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Biomedical subjects

C Chase

Publications and source records attributed to C Chase.

47 records · Page 3Linked to original sources
PubMed1977

Testing the significance of risk estimates for the predisposition of heterozygotes to common diseases.

A maximum-likelihood method has been used previously to estimate, from family studies, the relative risk of common disorders for heterozygous carriers of genes for certain autosomal recessive syndromes. In this paper statistical significance of relative risk estimates was evaluated using critical values from computer-generated sampling distributions of the test statistic. In several practical cases a significance test based on the computer-generated distribution was more conservative than a test which assumed normality for the sampling distribution.

Genes, Recessive↗
PubMed1976

Malignant neoplasms in the families of patients with ataxia-telangiectasia.

Ataxia-telangiectasia (A-T) is an autosomal recessive syndrome associated with a greatly increased incidence of malignant neoplasms in homozygous affected individuals. Heterozygotes for the gene for A-T are thought to comprise about 1% of the general population and, therefore, it is important to know whether this gene also predisposes the heterozygous carrier to cancers. Heterozygous carriers of this gene are common among the close relatives of patients with A-T, although individual carriers cannot be identified by any clinical criterion or laboratory test. For this reason, we compared the incidence of death from malignant neoplasms in 2 families of patients with A-T to that expected in a random sample of the general population. There were 59 deaths from malignant neoplasms in relatives dying before age 75, compared to 42.6 expected (p less than 0.02). For A-T heterozygotes younger than age 45, the risk of dying from a malignant neoplasm was estimated to be greater than 5 times the risk for the general population. A-T heterozygotes may comprise more than 5% of all persons dying from a cancer before age 45. The incidence of ovarian, gastric, and biliary system carcinomas and of leukemia and lymphoma was increased in these A-T families. Other neoplasms that may be associated with this gene in heterozygotes include pancreatic, basal cell, colonic, breast, and cervical carcinomas.

Ataxia Telangiectasia↗
PubMedDate not supplied

Neurologic features of Williams and Down syndromes.

Eight patients with Williams syndrome and 6 with Down syndrome, matched for age and full-scale IQ, underwent detailed neurologic testing as part of a large multidisciplinary research center study. Williams syndrome patients were small for gestational age and often had histories of failure-to-thrive and feeding problems as infants. Half of the Williams syndrome patients had epilepsy. On neurologic testing, Williams syndrome patients had greater difficulty with gross and fine motor coordination, oromotor skills, and cerebellar function than did those with Down syndrome. The neurologic distinctions between these 2 groups may reflect an underlying, as yet undefined, metabolic defect in Williams syndrome.

Adolescent↗
PubMedDate not supplied

Neurologic profiles of infants and children after perinatal stroke.

Twenty-nine children with a single, unilateral cerebral infarct acquired pre- or perinatally were examined subsequently for an average of 43 months. No consistent pre- or perinatal events were identified to explain the occurrence of the stroke. The children acquired motor milestones at nearly expected times, even in the presence of hemiparesis. In children older than 2 years of age, I.Q. scores all were within the normal range. More than one-half of the children experienced seizures at some time during the follow-up period. Good intellectual and functional motor outcome can be expected in children with isolated perinatal stroke.

Cerebral Infarction↗
PubMedDate not supplied

Effects of a continuous quality improvement program on helicopter liftoff times.

BACKGROUND: The continuous quality improvement (CQI) process addresses concerns from a systems approach, employing committees of employees rather than selected management personnel to identify and solve problems, improve patient care and efficiency, and enhance customer satisfaction. Little is known about the effects of the CQI process on an aeromedical program. OBJECTIVES: To create a CQI program within an aeromedical program and to investigate its effect on helicopter liftoff times for scene responses. METHODS: A CQI program was established at a busy aeromedical service that completed 897 missions in the previous year. A concern identified by the CQI committee was delays in helicopter liftoff time after receipt of mission requests for scene responses. Each component necessary for liftoff (dispatch, pilot weather check, and crew response) was identified, time limits were set for each, new procedures were developed, and all staff received training on the new procedures. Computer tracking of each of the identified component times allowed comparison of data pre and post procedure implementation of the CQI-developed procedures. RESULTS: After CQI changes in procedures were implemented, there were a total of 30 delays out of 323 calls (9% of liftoffs for on-scene flights). This represents a 6% reduction in total delays. The largest drop in component times was observed in crew response (2.6%). An unanticipated 10% drop in response times for interhospital liftoffs also occurred, presumably due to heightened awareness of the service to response times in general. CONCLUSIONS: These findings suggest that employing a program utilizing CQI concepts can shorten helicopter liftoff times and improve response times in aeromedical programs.

Air Ambulances↗
PubMedDate not supplied

Diagnosis and treatment of personality factors in chronic low back pain.

The differentiation between primary versus secondary gains is useful for an understanding of the management of chronic low back pain. Primary gain is defined as the direct reduction of pain and emotional distress. Secondary gain is defined as the reduction of anticipatory pain-fear through the avoidance of the occasions of rearousal of pain. This differentiation helps to clarify the diagnosis as well as the treatment of back pain. A person's fear of pain is considered to be the central psychological factor that interferes with successful treatment of chronic low back pain. Research provides insight into how the person both internally and externally protects against pain-fear. The Hysterical Conversion Scale on the MMPI is interpreted to be a measurement of the current level of pain-fear rather than a statement about the physical versus psychological nature of the pain. The reduction of pain-fear is shown to explain the behavior of hysterical conversion patients. Treatment suggestions are made that focus on reducing the patient's fear of pain. These include: considerations for when to operate; a recommendation to give the patient accurate expectations about the pain he/she will experience during treatment; and a specialized pain counselor in hospitals and clinics in order to help manage the level of pain-fear among low back patients.

Back Pain↗
PubMedDate not supplied

Puppets for Prevention: "playing safe is playing smart".

Successful use of puppetry for education of children is well documented in literature. However, in this age of mechanically animated toys and sophisticated children, we have matched realism with an element of high technology for optimal learning experience. This 15-minute video is the basis for a burn prevention and education program entitled "Puppets for Prevention." The video is a creative and lively discussion between two puppets. The dialogue is delivered in a manner that is not threatening. It covers the child's hospitalization, types of burns and how they heal, feelings on scarring and returning to school as well as the conventional preventive measures. The realism in the video comes from the puppets, which have been specially constructed to teach children about burns, skin grafts, donor sites, and rehabilitative garments. High technology comes from the use of the puppets' pretaped accounts incorporated with the actual puppet show creating a completely integrated presentation. Initial response has been overwhelmingly positive. Our survey of one control group one week after viewing the puppet show demonstrated that all found it favorable. Forty percent remembered basic first aid and 65% mentioned significant points of the presentation. We plan to continue ongoing evaluations with the estimated 1,500 children who will view our program this school year.

Burns↗
PubMedDate not supplied

An education program for nurses from referring hospitals in a perinatal regionalization system.

Administering high-quality perinatal care at a regional center involves more than providing in-center service. An outreach education program was developed for nurses in referring hospitals. The authors believe that through the carefully phased development of an outreach education program, quality perinatal care on all levels can be realized.

Education, Nursing, Continuing↗