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Biomedical subjects

D Allen

Publications and source records attributed to D Allen.

At least 235 records · Page 13Linked to original sources
PubMed1987

Does developmental content influence the effectiveness of anticipatory guidance?

We conducted a prospective, controlled study to evaluate the value of discussing developmental stages with mothers while providing anticipatory guidance during health maintenance visits. Eighty-three inner city mothers and their healthy, first-born infants were recruited within three days of birth and randomly assigned to either a control or intervention group. All mother-infant pairs were seen by the same pediatric provider for health maintenance visits when the infants were 2 weeks, 2 months, 4 months, and 6 months of age. At each visit, anticipatory guidance for all mothers included discussions of such age-appropriate issues as nutrition, safety, sleep, and common problematic behaviors. For the 39 intervention group mothers, the basis for such information was explained through age-specific discussions of affective, cognitive, and physical development. Dependent variables measured after the 6-month visit included maternal-infant interaction; maternal perceptions of infant temperament, family adaptation and adjustment, and satisfaction with the infant's behavior and development; and maternal satisfaction with pediatric services. Analyses of variance demonstrated no significant effect of treatment group on any of the outcome measures. These results do not support the importance of routinely discussing developmental stages during anticipatory guidance and suggest that specific, age-appropriate issues may be discussed without emphasizing the developmental basis for such information.

Adult↗
PubMed1986

Surgical management of chronic laminitis in horses: 13 cases (1983-1985).

Thirteen horses with chronic refractory laminitis were evaluated and treated. In each horse, deep digital flexor tenotomy was performed on all affected limbs at the level of the midpastern. Five horses returned to limited athletic endeavors, 6 horses improved and were comfortable on pasture, 1 horse improved clinically, but was euthanatized for economic reasons, and 1 horse improved, but deteriorated 9 months after surgery and was euthanatized. Results of this study indicated that deep digital flexor tenotomy at the level of the midpastern can be used effectively as a salvage procedure in horses with chronic refractory laminitis.

Animals↗
PubMed1986

Factors for prognostic use in equine obstructive small intestinal disease.

Twenty horses with small intestinal obstructions requiring surgery were evaluated prospectively. Ten horses lived (group 1) and 10 died (group 2). Eight of the horses in group 1 had simple obstruction and 7 of the horses in group 2 had strangulation obstruction. There was a significant difference (P less than 0.001) between the mean intraluminal hydrostatic pressure in horses of groups 1 and 2 (6.3 cm H2O and 15 cm H2O, respectively). The mean peritoneal fluid protein concentration in horses of groups 1 and 2 (2.8 mg/dl and 5.4 mg/dl, respectively) also differed significantly between groups (P less than 0.01). Histologic evaluation of the intestinal specimens from horses of group 1 (n = 3) and group 2 (n = 6) revealed more severe mucosal lesions in group 2. The measured values that were not significantly different between the 2 groups included PCV, total serum protein content, WBC count, anion gap, and duration of colic before admission. It was concluded that peritoneal fluid protein concentration and intraluminal hydrostatic pressure in small intestinal obstruction may be used as adjuncts to diagnosis and as prognostic indicators.

Animals↗
PubMed1986

Alterations in lipid and protein profiles of plasma lipoproteins in middle-aged men consequent to an aerobic exercise program.

Thirty-four healthy, untrained middle-aged males (mean = 58.2 years) volunteered for a longitudinal study investigating alterations in lipoprotein profiles consequent to 20 weeks of aerobic training. Twenty randomly selected experimental subjects (E) participated in a walk/run training program 3 d/wk, 48 min/d, at an intensity equal to 65% to 85% of their heart rate reserve, while 14 control subjects (C) remained in an untrained state. Blood samples were obtained in the morning after a 14-hour fast. Plasma lipoproteins were separated by ultracentrifugation and agarose-column chromatography into very low (VLDL), low (LDL), and high (HDL) density lipoprotein fractions. A training effect was evidenced in E by significant increases (P less than 0.001) in absolute VO2 max (15.2%) and relative VO2 max (16.8%). Dietary composition was monitored pretraining and posttraining with no significant change seen in either E or C. Alterations in the lipoprotein profile of E included a significant increase in HDL-cholesterol (16.6%) and significant reductions in VLDL-cholesterol (72.1%), LDL-triglyceride (26.5%), VLDL-protein (33.5%), and LDL-protein (18.7%). Furthermore, no significant changes in the level of HDL-protein and apolipoprotein AI in the HDL fraction were observed in either E or C. These data suggest that aerobic training can significantly increase HDL-cholesterol and alter lipoprotein profiles, which may subsequently reduce the risk of coronary artery disease.

Cholesterol↗
PubMed1986

An analysis of medical care at mass gatherings.

Emergency medical care at public gatherings is haphazard at best and dangerous at worst. The Arizona chapter of the American College of Emergency Physicians, through the Chapter Grant Program, studied the level of medical care provided at public gatherings in order to develop guidelines for emergency medical care at mass gatherings. The study consisted of a survey of medical care at 15 facilities providing events for the public. The results of these surveys showed a wide variation of medical care provided at mass events. Of the 490 medical encounters reviewed, 52.2% were within the realm of care of paramedics, but not basic emergency medical technicians. The most common injuries/illnesses were lacerations, sprains, headaches, and syncope. Problems noted included poor documentation and record keeping of medical encounters, a tendency for prehospital care personnel to make medical evaluations without transport or medical control, and variability of care provided. Based on this survey and a literature review, guidelines for medical care at mass gatherings in Arizona were determined using an objective-oriented approach. It is our position that event organizers have the responsibility of ensuring the availability of emergency medical services for spectators and participants. We recommend that state chapters or National ACEP evaluate the role of emergency medical care at mass gatherings.

Arizona↗
PubMed1986

Electrophysiological assessment of contrast sensitivity in human infants.

Contrast sensitivity functions (CSF's) were measured for a group of 6-month-old infants using the visual evoked potential (VEP). Sine-wave luminance gratings were counterphase modulated at 12 contrast reversals per s and simultaneously swept in contrast. Each contrast sweep lasted 10 s, spanning a range of 0.5 to 40% contrast in 19 equal logarithmic steps. The amplitude and phase of the response at the second harmonic were determined by a discrete Fourier transform. Contrast thresholds were estimated from a linear extrapolation to zero-amplitude of the VEP amplitude vs. log-contrast function. Contrast sensitivity was found to be nearly adult-like at 1 c/deg, but was not yet mature at higher spatial frequencies.

Child Development↗
PubMed1986

Comparative study of electrophysiological and psychophysical measurement of the contrast sensitivity function in humans.

We measured the human contrast sensitivity function (CSF) both electrophysiologically with the steady-state visual evoked potential (VEP) and psychophysically using a method of ascending limits. VEP contrast thresholds were determined using a rapid recording technique in which the contrast of a counterphase modulated sine wave grating was swept logarithmically from 0.5 to 40% over a period of 10 s. For this pattern reversal stimulus the amplitude and phase of the second harmonic response as a function of contrast were measured using a discrete Fourier transform (DFT). Psychophysical thresholds were determined on the same trials used to record the VEP. Near threshold the VEP amplitude vs. contrast function was approximately linear and VEP contrast thresholds were estimated by a linear extrapolation to zero amplitude. The contrast thresholds obtained by the two methods correlated at 0.914 for 5 observers, with a mean discrepancy of only 12%. At higher contrasts, the VEP amplitude vs. contrast function often became nonmonotonic, sometimes showing two amplitude peaks.

Electrophysiology↗
PubMed1986

Growth of severely impaired children: neurological versus nutritional factors.

Nineteen children with cerebral palsy who have had gastrostomies since 1981 and who have been followed for at least six months postoperatively were reviewed to assess the effects of gastrostomy feeding on their growth and to determine whether growth failure was due to neurological or nutritional dysfunction. The children's ages ranged from five to 168 months (mean 60.4 months) and follow-up extended from six to 41 months (mean 23.1 months). All were profoundly handicapped, with involvement of all four limbs. 11 also had seizures and all 19 were severely to profoundly retarded. Heights and weights were recorded during the visit immediately before surgery and at most recent follow-up. Data were recorded as a standard deviation score (Z-score). Before surgery the mean weight/height was -2.71 Z. Postoperatively this improved to -1.18 Z. 16 of the 19 children increased their weight/height ratio. Three children had a weight/height ratio greater than 10th percentile preoperatively. 11 achieved this on follow-up. Seven children were greater than 25th percentile for weight/height. Improvement in weight/height did not correlate with length of follow-up. For severely neurologically impaired children, nutritional factors play a major rôle in growth. By ensuring adequate caloric intake via gastrostomy, a significant number of children achieved adequate growth and better nutritional status.

Adolescent↗
PubMed1986

A prospective study of mammographic parenchymal patterns and risk of breast cancer.

Breast parenchymal patterns have been assessed by the method of Wolfe in a prospective study in Guernsey. Women with P2 or DY grades had approximately four times the risk of developing breast cancer compared with those with N1 or P1 grades. Age, weight, parity and age at birth of first child are all related to the distribution of mammographic patterns. The combination of these variables with Wolfe grades may identify subsets of the population at very high risk.

Adult↗
PubMed1986

Physicians' attitudes toward pain in children.

Physicians' attitudes toward pain in children were assessed in an attempt to explain why adults are administered more analgesics than children while in the hospital. A survey was conducted of all pediatricians, family practitioners, and surgeons in Hartford. Fifty-seven percent of the sample responded (112/195). Seventy-five percent of the sample felt that children experienced adult-like pain by age 2. Thirty-eight percent of the physicians were somewhat or significantly concerned about the risk of addiction when using narcotics in their young patients. Pediatricians were significantly more likely than surgeons or family practitioners to see younger children as having adult-like pain and to prescribe analgesics for children at an earlier age. Many other attitudinal differences were also related to specialty. Other demographic variables (age, sex, mode of practice, and personal experience with pain) had little effect on attitudes. These findings suggest possible explanations for the discrepancy between child and adult analgesic prescribing practices.

Adult↗
PubMed1986

Crystalloids versus colloids: implications in fluid therapy of dogs with intestinal obstruction.

Responses of jejunal transcapillary and transmucosal fluid fluxes to IV infusion of crystalloid or colloid solutions were evaluated in 12 dogs. One isolated intestinal segment in each dog was used as the control segment, and 2 segments were distended to a intraluminal hydrostatic pressure of 10 cm of H2O. The artery supplying 1 of the 2 distended (autoperfused) segments was cannulated and perfused with blood from the femoral artery. One of the 2 distended segments was autoperfused from the femoral artery. Intraluminal pressure was increased in the autoperfused segment and in 1 other segment for three, 20-minute periods after administration of the crystalloid or colloid solution. Net transmucosal fluid flux was estimated, using a volume recovery method. In each autoperfused segment, blood flow, capillary pressure, lymph flow, and plasma protein and lymph protein concentrations were measured during each 20-minute distention period. Systemic arterial pressure was monitored throughout the procedure. Plasma and tissue oncotic pressures were calculated from the plasma protein and lymph protein concentrations. Total vascular resistance and precapillary and postcapillary resistances were determined. Capillary pressure increased after infusion with colloids and crystalloids, with the effects being more prolonged in the colloid group. Plasma oncotic pressure transiently increased after infusion with colloids and decreased after infusion with crystalloids. Lymph flow increased only in crystalloid-treated dogs. Due to alterations in transcapillary fluid filtration, crystalloids induced a net loss of fluid into the intestinal lumen, whereas the fluid absorptive capacity of the jejunum was unaltered by colloid treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Interaction of test protocol and horizontal run training on maximal oxygen uptake.

Twenty-seven untrained college-age males (mean age = 23.1 yr) volunteered for this 12-wk training study, which investigated potential interactions between training specificity and treadmill protocol specificity. The study was designed to analyze the interaction between a subject's maximal oxygen uptake (VO2max) on an inclined protocol (IP) vs a horizontal protocol (HP) before and after training exclusively on flat terrain. Experimental subjects (E, N = 17) trained by running on flat terrain for 12 wk, 4 d/wk, 37 min/d at an intensity equal to 65 to 85% of their heart rate reserve while control subjects (C, N = 10) remained sedentary. All subjects underwent a minimum of four maximal treadmill tests (two with an IP and two with a HP) prior to training and two maximal treadmill tests (one IP and one HP) post-training. Multivariate analysis of variance and post-hoc t-tests using a pooled variance-covariance matrix were used to analyze the data. Alterations in E, consequent to training, included significant increases in VO2max [mean IP = 53.6 to 58.4 (+8.9%) and mean HP = 51.7 to 56.2 ml. kg-1 . min-1 (+8.7%)]. C showed a significant pre- to post-training decrease on the HP for VO2max [mean HP = 52.4 to 50.7 ml . kg-1 . min-1 (-3.2%)], but showed no significant change on the IP. There was no significant pre- to post-training interaction between protocols for VO2max. It was concluded that the post-training results do not support the concept of protocol specificity when evaluating VO2max in subjects trained exclusively on flat terrain.

Adult↗
PubMed1986

Interaction of test protocol and inclined run training on maximal oxygen uptake.

Twenty-two men, 17 to 27 years of age, volunteered to participate in an inclined terrain running program. Men were randomly assigned to a control (N = 10) or an experimental (N = 12) group. The experimental group ran on inclined terrain 4 times/wk for 35 min a session at an intensity of 65 to 85% of maximal aerobic power for 12 wk. The purpose of this study was to analyze the interaction between a subject's VO2max on an inclined protocol (IP) vs a horizontal protocol (HP) before and after training on incline terrain. VO2max, HRmax, VEmax, Rmax, and maximum treadmill time were evaluated on both treadmill protocols (IP and HP). Prior to training, results indicated no difference in VO2max values between protocols. Following training, VEmax, maximum treadmill time, and VO2max increased 8.7, 9.1, and 8.5%, respectively, on the IP and 5.8, 6.8, and 5.3% on the HP respectively. All increases were statistically significant at the 0.05 level. The post-training VO2max on the IP was significantly greater than the value on the HP. These results support the concept of specificity of training and indicate the importance of careful selection of both the test protocol as well as the test mode.

Adult↗