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Biomedical subjects

J T Jacobson

Publications and source records attributed to J T Jacobson.

At least 37 records · Page 2Linked to original sources
PubMed1990

Automated and conventional ABR screening techniques in high-risk infants.

Test validity is determined by the proportion of results that are diagnostically confirmed and predicted on the measures used to identify the disease process. This article summarizes the results of a series of 224 stable high-risk infants who were screened by automated (ALGO-1) and conventional (Bio-logics LT) ABR instrumentation. Failure criteria was defined as the absence or prolongation of a replicable wave V response (conventional) or Refer by the automated system. The overall failure rates at a 35 dB screening level were comparable between devices. Sensitivity and specificity measures for the ALGO-1 unit were 100 and 96 percent, respectively. Permanent hearing loss was demonstrated in 5 percent of the newborns screened in this study. Advantages of the automated system include a dual artifact rejection system, attenuating ear couplers, and a battery operated design. These findings suggest that the automated ABR screener is a viable alternative to conventional ABR instrumentation for the limited purpose of neonatal auditory screening.

Algorithms↗
PubMed1989

Hearing loss in prison inmates.

The incidence of hearing disorders in 34 State Penitentiary prison inmates all with a previous history of drug abuse were investigated. Subjects were evaluated using routine pure-tone air conduction audiometry, immittance measures, and short-latency auditory brain stem responses. Of the 34 inmates, 20 (58.8%) demonstrated normal bilateral peripheral hearing sensitivity, whereas 10 (29.4%) inmates presented with some degree of hearing impairment. In addition, the conflicting results of elevated pure-tone thresholds with normal immittance measures and normal ABR findings suggested that four (11.8%) subjects exhibited functional hearing loss. The results of this study support the reported high incidence of hearing loss in the prison population. The synergistic effects of drug abuse, noise exposure, and head trauma as possible contributing factors are discussed.

Adolescent↗
PubMed1988

Serious Pseudomonas infections associated with endoscopic retrograde cholangiopancreatography.

After observing a single case of Pseudomonas aeruginosa bacteremia following endoscopic retrograde cholangiopancreatography (ERCP), six other P. aeruginosa infections that were temporally related to ERCP were retrospectively found over one year (August 1985 through July 1986) at LDS Hospital. In all seven patients, infection developed within five days after an ERCP. Five patients had bacteremia and two had cholangitis. All five of the Pseudomonas isolates available for testing were serotype 010. Cultures from the ERCP endoscope and several other endoscopes also yielded P. aeruginosa serotype 10, as did environmental cultures from equipment used to clean endoscopes. Among 167 ERCPs performed during the outbreak period, no other patient acquired P. aeruginosa infection. Each of the patients in the outbreak received the first scheduled ERCP of the day. The mean duration between the cleaning of the ERCP endoscope and its subsequent use was significantly longer in cases than in matched controls, a factor that may have permitted contaminating organisms to achieve high inocula in the inadequately cleaned endoscope. Epidemic control measures included improved disinfection of endoscopes, ongoing surveillance, and appropriate antimicrobial prophylaxis. This experience suggests that exogenous infection with Pseudomonas is associated with ERCP, that protracted and insidious outbreaks may occur, and that the occurrence of even a single case of Pseudomonas infection after ERCP should stimulate an epidemiologic investigation.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1987

The effects of ABR stimulus repetition rate in multiple sclerosis.

The purpose of this study was to monitor the effects of auditory brain stem response (ABR) repetition rate in previously confirmed multiple sclerosis (MS) patients. Ten definite MS patients (20 ears) presenting neurological evidence of brain stem involvement were tested. All patients had hearing thresholds of 20 dB HL or better between 250 and 4000 Hz. ABRs were recorded with four click stimulus repetition rates at 70 dB SL. An analysis of variance (ANOVA: Group X Rate X Ear) resulted in significant group (normal versus MS) and rate (10, 33, 67, and 80/sec) effects. Increasing the repetition rate significantly improved the detection of abnormal latency measures (Duncan's multiple range test). Absent or prolonged wave I response latencies were recorded in 25 to 40% of all MS patients tested and were rate dependent. The findings of this study encourage the inclusion of faster repetition rates when using ABR as a supportive measure in the diagnosis of suspected MS patients.

Acoustic Stimulation↗
PubMed1986

Adapting disease-specific isolation guidelines to a hospital information system.

The authors modified the Centers for Disease Control's guideline for disease-specific isolation precautions to a hospital computerized information system. Entering a suspected diagnosis selected from the isolation option on computer terminals generated: a printout listing the isolation instructions, infective material(s), and persons who should avoid exposure; an order for the appropriate supplies; a patient charge based on the supplies required; and an option for stopping, changing, or listing the orders. In order to implement this system, both extensive in-service training for nurses and efforts to change ordering practices of physicians were necessary. Prevalence surveys before and after computerization were used to evaluate the new system. Combined surveys showed that isolation was ordered for only 21% of patients when indicated. Failure to isolate was identified as a significant problem. As a consequence, continuous surveillance and consultation of all infected patients were instituted, resulting in isolation orders for 81% when indicated. The computerized disease-specific system has resulted in better and more accurate use of isolation, probably due to in-service education and surveillance efforts.

Centers for Disease Control and Prevention, U.S.↗
PubMed1985

Infections acquired in clinical laboratories in Utah.

We reviewed laboratory-acquired infections occurring in Utah from 1978 through 1982. Written and telephone interviews of supervisors of 1,191 laboratorians revealed an estimated annual incidence of 3 laboratory-acquired infections per 1,000 employees. Infections, in order of frequency, included hepatitis B (clinical cases), shigellosis, pharyngitis, cellulitis, tuberculosis (skin test conversion), conjunctivitis, and non-A, non-B hepatitis. One-half of large laboratories (over 25 employees), but only 12% of smaller laboratories, reported infections. The annual incidence, however, at smaller laboratories was more than three times greater than at large laboratories (5.0 versus 1.5 per 1,000; P less than 0.05, chi-square test). Microbiologists were at greatest risk of infection, with an incidence of almost 1%, followed by generalists and phlebotomists. Shigellosis was acquired only by microbiologists and accounted for more than half of their infections. The most common laboratory-acquired infection, hepatitis B, affected a microbiologist, a hematologist, a phlebotomist, a pulmonary blood gas technician, and a blood bank technologist who died from her illness. Clinical cases of hepatitis B occurred at a rate 10 times higher than the rate in the general U.S. population. The incidence of tuberculosis skin test conversion was intermediate between rates reported for hospital employees and for the state of Utah.

Aerosols↗
PubMed1985

Comparison of auditory brainstem response and behavioral screening in neonates.

This paper reports on two studies, one in Halifax and the other in Ottawa, which compared behavioral methods and BERA in the screening of hearing loss in neonates. The Halifax study used BERA as the screening procedure for infants of a neonatal intensive care unit (NICU) and as a supplementary procedure to behavioral screening test for non-NICU but "at risk" infants. The results of this study indicate false positive rates with the behavioral test of 86.1 and 50.5% for NICU and at risk groups respectively. The Ottawa study evaluated the Crib-o-gram as a screening test for NICU infants using BERA as the standard. The results of this study indicated that approximately one third of babies with normal BERA thresholds failed Crib-o-gram screening and that Crib-o-gram could identify moderately/severe losses.

Acoustic Stimulation↗
PubMed1985

Normative aspects of the pediatric auditory brainstem response.

The success of any test procedure that involves decision analysis must be based on sound principles, reasonably obtainable data, and a knowledge of response variability. The use of brainstem electric response audiometry (BERA) has gained a prominent role in the clinical assessment of auditory, otoneurologic, and neurologic deficits. However, the road to clinical utility has not been without obstacles. The brainstem response has been besieged with numerous variables which have curtailed universal acceptance and contributed to a lack of established standards. Before BERA is used with any degree of confidence, response variability must be defined and controlled. The purpose of this paper is to review those technical, physiologic, and pathologic conditions which affect response measurement.

Adolescent↗
PubMed1984

Injection-site abscess caused by group A beta-hemolytic Streptococcus. An unusual complication of tonsillectomy and intramuscular injection.

The epidemiologic investigation of any IM injection site infection can be quite complex. In this particular case, one potential source of the organism was established (the patient herself), another source was shown to be less likely (the nurses administering the medications), and a third possible source (the single-dose unit medications) could not be eliminated.

Abscess↗
PubMed1981

Intensive care nursery noise and its influence on newborn hearing screening.

Numerous studies have recently reported the possible damaging effects noise exposure may have on premature infants. While noise levels appear to be within established damage risk criteria for an adult, there is little evidence to support the assumption that intensity levels and duration are similar for an infant population. It was the purpose of this study to measure sound pressure levels within an intensive care nursery and a series of isolettes and to report the behavioral pass/fail screening status of infants who were confined to those settings immediately after birth. It is suggested from the results of our study that due to the stimulus parameter used in behavioral testing, noise exposure is not an influencing factor in infant hearing screening.

Auditory Fatigue↗