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Biomedical subjects

J Hanley

Publications and source records attributed to J Hanley.

At least 73 records · Page 4Linked to original sources
PubMed1988

Factors predisposing to difficult labor in primiparas.

Why do some women have difficult labor whereas other women have relatively easy labor? A study of possible predisposing factors was conducted in 398 and 383 primiparas admitted for uncomplicated spontaneous labor at two hospitals. Psychosocial factors, notably anxiety about childbirth, and physical factors, especially maternal height and body mass index, were measured before the onset of labor. Difficult labor was defined in primiparas admitted to the hospital for spontaneous uncomplicated labor as (1) prolonged labor that was longer than 15 hours from admission until full dilation with vaginal delivery or (2) cesarean section. Anxiety about childbirth as self-reported before the onset of labor did not predispose to difficult labor at either hospital. Short height and heavy body mass index predisposed to difficult labor. Further work is needed to elucidate psychosocial factors predisposing to difficult labor.

Anxiety↗
PubMed1988

Efficacy of sequential cyclical hormonal therapy in endometrial cancer and its correlation with steroid hormone receptor status.

Forty-six eligible women with metastatic endometrial cancer were randomly allocated to receive monthly cycles of either CAF (cyclophosphamide, adriamycin, 5-fluorouracil) or CAF plus Provera 200 mg daily for 3 weeks followed cyclically by Tamoxifen 20 mg daily for 3 weeks. Overall response rates of 15 and 43% were seen with CAF and CAF plus hormonal therapy. Using a multivariate analysis of the results, this difference is significant (P value 0.05). In 8 patients with operable endometrial cancer, negative estrogen receptor concentration (ER less than 15 fmole/mg protein) and Grade 3 disease, the clinical course was aggressive in 4 patients with systemic and local relapse. In 10 other similar patients (negative ER and Grade 3) who received adjuvant cyclical hormonal therapy only 1 relapsed and the other 9 are disease-free for an average of more than 31 months. Sequential cyclical hormonal therapy with ER and progesterone receptor analysis has a place in the management of endometrial carcinoma.

Adenocarcinoma↗
PubMed1988

Detection of pilus subunits (pilins) and filaments by using anti-P pilin antisera.

P pilus filaments are important in binding to globoside through an adhesin located at the tip of the pilus. There is considerable antigenic variation among P pili, and the immunologic response is usually serotype specific. We purified denatured pilin subunits and used them as immunogens to prepare more broadly cross-reactive antisera. Although antifilament antisera (AFA) detected predominantly the homologous strain, antisubunit antisera (ASA) prepared from two different strains detected P pili in 16 of 16 and 14 of 16 P-piliated strains by Western blotting (immunoblotting). The binding of ASA to the homologous pilus filament was inhibited by only 3 of 17 strains. ASA agglutinated only two of nine heterologous strains and immunoprecipitated pili from one of three heterologous strains. By immunoelectron microscopy ASA was seen to bind to pilus filaments but not as strongly as AFA. Antiserum raised to the denatured pilin subunit was not substantially more reactive with pilus filaments derived from heterologous strains than was AFA. ASA was, however, a very useful probe for detecting most P pilins.

Agglutination Tests↗
PubMed1988

The human antibody response to uropathogenic Escherichia coli: a review.

Urinary tract infections caused by Escherichia coli are associated with a local and systemic antibody response. We have studied the serum and urine antibody responses to Escherichia coli in men and women with pyelonephritis, cystitis, and asymptomatic bacteriuria. Protein immunoblots consistently demonstrated serum antibody response to lipopolysaccharide (LPS). Anti-LPS antibody titres rose significantly and progressively when comparing acute with convalescent sera in those who have had their first urinary infection. For those with repeated infections, high titre LPS antibodies were present and did not change significantly between acute and convalescent sera. Antibody responses to the major outer membrane proteins were present but did not differ significantly when compared with normal human serum. A specific anti-P pilus antibody response was demonstrated by immunoblotting. Anti-P pilus antibody was quantitated using ELISA and the titres were found to be very low. Three other techniques were also used to demonstrate the presence of serum antibody. Antibody was detectable by immunofluorescence, but the antigenic specificity of the antibody was more difficult to ascertain. Immunoprecipitation was more specific for determining the nature of the antibody response. Lastly, immunoelectron microscopy was valuable in demonstrating antipilus and antiflagellar antibodies. Immunoelectron microscopy and immunoblotting provided evidence that human antiserum to P pili was modestly cross-reactive and could bind heterologous P pili. These studies indicated that the major antibody response in humans occurs after pyelonephritis and is directed against LPS. An anti-P pilus response is frequently present and is cross-reactive to some extent with other P pili.

Animals↗
PubMed1988

Visits to physicians before and after exposure to urea formaldehyde foam insulation.

The average number of visits to a physician made by a sample of 351 residents of homes insulated with urea formaldehyde foam insulation in Montreal in the one year period before exposure was 5.25, and in the year following 5.62, an increase of 7 per cent (odds ratio 1.07, 95% CI = 1.00, 1.15). The increase in visits in the post insulation year was limited to subjects who had the product installed in the winter (OR = 1.48, 95% CI = 1.18,1.85), and was not seen for study subjects who insulated their homes during other seasons of the year.

Construction Materials↗
PubMed1987

Trial of a geriatric consultation team in an acute care hospital.

A controlled trial was conducted to examine the effects of superimposing an interdisciplinary geriatric consultation team upon the conventional patterns of care in medical wards of an acute care hospital. Two hundred and twenty-two patients, aged 69 years of age or older, admitted from the emergency room to two trial wards and 182 similar patients admitted to two control wards where the team did not work, were followed. Evaluations at admission, two and four weeks, and three and six months postadmission by independent evaluators allowed comparisons between the care groups with reference to survival, length of stay, disposition, physical, mental, and social functional levels, and use of services after discharge. Data from charts and treatment logs allowed the care processes to be compared. Findings determined that patients in the two groups were alike on socio-demographic and clinical characteristics at entry. Results demonstrated that patients in the trial and control groups fared similarly on the outcome measures at each evaluation point, although a trend toward better survival among team patients was noted. It was concluded that the addition of a consultative geriatric team to the medical wards failed to show a significant impact on patient outcomes.

Aged↗
PubMed1987

A survey of the younger chronic sick and disabled living in the community in Lothian Region.

A postal survey of households was carried out in Lothian Region to try to determine the number of physically disabled people aged between 16 and 64 living in the community. More information was gained by interviewing those who identified themselves as disabled. It was estimated that there were between 20,000 and 24,000 people aged between 16 and 64 living in the community in Lothian who felt that their activities were restricted by physical impairment, but only about 2500 of those were restricted to the extent that they scored 80 or less on the Barthel index.

Activities of Daily Living↗
PubMed1987

Double blind randomized prospective trial of levamisole/placebo in stage I cutaneous malignant melanoma.

One hundred and fifty-six Stage I, Clark's Level III, IV, and V cutaneous malignant melanoma patients were randomized, 83 to Levamisole and 73 to placebo. One hundred and thirty-seven patients were evaluable. Their median follow-up time was 5 years. The 2 groups were comparable in terms of patient characteristics, except for a slightly higher percentage of Clark's level III in the placebo group (57.8 vs 52%). Severe toxicity leading to discontinuation of the medication occurred in 32 patients in the Levamisole arm, versus 10 in the placebo arm. Thirty per cent of patients receiving Levamisole have recurred in comparison with 26% of those on placebo treatment, and despite a trend in the delay of appearance of distant metastasis in the patients receiving Levamisole (30 months versus 9 months in the placebo patients), this drug does not appear to be effective in altering the disease-free survival or the survival of Stage I patients in the dosage schedule utilized in this study.

Adult↗
PubMed1986

Measurability of non-small-cell lung cancer on chest radiographs.

Response rates to various drug regimens are determined in multi-center trials by radiographic measurement of tumor dimensions before and after treatment. The way in which lesions are measured may affect the reported results. Lesions due to primary lung cancer may be more difficult to assess than rounded peripheral metastases. No previous study has assessed the variability of tumor measurements in patients with primary lung cancer. Nineteen radiographs from 12 patients with non-small-cell lung cancer (NSCLC) were shown to 25 experienced readers on two separate occasions. Pre- and post-treatment (combined chemotherapy and radiotherapy) radiographs were first shown separately, unidentified and in random order. Three months later, they were shown side by side with the facility for comparison. A decrease in tumor size of greater than or equal to 50% was considered as a "response." Viewing paired films together increased the viewers ability to measure tumors compared with reading each film of the radiographic pair individually. Fifty-one percent of unmeasurable pairs became measurable when read together, whereas 13% of previously measurable pairs now became unmeasurable. The interobserver variation in measurements was 10% to 265%, while the intraobserver variation was 4% to 10%. The correlation between responses calculated on the first and second readings often was no better than chance alone. Subjective impressions of degree of improvement showed no good correlation with response rates measured objectively. Because of the large variation in measurements and consequently in response rate, we recommend that all radiographs be reviewed by a single observer for any particular study, and pre- and post-treatment radiographs be evaluated together.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Dental insurance and the oral health of preschool children.

Using data from the Rand Health Insurance Experiment, the effects of cost-sharing plans on the health of the primary teeth in 264 children aged 3 to 5 years were investigated. From six areas in the United States, families were assigned at random to different dental and medical insurance plans. The plans varied in the amount of required cost sharing. Families participated in the study for 3 (70%) or 5 (30%) years. Children covered by the plan (requiring no cost sharing) had significantly fewer decayed teeth and deft (decayed, extracted, and filled teeth) at the end of the study than did children covered by the cost-sharing plans. No differences existed among plans in the number of extracted and restored teeth. Children of middle- and low-income families benefited most from having access to free dental care.

Child Health Services↗
PubMed1985

Fitting relationships between exposure and standardized mortality ratios.

Practical methods are described for formal fitting of simple (linear) relationships between exposures in several subgroups and standardized mortality (or morbidity) ratios (SMRs) for these groups, whether derived from a cohort study by the person-years method or otherwise. The observed events are assumed to have Poisson variation about the fitted relationships. Procedures are outlined for obtaining parameter estimates by iterative weighted least squares regression, which is not only equivalent to, but also the simplest form of maximum likelihood estimation. A test of fit is available in a chi 2 statistic for deviations of observed data from "fitted" values. A further test allows one to examine whether the SMR at zero exposure is different from unity. The concept of relative slopes is discussed, and methods are given for obtaining estimates and confidence intervals. Generalizations to more than one exposure, and to quadratic and other relationships, are explained. Steps for computing the basic fits are detailed, and instructions for adapting packaged computer programs given. Illustrations are provided from data of lung cancer SMRs in relation to exposure to asbestos and to smoking.

Asbestosis↗
PubMed1985

Immunochemical characterization of P pili from invasive Escherichia coli.

P pili (or fimbriae) are present on most pyelonephritogenic Escherichia coli strains, and they mediate binding to erythrocytes and epithelial cells. To determine the antigenic diversity of P pili, we purified the pili from 14 bacteremic E. coli strains which caused mannose-resistant hemagglutination. Pilus preparations consisted of one to three bands in sodium dodecyl sulfate-polyacrylamide gel electrophoresis and ranged in molecular weight from 14,000 to 19,500. There was no single band common to all the strains. An enzyme-linked immunosorbent inhibition assay detected 20 ng of pilus antigen. When four different rabbit antisera were used, only two or fewer heterologous strains could inhibit the enzyme-linked immunosorbent assay. Immunoblots yielded the same results. Protein sequences of four P pili had identical N termini. These results show that despite having identical amino-terminal sequences, P pili are antigenically heterogeneous. The receptor-binding domains which are likely to be identical in all strains must be immunorecessive.

Amino Acid Sequence↗
PubMed1984

Breath hydrogen excretion in normal newborn infants in response to usual feeding patterns: evidence for "functional lactase insufficiency" beyond the first month of life.

Sequential studies of morning breath hydrogen excretion were carried out in the homes of 16 normal breast-fed or formula-fed infants during the first 5 months of life. Except for two infants whose stools did not produce H2, all infants had elevated breath H2 excretion (greater than 10 parts per million) during and after the first month of life. There was a significant relationship to age (P less than 0.005) for all three measures of H2 excretion (4-hour average, peak, and preprandial), with mean values being highest in month 2, elevated but lower in month 1, and dropping significantly in months 3 and after. Additional 24-hour studies with six 7-week-old infants demonstrated that H2 excretion was inversely related to state of arousal, more likely to be detected in the afternoon, and not clearly related to time of feeding. These findings suggest that incomplete lactose absorption in response to usual feeding patterns persists beyond the first months of life in all infants. The pattern of breath H2 excretion indicates a probable developmental change in quantity and consistency of carbohydrate substrate delivered to colonic flora. Although elevated breath H2 excretion in response to normal feeding demonstrates incomplete absorption, it should not be used to determine an infant's status as a "lactose malabsorber."

Breast Feeding↗
PubMed1983

Lung structure as a risk factor in adverse pulmonary responses to asbestos exposure. A case-referent study in Quebec chrysotile miners and millers.

To investigate the hypothesis that lung structure may predispose to the development of asbestos-related pulmonary fibrosis, we carried out a case-referent study using data gathered in a cross-sectional study of Quebec chrysotile asbestos miners and millers. Tracheal and thoracic measurements were derived from the routine chest radiographs of 44 men with established radiologic fibrosis and compared with similar measurements for 88 men matched for age and cumulative exposure in the same industry who had not developed pulmonary fibrosis. Intrathoracic tracheal lengths were, on the average, shorter, and transthoracic diameters narrower in cases compared with those in referents. In addition, cases were shorter than the referents, suggesting that height might be an indirect measure of the structural characteristics relevant to the response to inhaled asbestos particles. Our findings are thus consistent with the hypothesis outlined, and they suggest a line of investigation that might be useful in relation to other inhaled pollutants.

Adult↗