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Biomedical subjects

B J Anderson

Publications and source records attributed to B J Anderson.

At least 109 records · Page 6Linked to original sources
PubMed1991

Clinic attendance and glycemic control. Study of contrasting groups of patients with IDDM.

OBJECTIVE: To assess factors associated with attendance at a specialized clinic for diabetes care. RESEARCH DESIGN AND METHODS: Adults with insulin-dependent diabetes mellitus (IDDM) in poor (HbA1 greater than or equal to 12%) versus good (HbA1 less than or equal to 10%) control and with no known complications comprised the study group. RESULTS: Infrequent attenders were in worse glycemic control than regular attenders (chi 2 = 6.60, P less than or equal to 0.01) and held health beliefs that downplayed the importance of getting advice from physicians (P less than or equal to 0.002) or providing opinions to physicians about what might be done to improve their health (P less than or equal to 0.001). CONCLUSIONS: Because infrequent attenders are more likely to be in poor glycemic control and thus at greater risk for diabetic complications, engaging them in regularly supervised treatment has important personal and public health implications. Additional studies are needed to understand why some diabetic patients limit their contact with medical providers and to develop more effective strategies for reversing this process. Initial findings from this study suggest that patient beliefs about the doctor-patient relationship may influence clinic attendance.

Adult↗
PubMed1991

Behavior and personality traits among DUI arrestees, nonarrested impaired drivers, and nonimpaired drivers.

Eight types of drinking driver groups were compared on several personality and behavior traits. It was found that impaired drivers arrested after an accident or moving violation were significantly higher in hostility, psychopathic deviance, nontraffic arrests, frequency of impaired driving, accidents after drinking, and drinks consumed per week than impaired drivers caught in roadblocks. Neither impaired drivers stopped in roadblocks nor impaired drivers never arrested differed from nonimpaired drinking drivers or nondrinking drivers on most measures examined.

Adolescent↗
PubMed1991

Management of oral mucosal dysplasia with beta-carotene retinoic acid: a pilot cross-over study.

Mucosal dysplasia in the head and neck region is recognized to be a precancerous lesion. Between January 1983 and December 1987, a pilot study was conducted at the Manitoba Cancer Treatment and Research Foundation to determine the effects of beta-carotene and cis-retinoic acid on mucosal dysplasias. Eighteen patients were treated with a "cross-over" regimen. The overall response to treatment was 61%, with 33.3% complete responses. Patients who smoked had a significantly better response than nonsmokers. The response rate for 9 of 11 smokers was 81.2%, and 2 of 7 nonsmokers or 28.6% responded to this protocol. The beneficial effect of these drugs should be established by prospective, randomized trial in high risk populations.

Adult↗
PubMed1990

Prothrombinex-induced thrombosis and its management with regional plasminogen activator in hepatic failure.

Fulminant hepatic failure causes a bleeding diathesis as a result of impaired synthesis of hepatic clotting factors, thrombocytopenia, fibrinolysis and disseminated intravascular coagulation. Administration of clotting factor concentrates can cause thrombosis in patients with acute hepatic failure. Regional infusion of recombinant tissue-type plasminogen activator may be used to induce local thrombolysis. A case report of a five-year-old child is presented and the literature is reviewed.

Blood Coagulation Disorders↗
PubMed1990

Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats.

The role of the cerebellar cortex in motor learning was investigated by comparing the paramedian lobule of adult rats given difficult acrobatic training to that of rats that had been given extensive physical exercise or had been inactive. The paramedian lobule is activated during limb movements used in both acrobatic training and physical exercise. Acrobatic animals had greater numbers of synapses per Purkinje cell than animals from the exercise or inactive groups. No significant difference in synapse number or size between the exercised and inactive groups was found. This indicates that motor learning required of the acrobatic animals, and not repetitive use of synapses during physical exercise, generates new synapses in cerebellar cortex. In contrast, exercise animals had a greater density of blood vessels in the molecular layer than did either the acrobatic or inactive animals, suggesting that increased synaptic activity elicited compensatory angiogenesis.

Animals↗
PubMed1990

Risk factors to health in diabetic children: a prospective study from diagnosis.

This study explored associations between health status and psychosocial, family, and demographic factors among 42 children with recently diagnosed diabetes mellitus. Health status was assessed using glycosylated hemoglobin (HbA1), a measure of the children's level of metabolic control. Four groups of variables were investigated as possibly relating to metabolic control: demographics, family social climate, child's self-concept, and compliance with the treatment regimen. Metabolic control was associated with race, number of parents in the home, family cohesion, and socioeconomic status. Multiple regression analysis indicated that children from black and single-parent families were at higher risk for poorer disease control and that this pattern persisted 2 and 3 years after diagnosis. These findings can help identify families that may benefit from more effective interventions involving social work practice.

Child↗
PubMed1990

Assessing family sharing of diabetes responsibilities.

This study examined sharing of diabetes responsibilities between mothers and their diabetic children and the relationship between patterns of mother-child sharing of responsibility for diabetes tasks and demographic variables, adherence, and metabolic functioning in children with insulin-dependent diabetes mellitus (IDDM). A factor analysis of the Diabetes Family Responsibility Questionnaire (DFRQ), a 17-item questionnaire developed for the present study, resulted in a meaningful three-factor solution. Factors included responsibilities related to regimen tasks, General Health Maintenance, and Social Presentation of Diabetes. Analysis indicated that the DFRQ had adequate internal consistency and concurrent validity. One hundred and twenty-one children with IDDM, 6-21 years of age, and their mothers completed the DFRQ. Glycosylated hemoglobin (HbA1c) was used to index the child's level of metabolic control. Results of multiple regression analyses indicated that the child's age, disease duration, and sex are significant predictors of mother and child patterns of sharing diabetes responsibilities. Disagreements between mothers and children in perceptions of who is assuming responsibility and adherence level were significant predictors of HbA1c. Results indicated that children assume increasing responsibility with increasing age. Clinicians should not assume that mothers and children communicate about the sharing of diabetes responsibilities in the family or about changes in expectations of who is responsible as children develop. To foster better control and adherence in diabetic children, members of the health care team can help to identify diabetes tasks for which no one in the family takes responsibility.

Adolescent↗
PubMed1990

Oral premedication in children: a comparison of chloral hydrate, diazepam, alprazolam, midazolam and placebo for day surgery.

A double-blind study consisting of 339 randomly selected children investigated the effects of several premedicants on the preoperative and postoperative behaviour of children who underwent day-stay surgery. Patients were allocated into two groups. Group 1 consisted of 165 children aged between 6 and 47 months. Group 2 consisted of 174 children aged four years and older to a body weight of 50 kg. Each child received one premedicant. Both groups included alprazolam 0.005 mg/kg, midazolam 0.3 mg/kg and placebo. In addition Group 1 included chloral hydrate 40 mg/kg and Group 2 diazepam 0.25 mg/kg. Chloral hydrate produced superior conditions (more patients calm or asleep) at induction of anaesthesia. Postoperative behaviour and incidence of vomiting were similar for all drugs. No premedicant reduced anxiety in the older group. The time to awaken postoperatively with diazepam was longer than with placebo. Alprazolam and midazolam were unpalatable for children over four years and conferred no advantage over placebo.

Administration, Oral↗
PubMed1990

Postoperative pain control with a continuous infusion of epidural sufentanil in the intensive care unit: a comparison with epidural morphine.

A prospective, randomized, double-blind trial was conducted to compare the analgesic actions and side effects of sufentanil continuously infused (5 micrograms/h) into the lumbar epidural space (L2-3) with those of an infusion of lumbar epidural morphine (0.5 mg/h). Forty patients admitted to an intensive care unit after elective major abdominal surgery participated over a varying period of 24-40 h. Post-operative pain was treated with an epidural bolus of either sufentanil (50 micrograms) or morphine (5 mg), followed by a continuous infusion of the same opiate. The quality of pain relief was similar in each group. The sufentanil group had a more rapid onset of analgesia. The incidence of nausea and vomiting, pruritus, and drowsiness was similar in the two groups. In spontaneously breathing patients there were no respiratory complications requiring treatment. Forced vital capacities were statistically significantly better during the first 1-4 h with sufentanil.

Adult↗
PubMed1990

Problems of the National Practitioner Data Bank.

After a two-year delay, the National Practitioner Data Bank, authorized by the Health Care Quality Improvement Act of 1986, has yet to begin its mission to collect and disseminate information concerning adverse actions affecting physicians' hospital privileges, licensure, and malpractice claims experience. This article discusses some of the problems that are likely to arise in the operation of the Data Bank.

American Medical Association↗
PubMed1990

Intellective functioning and strategy use in children with insulin-dependent diabetes mellitus.

The cognitive development of children with either early or late onset insulin-dependent diabetes mellitus (IDDM) was investigated with tasks measuring intellectual ability, memory, and academic progress. In addition, children's perceptions of their competence and parents' perspectives on family functioning and their children's behavior were compared. It was found that children with IDDM scored within the normal range on standardized measures of intelligence and academic performance but evidenced some school difficulties, as reflected in subscale performance as well as in their need of remedial education services. Further, evidence was found to suggest deficiencies in children's use of strategies to organize and recall information, particularly for those with early onset of disease. Children's perceived self-competencies and parents' reports of family functioning were strikingly similar across groups. However, parents of those children whose illness began prior to age 5 reported their children to have poor attention spans and difficulty completing tasks.

Achievement↗
PubMed1989

Interactions among DUI offender characteristics and traditional intervention modalities: a long-term recidivism follow-up.

Using long-term DUI (Driving Under the Influence of Alcohol) arrest recidivism data from a controlled study of DUI intervention effectiveness, interactions among DUI interventions, age, race, education, and alcohol severity were estimated using logit analysis. Data were collected in a 9-year follow-up study of the Mississippi DUI Probation Project. The effects of short-term interventions (alcohol education schools for low alcohol severity offenders and structured group interventions for high alcohol severity offenders) were specified by educational level. Short-term rehabilitation was modestly effective for those with less than 12 years of education, but less effective or detrimental for the more highly educated. The effects of probation were specified by age and education, being more effective for those under 30 years and 55 years or older than for the middle age group. Probation was most effective for well-educated older (55+) offenders. An analysis of the under 30 years group also suggested that probation was especially effective for young well-educated Minority offenders.

Accidents, Traffic↗
PubMed1989

Congenital myotonic dystrophy in children--a review of ten years' experience.

A review of the anaesthetic management of children with congenital myotonic dystrophy anaesthetised at the Royal Children's Hospital over the past ten years is presented. Seven children underwent a total of fourteen anaesthetics. Anaesthetic considerations must include the degree of muscle weakness and hypotonia altering muscle relaxant requirements, aspiration risk due to palatopharyngeal dysfunction, and cardiomyopathy. Succinylcholine caused muscle contracture in a patient without clinical myotonia. This drug should be avoided. Although a low threshold to institute postoperative respiratory support must exist when treating neonates and infants, the older children did not clinically exhibit increased sensitivity to respiratory depressant drugs.

Anesthesia↗
PubMed1989

Effects of peer-group intervention on metabolic control of adolescents with IDDM. Randomized outpatient study.

In children with insulin-dependent diabetes mellitus (IDDM), deterioration in metabolic control frequently occurs during early adolescence. To prevent this predictable increase in blood glucose levels, we randomly assigned young adolescents with IDDM to an intervention based on problem solving with self-monitoring of blood glucose (SMBG) integrated into standard outpatient care or to standard care only for an 18-mo period. At follow-up, 50% of the standard-care adolescents exhibited greater than 1% increase in glycosylated hemoglobin (HbA1) levels over baseline values, indicating a deterioration in metabolic control, compared to only 23% of the intervention group. Follow-up HbA1 means +/- SD were 10.10 +/- 2.00% for intervention and 11.04 +/- 2.28% for standard-care adolescents, indicating a significantly lower value in the intervention group (P = .04). At follow-up, a greater percentage of intervention than standard-care adolescents reported using SMBG information when they exercised (60.0 vs. 33.3%, chi 2 = 4.29, P = .04). Our data suggest that clinic-based problem-solving groups can be more effective with young adolescents with IDDM than conventional treatment in preventing the expected deterioration in blood glucose.

Adolescent↗
PubMed1988

Inspired oxygen and nitrous oxide concentrations in volunteers during nitrous oxide sedation with a Hudson mask.

Ten volunteers were given varying ratios of oxygen and nitrous oxide at 4, 6 and 8 litres per minute using a Hudson mask delivery system. Maximum and minimum inspired oxygen concentrations, maximum inspired nitrous oxide concentrations and end tidal carbon dioxide concentrations were measured using the Datex Cardiocap CCI-104 monitor. Although pharyngeal oxygen fraction varies with the Hudson mask because the inspiratory flow exceeds the entrainment of the mask by a variable amount during much of the cycle, at 8 litres/minute flow with a ratio of 3 to 5, oxygen to nitrous oxide, safe levels of oxygen were delivered (range of means 26-31%) with basal nitrous oxide levels (mean maximum inspired N2O, 34%). When nitrous oxide sedation is used clinically, nitrous oxide must be used with consideration of safe oxygen levels. This study did not detect unsafe pharyngeal oxygen levels in the ratios investigated, where the maximum delivered nitrous oxide concentration was 75%.

Humans↗