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Biomedical subjects

J Rodgers

Publications and source records attributed to J Rodgers.

At least 73 records · Page 4Linked to original sources

Do shifts toward service industries, part-time work, and self-employment explain the rising uninsured rate?

It is conventional wisdom that the increase in the number of uninsured people during the 1980s was due, in part, to systematic trends in employment, specifically: 1) shifts from full-time to part-time jobs and to self-employment; and 2) changes in the industrial mix of employment, especially toward the service industries. This paper uses the March Current Population Survey data from 1980 through 1987 to measure the contribution of these factors to the rise in the uninsured. In the first case, we find the premise of rising part-time work and self-employment to be untrue. In the second case, less than 15% of the decline in health insurance over this period was due to employment shifting from higher-coverage to lower-coverage industries. Instead, the decline resulted from falling coverage rates across all industries. This is not to dismiss the possible importance of such employment trends over decades, but to emphasize the need to investigate other causes of the change during recent years.

Data Collection↗

Role of serological tests in the diagnosis of immune complex disease in infection of ventriculoatrial shunts for hydrocephalus.

Seven cases of ventriculoatrial shunt infection with immune complex disease are reported in order to demonstrate the usefulness of measurement of levels of specific antibody to Staphylococcus epidermidis in diagnosis. Blood and cerebrospinal fluid cultures gave misleading results, and there was initial doubt about the diagnosis in all seven cases. All showed grossly elevated titres of antibody to Staphylococcus epidermidis, with raised serum C-reactive protein levels and depressed complement levels. Measurement of antibody to Staphylococcus epidermidis enables the diagnosis of chronic ventriculoatrial shunt infection to be made rapidly and reliably.

Adolescent↗

The effects of extracellular slime from Staphylococcus epidermidis on phagocytic ingestion and killing.

Extracellular slime (Ecs) from three strains of Staphylococcus epidermidis was prepared and added to fresh suspensions of polymorphonuclear neutrophils. Phagocytic ingestion and killing of opsonised and unopsonised S. epidermidis strains was assessed over time using slide preparations stained by the Gram's method and microbiological culture. Both phagocytic ingestion and killing were inhibited. Investigation as to one possible mechanism of action of Ecs on phagocytes was performed using 1 mu polystyrene spheres which were incubated overnight with Ecs. It was found that the surface tension was altered with Ecs making the beads more hydrophilic, a factor which may interfere with the phagocytic response to infection.

Bacterial Proteins↗

Serological response to coagulase-negative staphylococci in patients with peritonitis on continuous ambulatory peritoneal dialysis.

Sera and dialysis effluent from 20 patients on continuous ambulatory peritoneal dialysis (CAPD) with coagulase-negative staphylococcal (CNS) peritonitis were examined by immunoblotting for antibody activity against CNS. Immunoblotting was highly sensitive and demonstrated significantly greater antibody activity in serum and dialysate of infected patients compared with that of uninfected CAPD patients or healthy volunteers. Fourteen of 20 infected CAPD patients had strong antibody activity (> 7 bands); one patient had equivocal activity. Five patients had weak antibody activity, two of whom suffered from recurrent peritonitis with distinguishable CNS strains despite a satisfactory CAPD technique. One patient with a poor CAPD technique had strong antibody activity, but suffered from recurrent peritonitis. Examination of sequential sera suggested that seroconversion occurred soon after insertion of the Tenckhoff catheter, possibly in the absence of clinical infection. Antibody activity against a 25 kDa staphylococcal protein was significantly associated with peritonitis.

Antibodies, Bacterial↗

Dietary supplementation with fish oil in ulcerative colitis.

OBJECTIVE: To determine the efficacy of fish oil supplementation in patients with active ulcerative colitis. DESIGN: Multicenter, randomized, double-blind, placebo-controlled, crossover trail with 4-month treatment periods (fish oil and placebo) separated by a 1-month washout. SETTING: Four gastroenterology divisions. PATIENTS: Twenty-four patients with active ulcerative colitis entered the study. Five dropped out, and one was noncompliant. Eighteen patients completed the study. All patients had active disease as manifested by diarrhea and rectal inflammation. INTERVENTIONS: Treatment with prednisone and sulfasalazine was continued. Fish oil supplementation consisted of 18 Max-EPA (eicosapentaenoic acid) capsules daily (eicosapentaenoic acid, 3.24 g; and docosahexaenoic acid, 2.16 g). Placebo supplementation consisted of 18 identical capsules containing isocaloric amounts of vegetable oil. MEASUREMENTS: Patients were evaluated at study entry and after each diet period. Evaluations included a review of symptoms, flexible sigmoidoscopy, rectal biopsy, and rectal dialysis to measure prostaglandin E2 and leukotriene B4 levels. RESULTS: Fish oil supplementation resulted in a significant decrease in rectal dialysate levels of leukotriene B4 from 71.0 to 27.7 pg/mL (average change, -43.3 pg/mL; 95% CI, -83 to -3.6). Significant improvements were seen in acute histology index (average change, -8.5 units from a baseline of 10.5 units; CI, -12.9 to -4.2) and total histology index (average change, -8.5 units from a baseline of 14.80; CI, -13.2 to -3.8) as well as significant weight gain (average weight gain, 1.74 kg, CI, 0.94 to 2.54). No significant changes occurred in any variable during the placebo period. Seven patients received concurrent treatment with prednisone. During the fish oil supplementation period, the mean prednisone dose decreased from 12.9 mg/d to 6.1 mg/d and rose from 10.4 mg/d to 12.9 mg/d during the placebo diet period (P greater than 0.20). CONCLUSIONS: Four months of diet supplementation with fish oil in patients with inflammatory bowel disease resulted in reductions in rectal dialysate leukotriene B4 levels, improvements in histologic findings, and weight gain.

Adult↗

Radiotherapy of malignant subdiaphragmatic implants in advanced ovarian carcinoma: a new technique.

We report the development of a new technique using remote afterloading intraoperative radiation therapy to deliver a tumoricidal dose to diaphragmatic tumor implants. A multi-positional lucite applicator was designed based on anatomic studies of the diaphragmatic surface to accommodate a high dose rate iridium source in a series of needles placed 1.5 cm apart. The applicator curvature can vary from planar to full accommodation of the diaphragmatic surface with a constant source to surface distance of 0.5 cm. The applicator has been piloted in three patients with ovarian carcinoma with residual subdiaphragmatic disease found at second look laparotomy, to deliver a dose of 1,500 to 2,000 cGy at 0.5 cm. Tolerance of the diaphragm and hepatic surface has been excellent. There were no postoperative complications and no deterioration in liver function studies. The additional postoperative external beam irradiation directed with the aid of surgically placed clips and gated to respiratory movements permits achievement of a tumoricidal dose while limiting the treated volume and related toxicities.

Brachytherapy↗

Memory after treatment for acute lymphoblastic leukaemia.

Long term survivors of acute lymphoblastic leukaemia (ALL) often experience cognitive difficulties, which may be related to impairment of memory function. Memory ability has been studied in a group of survivors of ALL along with sibling controls and in children who have received treatment for other forms of cancer. Children in the ALL group were found to have significant deficits in memory function in tasks which required the application of strategic planning behaviour. These deficits are potentially remediable by educational strategies.

Adolescent↗

Cognitive function after two doses of cranial irradiation for acute lymphoblastic leukaemia.

The cognitive function of 23 children given cranial irradiation in a dose of 24 Gy was compared with that of 41 given 18 Gy. No significant differences were found in intellectual function or in mean number of intelligence quotient points lost between patients in the two treatment groups. A reduction in the dose of cranial irradiation does not seem to alleviate long term neuropsychological deficits.

Child, Preschool↗

Determination of C reactive protein: an evaluation of three methods.

Two semi-quantitative methods--a latex kit and a precipitin test--and a quantitative turbidometric technique were compared to determine the concentration of C reactive protein in serum. Neither of the semi-quantitative tests was found superior in respect of performance or rapidity to the turbidometric method. The cost of capital equipment needed for the latter is high, but it may also be used for a range of other rapid quantitative determinations.

Adolescent↗

The characterization and modelling of antipredator defensive behavior.

The mammalian behavioral antipredator defense systems have been characterized in terms of reactions to present, localizable, threat stimuli: Analysis of the relationship between features of the predator and the environment, and specific defensive behaviors indicates that the latter can be predicted with a high degree of accuracy. A different set of defensive behaviors are seen when rats living in burrow systems are confronted by a predator outside the burrow. Flight to the burrow and immobility inside the burrow are followed by active investigation of the surface where the cat was seen (risk assessment), with all of these accompanied by inhibition of nondefensive behaviors such as eating, drinking, sexual behavior and aggression. Two additional behaviors are described in this context, ultrasonic cries made at a high initial rate (50% time) by animals inside the burrow systems, and declining over 1-2 hours following predator exposure, and, a specific modification of eating patterns when the subjects return to the surface and begin to eat. Eating bouts are shortened, with fewer episodes of continuous eating, interspersed with intervals of scanning of the environment, a vigilance activity previously reported in field research. This analysis of a broad spectrum of defensive behaviors is being used to develop test batteries providing simplified models of these phenomena.

Aggression↗