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Biomedical subjects

P Case

Publications and source records attributed to P Case.

17 recordsLinked to original sources
PubMed2000

Colonic cleansing, fluid absorption, and discomfort following tap water and soapsuds enemas.

Tap water and soapsuds are common enema solutions, but little is known about their effectiveness. Consequently, nurses have no guidance when choosing the best enema for a given patient. In this study, liver transplant patients were given either a tap water or soapsuds enema preoperatively. Amount of enema instilled into the colon and output were measured. Soapsuds enemas produced significantly greater output than tap water and were equally well tolerated. Most subjects who received tap water enemas retained more fluid than was eliminated. Based on these findings, nurses should use caution when giving repeated enemas to patients sensitive to large fluid loads.

Adult↗
PubMed1999

Categorization of ambiguous sentences as a function of a changing prosodic parameter: a dynamical approach.

The present study investigates the dynamics of changes in interpretation of ambiguous sentences. The sentences used had alternative interpretations with different surface structures (bracketing). Continua were created by systematic manipulation of prosodic cues (relative foot duration), resulting in stimulus sentences that spanned the range between the two interpretations. Continua were presented to subjects who were requested to indicate as quickly as possible which meaning they perceived. The pattern of responses and response times revealed the presence of hysteresis. That is, when the values of prosodic parameters are congruent with both interpretations, the individual's recent history decides which meaning will be perceived. Thus, we can treat this categorization process as a transition from an initially stable meaning that loses stability with variations in prosody (our control parameter). The same underlying dynamics have been observed in studies of perception of syllables and aspects of visual perception. Apart from demonstrating the same characteristics of pattern formation at various levels of cognition, the study points to the usefulness of the dynamical approach in the investigation of language understanding.

Cognition↗
PubMed1998

Arrests and incarceration of injection drug users for syringe possession in Massachusetts: implications for HIV prevention.

Multiperson use of syringes is a major risk behavior responsible for the spread of HIV-1 among injection drug users (IDUs). In Massachusetts, two laws regulate syringes: one is a prescription law prohibiting possession or purchase of syringes without a prescription, and the other makes it illegal to possess drug paraphernalia, including syringes. In 1993, Massachusetts amended the prescription law to permit the establishment of syringe exchange programs in two cities. Enrolled participants are allowed to possess syringes anywhere in the state, and about 5% of the estimated 40,000 IDUs in Massachusetts are program participants. To understand how HIV prevention efforts with active IDUs may be constrained by the enforcement of laws criminalizing possession of syringes after the amendment in the law, we reviewed data from multiple sources to assess the number of arrests for syringe possession in 10 large cities in Massachusetts to evaluate incarceration rates and lengths of sentences for those convicted of syringe possession and to estimate costs of incarceration for those convicted of syringe possession. At least 824 persons were arrested for syringe possession in 1995. In examining the data on convictions, we found that 417 persons were convicted in 1994 of syringe possession in the absence of other serious charges, and of these, 41.0% were sentenced to incarceration. The average sentence imposed was 5 months (range, 3 days-2 years). Assuming that those convicted serve about two thirds of their sentences, the cost of incarceration was estimated at $1,140,183 excluding costs for arrest, pretrial detention, prosecution, or other costs of enforcement. Costs for incarcerating persons convicted of both syringe and drug possession were not included; the total cost of incarceration of persons convicted of possession of a syringe, with or without other major charges, is probably considerably higher. Had these funds been allocated to pay for drug treatment, 1629 admissions to drug detoxification programs could have been purchased. Retaining drug paraphernalia and syringe prescription laws in Massachusetts may contribute to HIV transmission. These findings support the recommendation of the American Medical Association to modify drug paraphernalia laws so that IDUs can purchase and possess syringes without a prescription.

Boston↗
PubMed1998

Access to sterile syringes in Maine: pharmacy practice after the 1993 repeal of the syringe prescription law.

In October 1993, the Maine legislature repealed the prescription law regulating the sale of syringes. The new law allowed but did not require licensed pharmacists to dispense syringes without a prescription to anyone 18 years of age or older. From November 1995 to January 1996, we conducted a telephone survey of 208 Maine pharmacists to evaluate the sale of syringes with and without a prescription and to assess pharmacists' willingness to sell syringes without a prescription. We found that 94% of pharmacists were willing, in all cases or at the discretion of the pharmacist, to sell syringes without a prescription. However, when asked specifically about willingness to sell syringes without a prescription to suspected injection drug users (IDUs) > or =18 years of age, 47% were willing, 40% were not willing, and 13% did not know or declined to answer. Pharmacists reported other requirements for the purchase of syringes without a prescription, such as the requirement for the customer to provide a reasonable justification for the purchase. In all, there were 31 (15%) pharmacists in the sample willing to sell syringes to without a prescription with no additional requirements for purchase to suspected IDUs as permitted by law. There were few negative incidents reported involving IDUs and the sale of syringes without a prescription since amendment of the law. Although sales of syringes without a prescription were reported, the numbers sold fell short of the estimated number of syringes required for IDUs in Maine to use a new syringe for every injection. Despite the change in the prescription law intended to increase access to syringes, the data suggest barriers such as drug paraphernalia laws and pharmacy policies may prevent IDUs from purchasing syringes and contribute to ongoing transmission of HIV. Amendment of the drug paraphernalia and syringe possession laws, clarification of the legitimate medical purpose of access to sterile syringes for IDUs, and offering pharmacists continuing education on the prevention of blood-borne disease appear to be necessary steps in the effort to decrease the transmission of HIV among IDUs in Maine.

Adult↗
PubMed1997

Anxiety in liver transplant patients.

Anxiety is a common symptom experienced by patients recovering from a liver transplant. The times of liver biopsy and organ rejection were described by 33 participants as their most anxiety-producing experiences. This was measured by the State-Trait Anxiety Inventory and a visual analogue scale.

Adult↗
PubMed1995

Evaluation of a dynamical model of speech perception.

Previous work (Tuller, Case, Ding, & Kelso, 1994) has revealed signature properties of nonlinear dynamical systems in how people categorize speech sounds. The data were modeled by using a two-well potential function that deformed with stimulus properties and was sensitive to context. Here we evaluate one prediction of the model--namely, that the rate of change of the potential's slope should increase when the category is repeatedly perceived. Judged goodness of category membership was used as an index of the slope of the potential. Stimuli from a "say"-"stay" continuum were presented with gap duration changing sequentially throughout the range from 0 to 76 to 0 msec, or from 76 to 0 to 76 msec. Subjects identified each token as either "say" or "stay" and rated how good an exemplar it was of the identified category. As predicted, the same physical stimulus presented at the end of a sequence was judged a better exemplar of the category than was the identical stimulus presented at the beginning of the sequence. In contrast, stimuli presented twice near the middle of a sequence with few (or no) stimuli between them, as well as stimuli presented with an intervening random set, showed no such differences. These results confirm the hypothesis of a context-sensitive dynamical representation underlying speech.

Humans↗
PubMed1994

Substance P, neurofilament, peripherin and SSEA4 immunocytochemistry of human dorsal root ganglion neurons obtained from post-mortem tissue: a quantitative morphometric analysis.

Immunocytochemical studies on lumbar dorsal root ganglia obtained at routine postmortem 24-36 h after death were carried out, and neuronal cross-sectional areas measured. The subjects were elderly (76-81 years), of both sexes, had died from heart attack or haemorrhage, and had no clinical evidence of clinical neuropathy or of disease known to be associated with neuropathy. The data were consistent between ganglia from the three subjects. There were striking similarities with data from other species. Two populations of cell profiles with overlapping size distributions were distinguished with an anti-neurofilament antibody, neurofilament-rich (45% of cell profiles) with a large mean area and neurofilament-poor with a smaller mean area. Anti-substance P and anti-peripherin antibodies both labelled a population with a small mean area, with extensive co-localization between them. There were also some differences between these human dorsal root ganglia and dorsal root ganglia from some other species. More neuronal profiles were labelled for substance P in humans (44%) than in rat (20%). More neuronal profiles were labelled for SSEA4 (stage specific embryonic antigen 4) in human (40.5%) than in rat dorsal root ganglia (10%), and the SSEA4-positive profiles were relatively smaller in human than in rat. No selective accumulation of lipofusin in profiles of large cells was apparent. This study also shows that quantitative morphometric analysis of immunocytochemically labelled dorsal root ganglion neuronal profiles can be carried out successfully on human sensory ganglia obtained at post-mortem. This is the first demonstration of the two main subgroups of dorsal root ganglia neurones with neurofilament-rich and poor somata in human tissue. The size distributions of neurons with neurofilament, substance P and peripherin are consistent with these neuronal populations having similar functional properties to those described in other species. From the known sensory and fibre loss with aging, it is speculated that the loss of some large diameter neurones with myelinated fibres and low mechanical thresholds, might account for the high percentage of neurones expressing substance P.

Aged↗
PubMed1994

The nonlinear dynamics of speech categorization.

Little is known about the processes underlying the nonlinear relationship between acoustics and speech perception. In Experiment 1, we explored the effects of systematic variation of a single acoustic parameter (silent gap duration between a natural utterance of s and a synthetic vowel ay) on judgements of speech category. The resulting shifts in category boundary between say and stay showed rich dynamics, including hysteresis, contrast, and critical boundary effects. We propose a dynamical model to account for the observed patterns. Experiment 2 evaluated one prediction of the model, that changing the relative stability of the two percepts allows categorical switching. In agreement with the model; an increase in the number of stimulus repetitions maximized the frequency of judgments of category change near the boundary. Thus, a dynamical approach affords the rudiments for a theory of the effects of temporal context on speech categorization.

Acoustic Stimulation↗
PubMed1991

Evaluating needle exchange: do distributed needles come back?

We employed capture-recapture methods as a strategy for evaluating needle exchange. Needles distributed by the exchange at two time periods were marked with color coded bands indicating the date and site of distribution. Half of the marked needles (2,068/4,239) returned within two weeks of distribution, and 61 percent (2,593/4,239) returned during the study period. The rate of return for stationary exchange sites (63 percent) was greater than that for roving/mobile sites (51 percent; chi 2 = 28.6, p less than .001). Of all needles returned, 87 percent (2,248/2,593) returned to the site of original distribution.

Acquired Immunodeficiency Syndrome↗
PubMed1990

AIDS prevention for intravenous drug users in the community: street-based education and risk behavior.

Conducted a study of behavior change associated with a street-based AIDS education project targeted to intravenous (IV) drug users in San Francisco. Two cross-sections were sampled from drug detoxification clinics and street locations in 1986 (n = 438) and 1987 (n = 623). Significant increases were reported in the percentage of IV drug users who used bleach to decontaminate syringes, who did not share needles in past year, and in condom use. A significant reduction in an index of the number of needle-sharing partners was reported. Respondents ranked treatment program as most important source of AIDS information prior to implementation of the program, and ranked outreach workers as most important after implementation. Findings suggest that this community-based outreach program had at least some impact on knowledge about AIDS and may have led to reductions in behaviors known to transmit HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The prevalence of high-risk sexual behavior in male intravenous drug users with steady female partners.

A sample of 149 (70 White, 79 Black) male intravenous drug users with steady female sexual partners was interviewed in 1987, in treatment and street settings, about sexual practices during the previous five years. Eighty-three percent had multiple partners, 15 percent reported male sexual contact, 38 percent reported heterosexual anal intercourse, and 73 percent never used condoms. Thirty-seven White and 30 Black subjects reported bisexuality or heterosexual and intercourse or both.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Topical minoxidil for hair regrowth.

Minoxidil, a potent peripheral vasodilator used orally for refractory hypertension, has produced hypertrichosis. To determine the efficacy and safety of 1% or 5% topical minoxidil for the stimulation of scalp hair regrowth, we studied fifteen normotensive patients, five with androgenic alopecia and ten with alopecia areata diagnosed clinically and by biopsy, for 12 months. Three of five patients with androgenic alopecia using 5% minoxidil for 12 months noted hair regrowth, ranging from minimally observable hair to an appreciable restoration of larger, pigmented, terminal hair in one patient. Among the patients with androgenic alopecia, regrowth response corresponded to the serum minoxidil blood levels. None of the patients with alopecia areata receiving either 1% or 5% minoxidil noted hair regrowth despite comparable minoxidil blood levels. Improved local absorption of topical minoxidil solution may promote hair regrowth in androgenic alopecia.

Administration, Topical↗
PubMed1984

Subcutaneous phaeohyphomycosis caused by Exophiala spinifera.

The second human subcutaneous infection due to Exophiala spinifera from the United States is described. Identification was based on the morphology of the fungus in tissue and the morphological features of the culture obtained from the biopsy material. Correct diagnosis and treatment with ketoconazole and 5-fluorocytosine cured the infection.

Flucytosine↗
PubMedDate not supplied

Psychological assessment and AIDS research with intravenous drug users: challenges in measurement.

The instruments used for psychological assessment have been under close scrutiny for many years. In particular, ethnic and racial minorities have pointed out that misapplication of instruments standardized to White middle-class norms can result in incorrect assessments. An analogous situation exists with IVDUs. In the work of the present authors with IVDUs, they were found to be a very diverse group. Contrary to common wisdom, they differ by race, ethnicity, age, and drug use profiles. However, their economic circumstances and social stigma make them a special case in terms of psychological assessment. Given the unique characteristics of IVDUs, it behooves researchers to carefully examine the standardized instruments that are available for psychological evaluation. Too often, measures standardized on White middle-class samples lack the value neutrality that makes them applicable across disparate groups. In addition, many such measures are designed with certain presumptions that do not necessarily hold true with this population (e.g., willingness and/or ability to communicate intimate information about one's feelings and psychological states). This article briefly describes some of the challenges encountered in examining standardized instruments for use in the study of IVDUs, their health psychology and AIDS-related behavior. Concerns with self-report biases, literacy, attentional focus, measurement constructs, and drug states confounding psychological states all pose challenges to psychological research with this heterogeneous population. While the need for direct intervention on the sexual and needle-sharing behaviors of IVDUs remains paramount in the combat against the spread of AIDS, researchers must also continue with the further development of basic measurement tools.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Estimation of the prevalence of injection drug use in greater Boston in 1993.

This article is a report on different methods of estimation of the number of injection drug users (IDUs) in the Boston standard metropolitan statistical area (SMSA) in 1993. Because the sharing of needles is a means of transmission for HIV, an estimate of the prevalence of injection drug use is essential for acquired immunodeficiency syndrome (AIDS) prevention programs. The data for this study come from the Massachusetts Department of Public Health Bureau of Substance Abuse, the Massachusetts AIDS Surveillance Unit, the Drug Abuse Warning Network (DAWN), the National Household Survey on Drug Abuse: Population Estimates 1993, and the Massachusetts State Police Crime Reporting Unit. The estimates in this study can be assessed with regard to the different time frames that are involved, noting that some estimates are useful only to establish upper or lower bounds. The estimate that best meshes with the findings of this report is that there were between 13,500-16,500 injection drug users in greater Boston and 45,000-60,000 IDUs in Massachusetts in 1993.

Acquired Immunodeficiency Syndrome↗