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Biomedical subjects

J H Brooks

Publications and source records attributed to J H Brooks.

At least 19 recordsLinked to original sources
PubMed1996

Serum testosterone in violent and nonviolent young offenders.

Single morning serum testosterone samples from 194 15-17 year old male young offenders were compared between subgroups based on violent (n = 75), non-violent (n = 102), and sexual (n = 17) offenses. The violent group had the highest level of testosterone and differed significantly from both the nonviolent and sexual offender groups which were statistically equivalent. The offenders were also classified according to native/metis (n = 68) and Caucasian (n = 126) groups, and the native/metis group had significantly higher testosterone than the Caucasian group. Higher testosterone in the native/metis group may be because this group committed significantly more violent offenses than the Caucasian group. Genetic factors, such as the human leucocyte antigen system, may also be associated with higher testosterone in the native/metis group.

Adolescent↗
PubMed1994

Staphylococcus aureus cellulitis: an unusual presentation.

Staphylococcus aureus has long been known as one of the most virulent microbes, with capabilities that make it threatening in both nosocomial and community-acquired infections. It remains the most frequent cause of skin-structure and traumatic infections in the community. S. aureus infections in the maxillofacial region are likely to be associated with a known portal of entry, but this is not always the case. Once invasion occurs, the organism may produce virulent enzymes including coagulase, hyaluronidase, proteases, DNA-ase, lipases, hemolysins, and lysozyme as well as exotoxins. Markel et al point out that cellulitis associated with coagulase-positive staphylococci will often resolve without abscess formation. Hence, there is often no site from which to obtain specimens, making this infection a diagnostic and therapeutic challenge. This report describes an infection in which the etiologic organism was identified as S. aureus. The source of the infection, however, remained unclear.

Cellulitis↗
PubMed1993

Linking environmental and health care databases: assessing the health effects of environmental pollutants.

The assessment of pollutant effects on health status requires the mergence and analysis of two different databases: pollution measurements and health care information. This paper compares two subsets of these data: Ohio Environmental Protection Agency data on ambient air pollutants and Ohio Medicare data on respiratory diseases. Small area analysis was performed to assess statewide variations in hospital admission rates for respiratory diseases. The ambient air pollutant levels for each small area were compared to the variations in respiratory disease rates. Five groups of diseases correlated with pollutant levels. In addition, pollutant levels were significantly associated with medical complications. This study demonstrates the feasibility and benefit of linking environmental and health care databases and suggests the need for a more comprehensive, automated analysis of more pollutants and diseases.

Air Pollutants↗
PubMed1993

Research review: pattern analysis for quality problems in medicine.

In conclusion, these results suggest that pattern analysis may provide a flexible and dynamic tool with which to sort cases prior to review, and evaluate changing medical practice patterns. Patterns analysis may also provide a way to avoid spending time and resources on cases with a low probability of quality problems. Lastly, pattern analysis promises to increase timely information and feedback to health care professionals and organizations.

Data Collection↗
PubMed1992

Systems versus performance problems: a peer review organization's perspective.

An analysis of Ohio's Medicare data base by the state's Peer Review Organization, using the most common diagnosis-related group in the Medicare population (heart failure and shock), from January 1, 1989 to January 1, 1991, identified 72 cases with confirmed quality-of-care problems. The analysis was performed to determine whether the majority of quality-of-care problems are related to systems or performance deficiencies. Study results indicated that health care workers are being inappropriately blamed for problems that are inherent in the health care system--74% of problems were related to inefficiencies in the health care delivery system, and 26% were determined to reflect performance problems.

Clinical Competence↗
PubMed1992

Unnecessary hospitalization of Medicare patients in Ohio. A preliminary profile.

Peer review organizations (PRO) review the health care given to Medicare beneficiaries. If a PRO determines that a hospital admission was unnecessary, the hospital is not reimbursed for the medical care and the case is "denied." The average hospital denial rate on Ohio is 2%; however, the denial rate for hospital admissions of one day or less is 7.5%. An analysis of hospitals and diagnoses for one-day hospital admission denials was performed, showing that urban hospitals and disorders of the circulatory and digestive systems predominate. The inappropriate utilization of health care resources costs millions of dollars per year in Ohio and could be costing the nation billions of dollars. There is an urgent need to research why resources are used less effectively by some hospitals and for some diseases.

Ambulatory Care↗
PubMed1992

Health care quality problems in Ohio: analysis by diagnosis related groups.

Quality problems occur throughout the health care system, regardless of the disease or diagnosis. Peer review groups and health care organizations can take advantage of this finding to design quality improvement programs that will have a greater impact on health care quality than traditional quality assurance programs. Problems associated with high volume diagnoses or high risk procedures can be analyzed with the understanding that lessons learned in those examinations can be applied to many other aspects of health care. Continuous quality improvement can be implemented, using specific indicators and criteria as models for the overall factors contributing to quality in the health care system. Quality improvement experts estimate that the majority of all quality problems originate in the system, rather than in the performance of individuals. An in-depth analysis of our hospital and health care systems, complementing the performance-based quality assurance programs already in place, will facilitate the comprehensive improvement of quality throughout our health care institutions.

Databases, Factual↗
PubMed1989

Chlamydia trachomatis infection in late pregnancy: a prospective study.

During a 1-year period, 3309 women were screened in pregnancy for Chlamydia trachomatis infection. A cervical swab was taken and chlamydial antigen was detected, using a monoclonal antibody ELISA technique, in 198 women (6%). The prevalence of chlamydial infection was high in women under 20 years (14.5%), single women (14.2%) and black women (16.8%). Binomial regression of these data estimates a relative risk of 2.9 for women under 20 years compared with women aged 25 and over. There was an interaction between race and marital status with a high risk in single white and single asian women (2.3, 4.5 respectively) but a similar risk in black single and black married women (3.0, 4.0 respectively). Parity and social class did not effect the prevalence of antigen carriage. There was no demonstrable effect of maternal antigen carriage on outcome of pregnancy, gestation or admission to neonatal unit. Infants of 174 antigen-positive mothers were followed-up. Tissue culture for Chlamydia trachomatis was positive in 43 (24%) infants. Complications occurred in 23 (53%): 17 had conjunctivitis, three had lower respiratory tract infection and three both complications. Amongst 131 chlamydia-negative infants, complications occurred in 21 (16%). Since this infection, in infants, responds promptly to erythromycin therapy, screening and treatment in pregnancy will convey little benefit in prevention of perinatal morbidity or perinatal mortality.

Adult↗
PubMed1984

The efficacy of graduated compression stockings in the prevention of deep vein thrombosis after major gynaecological surgery.

The efficacy of graduated compression stockings in the prevention of deep vein thrombosis (DVT) after major gynaecological surgery was investigated in a controlled randomized prospective trial in 196 patients who were greater than 35 years of age. The stockings were worn by 104 of the 196 patients throughout their stay in hospital, the other 92 patients did not wear the stockings (control group). All the patients were scanned for DVT postoperatively with the 125I-labelled fibrinogen test. None of the 104 patients who wore the stockings developed a thromboembolism, but four of the 92 control patients who did not wear the stockings had DVT. This difference between the two groups was statistically significant.

Adult↗
PubMed1977

Intradermal administration of bivalent and monovalent influenza vaccines.

Intradermal (ID) administration of 0.1 ml of a bivalent influenza vaccine containing 40 CCA units each of influenza A/New Jersey (Hswine 1N1) and A/Victoria (H3N2) virus antigens and of a monovalent vaccine containing 100 CCA units of influenza B/Hong Kong virus to 70 adult volunteers produced no serious reactions and only 7% bothersome side effects. Excluding persons with high (1:64 or greater) initial antibody titers, then 90% and 85% of persons had fourfold or greater rises in HAI antibodies to A/New Jersey and B/Hong Kong antigens, whereas 53% had rises to A/Victoria. The authors feel the ID route deserves further consideration for giving killed influenza vaccines to adults. However, an influenza virus type that was prevalent for many years may fail to give sufficient rise in HAI to consider the patient protected.

Adult↗