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Biomedical subjects

J Davis

Publications and source records attributed to J Davis.

At least 181 records · Page 10Linked to original sources
PubMed1998

Independent living skills and posttraumatic stress disorder in women who are homeless: implications for future practice.

OBJECTIVE: Service delivery through community-based programs is the future of occupational therapy. This study examined independent living skills, traumatic experiences, and symptoms of Posttraumatic Stress Disorder (PTSD) in a sample of women residing in a supportive housing program for women and families who are homeless in order to determine the needs of this population and the possible role of occupational therapy in such a community-based program. METHOD: Twenty-four women residing in a supportive housing shelter in Kansas City, Missouri, volunteered to participate in this study. The participants were evaluated for independent living skills with the Kohlman Evaluation of Living Skills. A structured interview format was used to determine whether participants experienced a trauma and whether they met diagnostic criteria for PTSD. RESULTS: Results indicated that women who are homeless have deficits in independent living skills, especially in the area of money management. Results also indicated that traumatic experiences and PTSD are more prevalent among women who are homeless than among women in the general population. The relationship between independent living skills and PTSD among women who are homeless was not made clear by this study. CONCLUSION: The information gathered in this study underscores the importance of identifying and addressing occupational and mental health issues of women who are homeless. Results suggest that occupational therapists have a major role to play, evaluating and facilitating independent living skills, as members of multidisciplinary treatment teams in supportive housing programs for persons who are homeless.

Activities of Daily Living↗
PubMed1997

Ventricular and myocardial efficiencies during acute aortic regurgitation in conscious dogs.

BACKGROUND: Alterations in cardiac efficiency may signal pathologic stresses and energetic adaptation during aortic regurgitation (AR). METHODS AND RESULTS: LV systolic function, left coronary blood flow, and AVO2 difference were measured in conscious dogs to assess LV and contractile efficiencies at baseline, 1 day (n=10), 1 week (n=10), and 3 weeks (n=8) of AR. LV systolic function was assessed by the preload recruitable stroke work relationship. Total LV Efficiency (TEFF=SWxHeart Rate/MVO2) and contractile efficiency (CEFF=1/the slope of the MVO2 -pressure-volume area relationship) and steady-state potential energy (PVA-SWxHR), mechanical coupling efficiency (MCE=SWxHR/PVA) were calculated. LV systolic function decreased by 17% at 1 day (P<.05) and by 24% at 3 weeks (P<.05). CEFF decreased from 58+/-8% to 38+/-10% (P<.05) at 1 day, normalized at 1 week, and decreased to 28+/-14% at 3 weeks (P<.05). TEFF was not altered at 1 day and 1 week but decreased by 3 weeks (P<.05). MCE trended downward from baseline of 47+/-5%, reaching significance at 3 weeks (34+/-6%, P<.05). CONCLUSIONS: CEFF decreases acutely, indicating diminished economy of myocardial contraction. CEFF normalizes at 1 week, suggesting adequate compensation. TEFF is not altered in early AR. By 3 weeks, LV systolic dysfunction is accompanied by depressed TEFF, mechanical coupling, and CEFF signaling the onset of decompensated AR. Thus, volume overload of acute AR resulted in early compensation at the expense of myocardial efficiency with subsequent global dysfunction characterized by depressed LV systolic mechanics, mechanical, coupling, and contractile efficiencies.

Acute Disease↗
PubMed1997

Urinary diagnosis of gonorrhoea and Chlamydia in men in remote aboriginal communities.

AIMS: (1) To evaluate the acceptability and validity of an intervention based on urine tests for diagnosis and treatment of gonorrhoea and chlamydia in men in remote Aboriginal communities. (2) To provide a prevalence estimate of these infections in the male population in the surveyed communities. METHODS: First-void urine samples from 460 men in remote communities and 33 men in the Alice Springs Gaol were tested for gonorrhoea and chlamydia with at least one of polymerase chain reaction (PCR), enzyme immunoassay (EIA) and culture (gonorrhoea only). RESULTS: One hundred and three men (20.9%) were infected with gonorrhoea or chlamydia. The prevalence of infection for gonorrhoea only was 11.7%, for chlamydia only 4.1% and for dual infection 5.1%. Eighty-eight infected men and 45 of their sexual partners were recorded as having been treated within two months of testing. PCR tests detected the largest number of infections and were the easiest to use. CONCLUSIONS: The prevalence of these infections was higher than anticipated. Urine PCR tests were acceptable to men and are well suited to the remote-community setting. As an effective alternative to urethral swabs, they permit a range of community-based strategies to address high rates of infection with gonorrhoea and chlamydia.

Adolescent↗
PubMed1997

Effect size of efficacy measures comparing divalproex, lithium and placebo in acute mania.

Effect size (ES) is a statistical concept that can be used to improve the interpretation of results from psychopharmacological studies. ES may aid interpretation of results when sample size is unbalanced or small or when units or levels of baseline measures differ across items. Usually, an investigator can define a threshold value for a clinically meaningful ES based on published data and clinical judgment or by resorting to conventions, e.g., a medium ES = 0.5 S.D., which can usually be discerned by the trained clinician. In the present study, we apply ES analysis to results from a study comparing the effectiveness of divalproex (DIVAL), lithium (LI), and placebo (PLA) in hospitalized, acutely manic patients. One hundred seventy-six patients were randomly assigned to DIVAL, LI, or PLA in a 2:1:2 ratio, with drug administered in a double-blind, parallel group design for 21 days. The primary efficacy measure was the Mania Rating Scale from the Schedule for Affective Disorders and Schizophrenia, composed of the Manic Syndrome Score (MSS) from items that are relatively specific to the manic state, and the Behavior and Ideation Score (BIS), which reflects severe but nonspecific psychopathology. Improvement of the MSS after 5 days of treatment was difficult to interpret based on percentage change (DIVAL = 19%, LI = 13.5%, PLA = 8.5%). However, the corresponding effect sizes of 0.79, 0.55, and 0.35 indicated a medium to marked ES for DIVAL, a medium ES for LI, and a small ES for PLA at this early point in treatment. Similarly, the ES for change on the MSS at the end of treatment indicated a large, readily observable improvement with both DIVAL (ES = 1.01) and LI (ES = 0.79) vs. an ES of 0.37 for PLA. ES analysis also indicated that the BIS is a less robust indicator of change to either drug. The ES at the end of treatment for the BIS was 0.67 for DIVAL-, 0.62 for LI-, and 0.25 for PLA-treated patients.

Adolescent↗
PubMed1997

Ultrasound velocity and broadband attenuation as predictors of load-bearing capacities of human calcanei.

The main purpose of this study was to determine whether calcaneal ultrasound parameters, measured in the mediolateral direction, reflect load-bearing capacities of human calcanei. Broadband ultrasound attenuation (BUA) and ultrasound velocity (UV) were measured in 20 cadaveric calcanei with a mean age of 74.1 (SD 8.8). Normalized BUA (nBUA) was determined by dividing BUA by the calcaneal thickness obtained using a pulse-echo technique. The bone mineral density (BMD) of each calcaneus was measured by quantitative computed tomography. The calcanei were embedded in PMMA to simulate the midstance physiologic orientation during compressive testing in the load-bearing direction. The failure load, stiffness, and energy absorption were determined for each calcaneus. It was shown that BMD was well correlated with all ultrasound parameters (P < 0.0001). BMD, BUA, nBUA, and UV were all significantly associated with calcaneal failure load, stiffness, and energy absorption capacity (P < 0.05). nBUA was found to be the strongest predictor of all compressive properties. BUA and BMD demonstrated similar predictability of stiffness and energy absorption capacity, however, BUA showed a more significant relationship to the failure load of the calcaneus than did BMD. UV was found to be inferior to BMD, as well as BUA or nBUA, in assessing failure load, stiffness, and energy absorption capacity. It was also shown that nBUA was superior to BUA in the assessment of load-bearing capacity, but not in the prediction of BMD. Multivariate regression analysis showed that the combination of BUA or nBUA with UV did not improve the predictability of failure load, stiffness, and energy absorption capacity over that of BUA or nBUA alone (P > 0.5).

Absorptiometry, Photon↗
PubMed1997

Presence of the T-cell activation marker OX-40 on tumor infiltrating lymphocytes and draining lymph node cells from patients with melanoma and head and neck cancers.

BACKGROUND: The OX-40 antigen is a cell surface glycoprotein in the tumor necrosis factor receptor family that is expressed primarily on activated CD4+ T cells. Selective target organ expression of the OX-40 receptor on autoantigen specific T cells has been found in autoimmune disease. In order to evaluate whether OX-40 is expressed on T cells from patients with nodal-draining carcinomas, OX-40 expression was assessed in tumor infiltrating lymphocytes (TILs), draining lymph node cells (DLNCs), and/or peripheral blood lymphocytes (PBLs) of 13 patients with head and neck squamous cell carcinomas and 9 patients with melanomas. METHODS: Cell phenotype was determined by fluorescence cell analysis using a monoclonal antibody to human OX-40, and CD4+ T cell lymphokine production was determined by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Expression of the OX-40 receptor was found in as many as 31% of the TILs and as many as 28% of the DLNCs tested. Conversely, no OX-40 expression was found in PBLs. In addition, CD4+ T cells isolated from DLNCs (but not from TILs or PBLs) secreted a Th1 pattern of cytokines (IL-2, gamma interferon). Co-culture of autologous CD4+ TILs with an MHC class II+ melanoma cell line transfected with OX-40 ligand cDNA resulted in T cell proliferation and in vitro tumor regression. CONCLUSIONS: These findings suggest that OX-40+ CD4+ T cells isolated from tumors and their adjacent draining nodes may represent a tumor-specific population of activated T cells capable of mediating tumor reactivity. These cells may play an exploitable role in future trials of immunotherapy.

CD4-Positive T-Lymphocytes↗
PubMed1997

Effects of neutralizing on intrusive thoughts: an experiment investigating the etiology of obsessive-compulsive disorder.

A large sample of non-clinical subjects were screened and those who reported experiencing relatively frequent intrusive thoughts with associated neutralizing were selected. These subjects were randomly allocated to one of two conditions: both groups listened to repeated recorded presentations of one of their intrusive thoughts and were then required either to (a) neutralize it, or (b) distract themselves for a similar period. Ratings of discomfort were taken during this procedure (first phase), and during identical presentations of the same thought without neutralizing or distracting (second phase). Results showed that the group who neutralized during the first phase experienced significantly more discomfort during the second phase and significantly stronger urges to neutralize and distract. There was also evidence that engaging in neutralizing responses during the first phase made it difficult to stop neutralizing during the second phase. The results are considered in the context of the cognitive-behavioural hypothesis that obsessional disorders develop as a consequence of neutralizing normal intrusive thoughts.

Adolescent↗
PubMed1997

Uterine artery atherosclerotic disease: histologic features and clinical correlation.

OBJECTIVE: To determine whether uterine artery atherosclerosis is associated with known cardiovascular risk factors in women undergoing hysterectomy. METHODS: Seventy-four women undergoing hysterectomy between September 1995 and March 1996 were evaluated. Following hysterectomy, samples of the uterine artery were collected for histologic evaluation. Plaque complexity and histologic measurements were compared with regard to known cardiovascular risk factors. RESULTS: Among the 59 premenopausal women, 55.9% had intimal thickening 40.7% had simple plaques, and 3.7% had complex lesions in the uterine artery samples. Among postmenopausal women, 40% had intimal fibrosis, 20% had simple plaques, and 40% had complex lesions. Postmenopausal status was correlated strongly with the presence of advanced atherosclerotic disease (P < .001). Postmenopausal women had significantly greater intimal area (P = .01), intimal area/medial area (P = .002), intimal area/vessel area (P = .002), maximal intimal thickness/medial thickness (P = .01), and significantly less medial thickness (P < .001). A significant linear correlation existed between age and the intimal/medial ratio among premenopausal women (P = .04) and postmenopausal women (P = .01). Patients with electrocardiogram (ECG) abnormalities had significantly greater intimal/medial area as well (P = .02). Hypertension was associated with complex lesions among the postmenopausal patients (P = .01). Preoperative cholesterol levels greater than 200 mg/dL were associated with greater intimal thickness (P = .05) and intimal thickness/medial thickness (P = .03). CONCLUSION: The severity of uterine artery atherosclerosis is significantly correlated with known risk factors for cardiovascular disease: increasing age, postmenopausal status, ECG abnormalities, and hypertension. Uterine artery histologic analysis may provide a means of assessing the degree of atherosclerosis in other, critical, vascular beds.

Adult↗
PubMed1997

Selective activation of the external oblique musculature during axial torque production.

OBJECTIVE: To investigate whether different geographical regions of the external oblique musculature can activate at different levels and, if they do, to quantify the magnitude of these differences as a function of postural parameters during twisting exertions. DESIGN: Repeated measures design using electromyography on healthy subjects. BACKGROUND: The majority of the models currently used to assess spinal loading have represented the trunk musculature using single force vectors connecting a muscle's point of origin to its point of insertion. However, for muscles with large areas of origin and/or insertion (such as the external obliques), this single vector modelling approach misrepresents the multiple vector reality which, in turn, underestimates the complex loads these muscles can develop. METHODS: Nine subjects performed sub-maximal isometric axial twisting exertions (20, 40 and 60% of maximum voluntary contraction) while assuming six different postures defined by three levels of axial rotation (-20 degrees, 0 degrees and 20 degrees ) and two levels of sagittal flexion (0 degrees and 20 degrees ). As the subjects performed these isometric exertions, the integrated electromyographic activity was sampled using surface electrodes at five different locations over the right and the left external oblique muscles. RESULTS: The results showed significant (p<0.05) regional differences in the activation profiles and these activation profiles changed as a function of trunk posture. CONCLUSIONS: The external oblique musculature is capable of differential activation and the activation profiles of the different regions are affected by the posture of the torso. RELEVANCE: These findings suggest that the external oblique muscle is capable of selective activation of different regions along its cross-section and should, therefore, be modelled using multiple vectors. The result can have a direct bearing on the calculated spine loading, especially lateral and anterior/posterior shear forces.

Journal Article↗
PubMed1997

Nitroarylhydroxymethylphosphonic acids as inhibitors of CD45.

A series of nitroarylhydroxymethylphosphonic acids was synthesized and evaluated as inhibitors of CD45. It was discovered that both the alpha hydroxy and nitro groups are essential for activity. Potency is enhanced by the addition of a large lipophilic group on the aryl ring adjacent to the phosphonic acid moiety. Kinetics studies have shown that these compounds are competitive inhibitors and thus bind at the active site of this enzyme.

Amino Acid Sequence↗
PubMed1997

A prospective study of PET-FDG imaging for the assessment of head and neck squamous cell carcinoma.

The main aim of the study was to evaluate the use of positron emission tomography using fluoro-deoxyglucose (PET-FDG) imaging for the detection of squamous cell carcinoma of the head and neck. Fifty-four consecutive patients with malignancies involving the head and neck were studied prospectively. Thirty-one patients presented with primary disease and 23 were suspected of recurrent or residual disease. All patients underwent full clinical staging, PET-FDG scans and anatomical imaging, 37 underwent computed tomography (CT), 13 magnetic resonance (MR) and four had both CT and MR. Clinical assessment, CT/MR, PET-FDG and histological examination were all evaluated independently of each other. All 31 primary head and neck malignant tumours were detected by PET-FDG. Based on 16 patients who underwent neck dissections, the sensitivity and specificity of PET-FDG for detecting nodal disease was 67% and 100% respectively, compared with clinical assessment of 58% and 75% and CT/MR of 67% and 25%. In all 12 patients, PET-FDG correctly identified the presence of absence or recurrent or residual disease. PET-FDG staged 13 post-treatment necks with an accuracy of 100% as compared to CT/MR which was accurate in 7 of 13 and clinical assessment which was accurate in eight. Three sites of abnormal tracer uptake unrelated to malignancy were recorded as incidental findings (mandibular osteomyelitis, 1: post glossectomy site, 2). PET-FDG was more accurate than CT/MR for identifying primary and recurrent tumours as well as metastatic lesions in the neck. If these diagnostic properties of PET-FDG are confirmed in further prospective studies, it could prove a valuable adjunct for the management of head and neck cancer.

Aged↗
PubMed1997

A comparison between the patella and the calcaneus using ultrasound velocity and attenuation as predictors of bone mineral density.

The bone mineral density (BMD), ultrasound velocity (UV) and attenuation were examined in sixteen matched sets of human patellae and calcanei. For the sixteen calcanei, BMD was strongly correlated with all ultrasound parameters. Calcaneal UV appeared to be inferior to attenuation in the ability to predict BMD. For the sixteen patellae, the average UV was found to be greater in the superior/inferior direction than in the anterior/posterior and medial/lateral directions. It was found that patella BMD was significantly correlated with each of three directional ultrasound velocities. The relationship between BMD and ultrasound attenuation parameters was not significant in the patella. A comparative study of the two different bone sets demonstrated that the BMDs of the patella and calcaneus were significantly correlated with each other. Ultrasound velocity of calcaneus, measured in the medial/lateral direction, was not significantly associated with any of three directional ultrasound velocities in the patella. Similarly, ultrasound attenuation parameters of calcaneus were not significantly correlated with those of patella. The present study also demonstrated evidence that when predicting BMDs at their respective sites using ultrasound, the calcaneus appeared to be superior to the patella.

Aged↗
PubMed1997

The expression of transforming growth factor-beta s and TGF-beta receptor mRNA and protein and the effect of TGF-beta s on human myometrial smooth muscle cells in vitro.

In this study we investigated the expression of transforming growth factor-beta (TGF-beta) isoform and TGF-beta receptor mRNA and protein, and the effect of TGF-beta 1-3 on the rate of DNA synthesis and proliferation of human myometrial smooth muscle cells in vitro. To determine these, we utilized primary cultures of myometrial smooth muscle cells, standard and competitive quantitative reverse transcription-polymerase chain reaction (RT-PCR), immunocytochemistry, enzyme-linked immunoassay, radioreceptor assay, [3H] thymidine incorporation and cell proliferation assay. Standard RT-PCR and immunocytochemistry revealed that myometrial smooth muscle cells express TGF beta 1-3 and TGF-beta type I-III receptor (TGF-beta R) mRNA and protein. Quantitative RT-PCR, using an external synthetic RNA standard, indicated that the cells express 10 copies/cell of TGF-beta 1 and TGF-beta 2, less than one copy/cell of TGF-beta 3 and TGF-beta type IR, three copies/cell of type IIIR, and > 200 copies/cell, of TGF-beta type IIR mRNA. The cells also synthesized and released TGF-beta 1 at the rate of 7.8 +/- 0.7 ng/10(6) cells, of which 1.4 +/- 0.2 ng/10(6) cells was in an active form. The rate of [3H] thymidine incorporation or proliferation of subconfluent quiescent smooth muscle cells was not altered by TGF-beta s (0.1-10 ng/ml) under serum-free conditions, nor in the presence of 10% fetal bovine serum (FBS). TGF-beta 1-3 at 0.25-0.5 ng/ml in the presence of 2% FBS, which induces half maximal stimulation of these cells, stimulated the rate (P < 0.05), whereas at higher doses it reduced the rate of [3H]-thymidine incorporation compared to the controls. The effect of TGF-beta was partially reversible using neutralizing antibodies specific to TGF-beta 1, TGF-beta 2 (10 micrograms/ml) or TGF-beta 3 (3-6 micrograms/ml). TGF-beta s had no significant effect on cell proliferation determined by cell counting. The data indicate that human myometrial smooth muscle cells express the necessary components of the TGF-beta system, suggesting an autocrine/paracrine role for TGF-beta s in myometrium.

Animals↗
PubMed1997

Nipple wound care: a new approach to an old problem.

Nipple soreness and nipple trauma have long been associated with breastfeeding, and persist despite the many clinical advancements in the field of lactation. Management of nipple wounds has been approached in a variety of ways over the years in an attempt to treat and resolve this problem. Incorporating the scientific principles of modern wound care management can provide additional effective treatment options. Wounds are characterized by depth and extent of tissue destruction, regardless of their location on the body. Current wound treatment methods employ the use of moisture to aid healing. A moist environment is critical for epithelization, the proliferation and migration of epithelial cells across the surface of a wound during healing. Nipple wounds also heal by this process. Using a particular type of wound dressing, a hydrogel sheet wound covering, on a nipple wound offers several advantages. These dressings help maintain a moist environment, decrease the chance of bacterial infection, are easy to use, and provide immediate pain relief.

Breast Feeding↗
PubMed1997

Injuries to the subaxial cervical spine: posterior approach options.

In patients with cervical instability as the primary injury, either ligamentous or bony, a posterior approach and stabilization is the most likely definitive treatment. The goals should be to obtain and maintain satisfactory alignment, promote fusion, and allow safe and early mobilization. Many techniques that differ in safety, ease of application, cost, biomechanical strength, and postoperative requirements of immobilization are available. This article reviews different methods of posterior surgical interventions in subaxial cervical spine injuries and discusses the advantages and disadvantages of each.

Bone Screws↗