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Biomedical subjects

C Rogers

Publications and source records attributed to C Rogers.

At least 109 records · Page 6Linked to original sources
PubMed1996

Early versus late prenatal care in New Mexico: barriers and motivators.

BACKGROUND: Adequate prenatal care is important for ensuring a good outcome for pregnant women and their children, and its initiation in the first trimester is a major component. We investigated barriers and motivators for women receiving early versus late prenatal care. METHODS: A self-administered questionnaire was distributed to 205 women who began prenatal care at the University of New Mexico Hospital Obstetrics Clinic in Albuquerque, New Mexico. The questionnaire assessed demographic information, insurance status, feelings about the pregnancy, health behaviors, and barriers and motivators to initiating prenatal care. The participants were Hispanic (41%) and non-Hispanic white (46%), low-income women with Medicaid (42%) or no health insurance (41%). They were divided into early (1st trimester 67%) and late (after 1st trimester 33%) care groups. RESULTS: Ethnicity, education, income, and age did not predict initiation of prenatal care. Late initiators cited financial problems (26%), not being aware of the pregnancy (15%), and dislike of going to doctors (14%) as reasons for the delay in seeking prenatal care. Over two-thirds of the pregnancies were unplanned, but 82 percent of the women felt positive about the pregnancy. CONCLUSIONS: Our study documents the continuing need for public health efforts to encourage women to seek early prenatal care. Specific attention should be directed toward women's perceived reasons for not initiating early care.

Adolescent↗
PubMed1996

Monocyte recruitment and neointimal hyperplasia in rabbits. Coupled inhibitory effects of heparin.

Among the many effects of heparin independent of its effects on coagulation are inhibition of vascular smooth muscle cell proliferation and regulation of leukocyte-blood vessel interactions. The potential link between these effects was examined in an animal model of vascular injury rich in inflammatory cells: the placement of endovascular metal stents in rabbit iliac arteries. Monocyte adhesion stimulated by early focal thrombus was maximal after 3 days, with infiltrating monocytes and intimal cell proliferation maximal after 7 days. Tissue monocyte number dictated cell proliferation at each time point (R2 = .92, P < .0001). Heparin reduced both early monocyte adhesion as well as monocyte infiltration within the neointima 7 and 14 days after stent placement. Reductions in adherent and tissue monocytes were commensurate with reductions in intimal cell proliferation and intimal thickening. At 14 days, heparin's inhibition of mononuclear cell adhesion was correlated with its suppression of intimal thickening (R2 = .82, P < .0001). Monocytes have been hypothesized to serve as markers, initiators, and promoters of arterial occlusive diseases. Heparin's ability to inhibit mononuclear cell adhesion and penetration and reduce neointimal size and cell proliferation after vascular injury may further implicate monocytes in the pathogenesis of neointimal hyperplasia after mechanical arterial injury.

Animals↗
PubMed1996

The use of conditioning to probe for CNS pathways that regulate fever and NK cell activity.

Immune and central nervous system (CNS) interactions are complicated because afferent signals from the immune system to the CNS in response to antigens or infections may elicit an immediate efferent response to the immune system. This communication loop is required for the homeostatic regulation of the immune system. Conditioning can be used as a tool to take the communication loop apart. In conditioned animals, the conditioned stimulus can be employed later to trigger the site of the association memory located within CNS, and set off the efferent pathway. Conditioning therefore allows one to isolate and identify the potential circuits in the brain that becomes conditioned. We have conditioned a pathway in the brain which can be used to modulate core body temperature (Tc) and natural killer (NK) cell activity. The Tc and NK cell activity are used as readouts to detect the expression of the conditioned response which is taking place in the brain. Since various cytokines (IFN, IL-1 etc) that are produced by antigenic stimulation invariably raise fever, it appears that the immune system could signal the CNS with nonspecific cytokines that activate the hypothalamic-pituitary pathway to modulate core body temperature. These observations infer that the thermoregulatory pathway in the brain becomes conditioned and points to a common pathway of communication in which interferon-beta, prostaglandin E2, CRH and ACTH appear to play a role in modulating both Tc and NK cell activity.

Animals↗
PubMed1996

Alcoholism and African-American women: a medical sociocultural perspective.

Today's research explaining women's usage of alcohol is inaccurate. Researchers have failed to include the powerful variable of race. African-American females are increasing their use of alcohol, yet the literature fails to tell why. To understand alcoholism among African-American women, it is necessary to conceive their culture, values, and role in society. This article highlights the biopsychosocial issues impacting female African Americans, and the need for unbiased research and treatment. Women who have the dual status of addiction and are members of a racial minority face a special range of stressors. Therefore, clinicians who serve them must possess more than generalized clinical skills.

Black or African American↗
PubMed1995

Endovascular stent design dictates experimental restenosis and thrombosis.

BACKGROUND: Vascular interventions that maximize initial lumen diameter provoke extensive neointimal hyperplasia but minimize its effects, causing long-term lumen size to be greater. Nevertheless, interventions such as endovascular stents, which increase lumen size above that achieved with balloon angioplasty, are subject to frequent thrombosis and restenosis. It has been unclear whether the response to stent-induced injury is determined solely by the degree of stent-induced arterial expansion or whether the geometric configuration of the stent or the material left in contact with the vessel wall also contribute. METHODS AND RESULTS: We examined the vascular response to steel stents deployed in denuded rabbit iliac arteries for 14 days. In one set of experiments, the effects of sten configuration were examined, holding diameter, mass, surface area, and stent surface material constant. In another set, stent surface material was changed, with mass, configuration, and diameter unaltered. Changing stent configuration to reduce strut-strut intersections by 29% without affecting mass or surface area reduced vascular injury by 42%, thrombosis by 69%, and neointimal hyperplasia by 38%. Monocyte adhesion to stented arteries correlated linearly with vascular trauma and neointimal hyperplasia (r = .96, P < .01 for each). When the stainless steel surface was coated with an inert polymer material, vascular injury and neointimal hyperplasia were unchanged but thrombosis was eliminated. CONCLUSIONS: Surface material and geometric configuration of stents may be more important than postplacement diameter in determining neointimal hyperplasia and thrombosis. Alterations in configuration affect vascular injury and neointimal hyperplasia, while surface material plays a greater role in thrombosis. Monocytes may be important modulators of stent-induced intimal thickening. Clinical confirmation of these findings may alter coronary stent deployment techniques and future stent designs.

Animals↗
PubMed1995

Histogranin, a modified histone H4 fragment endowed with N-methyl-D-aspartate antagonist and immunostimulatory activities.

Histogranin is a naturally-occurring pentadecapeptide with a structure 80% homologous with that a fragment-(86-100) of histone H4. First isolated from bovine adrenal medulla, the peptide was also shown to be present in the pituitary, brain, adrenal glands, blood plasma, lungs and spleen. At the subcellular level, histogranin is concentrated in secretory vesicles and it is released from perfused bovine adrenal glands 15-35 min after stimulation with carbamylcholine as opposed to catecholamines and [Leu5]enkephalin which are released immediately after stimulation. Rat brain membranes possess specific binding sites for [125I][Ser1]histogranin with characteristics of a receptor, namely high affinity, saturability, reversibility and sensitivity to heat and proteolytic enzyme treatments. Intracerebroventricular injections of synthetic histogranin (10-100 nmol) in mice protect them against N-methyl-D-aspartate (NMDA)-induced convulsions without affecting convulsions induced by (R,S)-alpha-amino-3-hydroxy -5-methyl-4-isoxazole-propionate (AMPA), kainate and bicuculline. The peptide also binds to specific sites on human peripheral blood mononuclear cells and it evokes the release of tumor necrosis factor-alpha (TNF), interleukin-1 (IL-1) and interleukin-6 (IL-6) from isolated rat macrophages in culture. Since the structure of histone H4 is considered as one of the most conservative, it is presumed that histogranin possesses its own precursor and that its gene is distinctly expressed.

Adjuvants, Immunologic↗
PubMed1995

Sudden death in individuals in hobble restraints during paramedic transport.

For patient and personnel safety, agitated and violent individuals are sometime physically restrained during out-of-hospital ambulance transport. We report two cases of unexpected death in restrained, agitated individuals while they were being trans-ported by advanced life support ambulance. Both patients had been placed in hobble restraints by law enforcement. At autopsy, toxicologic analysis revealed nonlethal levels of amphetamines in one patient and nonlethal levels of ethanol, cocaine, and amphetamines in the other. In both cases the cause of death was determined to be positional asphyxiation during restraint for excited delirium. Physicians and emergency service personnel should be aware of the potential complications of using physical restraints for control of agitated patients.

Adult↗
PubMed1995

Speech discrimination in patients with Bell's palsy and a paralysed stapedius muscle.

The contraction of the stapedius muscle results in a frequency dependant attenuation of sound through the middle ear. Idiopathic facial nerve paralysis (Bell's palsy) usually results in a paralysis of the stapedius muscle. This prospective study included 119 patients presenting with Bell's palsy over an 18-month period. After applying exclusion criteria, 80 patients with normal pure-tone audiograms underwent speech audiometry. This was performed on presentation and after recovery of the facial nerve palsy. Fifty-six patients (70%) with an absent stapedius reflex showed marked 'roll-over' from means of 98-49% on their speech audiogram. This resolved completely with recovery of the facial nerve palsy and return of the stapedial reflex. To determine whether this effect was due primarily to the paralysis of the stapedius muscle or to an associated polyneuropathy, a second study on six normal patients was done. These patients had both ears (12 in total) tested with speech filtered to simulate a paralysed stapedius muscle. This resulted in a mean 'roll-over' from 90.9 to 59.9%. The magnitude of this roll-over (31%) was only two-thirds of that seen in Bell's palsy patients (49%) with the difference between these means statistically significant (P < 0.05). This suggests that Bell's palsy, usually considered a mononeuropathy, involves certain of the auditory fibres of the eighth nerve and is a polyneuropathy. Stapedius function is important in speech discrimination at higher levels of sound intensity such as speech in noise and severing the stapedius tendon in stapes surgery may affect speech discrimination after successful surgery.

Adult↗
PubMed1995

Motivational styles in English and mathematics among children identified as having special educational needs.

This study is concerned with the identification, development and prevalence of three different motivational styles: learned helplessness, self-worth motivation and mastery orientation in two National Curriculum core subjects: English and mathematics. These three motivational styles are concerned with the ways in which children respond in the face of difficult and challenging educational tasks. Using Craske's (1988) procedures, a total of 437 children in their first year of secondary school (aged 11-12) were categorised into one of the three motivational styles. Children with special educational needs were identified using a battery of cognitive ability tests (Thorndike, Hagen & France, 1986). This study compares the prevalence of each motivational style in English and mathematics in children of different abilities and presents empirical support for the view that learned helplessness and self-worth motivation are more prevalent among children identified as having special educational needs. Further analyses indicate that: overall, learned helplessness and self-worth motivation are more prevalent in English than mathematics; learned helplessness is more prevalent among girls and self-worth motivation among boys in mathematics. Implications for teachers in developing teaching strategies which foster mastery orientation in their children are discussed.

Adolescent↗
PubMed1995

Excimer retreatment for scarring and regression after photorefractive keratectomy for myopia.

AIMS/BACKGROUND: Scarring associated with regression of refractive effect can occur after photorefractive keratectomy (PRK) for myopia. The experience of treating these complications is reported. METHODS: Eighteen of 285 eyes (6.3%) were retreated with the excimer laser. Age, sex, preoperative primary treatment keratometry, pre-primary treatment, pre-retreatment and post-retreatment spherical equivalents, best corrected and uncorrected visual acuities were recorded and analysed. RESULTS: At 6 months post-retreatment, the mean spherical equivalent was -2.07 dioptres (D) (SD 4.60 D). This spherical equivalent persisted in eyes followed for 12 months (-2.85D, SD 4.09 D). Nine of 18 eyes (50%) had uncorrected visual acuity of 6/12 (20/40) or better. If retreatment was undertaken within 6.5 months of the initial PRK, then scarring was likely to recur (p = 0.035). Nine of 10 eyes (90%) which had a retreatment spherical equivalent less than two thirds of their primary treatment spherical equivalent were within plus or minus 1.25D from emmetropia after retreatment. Four of 11 eyes (36%) followed for 12 months after retreatment rescarred with further regression. CONCLUSION: The data showed that eyes with scarring and regression of myopia should not be treated with PRK within 6 months of the initial procedure. Eyes with the highest percentage of regression towards their initial myopia tend to have a poor response to retreatment.

Adult↗
PubMed1995

Dexamethasone therapy is associated with a rise in urinary epidermal growth factor concentrations in the preterm infant.

The effect of glucocorticoid hormones on epidermal growth factor (EGF) concentrations has not been described in the premature infant. We examined this relationship in a group of infants treated with dexamethasone for airway edema (three to five doses) or chronic lung disease (six weeks of a tapering protocol). We collected urinary samples in 45 infants (25 for airway edema, 20 for chronic lung disease) before, during and after the use of dexamethasone. The EGF values were unchanged in infants that were given dexamethasone for airway edema. In contrast, all infants treated for chronic lung disease increased their EGF values by 1 week of therapy. At the end of the dexamethasone taper, ten of the infants had recovered successfully from ventilatory support. This group of infants had post-therapy EGF values that were significantly higher than pretherapy values. In the ten infants that were still ventilator dependent at the end of therapy, EGF values were not different from pretherapy values. We conclude that dexamethasone therapy was associated with an increase in urinary EGF values in the preterm infant treated for at least 1 week. The positive correlation of tapering from ventilatory support with increases in EGF values suggests that EGF may be a marker of dexamethasone effect or an effector of dexamethasone action.

Adrenocorticotropic Hormone↗
PubMed1994

A coin in the airway.

A 69-year-old Chinese woman with widely metastatic endometrial carcinoma was found at autopsy to have a quarter in her air passages. Inquiry showed that her family had placed the coin in her mouth at the time of death according to traditional Chinese funeral practices. This practice is apparently not widely known among forensic pathologists.

Aged↗
PubMed1994

Refractive keratoplasty for post-graft astigmatism.

Refractive keratoplasty using modified relaxing incisions with compression sutures was performed on 33 patients with high post-keratoplasty astigmatism. The mean reduction in keratometric astigmatism was 8.38 dioptres from a preoperative mean of 12.21 dioptres (SD, 3.59) to 3.93 dioptres (SD, 2.13). All patients noted a marked functional improvement. Two patients required reoperation. One patient required resuturing. Our modification of undercutting the relaxing incisions greatly increases the range of astigmatism that can be treated with this technique.

Astigmatism↗
PubMed1994

Sodium carbonate prevents NK cell conditioning by interfering with the US signal.

The conditioned enhancement of natural killer (NK) cell activity can be blocked by the injection of sodium carbonate solution prior to the association of the camphor odor conditioned stimulus (CS) with the polyinosinic:polycytidylic acid (poly I:C) unconditioned stimulus (US). We have experimentally dissociated the memory which is formed for camphor odor from that developed for the association of camphor with the US. The memory for the odor of camphor can be allowed to develop one day before the administration of the unconditioned stimulus. Sodium carbonate appears to act within the central nervous system to block the association of the unconditioned stimulus with the conditioned stimulus. The data also suggest that in conditioning of NK cell activity, there are two specific sites for memory of the response, one for the conditioned stimulus and the other for the association of the unconditioned stimulus with the conditioned stimulus.

Animals↗
PubMed1994

Nonphysician providers and limited-license practitioners: scope-of-practice issues.

The medical community recognizes that nonphysician providers are attempting to position themselves to assume larger, more independent roles in the new health care system. The American Medical Association (AMA) addressed this issue at its 1993 annual meeting of the house of delegates with the adoption of a resolution to study the role of mid-level practitioners. A report responding to the resolution was presented at the AMA's 1993 interim meeting of the house of delegates. The focus of the report was solely on the scope of practice of nurses; PAs were not included because they work under the supervision of physicians by law, and the American Academy of Physician Assistants has declared that it has no intention of seeking independent practice from physicians. The report reviews the qualifications and roles of a variety of APNs, and determines that "care by physicians does not equate to care delivered by nurses, allied health professionals, or nontraditional caregivers." It also states that substitution of physician care by nonphysicians raises questions of patient safety, competence of therapeutic decision, and fragmentation of care. The AMA report concludes that "physician care is based on cognitive and technical skills that are shaped by a unique education and experiences to form a foundation of clinical knowledge that allows physicians to decide what needs to be done across the wide variety of human maladies; that is irreplaceable by anyone with lesser training."

Allied Health Personnel↗
PubMed1993

Excimer laser photorefractive keratectomy: 12 months' follow-up.

OBJECTIVE: To report the results of 12 months' follow-up of patients with myopia treated with excimer laser photorefractive keratectomy. DESIGN: A prospective study of patients undergoing excimer laser photorefractive keratectomy for myopia was commenced in September 1991. The study included 50 eyes (38 patients) with preoperative myopia of -1.50 to -6.00 dioptres and a maximum astigmatism of 0.75 dioptres. RESULTS: Forty-six (92%) of the 50 eyes had an uncorrected acuity of 6/6 or better at 12 months, and 49 eyes (98%) had 6/12 or better. No patients had lost their best corrected acuity at 12 months. Forty-five eyes (90%) were within 0.50 dioptres of emmetropia and 47 eyes (94%) were within 1.00 dioptre of emmetropia. CONCLUSIONS: Excimer laser photorefractive keratectomy is a safe and predictable procedure for low to moderate myopia. It will increasingly be offered to patients as an alternative to the use of spectacles and contact lenses.

Adult↗