Search PubMed⌕ Search

Biomedical subjects

C Becker

Publications and source records attributed to C Becker.

At least 451 records · Page 25Linked to original sources
PubMedDate not supplied

Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. I: Goals, objectives, and data collection procedures.

In order to assess the impact of variations in stroke care on outcomes, and to make geographic comparisons, the three Community Hospital-Based Stroke Programs in North Carolina, Oregon, and New York, aggregated their data on 4,132 hospitalized stroke patients. Complete demographic data or "Major Profile" were obtained on 2,390 (57.8%) of the 4,132 stroke patients. This includes those patients on whom informed patient and physician consents were obtained during the hospitalization. Of the major profile patients, 1,490 (62.3%) were followed for periods up to one year, 502 (21.0%) were lost to followup and 398 (16.6%) died within the one year followup period. Incomplete demographic data or "Minor Profile" were observed on 1,742 (42.1%) of the 4,132 patients. Minor profile includes those who died before comprehensive interviews were completed or those for whom informed consent for an interview could not be obtained. Of the minor profile group, 813 (46.7%) died in hospital, and 929 (53.3%) were alive when discharged from the hospital. This paper, which describes the programs, data collection procedures, and study cases, also highlights specific issues on stroke diagnosis, risk factors associated with stroke, and the influence of interventions on stroke outcomes. We conclude that: 1) the merging of data on hospitalized stroke cases from rural and urban hospitals in geographically distinct regions can be used in the study of stroke diagnosis, the use of diagnostic tests, and the effect of interventions on stroke outcomes; and 2) these data are consistent with the hypothesis that part of the national decline in mortality from stroke is due to a decline in stroke severity.

Adult↗
PubMedDate not supplied

Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. II: Description of study population.

The three Community Hospital-based Stroke Programs collected data on 4132 stroke patients admitted to acute care hospitals during 1979 and 1980. White female stroke patients were older than the white male, nonwhite female and nonwhite male stroke patients. Nearly one-fourth (23%) of stroke patients were employed at the time of the event. Most (77%) of the patients were hospitalized for first stroke episodes. Eighty-three percent of the patients had at least one of the four major risk factors for stroke, namely, hypertension, diabetes, transient ischemic attacks and cardiac disease. Half (49%) of the patients were alert at the time of admission. The three diagnostic categories included infarction (60%), stroke not otherwise specified (30%) and hemorrhage (10%). Fourteen days was the median length of hospitalization; 50% of the stroke patients were discharged to a home setting, 31% were institutionalized and 19% died while in the hospital. The mean Barthel Index score for 2400 patients at the time of discharge was 61.8 (normal is 100). Of those patients who were working at the time of the stroke, 22% returned to work. In comparison to the patients in the National Survey of Stroke, patients in this Study were less severe at the time of admission (49% of patients in the National Survey of Stroke were stuporous or comatose compared to 21% of the patients in the current Study). The inhospital fatality was 30.7% in the National Survey of Stroke, and 19.7% in the current Study.

Activities of Daily Living↗
PubMedDate not supplied

Community Hospital-based Stroke Programs: North Carolina, Oregon, and New York. III. Factors influencing survival after stroke: proportional hazards analysis of 4219 patients.

The possible effect of age, race, sex, consciousness upon admission, geographic location, and history of selected risk factors on the survival after stroke due to infarction or hemorrhage was determined using proportional hazards analysis (Cox regression). For each diagnostic category the most significant prognostic factor was consciousness upon admission. Increasing age, cardiac disease, or previous stroke also decreased the survival time of patients with infarctions. For patients with cerebral hemorrhage, no other variable was significant after control for consciousness level.

Adult↗
PubMedDate not supplied

Evaluation of the North Carolina Stroke Care Program.

A study of 774 patients in eastern North Carolina was undertaken to determine the effects of a coordinated program of care and follow-up on recovery from stroke. The program was designed to coordinate and improve in-hospital stroke care and rehabilitation, to provide for education and training of the family for post-hospital care, and to coordinate and facilitate continued access to services after discharge. As measured by the Barthel Index at discharge, three, six and 12 months, the impact of the program was found to be minimal. Patients' scores throughout follow-up were influenced by age, whether the stroke event was new or recurrent, and the state of consciousness at admission. Follow-up Barthel scores were also related to scores obtained at discharge.

Activities of Daily Living↗
PubMedDate not supplied

Pilot survey of urinary porphyrins from persons transiently exposed to a PCB transformer fire.

In rats and humans chronically exposed to large amounts of PCB (polychlorinated biphenyls) and PCDF (polychlorinated dibenzofurans), the urinary excretion of uroporphyrin and coproporphyrin are altered. However, porphyrin excretion in humans after acute transient low level exposure has not been evaluated. Following such an exposure in which bystanders and firefighters were in contact with smoke from a PCB transformer fire, we surveyed 90 self-referred individuals by questionnaire and by determining single 24 hour urinary excretion of uroporphyrin and coproporphyrin 2-4 weeks after the fire. Questionnaire variables that assessed exposure were not associated with the magnitude of either uroporphyrin or coproporphyrin excretion. Uroporphyrin excretion was slightly elevated in nine subjects (range 66-106 micrograms/24 hours, normal less than 60), which is much less than in clinical cases of porphyria cutanea tarda. Uroporphyrin excretion was inversely correlated with coproporphyrin excretion (r = -0.3844, p = 0.0002). For 5 subjects (3 with elevated initial uroporphyrin excretion) retested at 3-4 weeks after the fire, all 5 showed increases in uroporphyrin and decreases in coproporphyrin excretion when compared to initial determinations. These two reciprocal relationships would be the expected result from inhibition of uroporphyrinogen decarboxylase, a known experimental effect of PCB and PCDF in mice. Overall, urinary porphyrin excretions were not altered or sensitive measures of exposure.

Air Pollutants↗
PubMedDate not supplied

[Epidemics and colonial medicine in West Africa].

We studied colonial medical practices and health policies in West Africa, which has faced endemics and epidemics that have affected entire societies. We found that attempts to centralize the organization of colonial medicine, which began in the late 19th Century, were limited until the end of World War I. Research and control programs expanded after 1920, concentrating on epidemics, but largely ignoring many major health problems, such as measles, whooping cough and malnutrition, the importance of which were not recognized until after World War II. This appraisal of colonial medicine highlights the difficulties of introducing modern medicine and its ideas into African societies. There have been various social reactions, resulting in the current duality in which traditional and modern medicine coexist.

Africa, Western↗
PubMedDate not supplied

Total recall.

Explore the source record for details and available documents.

Budgets↗
PubMedDate not supplied

MDR1 single nucleotide polymorphism C3435T in normal colorectal tissue and colorectal carcinomas detected by MALDI-TOF mass spectrometry.

Single nucleotide polymorphisms (SNPs) may contribute to the malignant process and may show clinicopathological importance as prognostic markers. The multidrug resistance gene MDR1 encodes a membrane transporter which confers cytostatic drug resistance in tumors and protects normal tissues from xenobiotics. We analyzed the C3435T SNP in the MDR1 gene which is associated with altered cellular drug uptake in matched tumor and normal tissues of 45 patients suffering from colorectal carcinoma. We have developed a highly sensitive matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) method to survey the C3435T polymorphism in PCR-amplified fragments of the MDR1 gene. Thirteen patients were homozygous for C/C (29%), 15 were heterozygous (33%) and 17 were homozygous for T/T (38%). None of the tumor samples showed an altered SNP compared to their matched normal tissue samples. As analyzed by the Kruskall-Wallis test, none of the clinicopathological parameters was significantly associated with homo- or heterozygosity. The combination of PCR, allele-specific primer extension reactions and MALDI-TOF-MS offers a promising alternative method for genotyping the MDR1 gene especially for heterozygous situations. The inherent advantages of MALDI-TOF-MS based genotyping include its high molecular resolution, high signal-to-noise-ratios and reproducibility, combined with an excellent sensitivity. As none of the tumor samples showed an altered state compared to their matched normal tissue samples, the genotypic frequency of this polymorphism seems not to be altered during colorectal tumorigenesis.

Adult↗
PubMedDate not supplied

[Evaluation of the risks of sexually transmitted diseases and HIV infection in a rural region of Senegal in 1991].

This study was performed in the Sereer region 150 km to the east of Dakar, the capital of Senegal. The population of the region is characterised by large seasonal migration, a high divorce rate (41% of marriages end in divorce) and frequent polygamy (1.8 married women per married man). We organised the medical centres in the region to monitor actively the epidemiology of HIV infection. Three populations were targeted: pregnant women presenting for their first prenatal consultation; patients presenting with STD; and people with chronic (more than three weeks) cough. The patients consulting for STD were recruited two ways: those presenting spontaneously and those identified during home interviews by the team performing a parallel sociological study of behaviour. Overall, the prevalence of HIV seropositivity was 0.2% of the women and 1.3% of the men (the difference is not significant). The seropositive individuals identified were 2 pregnant women and 5 patients (3 of 409 women and 2 of 84 men) with STD. There was no significant difference between the sex, age, marital status, or type of recruitment (spontaneous or identified by the sociological survey) of the HIV seropositive and seronegative individuals. The prevalence of treponema antibodies was 1.8% among pregnant women, 2% among STD patients and 2.4% among patients with chronic cough. There was no significant difference according to age, sex, marital status or motivation for consultation. More than half the patients consulting for STD presented biomedical disease. The majority of the STD patients were women: 70% of those spontaneous consulting; 90% of those identified by the survey; and 92% of those with biomedical disease were women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Manifestations and prognosis of congenital diaphragmatic hernia].

We conducted a retrospective examination of the data of 36 patients with congenital diaphragm defects detected at an early stage or even before birth. The course of pregnancy, pregnancy risks, prenatal findings, mode of delivery, clinical parameters, prenatal, perinatal and postnatal procedures, findings at surgery and surgical therapy were analyzed with respect to the patients' outcome. The following factors were seen to influence the prognosis: associated anomalies, prenatal diagnosis, maturity for age, weight, Apgar score, the size of the defect and the extent of the pulmonary hypoplasia (and--linked to this--the patient's cardiorespiratory condition prior to surgery), and possibly sex. The mortality of patients surviving until surgery became possible was 28%. Our standard procedure in case of diaphragm defects known before birth is primary intubation before the child's first spontaneous breath. We also consider the practice of delaying surgery until stabilization has been achieved and especially in the incubator on the ward the course of action with the fewest complications at present from the patient's point of view.

Abnormalities, Multiple↗
PubMedDate not supplied

[Effectiveness of multi-factorial intervention for reducing falls with proximal femoral fractures in homes for the aged and nursing homes. Goals and study design of a population-based study].

The article presents the design of an open controlled, non-randomized population based intervention trial in institutionalized elderly that will be performed in Ulm/Germany starting in 1998. The multimodal intervention includes education, counseling, training, and hip protectors as well as information on potential environmental modifications in nursing homes. Two historical and one geographical control group will be formed. All institutionalized elderly will be assessed by means of the Minimum Data Set of the Resident Assessment Instrument. The intervention will last 12 months. The main objective is to test a model for cost-effective reduction of proximal femoral fractures in institutionalized elderly and to demonstrate its effectiveness.

Accidental Falls↗