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Biomedical subjects

C H Davis

Publications and source records attributed to C H Davis.

102 records · Page 6Linked to original sources
PubMedDate not supplied

Profiles of functional recovery in fifty traumatically brain-injured patients after acute rehabilitation.

Research to demonstrate the efficacy of head injury rehabilitation is important at a time when cost-containment efforts are intensifying. A useful tool that would predict the functional improvement during hospitalization and length of stay (LOS) of persons with traumatic brain injury would be of benefit to patients and their families, insurance carriers, and rehabilitation specialists. This study examines functional improvements made by 50 traumatic brain-injured patients admitted to the rehabilitation unit at the University of California, Davis, Medical Center (UCDMC) as measured by the UCDMC Davis Functional Status Measure (DFSM), which was adapted from the Functional Independence Measure (FIM). The DFSM incorporates additional items to provide a more thorough measure of skills to be rehabilitated. The purpose of this study was to compare scores and profiles on the DFSM items obtained by patients with LOS greater than and less than and equal to the median rehabilitation LOS (23 days). Relationships were explored among admission DFSM scores, LOS for rehabilitation, discharge destination, and functional outcome. Results indicate that patients admitted to the rehabilitation unit attained a similar profile or level of function by discharge, regardless of admission Glasgow Coma Scale scores or admission DFSM scores. There were no significant differences in admission Glasgow Coma Scale score, age, acute LOS, or discharge disposition between the LOS groups. There was a significant difference in median admission DFSM score in 26 of 31 categories between the LOS groups. There was a significant difference in median DFSM change (admission to discharge) in 24 of 31 categories between the LOS groups. The admission DFSM total score was inversely proportional to the length of stay, with a correlation coefficient of 0.78. DFSM change and admission to discharge was linearly correlated with LOS (R = 0.66). The DFSM documents functional outcome and measures gains during inpatient rehabilitation. The DFSM profile is helpful in predicting the LOS needed to achieve those gains.

Activities of Daily Living↗
PubMedDate not supplied

Clinical magnetic susceptibility mapping of the brain.

A field mapping technique was used to detect changes in the local magnetic field in 14 tumors, five hematomas, one lacunar infarct, and two cases of multiple sclerosis. These changes were attributed to variations in the tissue susceptibility. A partial or complete rim of changed susceptibility was detected at the margin of five of the tumors and localized changes were seen within two of the tumors. All five hematomas displayed susceptibility effects. These were seen at the rim of the hematoma in all cases but central effects were also seen in four cases. One area of probable lacunar infarction also displayed susceptibility effects. The effects described may be due to the paramagnetic contribution of species such as deoxyhemoglobin, methemoglobin, free ferric iron, hemosiderin, and other breakdown products of blood. Local field inhomogeneities due to changes in tissue susceptibility have implications for magnetic resonance (MR) image interpretation and the performance of MR spectroscopy.

Brain Diseases↗
PubMedDate not supplied

Clinical use of rapid T2 weighted partial saturation sequences in MR imaging.

Rapid T2 dependent field echo [partial saturation (PS)] sequences were used in 38 patients with brain tumors, intracerebral hematomas, and cerebral infarction as well as other neurological and abdominal disease. Reduction in the radiofrequency excitation angle (alpha) from 90 to 30 degrees produced an increase in lesion contrast as did change of echo time (TE) from 33 to 59 or 120 ms using repetition time (TR) values in the range of 120-500 ms. The PS sequence showing most lesion contrast was compared with conventional spin echo (SE 1,500/80 and SE 1,500/120) and inversion recovery (IR 1,500/500/44 and IR 1,500/100/44) sequences. Although PS sequences with TE = 39 ms were usually inferior to conventional SE sequences, those with TE = 59 or 120 ms were comparable and in some cases (particularly hematomas) superior. The PS sequences with alpha of approximately 30 degrees, TR of 80-250 ms, and TE of 60-120 ms offer considerable savings in time compared with conventional sequences although more work will be required to explore the limits of this approach and to optimize sequences at different field strengths.

Brain Diseases↗
PubMedDate not supplied

In vitro activity of nonoxynol-9 on McCoy cells infected with Chlamydia trachomatis.

Nonoxynol-9, a nonionic detergent and active ingredient in spermicidal contraceptives, has been reported to have anti-chlamydial properties. However, in this study exposure of elementary bodies of Chlamydia trachomatis serovar E to nonoxynol-9 (12.5-10,000 micrograms/ml) had no effect on chlamydial infectivity. In contrast, uninfected McCoy cells incubated with increasing concentrations of nonoxynol-9 over 72 h displayed dose-related cytotoxicity. When infected McCoy cells were exposed to nonoxynol-9, the developing chlamydial inclusions did not stain with iodine even though they were similar in number and appearance to the inclusions in unexposed, infected monolayers. Transmission electron microscopy of nonoxynol-treated, infected cells revealed apparent damage to the inclusion membrane and reticulate bodies within. The infectivity of the chlamydiae in the iodine-negative inclusions on subpassage was only 0.3%. We conclude that the primary action of nonoxynol-9 is on the McCoy cell and that there may be secondary effects on the intracellular parasite.

Cells, Cultured↗
PubMedDate not supplied

The report to Congress on the appropriate federal role in assuring access by medical students, residents, and practicing physicians to adequate training in nutrition.

The Congress has had a long-time concern about the adequacy of nutrition education provided medical students and physicians during their training. Attempts over three decades to address this deficiency have been largely ineffective. Yet, recent changes in the delivery of health care from inpatient to outpatient services require physicians be competent in both applied nutrition and patient counseling. The importance of patient counseling is underscored by the surveys of the National Center for Health Statistics which reveal that overweight for the U.S. population has increased between the early 60s and the late 80s. These findings suggest that the Healthy People 2000 objective of reducing the prevalence of overweight may not be met. Congress evidenced its concern about the nutrition education in the medical curriculum in Section 302 of the National Nutrition Monitoring and Related Research Act of 1990 that required a report on the subject from the Secretary of Health and Human Services. The Division of Medicine in the Health Resources and Services Administration, an agency of the Public Health Service, responded by compiling the report. The report to Congress focuses on two issues--why it has been so difficult to increase the nutrition content of medical school curriculums and, if the Federal Government intervenes, what strategies might be effective.

Clinical Competence↗