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Biomedical subjects

J Gold

Publications and source records attributed to J Gold.

At least 109 records · Page 6Linked to original sources
PubMed1992

Energy demands for walking in dysvascular amputees as related to the level of amputation.

Cardiac function and oxygen consumption were measured in 25 patients who underwent amputation for peripheral vascular disease (PVD), and in five similarly aged control patients with PVD. Five patients at each of the midfoot, Syme's, below-, through-, and above-knee amputation levels and the five controls were measured at rest, normal walking speed, and maximum walking speed on a treadmill. At normal walking speed, all of the patients functioned at approximately 80% of their cardiac capacity. Normal walking speed and cadence decreased and oxygen consumption per meter walked increased with more proximal amputation. The ratio of cardiac function and oxygen consumption at normal walking speed as compared with at rest increased with more proximal amputation, and the capacity to increase walking speed and oxygen consumption lessened. Our results suggest that peripheral vascular insufficiency amputees function at a level approaching their maximum functional capacity. At more proximal amputation levels, the capacity to walk short or long distances is greatly impaired.

Amputation, Surgical↗
PubMed1991

Stressors and rewards of being an AIDS emotional-support volunteer: a scale for use by care-givers for people with AIDS.

This study describes scales which can be used to identify the levels of stress and reward associated with being a AIDS emotional-support volunteer. Four categories of stressors were identified. These were 'emotional overload', 'client problems', 'lack of support' and 'lack of training'. The reward categories were 'personal effectiveness', 'emotional support', 'social support' and 'empathy/self-knowing'. There were low, but positive correlations between these stressor scales and other measures of psychological morbidity, the 28-item General Health Questionnaire (GHQ) and the Maslach Burnout Inventory (MBI). Levels of stress and reward were positively correlated and, taken together, the scales may be of use as a measure of the degree of involvement of volunteers in the AIDS care-giving process. Although these scales were derived from items provided from AIDS emotional-support volunteers many of the items may also be relevant to other health workers providing care for people with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

New method for monitoring pulmonary artery catheter location.

OBJECTIVE: To test the ability of a modified pulmonary artery (PA) monitoring catheter to detect distal catheter migration. DESIGN: Prospective nonrandomized trial. PATIENTS: Surgical ICU patients requiring invasive hemodynamic monitoring. INTERVENTIONS: Eight patients received PA catheters modified to include a right ventricular (RV) pressure monitoring port located 7 cm from the tip. Fifteen patients received catheters with an RV port located 10 cm from the tip. Guided by the RV port pressure waveform, catheters were initially positioned so that the RV port was located just proximal to the pulmonic valve. MEASUREMENTS AND MAIN RESULTS: Pulmonary capillary occlusion pressure (PAOP) could not be obtained in six of the eight patients receiving the 7-cm RV port catheter unless the RV port was advanced into the PA. PAOP was consistently obtained in all 15 patients receiving the 10-cm RV port catheter, with the RV port positioned in the RV. Chest radiographs confirmed a central PA catheter position. In this group, distal migration of the catheter occurred 14 times in eight patients, as detected by appearance of a PA pressure waveform at the RV port. Distal migration was corrected by withdrawal of the catheter until an RV waveform reappeared at the RV port. CONCLUSIONS: We conclude that distal catheter migration occurs frequently with PA monitoring catheters, but can be detected at the bedside with a catheter modified to include an RV port 10 cm from the tip. This new catheter may add a margin of safety to PA monitoring and lower its overall cost by eliminating the need for chest radiographs ordered solely to confirm catheter tip location.

Aged↗
PubMed1991

Outbreak of human calicivirus gastroenteritis in a day-care center in Sydney, Australia.

Between January and March 1988, an outbreak of gastroenteritis occurred among children and staff at a day-care center in Sydney, New South Wales, Australia. Over an 11-week period, 53 persons had 101 episodes of gastroenteritis; some patients had 5 separate episodes. The principal etiologic agent in the outbreak, human calicivirus (HCV), was detected by electron microscopy in 32% of fecal specimens from children and staff members with symptoms but in only 8% of asymptomatic individuals (P less than 0.01). HCV was confirmed by both an enzyme immunoassay and solid-phase immune electron microscopy. HCV infection was a particular problem in infants, who had the highest age-specific attack rates, had the greatest symptomatic/asymptomatic infection ratio, and were most likely to have a second symptomatic episode. The mode of transmission of this virus was not identified, and extensive efforts to control the 11-week outbreak had little effect. Prolonged excretion of HCV by some symptomatic patients and high rates of asymptomatic infection may have contributed to the extended duration of the outbreak. HCV may be a common cause of gastroenteritis in children that is under-recognized because of insensitive methods of detection.

Australia↗
PubMed1991

Evaluation of bilirubin as possible protective factor in the prevention of retinopathy of prematurity.

Retinopathy of prematurity (ROP) appears to be a multifactorial disease, the prevention of which is probably impossible even with the most accurate methods of blood-gas monitoring and oxygen restrictions. The oxidative processes and consequent formation of free radicals are probably influenced by the availability of various antioxidants in the immature retina. Bilirubin, the end product of haem catabolism, has recently been regarded as a potential physiological antioxidant. In order to test the suggestion as to the possible effect of bilirubin in reducing the incidence of ROP a retrospective study was undertaken of the medical records of 151 neonates born between 1984 to 1988 who weighed less than 1500 g. Of these, 78 had various degrees of ROP, whereas 73 had no ROP and served as a control group. The daily mean bilirubin values were analysed in accordance with gestational age and birth weight as well as the severity of ROP, and the results were compared with those obtained for the control group. The results showed no correlation between bilirubin levels and severity of ROP in all subgroups of gestational age and birth weight. These findings indicate that there is no apparent protective effect of bilirubin on the development of ROP.

Bilirubin↗
PubMed1991

Sexually transmissible diseases in injecting drug users.

Self-reported histories of sexually transmissible diseases (STDs) and HIV serostatus were investigated as part of a study of HIV risk behaviour in a sample of 1245 Syndey injecting drug users (IDUs) (mean age 27.5 years) both in and out of treatment. A high lifetime prevalence of STDs was reported in both men and women. For male IDUs, the lowest reported lifetime prevalence of STDs was in heterosexuals, with bisexuals intermediate and homosexuals reporting the highest prevalence. HIV seroprevalence followed the same pattern. For women, bisexuals had the highest reported STD history, heterosexual women were intermediate and homosexual women reported the lowest prevalence. Over one third of the bisexual women reported having been involved in prostitution. These data indicate that over one third of IDU men and over half of IDU women reported at least one STD in their lifetime. The high lifetime prevalence of STDs in IDUs indicates that this group is at increased risk of sexual transmission of HIV, given the importance of STDs as a cofactor. Reducing the prevalence of STDs in IDUs is a possible additional strategy to diminish the spread of HIV among IDUs and from them to non-IDU sexual contacts.

Adult↗
PubMed1990

HIV-related risk-taking behaviour, knowledge and serostatus of intravenous drug users in Sydney.

This study was carried out in 1987 to investigate the relationships between human immunodeficiency virus (HIV)-related risk-taking behaviour, demographic characteristics and serostatus of 181 intravenous drug users in Sydney. Subjects were predominantly heterosexual men in their late twenties with limited secondary education. The majority (77%) had been injecting drugs for more than two years and were daily (91%) injectors of heroin (87%). Eighty per cent had shared injection equipment. Condom use was uncommon (15%) except during prostitution (72%). Sixty-nine per cent of all subjects were at risk of HIV infection due to either unsafe sexual practices or sharing of injection equipment. Thirty per cent of the sample had been in prison at some time since 1981 and half of these (15%) had used intravenous drugs and shared injection equipment while in custody. Thirteen per cent of men who had been imprisoned reported anal intercourse with other male prisoners. HIV antibody test results were available from 132 subjects of whom 12 (9%) (95% confidence intervals [CI], 4%-14%) were seropositive. The majority (67%) of seropositive subjects were homosexual/bisexual men but no other behavioural or demographic factor differentiated seropositive from seronegative subjects. The HIV seroprevalence (9%) found in this study of intravenous drug users in Sydney is significantly higher than a 1985 estimate of 0.5% (P less than 0.001). This finding and the level of risk-taking behaviour by this sample indicates that strategies introduced at the time may have been inadequate to prevent HIV infection among intravenous drug users in Sydney. Widespread HIV infection in Australian intravenous drug users may be imminent unless major changes in HIV-related risk-taking behaviour occur in the near future.

Adult↗
PubMed1990

Intravenous drug users who present to the Albion Street (AIDS) Centre for diagnosis and management of human immunodeficiency virus infection.

Intravenous drug users who presented to the Albion Street (AIDS) Centre for human immunodeficiency virus (HIV) antibody screening during the period March 1, 1985 to January 31, 1989, were included in this study. Information on medical history and HIV risk-related behaviour was collected by means of a standardized, computer-coded medical record. Of the 1222 intravenous drug users in this study, 72.3% were men, 26.9% were women and 0.8% were transsexual, with 60.1% of the total claiming exclusive heterosexuality. Of the sample, 40.2% were current intravenous drug users, and 86.8% recorded having shared needles and syringes. Among this sample, the over-all prevalence of HIV seropositivity was 14.5%. Of subjects who were diagnosed as HIV seropositive, 43.8% were homosexual men, 13.1% were bisexual men and 5.3% were heterosexual men. Of all intravenous drug users, 49.9% had a history of at least one sexually-transmitted disease, with 21.8% reporting a history of more than one. Fifty-two per cent of the sample reported that they had been infected with hepatitis B previously. There was no over-all increase in the annual rate of HIV infection among this population of intravenous drug users. The sexual activity and prevalence of hepatitis and other sexually-transmitted diseases among this group are suggestive of widespread, continuing risk behaviour.

Adult↗
PubMed1990

Dental pathology and alcohol-related indicators in an outpatient clinic sample.

A relationship between alcoholism and dental pathology (particularly missing teeth), has been reported in studies of male, inpatient alcoholics. The present exploratory study was undertaken to assess how readily these findings can be generalized to an unselected sample of male and female dental patients. Data on drinking behavior, alcohol-related problems, and risk factors for alcoholism were obtained through an interview and questionnaire. A dental chart review provided measures of dental pathology. The results showed that measures of dental pathology (including tooth loss, carious teeth, and periodontal disease) correlated significantly with alcohol-related indicators. The associations were more evident for males than for females, which is consistent with some studies of alcohol-related medical consequences. The results suggest that further analytic studies of alcohol consumption and dental pathology are warranted. Because the relationship between tooth loss and harmful drinking was clearest among males with a history of conduct problems, subsequent research would benefit from a focus on this high-risk group.

Adult↗