of coronary heart disease risk factors in this tribe. Coronary heart disease risk characteristics were common, particularly overweight (men, 35%; women, 62%), hypertension (men, 23%; women, 14%) and diabetes mellitus (men, 17%; women, 25%). Among 20- to 39-y-olds, a large proportion of men reported that they currently smoked cigarettes (23%); use of chewing tobacco or snuff was also prevalent among these 20- to 39-y-old men (37%) and women (31%). Although serum concentrations of total cholesterol were fairly comparable to those seen in the general U.S. population, fasting serum triglyceride concentrations were high (median: men, 132 mg/dL; women, 137 mg/dL), and concentrations of HDL cholesterol were low, particularly among women (median: men, 42 mg/dL; women, 44 mg/dL). Body mass index was associated with levels of most risk factors, and, independently of the level of overweight, a truncal pattern of body fat was related to adverse lipid levels among men. A large proportion of men (20%) and women (30%) reported not having participated in physical activity during the preceding month. Lessons learned from past intervention activities among the Navajo, particularly those for diabetes, may be useful in managing these risk factors to reduce the future burden of coronary heart disease.

Adolescent↗
PubMed1997

Near doubling of heart rate after intravenous verapamil for treatment of atrial fibrillation without preexcitation.

Initial treatment of atrial fibrillation often involves pharmacological therapy to control ventricular response. While verapamil is usually safe and effective when used for this purpose, we report a proarrhythmic response. In this report a 30-year-old female presented with palpitations associated with atrial fibrillation and a ventricular response of 145 beats/min. Soon after she was given 5 mg of intravenous verapamil her ECG documented a regular wide QRS tachycardia at 290 beats/min. After 7 seconds the rhythm returned to an irregularly irregular narrow QRS tachycardia at 125-150 beats/min. At a later electrophysiology study there was neither evidence of preexcitation nor inducible supraventricular or ventricular tachycardia. These data suggest that verapamil may have been associated with acceleration of the heart rate. The mechanism of proarrhythmia may be related to an alteration in the atrial rhythm from atrial fibrillation to atrial flutter, with additional factors as well.

Adult↗
PubMed1997

Low prevalences of HIV infection and sexually transmitted disease among female commercial sex workers in Mexico City.

OBJECTIVES: This study tried to determine human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevalences among female commercial sex workers in Mexico City. METHODS: A sampling frame was constructed that included bars, massage parlors, and street corners. RESULTS: Prevalences for Treponema pallidum, herpes simplex virus type 2, HIV, Neisseria gonorrhoeae, and Chlamydia trachomatis were 6.4%, 65%, 0.6%, 3.7%, and 11.1%, respectively. A significant association was found between higher STD frequencies and working at street sites. CONCLUSIONS: Most STD frequencies were lower in comparison with rates found for female sex workers in other countries. However, preventive programs against STD/ HIV are needed in this population.

Female↗
PubMed1996

Compliance with guidelines results in appropriate ondansetron prescribing at Christchurch Hospital.

AIM: To assess compliance with established consensus derived guidelines for ondansetron therapy and to estimate the cost of any non-guideline use. METHODS: All inpatients (including paediatric patients) at Christchurch Hospital who received ondansetron during August 1993 were identified by daily review of medication charts. Outpatients who received ondansetron prescriptions were identified from pharmacy records. All patients' medical records were then examined and ondansetron therapy was compared with the guideline recommendations for indication and dosage. The total cost of ondansetron for each patient was also calculated. RESULTS: Ondansetron was prescribed for 64 patients (41 female, 23 male) during the one month period. Fifty patients received ondansetron therapy in accordance with all indication and dosage aspects of the guidelines. The main guideline indication for use was highly emetogenic chemotherapy with 28 patients. Fifteen patients received ondansetron because of failure of standard antiemetic therapy and nine because they were paediatric chemotherapy patients. Of the 12 patients who received ondansetron outside the guidelines indications, nine had received 'moderately highly' emetogenic chemotherapy (whereas the guidelines state 'highly' only), two had severe asthma, one received radiotherapy. Two patients did not comply with the dosage recommendations as they received ondansetron more than 24 hours after the initial cytotoxic dose. Total ondansetron expenditure for the period was $12,789 (inpatient $8492 outpatient $4297). Expenditure related to the nonguideline usage was $536 (4.2% of the total monthly ondansetron expenditure). CONCLUSION: There was high compliance with the guidelines. This supports the use of guidelines in encouraging appropriate prescribing.

Adult↗
PubMed1996

Sex masks: the double life of female commercial sex workers in Mexico City.

The central topic of the article is the divided world of female commercial sex workers (FCSW) in Mexico City. Fourteen focus group sessions were conducted with 133 FCSW from varying socio-economic levels and types of work site, as well as seven individual interviews. FCSW live in a constant double bind, as mother and "prostitute," and come into daily contact with society's double standard for women. Reactions include justifying sex work as a better paying employment opportunity for women, as a necessary evil, and as a type of social service, while at the same time hiding their profession from their families. FCSW also live out an archetypal female ambivalence, their selves divided between the mother/"saint" and the traitor/"prostitute." This article defines elements which should be taken into account in culturally appropriate programs for prevention of HIV/AIDS transmission, especially the importance which FCSW give to their role as mothers and promotion of the condom as a physical and symbolic barrier between professional and private life.

Condoms↗
PubMed1996

An integrated approach to Smart House technology for people with disabilities.

It is now commonly accepted that 'Smart House' technology can play a significant part in helping both elderly and disabled people enjoy a greater degree of independence in the near future. In order to realize this aspiration, it is necessary to examine a number of factors: the development of the appropriate Home Bus technologies and supported devices; the development of the appropriate user interfaces that will allow people with a range of special needs use the system; the incorporation of the requirements of the 'Smart House' controller with the other technological needs of the user; and the development of mainstream technologies that will affect the cost and availability of devices to the user. This paper will examine the above points and suggest appropriate actions and trends. It will draw upon the work of a four-member consortium currently finalizing a technical development project under the EC TIDE program, the experience of research and commercial organizations engaged in development work in associated areas and the experiences of the Dublin-based, Central Remedial Clinic and in particular, its Client Technical Services Unit. The CTSU have been actively engaged in the development of systems for clients and direct clinical assessments for the last 12 years.

Biomedical Engineering↗
PubMed1996

Neointimized Gore-Tex graft for ureteral prosthesis in the dog.

OBJECTIVES: To determine the feasibility of replacing a ureteral segment with a neointimized Gore-Tex graft. METHODS: Seven adult mongrel dogs underwent a two-stage operative procedure. The first procedure involved arterializing the graft to stimulate spread of a luminal neoendothelium by transmural capillary growth. Eight weeks after the initial procedure, a segment of the ipsilateral ureter was replaced with a segment of the neointimized graft. RESULTS: Histologic evaluation of a portion of the graft removed during the second procedure demonstrated transmural neocapillary ingrowth in all grafts; however, there was no neoendothelial growth on the luminal surface. In 5 dogs the graft was occluded with blood clot and was not suitable for a ureteral prosthesis. In 2 dogs the graft was patent and was successfully incorporated into the urinary system. After 1 year of observation, both of these dogs maintained a patent ureter and had no evidence of hydronephrosis on intravenous urogram. CONCLUSIONS: These data demonstrate that a Gore-Tex graft can be used as a ureteral prosthesis in the dog. The importance of preliminary arterialization, however, remains to be determined.

Animals↗
PubMed1996

Intraoperative salvage in patients undergoing elective abdominal aortic aneurysm repair: an analysis of cost and benefit.

PURPOSE: Although autologous blood procurement has become a standard of care in elective surgery, recent studies have questioned its cost-effectiveness. We therefore reviewed our 3-year experience with intraoperative cell salvage in patients who underwent elective abdominal aortic aneurysm repair. METHODS: A 3-year retrospective chart review of elective abdominal aortic aneurysm (infrarenal and suprarenal) repair was performed. Transthoracic repairs were excluded. RESULTS: Estimated blood lost was 1748 +/- 1236 ml, or 35% of baseline blood volume (5012 +/- 689 ml). Overall, 164 (89%) received red blood cell (RBC) transfusions (3.5 +/- 2.0 U/patient). The cost per patient for cell salvage was $315 +/- $97, representing 31% of all RBC costs and 24% of total blood component costs. Mean salvage volume infused was 578 +/- 600 ml; at a mean hematocrit level of 55.7% the RBC volume infused from salvage during surgery was 313 +/- 328 ml (representing 27% of total RBC volume lost during the hospital stay). This mean RBC volume salvaged represented the equivalent of 1.6 blood bank RBC units. The mean blood bank costs saved by using cell salvage was $248, or 79% of the $315 actually spent for salvage. We found no decrease in percentage of patients undergoing transfusion until salvage volumes that were infused exceeded 750 ml, or the equivalent of two blood bank units; all of these patients who benefitted had estimated blood lost > or = 1000 ml. CONCLUSIONS: We conclude that use of intraoperative cell salvage was most beneficial for patients who had estimated blood loss greater than or equal to 1000 ml and cell salvage volumes infused greater than or equal to 750 ml. Patients who are estimated to lose less than 1000 ml receive little benefit yet incur substantial costs from intraoperative cell salvage.

Aged↗
PubMed1996

Semi-preparative isolation of plant sulfoquinovosyldiacylglycerols by solid phase extraction and HPLC procedures.

Techniques are described for the semi-preparative isolation of sulfoquinovosyldiacylglycerol from plant leaf tissue lipid extracts and the resolution and analysis of component molecular species. Sulfoquinovosyldiacylglycerol was resolved from phospholipids in a polar lipid fraction by isocratic normal phase HPLC with detection at 208 nm. The mobile phase was composed of heptane-isopropanol-0.001 M KCl 40:52:8 (v/v/v). Yields from spinach leaf lipid extracts were 1.8 mg.10 g-1 fresh wt leaf tissue. Molecular species components of purified sulfoquinovosyldiacylglycerol were separated by reversed-phase C18 HPLC, and fatty acid positional distribution was defined.

Chromatography, High Pressure Liquid↗
PubMed1996

MAGIC: an experimental system for generating multimedia briefings about post-bypass patient status.

We describe MAGIC, an experimental system for generating multimedia briefings about the clinical status of post-bypass patients entering a cardiac ICU. MAGIC is a distributed system whose components use knowledge-based techniques for planning and generating briefings in text, speech, and graphics. These briefings are coordinated together by reasoning with dynamically generated temporal and spatial constraints. Formative evaluation using system mock-ups with ICU nurses and residents have been used to determine the general format and content of these briefings. We present an overview of MAGIC's architecture and show what it can currently generate.

Computer Systems↗