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Biomedical subjects

D Essex-Sorlie

Publications and source records attributed to D Essex-Sorlie.

13 recordsLinked to original sources
PubMed2000

Impact of qualified (indeterminate) diagnoses on the accuracy of renal, thyroid, and breast fine-needle aspiration biopsy.

A qualified (indeterminate) diagnosis (QD), such as "suggestive of malignancy," is thought to complicate patient management by heightening clinical uncertainty. We report that QDs increase the overall effectiveness of renal, thyroid, and breast fine-needle aspiration (FNA) biopsy and that the probability that a qualified diagnosis is negative (QDN) can be predicted by the formula QDN = number of QDs x (proportion of false-negative outcomes/disease prevalence expressed as a proportion). Results of renal (n = 24), thyroid (n = 163), and breast (n = 456) FNA biopsies performed from January 1992 through December 1998 were reviewed and correlated with results of tissue biopsies. For each body site, the FNA biopsies were placed into 1 of 2 diagnostic categories: unqualified diagnoses (UQDs) or QDs. Comparison of test performance characteristics for UQDs only and UQDs combined with QDs demonstrated that inclusion of UQDs increased FNA sensitivity and reduced FNA false-negative diagnoses. More important, the probability that a QD was negative could be predicted from test performance characteristics derived from UQDs.

Biopsy, Needle↗
PubMed1994

Intake of 25 g of soybean protein with or without soybean fiber alters plasma lipids in men with elevated cholesterol concentrations.

Twenty-one mildly hypercholesterolemic men consumed a diet that was low in fat (< 30% of energy) and cholesterol (300 mg/d) and were given muffins containing 25 g protein + 20 g dietary fiber daily from either isolated soybean protein + soybean cotyledon fiber, isolated soybean protein + cellulose, casein + soybean cotyledon fiber or casein + cellulose. All subjects progressed through the low fat, low cholesterol baseline period, lasting 2 wk, and then through all four dietary treatments, lasting 4 wk each, according to a Latin square design. Plasma concentrations of total, LDL, HDL and VLDL cholesterol, total and VLDL triacylglycerols, and apolipoprotein A-I and B were measured at the end of each period. When data from all subjects were analyzed, dietary treatments did not influence lipemia; however, in subjects with initial total cholesterol concentrations > 5.7 mmol/L, both isolated soybean protein treatments resulted in significantly lower total cholesterol compared with the two casein treatments (P < 0.05). In addition, a negative linear relationship was observed when a subject's total or LDL cholesterol change after each of the soybean treatments was regressed against the subject's baseline cholesterol concentration (P < 0.05). Apolipoprotein A-I varied dependent on baseline cholesterol with no apparent pattern, whereas apolipoprotein B levels were not affected. Results indicate that consumption of 25 g soybean protein/d is associated with lower total cholesterol concentrations in individuals with initial cholesterol concentrations > 5.7 mmol/L.

Adult↗
PubMed1994

The Americans with Disabilities Act: I. History, summary, and key components.

This report presents (1) a brief history and summary of the Americans with Disabilities Act and (2) an extensive section of definitions and explanations of key components--such as disability, qualified individual with a disability, reasonable accommodation, and undue hardship--and their relevance to medical schools. While these definitions are numerous and somewhat technical, an understanding of them is essential for medical school faculty, staff, and administrators to assess the Act's impact on and implications for their institutions and to assure adequate and appropriate compliance. Gaining such understanding is important, for although some authorities believe that the Act will have minimal impact on most colleges and universities, the author maintains that experience at her medical school does not support this view. A companion article, published in this issue of Academic Medicine, focuses on the implications of the Act for colleges of medicine and offers suggestions for compliance.

Persons with Disabilities↗
PubMed1994

The Americans with Disabilities Act: II. Implications and suggestions for compliance for medical schools.

There is a need for more information about the Americans with Disabilities Act that is tailored to colleges of medicine so that faculty, staff, and administrators can understand and carry out their responsibilities under the Act. This report (Part II) and the previous one (Part I) in the same issue of Academic Medicine address this need. In Part I, key terms of the Act are defined; the present report focuses on the educational relationship between medical schools, applicants, and students in the context of the Act. A comprehensive array of the Act's implications are discussed in question-and-answer format. For example, what impact does the Act have on the application and admission process? Can a college of medicine ask students whether they have a disability? When does a school's duty to accommodate a disabled student begin? The report concludes with 15 recommended steps that colleges should take to comply with the Act, such as (1) colleges should develop policies and procedures for applicants and students who want to request accommodation for disabilities; (2) colleges should identify the essential abilities and skills required for admission and for participation in the degree program; and (3) colleges should consider instituting alternate dispute resolution procedures. Although following the recommended steps may seem overwhelming, medical schools are obligated by law to accommodate qualified disabled persons; failure to comply with the Act deprives academically qualified persons with disabilities of the opportunity to demonstrate their ability to fulfill degree requirements and become physicians. Medical educators must continue to adjust their understanding and knowledge of the Act's implications for medical schools, given that the interpretation of the Act will evolve as the courts amplify and implement it.

Persons with Disabilities↗
PubMed1992

Effects of intracameral injection of tissue plasminogen activator on corneal endothelium and intraocular pressure in dogs.

Contact wide-field specular microscopy was performed on eyes of 16 healthy dogs after tissue plasminogen activator at a concentration of 25 micrograms/100 microliters (group 1, n = 8) or 50 micrograms/100 microliters (group 2, n = 8) was injected into 1 anterior chamber of each dog. The contralateral eye served as a nontreated control. Applanation tonometry was used to measure intraocular pressure in both eyes for up to 168 hours. By use of computerized morphometric analysis and pachymetry, changes from baseline values in endothelial cell density, cell morphologic features, and corneal thickness were evaluated at postinjection hours 24, 48, and 168. Significant mean differences in intraocular pressure were not detected between treated eyes of group-1 dogs and those in group 2 at designated times, or between treated and nontreated eyes of dogs in either group. Mean corneal thickness of treated and nontreated eyes was similar in both groups through postinjection hour 168. Changes in mean percentage of endothelial cell sides were observed only in treated eyes of group-2 dogs, with the mean percentage of hexagons at postinjection hour 168 decreasing by 18%, a decrease that was significantly (P less than 0.05) greater than the decrease in nontreated eyes. The mean percentage of 6-sided cells in treated eyes of group-2 dogs was significantly (P less than 0.05) less than that in treated eyes of group-1 dogs at postinjection hour 168.

Animals↗
PubMed1992

Use of tissue plasminogen activator for intraocular fibrinolysis in dogs.

Fibrin clots were induced in eyes of dogs by injection of autogenous citrated plasma into the anterior chamber. Twenty-four hours after clot formation, 0.01 ml of tissue plasminogen activator at a concentration of 1 microgram/100 microliters (group 1, n = 5) or 25 micrograms/100 microliters (group 2, n = 5) was injected into 1 anterior chamber of each dog. The contralateral eye served as a nontreated control. Serial photographs were taken of the fibrin clots after intracameral injection of tissue plasminogen activator. Computerized morphometric analysis was then used to evaluate changes in cross-sectional surface area of the fibrin clot. Significant (P less than 0.001) fibrin-clot lysis was detected in treated eyes of group-2 dogs, but was not found in treated eyes of group-1 dogs. A mean decrease of greater than 90% in clot surface area was detected by 120 minutes after injection in treated eyes of group-2 dogs.

Animals↗
PubMed1991

Does infant feeding method influence maternal postpartum weight loss?

We conducted a retrospective study of 411 women to determine whether a significant relationship existed between method of infant feeding (breast vs bottle) and postpartum weight loss at 6 weeks and 12 months. In addition to method of infant feeding, the variables parity, gravidity, mode of delivery, maternal age, maternal prepregnancy weight, infant sex, and payment status (whether receiving assistance from the Aid to Dependent Children [ADC] program) were studied in terms of their association with weight loss. In general, no consistent relationship was found between method of infant feeding and postpartum weight loss. However, in the ADC group at 6 weeks and in the non-ADC group at 12 months, nonlactating women had lost more weight than had their lactating counterparts, in spite of the theoretical energy deficiency of breast-feeding women. Women who gained more weight during pregnancy consistently lost more weight following delivery, regardless of their prepregnancy weight. These results indicate that infant feeding method was not related to differences in postpartum weight loss between lactating and nonlactating counterparts.

Adolescent↗
PubMed1990

Effects of intracameral injection of viscoelastic solutions on corneal endothelium in dogs.

Contact in vivo wide-field specular microscopy was performed on right eyes of 20 healthy dogs after sodium hyaluronate (1%, n = 5), sodium chondroitin sulfate (4%) and sodium hyaluronate (3%, n = 5), hydroxypropyl methylcellulose (2%, n = 5), or balanced salt solution (control, n = 5) was injected into the anterior chamber. Using computerized morphometric analysis and pachymetry, changes in endothelial cell density, cell morphologic features, and corneal thickness from baseline values were evaluated at postinjection hour (PIH) 72 and PIH 168. Changes were not seen in endothelial cell density or cell morphologic features in any treated eye. The mean corneal thickness of all treated eyes at PIH 72 increased 6%, significantly greater than that of the nontreated eyes (P = 0.03). Mean corneal thickness of treated and nontreated eyes was similar at baseline and PIH 168 in all treatment groups.

Animals↗
PubMed1990

Quantitative noninvasive assessment of liver size in clinically normal dogs.

Measurements of liver size were made from radiographs of 16 clinically normal anesthetized dogs. Two measurements were made from each of 3 views: right and left lateral and ventrodorsal. Each measurement was correlated with liver weight and volume. Liver weight and volume were also correlated with both measurements from the same radiograph multiplied together. All measurements, with the exception of ventrodorsal depth, correlated significantly (P less than 0.05) with liver weight and volume. The multiplication of the 2 measurements made from the right lateral radiograph correlated most highly with liver weight. These data were then compared with those from similar studies involving liver measurements obtained from nuclear scintigraphic and ultrasonographic scans on the same dogs. The radiographic measurements made from the right lateral view had the highest correlation with liver weight, followed by the nuclear scintigraphic measurements made from the same position.

Animals↗
PubMed1989

Effects of intracameral injection of viscoelastic solutions on intraocular pressure in dogs.

Intraocular pressure (IOP) was determined in right eyes of 20 healthy dogs after sodium hyaluronate (1%, n = 5), sodium chondroitin sulfate (4%) and sodium hyaluronate (3%, n = 5), hydroxypropyl methylcellulose (2%, n = 5), or balanced salt solution (control, n = 5) was injected into the anterior chamber. Applanation tonometry was used to measure IOP in both eyes of each dog for up to 168 hours. The 3 viscoelastic solutions resulted in an increased mean IOP by postinjection hours (PIH) 2; from PIH 12 until PIH 72, the IOP was significantly (P less than 0.001) lower than baseline. The control group did not have an increase in IOP at PIH 2; mean IOP decreased below baseline measurements within 2 hours and remained lower until PIH 72. Mean differences in IOP were not found among treated eyes (P = 0.50), and a significant interaction of any treated eyes in a group was not detected (P = 0.21). By PIH 168, the IOP approached baseline values in all groups.

Analysis of Variance↗
PubMed1988

Treatment and follow-up of obesity in adolescent girls.

An intervention program was conducted for 12 postmenarche, 12-15-year-old obese girls. Weight Winners, a multicomponent and multidisciplinary after-school intervention program, was developed in which behavior modification, aerobic exercise, and modeling appropriate behaviors for weight control were emphasized. Evaluation made before and immediately after the intervention and at a nine-month follow-up suggested that the after-school treatment program was successful in: 1) reducing the rate of gain and decreasing body weight by 11% while maintaining lean tissue and resting energy expenditure (REE), and 2) improving eating and exercise behaviors. Significant changes in eating behaviors (p less than 0.05) were: more low-calorie, nutritionally dense foods were consumed; the frequency and amount eaten decreased; and the speed of eating slowed. Implementing a fee contingent on attendance and on record keeping appeared to reduce attrition. Subjects cited the Weight Winners program, aerobic exercise, changes in eating behaviors, group and family support, and encouragement and praise from the group leaders as important contributions to their success in weight control. Barriers to change were reported by participants as boredom, hunger, lack of family and peer support, and having food in sight. An increase in lean tissue was associated with both improved self-esteem (p less than 0.05) and improved self-control (p less than 0.05). Subjects who had been obese the longest were the most responsive to hunger cues (p less than 0.05).

Adolescent↗