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Biomedical subjects

J Miller

Publications and source records attributed to J Miller.

At least 1,315 records · Page 73Linked to original sources
PubMedDate not supplied

Louse comb versus direct visual examination for the diagnosis of head louse infestations.

The techniques used for diagnosis of head louse (Pediculosis capitis) infestation are a source of controversy. Most epidemiologic and diagnostic studies have been done using direct visual examination. The main objective of this study is to compare the efficacy of direct visual examination versus the louse comb method. The hair of each child was examined twice; one team used a screening stick and another team used a louse comb. Seventy-nine boys and 201 girls, 7-10 years old were examined. Examination with a louse comb found that 25.4% of the children were infested with both lice and nits, while another 31.3% had nits only. Boys were significantly less infested with lice and nits than girls (lice: 15.2 and 29.6%; nits: 21.5 and 35.4%, respectively). The infestation rate with lice and nits was significantly higher in children with long (68.9%) and medium-length (63.9%) hair than in children with short hair (44.0%) (p < 0.01). Direct visual examination found that 5.7% of the children were infested with both lice and nits, and another 49.0% with nits only. The average time until detection of the first louse was 57.0 seconds with the comb as compared to 116.4 seconds by direct visual examination. Diagnosis of louse infestation using a louse comb is four times more efficient than direct visual examination and twice as fast. The direct visual examination technique underestimates active infestation and detects past, nonactive infestations.

Animals↗
PubMedDate not supplied

Domestic violence in the Arab American population: transforming environmental conditions through community education.

The purpose of this research was to assess and provide community interventions for victims of domestic violence in the Arab American immigrant population in a large midwestern city of the United States. The theoretical framework of critical social theory provided the context for the research. A survey tool for assessing domestic violence was administered in the homes of 202 Arab American immigrants, followed by open discussion with the Arabic data collector. Findings from the research were used to develop and implement specific community education programs and clinic resources for the local immigrant population.

Adolescent↗
PubMedDate not supplied

Use of cognitive state predicates by language-impaired children.

Two studies of the use of cognitive state predicates by children with specific language impairment (SLI) were conducted. Study I analysed longitudinal language samples collected from 26 children with SLI and 25 children with normal language (NL) development, aged 4;4 and 2;11, respectively, at Time I. Study II analysed samples from SLI children with more severe delays at an earlier language stage. There were 10 SLI children and 10 NL children, aged 4;11 and 2;8, respectively, matched by MLU. All cognitive state predicates were identified using both broad and narrow definitions. In Study 1, the SLI children used cognitive state predicates less frequently than their mental age peers, and with no greater frequency or variety than their younger, language peers. In Study II, children with SLI used more predicates referring to communication events, but there were no further group differences. These findings are discussed as they relate to two current psycholinguistic issues: the possible dissociation of grammar and the lexicon, and the role of language in the development of children's theory of mind.

Age Factors↗
PubMedDate not supplied

Animal-assisted therapy: an in-depth look.

Animal-assisted therapy has gained widespread support and application over the past few decades. This article reviews the history of animal-assisted therapy; discusses its present goals and applications, including those pertinent to critical care; and notes questions requiring further research.

Animals↗
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The effect of intravenous sodium diatrizoate on the function of the transplanted canine kidney.

The response of the canine renal autograft and allograft was measured following intravenous injection of 1 cc/kg 50% sodium diatrizoate (50% Hypaque). There was no significant effect on glomerular filtration rate or renal plasma flow immediately after injection; likewise there was no significant change in GFR 24 hours following injection compared to control animals.

Animals↗
PubMedDate not supplied

Nuclear size, shape, and density in endometrial carcinoma: relationship to survival at over 5 years of follow-up. Does analyzing only cells occupying the G0-G1 peak add useful information?

OBJECTIVE: The authors, using image analysis, previously demonstrated nuclear size and summed optical density to be independent prognostic indicators of recurrence in patients with endometrial carcinoma. The same tumors were analyzed by studying the optical features in the G0-G1 peak to see if this changed the values found as well as their importance as prognostic features at greater than 5 years of follow-up. METHODS: Tumors from 74 consecutive patients, surgically treated, with endometrial cancer, were evaluated. Survival, depth of invasion, lymphvascular space invasion, FIGO stage, grade, histology were analyzed. DNA index, progesterone receptor status, as well as nuclear size (NUSZ), shape (NUSH), and summed optical density (NUSD) were evaluated. NUSZ, NUSH, and NUSD were quantified using image analysis. RESULTS: Fifteen patients died from disease during the observation period of the study. Mean follow-up was 82 months with a median of 84 months. Forty-nine patients had stage I cancers, five stage II, 17 stage III, and three stage IV. NUSZ and NUSD were all significantly different between the original (entire cell cycle) and the re-measured (G0G1 only) values (both P < 0.001). Multivariate analysis showed both the original (P = 0.0001) and G0G1-only (P = 0.046) NUSZ and the original (P = 0.0002) and G0G1-only (P = 0.018) NUSD to be independent prognosticators of survival. CONCLUSION: Image analysis is able to quantify cellular and nuclear parameters not otherwise quantifiable. NUSD and NUSZ correlated with traditional prognostic indicators, were demonstrated independent predictors of survival at over 5 years of follow-up. Although the re-measured NUSZ and NUSD from only the G0-G1 peak were significantly different from the original NUSZ and NUSD, they were not as valuable as prognostic factors. Nuclear size and summed optical density measured from the entire cell cycle are independent prognostic indicators of survival at greater than 5 years of follow-up. Measuring nuclear morphometric features in the G0-G1 peak only does not add any new prognostic information.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Stage IV ovarian cancer: a retrospective study on patient's management and outcome in a single institution.

The management of stage IV epithelial ovarian carcinoma remains controversial. The aim of this study was to evaluate and compare our results to other published series. A retrospective database and casenote review was performed on all patients diagnosed with stage IV disease over a ten-year period (1992-2002). Survival analysis was performed using the Kaplan-Meier and Mantel-Haenszel methods. The study group comprised 23 women. Nine had positive pleural effusions (39.1%), and 14 had other sites of metastases (60.9%). Nine patients underwent interval debulking (39.1%), and 14 were operated on primarily (60.9%). We had six postoperative complications (26.1%) but no perioperative deaths. Optimal cytoreduction (inferior or equal to 2 cm residual disease) was obtained in 18 patients (78.3%). The overall median survival was 22.6 months. There was no statistically significant difference in overall or disease-free survival between primary surgery and interval debulking. Patients with positive pleural effusions had significantly reduced survival compared to those with distant metastases in other sites. Interestingly, there was no difference in survival between optimally and suboptimally cytoreduced patients. Debulking surgery can be performed in patients with stage IV ovarian cancer, with an acceptable level of morbidity. Optimal cytoreduction is achievable in the majority of these patients. Interval debulking should be considered in selected patients.

Adult↗
PubMedDate not supplied

A randomized trial of heparin and saline for maintaining intravenous locks in neonates.

PURPOSE: To determine the effects of saline, heparin 2 units (U) per ml saline, and heparin 10 U/ml saline flush solutions on the duration of intravenous (i.v.) locks and the incidence of i.v. infiltration in neonates. DESIGN: Randomized double-blind experiment. SETTING: Tertiary-care nursery. PARTICIPANTS: Neonates (N = 90) hospitalized at birth in the intensive, intermediate care, or newborn units. MAIN OUTCOME MEASURES: Total hours from the time the i.v. was inserted to the time the i.v. was removed; hours from the time the i.v. was first flushed to the time the i.v. was removed; number of i.vs. removed because of infiltration. RESULTS: No statistical or clinical differences between the three groups for duration of i.v. nor for incidence of complications. CONCLUSIONS: The use of heparin in i.v. lock flush solution did not affect the duration of i.v. locks nor the incidence of infiltration in neonates.

Anticoagulants↗
PubMedDate not supplied

Variation in the process of pediatric asthma care.

In May 1994, the continuous quality improvement team at Hermann Children's Hospital in Houston, TX, began to study the structure, process, and outcome of asthma care for pediatric patients. The team's immediate goals were to identify variation in the treatment of pediatric asthma and to determine the most cost-effective interventions. This article details the team's development of a clinical pathway to reduce variation in patient care; use of the pathway led to a reduction in length of stay and a corresponding reduction in costs.

Adolescent↗
PubMedDate not supplied

Effects of a decision support system on the diagnostic accuracy of users: a preliminary report.

OBJECTIVES: To assess the effects of incomplete data upon the output of a computerized diagnostic decision support system (DSS), to assess the effects of using the system upon the diagnostic opinions of users, and to explore if these effects vary as a function of clinical experience. DESIGN: Experimental pilot study. Four clusters of nine cases each were constructed and equated for case difficulty. Definitive findings were omitted from the case abstracts. Subjects were randomly assigned to one of four clusters and were trained on the DSS prior to use. SUBJECTS: The study involved 16 physicians at three levels of clinical experience (six general internists, four residents in internal medicine, and six fourth-year medical students), from three academic medical centers. PROCEDURE: Each subject worked up nine cases, first without and then with ILIAD consultation. They were asked to offer up to six potential diagnoses and to list up to three steps that should be the next items in the diagnostic workup. Effects of DSS consultation were measured by changes in the position of the correct diagnosis in the lists of differential diagnoses, pre- and post-consultation. RESULTS: The DSS lists of diagnostic possibilities contained the correct diagnosis in 38% of cases, about midway between the levels of accuracy of residents and attending general internists. In over 70% of cases, the DSS output had no effect on the position of the correct diagnosis in the subjects' lists. The system's diagnostic accuracy was unaffected by the clinical experience of the users.

Decision Making↗
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Seasonal birth patterns of neurological disorders.

Existing seasonal birth studies were reviewed for multiple sclerosis (MS), Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis (ALS), epilepsy, cerebral palsy, congenital malformations of the central nervous system and mental retardation. Epilepsy appears to have the most consistent pattern, with an excess of births in winter and a deficit in September. MS, ALS and possibly Parkinson's disease appear to have an excess of spring births. Studies of cerebral palsy are not conclusive, although there are suggestions that there may be an excess of summer births. The findings for Alzheimer's disease, congenital malformations of the central nervous system, and mental retardation are contradictory and insufficient to draw any conclusions.

Central Nervous System Diseases↗
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Apoptosis in auditory brainstem neurons after a severe noise trauma of the organ of Corti: intracochlear GDNF treatment reduces the number of apoptotic cells.

We have studied the morphological and cellular changes in the cochlear nucleus (CN) after cochlear nerve degeneration and whether these changes can be prevented by rescuing the primary cochlear neurons from degeneration with local glial cell line derived neurotrophic factor (GDNF) treatment. Degeneration of spiral ganglion neurons was seen to lead to a reduction of the volume of the anteroventral cochlear nucleus (AVCN); the size of the cell nuclei in the AVCN also was reduced. No differences were observed in cell density. After intrascalar GDNF treatment the volume of the AVCN was significantly larger when compared to the untreated side, and the size of the cell nuclei in the AVCN was significantly larger on the treated side. After degeneration of spiral ganglion neurons, an increased number of apoptotic cell nuclei were seen in ipsilateral CN and superior olivary complex. This increase was significantly smaller after intrascalar GDNF treatment. Degeneration of primary cochlear neurons seems to lead to an increase in the number of CN neurons undergoing apoptotic cell death. This can be prevented partially by rescuing primary cochlear neurons from degeneration with local GDNF treatment.

Animals↗
PubMedDate not supplied

Primate model for studies of clinical problems of middle ear functions.

Eustachian tube and middle ear function has been studied in the acute and chronically prepared Rhesus monkey preparation. Measures have included observations of tympanometry and input impedance of the middle ear, of transmission of energy through the middle ear, of static middle ear pressure and of threshold and suprathreshold hearing. Positive and negative long and short-term static middle ear pressures, the effects of middle ear fluids, and various aspects of Eustachian tube function in both normal and pathologic preparations have been studied. In general our observations indicate that the Old World monkey may provide a model permitting acquisition of quantitative data of a variety of middle ear functions under carefully controlled laboratory conditions, including those requiring measures simply not possible in man.

Animals↗
PubMedDate not supplied

Anatomical effects of sudden middle ear pressure changes.

Acute middle ear (ME) and inner ear changes following brief unilateral phasic ME pressure changes (up to +/- 6000/mm H2O) were studied in the guinea pig. Middle ear findings included perforation of the tympanic membrane, serous and serosanguinous exudate and hemorrhage of tympanic membrane and periosteal vessels. Changes were related to magnitude of applied pressure. Perforation and hemorrhage were more commonly seen with negative rather than positive pressure. Air bubbles behind the round window were seen with positive pressures. Occasional distortion, but never perforation of the round window, was noted. Hemorrhage of the scala tympani was observed with both positive and negative pressures; scala vestibuli hemorrhage was found with negative ME pressure. In some instances pressure direction and magnitude related changes were seen in the contralateral ear.

Animals↗
PubMedDate not supplied

Relationship of normal serum vitamin B12 and folate levels to cognitive test performance in subtypes of geriatric major depression.

This retrospective study evaluated the relationships between normal serum vitamin B12 and folate levels and neuropsychologic measures in a sample of 60 geriatric inpatients with psychotic depression, nonpsychotic depression, bipolar disorder, and dementia--all consecutively referred for cognitive testing. The psychotic depression subgroup demonstrated numerous significant positive correlations between B12 and cognitive subtests not seen in other diagnostic subgroups, especially those of IQ, and verbal and visual memory. Metabolic factors including vitamin B12 may play specific roles in the cognitive dysfunctions of different geropsychiatric disorders.

Aged↗