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Biomedical subjects

N E Johnson

Publications and source records attributed to N E Johnson.

At least 37 records · Page 2Linked to original sources
PubMed1991

Clinical features of misdiagnosed appendicitis in children.

STUDY OBJECTIVE: To compare clinical features of children with misdiagnosed appendicitis with those of children with appendicitis initially diagnosed correctly. DESIGN: Retrospective review of hospital, emergency department, and clinic records. SETTING: University medical center with annual ED census of 40,000 patients. PARTICIPANTS: Children less than 13 years old admitted between May 1, 1979, and April 30, 1989, with a discharge diagnosis of appendicitis. MEASUREMENTS: Records were reviewed for historical, physical examination, laboratory, and pathologic features for all patients on their initial presentation to a physician and on final presentation during which the correct diagnosis was made. Using chi 2 analysis and Student's test, clinical features of misdiagnosed patients and patients diagnosed correctly were compared. RESULTS: One hundred eighty-one cases were identified with 50 initially misdiagnosed. On initial presentation, misdiagnosed patients were younger and more likely to have vomiting before pain onset, constipation, diarrhea, dysuria, and signs and symptoms of upper respiratory infections. Misdiagnosed cases were less likely to have right lower quadrant tenderness and documentation of bowel sounds, peritoneal signs, and rectal examinations. On final presentation, misdiagnosed patients were more likely to have pain duration of more than two days, temperature of more than 38.3 C, and to appear lethargic and irritable (P less than .05 for all measurements). CONCLUSION: Clinical features of children with misdiagnosed appendicitis differ from those of children with appendicitis initially diagnosed correctly.

Appendicitis↗
PubMed1991

Matriarchy, polyandry, and fertility amongst the Mosuos in China.

A survey of 232 households of the Mosuo minority group in Yunnan Province, People's Republic of China, suggested that polyandrous matriarchy did not raise the birth rate per household, but lowered the community birth rate by restricting many women's chances of marrying. The results imply that tolerance by the national government of polyandry within certain minority groups (e.g. Mosuos and Tibetans) will not prevent but may aid the attainment of zero population growth by China in the twenty-first century.

Adolescent↗
PubMed1990

Ketamine sedation for pediatric procedures: Part 1, A prospective series.

Emergency physicians frequently perform painful but necessary procedures on frightened children. We conducted a prospective, uncontrolled clinical trial of ketamine sedation (4 mg/kg IM) to facilitate a variety of procedures in 108 children aged 14 months to 13 years. Acceptable conditions were achieved with a single injection in 97% of the patients, and adjunctive restraint or local anesthesia was not required in 86%. Full sedation was produced within five minutes in 83%. Mean duration from injection to dischargeable recovery was 82 minutes (range, 30 to 175 minutes). One 18-month-old child vomited shortly after injection and experienced transient laryngospasm with cyanosis; intubation was not required, and there were no adverse sequelae. Airway patency and independent respirations were fully maintained in all other patients; no hemodynamic instability occurred at any time. There were no other clinically significant complications. Emesis well into the recovery phase was noted in 6% of the patients. Nightmares were not observed. Response from parents and physicians was strongly positive. Ketamine can be effectively used by emergency physicians to facilitate procedural sedation, yet equipment and expertise for advanced airway management are mandatory due to the rare occurrence of laryngospasm.

Adolescent↗
PubMed1990

Ketamine sedation for pediatric procedures: Part 2, Review and implications.

Ketamine produces rapid and consistent pediatric sedation with a predictable onset and recovery time. A wide margin of safety is afforded without the respiratory and cardiovascular depression commonly seen with alternative agents. The efficacy of ketamine is well established in anesthesia and dentistry and has extensive applications in other specialties. Ketamine sedation facilitates superior technical and cosmetic results while minimizing emotional trauma to distraught children. The much-feared complications of aspiration and laryngospasm are extremely rare when ketamine is used with proper precautions. Ketamine deserves increased use in the ED, and we advocate additional clinical investigation in this setting.

Child↗
PubMed1989

Polygamy and fertility in Somalia.

The 1983 Somali Family Health Survey showed that polygamy and monogamy selected women with different social characteristics. Wives in polygamous unions were prone to be younger at first martial cohabitation and to have previous marital disruptions. Since a young age at first cohabitation and number of previous marriages have opposite effects on the cumulative fertility rate of women, the difference in this rate between wives in polygamous and monogamous unions vanished when both factors were controlled in a multivariate analysis.

Adolescent↗
PubMed1989

Son preference and child replacement in Bangladesh: a new look at the child survival hypothesis.

Birth history data from women in the 1975-76 Bangladesh Fertility Survey were used to search for intentions to replace dead children. The median intervals between successive births of orders (i) and (i + 1) were not shorter when some siblings of orders below (i) had died. Nor was the median duration between the death of a child and the first posthumous birth shorter when the dead child was a boy or when it was survived by fewer than two brothers. The median intervals were generally shorter when the mother lived in an urban rather than a rural area but this difference was attributable only to the shorter duration of breast-feeding by urban women. These results disputed the notions that the timing of births was deliberately quicker to replace a dead child, that attempts at replacement were sex-selective, or that child replacement intentions were stronger in urban than in rural populations.

Adult↗
PubMed1989

Nutrient misclassification: bias in the odds ratio and loss of power in the Mantel test for trend.

The effect of misclassification by one-, two-, or seven-day food records on the apparent magnitude of results was quantified for two hypothetical models of association of diet with disease. For each of 106 women, classification to quintiles of intake was calculated from 37 to 72 one-day records and compared to classification by one- to seven-day records. In analyses based on few records per subject, odds ratios were biased toward unity and results from models differing in strength of association of diet with disease were more similar. Loss of power in a test for trend was especially important for associations of the magnitude probable for diet and disease relationships (odds ratios of 3.00 or less) and for samples of 100 cases and 100 controls or fewer. The measurement error associated with diet measures currently in use can obscure relatively strong associations even without biased or confounded measures.

Adult↗
PubMed1987

Misclassification of nutrient intake of individuals and groups using one-, two-, three-, and seven-day food records.

In this study, 6,844 food records were collected during three years (1979-1982) from 106 volunteer Wisconsin women, aged 35-65 years. Subjects recorded all intake of food, and vitamin/mineral supplements on a structured, precoded form. One-, two-, three-, and seven-day records were compared with usual intake of calcium, kilocalories, vitamin A, and vitamin C. Usual intake was calculated using 37-72 food records per subject. Estimates of group means from a small number of records were not significantly different from mean usual intake (p greater than 0.05). Correlations with usual intake ranged from 0.43-0.64 and from 0.71-0.90 for the one day and the seven-day estimates, respectively. For the one-day record, 43-67% of subjects were correctly classified to the extreme quintiles of intake, 52-76% for the seven-day record. Classification was least good for vitamin A, better for other nutrients with lower intraindividual variance. However, overall agreement with usual classification of assignment to quintiles even with the seven-day record was less than 55% for all four nutrients. Effects at extremes of intake might be more easily analyzed than dose-response relations.

Adult↗
PubMed1986

Relationships between usual nutrient intake and bone-mineral content of women 35-65 years of age: longitudinal and cross-sectional analysis.

In a 4-yr clinical trial, effect on single-photon absorptiometric measurements of arm bones of usual intakes of energy and 14 nutrients plus vitamin-mineral supplements was studied in 99 women, aged 35-65, randomly assigned to placebo (NS) or calcium-supplemented (1.5 g)(S) groups. Cross-sectional analysis of initial bone measurements showed vitamin C (r = 0.313, p less than 0.05) and niacin (r = 0.353, p less than 0.01) correlated with ulna in postmenopausal subjects (n = 67). Longitudinal analysis of bone-change rates of postmenopausal subjects (NS + S) showed higher calcium intakes associated with lower loss rates of humerus bone-mineral content (BMC) (r = 0.360, p less than 0.01). In postmenopausal NS but not S subjects, energy, protein, calcium, phosphorus, zinc, and folate correlate significantly with change in radius BMC; high levels of intake correlated with slower loss (p less than 0.05). Several nutrients besides calcium are related to bone loss in women.

Adult↗
PubMed1985

Effects on blood pressure of calcium supplementation of women.

The relationship between dietary and supplemental (1.5 g/d) calcium intake and blood pressure was examined in 81 normotensive and 34 medicated hypertensive women between the ages of 35 and 65 years who completed a 4-yr clinical trial to assess age-associated bone loss in women. Calcium intakes were monitored during the entire study. Resting blood pressures and systolic blood pressure response (SBPR) to a stress test were recorded three times during the study. At the end of the study there was no relationship between systolic or diastolic blood pressure or SBPR and total calcium intake in normotensive women (n = 81). In the medicated hypertensive group (n = 34) there was a 13 mm Hg decrease in systolic pressure of supplemented women (n = 18) and a 7 mm Hg increase in unsupplemented women (n = 16) over the 4 yr (p less than .02).

Adult↗
PubMed1985

Effects of intraindividual and interindividual variation in repeated dietary records.

In this study 5,115 daily diet records were collected from 151 women on two randomly selected days per sampling month (29 days) over a two-year period. Yearly estimates of the ratios of intraindividual (sigma w2) and interindividual (sigma b2) variance components were calculated for dietary intake of 15 nutrients and for dietary intake + vitamin/mineral supplements. From one year to the next, corresponding ratios of sigma w2/sigma b2 were nearly identical. Intraindividual variation in dietary intake of all 15 nutrients was greater than interindividual variation (sigma w2/sigma b2 greater than 1). Variance component ratios for highly supplemented nutrients such as iron, vitamin C and B vitamins were less than one (sigma w2/sigma b2 less than 1). Using the ratios of sigma w2/sigma b2, it was calculated that between six and 99 repeated records measuring dietary intake and between two and 31 records measuring total intake may be needed per individual to ensure that the estimate of the population correlation (rho DF) between an individual's "usual" dietary intake or total intake of a dietary risk factor and an individual's mean or usual level of a physiologic risk factor was within 10% of the true population correlation coefficient (rho xy). It was also found that twice as many dietary records per individual were required to estimate the population slope (beta xy) within 10%. These results have serious implications for the design and analysis of prospective nutritional studies.

Adult↗
PubMed1984

A two-year dietary survey of middle-aged women: repeated dietary records as a measure of usual intake.

A two-year survey of the dietary consumption and supplement use patterns of adult women was conducted at the University of Wisconsin-Madison. Participants were asked to record their diet on two randomly selected days per month over a two-year period. Each subject filled out an average of 19 records a year, for an overall 71% return rate. Because of the sampling design, it was possible to estimate each woman's "usual" or average daily dietary and total intake (diet plus supplements) of 15 nutrients. Many women were consuming usual amounts of energy, calcium, iron, magnesium, vitamin B-6, and, especially, zinc and total folate that were 30% to 50% below recommended levels. It was also found that the women generally took vitamin/mineral supplements for nutrients already adequately supplied in the diet. Low nutrient intakes may have been due, in part, to underreporting of food intakes.

Adult↗
PubMed1983

Serum albumin and gamma globulin in Trypanosoma cruzi infections.

This paper examines the association between serum protein levels and infection with Trypanosoma cruzi in a region of Central Brazil. 148 people 6 to 78 years of age, were included in this study. There were no statistically significant difference in albumin levels between those with positive T. cruzi serology (2.94 +/- 0.74 g/100 ml) and those with negative serology (3.04 +/- 0.61 g/100 ml). Thus the null hypothesis of no association between infection with T. cruzi and serum albumin is accepted. Gamma-globulin levels were elevated in both groups and were significantly greater (p less than 0.05) in the group with positive T. cruzi serology (1.91 +/- 0.41 g/100 ml) than in the group with negative serology (1.75 +/- 0.41 g/100 ml). The serum albumin levels suggest that malnutrition (either associated with low protein intake or increased loss due to hookworm) is a major problem and unlikely to change if T. cruzi transmission was controlled.

Adolescent↗
PubMed1983

Nutritive value of food served calculated from food purchased in 14 nursing homes.

A three-day average of the nutritive value of pounds of food served indicated that none of the 14 nursing homes surveyed served a selection of foods which supplied recommended amounts of vitamin B6 and folacin when compared with the Recommended Dietary Allowances. Suggestions for limiting kilocalories, while providing adequate sources of other nutrients to residents, include: decreasing high caloric-low nutrient foods and total pounds of meat, increasing the proportion of fish and poultry in relation to red meats, and increasing pounds of leafy vegetables, bananas, and dry cereals.

Dietary Services↗