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Biomedical subjects

K A Miller

Publications and source records attributed to K A Miller.

At least 73 records · Page 4Linked to original sources
PubMed1985

Adolescent pregnancy: critical review for the clinician.

Adolescent pregnancy is a major health and socioeconomic problem with unique medical and psychosocial consequences for the patient and society. Consequently, it demands our attention and understanding of the problem and its causative factors. Survey data have documented that a majority of adolescents are sexually active, and that currently, almost 1 in 10 adolescents become pregnant each year. Over the last 2 decades, comprehensive adolescent pregnancy programs have shown that the high frequency of adverse obstetric and neonatal outcomes are closely associated with low socioeconomic status, poor prenatal nutrition and general health, and chemical use, but not maternal age. These adverse medical consequences and the psychosocial problem of the parents and infant are treatable with programs that adapt to the patient population and provide extensive support, education, and counseling in addition to continuity obstetric care initiated early in the pregnancy. One of the greatest needs of the adolescent is a competent and caring adult to serve as an advocate to guarantee access to medical and support services. To this end, responsible and qualified professionals who can relate to adolescents should resume this role in the coordination of a comprehensive care approach. This approach will not only reduce the medical risks associated with adolescent pregnancy, but it will decrease the number of repeat teenage pregnancies, promote school retention, increase compliance with health care regimens for the parent and child, and stimulate personal growth and development. All communities should develop programs to promote optimal medical care, psychosocial support, necessary financial support, and accessible education, since adolescent pregnancy occurs in all social, racial, ethnic, and economic groups in all parts of our country. Finally, the role of the adolescent father should be continually emphasized as a potential source of support to the adolescent mother and their infant and a stabilizer in the teenage family unit. In accord with such emphasis, recognition should be afforded to the psychologic and interpersonal needs of the adolescent father.

Adolescent↗
PubMed1984

Rubella susceptibility in an adolescent female population.

A survey of 1,008 adolescent girls was performed to characterize adolescent rubella immunity, and susceptibility was defined as a hemagglutination antibody titer of less than 1:8 (the definition used by the Minnesota State Health Department and the pediatric literature). The incidence of rubella susceptibility was 9.1% in the study population and was evenly distributed with regard to current age, age at time of vaccination, and source of vaccination. In subjects with a history of rubella vaccination, 7.4% were susceptible, whereas in the unvaccinated population, the susceptibility rate was 31.7%. Because rubella is a relatively benign disease except when acquired by the fetus during pregnancy, and adolescents are not only approaching the traditional age of motherhood but also experiencing pregnancy in increasing numbers, it is important for physicians to substantiate the rubella susceptibility status of their adolescent female patients.

Adolescent↗
PubMed1984

Adolescent pregnancy: a combined obstetric and pediatric management approach.

During the past decade, the relative increase in adolescent pregnancy has forced physicians and other health professionals who provide services to teenagers to be aware of the factual data relating to teenage pregnancy and the pertinent social issues in order to serve as advocates for both the parent and the child. In this article, we review the existing demographic data regarding adolescent pregnancy in conjunction with current approaches to intervention programs for the maintenance of a stable environment and optimal development of the parent and the child.

Adolescent↗
PubMed1984

Aortic regurgitation in scleroderma.

Two cases of scleroderma with isolated aortic regurgitation are described. Other known causes of aortic regurgitation were not apparent. None of the patients gave a history of rheumatic fever. It appears likely that aortic regurgitation is related to scleroderma in these two patients. Aortic regurgitation in scleroderma is, however, rare.

Adult↗
PubMed1982

Theophylline compliance in adolescent patients with chronic asthma.

Twenty-one chronic asthma patients ages 12 to 17 years were studied to determine their compliance in taking medication. Serum theophylline concentrations were determined and theophylline dosage (milligrams per kilogram body weight per day) was calculated in participants who had allegedly followed their medication regimen. Although the theophylline dosage followed the guidelines in the literature, only 10% of the patients had serum levels in the therapeutic range. This study suggests that noncompliance among adolescent asthmatics is similar to the noncompliance found in adolescents with other chronic illnesses and that physicians should use drug levels in designing optimal short- and long-term management programs. Further, it emphasizes the need for physicians to educate their patients as to the therapeutic actions of the medication they are taking and the necessity of medication compliance.

Adolescent↗
PubMed1982

Child abuse and neglect.

Family physicians annually see a large number of children at risk for child abuse and neglect. Because of the family physician's orientation toward a vision of the family constellation as a whole rather than a grouping of individual members, and because of trained sensitivity and gravitation toward a generally humanistic approach to clinical problems, the family physician is well equipped to identify child abuse and neglect. An appropriate assessment and management scheme includes a well-documented history, a complete physical examination, clinical laboratory evaluation, utilization of consultation services, selection of a diagnostic category, and choice of disposition. The family physician's primary function rests in his ability to coordinate and facilitate the process of problem resolution while simultaneously supporting the family as an intact unit.

Adolescent↗
PubMed1981

Family studies with HLA typing in Reiter's syndrome.

Twelve consecutive patients with Reiter's syndrome, nine with the B27 antigen (B27 positive) and three without (B27 negative), and their 45 first degree relatives were studied clinically and with HLA typing. Two of the four adult male first degree relatives with the B27 antigen had classic Reiter's syndrome. In addition, one of two B27 positive adult male second degree relatives studied in one family had classic Reiter's syndrome. The data, although limited, suggest that the familial occurrence of Reiter's syndrome is higher than previously recognized, especially in adult male first degree relatives with the B27 antigen, and is similar to the degree of familial aggregation reported in ankylosing spondylitis.

Adolescent↗
PubMed1981

Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls.

Detailed clinical study of 50 patients with primary fibromyalgia and 50 normal matched controls has shown a characteristic syndrome. Primary fibromyalgia patients are usually females, aged 25-40 yr, who complain of diffuse musculoskeletal aches, pains or stiffness associated with tiredness, anxiety, poor sleep, headaches, irritable bowel syndrome, subjective swelling in the articular and periarticular areas and numbness. Physical examination is characterized by presence of multiple tender points at specific sites and absence of joint swelling. Symptoms are influenced by weather and activities, as well as by time of day(worse in the morning and the evening). In contrast, symptoms of psychogenic rheumatism patients have little fluctuation, if any, and are modulated by emotional rather than physical factors. In psychogenic rheumatism, there is diffuse tenderness rather than tender points at specific sites. Laboratory tests and roentgenologic findings in primary fibromyalgia are normal or negative. Primary fibromyalgia should be suspected by the presence of its own characteristic features, and not diagnosed just by the absence of other recognizable conditions. This study has also shown that primary fibromyalgia is a poorly recognized condition. Patients were usually seen by many physicians who failed to provide a definite diagnosis despite frequent unnecessary investigations. A guideline for diagnosis of primary fibromyalgia, based upon our observations, is suggested. Management is usually gratifying in these frustrated patients. The most important aspects are a definite diagnosis, explanation of the various possible mechanisms responsible for the symptoms, and reassurance regarding the benign nature of this condition. A combination of reassurance, nonsteroidal antiinflammatory drugs, good sleep, local tender point injections, and various modes of physical therapy is successful in most cases.

Adolescent↗
PubMedDate not supplied

Hepatic CYP1A levels and EROD activity in English sole: biomonitoring of marine contaminants in Vancouver Harbour.

To assess chemical contaminant stress in the marine environment, ethoxyresorufin-O-deethylase (EROD) activity and cytochrome P450 1A (CYP1A) expression were measured in 88 English Sole (Pleuronectes vetulus) collected during May and June 1999 from four sites in Vancouver Harbour and at an expected reference site outside the harbour. Hepatic microsomes were prepared from the fish and analyzed for total CYP content, EROD activity, and CYP1A protein levels. Hepatic EROD activity and CYP1A protein levels were elevated in fish from two sites in the inner harbour. A comparison with sediment chemistry data showed that fish with increased EROD activity and CYP1A levels came from sites containing relatively high levels of polycyclic aromatic hydrocarbons and polychlorinated biphenyls. Unexpectedly high levels of EROD activity and CYP1A protein were also found in fish from a reference site near Gibsons, in Howe Sound. The elevated EROD activity and CYP1A expression in fish from this site cannot be explained by the chemical analysis data collected.

Animals↗