Search PubMed⌕ Search

Biomedical subjects

J Mason

Publications and source records attributed to J Mason.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Backboard versus mattress splint immobilization: a comparison of symptoms generated.

The study objective was to compare spinal immobilization techniques to a vacuum mattress-splint (VMS) with respect to the incidence of symptoms generated by the immobilization process. We used a prospective, cross-over study in a university hospital setting. Participants consisted of 37 healthy volunteers without history of back pain or spinal disease. Interventions consisted of two phases. In Phase I, subjects were randomly assigned to be immobilized on either a wooden backboard or a mattress-splint for 30 min. The incidence and severity of any symptoms generated by the immobilization process were recorded. In Phase II, the two groups were again tested after a 2-week washout period, with the method of immobilization being reversed. Symptoms and severity were again recorded. Pain symptoms were confined to four anatomic sites: Occipital prominence, lumbosacral spine, scapulae, and cervical spine. After adjusting for the effect of order of exposure, subjects were 3.08 times more likely to have symptoms when immobilized on a backboard than when immobilized on the VMS. They were 7.88 times more likely to complain of occipital pain and 4.27 times more likely to complain of lumbosacral pain. Severity of occipital and lumbosacral pain was also significantly greater during backboard immobilization. We conclude that, when compared to a VMS, standard backboard immobilization appears to be associated with an increased incidence of symptoms in general and an increased incidence and severity of occipital and lumbosacral pain in particular.

Adolescent↗
PubMedDate not supplied

Influence of Holter monitor and electrophysiologic study methods and efficacy criteria on the outcome of patients with ventricular tachycardia and ventricular fibrillation in the ESVEM trial.

Because not all laboratories use the monitoring and stimulation protocols used in the Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, we reanalyzed the ESVEM patients' data using alternative, commonly used Holter monitor (HM) and programmed stimulation efficacy criteria to determine if different criteria would have changed the trial's conclusions. Also, because beta-blocker use and coronary artery disease frequency were not equally distributed between the two limbs in ESVEM, we reanalyzed the ESVEM data adjusting for the possible effect of these variables. In the HM limb, drug efficacy in the original ESVEM analysis was declared by reduction of total premature ventricular complexes (PVCs) by 70%, pairs by 80%, runs of 3 to 15 beats by 90%, and all ventricular tachycardia (VT) more than 15 beats by 100%. In this analysis, we examine outcome in subjects meeting two more stringent sets of criteria, (1) reduction of total PVCs by 70%, of pairs by 80%, and of all VT by 100% (new criteria set 1) and (2) reduction of total PVCs by 80%, of pairs by 90%, and of all VT by 100% (new criteria set 2). In electrophysiology (EPS) limb patients, we compared arrhythmia recurrence when efficacy was declared with triple extrastimuli as compared with maximally testing with double extrastimuli, and arrhythmia recurrence was compared in patients tested with identical versus any more aggressive protocol on drug than was used before drug. We also compared the predictive accuracy of zero versus 3 to 15, and 0 to 5, 6 to 10, and more than 10 induced beats on drug. Additionally, we compared predictive accuracy of the HM- and EP-guided limbs excluding patients on beta blockers and those with noncoronary disease. Lastly, to determine whether concordant results on HM and EPS testing would provide more accurate efficacy predictions than EP testing alone, HM recordings obtained in EPS-limb patients but not processed or used during the course of the EVSEM study were analyzed. The original ESVEM HM criteria, new set 1, and new set 2 yielded predicted drug efficacy rates of 77%, 68%, and 58%, respectively; however, arrhythmia recurrence rates were unchanged. Similarly, arrhythmia recurrence rates for patients tested with triple versus less than triple extrastimuli (p=.238), more aggressive versus identical protocols (p=.955), and 0 to 5 v 6 to 10 v more than 10 induced beats (p=.263) or 0 v 3 to 15 induced beats (p=.106) were unchanged. in the 215 (of 286) patients with coronary disease and not receiving beta blockers, there was still no difference in arrhythmia recurrence or mortality between the noninvasive and invasive limbs in ESVEM. Lastly, in patients with drug efficacy predictions by EPS testing, there was no difference in outcome in patients who had concordant versus discordant efficacy prediction by simultaneously obtained HMs. The use of more stringent testing methods and efficacy criteria would not have significantly improved the predictive accuracy of drug assessment by HM or EPS in the ESVEM trial. Additionally, excess noncoronary disease in EP-guided patients and excess beta-blocker used in HM-guided patients did not influence the results in the ESVEM trial.

Actuarial Analysis↗
PubMedDate not supplied

Biochemical screening of hospitalized geriatric patients.

Blood specimens were collected from 50 hospitalized geriatric patients with a range of chronic diseases. Analyses were conducted for 12 plasma components. Additional tests were performed on patients with abnormal results in the first tests. Of the 50 patients, 21 (42 per cent) had biochemical abnormalities, often unexpected on the basis of current diagnoses. It is suggested that routine biochemical screening should be conducted on geriatric patients at regular intervals.

Aged↗
PubMedDate not supplied

The case for financial incentives to encourage organ donation.

The existing system of organ procurement has failed in its mission of providing an adequate number of organs for transplantation. The organ shortfall results in diminished life expectancy and quality of life for dialysis patients and in increased mortality for patients with end-stage cardiac disease and liver failure who are unable to obtain transplants. Oft-repeated arguments against sale of human organs do not stand up to careful examination, and seem anachronistic in the context of widespread current acceptance of financial incentives for tissue donation in analogous fields, such as reproductive medicine. This essay advocates the staged introduction of a reward-based system of organ donation, initially for cadaveric harvesting and, possibly, later for living donation. Although imperfect, the proposed approach would represent a significant improvement over the status quo.

Europe↗
PubMedDate not supplied

Psychological correlates of growth hormone response to stress.

A stressful interview was conducted in 52 older people to determine whether a stress provoked change in growth hormone (GH) is correlated with anxiety and "defensiveness." The interview was referred to events surrounding the potential loss of a spouse hospitalized two months previously: in 29 instances, the spouse had died before this interview. GH was measured before and, in 23 subjects, during the interview. After the interview, in addition to GH, anxiety was measured using the Taylor Manifest Anxiety Scale (MAS), and defensiveness using the Crowne Marlowe Social Desirability Scale (SD). An elevation of at least 2.0 ng/ml in GH was used to classify subjects as GH responders (Rs) and nonresponders (NRs). Although the Rs and NRs had similar mean scores on defensiveness (SD), the Rs scored higher on anxiety (MAS) (14.9 vs. 10.2, p less than 0.05). Using a median cutoff with anxiety (MAS) alone, only 59% of the Rs were correctly classified as Rs. However, combining both scales in a discriminant function analysis (DFA) improved the ability of either scale alone to distinguish the Rs from the NRs. Using the DFA, 73% of the 29 NRs were correctly classified and 70% of the 23 Rs were correctly classified (p less than 0.005). With higher levels of defensiveness (SD), relatively low levels of anxiety were needed to provoke a GH response. This finding supports previous studies of GH response to stress and provides a multivariate model for the interaction of anxiety and "defensiveness."

Anxiety↗
PubMedDate not supplied

Urinary-free cortisol excretion in relation to age in acutely stressed persons with depressive symptoms.

We examined the relationship between age and urinary excretion of free cortisol in acutely stressed middle-aged and elderly persons. We observed that elderly persons under stress excreted larger amounts of urinary-free cortisol than did middle-aged persons; Pearson's r between age and cortisol = 0.38, p less than 0.05. When the sample was stratified by severity of depressive symptoms, the relationship between age and cortisol excretion was strongly accentuated among those with severe depressive symptoms (r = 0.62, p = 0.01) and diminished among those with milder symptoms (r = 0.25, N.S.). Potentially confounding factors such as diet, use of medications, and physical stature were controlled and did not explain the observations. The high depression scores in this acutely stressed sample were indicative of a higher severity of stress response and also a higher risk of occurrence of depressive syndromes. The depressive syndromes did not resemble depressive disorder of an endogenous nature.

Adjustment Disorders↗
PubMedDate not supplied

Relationships between thyroid hormones and symptoms in combat-related posttraumatic stress disorder.

This study was designed to investigate relationships between serum thyroid hormone levels and the severity of posttraumatic stress disorder (PTSD) symptoms in a group of 65 male Vietnam combat veterans who participated as members of cohorts in an elective inpatient treatment program. Thyroid hormone measures included serum free and total triiodothyronine (T3), free and total thyroxine (T4), and thyroxine-binding globulin. To estimate symptom severity, the Clinician-Administered PTSD Scale (CAPS-2), based on DSM-III-R diagnostic criteria for PTSD, was used. Significant positive correlations were observed between free T3, total T3, total T4, and the "hyperarousal" frequency subscale score and the CAPS-2 frequency sum score. Patients with increased thyroid hormone levels and increased hyperarousal symptoms might constitute a clinically significant subtype among patients with PTSD. Alternatively, increased thyroid activity and hyperarousal symptoms may be associated with phase-related characteristics in PTSD. Research strategies for further evaluation of these preliminary findings are discussed.

Adult↗
PubMedDate not supplied

Elevations of serum T3 levels and their association with symptoms in World War II veterans with combat-related posttraumatic stress disorder: replication of findings in Vietnam combat veterans.

OBJECTIVE: In previous serum thyroid studies, we reported an unusual thyroid profile, including elevated levels of total and free triiodothyronine (T3), total thyroxine (T4), and thyroxine-binding globulin (TBG) with no elevations in free T4 and thyrotropin (TSH) in Vietnam veterans with combat-related posttraumatic stress disorder (PTSD) compared to control subjects. In a subsample of Vietnam veterans, we found a significant positive correlation between total T3, free T3, and PTSD symptoms, specifically hyperarousal symptoms. In the present study, we explored the generalizability of our findings to World War II (WWII) veterans with PTSD. METHOD: Clinical symptoms were assessed in and serum thyroid measures were obtained from 12 WWII veterans with PTSD and 18 WWII veterans without PTSD. RESULTS: WWII veterans with combat-related PTSD showed elevations of serum total and free T3 with no elevations of free T4 and TSH compared to control subjects, replicating the results of our previous studies. A significant positive relationship between total and free T3 and PTSD symptoms, specifically hyperarousal symptoms, was also replicated in the total WWII group. Elevations of total T4 and TBG were not replicated in the WWII group with PTSD, which may indicate a shift with age in the free/bound dynamics of the thyroid alterations observed. CONCLUSIONS: This study supports the observation that the thyroid system is altered in chronic combat-related PTSD. The observed alterations of thyroid function along with PTSD symptoms appear to be chronic, detectable 50 years after the war.

Chronic Disease↗
PubMedDate not supplied

Use of fluorescein for detecting cerebrospinal fluid rhinorrhoea: A safe technique for intrathecal injection.

The use of intrathecal injections of fluorescein has a role in the diagnosis and management of cerebrospinal fluid leaks using endoscopic techniques. The Polymedic 'pencil point' needle has a lower incidence of headache after dural puncture than standard bevelled needles. We describe a safe method of introducing fluorescein into the thecal space.

Cerebrospinal Fluid Rhinorrhea↗
PubMedDate not supplied

Bicycle accidents and injuries among adult cyclists.

Bicycling accidents comprised the greatest recreational source of Emergency Room visits last year, numbering over 500,000. To evaluate cycling morbidity, 492 active adult bicyclists from a metropolitan area responded to a survey to determine cycle use and accident patterns. Nearly half (46%) have been involved in an accident with the cyclists being at fault 58.7% of the time. Soft tissue injuries to the extremities predominated with 9.3% of all injuries requiring hospitalization (average, 7 days) and 22.5% missing days from work or school. Significant factors contributing to bicycle accidents included rider carelessness (58.7%), cycle malfunction (14.9%), environmental factors (36.9%), turns (22.9%) and hills (13.4%), and companion riders (15%). The use of riding helmets decreased the severity of injury and hospitalization time. The education of cyclists and drivers with the integration of bicycles into normal traffic patterns should help decrease the morbidity and mortality.

Accident Prevention↗
PubMedDate not supplied

Occurrence of Salmonella enteritidis in the U.S. commercial egg industry: report on a national spent hen survey.

In order to estimate the prevalence and distribution of Salmonella enteritidis in U.S. commercial egg-production flocks, a survey of spent laying hens was conducted over a 3-month period. Seven of the 10 largest spent-hen processing plants in the United States participated. Ceca were sampled twice weekly from birds presented for slaughter at these plants. Samples were cultured for Salmonella and S. enteritidis, and S. enteritidis isolates were phage-typed. Overall, 23,431 pooled cecal samples were collected from a total of 406 layer houses. Salmonella (any serotype) and S. enteritidis were recovered from 24% and 3% of the pooled samples, respectively. The distribution of S. enteritidis phage types was consistent with data reported by others. Regionally, the estimated prevalence of S. enteritidis-positive houses (i.e., at least one positive sample found in a house) for the Northern, Southeastern, and Central/Western regions was 45%, 3%, and 17%, respectively. Overall, the prevalence of Salmonella-positive houses was 86%.

Abattoirs↗
PubMedDate not supplied

Infrapopliteal bypass grafts for severe ischaemia of the lower limb.

A retrospective survey of 27 infrapopliteal bypass grafts performed for rest pain revealed a cumulative limb salvage rate of 65.3% with an overall operative mortality of 8%. When pre-operative angiography demonstrates a patent infrapopliteal artery, reversed saphenous vein bypass grafting offers a realistic alternative to primary amputation when femoropopliteal occlusion threatens limb viability.

Adult↗
PubMedDate not supplied

Salmonella enteritidis in eggs from commercial chicken layer flocks implicated in human outbreaks.

Eggs were cultured from four commercial chicken layer houses implicated in three human outbreaks of Salmonella enteritidis serotype enteritidis infection as part of the activities of the USDA-APHIS, VS, Salmonella enteritidis Task Force. Each house was part of a multiple in-line complex, ranging from three to seven houses. Houses were located on three separate farms, and each house contained between 50,000 and 80,000 chickens. S. enteritidis phage types 8, 13a, and 23 were isolated from samples taken from environmental and organ tissue samples, but only phage type 8 was cultured from eggs. Phage type 8 was isolated from humans in all three S. enteritidis outbreaks. Frequency estimates of contaminated eggs ranged from 0.03% to 0.90%.

Animals↗
PubMedDate not supplied

Occurrence of Salmonella enteritidis in unpasteurized liquid egg in the United States.

In order to gain a greater understanding of the occurrence and distribution of Salmonella enteritidis in the United States, a survey of unpasteurized liquid egg (collected at 20 egg-breaking plants across the United States) was conducted over a 52-week period. Weekly liquid egg samples were submitted for Salmonella culturing at the National Veterinary Services Laboratories. Group D positive salmonellae were serotyped and phage-typed. On a regional basis, the Northern Region of the United States had the highest S. enteritidis recovery, with 20% of the samples submitted from plants in that region culture-positive for this serotype. Salmonella enteritidis positives from the Southeast, Central, and Western regions were 10%, 15%, and 6% of the samples submitted, respectively.

Bacteriophage Typing↗
PubMedDate not supplied

Social class and chronic illness in Dublin.

Information on the social class distribution of illness is scarce in Ireland. The aim of this study was to document the social class distribution of 12 common chronic conditions in middle-aged persons in Dublin. Data were collected on 3,111 individuals attending three large general practices over the course of a calendar year, and 1,024 individuals living in the same areas. Ten out of the 12 conditions studied were significantly more common in those from social classes five and six, than those from social classes one and two. Persons from social classes three and four, classes five and six, had an overall excess morbidity rate of 21% and 70% respectively. The distribution of chronic illness in middle-aged residents of Dublin is social class related.

Chronic Disease↗
PubMedDate not supplied

Care and control.

Explore the source record for details and available documents.

Adolescent↗