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Biomedical subjects

E Shaw

Publications and source records attributed to E Shaw.

At least 37 records · Page 2Linked to original sources
PubMed1999

The effect of a peer counseling program on breastfeeding initiation and longevity in a low-income rural population.

Breastfeeding rates among low-income women in the east-south-central United States are among the lowest in the country. This study examined the effect of a peer counseling program on breastfeeding initiation and duration in a low-income rural population in West Tennessee. A postpartum survey and chart review were conducted with WIC clients at nine health departments. Response rate was 99% (291/293). Breastfeeding initiation and duration at 6 weeks were increased in the peer counselor group (n = 156) compared with women in the no-peer counselor group (n = 135) (53% vs. 33%, p < 0.001, and 26% vs. 13%, p = 0.006, respectively). Multivariate analysis revealed that women in the peer counselor group were significantly more likely to initiate breastfeeding (OR = 2.43, 95% CI = 1.23-4.67) and to be breastfeeding at 6 weeks (OR = 2.78, 95% CI = 2.08-9.51), than those in the no-peer counselor group.

Adolescent↗
PubMed1998

Adolescents' insight in heavy drinking.

PURPOSE: Because so few adolescents with alcohol problems seek treatment, this study examined the factors associated with adolescents' recognition or insight into having a substance use problem. METHOD: Data were extracted from a self-report questionnaire used in an epidemiological study of public middle school students on substance abuse in Arkansas. Those drinking heavily were divided into "admitters" and "deniers" based on their response to the question of having a substance use problem. Odds ratios were calculated to measure the association of several variables with admitting a problem. RESULTS: Of 3395 adolescents, 13.4% (455) met or exceeded our threshold for heavy drinking. Only 15.9% (65) of these heavy drinkers acknowledged having a substance use problem. Reporting more types of negative social events related to alcohol use and scoring higher on a measure of positive alcohol expectancies were significantly related to admitting to a substance use problem. Recent health care contact and perceived environmental factors did not independently contribute to insight. CONCLUSIONS: If these results are generalizable, treatment and educational interventions should emphasize linking alcohol use and negative social consequences.

Adolescent↗
PubMed1997

Psychological morbidity associated with abdominal aortic aneurysm screening.

OBJECTIVES: To identify whether abdominal aortic aneurysm screening causes anxiety in those screened and whether the diagnosis of an aneurysm produces sustained anxiety in subjects in comparison with those in whom no abnormality is detected. DESIGN: Prospective case controlled study. MATERIALS AND METHODS: The 28-item General Health Questionnaire (GHQ) was used to assess psychological morbidity in 161 men attending for routine aneurysm screening in the Gloucestershire Aneurysm Screening Programme. One hundred men had a normal aorta and 61 were identified as having aneurysms. The GHQ was administered just before screening and 1 month later. An anxiety linear analogue scale was also used. RESULTS: There was no difference in anxiety levels between those men with normal aortas and those with aneurysms either before or after screening. There was a statistically significant reduction in both these groups 1 month after screening. CONCLUSION: This study shows that although the invitation to aneurysm screening may cause some mild anxiety, this is not prolonged even when an asymptomatic aneurysm is diagnosed.

Aged↗
PubMed1997

What is the long-term outcome for patients with very small abdominal aortic aneurysms?

OBJECTIVE: To determine the long-term outcome for patients with abdominal aortic aneurysms (AAA) less than 4 cm in AP diameter (very small AAA). DESIGN: Population-based screening study. MATERIALS AND METHODS: One hundred and forty-two patients who had AAA less than 4 cm at presentation were assessed by ultrasound at intervals of 6-12 months. The records of these patients were reviewed. RESULTS: During the period of follow-up the median annual growth rate for aneurysms while under 3.0 cm was 1 mm, rising to 2 mm when between 3.0 and 3.9 cm, and 3 mm when between 4.0 and 4.9 cm in diameter. Elective aneurysm repair was undertaken when aneurysms exceeded the threshold value, which itself increased from 4 cm to 5.5 cm in the 9 years of follow-up. More patients died with their aneurysm (n = 35) then underwent surgery (n = 23). There was one perioperative death, and three unrelated late deaths after resection. One aneurysm ruptured in a patient who had refused follow-up 5 years previously. CONCLUSIONS: This study suggests that aneurysms less than 4.0 cm diameter are relatively benign, and questions the appropriateness of early intervention.

Adult↗
PubMed1997

Sleep in the laboratory and sleep at home: comparisons of older insomniacs and normal sleepers.

Many laboratory polysomnographic (LPSG) studies have shown only modest sleep differences between insomniacs and matched, noncomplaining normal controls. However, the extent to which LPSG methodology affects the outcome of such comparisons has yet to be tested. In the current investigation, 32 (16 females, 16 males) older (age > or = 60 years) insomniacs and an age-matched and gender-matched sample of 32 noncomplaining normal sleepers underwent three consecutive nights of LPSG monitoring and another three consecutive nights of PSG monitoring in their homes (HPSG). By random assignment, one-half of the subjects in each group underwent LPSG first, whereas the remaining subjects underwent HPSG first. Each PSG recording was blindly scored using conventional scoring criteria, and resulting measures of total sleep period, total sleep time, sleep efficiency percent, stage 1 time, slow-wave sleep time, and rapid eye movement latency were used to compare the two subject groups within each PSG recording site (i.e. lab and home). Statistical analyses showed the normals sleepers and insomniacs evidenced similar pronounced first night effects (FNEs) when undergoing LPSG. However, neither mean values of the selected sleep parameters nor measures reflecting their night-to-night variability differentiated the insomniacs from the normal sleepers when such measures were derived from LPSG. In contrast, FNEs were generally absent for both subject groups when they underwent HPSG. Moreover, the insomniacs displayed significantly greater variability in several of their sleep measures during HPSG than did the normal sleepers. Overall, results suggest FNEs are a concern mainly when using LPSG, and HPSG may be more sensitive than LPSG for documenting sleep differences between normal sleepers and insomniacs. Additional studies are needed to determine if the findings reported herein are similar for young and middle-aged adults.

Aged↗
PubMed1997

Do our methods lead to insomniacs' madness?: Daytime testing after laboratory and home-based polysomnographic studies.

Complaints of daytime dysfunction are common among chronic insomniacs, but laboratory comparisons of insomniacs and age-matched and gender-matched normal controls have generally failed to document these complaints. However, a few studies, which allowed subjects to sleep in their homes on the nights before daytime testing, have shown some relative diurnal deficits among insomniacs. The current study compared the effects of nocturnal laboratory and home polysomnogram (PSG) studies on subsequent daytime test results among older insomniacs and normal sleepers. Insomniacs (n = 32) and normal sleepers (n = 32) were randomly assigned to first undergo three nights of nocturnal PSG monitoring either in the sleep laboratory (16 insomniacs, 16 normal sleepers) or in their homes (16 insomniacs, 16 normal sleepers). Following the third night of PSG monitoring, subjects spent 1 day in the sleep laboratory, where they completed a four-trial multiple sleep latency test along with four trials of a computer-administered performance test battery. Results showed that insomniacs, as a group, were slightly, albeit consistently, sleepier than were normal sleepers following nights of home sleep monitoring, but a reverse of this trend was found among subjects who underwent nocturnal laboratory PSG before daytime testing. Furthermore, normal sleepers showed faster reaction times on a signal detection task than did insomniacs within the subgroup who underwent home PSGs prior to such testing. However, within the subgroup that underwent nocturnal laboratory PSGs, insomniacs' signal detection reaction times were significantly faster than those shown by normal sleepers. Results provide some support for the speculation that the nocturnal PSG monitoring site, used as a precursor to daytime testing, may systematically affect daytime comparisons between insomniacs and matched controls. Moreover, these results suggest that the use of home-based nocturnal PSG monitoring prior to daytime testing may provide an enhanced understanding of insomniacs' diurnal complaints.

Aged↗
PubMed1996

Isolation of a Chinese hamster ovary cell clone possessing decreased mu-calpain content and a reduced proliferative growth rate.

A Chinese hamster ovary cell line (CHOp) was cultured in the presence of benzyloxycarbonyl-Leu-Leu-Tyr diazomethyl ketone (ZLLY-CHN2), to select for resistance to this cell-permeant calpain inhibitor. A clone isolated after several courses of exposure (SHI cells) demonstrated decreased sensitivity to ZLLY-CHN2 toxicity and a decreased growth rate. SHI cells also possessed less mu-calpain isozyme relative to CHOp cells, as determined by activity measurement or by protein immunoblotting. Activities of m-calpain, calpastatin, cathepsin B, cathepsin L, and glycogen phosphorylase were not altered. SHI mu-calpain was partially purified by sequential chromatography on Bio-Gel A-1.5m and DEAE-Sepharose. Its chromatographic behavior in either system was the same as for CHOp mu-calpain. Further studies with the partially purified SHI and CHOp mu-calpain fractions failed to distinguish any difference in Ca2+ requirement or in sensitivity to inhibition by calpastatin or ZLLY-CHN2 for these enzymes. These experiments suggest that SHI cells underproduce a form of mu-calpain which is very similar to, if not identical with, CHOp mu-calpain. SHI cells displayed a population doubling time of 29 h compared with 19 h for CHOp cells. The decreased growth rate of SHI cells was the result of a prolonged G1 phase. Introduction of purified human mu-calpain into SHI cells by electroporation transiently restored the growth rate and also increased toxicity associated with exposure to ZLLY-CHN2. SHI cells should be a valuable model in further studies to delineate the function of mu-calpain in cell proliferative growth.

Animals↗
PubMed1996

Radiosurgery for the treatment of previously irradiated recurrent primary brain tumors and brain metastases: initial report of radiation therapy oncology group protocol (90-05).

PURPOSE: To determine the maximum acutely tolerable dose of single fraction radiosurgery in patients with recurrent previously irradiated primary brain tumors or brain metastases. METHODS AND MATERIALS: Between August 1990 and September 1993, 102 analyzable patients were entered on Radiation Therapy Oncology Group (RTOG) protocol 90-05, 38 of whom had recurrent primary brain tumors (median prior dose 60 Gy), and 64 of whom had recurrent brain metastases (median prior dose 30 Gy) < or = 40 mm in maximum diameter. Unacceptable toxicity was defined as irreversible Grade 3, any Grade 4, or Grade 5 central nervous system (CNS) toxicity according to the RTOG CNS criteria, occurring in > 20% of patients per treatment arm within 3 months of radiosurgery. RESULTS: Patients were initially entered onto one of three treatment arms according to the maximum diameter of the recurrent lesion. Twelve to 22 patients were entered on each arm. The dose levels were: arm 1, < or = 20 mm, 18 Gy; arm 2, 21-30 mm, 15 Gy; and arm 3, 31-40 mm, 12 Gy. Subsequently, doses were escalated as follows: arm 4, < or = 20mm, 21 Gy; arm 5, 21-30 mm 18 Gy; and arm 6, 31-40 mm, 15 Gy. Unacceptable acute toxicity secondary to cerebral edema occurred in 0, 7 and 5% of patients on Arms 1, 2 and 3, respectively, and in no patients on arms 4, 5, or 6. Multivariate analysis revealed that tumor volume > or = 8200 mm(3) and a ratio of maximum dose to prescription dose (MD/PD) > or = 2 were significantly associated unacceptable toxicity. Of 15 patients with both tumor volume > or = 8200 mm(3) and MD/PD > or = 2, unacceptable toxicity occurred in 2 of 4 treated with a single isocenter and 1 of 11 treated with multiple isocenters. Subsequently, operation for symptomatic radionecrosis was required in 6% of patients. CONCLUSION: We found that the incidence of acute toxicity was acceptable at 0-7% in patients with recurrent, previously irradiated primary brain tumors or brain metastases < or = 40 mm in maximum diameter treated according to the protocol described.

Adult↗
PubMed1995

Factors associated with noncompliance of patients taking antihypertensive medications.

Poor adherence to drug therapy decreases the effectiveness of antihypertensive treatment. Patients must take more than 80% of their antihypertensive drugs to maintain adequate blood pressure control. To understand the incidence of noncompliance and contributing factors, a pilot study was conducted in which a questionnaire was devised and administered to a random sample of 243 hypertensive patients of the adult ambulatory care clinic at Methodist Hospital of Indiana. Ninety-eight patients completed the telephone survey. Demographic data were obtained through chart reviews. The results indicated that 30-46% of the patients were noncompliant with their antihypertensive drug regimens. Factors found to be associated with noncompliance were; employment (P = .0077), use of home remedies (P = .0043), age (P = .0165), experience of side effects (P = .0051), level of concern with missed doses (P = .0043), and cost (P = .014). The incidence of noncompliance in this pilot sample is lower than the estimated 50% noncompliance rate of published data. More research is needed to understand the determinants of noncompliance in order to design interventions to improve compliance.

Adult↗
PubMed1995

Prevalence of and risk factors for Chlamydia in a rural pregnant population.

BACKGROUND: Chlamydia trachomatis infection is the most common sexually transmitted bacterial disease in the United States. Perinatal infection with C trachomatis has been associated with preterm labor, preterm rupture of membranes, stillbirth, and both conjunctivitis and pneumonia in newborns. Little is known about the prevalence of C trachomatis infection in rural pregnant women. METHODS: We completed a retrospective chart analysis of 347 obstetric patients in a rural family practice residency training program to determine the prevalence, associated risk factors, and screening criteria for cervical C trachomatis infection. RESULTS: The prevalence of C trachomatis infection in our study was 9.0%. Factors predictive of a positive test for C trachomatis infection included single marital status, African-American race, history of sexually transmitted diseases, presence of gonorrhea during the current pregnancy, age less than 20 years, and late onset of prenatal care. CONCLUSIONS: The prevalence of C trachomatis in this rural obstetric population emphasizes the importance of laboratory screening of rural pregnant women for this disease.

Adolescent↗
PubMed1994

Sequence and structure similarities of cathepsin B from the parasite Schistosoma mansoni and human liver.

A three-dimensional structure of Schistosoma mansoni cathepsin B was modelled using the coordinates of the crystal structure of the human liver enzyme. Both enzymes appear to share remarkable structural similarity. However, an examination of the models complexed with two synthetic inhibitors revealed differences in inhibitor binding, as confirmed by differences in the 50% inhibitory concentration of the same inhibitor.

Amino Acid Sequence↗
PubMed1994

Screening for abdominal aortic aneurysm: a single scan is enough.

A group of 223 men who were found to have a normal abdominal aortic diameter (less than 2.6 cm) at the age of 65 or 66 years when first examined by ultrasonography in 1988 was studied again 5 years later. Twenty-seven patients had died, none from confirmed aneurysm rupture, and repeat scans were obtained in 189 of the 196 survivors. A further patient was reassessed at laparotomy. Mean aortic diameter was unchanged during the intervening 5 years and 166 of 189 repeat scan measurements were within 3 mm of the original value. Only two patients were found to have an aortic diameter of 3 cm or more on rescanning. These results suggest that a single ultrasonographic examination at the age of 65 years can safely be used to exclude over 90 per cent of those examined from future risk of significant aneurysmal dilatation of the aorta, with important cost and organizational benefits for a population screening programme.

Aged↗
PubMed1994

Inhibition of growth of human TE2 and C-33A cells by the cell-permeant calpain inhibitor benzyloxycarbonyl-Leu-Leu-Tyr diazomethyl ketone.

Calpains are Ca(2+)-requiring, nonlysosomal proteases which are thought to participate in some aspects of intracellular Ca(2+)-signal transduction. However, their exact physiologic function has not yet been established. Addition of the cell-permeant, irreversible calpain inhibitor, ZLLY-CHN2, to human TE2 or C-33A cells inhibited growth, as assessed either by mitochondrial MTT reductase activity or by direct cell counting. Inhibition of growth produced by a 24-h exposure to 50 microM ZLLY-CHN2 was reversed upon substituting growth medium without inhibitor. Homogenates produced from cells cultured in the presence of ZLLY-CHN2 displayed decreased calpain and Ca(2+)-independent proteolytic activities. Protein immunoblot analysis showed that cell cultures which had lost 80% of their calpain activity still retained full calpain immunoreactivity. Therefore, inhibition by ZLLY-CHN2 appeared to result in accumulation of irreversibly inactivated calpain within the cells. Homogenates from cells cultured in the presence of 20 or 50 microM ZLVG-CHN2, a cell-permeant inhibitor with little activity against calpains, had decreased Ca(2+)-independent proteolytic activity, but demonstrated no decrease in calpain activity. ZLVG-CHN2 did not inhibit cell growth under these conditions. Growth of Saccharomyces cerevisiae cells, which do not appear to express calpain-like proteases, was not inhibited by including 50 microM ZLLY-CHN2 in the culture medium. These results indicate that calpains participate in the social regulation of cell growth in multicellular organisms.

Calcium-Binding Proteins↗