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Biomedical subjects

L K Brown

Publications and source records attributed to L K Brown.

At least 73 records · Page 4Linked to original sources
PubMed1991

Pulmonary function testing in bronchial asthma: standard and emerging techniques.

Despite the myriad of tests available to characterize bronchial asthma, the simple forced expiratory spirogram remains the most straight-forward and reliable technique to diagnose the disorder and gauge its severity. When combined with bronchodilator and bronchial challenge testing, a wide range of clinical situations can be evaluated, even in the office setting. A well-performed forced expiratory spirogram remains the cornerstone of pulmonary function testing; the emergence of the additional analytic techniques described holds the promise of even greater utility in the future.

Asthma↗
PubMed1991

Child and adolescent psychiatrists and HIV disease: a survey.

During the spring and summer of 1989, all members of the American Academy of Child and Adolescent Psychiatry in nine states were sent questionnaires to determine the extent of child and adolescent psychiatrists' human immunodeficiency virus (HIV)-related knowledge, experience, comfort in working with HIV patients, and opinions regarding perceived educational needs about HIV. The response rate was 54% (N = 511). Two-thirds of the respondents indicated they had treated or had consulted on an HIV-infected patient. Most psychiatrists indicated reasonable comfort in working with HIV patients. Knowledge about HIV was found to be variable. Results suggest that child psychiatrists are engaging in HIV-related activities in all parts of the country, and further information or education would be welcomed by a majority of Academy members, particularly at nationally sponsored events.

Adolescent↗
PubMed1991

HIV prevention for adolescents: utility of the Health Belief Model.

The Health Belief Model (HBM) has been applied to diverse sets of health behaviors. Research that suggests difficulties of the HBM in predicting future behaviors, especially HIV-related, is reviewed. Prominent features of adolescence that influence HIV-related risk behaviors are discussed including: cognitive immaturity, struggle for psychological autonomy, peer influences, and physical development. It is suggested that a model is needed to guide prevention efforts, and that these adolescent-specific factors need to be incorporated into any such model.

Adolescent↗
PubMed1991

Lung function in former intravenous drug abusers: the effect of ubiquitous cigarette smoking.

PURPOSE: To determine whether former intravenous drug abusers (IVDAs) demonstrate reductions in pulmonary function, especially in the diffusing capacity (DLCO), after adjustment for the effects of their ubiquitous smoking habit. Knowledge of baseline DLCO in this high-risk group is important in evaluating the effects of human immunodeficiency virus (HIV) and ensuing opportunistic infections. PATIENTS AND METHODS: Measurements of single-breath DLCO, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) were compared with predictive values that adjust for the effects of smoking. Patients were 98 ambulatory former IVDAs regularly attending a methadone maintenance program (62 men and 36 women; 94 current smokers, two ex-smokers, and two nonsmokers). RESULTS: When adjusted for smoking, FEV1 and DLCO were no different in the study sample than in cross sections of the general population: mean FEV1 105% predicted (men) and 97% predicted (women), mean DLCO 95% predicted (men) and 99% predicted (women). Eleven percent of the IVDAs had abnormal values for DLCO; only one subject had a value less than 50% of predicted. CONCLUSIONS: Most former IVDAs who regularly attend an ambulatory methadone program have normal DLCO values when the effects of smoking are taken into account. A decrease in DLCO in such subjects is presumptive evidence of superimposed disease, most likely related to opportunistic infections or HIV-associated malignancy or alveolitis.

Adult↗
PubMed1990

Differences in AIDS knowledge and attitudes by grade level.

Grade-related similarities and differences in AIDS knowledge and attitudes were assessed in 441 fifth, seventh, and tenth graders from one school district. Grade level was a significant variable (p less than .01) on 53% of items. Grade-related differences in knowledge were apparent when students responded to questions tapping information not covered widely in the media and in attitudes when personal engagement in behavior was implied. Cognitive and emotional factors related to developmental milestones were postulated to account for these differences. These findings need to be considered in planning and implementing AIDS prevention programs, especially as education is begun for younger children.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pulmonary diffusing capacity in left ventricular dysfunction.

The purpose of this study was to determine whether there are any consistent spirometric or Dsb findings in patients with LV dysfunction characterized by a clinical diagnosis of CHF and an EF less than 40 percent. We performed spirometry and Dsb in 34 patients, and found that EF correlated only with Dsb. When we separated the patients into those with rales and those without, Dsb correlated strongly with EF only in those with rales. There was no correlation with other spirometric values. Mean Dsb percent predicted was significantly lower in patients with rales despite similar mean EF. Only two of 23 patients without rales had a reduced Dsb while only one of 11 with rales had a normal Dsb. We conclude that Dsb is a good predictor of clinically evident heart failure. When rales are absent, Dsb should be normal in patients with LV dysfunction; when present, Dsb will be diminished in proportion to the EF.

Aged↗
PubMed1990

Traumatic amputation. Mechanisms of injury, treatment, and rehabilitation.

Traumatic amputations are one of many injuries that can occur to the body's musculoskeletal systems. Degloving, partial and total amputations are common types of traumatic injuries. Since traumatic amputations are very life threatening, emergency treatment must be initiated quickly and directed toward profuse blood loss and potential hypovolemia. Not only do traumatic amputees undergo extreme physiological changes, but they must also encounter the psychological trauma of an amputation. Due to a loss of body part(s) and alteration in body image, the amputee often experiences the stages of grieving which may take months and years to resolve. Extensive rehabilitation with the use of an interdisciplinary team approach is one of the most successful ways to return the amputee to the work place. A combination of occupational therapy, physical therapy, vocational rehabilitation and psychological support generally promote a sense of well being and return the traumatic amputee to a level of independence.

Accidents, Occupational↗
PubMed1990

"What upsets me most about AIDS is ...": a survey of children and adolescents.

While AIDS-related knowledge and attitudes have been studied in different populations, little attention has been given to emotional reactions to the epidemic or to the validity of frequently employed forced-choice questionnaires. Spontaneous emotional reactions to the AIDS crisis were assessed in 441 fifth, seventh, and tenth graders from one school district. Students responded to one open-ended question, "What upsets me most about AIDS is...." Loglinear analysis revealed grade as a significant variable: fifth graders were most upset by AIDS' lethality, while tenth graders felt helpless. Cognitive and emotional factors were postulated to account for these differences. Students who correctly responded to knowledge-related, open-ended questions were likely to correctly answer comparable forced-choice questions. AIDS education strategies that consider grade-specific anxieties are suggested.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The impact of AIDS education on junior and senior high school students. A pilot study.

Prevention, through school-based education campaigns, has been suggested as a response to the AIDS crisis although the impact of such education is unproven. The seventh and tenth grade classes (n = 313) in one Rhode Island school district were surveyed regarding AIDS knowledge, attitudes, and coping skills before and after a two-session educational program. Following instruction, students reported more knowledge, greater tolerance of AIDS patients, and more hesitancy toward high-risk behaviors, but the changes were modest. Using residual change scores to control for baseline levels, two subgroups (seventh grade boys and tenth grade girls) changed the most in tolerance, and the correlations between variables were the strongest. In the general sample, change in knowledge was independent of change in tolerance, attitudes regarding high-risk behaviors, or coping strategies. These data lend support to the potential usefulness of school-based education programs, especially if behavior and coping skills are emphasized in the education. Evaluation of such programs should include assessment of change in subgroups to determine components of programs that can be tailored for more effective education.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS education in the schools: a literature review as a guide for curriculum planning.

As plans for massive public AIDS education grow, pediatricians will become increasingly involved with school systems as consultants and leaders. A review of relevant literature on students' current level of knowledge about AIDS and on educational efforts to date with high-risk groups (homosexuals and intravenous drug users) provides the rationale for school-based AIDS education. Literature describing the approaches used and the impact of programs for sex education, drug abuse prevention, and reduction of prejudice towards the disabled is reviewed to extrapolate that which applies to AIDS education. Important developmental characteristics of adolescents are discussed insofar as they have implications for the planning of AIDS curricula.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Flexible bronchoscopy in the diagnosis of Pneumocystis carinii pneumonia in patients with acquired immune deficiency syndrome.

Seventy-seven patients with acquired immune deficiency syndrome (AIDS) and suspected of having Pneumocystis carinii pneumonia (PCP) had flexible bronchoscopy. The diagnosis was established in 52 of the 54 patients (96%) who proved to have PCP. There was one false-positive result. The remaining 22 patients and the patient with the false-positive diagnosis had diseases other than PCP, or no diagnosis. Flexible bronchoscopy is a safe and sensitive diagnostic procedure in patients with PCP complicating AIDS, and is recommended as the first invasive diagnostic procedure when patients at risk for AIDS have acute pulmonary complications.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Inverse relationship between megakaryocyte buoyant density and maturity.

We examined the relationship between rat megakaryocyte buoyant density and maturation stage in continuous Percoll density gradients. An average of 88% of megakaryocytes had buoyant densities less than 1.054 g/ml. There was an inverse relationship between megakaryocyte buoyant density and maturation. Morphologically mature forms comprised 90% of the megakaryocytes with buoyant densities of 1.030-1.033 g/ml. In contrast, immature morphology was present in three-quarters of megakaryocytes with buoyant densities of 1.042-1.046 g/ml. These morphological findings were confirmed by [3H]thymidine labelling studies. Cell viability assessed by trypan blue exclusion was highest among more dense megakaryocytes of which the majority were immature. The lowest trypan blue exclusion was found in the less dense, predominantly mature megakaryocytes indicating that these cells are more susceptible to membrane damage during marrow suspension. Megakaryocyte DNA content distributions and platelet antigen levels, determined by two-colour flow cytometry, were also related to megakaryocyte density; the more dense megakaryocytes showed an approximately two-fold higher proportion of 8N cells and less platelet antibody binding than did less dense megakaryocytes. These studies suggest that megakaryocytes can be fractionated according to their buoyant densities into immature and mature populations suitable for molecular studies of differentiation.

Animals↗
PubMed1986

Percutaneous gastrostomy and gastroenterostomy: 1. Techniques derived from laboratory evaluation.

Various techniques, guidance systems, instruments, and the postmortem effects of percutaneous gastrostomy (PG) and percutaneous gastroenterostomy (PGE) were evaluated in 30 laboratory animals and five human cadavers. Methods to distend the stomach included air, fluid, intragastric balloon, and percutaneous needle inflation; a variety of trocar systems and catheters inserted by Seldinger technique (including those adapted from other uses and several designed specifically) were assessed. Fluoroscopy was the preferred guidance system, though sonography proved valuable (liver position, depth calculation to the stomach, localization of vessels to avoid), and the entire PG procedure was performed under sonographic guidance in four animals. Although the procedure was safe in most cases, several major complications did occur: laceration of a low-lying liver with exsanguination, malpositioned catheters in the lesser sac and adjacent to the spleen, and violation of the backwall of the stomach with laceration of celiac and splenic vessels. The animals and cadavers underwent autopsy. Autopsy revealed that firm gastrocutaneous tracts were formed by 7 days. There were few instances of wound infection, intraperitoneal fluid leakage, or evidence of trauma to the stomach when the catheters were well seated. Injury to the inferior epigastric artery is a potential hazard, and in cadaver dissections was located between the middle third and outer margin of the rectus abdominis muscle. Laboratory experience has been, and continues to be, an important means to improve and use new techniques for PG and PGE.

Animals↗