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Biomedical subjects

B Rogers

Publications and source records attributed to B Rogers.

At least 91 records · Page 5Linked to original sources
PubMed1994

Silent aspiration prominent in children with dysphagia.

Children with neurologically-based dysphagia are at high risk for silent aspiration. Aspiration can lead to complications such as acute pneumonia and chronic lung disease. Thorough evaluation of the oral, pharyngeal, and esophageal phases of swallowing is crucial for patients with dysphagia. The videofluoroscopic modified barium swallow study (MBS) is the procedure of choice for children to delineate the pharyngeal and upper esophageal phases of the swallow that can only be inferred by bedside clinical assessment. This study describes attributes of aspiration and pharyngeal motility in a large sample of infants and children assessed with MBS. Aspiration was observed in 48 (26%) of 186 children, primarily on liquid before or during swallows. Aspiration was trace (less than 10% of a bolus) and silent in 94%. Relationships to clinical history and implications for management are discussed. Given the lack of objective clinical information to identify children at risk for aspiration, MBS should be considered in all children with severe dysphagia to rule out or confirm aspiration.

Adolescent↗
PubMed1994

Cystic periventricular leukomalacia and type of cerebral palsy in preterm infants.

A case series design was used to identify cases of cystic periventricular leukomalacia (N = 31) identified by neurosonography at one regional tertiary intensive care nursery. Patients were preterm infants born at < or = 32 weeks of gestation who had cysts involving predominantly the middle-posterior or posterior periventricular regions. Neurodevelopmental evaluations were made for 26 (96%) of 27 survivors. All infants assessed had cerebral palsy (i.e., 54% quadriplegia, 42% diplegia, and 4% hemiplegia). Most cognitive delays and all sensory impairments occurred in children with quadriplegia. Periventricular cysts were most extensive on parasagittal, anteroposterior views. The parasagittal, anteroposterior extent of periventricular cysts was most accurate in predicting the type and severity of motor and cognitive disabilities. Quadriplegia was associated with larger and more extensive cysts.

Cerebral Palsy↗
PubMed1994

Use of minor tranquilizers and antidepressant medications by depressed outpatients: results from the medical outcomes study.

OBJECTIVE: The purpose of this study was to compare use of minor tranquilizers and antidepressant medications by depressed outpatients across different treatment settings. METHOD: The study subjects were 634 patients with current depressive disorder or depressive symptoms who visited general medical clinicians, psychiatrists, psychologists, or other therapists. Data on use of medication in different types of clinical practices with different types of payment plans were gathered from structured interviews by study clinicians and from surveys of patients. RESULTS: Of the depressed patients, 23% had recently used an antidepressant medication and 30% had used a minor tranquilizer. The level of use was similar for different types of depression. Patients of psychiatrists were the most likely to use medications. In the practices of physicians, but not nonphysicians, the more severely distressed patients were more likely to use antidepressant medications. Of the patients taking an antidepressant medication, 39% used an inappropriately low dose. Patients in prepaid health care plans were twice as likely as those in fee-for-service care to use minor tranquilizers. CONCLUSIONS: Less than one-third of the depressed outpatients used antidepressant medications, and the probability of use was similar for major depression and other types of depression for which efficacy is less well established. Use of antidepressant medications among patients of nonphysicians was unrelated to the level of psychological sickness, suggesting the need for more cooperation among provider groups. Minor tranquilizers were used more often than antidepressants, particularly among patients in prepaid plans, despite controversy over their efficacy.

Adult↗
PubMed1994

Research and policy.

Explore the source record for details and available documents.

Diffusion of Innovation↗
PubMed1994

Advancing the profession of occupational health nursing: AAOHN's strategic planning process.

1. AAOHN's strategic plan for 1993-98 was developed through a collaborative effort with emphasis on member input. 2. A model for the strategic plan which emphasized data acquisition and analysis was developed. 3. A revised mission statement and standards for occupational health nursing practice, along with expanded scope of practice, were developed.

Decision Making, Organizational↗
PubMed1994

Linkages in environmental and occupational health: assessing, detecting, and containing exposure sources.

1. The occupational health nurse is in a key position to recognize environmental and occupational exposures and assess potential interactions to reduce risks. 2. Hazardous exposures may emanate from chemical, physical, and biological agents that can be found in the workplace, home, and community. Synergistic reactions may pose greater harm than is apparent. 3. Multidisciplinary efforts with community involvement and coalition building can be a successful approach to minimizing environmental/occupational risks from toxic exposures.

Community Participation↗
PubMed1994

Long-term morbidity and management strategies of tracheal aspiration in adults with severe developmental disabilities.

The feeding skills and health of 73 adults with severe developmental disabilities who aspirated were examined between 1986 and 1990. Sixty individuals had profound mental retardation (82%) and 48, cerebral palsy (66%). Modified barium swallow studies, esophagrams and gastric follow-throughs were completed on 67 clients (92%). Twenty adults aspirated barium. Aspiration was specific for barium texture in 8 (40%). Mobility, level of mental retardation, or feeding skills did not discriminate those who aspirated. Mealtime respiratory distress (65%) or chronic lung disease (55%), however, were significantly associated with aspiration. More studies are needed on the early identification and management of aspiration.

Adolescent↗
PubMed1993

Hypoxemia during oral feedings in adults with dysphagia and severe neurological disabilities.

Signs of respiratory distress including coughing, choking, and gagging are not uncommon during oral feedings in patients with severe dysphagia. Aspiration pneumonia and chronic lung disease are recognized complications. Pulse oximetry, respiratory inductance plethysmography, and nasal airflow measurement by thermistors are accurate noninvasive methods of monitoring cardiopulmonary adaptation during oral feedings in patients with severe dysphagia. We report significant, previously unrecognized, acquired hypoxemia during oral feedings in two patients with severe cerebral palsy and one with multiple sclerosis. The episodes of hypoxemia occurred only while swallowing specific food textures. Periods of hypoxemia most probably resulted from aspiration during oral feedings. Cardiopulmonary adaptation may prove to be an important consideration in decisions regarding the method and advisability of continued oral feedings in patients with severe dysphagia.

Adult↗
PubMed1993

Type IV collagen localization in hamster tracheal epithelial cell cultures.

Hamster tracheal epithelial (HTE) cell cultures when grown on collagen coated Millicell-HA filters for 28 d in vitro have an incomplete basal lamina-like structure at the basal plasmalemma/collagen interface. EM evaluation of 42 d HTE cell cultures also revealed the presence of hemidesmosome-like structures on the basal plasmalemma. In order to better characterize this discontinuous basal lamina-like material, HTE cultures at 7, 14, 21, and 28 d were evaluated for the presence of type IV collagen, a basal lamina component. Immunocytochemical treatment of HTE cultures at these time points resulted in the presence of reaction product at the base of the cell layer. When immunocytochemical procedures for the localization of type IV collagen were carried out with normal mouse trachea, the results were also positive. Immunoblotting evaluation of HTE cell supernatants and conditioned media also indicated the presence of type IV collagen. Taken altogether, the presence of what appears to be basal lamina, hemidesmosome-like structures and immunocytochemical and immunoblot data showing the presence of type IV collagen in HTE cultures suggest that HTE cells may be producing basal lamina components but cannot organize them into a complete basal lamina.

Animals↗
PubMed1993

A transcriptional switch between the Pig-1 and Sgs-4 genes of Drosophila melanogaster.

Pig-1 and Sgs-4 are a pair of closely linked and divergently transcribed Drosophila melanogaster genes, which are both expressed in larval salivary glands but at different times during development. While Sgs-4 is expressed at high levels only at the end of the third instar, Pig-1 exhibits a major peak of expression during late second and early third instar. Thus, Pig-1 expression declines as Sgs-4 expression is induced. In this paper, we show that three adjacent elements located within the short region between these genes can account for the switch from Pig-1 to Sgs-4 expression. A 170-bp segment acts as an enhancer to direct Sgs-4 expression in late-third-instar salivary glands. A 64-bp sequence located just upstream from the enhancer can modify its temporal specificity so that it works throughout the third instar. Expression induced at mid-third instar by a combination of these two elements can be repressed by a negative regulatory sequence located still further upstream. We present evidence suggesting that the changing interactions between these regulatory elements and the Sgs-4 and Pig-1 promoters lead to the correct pattern of expression of the two genes.

Age Factors↗
PubMed1993

Prevalence of diagnosed diabetes and selected related conditions of six reservations in Montana and Wyoming.

OBJECTIVE: To describe the prevalence of diabetes and related complications in Plains Indians. RESEARCH DESIGN AND METHODS: The medical records of individuals with diagnosed diabetes seen in IHS facilities before 1 January 1987 were reviewed. Records were obtained from primary care clinics and hospitals accessible to the following six reservation communities in Montana and Wyoming: Blackfeet, Crow, Fort Belknap, Fort Peck, Northern Cheyenne, and Wind River. Medical records were reviewed to ascertain accuracy of diagnosis and associated complications. RESULTS: Age-adjusted prevalence rate of diagnosed diabetes was 119/1000 adults > or = 15 yr of age. CONCLUSIONS: Diabetes rates in Plains Indians are higher than rates described for the general U.S. population.

Amputation, Surgical↗
PubMed1993

Employee satisfaction with occupational health services: results of a survey.

Employee satisfaction with occupational health care services can be one important indicator of quality of care. Satisfaction assessment can provide feedback to improve health care services and utilization. Employee satisfaction with health care services may be a reflection of the value the company places on health care and safety.

Cross-Sectional Studies↗