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Biomedical subjects

M Harvey

Publications and source records attributed to M Harvey.

At least 145 records · Page 8Linked to original sources
PubMed1989

Mania precipitated by benzodiazepine withdrawal.

A case of mania following abrupt benzodiazepine withdrawal in an 83-year-old woman is described. It is argued that the withdrawal state acted as a significant life event in precipitating the manic episode.

Aged↗
PubMed1987

Impact of multiple comparisons in randomized clinical trials.

The randomized clinical trial is the preferred research design for evaluating competing diagnostic and therapeutic alternatives, but confidence in the conclusions from a randomized clinical trial depends on the authors' attention to acknowledged methodologic and statistical standards. This survey assessed the level of attention to the problem of multiple comparisons in the analyses of contemporary randomized clinical trials. Of the 67 trials surveyed, 66 (99 percent) performed multiple comparisons with a mean of 30 therapeutic comparisons per trial. When criteria for statistical impairment were applied, 50 trials (75 percent) had the statistical significance of at least one comparison impaired by the problem of multiple comparisons, and 15 (22 percent) had the statistical significance of all comparisons impaired by the problem of multiple comparisons. Although some statistical techniques are available, there still exists a great need for future work to clarify further the problem of multiple comparisons and determine how the impact of this problem can best be minimized in subsequent research.

Clinical Trials as Topic↗
PubMed1985

Influence of sex differences and knee joint position on electrical stimulation-modulated strength increases.

This study examined the influence of sex differences and knee joint position on the effectiveness of isometric electrical stimulation in improving isometric and isokinetic strength. Twenty-seven females and 28 male subjects were assigned to either a control group (C) that received no electrical stimulation, to an experimental group that received stimulation of the quadriceps with the knee flexed at 65 degrees (EF), or to an experimental group that received electrical stimulation of the quadriceps with the knee fully extended (EE). Experimental subjects received 15 min of electrical stimulation 3 times/wk for a total of 6 wk. Before and after the study, knee extension strength was measured with a Cybex II, isometrically at 65 degrees of knee flexion and isokinetically at 30 degrees . s-1, 60 degrees . s-1, 90 degrees . s-1, and 120 degrees s-1. Multivariate analysis of covariance, using the pretests as the covariate, revealed no sex differences in responsiveness to electrical stimulation. EF was superior to EE at 30 degrees . s-1 and 120 degrees . s-1 in females and at 120 degrees . s-1 in males (P less than 0.05). Male and female EF was superior to C in all tests. EE was higher than C at isometric, 30 degrees . s-1, 90 degrees . s-1, and 120 degrees . s-1 in females and at isometric and 30 degrees . s-1 in males. These data suggest that electrical stimulation at the quadriceps can increase isometric and isokinetic strength and may be more effective in improving isokinetic strength if the knee is flexed during treatment.

Adult↗
PubMed1984

Malignant neoplasia in patients with abdominal aortic aneurysms.

Thirty-eight percent of 69 patients with abdominal aortic aneurysms were on record for having malignant neoplasms with the Connecticut State Tumor Registry five to ten years following aneurysm repair. Thirteen percent of 61 patients with atherosclerotic occlusive disease were on record for having malignant neoplasms as a contemporaneous case-control group. The crude and adjusted odds-ratios for this difference in patients with aneurysms v patients with atherosclerotic disease were statistically significant. There are several theoretical explanations for these observations, spanning the gamut from possible immunologic mechanisms to hypothetical disturbances in the relationship of epithelia to connective-tissue matrix in the patients with aneurysms.

Adult↗
PubMed1984

Diagnostic bias and toxic shock syndrome.

Diagnostic bias could have occurred in the tampon/toxic shock syndrome association if the original diagnostic judgments by physicians or the subsequent diagnostic selections by investigators were influenced by knowledge of the patient's gender, menstrual history, or catamenial product. To determine whether such diagnostic bias can occur, a set of descriptive vignettes was prepared for six cases (Series X) having diverse resemblances to toxic shock syndrome or Kawasaki's disease. For each vignette in Series X, a paired case in a complementary Series Y was described in identical text except for different information about gender, menstrual history, or tampon use. Either Series X or Series Y was sent to a randomly selected sample of internists, family practitioners, and infectious disease subspecialists. The physicians were asked to provide a diagnosis for each case, using their own nomenclature or choosing from a list of 22 diagnostic possibilities. Six weeks later, respondents were asked to provide diagnoses for the complementary series of cases. Regardless of medical specialty or type of series received first, the 368 responding physicians were more likely to diagnose toxic shock for menstruating tampon-users or menstruating women than for non-menstruating women or men. In the most striking difference, toxic shock was diagnosed in 85 percent of instances when the case was described in a menstruating tampon-user, but in 23 percent of instances when the same case was described in a man (odds ratio = 18.8). Since the current epidemiologic data may be seriously distorted by diagnostic bias, the results indicate the need for scientifically valid investigations of the toxic shock syndrome/tampon relationship.

Adolescent↗
PubMed1984

Methanogenic activity and structural characteristics of the microbial biofilm on a needle-punched polyester support.

In a downflow stationary fixed-film anaerobic reactor receiving a swine waste influent, few bacteria were observed to be tightly adherent to the surfaces of the needle-punched polyester support material. However, there was a morphologically complex, dense population of bacteria trapped within the matrix. Frequently large microcolonies of a uniform morphological type of bacteria were observed. These were particularly evident for methanosarcina-like bacteria which grew forming large aggregates of unseparated cells. Leafy deposits of electron-dense, calcium- and phosphorus-enriched material coated the polyester matrix and some cells. As the biofilm matured there was more extensive mineral deposition which completely entrapped cells. The entrapped cells appeared to autolyze, and many were partially degraded. Further impregnation of the matrix with minerals and apparent cell death may eventually have a deleterious effect on the methanogenic activity of the biofilm.

Journal Article↗
PubMed1982

Toxic shock and tampons. Evaluation of the epidemiologic evidence.

The main evidence that tampons are an etiologic cofactor in the development of toxic shock syndrome (TSS) comes from epidemiologic case-control studies. The patients chosen as cases in those studies were assembled from reports submitted to health agencies in response to publicity that may have influenced physicians to diagnose TSS and to submit reports particularly in situations where the patient was a menstruating tampon user. When the submitted reports were checked for fulfillment of TSS diagnostic criteria, and when cases or controls were asked about antecedent tampon usage, suitable scientific precautions were not used to achieve "blinded" objective decisions. Since these biases would have distorted the statistical relationships, the etiologic role of tampons in TSS has not been scientifically proved.

Clinical Trials as Topic↗
PubMed1981

Haemolytic anaemia with hypernephroma.

A case is reported of Coombs' positive haemolytic anaemia associated with hypernephroma. The anaemia regressed on removal of the tumour but returned when secondary deposits developed.

Adenocarcinoma↗