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Biomedical subjects

D L Miller

Publications and source records attributed to D L Miller.

589 records · Page 33Linked to original sources
PubMedDate not supplied

Case-control study of sexually transmitted diseases as cofactors for HIV-1 transmission.

The aim of the study was to investigate the association between infection with HIV-1 infection and a history of other sexually transmitted diseases (STD). We were able to match 1295 HIV-1 infected patients who attended St Mary's Hospital between 1985 and 1991 with 1273 seronegative controls on gender, sexual orientation, injecting drug use and age at time of test. The cases were 3 times more likely to have a history of ever having had another STD than the controls: multivariate conditional logistic regression showed that, after controlling for sexual behaviour, for known sexual contact with an HIV infected individual or AIDS patient or with a resident from a high HIV prevalence area, area of residence and for year of test, a history of gonorrhoea, syphilis, hepatitis B, genital herpes or genital warts were all significantly associated with HIV-1 seropositive status. These findings reinforce the need for HIV containment strategies to be promoted in conjunction with containment programmes for others STDs.

Adult↗
PubMedDate not supplied

Survival and the use and costs of hospital services for London AIDS patients treated with AZT.

The aim of this study was to evaluate the survival patterns and use and cost of hospital services of AIDS patients treated with azidothymidine (AZT) at St Mary's Hospital, London. A retrospective analysis of inpatient and outpatient case notes was performed, as was a survey of HIV-related care costs in 37 clinical departments. Of the 183 AIDS patients managed between 1 January 1987 and 30 September 1989, 132 were treated with AZt and 51 without AZT. Mean age at time of AIDS diagnosis for these predominantly homosexual men was 37.5 years for those treated with AZT compared with 40.7 years for those not on AZT. Median survival time from date of AIDS diagnosis was significantly longer for patients treated with AZT compared with those not treated with AZT (23 vs 13.5 months, P = 0.0004). The interval from diagnosis of HIV infection to date of AIDS diagnosis did not differ significantly between groups. Inpatients and outpatients use of services was greater for those receiving AZT than for those who did not. Costs reflected this increase use of services and the costs for those treated with AZT were pounds 3061 per AIDS patient-year higher compared with AIDS patients not receiving AZT; 36% of this cost was directly attributable to the cost of AZT itself. The introduction of AZT into routine clinical practice seems to have been a cost-effective intervention though it has been associated with an increased use of hospital services and associated costs per AIDS patient-year as well as increases survival time from AIDS diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Perioperative care of the elderly patient: special considerations.

Unlike older studies, which cited age as an independent risk factor for surgical mortality, recent studies indicate that the presence of underlying diseases and the type, duration and urgency of surgery are better predictors of outcome than age alone. A preoperative assessment that defines medical, functional, and psychosocial problems of elderly patients can lead to interventions to improve surgical outcomes.

Aged↗
PubMedDate not supplied

Direct infusion of EOE-13 into the hepatic artery. Experimental evaluation of safety in monkeys.

Ethiodized Oil Emulsion 13 (EOE-13) is an intravenous liver-spleen specific CT contrast agent. We infused EOE-13 directly into the hepatic arteries of five rhesus monkeys. Normal saline was administered in the same fashion in two control animals. Serial laboratory studies showed no major toxicity over a seven-day period. Intra-arterial EOE-13 has potential usefulness in the evaluation of hepatic artery infusion chemotherapy.

Animals↗
PubMedDate not supplied

Intraarterial digital subtraction angiography of spinal arteriovenous malformations.

Intraarterial digital subtraction angiography (DSA) in two patients with spinal dural arteriovenous fistulas demonstrated the major feeding arteries and the venous drainage of the respective malformations. However, the dural component of the malformations--which distinguishes them from intradural malformations--could not be recognized, nor was normal cord vasculature demonstrated. In a patient with an intradural arteriovenous malformation (AVM), only major arterial feeders were demonstrated. Intraarterial DSA provides essential anatomic information with an increased margin of safety in spinal AVMs, but supplemental selective arteriography, conventional or digital, also is currently required.

Angiography↗
PubMedDate not supplied

Anatomy of the junction of the inferior petrosal sinus and the internal jugular vein.

PURPOSE: To evaluate the anatomy of the junction of the inferior petrosal sinus and the internal jugular vein. METHODS: Using a previously described classification system, we prospectively classified venous anatomy bilaterally in 135 of 136 persons consecutively undergoing inferior petrosal sinus sampling. RESULTS: Type IV anatomy, with no anastomosis between the inferior petrosal sinus and the internal jugular vein, was significantly less frequent in our series than in a previous series (1 versus 7%; P < .001). Venous anatomy did not differ significantly between the left and the right junctions or between men and women. Venous anatomy was symmetric in only 65% of subjects (86 of 133). We describe an uncommon variant anatomy, incomplete type IV, found in 4.5% of our subjects (six of 133), that may cause incorrect results of petrosal sinus sampling. CONCLUSION: Bilateral sampling of pituitary venous effluent can be accomplished by the methods described, despite the presence of either incomplete or true type IV venous anatomy. Bilateral petrosal sinus sampling is anatomically possible in 99% of persons.

Adolescent↗
PubMedDate not supplied

Direct origin of the artery of the cervical enlargement from the left subclavian artery.

An anatomic variation is described in which the principal radiculomedullary artery to the cervical spinal cord, the artery of the cervical enlargement, arises directly from the left subclavian artery. This anomaly is important clinically because it may be necessary to catheterize this vessel selectively during spinal arteriography, and also because unintentional injection of this vessel can be associated with complications.

Angiography, Digital Subtraction↗
PubMedDate not supplied

Factors influencing dental hygiene retention in private practice.

PURPOSE: The objective of this study was to identity specific factors that contribute to dental hygienists remaining in the same private practice employment setting for five or more years. Working conditions, the employer and the organizational structure of the employment setting, scope of practice, and personal factors were assessed. METHODS: In 1992, a self-designed questionnaire was sent to a sample of 1,200 licensed dental hygienists. One state was randomly chosen from each of the 12 American Dental Hygienists' Association (ADHA) regions of the United States, and 100 licensed dental hygienists were randomly selected from each of these twelve states. Data were analyzed using univariate analysis (frequency distribution) and multivariate analyses (factor analyses). RESULTS: A 62.9% (n = 755) response rate was obtained from the 1200 questionnaires mailed. Of those dental hygienists, 14.3% (n = 108) were not practicing, and 85.7% (n = 647) were currently practicing. Nearly two-thirds (63.3%; n = 480) of the total number of respondents had been practicing five or more years in the same practice setting. Six major factors were identified by dental hygienists as reasons for remaining in one private practice setting for at least five years (1) quality/safe work environment, (2) time management for high-quality dental hygiene services, (3) effective employer office policies/procedures and personnel management, (4) employer support of professional career, (5) supportive work environment, and (6) variety in scope of practice. CONCLUSIONS: Factors identified in this study as influential in dental hygienists' retention in private practice are similar to those identified as reasons for leaving the profession in previous attrition and reentry studies. To increase retention and job satisfaction of dental hygienists in the private practice setting, strategies for effectively working with employers should be emphasized in dental hygiene and dental curriculums and in continuing education programs.

Adult↗