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Biomedical subjects

G H Fick

Publications and source records attributed to G H Fick.

36 records · Page 2Linked to original sources
PubMed1993

Clinical interpretation of the mini-mental state.

The Mini-Mental Status Examination (MMSE) is a brief, structured test of cognitive function. The test is often used as a screening or case-finding instrument for the detection of organic mental disorders or cognitive impairment. However, many clinicians incorporate the MMSE into their clinical mental status examination. In both contexts, cutoff scores are often utilized to interpret the results, with scores below the cutoff being interpreted as evidence of cognitive dysfunction, and scores above the cutoff being interpreted as evidence against such dysfunction. However, when the test is done as part of a mental status examination, the application of a cutoff score fails to take account of prior clinical information, which is critical to the interpretation of all diagnostic tests. In this paper, an alternative approach to interpretation is proposed. In the proposed method, guidelines for interpretation are based on the probability of being free of organic disease at each potential score. Scores are interpreted in terms of their consistency or inconsistency with a prior diagnostic impression. This takes prior clinical information and clinical judgment into account. Although different from the traditional way of interpreting the MMSE, the proposed method can be implemented on an intuitive level and does not require mathematical calculations, which are inconvenient at the bedside.

Cognition Disorders↗
PubMed1993

Determinants of midwall circumferential segmental length of the canine ventricular septum at end diastole.

The ventricular septum attaches to the insertion points of the ventricular free walls, separates, and is shared by both the left (LV) and right (RV) ventricles. Changes in the transseptal pressure gradient (PTS, the difference between LV and RV pressures) will change the stress in the septum and, therefore, the length of the septal segment (Ls). However, since most of the septal myocardial fibers are continuous with those of LV free wall and the septum appears to be an integral part of LV, one might also expect that if the LV transmural pressure (Plvtm; the difference between LV and pericardial pressure) is raised, Ls would increase even in the absence of any change in PTS. Therefore, we hypothesized that at end diastole, Ls depends on both Plvtm and PTS. To test this hypothesis, we measured Ls (sonomicrometry), LV and RV pressures (micromanometers), and pericardial pressure (flat liquid-containing balloon) in seven anesthetized open-chest dogs. Plvtm was increased through volume loading, whereas PTS was maintained constant at 10, 5, 0, -5, -10, and -15 mmHg by adjusting the degree of constriction of the pulmonary artery or aorta. These procedures were performed first with pericardium reapproximated and then after the pericardium had been opened widely. At each controlled PTS level, Ls increased linearly with the increase in Plvtm. Both the slope and the intercept of this Ls-Plvtm relation were affected by PTS in a nonlinear fashion. (ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

The epidemiology of premenstrual symptoms in a population-based sample of 2650 urban women: attributable risk and risk factors.

This epidemiologic survey achieved a reliable measure of the prevalence of premenstrual symptoms by avoiding the biases of small or selected samples, anamnestic error, and subjective expectation. From 6232 women (a 78.8% response), aged 20-49 years, identified through a random sample of urban households, the 24-hour prevalence of symptoms was obtained using the Moos' Menstrual Distress Questionnaire, administered without reference to the menstrual cycle. For 71% of the naturally cycling women, current cycle phase was determined by follow-up (n = 2650); but a higher prevalence of severe or moderately severe affective symptoms in the premenstrual compared to the mid-cycle phase was not found. However, observed risk factor interactions led to the conclusion that premenstrual distress is a discrete mood disorder, affecting women aged 25-35 years, with probable ovulatory cycles, and vulnerable to stress; and that the risk of affective symptoms attributable to the premenstrual state was one percent.

Adult↗
PubMed1992

Hypocomplementemia and leukocytosis in diarrhea-associated hemolytic uremic syndrome.

Sixty-eight children with diarrhea-associated hemolytic uremic syndrome (D+HUS) were retrospectively examined to assess clinical variables associated with the combination of leukocytosis and hypocomplementemia. There was a statistically significant association between the white blood cell count (WBC) and the level of the third component of the complement system (C3). Children with both a low C3 and a high WBC were significantly younger and required hospitalization for a significantly longer period of time. Although there were also trends to increases in the presence of anuria and central nervous system complications and in the duration of anuria, elevated WBC, thrombocytopenia, dialysis, and hemorrhagic colitis in children with both an elevated WBC and a low C3, these changes did not achieve statistical significance. The presence of a low C3 and an elevated WBC may indicate a subset of children with D+HUS with a more severe episode.

Age Factors↗
PubMed1991

Serologic response to treatment of infectious syphilis.

OBJECTIVE: To evaluate the serologic response to treatment of patients with infectious syphilis. DESIGN: Historical cohort study of all cases of infectious syphilis in Alberta from 1981 to 1987. PATIENTS: A total of 1090 patients were entered; 857 with primary syphilis, 183 with secondary syphilis, and 50 with early latent disease. Two hundred and eight patients were excluded who either were pregnant, had negative serologic results before treatment, had clinical relapse, were treatment failures, or were lost to follow-up. INTERVENTIONS: All 882 evaluable patients were treated with a recommended antibiotic regimen for infectious syphilis and returned for re-assessment including repeat serologic testing. MEASUREMENTS AND MAIN RESULTS: Seventy-two percent (95% CI, 66% to 77%) and 56% (CI, 43% to 70%) of patients with initial episodes of primary or secondary syphilis had seroreverted according to rapid plasma reagin (RPR) test results by 36 months. A 2- and 3-tube decline was seen by 6 and 12 months in primary and secondary syphilis. Early latent syphilis resulted in only a 2-tube decrease at 12 months. Serologic response was not affected by sex, age, race, or sexual orientation. Patients with their first infection were more likely to experience RPR seroreversal than those with repeat infections. The RPR reversal rates also depended on the pretreatment titer and stage of disease. At 36 months, 24% (CI, 20% to 28%) of patients had nonreactive fluorescent treponemal antibody absorption tests (FTA-Abs), and 13% (CI, 11% to 15%) had nonreactive microhemoglutination tests for Treponema pallidum (MHA-TP). CONCLUSIONS: Adequate therapeutic response for syphilis must be based on illness episode and the pretreatment RPR titer. Treponemal tests can demonstrate seroreversion after 36 months, and a negative treponemal test does not rule out a past history of syphilis.

Alberta↗
PubMed1991

Effects of maturation and co-culture treatments on the developmental capacity of early bovine embryos.

A total of 901 cumulus-oocyte complexes (COCs) were collected from bovine ovaries obtained at a local abattoir. COCs randomly assigned to Treatment I (n = 451), were cultured in TCM-199 + 10% fetal bovine serum (FBS) and hormones, while oocytes in Treatment II (n = 450) were cultured in TCM-199 + 20% estrous cow serum (ECS). Assessment of maturation revealed that 91.3% (42/46) of oocytes in Treatment I had reached metaphase II of meiosis, which was greater (P less than 0.05) than the 73.3% (33/45) in Treatment II. Following in vitro fertilization, 203 oocytes from Treatment I were co-cultured on bovine granulosa cells (Treatment IA) while the remaining 202 oocytes were co-cultured on bovine oviductal cells (Treatment IB). Similarly, 203 oocytes from Treatment II were co-cultured on granulosa cells (Treatment IIA) or oviductal cells (Treatment IIB, n = 202). Co-culture was maintained for 8 days. The proportion of cleaved zygotes was higher (P less than 0.05) in Treatment IB (86.6%) compared to Treatments IA (78.8%), IIA (58.1%), and IIB (64.8%). The proportion of cleaved zygotes that progressed beyond the 16-cell stage was also greater (P less than 0.001) in Treatment IB (71.4%) compared to Treatments IA (50.0%), IIA (35.4%) and IIB (55.8%). Treatment IB also produced the highest proportion of blastocysts (P less than 0.0001) (41.1%) versus 24.6% (IA), 11.3% (IIA) and 18.3% (IIB). The proportion of day 6 morulae that progressed to form day 8 blastocysts was similar for both co-culture treatments (IA, 70.1%; IB 70.2%; IIA, 51.5%; IIB 50.8%) and varied only between in vitro maturation groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

The use of intravenous gammaglobulin in the treatment of typical hemolytic uremic syndrome.

Nine children with acute typical post-diarrhea hemolytic uremic syndrome (HUS) were treated with intravenous gammaglobulin (IVIG). These children were compared to nine children with HUS who did not receive IVIG. The use of IVIG did not appear to have a beneficial effect on eight of the nine treated children. There were no significant differences found in the duration of hemorrhagic colitis, thrombocytopenia, elevation of the white blood count (WBC), anuria, dialysis, or hospitalization, or the presence of a central nervous system complication or pancreatitis. Although no significant difference was found in the duration of thrombocytopenia, there was a trend towards a longer duration of thrombocytopenia in children treated with IVIG (P = 0.13). One child demonstrated both an increase in her platelet count and a decrease in her WBC count within 24 h of receiving her first dose of IVIG.

Adolescent↗
PubMed1989

Analysis and comparison of sigmoidal curves: application to dose-response data.

A number of physiological or pharmacological studies generate sigmoidal dose-response curves. Ideally, data analysis should provide numerical solutions for curve parameters. In addition, for curves obtained under different experimental conditions, testing for significant differences should be easily performed. We have reviewed the literature over the past 3 years in six journals publishing papers in the field of gastrointestinal physiology and established the curve analysis technique used in each. Using simulated experimental data of known error structure, we have compared these techniques with nonlinear regression analysis. In terms of their ability to provide accurate estimates of ED50 and maximal response, none approached the accuracy and precision of nonlinear regression. This technique is as easily performed as the classic methods and additionally provides an opportunity for rigorous statistical analysis of data. We present a method of determining the significance of differences found in the ED50 and maximal response under different experimental conditions. The method is versatile and applicable to a variety of different physiological and pharmacological dose-response curves.

Animals↗
PubMed1989

Volume-pressure analysis of reflex changes in forearm venous function. A method by mental arithmetic stress and radionuclide plethysmography.

Mental arithmetic stress is known to cause forearm arterial dilation, but the venous responses, including possible changes in the volume-pressure relation, have not been defined. Hence, 10 apparently normal subjects, eight men and two women, mean age 46 +/- 9 years, were studied before and during mental arithmetic stress. Changes in forearm venous volume were estimated with 99mTc blood pool scintigraphy. Group variability of this measurement technique was 1.8 +/- 2.3%. A brachial blood pressure cuff was used to obtain venous occluding pressures of 0, 10, 20, and 30 mm Hg. Mental arithmetic stress increased group systolic and diastolic blood pressure from 126 +/- 12 to 152 +/- 20 mm Hg and from 83 +/- 8 to 93 +/- 15 mm Hg, respectively (p less than 0.001). Heart rate increased from a mean of 75 +/- 15 to 85 +/- 17 beats/min (p less than 0.01). There was no evidence of interaction between or nonlinearity of the volume-pressure plots. Linear regression then yielded the equations V = 99.8 + 0.96P before and V = 86.3 + 0.96P during mental arithmetic stress, which represents a 13.5 +/- 1.6% decrease in forearm vascular volume (p less than 0.001). We conclude that 1) a linear relation exists between forearm venous volume and pressure at physiologic pressures before and during mental arithmetic stress; 2) mental arithmetic stress causes forearm venoconstriction; and 3) such venoconstriction takes place by a parallel shift in the volume-pressure relation (i.e., a shift in unstressed venous volume).

Adult↗
PubMed1984

A comparison of plans for hypertension screening.

Correcting to the work by Donner and Bull [1], it is reported that, in the setting they considered, screening plans based on the mean have higher power (probability of identifying a true hypertensive) than screening plans based on the minimum. However, for any reasonable size (probability of a false diagnosis of hypertension) the powers of the two plans are close.

Blood Pressure Determination↗
PubMed1984

Correlations between laparoscopic and hysteroscopic findings in 497 women with otherwise unexplained infertility.

Laparoscopy and hysteroscopy were undertaken simultaneously in 497 women presenting with otherwise unexplained infertility. Of them, 285 complained of primary infertility and 212 of secondary infertility. Laparoscopic evidence of pelvic inflammatory disease in the absence of endometriosis was noted in 103 patients with primary and in 108 women with secondary infertility. Lesions were noted on hysteroscopy in both groups as well as in 34% of women with normal laparoscopic examinations. No specific dependency could be demonstrated between any laparoscopically detected lesion and hysteroscopically detected lesion. A significant dependency was demonstrated only between a history of secondary infertility and uterine adhesions (chi 2 = 12.03, 1 df, p less than 0.01). While the combined endoscopic findings did not demonstrate any dependency, the findings of this study demonstrate the importance of hysteroscopy in assessing all patients with infertility, especially those with secondary infertility.

Adolescent↗
PubMedDate not supplied

Early macular dysfunction detected by focal electroretinographic recording in non-insulin-dependent diabetics without retinopathy.

The focal electroretinogram, which measures the functional integrity of the distal retina of the macula, was recorded with a hand-held stimulator-ophthalmoscope in 26 eyes from patients with non-insulin-dependent diabetes mellitus with normal fundus photography, and in 52 control eyes of similar age range. Implicit time and amplitude of the responses were studied as a function of the age, glycemic control through glycosylated hemoglobin measurement and duration of diabetes. Implicit time and amplitude were significantly delayed (F=5.05, p=0.028) and reduced (F=11.26, p=0.013) in diabetic patients without diabetic retinopathy compared to control subjects. Moreover, there was a significant relationship between the implicit time (r=0.57, p=0.002) and amplitude (r=-0.65, p=0.0004) with the duration of diabetes but not with hemoglobin Alc. These results strongly suggest an early macular dysfunction in non-insulin-dependent diabetes mellitus before the appearance of diabetic retinopathy.

Aged↗
PubMedDate not supplied

The distribution of injuries in men's Canada West university football. A 5-year analysis.

We conducted a prospective cohort study from 1993 to 1997 to determine the frequency and severity of injury in men's Canada West university football. The Canadian Intercollegiate Sport Injury Registry was used to document baseline preseason data, daily athlete participation, and subsequent injury from five varsity football teams. An injury was defined as "any injury resulting in one or more complete or partial sessions of time loss" or "any concussion or transient neck neurologic injury." The annual proportion of injured athletes ranged from 53.5% to 60.4%, with a 5-year total of 1,811 injuries. Regression analysis indicated that the rate of nonconcussion, nonneck neurologic injuries increased. Concussion (N = 110), hamstring strain (N = 88), and brachial plexus (N = 84) injuries were the most common, specific injury diagnoses. Knee injuries resulted in the highest rate of severe (greater than or equal to 7 sessions of time loss) injury and resulted in the most time loss (3,350.5 sessions). Ligament sprains and muscle strains and spasms accounted for approximately half of all injury diagnoses. A total of 1,173 injuries (65%) were related to contact between players or between players and other obstacles. Future studies should be conducted to identify risk factors for the ultimate purpose of implementing injury prevention strategies.

Adolescent↗
PubMedDate not supplied

Prognostic factors in typical postdiarrhea hemolytic-uremic syndrome.

Sixty-one patients with typical postdiarrhea hemolytic-uremic syndrome were retrospectively examined to determine factors influencing the prognosis. A poorer prognosis was found in younger patients, in those with an elevated white blood cell count on admission, and in those with a prolonged duration of elevated white blood cell count, thrombocytopenia, and anuria.

Adolescent↗