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Biomedical subjects

C Bennett

Publications and source records attributed to C Bennett.

At least 55 records · Page 3Linked to original sources
PubMed1994

Lower urinary tract reconstruction following cystectomy in women using the Kock ileal reservoir with bilateral ureteroileal urethrostomy: initial clinical experience.

Since June 1990, 14 women 31 to 70 years old (mean age 57 years) have undergone lower urinary tract reconstruction by bilateral ureteroileal urethrostomy using a Kock ileal reservoir. Indications for cystectomy included transitional cell carcinoma in 9 patients, urachal adenocarcinoma in 2, cervical carcinoma in 1, mesenchymal tumor of endometrial origin in 1 and a fibrotic radiated bladder in 1. Early and late complications have been few, occurring in 2 patients and 1, respectively. Excellent continence has been achieved during the day and night in 100% of patients. Of the 14 patients 12 void volitionally per urethra without high residual volume, while 2 require intermittent catheterization. All patients are completely satisfied. Tumor recurred in the pelvis in 1 patient with an extensive mesenchymal tumor necessitating conversion to a continent cutaneous Kock reservoir. All patients are currently alive without evidence of disease. This initial experience with lower urinary tract reconstruction in women has yielded extraordinary results and we believe that the option of lower urinary tract reconstruction following cystectomy can be offered safely to selected female patients.

Adult↗
PubMed1994

Racial differences in cervical cancer mortality in Chicago.

Racial differences in cervical cancer mortality in Chicago were examined. Age-adjusted mortality in Blacks (10.0/100,000) was over twice the rate found in Whites (4.6/100,000). Age-specific rates also showed significant excess mortality among Blacks. After stratification by a group-level defined poverty indicator, the race differential in age-adjusted rates remained significant. The race differential in age-specific rates diminished in the group with more than 30% living below the national poverty level, in contrast to the group with 30% or fewer living below the national poverty level, in whom race differences were more marked. Methodological issues concerning hysterectomy prevalence, Hispanic ethnicity, and social class must be considered with respect to interpretation of these findings.

Adolescent↗
PubMed1994

Latent inhibition, context specificity, and context familiarity.

In two appetitive licking experiments, thirsty rats were pre-exposed on two stimuli prior to conditioning sessions in which one or both of these stimuli were paired with water. Consistent with other results, latent inhibition was disrupted when conditioning took place in a context different from that in which stimulus pre-exposure had occurred. But in animals given prior exposure to the context of stimulus pre-exposure before the start of stimulus pre-exposure, substantial and equivalent latent inhibition was evident whether or not there was a change of context between stimulus pre-exposure and conditioning. These results are discussed in terms of current theories of latent inhibition.

Animals↗
PubMed1994

Evaluation of two AIDS education programs for impoverished Latina women.

This paper evaluates and contrasts the effectiveness of two culturally sensitive AIDS education programs developed by the UCLA AIDS Nursing Network and delivered to 213 impoverished Latina homeless or drug-addicted women in Los Angeles. The Comprehensive Health Seeking and Coping Paradigm guided the program, which was implemented by specially trained Latina nurses and outreach workers. A quasi-experimental design was employed where women were randomized by site into Specialized (N = 82) and Traditional (N = 131) programs. Repeated measures ANOVAS and log-linear models were used to evaluate improvement over a two-week period for women in both groups and to identify interactions with program type. Two-week posttest analyses were also conducted to assess program effectiveness, controlling for baseline values of the measure in question, nonequivalency between groups at baseline, and selected demographic characteristics, including acculturation. Results indicated that women in both AIDS education programs improved significantly in cognitive, behavioral, and psychologic outcomes.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Results of the ACSUS for pediatric AIDS patients: utilization of services, functional status, and social severity.

OBJECTIVE: This study describes demographic characteristics of pediatric AIDS patients, describes hospital and community-based service utilization patterns, and analyzes medical and social support service usage patterns with respect to patient demographic characteristics, clinical trial participation, functional/developmental status, and social environment. DATA SOURCES AND STUDY SETTING: Data reported in this study are from the AIDS Costs and Service Utilization Survey (ACSUS) and cover the six-month period beginning March 1991 (N = 135). Pediatric patients who sought care for HIV-related problems were sampled at seven different hospitals in five metropolitan regions of the United States. All of the participating hospitals had clinics specifically serving pediatric patients infected with HIV. The sample consists of HIV-positive patients who had had at least one HIV-related symptom or condition. STUDY DESIGN: A stratified probability sample design guided the sampling strategy, which included oversampling in two large hospitals from two of the five metropolitan areas. Survey data cover an 18-month time period of health care utilization, cost, and financing information from HIV-infected patients and their providers. Utilization measures are standardized to a six-month period. Per capita income, family structure, informal personal network, functional status, and clinical trial participation are tested for associations with patterns of utilization. In addition, a weighted ten-point social severity scale was developed to assess family/household stability. DATA COLLECTION: Data were collected through a screener instrument completed by the person accompanying the child to a hospital clinic visit (usually a a parent), and through two interviews conducted in person with the patients' primary caregivers. Data from the questionnaires were coded and assembled into computerized SAS analysis files by WESTAT: PRINCIPAL FINDINGS: Children in this sample are 62 percent African American, 25 percent Hispanic, and 10 percent White. Medicaid is the primary payer for 92 percent. Mean per capita income is $3,440. Fewer than one-half (41 percent) of the families of the children receive Aid to Families with Dependent Children (AFDC). (AFDC). Within the six-month period, approximately one-third of the sample (29.6 percent) was hospitalized. Mean length of stay was 16.0 days. Clinical trial participation was positively related to mean number of hospital clinic visits and receipt of formal (paid) home care. There were no differences in use of community clinic, mental health, and inpatient facilities by clinical trial status. Participation in clinical trials was positively related to income and negatively related to social severity. In four cities, emergency room use was consistently lower for clinical trial participants than for nonparticipants. CONCLUSIONS: Data from the first six months of the ACSUS pediatric sample suggest that participation in clinical trials may bring about access to social services that appear to reduce emergency room use. However, the findings reported here are descriptive and exploratory. Further multivariate, nonparametric analyses of the full 18-month provider-patient merged data set are necessary to confirm the simple correlations found in this study.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Outcomes of specialized and traditional AIDS counseling programs for impoverished women of color.

The efficacy and differential effects of specialized (S) and traditional (T) AIDS education programs on cognitive, behavioral, and psychological outcomes were investigated. The sample consisted of 858 impoverished African-American and Latina women (S = 448, T = 410). At baseline, women in the traditional group reported significantly higher distress, greater knowledge of AIDS, and less problem-focused coping. Significant improvements over the 2-week intervention interval were found for participants of both AIDS education programs for appraisal of threat, concerns, knowledge, and attitudes about AIDS, emotion-focused coping, number of sexual partners, IV and non-IV drug use, depression, and distress. However, multivariate analysis indicated that the traditional group had slightly better posttest scores on concerns, emotion-focused coping, knowledge of AIDS, and number of partners than the specialized group. The specialized group reported greater use of problem-focused coping. These differences do not detract from the substantial improvement found for both groups, but they do reinforce the conclusion that the specialized program was not more effective than its standard counterpart.

Acquired Immunodeficiency Syndrome↗
PubMed1993

GM-CSF as an adjunct to autologous bone marrow transplantation.

Patients with cancer can now benefit from intensive drug dosage. Intensive drug dosage has become more effective because of the availability of better anti-emetics, hematopoietic growth factors such as granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte CSF (G-CSF), erythropoietin, etc. and improvements in hematopoietic stem cell transplantation. We have evaluated the clinical and cost effectiveness of GM-CSF in patients undergoing autologous bone marrow transplantation (AuBMT) for Hodgkin's disease. Administration of GM-CSF after AuBMT enhances myeloid and platelet recovery and is cost effective in the treatment of patients with relapsed Hodgkin's disease who received intensive chemotherapy and AuBMT. We also describe the use of various new therapeutic approaches with emphasis on clinical and cost benefit. Further work is needed to improve the route and duration of growth factor(s) infusion and the timing of the various treatments.

Antineoplastic Agents↗
PubMed1993

Human T cell leukemia virus (HTLV-I/II) serodiagnostic testing: disparate results among a cohort of intravenous drug users.

Three hundred and forty-six sera collected over a 2-year period from 154 San Francisco IV drug users were subjected to HTLV-I/II RIPA, Western blot (WB), Du Pont ELISA, and p24 radioimmunoassay (RIA). Tests were performed at separate sites and code not broken until study end. RIPA-positive and -negative controls consisted of Japanese adult T cell leukemia patients, healthy blood donors, and non-IV drug-using HIV-positive men. RIPA identified HTLV-I/II-positive sera not identified by the other tests. Positive RIPAs were noted in 43% of negative ELISAs (n = 279), 34% of negative WBs (n = 243), and 40% of negative RIAs (n = 270). Seventy-two sera were negative by all 3 assays, but were RIPA positive. All sera positive by RIA (n = 76) and WB (n = 67), and 66 of 67 by ELISA, were positive by RIPA. Thirty-five of 36 indeterminate WBs were RIPA positive. Seven samples indeterminate by RIPA were negative by WB and RIA; one of seven was positive by ELISA. In all instances, samples negative by RIPA (n = 154) were ELISA, p24 RIA, and WB negative or indeterminate. We conclude that when studying HTLV-I/II-endemic cohorts, screening ELISA or RIA followed by confirmatory WB or RIPA only of seropositive samples may result in a substantial number of undetected cases. Additional studies focusing on performance characteristics of serodiagnostic tests are needed to ensure accurate inferences are made in assessing HTLV-I/II prevalence rates among high-risk groups. The RIPA may be a uniquely sensitive assay to detect HTLV-I/II gene-encoded products.

Adult↗
PubMed1993

Role of granulocyte-macrophage colony stimulating factor (GM-CSF) after autologous bone marrow transplantation for Hodgkin's disease.

Use of growth factors to augment hematopoietic recovery after cytotoxic therapy is a useful method for dose intensification. We wanted to evaluate the clinical and cost-effectiveness of granulocyte-macrophage colony stimulating factor (GM-CSF; Leucomax) in patients undergoing autologous bone marrow transplantation (ABMT) for Hodgkin's disease. Twenty-four patients with Hodgkin's disease were treated with high-dose chemotherapy and ABMT. Patients were then randomized in a double-blind manner to receive GM-CSF intravenously (10 micrograms/kg) over 6 h or placebo until the absolute neutrophil count (ANC) was greater than 1000/mm3 for 3 days. The study medication was stopped after 30 days. Patients treated with GM-CSF (n = 12) had shorter periods of neutropenia (median duration of an ANC of less than 1000 cells/mm3, 16 versus 27 days on placebo; p = 0.23), shorter periods of platelet-transfusion dependency (median duration, 13.5 versus 21 days on placebo; p = 0.03), shorter hospitalizations (median hospital stay, 32 versus 40.5 days on placebo; p = 0.0004). Other clinical outcomes, such as frequency and severity of toxicities, development of pneumonia or infection, in-hospital death, and response rate were similar in the two groups. Actuarial long-term disease free survival was 58% for patients treated with GM-CSF and 50% for patients who received placebo after 38 months of follow up (p = 0.6).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

HIV/AIDS. Some organizational and managerial issues.

Discusses factors emerging from research into the management and organizational processes involved in developing services for HIV/AIDS which affected the speed and character of the response made by health authorities. An early response was promoted by perceived high local prevalence, an existing service infrastructure, and high status individuals "championing" the issue and helping to foster a mobilizing sense of crisis. Responses were shaped by the diverse interests and perspectives of those developing services; the lack of established guidelines for treatment and service delivery; and ring-fenced funding. The idiosyncratic nature of initial service development has sometimes made later strategic choices difficult. Argues that if the momentum of service development is to be sustained, HIV/AIDS needs to be integrated into mainstream service provision and managers need improved information about local prevalence and the evaluation of service initiatives.

Acquired Immunodeficiency Syndrome↗
PubMed1993

AIDS-related knowledge, perceptions, and behaviors among impoverished minority women.

OBJECTIVES: The aims of this study were to (1) describe AIDS-related knowledge, perceptions, and risky behaviors of impoverished African-American and high- and low-acculturated Latina women; (2) delineate relationships involving high-risk behaviors; and (3) determine whether risky behaviors differ by race and levels of acculturation. METHODS: Survey instruments were administered to 1173 impoverished women of color residing in homeless shelters and drug recovery programs. RESULTS: Differences based on ethnicity and level of acculturation were found in AIDS-related knowledge, perceived risk of acquiring AIDS, and risky behaviors. Low-acculturated Latinas reported low perceived risk and were least likely to engage in illegal drug use and sexual activity with multiple partners. Intravenous drug use was most prevalent among high-acculturated Latinas, whereas nonintravenous drug use and high-risk sexual activity was most prevalent among African-American women. CONCLUSIONS: The data indicate the need for culturally sensitive AIDS prevention programs for women that deal with general issues of drug use and unprotected sex, and that include separate sessions for women of different ethnic backgrounds and acculturation levels to address specialized areas of concern.

Acculturation↗
PubMed1993

The significance of gender boundaries in preadolescence: contemporary correlates and antecedents of boundary violation and maintenance.

Previous research has established the importance of gender boundaries as a normative aspect of development in middle childhood. Here, the nature and importance of gender boundaries as an individual differences construct was explored. Ratings of gender boundary violation and gender boundary maintenance were made of 47 10-11-year-old children participating in a series of summer day camps. These ratings were supported by videotape-based behavior codings of gender boundary violating behaviors and by live observations of sheer number of associations with members of the opposite gender. In addition, considerable external validation of these individual differences was obtained. Children low on gender boundary violation and (especially) children high on boundary maintenance were independently judged by camp counselors to be socially competent. They also were found to be higher on a friendship variable, based on observation. Those who violated boundaries were especially unpopular with peers, based on a child interview. Finally, boundary violation and maintenance were related to attachment history and to early measures of parent-child generational boundary distortions.

Child↗
PubMed1992

Blood-containing aerosols generated by surgical techniques: a possible infectious hazard.

The aerosols generated in an operating room during surgery were simulated in the laboratory by using a variety of common surgical power tools. A Stryker bone saw, a Hall drill, and a Shea drill were used on bone, and a Bovie electrocautery was used in both the cutting and coagulation modes on tendon, all in the presence of a thin film of blood. A 10-stage, low-pressure cascade impactor was used to determine the particle size distribution of each aerosol, and Hemastix was used to assess the hemoglobin content of each particle size fraction. The same assessment was done for another series of blood aerosols that had previously shown the ability to infect human T-cell cultures. All of the tools tested produced blood-containing aerosol particles in the respirable size range (less than 5 microns). Because surgical masks offer little protection against such particles, personal sampling is indicated to define the risk of exposure to bloodborne pathogens by this route.

Aerosols↗
PubMed1992

Human T-cell leukemia virus type-I/II (HTLV-I/II) serologic testing: the importance of assaying for the full complement of viral antigens.

Seventy-one Japanese adult T-cell leukemia (ATL) patients and 411 Japanese asymptomatic patients from HTLV-I endemic regions of southern Japan were found to be seropositive by radioimmunoprecipitation assay (RIPA). Of these 482 positive controls, 62% of ATL patients and 67% of the asymptomatic seropositive patients were found to harbor antibodies to p40x. Additionally, 333 preselected Japanese blood donors who were identified as seropositive by particle agglutination (PA) assay were further tested for antibodies to HTLV-I/II gene encoded envelope (env) or group specific antigens (gag) by means of enzyme-linked immunosorbent assay (ELISA) and RIPA. Concordance between ELISA and RIPA was noted in 318 samples (92.5%). Discordance between ELISA and RIPA was observed in 15 sera (7.5%)--2 were seropositive by ELISA and seronegative by RIPA and 13 were seronegative by ELISA and seropositive by RIPA. Seven of these 13 samples (53.8%) contained antibodies to p40x by RIPA and may represent ELISA false negatives on the basis of both clinical and laboratory data. Current HTLV-I/II ELISA kits may yield false negative results. Additional research into the development of rapid detection cost-efficient assays that test for the full compliment of viral antigens is needed.

Agglutination Tests↗
PubMed1992

Short-term effects of dietary-fat ingestion on energy expenditure and nutrient balance.

Joule for joule, dietary fat may promote obesity more than protein or carbohydrate. In this study we determined whether the addition of 50 g dietary fat to a standard breakfast would increase energy expenditure or fat oxidation during the immediate 6-h postprandial period or over the ensuing 18 h. We also determined whether subjects with a high level of aerobic physical fitness would show a greater increase in fat oxidation after the ingestion of the extra fat than would less fit subjects. Adding fat did not increase fat oxidation or energy expenditure either during the immediate 6-h postprandial period or over the following 18 h. This was true regardless of the subject's fitness level. Acutely, dietary fat ingested in excess of its usual rate of oxidation appears to be stored in the body. Being physically fit does not appear to provide an advantage in avoiding short-term storage of excess dietary fat.

Adult↗