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Biomedical subjects

C Goldsmith

Publications and source records attributed to C Goldsmith.

At least 55 records · Page 3Linked to original sources
PubMed1991

The accuracy of clinical findings and laparoscopy in pelvic inflammatory disease.

The accuracy of clinical diagnosis for pelvic inflammatory disease was determined in 95 women who presented with pelvic pain to primary care physicians and then were referred to gynecologists. Laparoscopy or laparotomy with endometrial biopsy and fimbrial minibiopsy revealed that prevalence of pelvic inflammatory was 46% (44/95) and positive and negative predictive values of gynecologists were 74% (23/31) and 67% (43/64) (p = 0.0002). If histopathologic diagnosis was the standard, clinical accuracies of the gynecologists were no better than chance (p = 0.43), suggesting an expectation bias for visual diagnosis. Laparoscopy had a sensitivity of 50% (12/24) and a specificity of 80% (40/50) for salpingitis if the standard was fimbrial histopathologic diagnosis (p = 0.01). These results support the routine use of laparoscopy, supplemented when negative by endometrial and fimbrial minibiopsy, to accurately diagnose pelvic inflammatory disease.

Cervix Uteri↗
PubMed1991

Measuring quality of movement in cerebral palsy: a review of instruments.

There is a lack of appropriate evaluation instruments in the area of quality of movement in cerebral palsy. Ten measures of quality of movement, or gross motor performance, published between 1965 and 1990, were reviewed according to established criteria. These criteria include the purpose of the measure, validity, reliability, responsiveness, range of items, and description of qualitative components. These measures provide a foundation for further instrument development in the area of quality of movement. [Boyce WF, Gowland C, Rosenbaum PL, et al. Measuring quality of movement in cerebral palsy: a review of instruments.

Cerebral Palsy↗
PubMed1991

Development of a quality-of-movement measure for children with cerebral palsy.

Development of a suitable measure of quality of movement, or gross motor performance, for children with cerebral palsy is a complex undertaking. A variety of conceptual, methodological, and practical issues inherent in such a project are discussed in this article. We report on the methodology used in the planning and construction of the Gross Motor Performance Measure. The measure has been developed by a multicenter, interdisciplinary group of therapists, methodologists, research staff, and international experts. Five attributes of gross motor performance have been defined, scaled, and operationalized. Results of content validity studies demonstrate that the measure has adequate completeness, clarity, and potential for evaluating change in quality of movement in children who have cerebral palsy. The measure is currently undergoing extensive testing to determine the reliability, validity, and responsiveness of the obtained scores. [Boyce WF, Gowland C, Hardy S, et al. Development of a quality-of-movement measure for children with cerebral palsy.

Cerebral Palsy↗
PubMed1991

Outbreak of human calicivirus gastroenteritis in a day-care center in Sydney, Australia.

Between January and March 1988, an outbreak of gastroenteritis occurred among children and staff at a day-care center in Sydney, New South Wales, Australia. Over an 11-week period, 53 persons had 101 episodes of gastroenteritis; some patients had 5 separate episodes. The principal etiologic agent in the outbreak, human calicivirus (HCV), was detected by electron microscopy in 32% of fecal specimens from children and staff members with symptoms but in only 8% of asymptomatic individuals (P less than 0.01). HCV was confirmed by both an enzyme immunoassay and solid-phase immune electron microscopy. HCV infection was a particular problem in infants, who had the highest age-specific attack rates, had the greatest symptomatic/asymptomatic infection ratio, and were most likely to have a second symptomatic episode. The mode of transmission of this virus was not identified, and extensive efforts to control the 11-week outbreak had little effect. Prolonged excretion of HCV by some symptomatic patients and high rates of asymptomatic infection may have contributed to the extended duration of the outbreak. HCV may be a common cause of gastroenteritis in children that is under-recognized because of insensitive methods of detection.

Australia↗
PubMed1990

Methotrexate in rheumatoid arthritis. Impact on quality of life assessed by traditional standard-item and individualized patient preference health status questionnaires.

In a double-blind, randomized trial of methotrexate vs placebo in rheumatoid arthritis, the effect of treatment on physical, social, and emotional function was measured in two different ways: the same, standard measurements in all patients, and individualized measurements selected by the patients at the start of the trial as representing the functions they most wanted to have improved by treatment. On the standard measurements, methotrexate-treated patients fared better than placebo-treated patients in their physical, social, and emotional function by 11%, 5%, and 6%, respectively, results that, although statistically significant, were small. However, methotrexate-treated patients were 29% better in the individualized measures, a result that was both highly statistically significant and greater than the differences in the standard measurements or in joint counts, grip strength, proximal interphalangeal joint circumference, morning stiffness, or walking time. Because the individualized measurements were as efficient as the best direct joint examination measures, yet reflected functional outcomes of greatest importance to individual patients, they constitute useful measures for such trials.

Adult↗
PubMed1990

An evaluation of four different measures of abdominal muscle strength: patient, order and instrument variation.

We compared 4 measures of abdominal muscle strength in 24 male subjects aged 20-52 years, 12 without low back pain (LBP) and 12 with LBP. The manometer to knee and manometer to sternum methods involved 2 positions of testing abdominal muscle strength using the adapter sphygmomanometer, a 3rd method was a scheme of graduated sit-ups, and the 4th had the sphygmomanometer bladder replaced by a disposable plastic tube and the subject blowing into the manometer. Order of methods was controlled with knee 4 x 4 latin squares. Analysis of variance showed that order of measurement was not significant [F (3,60) = 0.24, P2 = 0.725], but methods were different [F (3,60) = 86.80, P2 less than 0.01], and subjects without LBP had higher abdominal muscle strength than subjects with LBP [F (1.60) = 89.29, P2 less than 0.001]. The manometer to knee and manometer to sternum methods were equally sensitive and more sensitive than the graduated sit-up and blow into manometer methods. The manometer to sternum method was best as it was not painful and exercised the abdominals well.

Abdominal Muscles↗
PubMed1990

The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis--a randomized controlled trial.

Fifty-three patients with ankylosing spondylitis (AS) were randomly allocated; 26 experimental patients received physiotherapy and disease education, 27 control patients received neither. The primary treatment outcome was change in spinal mobility measured at 4 months by fingertip-to-floor distance. Experimental patients had more improvement in fingertip-to-floor distance (p2 less than 0.004) and in function (p2 less than 0.001) than control patients. Physiotherapy with disease education is effective in the treatment of patients with AS.

Adolescent↗
PubMed1988

Lung cancer cell type and mining exposure.

It is frequently stated that the most common primary lung cancer cell type in asbestos-exposed persons is adenocarcinoma. Recently a contrary opinion has been expressed. This study compares the cell types recorded among deceased South African miners whose lungs were examined at the National Centre for Occupational Health. It supports the opinion that adenocarcinoma is not associated with asbestos exposure. From the large database available, there is no evidence of a consistent association between any particular cell type and specific mining exposure.

Adenocarcinoma↗
PubMed1988

Ultrastructure of human immunodeficiency virus type 2.

The ultrastructure of human immunodeficiency virus type 2 (HIV-2) was determined by negative stain and thin section electron microscopy (EM). Some virus particles had surface projections about 10 nm in length which were evenly spaced. Nonidet P40-treated particles which were penetrated by stain revealed a distinctive off-centre cone-shaped core and, in addition, free-lying cores were also seen in detergent-treated preparations. The surface of the cores was composed of a layer of small subunits. The structure of HIV-2 determined by thin section EM was the same as that deduced by negative stain EM.

Acquired Immunodeficiency Syndrome↗
PubMed1988

PaperChase: computerized bibliographical retrieval for the physician.

PaperChase is a computer program that permits any physician or scientist to search the National Library of Medicine's MEDLINE data base of references to the biomedical literature. Written for the clinician rather than for the search librarian, PaperChase permits the user to search the entire MEDLINE collection of over 5,000,000 references published in 4,000 biomedical journals dating back to 1966. PaperChase is now available throughout the world to anyone who has a computer terminal or personal computer, and a modem. No special training is needed for a successful search. There is no user's manual. Users can search by title word, Medical Subject Heading, author's name, journal title, year of publication, language of publication, or any combination of the above. Users can read abstracts online, and they can request that a photocopy of the full text of any article be mailed to them.

Abstracting and Indexing↗
PubMed1988

Billing patterns of general practitioners and family physicians in Ontario: a comparison of graduates of McMaster Medical School with graduates of other Ontario medical schools.

This descriptive study which uses data obtained from the Ontario Health Insurance Plan has identified a number of differences in the style of practice chosen by general practice/family medicine (gp/fm) physicians who graduated from McMaster medical school from that of other contemporary Ontario gp/fm graduates who are practicing in Ontario. McMaster gp/fms were more likely to be certified in Family Medicine, saw fewer patients per month than the comparison group, and billed less services but the cost per service billed was somewhat higher.

Curriculum↗
PubMed1988

An experiment in reducing interobserver variability of the examination for joint tenderness.

This experiment was designed to test the feasibility of reducing interobserver variability of the joint examination by agreement on a standard examination. Six rheumatologists independently examined 6 patients with rheumatoid arthritis (RA) in predetermined order, before and after a standardization of examination techniques. Results of an analysis of variance showed a reduction of the percent of variability due to observers from 13.8%, before standardization, to 3.2% after standardization, and an improvement in the percent variability related to patient differences from 70.7%, before standardization, to 86.3% after standardization. Such a reduction in observer variability has a potential for allowing a reduction in sample sizes required for RA clinical trials.

Analysis of Variance↗
PubMed1987

Respiratory questionnaires in occupational studies: their use in multilingual workforces on the Witwatersrand.

The mother tongue of the majority of black workers in the industrial workforces of the Witwatersrand is either Zulu or S Sotho/Tswana, and these are also the main languages spoken in the area. However a substantial minority cite one of several other languages as their mother tongue. In consequence, in occupational surveys using a respiratory questionnaire, the accepted practice has been to use multilingual interviewers who administer the questionnaire in whichever of the two main languages the interviewee requests, but work from an English language version. To test the reproducibility of the information so gathered, a standardized questionnaire was administered to 56 subjects on two occasions approximately three weeks apart by each of two interviewers, one of whose mother tongue was Zulu and the other S Sotho. Reproducibility was little affected by whether the interviewer used her mother tongue or not, pointing to the multilingual competence of both interviewers. Reproducibility was, however, less in subjects not interviewed in their mother tongue compared to those who were. In general, reproducibility was also less for symptom than for history questions, though the phlegm question performed comparably to that reported for more homogeneous language/ethnic groups. Thus, even if internally valid, respiratory symptom information obtained by this method may have limited generalizability. However respiratory history information appears more reliable and may prove of value in the investigation of the natural history of chronic lung disease in this and similar communities.

Adult↗
PubMed1986

Construction of social value or utility-based health indices: the usefulness of factorial experimental design plans.

Global indices, which aggregate multiple health or function attributes into a single summary indicator, are useful measures in health research. Two key issues must be addressed in the initial stages of index construction from the universe of possible health and function attributes, which ones should be included in a new index? and how simple can the statistical model be to combine attributes into a single numeric index value? Factorial experimental designs were used in the initial stages of developing a function index for evaluating a program for the care of young handicapped children. Beginning with eight attributes judged important to the goals of the program by clinicians, social preference values for different function states were obtained from 32 parents of handicapped children and 32 members of the community. Using category rating methods each rater scored 16 written multi-attribute case descriptions which contained information about a child's status for all eight attributes. Either a good or poor level of each function attribute and age 3 or 5 years were described in each case. Thus, 2(8) = 256 different cases were rated. Two factorial design plans were selected and used to allocate case descriptions to raters. Analysis of variance determined that seven of the eight clinician selected attributes were required in a social value based index for handicapped children. Most importantly, the subsequent steps of index construction could be greatly simplified by the finding that a simple additive statistical model without complex attribute interaction terms was adequate for the index. We conclude that factorial experimental designs are an efficient, feasible and powerful tool for the initial stages of constructing a multi-attribute health index.

Activities of Daily Living↗