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Biomedical subjects

J Carter

Publications and source records attributed to J Carter.

At least 127 records · Page 7Linked to original sources
PubMed1995

Quality of life assessment in gynaecological cancer patients.

The feasibility of quality of life (QOL) assessment in a heterogeneous group of gynaecological cancer patients undergoing chemotherapy was determined. All new patients being prescribed cytotoxic chemotherapy were asked to complete a modified QOL assessment tool. The elected assessment tool is the Functional Assessment Cancer Therapy-General (FACT-G) tool, comprising 33 questions under 5 broad categories: physical well-being, social well-being, relationship with doctor, emotional well-being and functional well-being. Raw scores were calculated and then transformed to a 0-100 scale. Twenty eight patients received a total of 75 treatment cycles of chemotherapy. Four patients were not offered the assessment due to language difficulties. All patients offered the test satisfactorily completed the test to allow statistical analysis. The average number of chemotherapy courses received was 2.5 (range: 1-6). Of a total possible 2,475 study items (33 items x 75 cycles), 240 items were not answered (10%). Of these 240 unanswered items, 2 items (#14 and #15) comprised 38%. The mean transformed score for physical well-being was 32 (SE 2.5), for social well-being the mean transformed score was 50 (SE 1.7), relationship with doctor 86 (SE 2.4), emotional well-being 41 (SE 2) and functional well-being was 54 (SE 2.6). The assessment of QOL indices in gynaecological cancer patients undergoing chemotherapy is feasible. Further research needs to determine the optimal QOL tool for this patient population.

Adult↗
PubMed1995

Development of a robust flow cytometric assay for determining numbers of viable bacteria.

Several fluorescent probes were evaluated as indicators of bacterial viability by flow cytometry. The probes monitor a number of biological factors that are altered during loss of viability. The factors include alterations in membrane permeability, monitored by using fluorogenic substrates and fluorescent intercalating dyes such as propidium iodide, and changes in membrane potential, monitored by using fluorescent cationic and anionic potential-sensitive probes. Of the fluorescent reagents examined, the fluorescent anionic membrane potential probe bis-(1,3-dibutylbarbituric acid)trimethine oxonol [DiBAC(inf4)(3)] proved the best candidate for use as a general robust viability marker and is a promising choice for use in high-throughput assays. With this probe, live and dead cells within a population can be identified and counted 10 min after sampling. There was a close correlation between viable counts determined by flow cytometry and by standard CFU assays for samples of untreated cells. The results indicate that flow cytometry is a sensitive analytical technique that can rapidly monitor physiological changes of individual microorganisms as a result of external perturbations. The membrane potential probe DiBAC(inf4)(3) provided a robust flow cytometric indicator for bacterial cell viability.

Journal Article↗
PubMed1995

Gastric Bypass and Vertical Banded Gastroplasty- a Prospective Randomized Comparison and 5-Year Follow-up.

BACKGROUND: a prospective randomized study was undertaken to compare the outcome of vertical banded gastroplasty (VBG) and gastric bypass (GBP) in patients with clinically severe obesity. METHODS: eligibility criteria included Class IV obesity, < 50 years old and a history of at least one attempt of non-operative weight loss. Patients were managed conservatively for 3 months prior to surgery. Patients were followed post-operatively and monitored for early and late complications and their weight loss outcome for up to 5 years. RESULTS: 44 patients were recruited. Two patients withdrew within 4 weeks and were excluded. Twenty subjects had a GBP and 22 a VBG. There were no significant differences with respect to age, gender, maximum or pre-operative weight between the groups (p > 0.05). Patients who underwent GBP demonstrated significantly greater post-operative weight loss (p < 0.05) which was apparent from 6 months onwards. There were no deaths, pulmonary emboli, post-operative leaks or wound dehiscence. There were no instances of staple-line disruption. Symptomatic ulcer disease, confirmed endoscopically, developed in 25% of GBP patients. Nine patients developed gallstones post-operatively of whom five were in the VBG and four in the GBP group. CONCLUSIONS: weight loss following GBP was maintained, while VBG patients slowly regained.

Journal Article↗
PubMed1995

Otoacoustic emissions in sudden unilateral hearing loss associated with multiple sclerosis.

Sudden unilateral hearing loss may result from etiologies affecting cochlea, eighth nerve, or more central auditory tracts. Two case studies are presented in which the measurement of otoacoustic emissions helped rule out outer hair cell cochlear pathology. In both cases, the final diagnosis was sudden unilateral hearing loss associated with multiple sclerosis (MS). For one case, the sudden hearing loss was the first clinically recognized presenting sign of MS.

Acoustic Stimulation↗
PubMed1994

Prognostic indicators in bulimia nervosa treated with cognitive-behavioral group therapy.

Prognostic indicators of short-term outcome were identified in 69 women with the DSM-III-R diagnosis of bulimia nervosa who participated in a weekly 10-session structured cognitive-behavioral outpatient group program. Prior to treatment, all subjects completed the computerized Diagnostic Interview Schedule (DIS), the Moos Family Environment Scale (FES), the Diagnostic Survey for Eating Disorders (DSED), the Beck Depression Inventory (BDI), the Hopkins Symptom Checklist, Revised (SCL-90-R), the Bulimic Cognitive Distortions Scale (BCDS), the Eating Disorders Inventory (EDI), and the Bulimic Symptoms Checklist (BSCL). The latter three scales were readministered on completion of the 10-week group. Symptom improvement was assessed by examining percentage reduction in binge frequency, purge frequency, and summed scores for the EDI subscales Bulimia, Drive for Thinness, and Body Dissatisfaction. The only significant predictor of improvement in binge frequency and bulimic cognitions was family environment. Conflicted, controlling, and over-organized family environments appear to impede both reductions in binge frequency and changes in bulimic cognitions. Reduction in vomit frequency was associated with weight history and with laxative or diuretic use. The implications for planning psychotherapeutic interventions in bulimia nervosa are discussed.

Adolescent↗
PubMed1994

Child-rearing violence.

In 1989, a national, random sample of 801 adults was questioned about the punishment they received as children and the way they discipline their own offspring. Analysis revealed that verbal and physical discipline are not substitutes, but, instead, are commonly used together. Parents who yell frequently are the ones most likely to hit frequently, and vice versa. In addition, both physical and verbal violence appear to be transgenerational. Respondents who were spanked (yelled at) frequently as children are more prone to frequently spank (yell at) their own children. Still, most people are able to break out of the transgenerational cycle of punitive child rearing. This outcome may be found particularly among those who consider themselves to have been abused.

Child↗
PubMed1994

Dapiprazole clinical efficiency for counteracting tropicamide 1%.

We evaluated the clinical usefulness of dapiprazole in reversing the effects of tropicamide 1.0%. Our study was random, masked with placebo, and used one eye of each subject as a control. Thirty subjects were given dapiprazole as directed by the manufacturer 30 min after being dilated by one drop each of proparacaine 0.5%, tropicamide 1.0%, and then 5 min later another drop of tropicamide 1.0%. Pupil diameter, amplitude of accommodation, conjunctival injection, and intraocular pressure were evaluated. Each of these variables was measured: (1) before instillation of the diagnostic agents; (2) before the instillation of dapiprazole; and (3) at 30, 60, 120, and 180 min after the final instillation of dapiprazole. The average pupillary recovery time for dapiprazole-treated eyes was significantly less than for nontreated eyes. Accommodation also showed faster recovery. Comfortable reading ability returned after approximately 43 min with dapiprazole vs. 66 min without dapiprazole. All of our subjects exhibited conjunctival hyperemia after the administration of dapiprazole. This persisted throughout the 180 min observation period after its administration.

Accommodation, Ocular↗
PubMed1994

Respiratory effort perception at rest and during carbon dioxide rebreathing in patients with dystrophia myotonica.

BACKGROUND: Breathlessness appears to be closely related to the perception of the outgoing motor command to breathe and should be increased in the presence of muscle weakness. However, breathlessness is not a common symptom in patients with chronic muscle disease who have weak respiratory muscles. The factors that determine the perception of respiratory effort in such patients have not been examined. METHODS: The inspiratory effort sensation during resting breathing and progressive hypercapnia was investigated in 12 patients with dystrophia myotonica with weak respiratory muscles (nine men and three women of mean (SD) age 41.1 (10.5) years; maximum inspiratory pressure 43.1 (17.2) cm H2O) and an age and sex matched control group of normal subjects of mean age 39.6 (10.6) years and a maximum inspiratory pressure of 123 (15.2) cm H2O. RESULTS: During resting breathing with a mouthpiece no differences were seen in inspiratory effort sensation, mouth occlusion pressure, or tidal volume, but inspiratory time and cycle duration were significantly shorter in the patients with dystrophia. Minute ventilation (VE) was significantly higher in the patients (15.8 (4.0) l/min v 12.5 (2.6) l/min), while resting breathing was no more variable in the patients than in controls. The ventilatory response to carbon dioxide (VE/PCO2) was not significantly lower in the patients (14.9 (6.9) l/min/kPa) than in the controls (17.4 (4.3) l/min/kPa). Effort sensation responses to carbon dioxide driven breathing were similar in the control subjects and the patients. With regression analysis of pooled data neither maximum inspiratory pressure nor disease state contributed to perceived inspiratory effort during hypercapnia. CONCLUSIONS: Moderately severe global respiratory muscle weakness does not appear to influence the ventilatory response to rising carbon dioxide tension or the perception of inspiratory effort in patients with dystrophia myotonica.

Adult↗
PubMed1994

The effect of deprenyl and tocopherol on cognitive performance in early untreated Parkinson's disease. Parkinson Study Group.

We conducted prospective cognitive assessments over 14 +/- 6 (mean +/- SD) months of observation as part of the multicenter trial Deprenyl and Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP), which involved 800 patients with early untreated Parkinson's disease. We administered tests that measured memory, visuospatial, and frontal lobe functions. Subjects were randomly assigned to receive placebo, deprenyl (10 mg/d), tocopherol (2,000 IU/d), or both deprenyl and tocopherol. We analyzed treatment effects using annualized rates of cognitive change. We performed exploratory analyses to identify potential clinical and demographic correlates of cognitive performance. There was no significant effect of either deprenyl or tocopherol on cognitive test performance. In early untreated Parkinson's disease, cognitive performance appears to be stable and unrelated to either motor deterioration or treatment with deprenyl or tocopherol.

Aged↗
PubMed1994

How accurate is the pelvic examination as compared to transvaginal sonography? A prospective, comparative study.

Findings at pelvic examination in 120 patients were compared to those obtained by transvaginal sonography (TVS). Overall, 102 of 472 (22%) pelvic examination assessments did not agree with the TVS findings. Twenty-nine (36%) uterine assessments differed, while 46 (32%) ovarian assessments differed. Among 37 pelvic masses assessed in 20 cases (54%) the pelvic examination differed from the findings obtained by TVS. Only 4 (29%) cases assessed by pelvic examination were in agreement with the laparotomy findings as compared with 10 (71%) cases assessed by TVS.

Adolescent↗
PubMed1994

Flow characteristics in benign and malignant gynecologic tumors using transvaginal color flow Doppler.

OBJECTIVE: To assess flow characteristics of benign and malignant gynecologic tumors by transvaginal color flow Doppler. METHODS: Records of the Ultrasound Laboratory, Women's Cancer Center, University of Minnesota were analyzed retrospectively. Gray scale findings were recorded as either "diagnostic" or "nondiagnostic." Color flow assessment was performed on intratumor vessels or ovarian and/or uterine arteries. Flow was recorded as either "absent" or "present." Spectral analysis allowed determination of the systolic, diastolic, and mean velocities and calculation of the pulsatility and resistance indices. Malignancy was then predicted based upon color flow findings alone, with malignant tumors demonstrating increased color flow and a pulsatility index of at most 1.0 or a resistance index of at most 0.4. Color flow Doppler findings were then recorded as "giving additional useful information" that either confirmed questionable gray scale findings or changed the gray scale sonographic diagnosis, or as "not giving additional information" over the gray scale diagnosis. RESULTS: Two hundred thirty-one patients had gray scale sonography, and 167 also had color flow Doppler performed. Gray scale sonographic findings were sufficient to make a diagnosis in 156 (93%) of the scans. Color flow Doppler findings added useful information in 49 scans (30%). Increased color flow was highly significant (P < .0001), as was the calculated pulsatility index (P < .02) and resistance index (P < .008), in distinguishing benign from malignant tumors. Ovarian and uterine artery and intratumor assessments of the systolic, diastolic, and mean velocities were not significantly different between the benign and malignant tumors. Regression analysis confirmed the presence or absence of color flow as an independent predictor of malignancy or benignity (P < .0001). CONCLUSIONS: Our large study confirms the overall accuracy of gray scale scanning. When used alone, color flow Doppler--although specific--lacks sensitivity and predictive value as an independent predictor of malignancy. When findings were combined with those obtained from gray scale scanning, sensitivity, specificity, and predictive value were improved to acceptable levels. Significant differences existed between benign and malignant tumors for calculated pulsatility index and resistance index, but neither was sufficiently sensitive, specific, or predictive to be used alone as sole criteria of malignancy prediction. Other flow indices studied (systolic, diastolic, and mean velocities) in general did not differ significantly between groups. Physicians should be cautioned against using color flow findings alone for clinical decision making. We recommend a multi-institutional study to investigate the multiple vascular assessments to determine the role of color flow Doppler in the preoperative prediction of pelvic tumors and in screening for gynecologic abnormality.

Adult↗