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Biomedical subjects

D J Slymen

Publications and source records attributed to D J Slymen.

At least 55 records · Page 3Linked to original sources
PubMed1986

Raised serum levels of tumour necrosis factor in parasitic infections.

In a study of serum levels of endogenous tumour necrosis factor (TNF) in healthy people and patients with neoplastic or infectious disease, only patients with kala-azar (visceral leishmaniasis) and malaria were found to have a strikingly increased frequency of raised TNF levels (66.6% and 70.0%, respectively). 7.9% of samples from both healthy subjects and patients with neoplastic disease contained measurable TNF. The discovery of elevated TNF levels in the sera of patients with parasitic diseases suggests that this cytokine may play a part in host defences against parasitic infections.

Adult↗
PubMed1985

Analysis of the spontaneous variability of ventricular arrhythmias: consecutive ambulatory electrocardiographic recordings of ventricular tachycardia.

Results are reported of analysis of the variability of complex ventricular arrhythmias in a cohort of 110 patients selected for the presence of ventricular tachycardia (VT). All patients were enrolled in investigational antiarrhythmic drug trials and had an average of 4 consecutive days of placebo ambulatory electrocardiographic recording to serve as the database for this study. Using a statistical approach incorporating analysis of variance, the minimum percent reductions of ventricular premature complexes, couplets and VT were calculated to establish "drug effect" rather than variability at a significance level of 0.05. The relative variability of ventricular arrhythmias in prognostically important groups was also analyzed: (1) coronary artery disease (CAD) (n = 57) vs no CAD (n = 53); (2) patients with a left ventricular ejection fraction of 40% or less (n = 52) vs those with an ejection fraction greater than 40% (n = 58); and (3) patients with frequent runs of VT (10 or more runs/day, n = 63) vs infrequent VT (n = 47). Multiple regression analysis revealed that patients with CAD have significantly greater premature ventricular complex variability than patients without CAD (p less than 0.01). Also, patients with frequent VT runs have greater VT variability than that previously reported in smaller studies, thus requiring greater VT reductions to establish drug effect. Whether the variability of ventricular arrhythmia is itself an independent risk factor for sudden cardiac death is unknown.

Adult↗
PubMed1984

Diazepam and propranolol in panic disorder and agoraphobia.

The response to diazepam and propranolol hydrochloride was compared in 21 patients who (with one exception) met DSM-III criteria for panic disorder and agoraphobia. Each drug was administered for two weeks in double-blind fashion according to a crossover design. The response to diazepam was significantly superior on all measures. By observer rating, 18 patients showed at least moderate improvement with diazepam compared with seven receiving propranolol. Panic attacks and phobic symptoms responded to diazepam, but not to propranolol. The results suggest that benzodiazepines constitute effective short-term treatment for these newly defined disorders.

Adult↗
PubMed1983

Bladder cancer: factors affecting survival.

The identification of factors present at the time of initial evaluation may be important to predict the prognosis in patients with bladder tumor. Attempts were made to identify predictive factors of recurrence involving comparisons based on the 12-month recurrence rate and time to recurrence in a prospective clinical investigation of 468 patients with bladder tumor observed during a 5-year interval. In newly diagnosed bladder cancer patients stage, grade and size of the largest tumor at initial evaluation were significant factors affecting survival, and these factors acted independently. Age and stage were significant factors in patients with a history of bladder tumor. We herein estimated survival curves using the product-limit estimate. Comparisons of survival curves and analyses involving more than 1 potential prognostic factor were accomplished using Cox's proportional hazards model.

Carcinoma↗
PubMed1982

Predicting therapeutic outcome in patients with diffuse histiocytic lymphoma treated with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP).

Seventy-five patients with diffuse histiocytic lymphoma (DHL) ranging in age from 33 to 94 years were treated with cyclophosphamide, Adriamycin, vincristine and prednisone (CHOP). Thirty-eight patients (51%) achieved complete remission, but nine of these patients relapsed after remission lasting one to 23 months (median time to relapse, four months). We used multivariate analysis to identify those characteristics that significantly affected treatment outcome. The chances for complete remission were adversely affected by DHL appearing after histologic conversion from another lymphoma (P = 0.006), the presence of systemic symptoms (P = 0.24), and not having the large noncleaved (LNC) histologic subtype (P = 0.40). The chance for relapse from complete remission was increased only by the presence of systemic symptoms (P = 0.042). Overall survival was adversely affected by the presence of bone marrow involvement (P = 0.002), having other than LNC histologic subtype (P = .010), and the presence of systemic symptoms (P = 0.043). It appears that patients whose DHL appears de novo and who also are symptom status A (70% long-term disease-free survival) or have the LNC histologic subtype (67% long-term disease-free survival) have an excellent outlook when treated with CHOP at the doses used in this study. However, patients with B symptoms (16% long-term disease-free survival), histologic conversion to DHL (8% long-term disease-free survival), previous chemotherapy (8% long-term disease-free survival), and bone marrow involvement (8% long-term disease-free survival) respond poorly and for these patients other treatments need to be identified. In addition, patients with B symptoms who achieve complete remission with CHOP are at high risk to relapse (59% relapse rate) and should be considered for "intensification" therapy after complete remission is documented.

Adult↗
PubMed1982

Results of aggressive chemotherapy for acute nonlymphoblastic leukemia in adults.

Sixty-five patients with acute nonlymphoblastic leukemia, ranging in age from 16 to 73 years (median, 54), were treated with thioguanine, cytarabine, daunorubicin, prednisone, and vincristine to induce complete remission. Remission was maintained with monthly 5-day courses of cytarabine and thioguanine for 4 years. Of the entire group, 57% achieved complete remission and 29% died in the first 30 days of treatment. The median remission duration was 15 months, with 20% of the complete responders predicted to remain in complete remission for 4 years. No primary central nervous system relapses have occurred. Of six variables examined by multivariate analysis, only age was predictive of remission success. Before analysis, the patients were divided into groups by age: group 1--ages 16-42 years (n = 17); group 2--ages 43-59 years (n = 25); and group 3--ages 60-73 years (n = 23). Complete remission rates were 76% in group 1, 64% in group 2, and 35% in group 3 (P = 0.002). Lower remission rates for older patients resulted from more early deaths rather than resistant disease. Age and LDH levels affected remission duration. The median complete remission duration was 48 months in group 1 and 10 months in groups 2 and 3 (P = 0.004). In group 1, 41% of patients achieving complete remission are predicted to remain in complete remission for 4 years. We concluded that this five-drug induction regimen is highly effective for induction therapy in younger adults with acute nonlymphoblastic leukemia. The results in patients greater than or equal to 60 years of age are less satisfactory due to a lower remission rate and greater chance of early death. Furthermore, these results demonstrate that the program as described results in a longer duration of complete remission for patients of younger age.

Acute Disease↗
PubMed1980

The prognosis of anxiety neurosis.

One hundred twelve anxiety neurotics originally seen in the medical clinics of a university hospital were interviewed after six years, and their outcome was compared with that of 110 surgical control subjects. Although socially impaired to a greater extent than control subjects, the majority of patients with anxiety neurosis, despite persisting symptoms, were shown to have a favorable outcome. Sixty-eight percent were either recovered or mildly impaired at follow-up examination. Of the prognostic variables examined, duration of illness and social class proved predictive of outcome. Secondary depression, which was reported by 44% of the neurotic subjects, represented the most frequent and potentially serious complication.

Adult↗
PubMed1980

Propranolol in chronic anxiety disorders. A controlled study.

In a double-blind crossover study the beta-adrenergic blocking drug propranolol hydrochloride reduced symptoms in 17 of 26 patients with chronic anxiety disorders. Both somatic and psychic symptoms improved as judged by patient and observer ratings. The most frequent side effects (dizziness, fatigue, and insomnia) were difficult to distinguish from anxiety symptoms and were, for the most part, mild. The therapeutic and side effects observed suggested CNS activity of the drug. Although propranolol is of benefit to patients with anxiety, its efficacy, compared with that of other antianxiety drugs, has not been established.

Adolescent↗
PubMed1979

Stressful life events and burn injuries.

About half of the 67 adults admitted to a burn treatment unit during the course of a year were found to have pre-existing physical and/or psychiatric conditions that increased their susceptibility to injury. In addition, the majority of victims were unmarried, unemployed, and came from low social class, circumstances that tended to increase their vulnerability. A significant increase in stressful life events was reported by these patients during the year preceding burn injury. This life change was negatively correlated with age, income, and number of friends, and positively correlated with social class and psychiatric illness. Two subgroups of persons vulnerable to burns were identified, the first, older women with physical illness, and the second, persons of low social class with psychiatric disorders. The findings have implications for burn prevention and rehabilitation of burn victims.

Adult↗
PubMed1978

The familial prevalence of anxiety neurosis.

A family history study of 112 anxiety neurotics and 110 surgical controls showed that the morbidity risk for anxiety neurosis among first-degree relatives of neurotics was 18% compared to 3% among control relatives. Relatives of anxiety neurotics were also shown to be at higher risk for the development of alcoholism. Female relatives were found to be at greater risk than male relatives, reflecting their increased susceptibility to the illness. These data confirm previous findings of an increased familial prevalence of anxiety neurosis.

Alcoholism↗
PubMed1978

Secondary depression in anxiety neurosis.

Forty-four per cent of 112 patients with anxiety neurosis reported episodes of depression during the course of their illness compared with only 7 per cent of surgical controls. Although the majority developed in response to environmental circumstances and were of brief duration, they commonly led to psychiatric treatment or hospitalization in this group of patients. Patients who developed this complication were shown to have a more chronic and severe underlying illness.

Adjustment Disorders↗
PubMed1977

Depersonalization in accident victims and psychiatric patients.

A transient depersonalization syndrome was identified in nearly one third of persons exposed to life-threatening danger (accident victims) and close to 40% of a group of hospitalized psychiatric patients. Although the syndrome was similar in these populations, mental clouding developed more commonly among patients and alertness was more prominent among accident victims. Anxiety was significantly associated with the development of depersonalization among psychiatric patients and was almost certainly a factor in its appearance among accident victims. The findings suggest that this syndrome is a specific response to extreme danger or its associated anxiety.

Accidents, Traffic↗
PubMedDate not supplied

Clinician compliance with primary prevention of tobacco use: the impact of social contingencies.

BACKGROUND: This study evaluated clinicians' compliance with delivering written advice and information against tobacco use (prevention prescriptions) to adolescent patients. METHODS: Clinicians in 77 orthodontic offices were trained (and asked) to provide anti-tobacco counseling and prescriptions to 10- to 18-year-olds for 2 years. Each of eight prescriptions was provided for distribution to adolescent patients. Information concerning prescription-tracking methods and operant learning theory variables such as modeling and feedback was obtained using a cross-sectional interview of clinical staff. The proportion of prescriptions written was regressed on possible "determinants." Analyses were replicated for two time periods. RESULTS: Mean anti-tobacco prescription compliance was 66 and 73% for two separate time periods. Multiple regression analyses were computed for the first (R = 0.45, F(7,63) = 2.29, P < 0.001) and second (R = 0.48, F(7,63) = 2.76, P < 0.001) time periods. Prescription tracking and praise from patients were significant correlates for the first time period; praise and modeling were significant for the second time period. Twenty and twenty-three percent, respectively, of the variance in office prescription rate was explained. CONCLUSIONS: Results suggest that compliance with primary prevention procedures may be influenced by feedback from patients, staff modeling, and formal office tracking information.

Adolescent↗
PubMedDate not supplied

Reducing ultraviolet radiation exposure in children.

BACKGROUND: Project SUNWISE evaluated the effectiveness of a multicomponent intervention in reducing children's ultraviolet radiation (UVR) exposure. METHODS: Across four YMCAs, 48 aquatics classes (N = 169 children, mean age = 7) were randomly assigned to either the intervention or the control condition. The 6-week intervention included a UVR reduction curriculum presented at poolside by aquatics instructors and home-based activities for children and their parents. Outcome measures were (a) tanness-associated skin color dimensions assessed with a colorimeter, (b) specific daily solar protection behaviors of children as reported by parents, and (c) general solar protection behaviors. RESULTS: Controlling for intraclass clustering in all analyses, at posttest, no statistically significant between-group differences were found in tanness, daily solar protection scores, or general sunscreen use. The intervention group showed significantly greater general hat use relative to controls. CONCLUSIONS: The intervention failed to impact most of the outcome measures. Supplementing the behavior-focused intervention package with environmental supports may be warranted.

California↗
PubMedDate not supplied

Occupational exposure to coke oven emissions from 1979-1983.

Breathing zone samples of benzene soluble fraction of total particulate matter (BSFTPM) were obtained for coke oven workers at a selected steel plant from 1979-1983. Analysis of the 1622 samples, collected for compliance with the 1976 OSHA coke oven emissions standard, indicated that there were significant differences in exposures to BSFTPM among the following variables: job classifications, batteries where the employees were stationed, shifts during the work day, and years and quarters of the year when samples were collected. In comparison to studies conducted prior to 1976, exposures to BSFTPM in the current study are consistently lower for every job classification. However, even in 1983, a large percentage of the workers in many of the sampled job classifications had BSFTPM concentrations that were above 0.150 mg/m3, indicating that current engineering controls and work practices are not sufficient to provide exposure levels below the recommended standard.

Air Pollutants, Occupational↗
PubMedDate not supplied

Profiles of exercise history and overuse injuries among United States Navy Sea, Air, and Land (SEAL) recruits.

This prospective study examined running history as a risk factor for subsequent overuse injury in Navy Sea, Air, and Land (SEAL) recruits. Recruits preparing to be Navy SEALs undergo 6 months of rigorous physical training programs, which place these recruits at high risk for developing an overuse injury. We assessed the independent variables of age; prior running frequency, duration, and pace; and training surface. Univariate and multivariate estimates of risk were determined for each variable. We observed an incidence of 3.4 overuse injuries per 1000 recruit-days. Assessing the physical activity of the recruits in the 6 months before entrance into basic training, we found that the recruits who ran at a pace slower than 8 minutes per mile and on softer training surfaces were more likely to sustain an overuse injury during basic training, in both univariate and multivariate estimates of risk. Recruits who ran fewer weekly miles and for shorter durations before basic training were also more likely to sustain an overuse injury according to univariate estimates of risk. Our findings suggest that risk of overuse injuries can be reduced by adjusting exercise routines before training. Running on different type surfaces with a gradual increase in speed, duration, and weekly mileage in the period preceding basic training may reduce risk of overuse injury.

Adolescent↗