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Biomedical subjects

J C Higgins

Publications and source records attributed to J C Higgins.

11 recordsLinked to original sources
PubMed1999

Vasectomy techniques.

Vasectomy can be performed by means of various techniques, although each vasectomy technique requires isolation and division of the vas and operative management of the vasal ends. Removal of at least 15 mm of vas is recommended, although division of the vas without removal of a segment is effective when this technique is combined with other techniques for handling the vasal ends, such as thermal luminal fulguration and proximal fascial interposition. Ligation of the ends without the aid of surgical clips may result in necrosis and sloughing of the ends, which may cause early failure. Leaving the testicular end of the vas open has been shown to be effective and to result in a lower incidence of epididymal congestion and sperm granuloma. The no-scalpel technique offers shorter operating time, less pain and swelling, and faster recovery.

Humans↗
PubMed1998

Influence of an interventional program on resource use and cost in pediatric asthma.

OBJECTIVE: Asthma is the most common chronic condition of childhood, for which morbidity, mortality, and cost are increasing. This study was performed to determine whether patient education and assignment to a primary care provider improve outcomes and cost in the management of pediatric asthma. STUDY DESIGN: A prospective pilot study of 61 patients was conducted with a retrospective review. Data were obtained from health and pharmacy records. PATIENTS AND METHODS: Sixty-one unassigned pediatric asthma patients who were noted to be frequent users of emergency department services and who had no primary care provider were identified. This cohort received asthma education and was assigned a provider trained in the national asthma guidelines. Hospital admissions, Emergency Department and clinic visits, use of beta 2 agonists and anti-inflammatory drugs, number of chest radiographs, and continuity of care were recorded for a mean of 58.1 months before and 11.2 months after the intervention. A cost analysis was done. RESULTS: All measured parameters showed favorable changes after intervention, with the decrease in the number of prescriptions of monthly inhaled anti-inflammatory drugs and chest radiographs ordered being statistically significant (P = 0.007 and P = 0.040, respectively). Monthly admissions, Emergency Department visits, and clinic visits declined after intervention when evaluated after 22.8 months of follow up. Annual resource savings after intervention was estimated to be $4845.29 per patient for this military hospital. CONCLUSIONS: A combined intervention consisting of provider and patient education and assignment to a primary care provider was associated with improved care and economic outcomes in this group.

Asthma↗
PubMed1995

Accuracy of quantitation of aortic stenosis using femoral arterial recordings corrected for both temporal delay and systolic amplification.

Our study demonstrates the feasibility of substituting FA recordings, corrected for both temporal delay and systolic amplification, for central aortic recordings in assessing aortic valve stenosis. This method is accurate in estimating the transaortic valve gradient, the calculated valve area, and the calculated valve resistance, and obviates the risks and costs of 2 FA punctures.

Adult↗
PubMed1986

Separation of brain-damaged from psychiatric patients with the combined use of an ability and a personality test: a validation study with a Puerto Rican population.

The purpose of this study was to validate the results obtained by Watson, Gasser, Schaefer, Buranen, and Wold (1981) by utilizing the Smith Symbol-Digit Modalities Test (Form W) and the MMPI (Psychiatric-Organic) scale in combination. Forty recently admitted/readmitted male patients were given both the SDMT and the MMPI (P-O) at a point in their hospitalization in a private inpatient psychiatric hospital in Puerto Rico. The combined use of the Smith and the P-O scale, with the criteria originally developed by Watson et al. (1981), provided a modest level of discrimination by correctly identifying 80% of the brain-damaged sample (organic group) and 55% of the functional sample (psychiatric group) subjects. This combination of tests yielded an overall mean hit rate of 67.5%. These results moderately support the findings obtained by Watson et al. (1981).

Adolescent↗
PubMed1986

Serum osteocalcin is increased in patients with hyperthyroidism and decreased in patients receiving glucocorticoids.

Osteocalcin (OC) is a vitamin K-dependent protein which is synthesized by osteoblasts and is present in the circulation. We measured serum OC concentrations in 10 patients receiving corticosteroids (CS) for chronic obstructive pulmonary disease and in 9 hyperthyroid (HT) patients. Mean values ( +/- SE) were as follows: There was a significant correlation between OC and alkaline phosphatase (r = 0.607; P = 0.006) when CS and HT groups were combined. Elevated serum OC concentrations in hyperthyroid patients may reflect increased osteoblastic activity, while decreased levels in corticosteroid-treated patients may reflect decreased osteoblastic activity.

Adult↗
PubMed1981

Human dermal microvasculature: I. Its segmental differentiation. Light and electron microscopic study.

Light microscopic examination of I micrometer thick epoxy resin sections of human skin preserved in fixative normally used for electron microscopy allows division of the microvasculature of the reticular and superficial dermis into several distinct segments. More precise delineation of these components can be achieved by correlative study using electron microscopy. Measurement of vessel diameter in tissue sections is of limited value in vessel classification because there is a wide overlap between different vascular segments and the results are influenced by the type of fixative used for processing the tissue. Detailed observation of the morphological characteristics of the endothelium and its investment, including the elastic and basal laminae, is consider preferable for identifying individual vascular segments. Differences in body region do not appear to have any obvious influence on vessel structure although there are regional differences in vessel density and arrangement. In comparison with earlier studies on animal tissues or human skin, no structures resembling arteriovenous shunts or precapillary sphincters were observed in the present investigation. However, closed fenestrae and other structures thought to be transendothelial channels were often found at the tips of capillary loops adjacent to the epidermis.

Adult↗
PubMed1981

Human dermal microvasculature: II. Enzyme histochemical and cytochemical study.

An enzyme histochemical and cytochemical study of normal dermal microvasculature showed that respiratory enzymes, lipase and non-specific esterase occurred in all vascular segments. Lysosomal enzymes were also widely distributed and acid phosphatase activity was localized in lysosomes, Golgi apparatus and small portions of endoplasmic reticulum of both endothelial cells and pericytes. Alkaline phosphatase activity, however, was confined to the arterial side and tip of the capillary loop where it occurred in vesicles along the luminal surface of the endothelium and in junctions between endothelial cells. The localization of nucleoside phosphatase activity within the endothelium varied according to substrate; with adenosine triphosphate as substrate, the reaction product occurred in vesicles distributed throughout the endothelial cells; with adenosine diphosphate it was limited to vesicles along the luminal surface; and with adenosine monophosphate, activity was mostly localized to the lateral surfaces of endothelial cells. These findings suggest functional variation between different vascular segments and between various components of the endothelium. Attempts to demonstrate a specific Na+K+ adenosine triphosphatase (transport ATPase) within the endothelium were not successful.

Adult↗
PubMedDate not supplied

Extraskeletal Ewing's sarcoma of primary cardiac origin.

A 13-year-old boy presented with cardiac tamponade. Echocardiography revealed a large mass extending from the right and left ventricles into a large pericardial effusion. Pathology confirmed the first reported case of a primary cardiac extraskeletal Ewing's sarcoma.

Adolescent↗