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Biomedical subjects

C Brown

Publications and source records attributed to C Brown.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.

This article presents the development of a brief, self-report measure of female sexual function. Initial face validity testing of questionnaire items, identified by an expert panel, was followed by a study aimed at further refining the questionnaire. It was administered to 131 normal controls and 128 age-matched subjects with female sexual arousal disorder (FSAD) at five research centers. Based on clinical interpretations of a principal components analysis, a 6-domain structure was identified, which included desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. Overall test-retest reliability coefficients were high for each of the individual domains (r = 0.79 to 0.86) and a high degree of internal consistency was observed (Cronbach's alpha values of 0.82 and higher) Good construct validity was demonstrated by highly significant mean difference scores between the FSAD and control groups for each of the domains (p < or = 0.001). Additionally, divergent validity with a scale of marital satisfaction was observed. These results support the reliability and psychometric (as well as clinical) validity of the Female Sexual Function Index (FSFI) in the assessment of key dimensions of female sexual function in clinical and nonclinical samples. Our findings also suggest important gender differences in the patterning of female sexual function in comparison with similar questionnaire studies in males.

Adult↗
PubMedDate not supplied

Evaluation of a unique oral contraceptive in the treatment of premenstrual dysphoric disorder.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). This is the first trial of a unique oral contraceptive containing a combination of drospirenone (DRSP, 3 mg) and ethinyl estradiol (EE, 30 microg) for the treatment of PMDD. DRSP is a spironolactone-like progestin with antiandrogenic and antimineralocorticoid activity. Spironolactone has been shown to be beneficial in PMS, whereas oral contraceptives have shown conflicting results. In this double-blind, placebo-controlled trial, 82 women with PMDD (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. [DSM IV]) were randomized to receive DRSP/EE or placebo for three treatment cycles. The primary end point was change from baseline in luteal phase symptom scores as assessed on the Calendar of Premenstrual Experiences (COPE) scale. Patients treated with DRSP/EE showed a numerically greater change from baseline compared with those treated with placebo on each of the 22 COPE items and each of the 4 symptom factors. Between-group differences in symptom improvement reached statistical significance in factor 3 only (appetite, acne, and food cravings, p = 0.027). The secondary end points, Beck Depression Inventory (BDI) and Profile of Mood States (PMS), were consistent with the primary end point in that patients treated with the oral contraceptive showed a numerically greater improvement from baseline compared with those treated with placebo. The results of this study show a consistent trend in the reduction of symptoms that suggested a beneficial effect of DRSP/EE for the treatment of PMDD, despite limitations of the study design.

Adaptation, Psychological↗
PubMedDate not supplied

Role of the mononuclear phagocyte system in the immunopathogenesis of human immunodeficiency virus infection and the acquired immunodeficiency syndrome.

In studies aimed at defining monocyte and macrophage function in patients with human immunodeficiency virus (HIV) infection, we found impaired in vivo Fc receptor-specific clearance in 20 of 25 patients with acquired immunodeficiency syndrome (AIDS) and in five of 13 patients with AIDS-related illnesses. The in vivo function of macrophage C3 receptors was also found to be abnormal: AIDS patients had a relatively large release of cell back into the circulation, suggesting failure of macrophage phagocytosis. The antibody-dependent cell-mediated cytotoxicity of circulating mononuclear cells was significantly lower in AIDS patients than in healthy controls. Monocyte nonspecific phagocytosis and surface marker expression were intact. Defective monocyte and macrophage function is an integral part of the immunopathology of AIDS, leading to the failure to control opportunistic pathogens. Whether these defects are due to intrinsic infection of the mononuclear phagocytes with HIV or are secondary to other events in the network of HIV infection remains to be determined.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Intestinal transplantation in pediatric patients: a nursing challenge: Part One: Evaluation for intestinal transplantation.

Intestinal transplantation offers hope to children with intestinal failure and life-threatening complications of parenteral nutrition (PN). As more transplant centers are adding intestinal transplantation to their existing programs, new challenges are presented to nursing professionals. This three-part series will provide information for nursing professionals regarding evaluation for intestinal transplantation, donor preparation, the surgical procedure, immediate postoperative care of the transplant recipient, complications of intestinal transplantation, and long-term care of the intestinal transplant patient. Part 1 will discuss the indications for intestinal transplantation, the evaluation of patients for intestinal transplantation, the process of listing patients for intestinal transplantation, and the waiting time for donor organs for intestinal transplantation. The information presented represents the approach taken at University of Nebraska Medical Center.

Child↗
PubMedDate not supplied

Intestinal transplantation in pediatric patients: a nursing challenge. Part 2: Intestinal transplantation and the immediate postoperative period.

Intestinal transplantation offers new hope to children with intestinal failure and life-threatening complications of parenteral nutrition. As more transplant centers are adding intestinal transplantation to their existing programs, new challenges are presented to nursing professionals. This three-part series will provide information for nursing professionals regarding evaluation for intestinal transplantation, donor preparation, the surgical procedure, immediate postoperative care of the transplant recipient, and long-term care of the intestinal transplant recipient. This article focuses on donor selection and preparation, the surgical procedure for intestinal transplantation, the immediate postoperative course, immunosuppression, rejection, infections, fluid and electrolyte support, and nutrition. The information presented represents the approach taken at University of Nebraska Medical Center/Nebraska Health Systems.

Aftercare↗
PubMedDate not supplied

Determination of tissue viability in experimental electrical injuries.

Electrical burns or ischemia (induced by vascular ligation) were produced in the legs of 15 anesthetized dogs to study evolution of tissue changes compared with impedance alterations. After the application of 1-ampere currents at 60 Hz, animals were monitored from 1 to 4 days. Muscle impendance was measured with frequency sweeping to determine tissue destruction. Nuclear magnetic resonance spectroscopy (phosphorus 31) was used to assess metabolic activity, and results were compared to impedance measurements. In burned limbs, 70% reduction in muscle impedance was seen, which corresponds to decreased metabolic activity (absent organic phosphates) and suggests necrosis. Visually viable tissue had impedance decreases of 25% and levels of organic phosphates slightly lower than normal. Relaxation frequencies in dogs with severe burns exceeded 80 kHz; in viable tissue, 30 to 40 kHz (normal: 30 kHz). In ischemic muscle, organic phosphates decreased rapidly (1 to 2 hours); impedance changes evolved more slowly (1 day), but they ultimately reached the same degree of severity. Measurement of impedance may be a valuable adjunct in the evaluation of electrical burns, since significant changes strongly suggest nonviability.

Animals↗
PubMedDate not supplied

Rate-responsive pacing improves exercise tolerance in heart transplant recipients: a pilot study.

BACKGROUND: Chronotropic incompetence is one cause of diminished exercise capacity in heart transplant recipients. If reinnervation occurs, it often is late after transplantation and is not always accompanied by functional improvements in peak heart rate and appropriate tachycardia during exercise. To determine the efficacy of rate-responsive pacing on peak heart rate and exercise capacity, the authors studied eight male heart transplant recipients (age 57 +/- 12 years; 23 +/- 9 months after transplantation) that had either atrial or dual-chambered pacemakers. METHODS: All subjects completed two maximal graded exercise tests (GXT) using the Naughton treadmill protocol. During the first GXT, pacemakers were programmed for bradycardia support only and without rate responsiveness (unpaced). After a 14-day regimen of beta blockade with metoprolol to nullify the influence of circulating catecholamines on heart rate, subjects performed the second GXT with pacemakers programmed to respond optimally in the rate-responsive mode (paced). RESULTS: Peak heart rate (149 versus 129 bpm), peak oxygen uptake (18.9 versus 15.4 mL/kg/min), treadmill time to exhaustion (14.6 versus 12.4 min), and minute ventilation (76.7 versus 66.2 L/min) were significantly increased (P < or = 0.05) during the paced versus unpaced GXT. CONCLUSIONS: The results of this study demonstrate that chronotropic support of the transplanted heart using a rate-responsive pacemaker, with activity-based sensors programmed for maximal sensitivity, improves both peak heart rate and exercise capacity in heart transplant recipients significantly more than circulating catecholamines alone.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Testing toothbrushing ability of elderly patients.

An individual's ability to perform adequate oral care may become jeopardized by medical and physical insults associated with the aging process. Declines in oral care abilities may be difficult to identify, and usually go unnoticed and unaddressed. This study examined a tool developed to assess toothbrushing ability in elderly patients. The Toothbrushing Ability Test (TAT) was examined for its ability to predict brushing effectiveness (measured by plaque levels) and to determine its interrater and intrarater reliability. Fifty-eight dentate subjects, age 65 and older, from the Portland Veterans Affairs Medical Center and a community nursing home participated. Results showed highly significant Spearman correlations between TAT scores and plaque levels (r = 0.719; p < 0.000). Correlations also revealed high interrater (r = 0.87) and intrarater reliability (r = 0.82). The results suggest that the TAT is a practical and effective screening tool for assessing oral self-care ability in the elderly.

Aged↗
PubMedDate not supplied

The effects of cyclosporine versus standard care in dogs with naturally occurring glomerulonephritis.

Glomerulonephritis (GN) is a leading cause of chronic renal failure in dogs. However, little is known about the efficacy of available treatment options for GN in this species. The purpose of this study was to determine the effects of cyclosporine (Cy) administration on the outcome of naturally occurring GN in dogs. Thirteen dogs from 4 institutions were included in the study. Randomization of dogs into placebo-versus Cy-treated groups was stratified according to initial morphological diagnosis and contributing institution. Seven and 6 dogs were assigned to be given placebo or Cy, respectively. The initial Cy dose of 10 mg/kg every 24 hours was adjusted to maintain 24-hour trough, whole blood Cy concentrations between 250 and 400 ng/mL. There were no statistically significant differences between placebo- and Cy-treated groups with respect to serum total protein, albumin, urea nitrogen and creatinine, and plasma protein concentrations; platelet count; urine protein-creatinine ratio; endogenous creatinine clearance; 24-hour urine protein concentrations; or 24-hour urine protein-endogenous creatinine clearance ratio. However, PCV was significantly lower in the Cy-treated group. Decreased appetite, diarrhea, vomiting, weight loss, involuntary shaking, and thrombocytopenia were noted in both treatment groups; however, clinical signs in Cy-treated dogs subjectively were more severe. One Cy-treated dog developed gingival hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

The effects of a supervised toothbrushing programme on the caries increment of primary school children, initially aged 5-6 years.

Children in the London Boroughs of Kensington, Chelsea and Westminster have one of the highest levels of caries in England and Wales. In 1997/98, the mean dmft for 5-year-old children was 2.83 with only 45.9% of the children being caries free. The aim of this study was to determine whether teacher-supervised toothbrushing, once a day, at school, during term time, with commercial toothpaste containing 1,450 ppm fluoride, could reduce dental caries in primary school children when compared with children from the same community who did not receive this intervention. A total of 517 children (mean age 5.63 years) were recruited for the study. Class teachers were trained individually by the same dental hygienist in an appropriate toothbrushing technique for young children. Children in the intervention group brushed once a day at school. All examinations were by visual assessment only. All teeth present were assessed using the BASCD criteria. For children in the intervention group, the overall caries increment (2.60) was significantly less (10.9%; p < 0.001) than for children in the non-intervention group (2.92). Among different tooth surfaces, the difference in caries increment between the intervention group (0.78) and the non-intervention group (1.03) was greatest for the proximal surfaces (21.4%; p < 0.01). In conclusion, this study suggests that a programme of daily teacher-supervised toothbrushing with fluoride toothpaste can be effectively targeted into socially deprived communities and a significant reduction in dental caries can thereby be achieved especially among caries-susceptible children.

Cariostatic Agents↗
PubMedDate not supplied

Raising the bar: the use of performance guarantees by the Pacific Business Group on Health.

In 1996 the Pacific Business Group on Health (PBGH) negotiated more than two dozen performance guarantees with thirteen of California's largest health maintenance organizations (HMOs) on behalf the seventeen large employers in its Negotiating Alliance. The negotiations put more than $8 million at risk for meeting performance targets with the goal of improving the performance of all health plans. Nearly $2 million, or 23 percent of the premium at risk, was refunded to the PBGH by the HMOs for missed targets. The majority of plans met their targets for satisfaction with the health plan and physicians, as well as cesarean section, mammography, Pap smear, and prenatal care rates. However, eight of the thirteen plans missed their targets for childhood immunizations, refunding 86 percent of the premium at risk.

Adult↗
PubMedDate not supplied

HLA-DQ3 is associated with Graves' disease in African-Americans.

HLA heterogeneity occurs in various ethnic groups and has been significantly associated with Graves' disease. In this study we have determined that DQ3 is associated with Graves' disease in African-Americans. Human leukocyte antigen (HLA) typing of D-region antigens in 139 controls and 45 Graves' disease patients reveals significant differences for HLA-DR2, DR9, DQ1, and DQ3. The latter remained significant after correction. Increases in HLA-DR9 and DR3 are associated with increases in DQ3 and DQ2, respectively. The decrease in DR2 is associated with a decrease in DQ1. The associated increases and decreases in DR with DQ antigens probably reflect linkage disequilibrium. Patients were evaluated for autoantibodies against microsomal antigens and/or against thyroglobulin. All of the normal control volunteers were negative for thyroid antibodies and thirteen percent of patients produced autoantibodies. No significant associations were detected for antibody production, type of treatment required, age of onset, family history of Graves', status of T3, T4 levels, goiter and/or ophthalmopathy.

Adult↗
PubMedDate not supplied

TAP1 polymorphism identified in African-American Graves' disease patients.

Polymorphism in transporter associated with antigen processing (TAP)1 gene has been observed in African American Graves' disease patients. Single strand conformational polymorphism has been used to identify variation for the locus. First-strand cDNA was generated from cell lines obtained by Epstein-Barr virus immortalization. Four variant alleles for TAP1 have been observed and the products have been sequenced to compare with the location of observed with SSCP position patterns. Variants were detected and compared with substitutions within TAP1 polypeptide which includes changing valine to leucine and three (3) silent substitutions for glycine, glutamic acid and alanine.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Factor analysis on the Sensory Profile from a national sample of children without disabilities.

OBJECTIVE: The purpose of this study was to identify relationships in the 125 items of the revised Sensory Profile, a tool designed to assess children's responses to commonly occurring sensory events. METHOD: Parents of 1,115 children ages 3 to 10 years and without disabilities completed the Sensory Profile. The parents reported the percentage of time their children engaged in each of the 125 behaviors listed on the profile. RESULTS: Factor analysis revealed nine discreet factors that indicate sensory modulation and responsiveness: sensory seeking, emotionally reactive, low endurance/tone, oral sensory sensitivity, inattention/distractibility, poor registration, sensory sensitivity, sedentary, and fine motor/perceptual. CONCLUSIONS: In addition to the traditional method of organizing sensory history information by sensory system, we may need to consider a person's thresholds to sensory events as well as his or her responsiveness to sensation. Because the Sensory Profile factors in these children without disabilities are similar to patterns observed in children with various disabilities, it may be that some sensory processing problems are related to intensity or duration of behaviors as they begin to interfere with functional performance in daily life.

Attention Deficit Disorder with Hyperactivity↗