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Biomedical subjects

Jennifer S Kim

Publications and source records attributed to Jennifer S Kim.

8 recordsLinked to original sources
PubMed2007

Update on epinephrine for the treatment of anaphylaxis.

PURPOSE OF REVIEW: Epinephrine is the treatment of choice for anaphylaxis--a life-threatening and potentially fatal event. The purpose of this review is to highlight recent publications relevant to the management of anaphylaxis and identify potential barriers which prevent or delay appropriate administration of epinephrine. RECENT FINDINGS: Experts have moved towards a consensus on how to define anaphylaxis, which has a variable clinical presentation. A clear definition, across specialties, is necessary for more accurate determinations of prevalence, diagnosis and management. Epinephrine injected intramuscularly is the treatment of choice, but there remain gaps in physician knowledge despite increases in hospitalization rates for anaphylaxis. Epinephrine is also underused by parents, day-care centers and schools. Barriers to access for treatment exist in lower socioeconomic groups. Women appear to be at risk for suboptimal treatment when autoinjectors are used. Given these issues, other routes of administration of epinephrine have been explored. Epinephrine delivered via a sublingual route has been successful in animal studies. SUMMARY: Epinephrine is the primary therapy for anaphylaxis, yet studies show that it is underutilized. By addressing the contributory factors that have been identified, acute and long-term care of individuals with this potentially life-threatening disorder can be optimized.

Administration, Sublingual↗
PubMed2006

Training-induced plasticity in older adults: effects of training on hemispheric asymmetry.

The extent to which cortical plasticity is retained in old age remains an understudied question, despite large social and scientific implications of such a result. Neuroimaging research reports individual differences in age-related activation, thereby educing speculation that some degree of plasticity may remain throughout life. We conducted a randomized longitudinal dual-task training study to investigate if performance improvements (a) change the magnitude or pattern of fMRI activation, thereby suggesting some plasticity retention in old age and (b) result in a reduction in asymmetry and an increase in age differences in fMRI activation as a compensatory model of performance-related activation predicts. Performance improvements were correlated with an increase in hemispheric asymmetry and a reduction in age differences in ventral and dorsal prefrontal activation. These results provide evidence for plasticity in old age and are discussed in relation to an alternative argument for the role of reduced asymmetry in performance improvements.

Adaptation, Physiological↗
PubMed2006

Training-induced functional activation changes in dual-task processing: an FMRI study.

Although training-induced changes in brain activity have been previously examined, plasticity associated with executive functions remains understudied. In this study, we examined training-related changes in cortical activity during a dual task requiring executive control. Two functional magnetic resonance imaging (fMRI) sessions, one before training and one after training, were performed on both a control group and a training group. Using a region-of-interest analysis, we examined Time x Group and Time x Group x Condition interactions to isolate training-dependent changes in activation. We found that most regions involved in dual-task processing before training showed reductions in activation after training. Many of the decreases in activation were correlated with improved performance on the task. We also found an area in the dorsolateral prefrontal cortex that showed an increase in activation for the training group for the dual-task condition, which was also correlated with improved performance. These results are discussed in relation to the efficacy of training protocols for modulating attention and executive functions, dual-task processing, and fMRI correlates of plasticity.

Adult↗
PubMed2005

Parental use of EpiPen for children with food allergies.

BACKGROUND: EpiPen is often underused in children with food allergy experiencing anaphylaxis. OBJECTIVE: We explored whether underuse of EpiPen might be attributed to parental discomfort with administration, as measured by a lack of parental empowerment and knowledge of proper administration. METHODS: A written survey was mailed to parents of children with food allergy. Those children with physician-diagnosed food allergy who had been prescribed EpiPen were included in the analysis. Parents were recruited from a local food-allergy support group and private allergy practice. Perceived comfort with administering EpiPen was measured by using a 10-cm visual analog scale. Knowledge of EpiPen use and anaphylaxis was tested by using a series of multiple-choice questions. Empowerment was measured with a 16-item instrument that included statements from the Family Empowerment Scale. Multiple regression analysis was used to determine how much of the variance in the comfort ratings could be explained by knowledge, empowerment, and other factors assessed in the survey. RESULTS: Of 360 mailed surveys, 165 (46%) completed surveys met the inclusion criteria and were analyzed. Anaphylaxis was reported in 42% of children (n = 70); 8% of parents (n = 14) had administered EpiPen to their child. Factors correlating with comfort included prior administration of EpiPen ( P = .009), EpiPen training ( P = .005), and empowerment ( P < .0005). Neither a history of anaphylaxis nor knowledge correlated with an increased level of comfort with administration. CONCLUSIONS: Empowerment directly correlated with increased comfort with EpiPen use, but knowledge did not. Physicians should continue to instruct all parents on EpiPen administration because this correlated significantly with comfort. Other psychological factors beyond empowerment might contribute to underuse of EpiPen.

Adult↗
PubMedDate not supplied

Food allergy.

Explore the source record for details and available documents.

Food Hypersensitivity↗