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Biomedical subjects

C C Johnson

Publications and source records attributed to C C Johnson.

214 records · Page 12Linked to original sources
PubMedDate not supplied

The relationship between mood, somatization, and alexithymia in premenstrual syndrome.

To examine the relationship between mood, somatization, and alexithymia in premenstrual syndrome (PMS), 66 women with a prospectively confirmed diagnosis of PMS were compared with a group of 49 non-PMS control women on a battery of self-administered tests measuring depression, anxiety, somatization, and alexithymia. Based on their scores on the Beck Depression Inventory, the PMS patients were subdivided into a high-depression and low-depression group and compared with the non-PMS control group on all test measures. Significantly greater somatization and alexithymia were reported in the high-depression PMS group, and no differences were found on any of the test measures between the low-depression PMS and non-PMS control groups.

Adult↗
PubMedDate not supplied

A randomized, double-blind comparison of sulbactam/ampicillin and clindamycin for the treatment of aerobic and aerobic-anaerobic infections.

In a randomized, prospective, double-blind trial, sulbactam/ampicillin was compared with clindamycin in terms of efficacy and safety for the treatment of bacterial infections. Both sulbactam/ampicillin and clindamycin were given with gentamicin when this course was indicated by clinical or laboratory findings. In five patients the site of infection was pleuropulmonary; in 14, bone; in 11, skin and soft tissue; and in one, intraabdominal. The commonest anaerobes isolated were anaerobic cocci and Bacteroides species; the commonest aerobic and facultative bacteria were Enterobacteriaceae, Pseudomonas aeruginosa, and various gram-positive cocci. All of six assessable patients given sulbactam/ampicillin alone had satisfactory clinical responses, as did seven of nine patients given sulbactam/ampicillin plus gentamicin, all of six patients given clindamycin alone, and six of nine patients given clindamycin plus gentamicin. Pathogens were totally or partially eradicated in four of five, eight of nine, four of five, and three of nine assessable patients given these same regimens. Adverse reactions and laboratory abnormalities were relatively uncommon. Overall, sulbactam/ampicillin was as effective as clindamycin in the treatment of aerobic or mixed aerobic-anaerobic infections; however, the concomitant use of gentamicin was frequently required with both regimens.

Aged↗
PubMedDate not supplied

Uncommonly encountered, motile, anaerobic gram-negative bacilli associated with infection.

Motile, anaerobic gram-negative bacilli belonging to the genera Butyrivibrio, Succinimonas, Succinivibrio, Anaerovibrio, Wolinella, Campylobacter, Desulfovibrio, Selenomonas, and Anaerobiospirillum are being recognized in clinical specimens with increasing frequency. Over a 12.5-year period at the VA Wadsworth Medical Center, 13 clinical specimens yielded one of these organisms. Six isolates were recovered from infected wounds, five from respiratory tract specimens obtained from patients with anaerobic pleuropulmonary infection, and two from peritoneal fluid of patients with intraabdominal infection. The distribution of isolates among the genera was as follows: Wolinella, five; Selenomonas, three; unidentifiable motile gram-negative bacilli, two; Desulfovibrio vulgaris, one; Campylobacter concisus, one; and Succinimonas, one. Our experience provides the first case reports of infection involving the last two organisms mentioned. Clinical features of the infections caused by these motile anaerobes were studied, and the current medical literature on such infections was reviewed.

Bacterial Infections↗
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Health risks from contaminated water: do class and race matter?

The impact of contaminants in water on minorities and economically disadvantaged persons was reviewed. Environmental legislation governing water was summarized as background information against which relevant studies were evaluated. The majority of the available information was anecdotal or case study and did not lend itself to making quantitative comparisons or analyses. However, the data did present certain trends that led to the conclusion that inequities concerning exposure to contaminants in water may exist. The following recommendations were made: current data bases should be analyzed and new data bases created to facilitate assessments of exposure to waterborne contaminants to all populations; an analysis of populations not covered by the Safe Drinking Water Act should be undertaken; a survey should be conducted of the drinking water infrastructure and the results evaluated to identify any impacts to minorities and economically disadvantaged persons; the social, cultural and economic characteristics that influence human exposure to waterborne contaminants need to be identified; and better educational and community outreach programs need to be developed and implemented.

Adult↗
PubMedDate not supplied

Physiologic effects of deep hypothermia and microwave rewarming: possible application for neonatal cardiac surgery.

Deep hypothermia (20 C) without cardiopulmonary bypass is a valuable technique during cardiac surgery in infants but rewarming of the heart following circulatory arrest and cardiac repair has traditionally been a lengthy and difficult process. In experimental animals rewarming the heart with microwave energy, as reported in this work, warms the heart before warming the periphery. In 18 mongrel dogs that were surface cooled to 20 C, we found that during microwave rewarming the core temperature rose 4.7 C per hour. Whole body oxygen consumption, heart rate, and cardiac output returned to normal at rates equal to the rates at which they decreased during surface cooling. Blood pressure and arterial gases remained adequate. Microwave rewarming appears to be a useful method for reestablishment of cardiac function and normothermia following deep hypothermia.

Animals↗
PubMedDate not supplied

The effects of the child and adolescent trial for cardiovascular health intervention on psychosocial determinants of cardiovascular disease risk behavior among third-grade students.

PURPOSE: The Child and Adolescent Trial for Cardiovascular Health is a multi-site study of a school-based intervention designed to reduce or prevent the development of risk factors for cardiovascular disease. The goal was to change (or prevent) related risk behaviors and the psychosocial variables that theoretically influence those behaviors. DESIGN: A nested design was used in which schools served as the primary unit of analysis. Twenty-four schools participated at each of four sites (Austin, San Diego, Minneapolis, and New Orleans). Each site had 10 control and 14 intervention schools. SETTING AND SUBJECT: Ninety-six schools (with more than 6000 students) in the four sites were randomized to three treatment conditions: control, school-based interventions, and school-plus-family interventions. The sample included approximately equal numbers of males and females and was 67.5% white, 13.9% African-American, 13.9% Hispanic, and 4.7% other. MEASURES: The psychosocial determinants included improvements in dietary knowledge, intentions, self-efficacy, usual behavior, perceived social reinforcement for healthy food choices, and perceived reinforcement and self-efficacy for physical activity. RESULTS: The findings indicated significant improvements in all the psychosocial determinants measured (p < .0001). The results revealed a greater impact in the school-plus-family intervention schools for two determinants, usual dietary behavior and intentions to eat heart-healthy foods. CONCLUSIONS: These findings support theory-based interventions for changing selected psychosocial determinants of cardiovascular disease risk behavior among children.

Cardiovascular Diseases↗
PubMedDate not supplied

Development of a school-based nutrition intervention for high school students: Gimme 5.

PURPOSE: To describe a 4-year intervention targeting fruit/vegetable consumption by high school students. DESIGN: This is a cohort study involving six pairs of schools (n = 12) matched on gender, race, enrollment, and location with schools randomly assigned within pairs to intervention or control conditions. SETTING: Twelve Archdiocese of New Orleans high schools. SUBJECTS: Cohort was defined as students (n = 2339) who were ninth-graders in the 1993-94 school year who provided baseline data. INTERVENTION: Four components of the intervention are: (1) school-wide media-marketing campaign, (2) school-wide meal and snack modification, (3) classroom workshops and supplementary subject matter activities, and (4) parental involvement. MEASURES: Focus groups were conducted for target population input and program development. Process evaluation included student feedback on media-marketing intervention materials and activities reported here. Process measures also included school meal participation, student characteristics, and verification of intervention activities. RESULTS: Focus groups identified barriers to increased consumption of fruit and vegetables as lack of availability, variety, and inconsistency in taste. Student attitudes were favorable regarding a school program to improve diet and parental involvement. Low consumption of fruits/vegetables was reported. After a 2-month school-wide program introduction utilizing various media-marketing materials and activities, 93% of students were aware of the program and 96% could identify the healthy eating message. CONCLUSIONS: Program development can be guided and enriched by student input via focus groups. Media-marketing activities effectively delivered health messages and attracted students' attention. Materials and activities used were acceptable channels for increasing awareness, positive attitudes, and knowledge about fruits/vegetables.

Adolescent↗
PubMedDate not supplied

Lowering physician hospital resource consumption using low-cost, low-technology computing.

Anderson Area Medical Center physicians have been provided disease-specific and procedure-specific profiles of their practice experiences for more than 5 years. For 4 years, physicians were provided reports, in a variety of formats, detailing their clinical outcomes and consumption of hospital resources in treating patients with acute myocardial infarction (AMI), pneumonia, cholecystectomy, stroke, congestive heart failure, and total hip replacement. For the past 18 months, physicians have been provided a uniform format of monthly physician-specific reporting for stroke, AMI, pneumonia, diabetes, congestive heart failure, cholecystectomy, total hip replacement, new-born delivery, angina, and hernia repair. Using only a modest PC platform with database, word processing, and graphics programs operating in a DOS environment, an effective disease-reporting and procedure-reporting program is provided to medical staff with 3 person-days of effort per month. Education-based physician-practice reporting is effective in encouraging more resource-efficient decision making on the part of medical staff members. Average length of stay and total charges can be reduced significantly by providing physicians with profiles that show them their relative ranking with peers of several outcome and resource variables. Actual aggregate reductions in average total charges for each of three groups of patients profiled following educational reporting to physicians were $203,680 (AMI), $220,296 (pneumonia), and $146,832 (hip replacement). Total benefit for these three educational reports was $570,808. If educational effects persist for 1 year in the physician groups, the annualized estimate of aggregate charge reductions for 390 AMI patients, 483 pneumonia patients, and 52 hip-replacement patients is $1,568,644. Cost savings to the hospital would be near $706,000.

Cost Savings↗
PubMedDate not supplied

Occupational exposure to manganese, copper, lead, iron, mercury and zinc and the risk of Parkinson's disease.

A population-based case-control study was conducted in the Henry Ford Health System (HFHS) in metropolitan Detroit to assess occupational exposures to manganese, copper, lead, iron, mercury and zinc as risk factors for Parkinson's disease (PD). Non-demented men and women 50 years of age who were receiving primary medical care at HFHS were recruited, and concurrently enrolled cases (n = 144) and controls (n = 464) were frequency-matched for sex, race and age (+/- 5 years). A risk factor questionnaire, administered by trained interviewers, inquired about every job held by each subject for 6 months from age 18 onward, including a detailed assessment of actual job tasks, tools and environment. An experienced industrial hygienist, blinded to subjects' case-control status, used these data to rate every job as exposed or not exposed to one or more of the metals of interest. Adjusting for sex, race, age and smoking status, 20 years of occupational exposure to any metal was not associated with PD. However, more than 20 years exposure to manganese (Odds Ratio [OR] = 10.61, 95% Confidence Interval [CI] = 1.06, 105.83) or copper (OR = 2.49, 95% CI = 1.06,5.89) was associated with PD. Occupational exposure for > 20 years to combinations of lead-copper (OR = 5.24, 95% CI = 1.59, 17.21), lead-iron (OR = 2.83, 95% CI = 1.07,7.50), and iron-copper (OR = 3.69, 95% CI = 1.40,9.71) was also associated with the disease. No association of occupational exposure to iron, mercury or zinc with PD was found. A lack of statistical power precluded analyses of metal combinations for those with a low prevalence of exposure (i.e., manganese, mercury and zinc). Our findings suggest that chronic occupational exposure to manganese or copper, individually, or to dual combinations of lead, iron and copper, is associated with PD.

Age Factors↗
PubMedDate not supplied

The utility of Ki-ras mutation analysis in the cytologic diagnosis of pancreatobiliary neoplasma.

PURPOSE: Mutations involved in neoplastic progression may be able to serve as markers for the presence of small numbers of neoplastic cells that would otherwise escape detection in diagnostic assays. Previous retrospective studies have suggested that the sensitivity of the cytologic diagnosis of pancreatic and biliary tract carcinomas is improved when analysis includes Ki-ras exon 1, which is commonly mutated in these neoplasms. We report our experience with the systematic prospective application of Ki-ras gene analysis to the evaluation of fine-needle aspirates and brushings from the pancreatobiliary tract. MATERIALS AND METHODS: Between September 1996 and April 1999, 75 pancreatic fine-needle aspirates and common bile duct brushings submitted for routine cytologic diagnosis were also evaluated for mutations in Ki-ras exon 1 by polymerase chain reaction/single-strand conformation polymorphism analysis. After routine preparation of the specimens, residual material was used for molecular analysis. Results are compared with the morphologic diagnosis and available clinical information. RESULTS: Single-strand conformation polymorphism mutation patterns in Ki-ras were detected in 22 of the 70 consecutive clinical specimens with adequate DNA and at least 6 months of available clinical follow-up. Sensitivity, specificity, and positive predictive value for the presence of concurrent or subsequent pancreatobiliary carcinoma were 33%, 97%, and 93%, respectively, for definitive cytologic diagnosis alone, and 53%, 97%, and 95% for positive Ki-ras single-strand conformation polymorphism mutation pattern alone. If definitive positive cytology or atypical/suspicious cytology with a positive Ki-ras single-strand conformation polymorphism mutation pattern is used, sensitivity is 55%, specificity is 97%, and positive predictive value is 96% for the presence of pancreatobiliary carcinoma. DISCUSSION: Results support the routine use of Ki-ras mutational analysis to increase the sensitivity of the cytologic evaluation of pancreatobiliary fine-needle aspirates and common bile duct brushings with atypical or suspicious morphology without compromising specificity.

Adenocarcinoma↗
PubMedDate not supplied

Inadequate follow-up of abnormal mammograms.

Routine mammographic screening increases detection of nonpalpable breast cancer. Timely follow-up of abnormalities is essential because delays may lead to postponement of treatment and decreased survival for women who have cancer. The purpose of this study was to determine the percentage of women with an abnormal mammogram who do not have adequate follow-up and to determine factors associated with inadequate follow-up. The study was conducted in a metropolitan health system that includes a large urban teaching hospital in Detroit and 26 ambulatory care centers. From the radiology database, all women with an abnormal screening mammogram performed between January 1, 1992, and July 31, 1992 were identified. We defined adequate follow-up as follow-up within three months of due date. Follow-up status was determined using medical records and telephone interviews. The percentage of women with inadequate follow-up was calculated. Relative risks compared percentages of women with inadequate follow-up according to demographic and screening-related variables. We calculated adjusted relative risks using multivariate binomial regression. We identified 1,249 women with abnormal screening mammograms. Inadequate follow-up occurred for 226 (18.1%) of the women. Among women with follow-up recommended in 4-6 months, 36.8% had inadequate follow-up. Among women with immediate follow-up recommended (obtain additional views or outside films for comparison, ultrasound, biopsy, or surgical referral), 7.2% had inadequate follow-up. Inadequate follow-up was associated with lower estimated household income and no history of previous mammogram. Among women with inadequate follow-up who were interviewed, 87% reported that they had been notified of their results. We found that the percentage of women with inadequate follow-up of abnormal mammograms is high, especially among women who require six-month follow-up. Women with low income and no history of a previous mammogram were at greatest risk for inadequate follow-up. These results document a previously unrecognized problem with mammography screening and suggest that the implementation of tracking systems to ensure timely follow-up of abnormal screening mammograms is essential. Medical Subject Headings (MeSH): mammography, follow-up, screening.

Adult↗