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Biomedical subjects

P Jenkins

Publications and source records attributed to P Jenkins.

At least 19 recordsLinked to original sources
PubMed2001

The effects of pneumoperitoneum and patient position on hemodynamics during laparoscopic cholecystectomy.

BACKGROUND: The purpose of this study was to prospectively examine the combined effects of pneumoperitoneum and the reverse Trendelenberg position on cardiac hemodynamics during laparoscopic cholecystectomy. METHODS: Thirty-nine patients undergoing laparoscopic cholecystectomy as performed by a single surgeon were enrolled in the study. Hemodynamic data were collected continuously using a transthoracic bioimpedance monitor. All patients were subjected to insufflation pressures of 15 mmHg. Data were examined using mixed analysis of variance (ANOVA). RESULTS: Cardiac index fell 11% with induction of anesthesia (p < 0.05), with stroke volume decreasing 7.2% (p < 0.05). Insufflation caused significant decreases in stroke volume (SV) left ventricular end diastolic volume (LVEDV) but not cardiac index (CI). Placing the patients in the reverse Trendelenberg position caused no significant changes in these parameters. There were no significant differences between ASA (American Society of Anesthesiologists) classes I and II patients when compared to ASA III patients. CONCLUSIONS: Patients undergoing laparoscopic cholecystectomy experience significant hemodynamic depression. The effect of general anesthesia is the most profound. Insufflation of the abdomen caused more mild hemodynamic effects in our study. The addition of a reverse Trendelenberg position did not alter the patient's hemodynamic status.

Adult↗
PubMed2001

Sex, drugs, and hypertension: a methodological approach for studying a sensitive subject.

Sexual dysfunction is a recognized side effect of hypertension and antihypertensive medications in men, but is not established as a side effect in women, due to the lack of established methodology. An ambulatory medical record-based, case-control study was designed to study sexual function in treated and untreated hypertensive women and healthy controls. The research was performed in a teaching hospital with satellite clinics in upstate New York. There were 3312 medical records reviewed, 640 premenopausal Caucasian women in heterosexual relationships subjects were eligible for participatic diagnosis of mild hypertension (BP > or =140/90 mmHg and < 160/100 mmHg) for cases; no other significant medical history. A total of 241 women agreed to participate, 224 (35%) completed both a self-administered questionnaire and a telephone interview (112 healthy, 112 hypertensive). There was an initial 74% response rate among those eligible to participate, with 35% completing the entire study. Age and average blood pressure were not significant between 224 participants and 416 nonparticipants by 2-tailed t-test analysis. Seven composite variables were formed from a 47-item sexual response questionnaire. Initial unadjusted chi2 results reported women with hypertension had more difficulty than did healthy controls achieving lubrication and orgasm. Seven questions, each with the highest correlation to its respective composite variable (by Spearman's correlation), formed an abbreviated questionnaire. Quality of female sexual function was quantified in an ambulatory outpatient setting. A method was described to address hypertension, pharmacotherapy, and sexual functioning by employing self-administered questionnaires and telephone interviews. Initial analysis suggested that hypertensive women may have an impaired physiological sexual response. The abbreviated questionnaire generated from questions with the highest correlation to their respective composite variables may be useful in further evaluating this issue.

Adult↗
PubMed2001

Impact of a rural domestic violence prevention campaign.

Domestic violence is a prevalent health problem that in rural areas is further complicated by limited services, social isolation and the lack of privacy. Little is known about the impact of public health education on awareness, attitudes and behavior of the general public regarding domestic violence. This study sought to measure change in societal attitudes and behavioral intention in response to a seven-month public health education campaign targeting domestic violence in a rural county. From October 1998 to April 1999, the campaign used radio advertisements, posters, mailings to libraries and clergy, printed media articles, printed advertisements and health facility modifications. A random-digit-dialing telephone survey was used to evaluate attitudinal and behavioral changes in the intervention and comparison counties before and after the campaign. The response rates for the pre- (n =378) and postcampaign (n=633) surveys were 73 percent and 65 percent, respectively. Statistically significant increases in slogan and advertising recognition occurred in the intervention county (P=0.03), particularly among men recalling the campaign slogan (P=0.006). In a vignette regarding actions to be taken if the neighbor next door was abusing a partner, significant increases occurred in the intervention county in the percentage of respondents who thought that most people would talk to the victim (P=0.04), consult with friends (P=0.002) or talk to a doctor (P=0.004). Domestic violence agency hotline calls in the intervention county doubled following the campaign. Local public health education campaigns in a rural setting may be a valuable adjunct to national efforts, especially in reaching men.

Adolescent↗
PubMed2001

Variant chromatin structure of the oriP region of Epstein-Barr virus and regulation of EBER1 expression by upstream sequences and oriP.

Most of the Epstein-Barr virus genome in latently infected cells is in a standard nucleosomal structure, but the region encompassing oriP and the Epstein-Barr virus-encoded small RNA (EBER) genes shows a distinctive pattern when digested with micrococcal nuclease. This pattern corresponds to a previously mapped nuclear matrix attachment region. Although the EBER genes are adjacent to oriP, there is only a two- to fourfold effect of oriP on EBER expression. However, sequences containing a consensus ATF site upstream of EBER1 are important for EBER1 expression.

Chromatin↗
PubMed2001

Ruptured appendicitis among children as an indicator of access to care.

OBJECTIVE: To determine factors associated with ruptured appendicitis among children, using administrative databases. Insurance-related differences in the risk of ruptured appendix among adults in California have previously been described (Braveman, Schaaf, Egerter, et al. 1994). DATA SOURCES/STUDY SETTING: State of Maryland Medicaid claims data for children < or = 18 years of age from 1989 to 1993 and hospital discharge data for children < or = 19 years of age from 1989 to 1994 were analyzed. STUDY DESIGN: Administrative data analysis pre- and post-implementation of a Medicaid managed care program called Maryland Access to Care. DATA COLLECTION/EXTRACTION METHODS: Medicaid claims and hospital discharge ICD-9-CM codes were used to define hospitalization for ruptured and nonruptured appendicitis. Linear regression was used to model trends. Logistic regression was used to model the probability of ruptured appendicitis. PRINCIPAL FINDINGS: Among the 374 Medicaid inpatient claims for appendicitis, 37 percent were for ruptured appendicitis. Among the 5,141 hospital discharges for appendicitis, 30 percent were for ruptured appendicitis. Using Medicaid claims data, the probability of ruptured appendicitis was inversely related to age (OR = 0.86, 95% CI 0.81-0.91), white race (OR = 0.35, 95% CI 0.17-0.71) and preventive care visits (OR = 0.19, 95% CI 0.05-0.77). Using hospital discharge data, age (OR = 0.91, 95% CI 0.90-0.93) and female gender (OR = 0.87, 95% CI 0.77-0.99) were significant covariates. Insurance-related covariates were not significant in multivariate models addressing the probability of ruptured appendicitis. CONCLUSIONS: During a period of rapid managed care growth, insurance type was not associated with an increased risk of ruptured appendicitis among children in this geographic area. Age, female gender, and the number of preventive care visits are inversely related to the risk of ruptured appendix among children. The protective effect of preventive care visits suggests that a primary care relationship facilitates access to care, thus reducing delay in the management of appendicitis.

Adolescent↗
PubMed2000

Insights from a large rural population laboratory. Health census '89 and '99.

PURPOSE: Data are limited on health status behaviors and use of health services for rural residents. Yet rural areas now have higher rates of chronic diseases, such as coronary heart disease, than urban areas.METHODS: A population laboratory (Health Census) was established in rural Central NY (Otsego County) to study these variables in this population. HC '89 was a door-to-door enumeration of all permanent households in the country. In 1989, 44,500 adults in 18,000 households provided data on individual health screenings, cancer and cardiovascular risk factors, health behaviors, chronic disease, access to care, preventive services use, health insurance and emergency department utilization. Data collection for HC '99 will identify 10-year trends; it also includes baseline data for children. Also, households in six surrounding rural counties (N = 10,000) were sampled; cost benefits of different survey methods were assessed. Questions about perceived health status, and special health and pediatric preventive care needs were included. After 10 years of social change, many limitations of traditional survey methods became apparent; much more varied and frequent types of follow-up were needed to achieve adequate response rates.RESULTS: The HC '89 final response rate was 86%. There were significant socioeconomic gradients in use of preventive services (blood pressure screening, rectal exams, mammograms and Pap smears). Adults without health insurance or Medicaid had much lower utilization rates of screening tests and higher rates of cigarette smoking and obesity. Several community intervention programs were implemented as a result of HC '89. HC '99 provides additional analyses to examine change in preventive service use, self-reported chronic disease, and health services use; it will likely verify the persistence of socioeconomic gradients. Response rates are similar to '89, but achieved only with more intensive reinforcement.CONCLUSIONS: HC '89 confirmed a lag in positive health indices in rural populations in Central NY. Both newer methodologies now needed and results of HC '99 will serve as guides for smaller rural counties to develop affordable local health surveys and plan intervention strategies.

Journal Article↗
PubMed2000

Trends of gonorrhea and chlamydial infection during 1985-1996 among active-duty soldiers at a United States Army installation.

High rates of sexually transmitted diseases (STDs) have been reported in military populations. However, it remains uncertain whether the incidence of STDs is higher among military personnel than in the civilian population. The annual incidence of gonorrhea and chlamydia from 1985 through 1996 at Fort Bragg, North Carolina, was determined by use of a clinic database and demographic information for the entire installation. A direct standardization for age, sex, and race/ethnicity was performed, and the adjusted annual rates among active duty soldiers were compared with rates among men and women in North Carolina and the United States. Results showed that the adjusted incidence of gonorrhea and chlamydia among Fort Bragg soldiers remained higher overall than comparable state and national rates during the period of analyses. The 1996 adjusted chlamydia rates for male and female active duty soldiers were 3-fold to 6-fold higher than rates for males and females in North Carolina and in the United States as a whole. STDs continue to lead to significant morbidity in this representative military population.

Adolescent↗
PubMed2000

Does hypertension and its pharmacotherapy affect the quality of sexual function in women?

Considerable research has been conducted into the effects of antihypertensive drugs on male sexual functioning. This remains underexplored in women, even though almost half of treated hypertensives are women. An ambulatory medical record-based, case-control study was designed to study sexual function in treated and untreated hypertensive women and healthy controls. We conducted this study at a teaching hospital with satellite clinics in upstate New York. Of 3312 medical records reviewed, 640 premenopausal white women with or without mild hypertension (defined as blood pressure [BP] > or = 140/90 and < 160/110 mmHg), in heterosexual relationships, with no other significant medical history, were eligible. Of these, 241 women agreed to participate, and 224 (35%) completed both a self-administered questionnaire and a telephone interview. Analysis was conducted on 211 women (107 healthy controls, and 104 mild hypertensives, of whom 37 were unmedicated and 67 medicated). Questions on sexuality were classified into seven composite variables and later further divided. There were no demographic differences between participants and nonparticipants. Cases and controls differed only by age (P < .01); therefore, subsequent analysis was age-adjusted. Current smokers reported a significantly lower mean score for orgasm than did nonsmokers (P = .04). Women with unmedicated and medicated hypertension did not differ significantly on sexuality scores and were subsequently combined. Using age-adjusted ANOVA, women with hypertension reported significantly decreased lubrication and orgasm and increased pain compared to nonhypertensive women. There were no significant differences by ANOVA in the quality of sexual functioning between six treatment groups. In conclusion, the quality of female sexual functioning was quantified in an ambulatory outpatient setting. Hypertensive women, regardless of type of treatment, reported age-adjusted decrease in vaginal lubrication, less frequent orgasm, and more frequent pain when compared to nonhypertensive women. Emotional aspects of sexual functioning in hypertensive women do not appear to be impaired. These areas require further investigation. An incidental finding indicated diminished orgasm reported in current smokers, compared to nonsmokers, which was not associated with age or hypertension.

Adult↗
PubMed2000

Epidemiology of erectile dysfunction: a community-based study in rural New York State.

PURPOSE: Few published population-based studies that deal with the prevalence of erectile dysfunction (ED) involve rural populations. This study determined the prevalence and determinants of ED among a rural population. It also evaluated the relevance of some major predictors of help-seeking decisions. METHODS: A self-administered survey was conducted by mail among 5198 randomly selected men 50-76 years old, living in four rural counties in Central New York State. RESULTS: The response rate was 44.7% and the participation rate among respondents was 71.0%. Mean ages of men reporting and those not reporting ED were 64.5 7.2 and 59.8 7.2 years respectively. The mean duration of self-reported ED was 4.9 4.6 years. The overall prevalence of ED was 46.3% while the minimum prevalence was estimated as 21.3%. Age-specific prevalence was 26.0%, 34.9%, 46.9%, 57.8% and 69.4% among men 50-54, 55-59, 60-64, 65-69, and 70-76 years old respectively. There was a statistically significant relationship between age, socio-economic status, perceived state of health and erectile function status (p < 0.001). However, socio-economic status, marital status, perceived state of health and age were not significant predictors of help-seeking decisions. CONCLUSIONS: The prevalence of ED among men 50-76 years old in rural Central New York State is at least 21.3% and may be as high as 46.3%. Age, perceived state of health and socio-economic status were found to be important determinants of erectile dysfunction among this population. For purposes of comparative analyses, future epidemiological studies should report both the overall and minimum rates among men with clinically relevant erectile dysfunction.

Aged↗
PubMed2000

The boundary for growth of Zygosaccharomyces bailii in acidified products described by models for time to growth and probability of growth.

Models to predict days to growth and probability of growth of Zygosaccharomyces bailii in high-acid foods were developed, and the equations are presented here. The models were constructed from measurements of growth of Z. bailii using automated turbidimetry over a 29-day period at various pH, NaCl, fructose, and acetic acid levels. Statistical analyses were carried out using Statistical Analysis Systems LIFEREG procedures, and the data were fitted to log-logistic models. Model 1 predicts days to growth based on two factors, combined molar concentration of salt plus sugar and undissociated acetic acid. This model allows a growth/no-growth boundary to be visualized. The boundary is comparable with that established by G. Tuynenburg Muys (Process Biochem. 6:25-28, 1971), which still forms the basis of industry assumptions about the stability of acidic foods. Model 2 predicts days to growth based on the four independent factors of salt, sugar, acetic acid, and pH levels and is, therefore, much more useful for product development. Validation data derived from challenge studies in retail products from the U.S. market are presented for Model 2, showing that the model gives reliable, fail-safe predictions and is suitable for use in predicting growth responses of Z. bailii in high-acid foods. Model 3 predicts probability of growth of Z. bailii in 29 days. This model is most useful for spoilage risk assessment. All three models showed good agreement between predictions and observed values for the underlying data.

Food Microbiology↗
PubMed2000

Consultation rates with a doctor in 1996.

Data from 23 Sheffield practices showed general practitioner in-surgery consultation rates running at an average of 3395 per 1000 patients in 1996-1997. This is 30% above the equivalent contact rate found in the Fourth National Morbidity Survey of England and Wales in 1991-1992.

England↗
PubMed2000

The use of a geographical information system in investigating dental services.

OBJECTIVE: To determine the value of a geographical information system (GIS) in investigating the provision of dental care. DESIGN: Information about dental need and provision of dental services was obtained from districts within the West Midlands. A Geographical Information System (Atlas GIS) was used to answer three different questions about dental services provision within the West Midlands. A GIS is an interactive system that allows data to be analysed according to regular or irregular geographical areas. Once the system is established, it is fairly simple and quick to use. However, the financial and training issues mean that it may not be viable for such a system to be available within each health trust or district, but more appropriately as a central facility which can be accessed by several users. CASE STUDIES: The way in which this system was used to answer three different questions about dental service provision within the West Midlands is demonstrated and evaluated. CONCLUSIONS: Use of a GIS presents information in a way that increases its usefulness in the planning of dental services.

Cleft Lip↗
PubMed1999

The Electrochemistry of Nonaqueous Copper Phthalocyanine Dispersions in the Presence of a Metal Soap Surfactant: A Simple Equilibrium Site Binding Model.

The electrophoretic mobilities of copper phthalocyanine particles, dispersed in isoparaffin solutions containing zirconium octanoate, have been determined using phase-analysis light scattering. All the samples studied contained trace concentrations of water. The mobility values were converted to zeta potentials using the Hückel equation. All the systems studied exhibited a pronounced maximum in zeta potential as the zirconium octanoate concentration increased. The maximum occurred at a bulk zirconium octanoate concentration equivalent to that required for complete coverage of the particles. The zeta potential data were converted to surface charge density values through the use of the Poisson-Boltzmann equation. The latter were in the range 0.4 to 2.5 µC m-2. A simple two equation site binding theory, which considered the dissociation of zirconium octanoate and the subsequent adsorption of ions at a generic surface site, was successfully applied to the surface charge data. It is proposed that the maximum in the zeta potential and surface charge as a function of zirconium octanoate concentration was observed due to the preferential location of ZrO2+ ions at the particle surface, followed by charge neutralization with octanoate anions. It is suggested that water facilitates the dissociation process of the zirconium octanoate, although it does not directly contribute to the surface charge itself. Two plausible qualitative mechanisms are described. The first involves the presence of water at the particle-solution interface, whilst the second considers the formation of micelles in the bulk isoparaffin phase. Copyright 1999 Academic Press.

Journal Article↗
PubMed1999

Copper Phthalocyanine-Mica Interactions in Nonaqueous Media.

The interaction forces and adhesion of copper phthalocyanine particles with a mica substrate in isoparaffin were directly measured using an atomic force microscope. The study was conducted primarily to investigate the stabilization mechanism of copper phthalocyanine dispersions in a nonaqueous medium. The nature of the forces was examined in the presence of various concentrations of water and zirconium octanoate, both of which are present at the particle-isoparaffin interface. A weak attraction, as well as a small adhesion, exists between the copper phthalocyanine particles and the mica surface. These interactions are a function of the water content of the hydrocarbon phase and appear to be a result of capillary forces. The addition of zirconium octanoate produces significant short range repulsive forces with no adhesion between the copper phthalocyanine and mica surfaces. The shape of the force against distance curves suggests that the dispersion stability of the copper phthalocyanine arises through steric stabilization by adsorbed zirconium octanoate. The same qualitative interaction behavior was observed when the copper phthalocyanine particle was coated with a layer of polyvinyl acetate latex. Copyright 1999 Academic Press.

Journal Article↗
PubMed1999

Potential of polymeric lamellar substrate particles (PLSP) as adjuvants for vaccines.

In recent years microspheres or microparticles produced from biodegradable polymers such as poly(D,L-lactide) (PLA) and poly(D, L-lactide-co-glycolide) (PLGA) containing encapsulated vaccine antigens have been investigated for administration via parenteral, oral, and intranasal routes. These microparticles allow the controlled release of vaccines with an aim to reduce the number of doses for primary immunisation or to develop single dose vaccines. The polymer materials have been widely regarded as being of minimal toxicity. Evaluation of candidate systems in animal studies have shown antibody levels and cell responses similar to or greater than those observed with adjuvants such as alum. However, there are concerns regarding the integrity and immunogenicity of the antigen during the encapsulation process when the antigen is exposed to organic solvents, high shear stresses and the exposure of antigen to low pH which is caused by polymer degradation. An alternative approach would be to adsorb antigens to the surface of biodegradable polymer particles. Polymeric lamellar substrate particles (PLSP), produced by a simple precipitation of PLA, are suitable for this purpose. The adsorption of antigens onto these particles is a simple procedure. It avoids pH changes due to bulk polymer degradation and the use of solvents and therefore will be less damaging to the vaccine. Moreover, such systems will be much easier to scale up for a clinical study and eventual manufacture. The aim of this article is to discuss the preparation and physical characteristics of PLSP, antigen adsorption, in vivo efficacy of PLSP antigen systems and to consider the potential of PLSP as controlled release adjuvants for protein, peptide or viral vaccines.

Adjuvants, Immunologic↗
PubMed1999

Children's growth parameters vary by type of fruit juice consumed.

BACKGROUND: Excessive fruit juice consumption in young children has been associated with nonorganic failure to thrive and short stature in some children and with obesity in others. OBJECTIVE: To evaluate, in a sample of healthy young children, whether the associations between fruit juice intakes and growth parameters differ by the type of fruit juice consumed. DESIGN: Cross-sectional study. SETTING: General primary care health center in upstate New York. PARTICIPANTS: One hundred sixteen two-year-old children and one hundred seven five-year-old children, who were scheduled for a nonacute visit, and their primary care-takers or parents were recruited over a two-year period. METHODS: For 163 children (73% of total), 14 days of dietary records were available. The dietary records were entered and analyzed using the Nutrition Data System (NDS). Type of fruit juice was classified according to Nutrition Coordinating Center food codes. Height was measured using a Harpenden Stadiometer. Weight was measured using a standard balance beam scale. RESULTS: The children consumed, on average, 5.5 fluid oz/day of fruit juices, which were classified by the NDS software as 35% apple juice, 31% orange juice, 25% grape juice and 9% other types and/or mixtures of fruit juice. Children with higher fruit juice intakes had lower total fat, saturated fat and cholesterol intakes. Child height was inversely related to apple juice intake (p=0.007) and grape juice intake (p=0.02), after adjustment for child age, gender and energy intake (excluding fruit juice) and maternal height. Apple juice intake was correlated with child body mass index (p<0.05) and ponderal index (p<0.005), after adjustment for the above covariates. Total cholesterol, LDL-cholesterol, triglyceride and lipoprotein(a) levels were not related to intakes of any of the fruit juices examined. The children's ratios of total cholesterol to HDL cholesterol were correlated with grape juice intakes, while HDL-cholesterol levels were inversely related to grape juice intakes. There were no significant relationships between fruit juice intake and measures of anemia (hematocrit or mean corpuscular volume). CONCLUSIONS: The previously reported associations between short stature and high intakes of fruit juice were observed for intakes of both apple juice and grape juice. The associations between high fruit juice intakes and obesity were observed with apple juice intakes only. Because most of the fruit juice mixtures were classified as single fruit juices, the findings, especially those with grape juice, need to be cautiously interpreted. High intakes of fruit juice, however, appear to be associated with growth extremes in young children. Thus, it would seem prudent for parents and caretakers to moderate the fruit juice intakes of their young children.

Beverages↗