Biomedical subjects
Publications and source records attributed to C A Johnson.
Recidivism rates in psychiatric hospitals are high and rising. This article explores whether this costly phenomenon is related to quality of care, length of stay, or characteristics of patients.
This article presents data regarding the prevalence of trying smokeless tobacco in a longitudinal sample of 2,714 urban, ethnically diverse adolescent males and females. A predominance of trial use was found in white males in 8th and 9th grades. Also presented is the relation of smokeless tobacco onset to experimentation with other drugs (cigarettes, alcohol, marijuana), cigarette smoking in significant others, self-image as a smoker, risk taking, and smoking refusal self-efficacy. Smokeless tobacco onset was related to higher levels of cigarette smoking and lower quit rates, and was positively associated with use of cigarettes by significant others, one's self-image as a smoker, and with a disinclination to refuse cigarette offers. Finally, onset was more probable in individuals who had previously tried alcoholic beverages and marijuana, and who reported enjoying taking risks. A multivariate logistic regression analysis retained sex, smoking level, beer and wine use, and risk taking as predictors of smokeless tobacco onset. Apparently, smokeless tobacco is an additional activity in which drug-experimenting male adolescents are likely to participate.
The objective of this study was to evaluate the transferable embryo recovery rates from superovulated donor cattle after different artificial insemination (AI) schedules. Sixty mixed-breed crossbred females were administered follicle stimulating hormone (FSH) and prostaglandin F(2)alpha (PGF(2)alpha) to induce a superovulatory response. At standing estrus, donor females were randomly allotted to one of five treatment groups for AI. Donors were inseminated with two units of high-quality or low-quality frozen semen at 12, 24, 36, or 48 h after the onset of estrus in treatment Groups I, II, III, and IV, respectively, or inseminated with two units at 12, 24, 36, and 48 h (eight units/donor) in control Group V. Donor females inseminated once at either 12 or 24 h after the onset of estrus did not differ from donors inseminated in Group V in overall fertilization and transferable embryo recovery rates. The highest fertilization rate (89.5%) and transferable embryo recovery rate (74.9%) per donor resulted when AI was performed with high-quality semen at 24 h after the onset of estrus. These findings indicate that repeated insemination of superovulated beef cattle is not necessary to attain optimal fertilization rates and production of transferable quality embryos in beef cattle.
The authors have conducted a survey of the Departments of Motor Vehicles in all 50 states, the District of Columbia, and Puerto Rico requesting information about the visual standards, accidents, and conviction rates for different age groups. In addition, we have reviewed the literature on visual function and traffic safety. Elderly drivers have a greater number of vision problems that affect visual acuity and/or peripheral visual fields. Although the elderly are responsible for a small percentage of the total number of traffic accidents, the types of accidents they are involved in (e.g., failure to yield the right-of-way, intersection collisions, left turns onto crossing streets) may be related to peripheral and central visual field problems. Because age-related changes in performance occur at different rates for various individuals, licensing of the elderly driver should be based on functional abilities rather than age. Based on information currently available, we can make the following recommendations: (1) periodic evaluations of visual acuity and visual fields should be performed every 1 to 2 years in the population over age 65; (2) drivers of any age with multiple accidents or moving violations should have visual acuity and visual fields evaluated; and (3) a system should be developed for physicians to report patients with potentially unsafe visual function. The authors believe that these recommendations may help to reduce the number of traffic accidents that result from peripheral visual field deficits.
Only healthy animals should be included in a breeding program. The potential effects of maternal illness and therapeutic agents on the fetus or neonate are often ignored until veterinary assistance becomes an absolute necessity. We must be mindful of these effects in order to minimize maternal and neonatal morbidity and mortality.
To obtain information about predialysis characteristics and long-term outcome of patients on peritoneal dialysis (PD) for more than 4 years, we reviewed all patients starting PD who performed continuous ambulatory peritoneal dialysis (CAPD) and were at risk for more than 4 years. Sixty-two patients started; 42% were diabetic and 35% over age 60. Three recovered renal function, seven received transplants, and 12 switched to hemodialysis. Nineteen survived more than 4 years (long-term survivors, LTS), eight diabetic and 12 male. Twenty-one died on CAPD in less than 4 years (short-term survivors, STS). In comparison to STS, LTS were younger, with less prior cardiac disease, yet had higher predialysis serum creatinine values and lower hematocrits. LTS were observed for a mean of 65.3 +/- 3 months (48 to 91 months), and STS for a mean of 21 +/- 2 months. When compared to STS, LTS had fewer hospital days, hospital days for peritonitis, and a lower peritonitis rate, although the incidence of Staphylococcus aureus peritonitis was greater in LTS. Cardiovascular and thromboembolic events were less frequent in LTS, but bone fractures were seen more often in the LTS diabetic patients. Weight gain, especially in males, and hernias were noted in both groups. BP improved, and vision was maintained in both groups. Non-PD-related infections causing hospitalization were low in both groups. Improved mean hematocrit and hemoglobin A, values were seen only in LTS. Mean serum cholesterol values increased with time in LTS. This study reveals that potentially high-risk patients such as diabetics and the elderly can have prolonged survival on PD.(ABSTRACT TRUNCATED AT 250 WORDS)
Patients newly diagnosed with hematologic malignancies were followed for a 6-month treatment period to assess compliance with three regimen requirements for cancer therapy: anti-neoplastic medication self-administered intermittently, supportive medication self-administered daily, and monthly clinic appointments. The effect on compliance of three intervention "packages" (some combination of education, shaping of pill-taking behavior, and home restructuring) and the extent that patient satisfaction, knowledge, and uncertainty about illness-related events mediated the effects of the interventions were also examined. Blood levels of the drugs and self-report measures indicated that compliance with daily pill taking was higher for each intervention group compared to a control group. Similar results were obtained for compliance with clinic appointments. No improvement in intermittent self-medication was found. Although each intervention package increased patient knowledge and satisfaction, path analyses demonstrated that knowledge did not affect any aspect of compliance, whereas satisfaction was associated with increased appointment keeping only. Daily pill taking was influenced directly by the behavioral components of the interventions. Uncertainty did not influence compliance but was associated with depression, which was negatively correlated with intermittent self-medication.
Computed tomography (CT) scanning is widely used in evaluation of acetabular fractures. Three-dimensional (3D) images of the pelvis can be created from CT scan data. This article reports two studies, each employing one type of 3D imaging in acetabular trauma cases. The first was a study of 21 patients utilizing surface-rendered 3D images, the second, a study of 19 patients using volume-rendered 3D images. Both types of 3D images were clinically helpful and can be used in lieu of conventional plain films as a supplement to CT examination. Advantages of volume-rendered images are described.
Contrast sensitivity derangement may accompany keratoconus even in the presence of normal or near normal Snellen visual acuity. This has been demonstrated with computer-driven contrast sensitivity test devices. The purpose of this study was to evaluate the utility and efficacy of rapid screening devices for contrast sensitivity testing. However, such devices are often cumbersome and difficult to use clinically. We tested 12 patients with keratoconus on 2 simple chart systems designed to test contrast sensitivity in a rapid and clinically useful manner: the Vistech chart and the Regan multi-contrast visual acuity charts. Both devices detected the contrast sensitivity abnormalities present in early keratoconus, but some patients [with greater than or equal to 6/12 (20/40) visual acuity] were unable to respond to areas of the charts corresponding to high spatial frequency and/or low contrast tasks. Such simple wall charts may be useful in measuring the visual abnormalities in early keratoconus, in monitoring the progression of the disease, and in evaluating various treatment options.
The action of papain and bromelain, prepared over a pH range from 4.6 to 8.6, was evaluated for the ability to render red cells agglutinable by five incomplete antibodies of differing blood group specificities using a two-stage technique. The optimal pH for treatment of red cells by activated papain or bromelain was between 5.4 and 5.8. Above this pH range, a fall in serological sensitivity was apparent which was much more pronounced with papain than with bromelain. The optimal pH for enzyme treatment of red cells can be achieved in two-stage techniques, but not in one-stage techniques due to the buffering effect of serum proteins.
Compliance with oral self-administered allopurinol (daily medication) and prednisone (intermittent medication) as well as compliance with monthly scheduled clinic appointments, were examined in 108 patients with newly diagnosed hematologic malignancy. Baseline levels of compliance (control group) were compared to results obtained after implementation of three intervention packages, whose aim was to increase compliance. The packages included combinations of education, home psychologic support and restructuring, and training in pill taking. A 24-hour profile of the two drugs and their metabolites was first determined. Serum samples were then obtained monthly over 6 months and analyzed for presence of the drugs. Control patients were fully compliant with allopurinol only 16.8% of the time. This rate increased significantly (44% to 48% of the time) for those who received any one of the intervention programs. With respect to prednisone, control patients were compliant 26.8% of the time, with no real improvement after interventions. Finally, self reports overestimated compliance by a factor of two when compared to drug analysis. The results indicated that full compliance with oral medications was remarkably low among our patients who have treatable and in some cases curable hematologic malignancy. However, compliance can be significantly improved by the use of various intervention packages.
A simulation model of the walk-in emergency psychiatric service of a large metropolitan public hospital has been developed using Dynamo simulation language on an IBM-PC microcomputer. The model reveals the basis of equilibrium in the system, despite the rising demand for service.
The authors conducted a prospective study of 38 consecutive corneal transplant patients over a five-and-one-half month period in order to evaluate the effect of intraoperative hydration with topical Healon versus balanced salt solution on postoperative epithelial healing in the corneal graft. Eight independent variables, including patient age, sex, operating room time, donor age, donor time in McCarey-Kaufman media, intraoperative hydration with balanced salt solution versus Healon, and the amount of postoperative punctate epithelial keratitis measured on postoperative day 1, day 2, and at one week were compared using a multiple linear regression method. While the correlation between donor age (p = .060) and patient age (p = .088) with the amount of punctate epithelial keratitis at one week post graft approached statistical significance, only the Healon-treated group showed a high correlation to more complete graft healing one week postoperatively (p = 0.002). Topical Healon during keratoplasty may foster epithelial healing, but it also may present technical challenges of which the surgeon should be aware.
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A randomized study was initiated in neonates with neutropenia (absolute peripheral neutrophil count less than 1,500/microL) and suspected bacterial infection. Twenty infants with proven infection were enrolled, nine of whom had depletion of bone marrow stores of maturing neutrophils (less than or equal to 7% metamyelocyte, band and mature forms per 100 nucleated cells). These nine were randomized to receive 15 mL/kg of either buffy coat transfusions (group 2) or plasma and blood products (group 3). The remaining 11 (group 1) were observed. Peripheral neutrophil counts were monitored to determine the neutrophil response to transfusions. There were ten of 11 patients in group 1, two of four in group 2, and two of five in group 3 who lived at least seven days. No complications of transfusion were noted. No difference in the rate of peripheral neutrophil increase was found among the three groups. The study was stopped when it became clear that sufficient numbers of patients could not be entered into the study, in a reasonable period of time, to prove or disprove a clinically significant improvement in outcome. Although in vitro testing of the buffy coat preparations showed normal function in three of four cases, the clinical quality of the buffy coats may have been inadequate because of poor availability of whole fresh blood less than 24 hours old. The role of neutrophil transfusions in these patients remains unclear.
Posttraumatic osteomyelitis attributable to Staphylococcus aureus infection was experimentally induced in 30 dogs, after which the dogs were treated with clindamycin at various dosage regimens. Of the regimens evaluated, oral administration of 11 mg of clindamycin/kg of body weight twice daily for 28 days was the most effective treatment for the osteomyelitis.
Rat X rat hybridomas secreting monoclonal anti-idiotypic antibodies have been prepared from Hooded rats immunized with two tumour-reactive, syngeneic monoclonal antibodies 11/160 and M10/76 (specific, respectively, for the Hooded rat sarcomata HSN and MC24). The hybridomas were selected on the basis that the secreted antibodies competed with antigen for binding to the immunizing idiotype. One monoclonal anti-idiotype (HIM/1/230, gamma 2a isotype) that recognizes an antigen-binding site idiotope of antibody 11/160 has been found to substitute for antigen. Hooded rats vaccinated by three challenges with HIM/1/230 produce serum Ab3 that is indistinguishable in antigen specificity from the 11/160 Ab1, and show reduced tumour take following an i.v. challenge with 10(6) HSN cells. The response to vaccination with anti-idiotype was both qualitatively and quantitatively dependent on the mode of immunization. High titre 11/160-like Ab3 was generated only when the vaccine contained Freund's adjuvant, whereas resistance to tumour challenge was found only in animals vaccinated with anti-idiotype in the absence of adjuvant.