Biomedical subjects
Publications and source records attributed to P Gordon.
Chronic renal failure places many restrictions on children. Children's nurses need to assist the child with chronic renal failure in achieving as normal a life as possible. Purssell's model of normalisation provides a useful framework to identify strategies to help children cope. The need for further research in this area is established.
BACKGROUND AND OBJECTIVES: We conducted a study of family practice residency programs to investigate the number of deliveries performed by residents during training. METHODS: A one-page questionnaire was mailed to family practice residency program directors, requesting an estimate of the number of deliveries performed by each resident. In addition, information on residency characteristics was taken from the American Academy of Family Physicians Directory of Family Practice Residency Programs. RESULTS: Responses were received from 316 programs, for a response rate of 70%. Residency directors estimated that residents did a mean of 18 continuity and 24.5 obstetrics block month deliveries. On the average, residents delivered 93.9 babies in 3 years of residency. The number of continuity deliveries was related to location of the program and type of program. Total deliveries related to the presence of a competing obstetrics program, faculty who were doing their own deliveries, location of the program, and number of required months of obstetrics. On multivariate analysis, only the latter two variables predicted the number of total deliveries. CONCLUSIONS: Family practice residents deliver an average of 94 babies in 3 years of residency training. Programs that want to increase deliveries can best do so by increasing the number of required months of training.
BACKGROUND AND OBJECTIVES: This study validated the evaluation methods used in a family medicine clerkship by comparing students' scores to how students are rated in their first year of residency by residency directors. The clerkship evaluations consisted of three components: problem solving in small groups, clinical evaluations, and a final examination. These components were combined to form a composite clerkship score. Residency director ratings consisted of 20 individual scores and an overall average. METHODS: Scores received by students in the clerkship were correlated with ratings by residency directors given toward the end of the first year of residency. The correlations between Objective Structured Clinical Examination (OSCE) scores and residency directors' ratings were used as comparison. RESULTS: The composite clerkship score correlated with the director's rating, overall average, at r = .278. The highest individual component correlation was achieved by the clerkship final exam (r = .269). The total OSCE score correlated with the director's rating overall average at r = .304. CONCLUSIONS: This study provides evidence that, while not perfect, the family medicine clerkship evaluations perform nearly as well as the OSCE as a predictor of how students will be rated by their residency directors in their first year of residency.
The Sulfolobus solfataricus P2 genome collaborators are poised to sequence the entire 3-Mbp genome of this crenarchaeote archaeon. About 80% of the genome has been sequenced to date, with the rest of the sequence being assembled fast. In this publication we introduce the genomic sequencing and automated analysis strategy and present intial data derived from the sequence analysis. After an overview of the general sequence features, metabolic pathway studies are explained, using sugar metabolism as an example. The paper closes with an overview of repetitive elements in S. solfataricus.
Two unrelated boys are described who were born as collodion babies and subsequently developed non-bullous ichthyosiform erythroderma and flares of generalized sterile pustulosis, similar to generalized pustular psoriasis. Both patients had a good response to treatment with oral retinoids.
Items in event-based categorical relations, or "slot fillers," have been found to be recalled better by children than items in a taxonomic relation. This has been used as evidence that children's memory is organized around script-based representations rather than taxonomic structures. Others have attributed the superior recall of slot fillers to association and typicality rather than memory structure per se. This study was designed to see if the slot filler advantage remains when association and typicality were controlled for. Forty-five 3- to 4-year-olds were tested using a cued recall procedure in which typicality and association were varied for slot filler versus taxonomic coordinate lists of items. Only children receiving the typical + high association slot filler list showed significantly better recall than the taxonomic coordinate list. There were no differences between the atypical + low association slot filler list and the taxonomic coordinate list. These results suggest that the slot filler advantage can be attributed to the more traditional mechanisms of association and typicality.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Gastroesophageal reflux disease is a chronic disorder that requires long-term therapy in most patients. The appropriate medical therapy should be individualized to the severity of symptoms, the degree of esophagitis and the presence of other acid-reflux complications. Lifestyle changes should form the basis of any therapeutic approach. In patients with mild to moderate disease, initial therapy with histamine H2-receptor antagonists in conventional dosages is suggested. Prokinetic agents are potentially useful in patients with impaired esophageal or gastric motor function, but their efficacy as single agents does not appear to surpass that of standard doses of H2 blockers. Sucralfate, a cytoprotective agent, is an additional therapeutic option. For patients with more severe disease, omeprazole and lansoprazole provide unequaled healing rates and accelerated symptom relief. In most patients, maintenance therapy is vital. Surgery is indicated in patients whose disease is refractory to medical therapy and in those who develop complications not amenable to medical therapy.
The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82%). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children.
The present study examines noun-noun compounds where the internal noun is pluralized (e.g., new books shelf), contrary to normal constraints that prohibit such constructions. It is proposed that these apparent violations are licensed by a recursive mechanism where world formation passes into Syntax and back into Morphology. Thirty-six 3- to 5-year-olds were tested on their interpretations of compounds fronted by an adjective. When asked to point to a picture of a red rats eater, children preferred a picture where the rats were red over one in which the eater was red. The opposite preference was found when children were asked to point to a red rat eater. These response patterns reflect a recursive-syntactic interpretation when the noun is plural, but a non-recursive interpretation when the noun is singular. The results suggest that children's word formation processes allow complex interactions between grammatical systems from early in acquisition.
The safety and efficacy of the MRI contrast medium gadodiamide injection (OMNISCAN) in children is summarised. Four open and three double-blind, multinational, multicentre comparative trials have been undertaken. Overall, 353 patients (15 days to 18 years, plus one 21 years) received gadodiamide injection, and 128 (2-18 years) received gadopentetate dimeglumine (Magnevist), intravenously at 0.1 mmol/kg body weight, to aid the identification of CNS and body lesions. Adverse events were reported in 13 (4%) patients given gadodiamide injection and 8 (6%) given gadopentetate dimeglumine; few patients reported injection-associated discomfort. The post-contrast scan gave more diagnostic information in 223 (63%) patients given gadodiamide injection (CNS and body indications). In the comparative trials, the post-contrast scan gave more diagnostic information for 91 (65%) and 82 (64%) patients given gadodiamide injection and gadopentetate dimeglumine, respectively (CNS indications only). Gadodiamide injection (0.1 mmol/kg body weight) was safe and effective in infants, children and adolescents.
PURPOSE: To evaluate the tolerability of mangafodipir trisodium (MnDPDP) and its utility for enhancing the ability of magnetic resonance (MR) imaging to detect focal hepatic lesions compared with non-enhanced MR and contrast-enhanced computed tomography (CT). MATERIALS AND METHODS: 119 patients with focal hepatic lesions were examined by MR and by contrast-enhanced CT. MR was performed before and after the infusion of 5 mumol/kg MnDPDP, at a concentration of 10 mumol/ml. Histologic confirmation was obtained in 79 patients. RESULTS: There were no severe adverse events. Five patients reported mild adverse events related to the infusion. MnDPDP-enhanced SE T1 and GE T1 sequences revealed more focal lesions than the same sequences before contrast infusion in, respectively 22.6 and 36.1% of the cases, and fewer focal lesions in, respectively 5.9 and 1.7% of the cases. Contrast-enhanced MR demonstrated more focal lesions than the SE T2 sequence in 29.4% of cases and fewer lesions in 5.9% of cases. MnDPDP-enhanced MR revealed more nodules than CT in 31.1% of cases and fewer nodules in 13.4% of cases. The additional information provided by MnDPDP enhancement led to modification of management for 12 patients (10.1%). CONCLUSION: MnDPDP is a well-tolerated contrast agent allowing better MR detection of focal hepatic lesions than non-enhanced MR or contrast-enhanced CT.
Explore the source record for details and available documents.
PURPOSE: For the assessment of bioequivalence it is assumed that drug clearance in each subject on each of the study days is the same and any observed differences in AUC and/or Cmax between a brand and generic formulation are due to differences in bioavailability. We hypothesized that this assumption was invalid for highly variable drugs such as verapamil and tested it by comparing bioavailability for the brand vs itself. METHODS: To avoid any contribution from potential formulation differences, we evaluated bioavailability for isoptin SR 240 mg tablets in 9 healthy volunteers on 2 occasions separated by 1 week as part of a larger study. A validated HPLC assay was used to measure serial blood samples over 36 hours. RESULTS: The AUC0-1 varied 3.8 fold among subjects and 5/9 subjects had > 30% difference in AUC0-1 on the 2 days. After log transformation, the mean AUC0-1 +/- %cv (ng.h/mL) on Occasion 1 (878 +/- 38) was 23% greater (p = 0.031) than on Occasion 2 (713 +/- 41). The 90% confidence interval of Occasion 1/Occasion 2 was 106-143%. The Cmax varied > 9 fold (30-278 ng/mL) among subjects. The intrasubject difference between days ranged from -46% to +298%. The 90% confidence interval was 72-152% for Cmax. Since the same lot of Isoptin was used in the same subjects on 2 occasions, the observed differences must be due to biological variability in verapamil pharmacokinetics, not formulation differences. CONCLUSIONS: The intra-subject biological variability complicates bio-equivalence assessment and can lead to an erroneous assumption of bioinequivalence.
Explore the source record for details and available documents.
This investigation examined the validity of the Borg 15-category Ratings of Perceived Exertion (RPE) scale during semirecumbent exercise in 32 degrees C water. 9 men undertook 12 8-min. trials at 3 power outputs and 4 pedal-crank rates. The power output was distributed between the arms (20%) and legs (80%). RPEs were measured for the arms, legs, chest, and over-all body. Correlation coefficients for RPE expressed as a function of power output and gross metabolic efficiency (MEG) ranged from .56 to .83 and .54 to .70, respectively, for each pedal-crank rate. Validity coefficients were greatest at those pedal-crank rates having the highest MEG. The Borg 15-category RPE scale is valid for use during semirecumbent exercise in water.