Search PubMed⌕ Search

Biomedical subjects

J Campbell

Publications and source records attributed to J Campbell.

At least 73 records · Page 4Linked to original sources
PubMed2000

Training for surgeons using digital satellite television and videoconferencing.

The TETRASUR project (TELematics TRAining for SURgeons) has investigated the effectiveness of distance-learning technologies in the delivery of training for doctors who are studying for membership of the Royal College of Surgeons. Digital satellite television receivers and ISDN videoconferencing equipment have been installed in hospitals to deliver the course modules, including a series of live television programmes transmitted by satellite. ISDN videoconferencing was integrated, live, into the satellite broadcasts to bring in guest lecturers and for interactive discussions with the trainee doctors. Videoconferencing was also used for seminars and discussion groups. These methods proved to be effective and popular with the doctors, although there was some dissatisfaction with the visual quality of the ISDN videoconferencing at 128 kbit/s. Efforts are now being made to improve the quality of the video feed from remote sites using ISDN at 384 kbit/s.

Education, Distance↗
PubMed2000

Malignant primary hypertension in pregnancy treated with lisinopril.

OBJECTIVE: To report a case of a patient treated with an angiotensin-converting enzyme (ACE) inhibitor with a good neonatal outcome. CASE REPORT: A 39-year-old African-Caribbean patient who had chronic hypertension presented at 18 weeks' gestation with acute hypertension. She was being treated for chronic hypertension with lisinopril, but had self-discontinued treatment. Attempts to control her hypertension with labetolol, nifedipine, and methyldopa were ineffective. She was therefore offered termination of pregnancy so treatment with lisinopril could be restarted. The patient elected to continue with the pregnancy in spite of the fetal risks associated with the use of an ACE inhibitor. She was delivered of a girl at 26 weeks' gestation. The baby initially had renal failure and also developed acute necrotizing enterocolitis. The renal failure improved simultaneously with the latter complication, and it is postulated that there was enteric excretion of lisinopril. The baby was discharged home on day 102 with no further complications. DISCUSSION: ACE inhibitors are acceptable medications to use in the first trimester of pregnancy; however, fetal malformations and neonatal complications have been associated with their use later in pregnancy, and they have a perinatal mortality rate of 97/1000. Lisinopril is excreted in urine and feces unchanged, and its half-life is prolonged in anuric neonates. Peritoneal dialysis eliminates lisinopril; however, this neonate improved after treatment for necrotizing enterocolitis and simultaneous improvement in bowel function. CONCLUSIONS: ACE inhibitors should not be used in pregnancy beyond the end of the first trimester. In exceptional cases, they may be indicated for the control of severe hypertension when the patient is refractory to other medications. The patient should be fully counseled about the adverse effect profile and neonatal outcome. This case report documents a successful outcome for mother and baby in these circumstances.

Adult↗
PubMed2000

Mortality in male alcoholics after ten to fourteen years.

OBJECTIVE: Alcoholics frequently die prematurely. The purpose of this study was to determine: (1) whether subjects in a sample of 360 male alcoholics, followed over a period of 10-14 years, died prematurely: (2) if so, from what causes; and (3) whether such deaths are predictable from characteristics present at initial assessment. METHOD: Subjects were male veterans (N = 360) with a diagnosis of alcoholism admitted to an inpatient substance abuse treatment program at the Kansas City Veterans Affairs (VA) Medical Center during 1980-1984 who consented to participate in intake evaluations and subsequent follow-ups at 1 year and 10-14 years later. Of the 357 (99.2%) men located at the 10-14 year follow-up, 96 (26.6%) were confirmed as deceased, 255 survivors agreed to be reassessed and 6 subjects refused reassessment. Information regarding cause of death was obtained from death certificates, VA records and other sources. RESULTS: At intake, the subsequently deceased men were older, had less education, lower psychosocial functioning, more medical problems and greater psychiatric severity. Their overall death rate was 2.5 times greater than that of a reference group of men. Men in the 35-44 year age group were 5.5 times as likely to die. A statistical model utilizing measures of alcohol dependence to predict mortality from intake to 10-14 year follow-up indicated that alcoholics who limited drinking were half as likely to die whereas those who engaged in morning drinking were 2.5 times more likely to die. CONCLUSIONS: Alcoholic men, especially those in the group aged 35 to 44 years, have a significantly higher risk of premature death than a reference group of men. Men who engaged in morning drinking and could not limit drinking appeared to be at higher risk of mortality 10 years later.

Adult↗
PubMed2000

A Canadian survey on the management of corticosteroid induced osteoporosis by rheumatologists.

OBJECTIVE: To survey the practice pattern of Canadian rheumatologists (CR) on their management of corticosteroid induced osteoporosis in their premenopausal (PrM) and postmenopausal (PoM) female patients. METHODS: The practice pattern was surveyed using a 17 item questionnaire probing the diagnosis, prevention, treatment, and monitoring of osteoporosis in PrM and PoM women receiving longterm oral systemic corticosteroid therapy. RESULTS: Most CR investigated and treated osteoporosis themselves, 13% referred to other specialists for investigation, and 22% referred for treatment. Eighty-two percent of CR used dual energy x-ray absorptiometry (DEXA) to confirm a diagnosis of osteoporosis. Most CR initiated investigation for osteoporosis at the start or within the first year of starting longterm systemic corticosteroid therapy: PrM 87% and PoM 93%. The most frequently used initial strategy for the prevention of osteoporosis was as follows. PrM: calcium and vitamin D3 (53%); PoM: hormone replacement therapy (HRT) and calcium (29%). The most common initial choice for treatment of established osteoporosis was as follows: PrM: etidronate (53%); PoM: bisphosphonates +/- HRT (53%). Ninety-six percent of CR used only bone mineral density (BMD) measurement to monitor therapy for corticosteroid induced osteoporosis. Most CR monitored BMD every 12 to 24 months for PrM (81%) and PoM (84%). The BMD parameter(s) (T and Z scores as measured by DEXA) used to initiate therapy for corticosteroid induced osteoporosis was variable. CONCLUSION: It appears that, while certain trends are evident, there is still considerable variability in the management of corticosteroid induced osteoporosis.

Absorptiometry, Photon↗
PubMed2000

No programming required. Mobile PCs can help physicians work more efficiently, especially when the application is designed to fit the practice.

UNLABELLED: The Jacobson Medical Group San Antonio PROBLEM: Jacobson Medical Group (JMG) needed a way to effectively and efficiently coordinate referral information between their hospitalist physicians and specialists. SOLUTION: JMG decided to replace paper-based binders with something more convenient and easily updated. The organization chose to implement a mobile solution that would provide its physicians with convenient access to a database of information via a hand-held computer. RESULTS: The hand-held solution provides physicians with full demographic profiles of primary care givers for each area where the group operates. The database includes multiple profiles based on different healthcare plans, along with details about preferred and authorized specialists. KEYS TO SUCCESS: JMG adopted a user-friendly solution that the hospitalists and specialists would embrace and actually use.

Attitude to Computers↗
PubMed2000

Abuse during and before pregnancy: prevalence and cultural correlates.

This study examined the prevalence of abuse during pregnancy and the influence of cultural norms and acculturation on abuse in 1,004 Mexican American, Puerto Rican, Cuban American, Central American, African American and Anglo American women. Women were recruited from consecutive delivery logs in general community hospitals in Florida and Massachusetts. The Index of Spouse Abuse and the Abuse Assessment Screen ascertained history of adult physical, sexual, and emotional abuse, abuse during pregnancy, and childhood sexual abuse. An Interview Protocol assessed cultural attitudes, acculturation, and demographic information. Hispanic American women, as a whole, did not differ significantly from Anglo American women in their prevalence of abuse during pregnancy, after controlling for sociodemographic variables. However, Cuban American and Central American partners were significantly less likely to abuse their pregnant partners than were other groups even after adjustment. Women who spoke only Spanish (less acculturated) were less likely to report physical abuse from their partners both before and during pregnancy. Cultural norms, such as a partner's belief in wife/mother role supremacy and cultural group acceptability of men hitting women, were significantly positively related to both physical and emotional abuse. Other risk factors for abuse were the abuser not being the biological father of the baby, low income and little education, and being unmarried.

Acculturation↗
PubMed2000

Calorie use and obesity among diabetic and non-diabetic Mvskoke Indians.

Type 2 diabetes is a major cause of death among American Indians and obesity and physical inactivity are modifiable risk factors in the development of type 2 diabetes. Physical activity may have both a preventive effect and a secondary preventive effect of lessening insulin resistance in persons with type 2 diabetes. Moreover, for some individuals participation in daily regimens of physical activity is very difficult. Culture-specific physical activity may be an intervention to reduce obesity and prevent diabetes-related complications. Therefore, the research questions for this study were: (1) What is the body fat percentage of diabetic and non-diabetic Mskoke Indians?, (2) How does body fat percentage of Mvskoke Indians compare with recommended percentages for age and gender?, (3) What is the caloric use of Mvskoke Indians during daily and traditional cultural activities of dancing and stickball?, and (4) Are there relationships among body fat percentage, calorie use, gender, and diabetic status? The findings revealed that female diabetics' percentage of body fat in three age cohorts (40-49, 50-59, and 70+) was higher than that of non-diabetic females. By contrast, male diabetics had lower percentage of body fat than non-diabetic males. The actual mean percentage of body fat of the female participants ranged from 38.5% to 44%, roughly twice the standard recommended percentages of body fat of 20-24%. No significant difference was found in calorie use by gender or diabetic status. Analysis of calories during traditional activities revealed that 30 minutes of stickball used an average of 135.7 calories. Dancing for 33 minutes used an average of 149 calories. No significant relationship was found among percentage of body fat, caloric use, gender, and diabetic status.

Adolescent↗
PubMed1999

Physical and nonphysical partner abuse and other risk factors for low birth weight among full term and preterm babies: a multiethnic case-control study.

This study sought to determine the risk of low birth weight from intimate partner abuse. The case-control design was used in a purposively ethnically stratified multisite sample of 1,004 women interviewed during the 72 hours after delivery between 1991 and 1996. Abuse was determined by the Index of Spouse Abuse and a modification of the Abuse Assessment Screen. Separate analyses were conducted for 252 full term and 326 preterm infants. The final multiple logistic regression models were constructed to determine relative risk for low birth weight after controlling for other complications of pregnancy. Physical and nonphysical abuse as determined by the Index of Spouse Abuse were both significant risk factors for low birth weight for the full term infants but not the preterm infants on a bivariate level. However, the risk estimates decreased in significance in the adjusted models. Although today's short delivery stays make it difficult to assess for abuse, it is necessary to screen for domestic violence at delivery, especially for women who may not have obtained prenatal care. The unadjusted significant risk for low birth weight that became nonsignificant when adjusted suggests that other abuse-related maternal health problems (notably low weight gain and poor obstetric history) are confounders (or mediators) that help to explain the relation between abuse and low birth weight in full term infants.

Adolescent↗
PubMed1999

Comparison of two sampling tools for diagnosis of Tritrichomonas foetus in bulls and clinical interpretation of culture results.

OBJECTIVE: To compare sensitivity for diagnosing Tritrichomonas foetus infection in bulls using 2 sampling tools and to calculate negative predictive values for infection. DESIGN: Randomized clinical trial. ANIMALS: 30 Bos taurus bulls naturally or experimentally infected with T foetus. PROCEDURE: Preputial scrapings were obtained once/wk for 6 weeks using an artificial insemination pipette and a metal brush; which tool was used first for each bull was randomly determined. Samples were collected first from the left side of the prepuce and then from the right side and placed in commercially available transport media chi 2 Values and confidence limits were adjusted for effect of clustering of results by bull. RESULTS: Significant differences in sensitivity of results were not found between samples collected using the brush or pipette. Using the pipette, sensitivity was estimated to be 91.6% (95% confidence interval, 84.3 to 95.7%); negative predictive values ranged from 41 to 99% for prevalence of infection of 90 to 5%, respectively. Sensitivity was 88.8% for first sample obtained and 96.1% for second sample obtained. CONCLUSIONS AND CLINICAL RELEVANCE: Collection of preputial scrapings with an artificial insemination pipette or a metal brush and use of a commercially available culture system can provide a sensitive diagnostic test for T foetus infection in bulls. Calculated negative predictive values indicated that 1 or 2 tests would suffice in most clinical situations. For bulls from herds in which T foetus is endemic, 2 to 4 tests/bull may be required to ensure that each bull is not infected.

Animals↗
PubMed1999

Domestic violence against patients with chronic neurologic disorders.

BACKGROUND: Violent behavior caused by some neurologic disorders has been widely studied. However, the inverse, violence suffered by patients with neurologic disorders, has not been reported. Brain disorders frequently produce a high frequency of social, psychological, or physical disabilities that could leave patients vulnerable to domestic violence. OBJECTIVES: To determine the prevalence of domestic violence among female patients with chronic neurologic disorders and to identify possible diagnoses associated with the battering syndrome. DESIGN: Cross-sectional, self-administered, anonymous survey. SETTING: Tertiary care center for neurologic disorders in Mexico. PATIENTS: One thousand consecutive adult female patients with neurologic disorders, separated by medical diagnosis of functional or structural disorders. MAIN OUTCOME MEASURES: A modified version of the Abuse Assessment Screen was administered. Statistical analysis was performed using Poisson regression to estimate the prevalence ratio by univariate and multivariate analysis. RESULTS: Overall, 31.2% of women with chronic neurologic disorders were survivors of domestic violence. When separated according to the nature of the disease, 35.3% of patients with functional disorders and 28.1% of patients with brain structural disorders were victims of domestic violence (P = .02). Risk increased in relation to duration of marriage, number of children, and work outside the home. CONCLUSIONS: One third of female patients with chronic neurologic disorders in Mexico suffer domestic violence. A higher frequency of domestic violence was endured by patients with diagnosis of functional disorders as essential epilepsy, headache, migraine, trigeminal pain, depression, or vertigo. The possibility of domestic violence should be routinely explored in patients with chronic neurologic disorders of functional origin.

Adolescent↗
PubMed1999

Effects of early handling on amphetamine-induced locomotor activation and conditioned place preference in the adult rat.

RATIONALE: Altered hormonal stress responsiveness has been implicated in psychostimulant responsivity, and early handling represents a mild environmental manipulation which alters the hormonal profile following stress exposure. OBJECTIVE: The present experiments examined whether early handling in rats would alter locomotor effects of amphetamine, as well as cross-sensitization of locomotor responsiveness after chronic stress. Conditioned place preference (CPP) for amphetamine was also measured. METHODS: Handling consisted of daily 15-min isolation periods from days 1-12 postnatally. Novelty- and amphetamine (0, 1.5 mg/kg)-induced locomotion were examined using circular corridors in adult rats that were either restrained repeatedly over 8 days or not disturbed prior to testing. The effects of handling on amphetamine (0, 1, 2, 5 mg/kg) conditioned place preference (CPP) were also examined following 3 days of drug-compartment pairings. RESULTS: Early handling produced a more rapid post-stress recovery in corticosterone levels. Handled animals also exhibited a significant attenuation in amphetamine-induced CPP compared to non-handled controls. Locomotor responsiveness to novelty and amphetamine was not altered by early handling. Although no cross-sensitization was observed, evidence for stress sensitization was seen, but was unaffected by early handling. CONCLUSIONS: Handled animals showed an attenuated CPP for amphetamine, data suggesting that sensitivity to the reward value of drugs of abuse in adulthood may be susceptible to relatively minor environmental manipulations early in life. This effect of handling on CPP does not seem to reflect differences in locomotor sensitivity to amphetamine.

Amphetamine↗
PubMed1999

Evaluation of recombinant sporozoite antigen SPAG-1 as a vaccine candidate against Theileria annulata by the use of different delivery systems.

The major sporozoite surface antigen of Theileria annulata (SPAG-1) is a candidate for inclusion in a subunit vaccine. In this paper we summarize the results of 4 vaccination experiments using recombinant SPAG-1 expressed in different systems and presented in different adjuvants. The antigen has been presented as either a C terminal 108 amino acid peptide (called SR1) expressed as both beta-galactosidase and hepatitis B core antigen fusions or as a full-length form expressed as a GST fusion with an N terminal His6 tag. We used different adjuvants, namely Freund's, saponin, ISCOMs and a proprietary adjuvant supplied by SmithKline Beecham, which we call SKBA. The data point to the conclusion that SPAG-1 can elicit partial protection and is therefore suitable for inclusion in an eventual multicomponent subunit vaccine.

Animals↗