Search PubMed⌕ Search

Biomedical subjects

J Hassett

Publications and source records attributed to J Hassett.

29 records · Page 2Linked to original sources
PubMed1990

Test performance of a local examination at a nonlocal site for evaluation of surgical clerks.

Surgical clerkships frequently use locally prepared examinations or nationally available test item banks as an alternative to Surgery Shelf Examinations from the National Board of Medical Examiners (SSNBME) for student evaluation. This study examines performance of a well-designed, item-analyzed local examination (available nationally through the Association for Surgical Education) at a nonlocal site. A 100-item test with a stratified sample from a 442-item bank was administered to 72 third-year students in addition to the SSNBME. The Pearson product moment correlation coefficient between the two examinations was 0.61 (p less than 0.001). Test performance between the local site and nonlocal site was compared by the Kuder-Richardson formula 20 for subtest reliability (internal consistency) and difficulty index (percent correct responses) and the point biserial correlation coefficient (correlation of a student's performance on one item with performance on the rest of the items) for test item analysis. Data show that despite fair correlation with SSNBME, significant deteriorations in both test item performance and reliability occur with the use of a local examination at a nonlocal site. This likely results from problems with content validity at the nonlocal site. Clerkships that use local examinations or national test bank items are strongly advised to evaluate test performance and revise appropriately before using results for formal student evaluation.

Clinical Clerkship↗
PubMed1989

Immunophenotyping in a multicenter study: the Transfusion Safety Study experience.

The Transfusion Safety Study (TSS) is a cooperative investigation of factors that determine the occurrence of and modify the expression of transfusion-transmitted infections. A major component of its data is derived from lymphocyte immunophenotyping using a large panel of monoclonal antibodies and two-color flow cytometric analysis. The multicenter longitudinal character of TSS necessitates a uniformity of instrumentation, reagents, and protocols, as well as an intensive quality control program. The baseline assessment of a cohort of males 10 years of age and over with congenital clotting disorders (CCD) exemplifies the approach and some of the flow cytometry results. A comparison of anti-HIV-1 positive and negative subjects shows that more of the loss of T4+ cells was attributable to a decrease in the T4+4B4+ subset than the T4+2H4+ subset. There was an overall increase in CD8 cells, with a significant increase in the I2+T8+ and Leu7+T8+ cells, but a fall in NKH.1+T8+ cells. Monocytes, MO2+I2+ cells, increased. In CCD patients under the age of 10, both anti-HIV-1 positive and negative, there were absolute elevations in immunocytes, including CD4. There was also a distinctly different distribution of CD4 subsets. The suppressor inducer subset, 2H4+T4+, was increased relative to the helper inducer subset, 4B4+T4+, in the younger subjects.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Gastric bleeding in pseudoxanthoma elasticum.

We report a case of pseudoxanthoma elasticum and gastrointestinal bleeding, and document the degenerative changes of the gastric arterioles occurring over a 26-yr period. In addition to the internal elastic lamellar degeneration and dystrophic calcification, we describe the presence, ultrastructurally, of an abnormal collagen fiber. These degenerative changes in the gastric vascular bed can be a direct cause of gastrointestinal bleeding.

Gastrectomy↗
PubMed1987

The gut origin septic states in blunt multiple trauma (ISS = 40) in the ICU.

The association between support elements (ventilator days = Vd, enteral protein = EnP, number of antibiotics per day = AB/d) and the magnitude of the septic state (SSS) and its bacteriologic manifestations (bacti. log) in 66 patients with blunt multiple trauma (mean HTI-ISS = 40) over 1649 days have been studied retrospectively. SSS is measured by summing the standard deviation units of change in the septic direction for the 16 measurements taken every day in the intensive care unit. Increasing Vd is tightly associated with an increasing SSS (r = +0.52), after day 10 an increasing bacti. log (r = +0.21 to +0.32), and an increasing AB/d (r = +0.26) (all p less than 0.001, N = 1615 - 1626). The independent variables that best predicted Vd were delayed operations (DORS), day of rising EnP, and total positive blood cultures (TPC) (adj. R sq. = 0.84, F = 104, dF = 3/59). An increasing AB/d was associated with an increasing SSS (r = +0.38), increasing Vd (r = +0.26), and an increased bacti. log (r = +0.14 to +0.18) (all p less than 0.001, N = 1615). Only an increased EnP was consistently associated with a reduced SSS (r = -0.38) and a reduction in bacti. log (r = -0.10 to -0.21) (all p less than 0.001, N = 1626-1636). The independent variables Vd, EnP, AB/d, and TPC best predicted SSS for all surviving patients (adj. R sq. = 0.42, F = 268, dF = 4/1496). The patients who died of sepsis were not different in terms of bacti. log from those with equal Vd but were distinguished by zero EnP, high AB/d, and persistent ventilatory support. In conclusion, DORS is tightly associated with increased Vd, SSS, AB/d, and zero EnP. If Vd exceeds 10, there is an increasing bacti. log and evidence of infection probably from the gut. This responds only to increased EnP and not to AB/d. Death due to sepsis is not associated with increased bacti. log but with zero EnP and high AB/d and their consequences.

Adolescent↗
PubMed1981

Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions.

Four homosexual men presented with gradually enlarging perianal ulcers, from which herpes simplex virus was cultured. Each patient had a prolonged course characterized by eight loss, fever, and evidence of infection by other opportunistic microorganisms including cytomegalovirus, Pneumocystis carinii, and Candida albicans. Three patients died; Kaposi's sarcoma developed in the fourth. All were found to have depressed cell-mediated immunity, as evidenced by skin anergy, lymphopenia, and poor or absent responses to plant lectins and antigens in vitro. Natural-killer-cell activity directed against target cells infected with herpes simplex virus was depressed in all patients. The absence of a history of recurrent infections or of histologic evidence of lymphoproliferative or other neoplastic diseases suggests that the immune defects were acquired.

Adult↗