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Biomedical subjects

D Henry

Publications and source records attributed to D Henry.

144 records · Page 8Linked to original sources
PubMed1977

Peritoneal dialysis for severe methyprylon intoxication.

The appropriate therapy for methyprylon (Noludar) poisoning has remained controversial, owing to a lack of reliable pharmacologic data concerning the most effective way to remove the drug after a large ingestion. We recently employed peritoneal dialysis to treat a 16-year-old girl, who had ingested 6.3 gm of methypyrlon, and were able to recover more than 80% of the unmetabolized drug in the dialysate. Clinical recovery was complete within eight hours. This appears to be a safe and effective method to remove the drug in the child or adult with a serious intoxication.

Adolescent↗
PubMed1975

[The angiographic demonstration of a primary sarcoma of the pulmonary artery].

Following the findings of a primary sarcoma of the pulmonary artery and its angiographic demonstration, a search was made of the literature for this rare condition. Angiography is usually performed because a pulmonary embolism is suspected. It is best to inject contrast medium into the right atrium or ventricle. If an unusually large defect is demonstrated in the pulmonary artery, a primary malignant neoplasm should be considered in the differential diagnosis, particularly if the mass projects into the outflow tract of the right ventricle.

Aged↗
PubMedDate not supplied

National school teachers' knowledge of asthma and its management.

Asthma is the most common chronic medical condition that school teachers may encounter among their pupils. However management of asthma in schools and the role school teachers adopt in this condition has only recently been explored. The aim of this study was to determine teachers' knowledge of asthma and its management. A postal questionnaire was circulated to 199 school teachers from 46 schools in Dublin City. A 74 per cent response rate was obtained. The number of children with asthma as identified by teachers was 7.8 per cent which suggests that asthma may be unrecognised in a number of pupils. Knowledge on signs and symptoms of asthma, provoking factors of asthma and the nature of the disease was generally satisfactory. However, knowledge on asthma medications, the purpose of inhalers and teachers' understanding of the treatment and management of asthma was considered poor. Knowledge on exercise-induced asthma was limited. There is a need to provide school teachers with education on asthma and its management. School policies on asthma also need to be developed with particular reference to action necessary in the event of an acute severe attack of asthma.

Adult↗
PubMedDate not supplied

Clinical comparison of cefuroxime axetil and amoxicillin/clavulanate in the treatment of patients with secondary bacterial infections of acute bronchitis.

Two independent, investigator-blinded, multicenter, randomized clinical trials compared the clinical and bacteriologic efficacy and safety of two oral antibiotics, cefuroxime axetil and amoxicillin/clavulanate, in the treatment of patients with secondary bacterial infections of acute bronchitis (hereafter denoted acute bronchitis). Three hundred sixty patients with signs and symptoms of acute bronchitis were enrolled at 22 centers and were randomly assigned to receive 10 days of treatment with either cefuroxime axetil 250 mg twice daily (BID) (n= 177) or amoxicillin/clavulanate 500 mg three times daily (TID) (n = 183). Patients were assessed for both clinical and bacteriologic responses once during treatment (at 3 to 5 days) and twice after treatment (at 1 to 3 days and at 13 to 15 days). Bacteriologic assessments were based on sputum specimen cultures obtained before treatment and, when possible, after treatment. Organisms were isolated from the pretreatment sputum specimens of 162 (45%) of 360 patients, with the primary pathogens being Haemophilus influenzae, Haemophilus parainfluenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus (28%, 25%, 11%, 9%, and 8% of isolates, respectively). Thirty-four percent of the H influenzae isolates and 94% of the M catarrhalis isolates that were tested for beta-lactamase production were positive. A satisfactory clinical outcome (cure or improvement) was achieved in 86% (117 of 136) and 83% (130 of 157) of the clinically assessable patients treated with cefuroxime axetil or amoxicillin/clavulanate, respectively (P = 0.45). With respect to the eradication of bacterial pathogens, a satisfactory outcome (cure, presumed care, or cure with colonization) was obtained in 91% (53 of 58) and 86% (60 of 70) of bacteriologically assessable patients treated with cefuroxime axetil or amoxicillin/clavulanate, respectively (P = 0.32). Treatment with amoxicillin/clavulanate was associated with a significantly higher incidence of drug-related adverse events than was treatment with cefuroxime axetil (39% vs 23%; P = 0.001), primarily reflecting a higher incidence of drug-related gastrointestinal adverse events (37% vs 15%; P < 0.001), particularly diarrhea and nausea. Four patients in the cefuroxime axetil group and eight patients in the amoxicillin/clavulanate group withdrew from the study because of drug-related adverse events. These results indicate that cefuroxime axetil 250 mg BID is as effective as amoxicillin/clavulanate 500 mg TID in the treatment of patients with acute bronchitis but produces fewer gastrointestinal adverse events, particularly diarrhea and nausea.

Acute Disease↗
PubMedDate not supplied

The influence of physical properties and lipid content of bile on the human blood/bile ethanol ratio.

The relationship between ethanol levels in blood and bile was determined in human postmortem specimens. The influences of several physical properties--surface tension, specific gravity and viscosity--and bile lipid content on the blood/bile ethanol ratio were evaluated. A gas chromatographic direct injection technique was employed to determine the ethanol concentrations in postmortem blood and bile specimens. A positive correlation was established between the levels in the two fluids. No correlation could be found between the blood/bile ethanol ratios and the aforementioned physical properties of bile. Correction of the observed bile ethanol for lipid content had an insignificant effect on the ratio. The average blood/bile ethanol ratio was 1.03 +/- 0.29 (range: 0.32-2.91). The wide range observed makes it undesirable to use bile ethanol concentrations to predict specific blood ethanol concentrations. However, under certain conditions, bile ethanol levels may be used to estimate blood concentrations within a range of values.

Bile↗
PubMedDate not supplied

Psychiatric disorders in sexually abused children.

OBJECTIVE: This study was designed to compare the prevalence of psychiatric disorders in a clinical sample of sexually abused children referred for outpatient evaluation. Two a priori hypotheses were tested: (1) the sexually abused group would have more post-traumatic stress disorder than the non-sexually abused group and (2) non-sexually abused children referred for evaluation would have more diagnoses than the sexually abused group. METHODS: Twenty-six sexually abused children and 23 non-sexually abused children referred for psychiatric outpatient evaluation at a medical school center were matched by age, sex, race, and socioeconomic status and compared to determine differences in prevalence of Axis I, DSM-III-R disorders. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version was used for systematic diagnosis. RESULTS: Groups did not differ significantly in the number of diagnoses and, in both groups, attention-deficit hyperactivity disorder was the most frequent diagnosis. However, the prevalence of post-traumatic stress disorder among sexually abused children was significantly greater (p < .02), with 42.3% of sexually abused children and 8.7% of non-sexually abused children meeting full criteria. There were no significant differences between groups in other diagnostic categories. CONCLUSIONS: This study, using structured interviews and comparison groups, confirmed earlier findings suggesting that sexually abused children are at heightened risk for the development of post-traumatic stress disorder.

Adolescent↗
PubMedDate not supplied

Cost-effectiveness analysis in the treatment of hypertension: a medical view.

The clinical benefits of anti-hypertensive treatment include reductions in stroke and myocardial infarction, heart failure, renal and ocular damage and possibly cognitive impairment. The cost-effectiveness of treatment generally falls within a range considered acceptable to funders of health care in developed countries, and has been shown to vary with age, gender and pre-treatment blood pressure. In a largely asymptomatic condition, small quality of life impairments resulting from treatment could offset these clinical and economic benefits, but evidence suggests that treatment is associated with slight improvements in quality of life. A limitation of these analyses is that the needs of developing countries are not met. The cost-effectiveness of anti-hypertensive treatment may be unattractive to developing countries when compared with interventions that achieve greater health gains per dollar spent.

Adult↗
PubMedDate not supplied

Literacy and self-reported educational levels in relation to Mini-mental State Examination scores.

BACKGROUND AND OBJECTIVES: Because of its brevity and ease of use, the Mini-mental State Examination (MMSE) is commonly used to screen and follow patients with cognitive impairment. This pilot study attempted to determine the relationships between literacy, age, and self-reported educational level and the total MMSE score. METHODS: Cross-sectional analysis of all patients was followed by a family practice group at five local nursing homes. The associations between the patients' MMSE scores; literacy, as measured by the Rapid Estimate of Adult Literacy in Medicine (REALM); self-reported educational level; and age were determined using Pearson's correlation coefficient and stepwise multivariate linear regression. RESULTS: A total of 105 patients completed the study. Linear regression analysis showed that MMSE scores were significantly predicted by REALM score (P < .001) and the patient's age (P < .02). However, after accounting for REALM score and age, the self-reported educational level was not related to the MMSE score (P < .8). A significant relationship was seen between the REALM score and the subjects' self-reported educational levels (r = .44, P < .001) but not the subjects' ages (r = -.17, P < 0.09). A significant linear correlation was found between the MMSE and REALM scores (r = .71, P < .0001) and a significant inverse correlation was seen between MMSE scores and the patients' ages (r = -.28, P < .004). The correlation coefficient between the patients' MMSE scores and the self-reported educational levels was .33 (P < .0007). CONCLUSIONS: Practitioners who rely on the MMSE should be aware that patients may score in the demented range because they cannot read well enough to accurately complete the test. Literacy testing with REALM or other instruments may help identify such patients.

Aged↗
PubMedDate not supplied

Evaluating a cognitive/ecological program for the prevention of aggression among urban children.

The Metropolitan Area Child Study (MACS) is a multifaceted school- and family-based intervention and evaluation study designed to prevent and understand the development of aggressive behavior. The multifaceted interventions are grounded in combined social-cognitive and ecologic theories. Social-cognitive theories contend that cognitive scripts, attributions, and beliefs acquired early in life mediate the effects of ecological factors that influence the development of antisocial behavior. Prevention programs aimed at these cognitions must address multiple dimensions of the child's environment including family, peer, school, and community. The program has three levels of intervention delivered in two-year segments: (1) Level 1: a general enhancement classroom intervention that stresses culturally sensitive student and teacher interaction involving instructional and classroom management strategies and a social-cognitive curriculum that mitigates aggressive development; (2) Level 2: intensive small-group sessions designed to change children's cognitions and enhance peer relationship skills for at-risk children added to the general classroom enhancement program; and (3) Level 3: a one-year family relationship intervention that stresses parenting skill building and emotional responsiveness in family interactions added to the general enhancement and small-group training conditions. Sixteen Chicago-area schools are randomly assigned (four each) to a control group or one of the three intervention levels. Individual child assessment, peer assessments, classroom behavioral observations, and archival data are collected before the interventions begin, during the interventions, at the end of each intervention, and at a follow-up point. The pretests indicate that the children on average have higher levels of aggression than found nationally and elevated clinical levels of other psychopathologies. Across the four intervention levels there are no significant differences in ethnic composition, socio-economic status (SES), aggressive behavior, and normative beliefs about aggression.

Age Factors↗
PubMedDate not supplied

Determination of fat in olestra-containing savory snack products by capillary gas chromatography.

A quantitative method to determine fat in olestra-containing savory snack products was validated within the AOAC Peer-Verified Methods Program. The method may be used to demonstrate compliance with the guidelines of the U.S. Nutrition Labeling and Education Act for labeling products as "fat free" or "low fat." The method can measure total and saturated fat in savory snacks when present at levels of 0.2-10 g total fat and 0.1-3 g saturated fat per 30 g serving. The method is standardized to measure C6-C24 fatty acids. Extraction of olestra-containing savory snack samples with chloroform-methanol (modified AOAC Official Method 983.23) yields a lipid extract containing the total fat and olestra. The extracted lipid is hydrolyzed by lipase, yielding fatty acids and unreacted olestra. The fatty acids are precipitated as calcium soaps. Olestra is extracted from insoluble soaps with hexane and then discarded. The isolated soaps are converted back into fatty acids with hydrochloric acid and extracted with hexane. The isolated fatty acids are converted to methyl esters with boron trifluoride-methanol and quantitated by capillary gas chromatography using internal standard. Test samples were prepared by blending olestra-containing and full-fat (triglyceride) snacks to obtain 6 levels of spiking (0-10 g total fat added/30 g serving) in potato chips, potato crisps, cheese puffs, and nacho cheese-flavored corn chips. Results were linear (r2 > 0.997) between 0 and 10 g fat/30 g serving for each product matrix. Mean recovery was 101 +/- 6% standard deviation (SD) for total fat and 104 +/- 6% SD for saturated fat. Mean recovery by peer laboratory was 88 +/- 5% SD for total fat and 95 +/- 4% SD for saturated fat in potato chips (0-3 g total fat added/30 g serving). Two sets of 10 replicates of potato chips (0.5 g total fat/30 g serving and 0.16 g saturated fat/30 g serving) and potato crisps (0.5 g total fat/30 g serving and 0.16 g saturated fat/30 g serving) were analyzed by submitting and peer laboratories. Repeatability relative standard deviations ranged from 3.90 to 7.33% for total fat and from 4.01 to 11.53% for saturated fat. Reproducibility relative standard deviations were 7.33% (total fat, potato chips), 7.15% (total fat, potato crisps), 11.36% (saturated fat, potato chips), and 13.50% (saturated fat, potato crisps).

Dietary Fats↗