Search PubMed⌕ Search

Biomedical subjects

D Strickland

Publications and source records attributed to D Strickland.

At least 73 records · Page 4Linked to original sources
PubMed1989

Fetal monitoring and predictions by clinicians: observations during a randomized clinical trial in very low birth weight infants.

Predictions about perinatal outcome in very low birth weight infants were studied in a randomized clinical trial of electronic fetal monitoring and periodic auscultation to assess the effect of diagnostic monitoring information on clinicians' ability to predict perinatal outcomes. The only predictions consistently correct before monitoring information was available were those regarding infant survival (88% correct, kappa [kappa] = 0.40, P less than .001 for the electronic fetal monitoring group; 80% correct, kappa = 0.35, P less than .01 for the periodic auscultation group). After monitoring, predictions of 5-minute Apgar scores and arterial cord pH were significantly more accurate, and clinicians' confidence in their predictions increased significantly in both the electronic fetal monitoring and the auscultation groups. Predictions of 5-minute Apgar scores were significantly more accurate in the electronic fetal monitoring group (92% correct, kappa = 0.80) than in the periodic auscultation group (61% correct, kappa = 0.28) (Z difference = 3.04; P less than .01). We conclude that clinicians gain information during intrapartum monitoring that generally leads to improved predictions and increased confidence in predictions. In this study, they made more accurate predictions about 5-minute Apgar scores with electronic fetal monitoring, suggesting that electronic fetal monitoring may provide better information about neonatal well-being than does periodic auscultation. Improved information, as measured by clinical predictions, is probably highly valued by patients and clinicians and may be an important determinant of acceptance of this diagnostic technology.

Apgar Score↗
PubMed1988

The dynamic relations among interpersonal behaviors: a test of complementarity and anticomplementarity.

On the basis of the positions of behaviors relative to one another in the interpersonal circle, the principles of complementarity and anticomplementarity specify how people's behaviors influence one another in interpersonal interactions. Pairs of undergraduate women (1 subject, N = 80, and 1 confederate) collaborated for 16 min to create and agree on stories for two pictures. Confederates performed scripted roles that emphasized one of eight interpersonal behaviors. Behaviors were coded into eight categories, and the relative effect of each confederate behavior on each subject behavior was determined. Using the geometric properties of the interpersonal circle, vectors were calculated that identified the relative impact of each confederate stimulus behavior on the overall pattern of subject responses. Results were consistent with the dynamic relations among interpersonal behaviors that complementarity and anticomplementarity propose and demonstrated that how a person behaves toward another systematically and profoundly affects how the other behaves toward the person.

Adolescent↗
PubMed1987

A randomized trial of dexamethasone and acetazolamide for acute mountain sickness prophylaxis.

Forty-seven climbers participated in a double-blind, randomized trial comparing acetazolamide 250 mg, dexamethasone 4 mg, and placebo every eight hours as prophylaxis for acute mountain sickness during rapid, active ascent of Mount Rainier (elevation 4,392 m). Forty-two subjects (89.4 percent) achieved the summit in an average of 34.5 hours after leaving sea level. At the summit or high point attained above base camp, the group taking dexamethasone reported less headache, tiredness, dizziness, nausea, clumsiness, and a greater sense of feeling refreshed (p less than or equal to 0.05). In addition, they reported fewer problems of runny nose and feeling cold, symptoms unrelated to acute mountain sickness. The acetazolamide group differed significantly (p less than or equal to 0.05) from other groups at low elevations (1,300 to 1,600 m), in that they experienced more feelings of nausea and tiredness, and they were less refreshed. These drug side effects probably obscured the previously established prophylactic effects of acetazolamide for acute mountain sickness. Separate analysis of an acetazolamide subgroup that did not experience side effects at low elevations revealed a prophylactic effect of acetazolamide similar in magnitude to the dexamethasone effect but lacking the euphoric effects of dexamethasone. This study demonstrates that prophylaxis with dexamethasone can reduce the symptoms associated with acute mountain sickness during active ascent and that acetazolamide can cause side effects that may limit its effectiveness as prophylaxis against the disease.

Acetazolamide↗
PubMed1987

Status of infants at birth and risk for adverse neonatal events and long-term sequelae: a study in low birth weight infants.

We evaluated the relationship of infant status at birth to neonatal morbidity and long-term development in 246 low birth weight infants (600 to 1750 gm). Nineteen percent of infants had 1-minute Apgar scores of less than or equal to 3, and 8% had an umbilical artery pH of less than or equal to 7.2. Acidosis was associated with an increased risk of grade 3 to 4 intracranial hemorrhage (odds ratio = 3.3). Low 1-minute Apgar score was associated with an increased risk of death (odds ratio = 4.8). Grade 3 to 4 intracranial hemorrhage was a strong risk factor for cerebral palsy among survivors (odds ratio = 16.1), as was low 1-minute Apgar score (odds ratio = 2.9). Only 15% of cases of cerebral palsy in this study were associated with acidosis at birth.

Acidosis↗
PubMed1987

Health among municipal sewage and water treatment workers.

Municipal sewage treatment plant workers are potentially exposed to a multitude of industrial chemicals and pathogenic microorganisms. A questionnaire survey of working habits, lifestyle and symptoms of illness was conducted among 189 municipal sewage treatment plant workers processing between three and ten million gallons of wastewater daily in 16 plants in New York State between March and July of 1984. Water treatment plant workers in the same cities comprised the comparison group. Sewage workers reported a significantly higher frequency of headache, dizziness, sore throat, skin irritation and diarrhea within the month immediately preceding receipt of the questionnaire, after controlling for various possible confounders. Eye and skin irritation were significantly associated with exposure to mutagens. The health significance of these findings and possible sources of error in assessing risk are discussed.

Humans↗
PubMed1986

Urinary mutagens in municipal sewage workers and water treatment workers.

In view of the potential exposure of sewage treatment workers to a multitude of mutagenic substances, the frequency of urinary mutagens was measured by the Ames test among a sample of 164 sewage treatment workers employed in 14 sewage treatment plants which processed between 3 and 10 million gallons of sewage daily in New York State between March and July, 1984. The frequency was compared to that observed in 72 water treatment employees in the same municipalities. Sewage workers had a significantly higher risk for urinary mutagens after controlling for smoking, using the Ames test, both with and without the addition of the liver microsomal homogenate, S-9. More precise methods of measuring exposure in epidemiologic studies, particularly in environmental and occupational epidemiology, are in various stages of development. The application of one of these methods, the Ames test, to an occupational group (sewage workers) with potentially high exposure to mutagenic substances is described and the strengths and limitations of this application are discussed.

Adult↗
PubMed1986

Echocardiography, electrocardiography, and radiography of cats with dilatation cardiomyopathy, hypertrophic cardiomyopathy, and hyperthyroidism.

The echocardiographic, ECG, and radiographic findings of sequentially examined cats with dilatation cardiomyopathy (DCM, n = 7), hypertrophic cardiomyopathy (HCM, n = 8), and hyperthyroidism (HT, n = 20) were compared with those of healthy control cats (n = 11). Cats with DCM were easily differentiated from healthy cats by echocardiography and from cats with HCM and HT by a dilated left ventricle at end-diastole with a mean +/- SD of 2.20 +/- 0.36 cm, reduced fractional shortening (2.9% +/- 3.7%), reduced aortic amplitude (0.07 +/- 0.05 cm), reduced left ventricular wall amplitude (0.09 +/- 0.09 cm), and increased E-point septal separation (0.83 +/- 0.29 cm). The cats with HCM were most consistently recognized echocardiographically by increased left ventricular wall thickness at end-diastole (0.75 +/- 0.12 cm). Some cats with HT had abnormal echocardiograms with left ventricular wall hypertrophy. These cats could usually be differentiated from the cats with HCM because of normal or increased ventricular wall amplitude, aortic amplitude, or percentage of thickening of the left ventricular wall and interventricular septum. Left atrial enlargement (left atrial diameter greater than 1.57 cm or left atrium/aorta greater than 1.75) was commonly detected by the echocardiogram in cats with DCM, HCM, or HT. The echocardiogram was helpful in differentiating the type of cardiomyopathy (DCM, HCM, or HT) when plain thoracic radiographs indicated that cardiomegaly existed. The ECG may have indicated incorrectly that there was left ventricular enlargement in some cats with HT, and it did not indicate consistently that left ventricular enlargement existed when present in cats with DCM or HCM. The ECG was a poor indicator of left atrial enlargement in all cats.

Animals↗
PubMed1986

Repeatability of the M-mode echocardiogram and the effects of acute changes in heart rate, cardiac contractility, and preload in healthy cats sedated with ketamine hydrochloride and acepromazine.

In healthy cats sedated with a combination of ketamine hydrochloride and acepromazine, the reproducibility of sequential echocardiographic examinations was studied. The effects of experimental alteration in heart rate, contractility, and preload on the echocardiogram also were studied. Ten cats had M-mode echocardiograms recorded once weekly for 5 weeks. There were no statistically significant differences in echocardiographic measurements over time, although measurements of certain cardiac structures of an individual cat did vary from time to time. The cardiovascular system was altered by a constant infusion of isoproterenol, followed by a rapid intravenous infusion of isotonic fluid equal to 25% of the calculated blood volume, and then by a rapid withdrawal of blood equal to the amount of fluid previously given. Cardiac output using indocyanine green dilution curves were determined for each treatment and compared to the cardiac output calculated from the echocardiogram. The correlation coefficient was 0.90 for all treatments. During the infusion of isoproterenol a significant increase in the percent fractional shortening and left ventricular wall amplitude occurred compared to the control echocardiogram. After the rapid infusion of fluid, none of the mean echocardiographic measurements significantly changed from control values although the left ventricular chamber diameter at systole significantly increased, and the percent fractional shortening significantly decreased, when compared to values obtained during isoproterenol infusion. Significant changes recorded between echocardiographic measurements made after blood withdrawal compared to those made after fluid loading included an increase in left ventricular wall thickness at diastole, a decrease in left ventricular diameter at diastole, and a decrease in the present left ventricular wall thickening. Cats were terminated and the average of measurements made during the repeatability study of the septal and left ventricular wall thickness during systole, rather than during diastole, more closely approximated the postmortem measurements.

Acepromazine↗
PubMed1986

Host genetics: a key factor in regulating the distribution of parasites in natural host populations.

The immune response that expels the tapeworm Hymenolepis citelli from the small intestine of its host the white-footed deer mouse is genetically controlled. Patent infections with this tapeworm occur only in individuals that are homozygous for a recessive allele expressed at a single gene locus. By studying this natural host-parasite system in the laboratory it was shown that host genetics contributes to parasite overdispersion in a host population in the absence of all other ecological variables. Thus, the substantive influence of the proportions of resistant and susceptible genotypes in the host population must be considered when developing parasite population models of transmission or control measures.

Animals↗
PubMed1986

Effect of fasting on thyroxine, 3,5,3'-triiodothyronine, and cortisol concentrations in serum of dogs.

The present study was designed to compare basal and stimulated concentrations of 3,5,3'-triiodothyronine (T3), thyroxine (T4), and cortisol in serum of dogs fasted 12 or 18 hours (to represent overnight fasting) or 24 or 36 hours (to represent prolonged inappetence) with those of dogs that were not fasted. Twenty-five adult Beagle bitches were allotted to 5 experimental fasting groups (0, 12, 18, 24, and 36 hours). Blood samples for hormonal analyses were obtained 4, 3, 2, and 1 hour before food was removed; at the time of food removal; 1 hour after food was removed; and every 2 hours during experimental fasting until 0800 hours on the day fasting ended. Dogs were injected with 5 IU of thyrotropin, IV, and 2.2 IU of adrenocorticotropin/kg, IM, to evaluate thyroidal and adrenocortical endocrine reserves. Additional blood samples were collected 0.5, 1, 2, 3, and 4 hours after injections were given. Serum concentrations of T3, T4, and cortisol were determined by validated radioimmunoassays. Body weights and ages of the dogs and food consumption during a 2-hour preliminary feeding period before dogs were fasted did not differ among fasting groups. Length of fasting did not affect serum concentrations of T3 or T4 in dogs at 12, 18, 24, or 36 hours after food was removed. Mean serum concentrations of cortisol in dogs fasted 12 or 24 hours were lower than those in dogs that were not fasted. Serum concentrations of the hormones after thyrotropin and adrenocorticotropin were injected were not affected by fasting.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1980

Malignant melanoma: social status and outdoor work.

The incidence of, and mortality from, malignant melanoma of skin in whites are strongly influenced by socio-economic conditions. Professional and administrative workers have the highest rates of all. Clerks and salesmen have higher rates than skilled manual workers, who have higher rates than unskilled workers. Women, when classified by the occupation of their husbands, show a similar relationship to social status. The biases of incidence data from systems of cancer registration, and mortality data from death certificates are different, and the consistency of the data from different periods and from different populations suggests that the relationship is real. The bulk of the data is from Britain, but there is sufficient from the U.S. to indicate that the effect is not restricted to one country. No consistent increase in risk was found in outdoor workers compared with indoor workers of similar socio-economic status.

Administrative Personnel↗