Biomedical subjects

C A Marco

Publications and source records attributed to C A Marco.

27 records · Page 2Linked to original sources

PubMed1996

Are stress-induced immunological changes mediated by mood? A closer look at how both desirable and undesirable daily events influence sIgA antibody.

This investigation tested a three-path model of mood as a mediator of the relation between stress and immunity. Seventy-two married men completed end-of-day diaries in which they rated their mood for that day and the desirability of the day's events for I2 weeks. Events were coded as either desirable (nonstressful) or undesirable (stressful) in nature. Immunological functioning was assessed by secretory immunoglobulin-A NgA) antibody response lo an oral antigen. Regression analyses indicated that negative mood partially mediated the immunological response to both undesirable and desirable events. Undesirable events lowered antibody levels primarily by increasing negative mood: desirable events increased antibody levels by decreasing negative mood. Evidence for mediation by positive mood beyond that found for negative mood was weak.

Journal Article↗

PubMed1995

Fever in geriatric emergency patients: clinical features associated with serious illness.

STUDY OBJECTIVE: To determine the clinical significance of fever in geriatric emergency department patients. DESIGN: Case series with follow-up. SETTING: Urban, university-affiliated community hospital. PARTICIPANTS: Consecutive patients over the age of 65 years who presented to the ED during a 12-month period with an oral temperature of 100.0 degrees F (37.8 degrees C) or higher. RESULTS: We considered the following features indicators of serious illness: positive blood culture(s), related death within 1 month of ED visit, need for surgery or other invasive procedure, hospitalization for 4 or more days, IV antibiotics for 3 or more days, and repeat ED visit within 72 hours for related condition. Four hundred eighty-nine patients were eligible for study. Of the 470 patients with complete follow-up data, 357 (76.0%) had indicators of serious illness. Clinical features found to be independently associated with serious illness included oral temperature of 103 degrees F (39.4 degrees C) or more, respiration rate of 30 or more, leukocytosis of 11.0 x 10(9)/L or more, presence of an infiltrate, and pulse of 120 or more. At least one indicator of serious illness was present in 63 of 128 patients (49.6%) with none of these independently predictive clinical features. The most common final diagnoses were pneumonia (24.0%), urinary-tract infection (21.7%), and sepsis (12.8%). CONCLUSION: Fever among geriatric ED patients frequently marks the presence of serious illness. All such patients should be strongly considered for hospital admission, particularly when certain clinical features are present. The absence of abnormal findings does not reliably rule out the possibility of serious illness.

Aged↗

PubMed1995

Presentations and emergency department evaluation of HIV infection.

Patients with HIV infection may present with a wide variety of symptomatology, both related and unrelated to HIV infection. Evaluation should be conducted in an orderly fashion and should focus on the involved system, with particular attention to ruling out treatable infection, malignancy, or other HIV-related disease process.

AIDS Dementia Complex↗

PubMed1994

Adenosine for the treatment of supraventricular tachycardia in the ED.

To determine the safety and efficacy of intravenous adenosine as used in the emergency department (ED) for the treatment of presumed supraventricular tachycardia, the investigators performed a retrospective chart review in an urban, university-affiliated ED. Seventy-two consecutive patients were treated with intravenous adenosine for presumed supraventricular tachycardia. Of the 72 patients who were treated with adenosine, 46 patients had a confirmed diagnosis of supraventricular tachycardia. Of these, 39 of 46 (84.8%) converted to sinus rhythm after treatment. Of patients who successfully converted to sinus rhythm, none had recurrent tachycardia or required additional pharmacotherapy. Arrhythmias not successfully treated among the initially misdiagnosed patients were atrial fibrillation (n = 11), atrial flutter (n = 7), tachycardia of other origin (n = 5), and ventricular tachycardia (n = 2). No clinically significant adverse effects were noted among the study population. Intravenous adenosine is a safe and efficacious treatment for the emergent treatment of supraventricular tachycardia, including unstable patients (with hypotension and/or chest pain). It is also safe among patients initially presumed to have supraventricular tachycardia, who are later diagnosed with other arrhythmias.

Adenosine↗

PubMed1993

Daily stress and the trajectory of mood: spillover, response assimilation, contrast, and chronic negative affectivity.

Experience sampling methodology was used to examine the effects of current and prior problems on negative mood within and across days. Forty male community residents wore signal watches and kept dairy records of problem occurrence and mood 8 times a day for 8 consecutive days. Trait negative affectivity (NA), prior mood, and concurrent stress were related to mood during the day. Mood in response to a current problem was worse if the prior time had been problem free than if the prior time had been stressful. High NA Ss were more reactive to concurrent stressors than were low NAs, but the effect was small. NA and current-day stress were the major influences of mood across days. High NAs were more distressed by current-day problems and recovered more slowly from problems of the preceding day. The benefits of conceptualizing the effects of daily stressors on mood in terms of spillover, response assimilation, habituation, and contrast are discussed.

Adaptation, Psychological↗

PubMed1990

Relationship between JAS- and FTAS-Type A behavior and non-CHD illness: a prospective study controlling for negative affectivity.

In addition to posing a risk for coronary heart disease (CHD), Type A behavior has been suggested as a risk factor for non-CHD illness. Past evidence, however, has relied chiefly on retrospective studies of self-reported illness that failed to control for the potentially confounding effects of negative affectivity. The present investigation was an 18-month prospective study of Type A behavior and medical records of illness in which chronic negative affectivity was also assessed. Negative affectivity was associated with retrospective self-reported illness, but only Type A, as measured by the Jenkins Activity Survey (JAS) and the Framingham Type A Scale (FTAS), predicted medical records of subsequent illness severity and number of illness-related medical visits. Controlling for negative affectivity did not reduce these significant relationships. It was concluded that persons scoring high on the JAS or the FTAS may be a greater risk of minor illness when objective measures of illness are assessed over a period of 1 year or more. Alternative explanations and future directions for research are discussed.

Adult↗

PubMed1990

Acute intoxication.

Acute alcohol intoxication is a commonly encountered clinical presentation in Emergency Medicine. Its role should be considered in many Emergency Department presentations, specifically in major and minor trauma, and in gastrointestinal, metabolic, neurologic, and psychiatric disorders. The differential diagnosis of change in mental status must be considered in all intoxicated patients. Management of intoxicated patients is generally supportive although complications of chronic alcoholism should be considered. Management should consist of correction of complications resultant from intoxication, as well as observation and the provision of a safe environment for the patient during the recovery phase of acute intoxication.

Aftercare↗

PubMedDate not supplied

Profound bradycardia related to long bone fracture manipulation.

A 69-year-old male presented to the Emergency Department (ED) with a left comminuted femur fracture. Manipulation of the fractured leg resulted in profound bradycardia, necessitating cessation of the procedure in the ED. Various causes of sinus bradycardia, including vagal-mediated responses, as well as management of vagal-mediated bradycardia are discussed.

Accidental Falls↗

PubMedDate not supplied

Do the daily experiences of healthy men and women vary according to occupational prestige and work strain?

OBJECTIVE: This study evaluated the influence of occupational prestige and work strain on mood, the occurrence of interpersonal conflict, and ambulatory blood pressure and heart rate. METHODS: Participants were 50 men and 50 women matched for occupational prestige who were healthy and middle-aged and who completed measures of mood and conflict simultaneously with measures of ambulatory blood pressure and heart rate recorded every 30 minutes during waking hours of two workdays and one nonworkday; at the end of each day, overall ratings were made. Work strain was assessed by the Work Section of the Self-Evaluation and Social Support Interview Schedule. Multiple level random regression coefficients analyses were conducted. RESULTS: Men and women with low-prestige occupations experienced more interpersonal conflict, b = -0.03, p = .04, and higher ambulatory heart rate, b = -4.83, p = .004, throughout the three days of the study. Relative to those with low work strain, those reporting high work strain experienced negative emotion, b = -0.41, p < .0001, and boredom, b = -0.17, p < .0004. End of the day ratings of negative mood were more influenced by work strain among men than among women. No effects of occupational prestige or work strain were obtained for ambulatory blood pressure readings after adjustment for physical activity, posture, and location. CONCLUSIONS: Individuals in low-prestige occupations experience greater exposure to interpersonal conflict and arousal as indexed by heart rate, which might increase risk for stress-related illnesses often associated with social class. Individuals who report work strain experience negative mood and boredom, both at work and at home. The absence of work effects on ambulatory blood pressure may be due to the participants being healthy.

Adult↗