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Biomedical subjects

R B Davis

Publications and source records attributed to R B Davis.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Rectus femoris surgery in children with cerebral palsy. Part II: A comparison between the effect of transfer and release of the distal rectus femoris on knee motion.

Rectus femoris muscle (RF) surgery was performed in 98 children (136 sides) with cerebral palsy (CP). RF transfer was performed in 105 lower limbs, and distal RF release was performed in 31. Eleven (20 sides) similarly affected children had no RF procedure and are included for comparison. Gait analysis was performed just before and approximately 1 year after surgery. All children underwent other orthopaedic surgery at the time of the RF procedure. When preoperative knee range of motion (ROM) was > 80% of normal, there were no significant changes in knee motion in either the RF transfer or distal release groups. In patients with < 80% of normal knee ROM preoperatively, RF transfer was followed by maintained knee flexion in swing; patients who underwent distal RF release or no RF procedure showed a decrease (10 degrees and 6 degrees, respectively) in knee flexion postoperatively. These results suggest that the RF should be transferred and not released when knee ROM is < 80%.

Adolescent↗
PubMedDate not supplied

Kinematic and kinetic evaluation of the ankle after lengthening of the gastrocnemius fascia in children with cerebral palsy.

The effect of surgical lengthening of the gastrocnemius fascia on ankle joint kinematics and kinetics during gait in patients with cerebral palsy (CP) was evaluated. Twenty independent ambulators (24 sides) were included in this retrospective study. The evaluation included clinical examination, calculation of joint kinematics and kinetics, and collection of surface electromyography (EMG) during gait. Postoperative improvements were noted in static heelcord range of motion (ROM), with an associated increase in dorsiflexion in stance and swing. Kinetic analysis showed a decrease in the abnormal energy generated around the ankle in midstance and a statistically significant increase in the energy generated in late stance for push-off.

Adolescent↗
PubMedDate not supplied

How to create an effective scientific exhibit: analysis of award-winning exhibits from the 1998 RSNA meeting.

Although the most important component of an effective scientific exhibit is content, the way in which an exhibit is constructed can greatly influence its overall effectiveness. Choice of format should be determined by carefully analyzing the purpose of one's exhibit, expected audience, and data at hand, as well as type of meeting and funding. Depending on the type of data to be presented and available equipment and budget, the most appropriate style for a scientific exhibit may be a traditional mat board, computer-generated tiles or large-print backboard panel, traditional mat board with viewbox exhibit, matted transparency tiles with viewbox exhibit, or computer-generated large-film display. The authors analyzed 993 of 1, 041 (95.4%) scientific exhibits on display at the 84th RSNA Scientific Assembly and Annual Meeting and categorized each exhibit according to the following characteristics: display type and size, color scheme, display font size, and graphic styles. These characteristics were then correlated with scientific exhibit and design awards as well as invitations for submission to RadioGraphics. Chance of winning an award or being asked to publish the presentation in RadioGraphics was significantly increased for viewbox exhibits (compared with backboard panel exhibits) and for larger exhibits (compared with smaller exhibits).

Audiovisual Aids↗
PubMedDate not supplied

Discussion of hormone replacement therapy between physicians and their patients.

We determined the relationship between patients' socioeconomic status and discussions with their primary care physicians about hormone replacement therapy (HRT) among women facing a decision about HRT within the prior year. The study included telephone interviews and medical record reviews. The setting was a general medicine practice of an urban teaching hospital in Boston, Mass. Women ages 50-65 visiting an academic teaching practice over a 3-month period were selected randomly. Of the 198 potential subjects, 118 (60%) agreed to participate in the survey. We examined discussions of HRT by women who had faced the decision to initiate HRT within the previous year. Women who were not on HRT or had been on therapy for less than 1 year were asked if they had discussed HRT with their physician in the past year. Socioeconomic factors and comorbidities were elicited during the survey and abstracted by chart review. The mean age of the 118 participants was 57; 36% were black, 54% were white, 10% were other race, 17% had less than a high school education, 14% had diabetes, 31% had had a hysterectomy, and 7% had a history of breast cancer. Of the 80 women who did not use HRT or had used it for less than 1 year, 49 (61%) reported a discussion of HRT. In bivariable analysis, patients of white race were more likely to report a discussion than black patients (72% versus 43%, odds ratio [OR] 3.6, 95% confidence interval [CI] 1.3-9.7). After adjustment for history of osteoporosis and age, white patients were more likely to report a discussion (adjusted OR 3.3, 95% CI 1.1-9.8). Further adjustment for the presence of 2 or more cardiac risk factors did not change the result. Neither level of education nor family income were significantly associated with HRT discussion. Compared with white women, the African-American women we studied were less likely to discuss HRT with their physicians. Further study is needed to determine whether the failure to discuss HRT is due to failure to initiate a discussion on the part of patients, physicians, or both.

Aged↗
PubMedDate not supplied

Patient-centered quality measures for Asian Americans: research in progress.

We aim to develop and validate a questionnaire that examines quality of care from the patient's perspective for limited-English-proficient Asian Americans (AA) of Chinese and Vietnamese descent. We will conduct focus groups of patients to identify issues important to them, with an emphasis on communication and access to care. We will then draft a questionnaire and test its validity using standard survey research methods and direct observation of patient-provider encounters. Subsequent field testing will involve face-to-face patient interviews 1 month after an outpatient visit. We will evaluate alternate modes of administration to test feasibility and to maximize response. The result of our study will be a validated, culturally sensitive, patient-centered instrument that measures health care quality for limited-English-proficient AA patients. Our research will provide a template for developing future quality measures for other vulnerable populations.

Asian↗
PubMedDate not supplied

Brief communication: detecting depression: providing high quality primary care for HIV-infected patients.

Depression is common among HIV-infected patients, but little is known about risk factors for depression in this population. Several studies before protease inhibitors became available have reported inconsistent associations between depression and disease severity. Delivering high quality HIV care includes adequate detection and treatment of depression. The objective of this study was to describe the prevalence and correlates of depression among a contemporary group of HIV-infected patients. The setting and design for the study was a chart abstraction for HIV-infected patients in a primary care practice in Boston, Mass, in June 1997. Among 275 HIV-infected patients, depression was documented in 147 patient charts (53%), half of whom (n = 73, 27%) also received antidepressant medications. We used multivariable logistic regression to identify risk factors for depression among patients with both a chart diagnosis of depression and current antidepressant medication use. We observed increased risk of depression among patients with a history of substance use (odds ratio 2.7, 95% confidence interval 1.5-4.7), recent medical hospitalization (2.6, 1.4-5.0), and homosexual risk behavior (2.1, 1.1-4.2). Depression remains a common problem for HIV-infected patients, particularly among those with history of substance abuse, medical hospitalization, or homosexual risk behavior. Routine screening for depression in this population with special attention to those at higher risk may offer opportunities for earlier diagnosis and treatment.

Antidepressive Agents↗
PubMedDate not supplied

Use of screening and preventive services among women with disabilities.

Roughly 54 million Americans have some disability; at older ages, women are more likely to be disabled than men. Many people with disabilities today live virtually normal life spans, and therefore routine screening and preventive services are essential to their overall quality of care. We used the 1994-1995 National Health Interview Survey (NHIS), with Disability, Family Resources, and Healthy People 2000 supplements, to examine screening and preventive service use for adult women with disabilities living in the community--about 18.4% of women (estimated 18.28 million). Disability was associated with higher age-adjusted rates of: poverty; living alone; low education; inability to work; obesity; and being frequently depressed or anxious. Disabled women generally reported screening and preventive services at rates comparable to all women. Women with major lower extremity mobility difficulties had much lower adjusted odds of Papanicolaou smears (odds ratio, 0.6; 95% confidence interval, 0.4-0.9), mammograms (odds ratio, 0.7; 95% confidence interval, 0.5-0.9), and smoking queries (odds ratio, 0.6; 95% confidence interval, 0.5-0.8). Various approaches exist to improve access for disabled women to health care services.

Adult↗
PubMedDate not supplied

Screening admission CT scans in patients with AIDS--a randomized trial.

OBJECTIVE: To determine if the length of hospital stay could be reduced for patients with AIDS by performing screening head and abdominal-pelvic computed tomography (CT) scans within 24 hours of admission, regardless of presenting signs and symptoms. DESIGN: Randomized, prospective trial. SETTING: Tertiary, academic medical center. PATIENTS: On presentation to the emergency department, 42 patients with AIDS were identified as being eligible to participate in our study. Twenty-two patients consented to participate and were assigned to screening CT or control group. INTERVENTION: Patients assigned to the screening CT group had head and abdominal-pelvic CT scans within 24 hours of admission, regardless of presenting signs or symptoms. The findings of the screening CT scans were immediately communicated to the patient's referring physician. Patients assigned to the control group had CT studies done solely at the discretion of their physician. MAIN OUTCOME MEASURE: Length of stay for patients in the screening CT and control groups. RESULTS: The average length of stay for patients in the screening CT group was 1.3 days longer than the average length of stay for patients in the control group (95% CI, 1.4 days shorter to 4 days longer). The study was terminated after 22 patients were enrolled. CONCLUSION: Screening CT scans of the head and abdomen and pelvis at the time of hospital admission do not reduce the length of stay for patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Influence of strain of Mycoplasma synoviae and route of infection on development of synovitis or airsacculitis in broilers.

Two strains of Mycoplasma synoviae (WVU 1853 and F10-2AS) were compared for their relative pathogenicity in terms of airsacculitis and synovitis. Both strains produced air-sac lesions after aerosol exposure of chickens vaccinated against Newcastle disease and infectious bronchitis; both produced synovitis when inoculated into the foot pad. The WVU 1853 strain was more likely to result in synovitis, whereas the F10-2AS strain was more apt to produce air-sac lesions.

Aerosols↗
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A growth medium for the production of a bacterin for immunization against infectious coryza.

A serum-free modified Casman broth medium was developed to grow Haemophilus gallinarum to titers of 10-8 organisms per ml. Formalin-inactivated bacterins prepared form the broth culture were used to immunize chickens. A single dose of bacterin containing adjuvant protected 6 of 7 chickens against a homologous challenge 4 weeks postvaccination. A second dose given 3 weeks after the first offered no better protection than a single dose.

Animals↗
PubMedDate not supplied

In vitro characterization of field isolants of Pasteurella multocida from Georgia turkeys.

Field isolants of Pasteurella multocida from fowl cholera outbreaks in Georgia turkeys were characterized by three sets of criteria: differential biochemical reactions, in vitro drug sensitivity, and serology. Of the 30 isolants studied, 28 exhibited identical biochemical patterns. These were similar to previously described patterns for turkey isolants of P. multocida. The two exceptions were isolants recovered from the same farm at different times. They differed only in ability to ferment arabinose. The isolants were generally sensitive to broad-spectrum antibiotics in vitro. The majority were also sensitive to the sulfonamides tested. Variation was sufficient, however, to warrant recommending in vitro sensitivity testing as a guide to selection of the proper therapeutic regimen in individual cases. Of the 30 isolants tested, 57% were of Heddleston's serotype 3, 3% were of his type 4, and 40% precipitated with antisera against both types 3 and 4. The large proportion of cross-reactors is unique to Georgia isolants. The biochemical patterns, drug sensitivities, and serological types had no apparent relationship to each other.

Animals↗
PubMedDate not supplied

Three-dimensional lower extremity joint kinetics in normal pediatric gait.

Gait analysis is becoming a more integral part of the decision-making process in treatment of children with neuromuscular problems. A normal reference, however, must be available for comparison when one makes decisions. We wished to develop a normal pediatric database for joint kinematics and kinetics which could then be used as a reference for clinical gait analysis. Thirty-one normal children underwent a complete gait analysis including calculations of three-dimensional joint kinematics and kinetics. The pediatric data were similar to that of normal adults.

Adolescent↗
PubMedDate not supplied

Studies of avian urolithiasis associated with an infectious bronchitis virus.

Avian urolithiasis syndrome was diagnosed in 14-to-25-week-old chickens from a multiple-age caged-layer complex housing more than 2.5 million chickens. Losses from this syndrome ranged from 0.5 to 1.0% per week. Seven-to-14-week-old pullets from this facility had multifocal renal tubular necrosis leading to interstitial fibrosis, tophus formation, and tubular dilation. A coronavirus was isolated in embryos inoculated with pooled samples of trachea, kidney, and cecal tonsil of 4-week-old pullets. This virus, identified as 85-209, was related to infectious bronchitis virus strain Florida 88 by hemagglutination-inhibition assay. Day-old specific-pathogen-free chicks were inoculated with fifth-embryo-passage amnioallantoic fluid containing this virus. These chicks developed histologic lesions of tracheitis at 5 to 7 days postinoculation. Half the chicks inoculated by eyedrop developed renal tubular necrosis after 7 days. Urolithiasis in the flock investigated was attributed to renal damage by this strain of infectious bronchitis virus occurring in 4-to-7-week-old pullets and progressing to segmental atrophy, hyperplasia, and ureteral stone formation in 14-to-25-week-old chickens.

Animals↗
PubMedDate not supplied

Serological evaluation of some psittaciformes for budgerigar fledgling disease virus.

Breeding psittaciform birds (psittacines) from three geographically separated aviaries experiencing fledgling mortality were monitored during 1983 and 1984 for specific serum antibody to budgerigar fledgling disease virus (BFDV) using a fluorescent-antibody virus-neutralization test. Neither the time nor the extent of exposure to the virus was known. Serological titers were positive in 45% of birds sampled from Aviary 1, 25% from Aviary 2, and 11% from Aviary 3. Several species of psittacine birds within each aviary were serologically positive for BFDV. The results indicated that a papovavirus similar to BFDV appears to infect a wide range of captive adult psittacine birds. Macaws (Ara sp. and Anodorhynchus sp.) were evaluated for distribution of infection. Each species within these two genera showed positive serological titers to BFDV. Three groups of birds showed a decrease in serum antibody titer to BFDV at 1 and 2.5 months after the first sampling. Positive titers decreased from 66 to 20% for one group and from 60 to 50% for a second group in 1 month, and they decreased from 42 to 17% for a third group in 2.5 months.

Animals↗
PubMedDate not supplied

Correlation of serum antibody titer for avian encephalomyelitis virus (AEV) in hens with the resistance of progeny embryos to AEV.

Serum antibody titers for avian encephalomyelitis virus of vaccinated breeding hens were correlated with the resistance of the hens' progeny embryos to viral challenge. All of the embryos from hens that had enzyme-linked immunosorbent assay titers greater than 400 were resistant to challenge, and two-thirds of the embryos from hens that had titers greater than 300 were resistant. About one-half of the embryos from hens that had titers from 100 to 300 were immune to challenge.

Animals↗
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Salt poisoning in turkey poults.

A 4% mortality in 5-to-11-day-old turkey poults was attributed to 1.85% sodium chloride in the feed. The syndrome included peracute respiratory distress, ascites, and sudden death that resembled peracute heart failure. Clinical signs were observed only in the final phase of the toxicity, but progressive histologic lesions were found. Live, apparently unaffected poults showed increases in intracellular glycogen and cytoplasmic granularity, loss of striation, and early mild intercellular myocardial edema; similar but more severe histologic lesions were seen in live, ascites-affected poults. The ascites-affected poults had hydropericardium and hydrothorax which seemed to develop just minutes before death. Ultrastructurally, focal areas of myocardial cells exhibited myofibrillar disarray, lysis of myofilaments, widened Z-bands, and dilation of sarcoplasmic reticulum.

Animals↗
PubMedDate not supplied

Vaccination for hemorrhagic enteritis of turkeys.

Laboratory and field evidence indicates that a safe and effective procedure has been developed for vaccinating turkey poults against hemorrhagic enteritis of turkeys. Vaccination is by drinking-water administration of turkey-spleen-propagated pheasant-origin live avirulent virus to 4 1/2-week-old-poults. The effect of vaccination was studied in a field location having recurrent 10-15% mortality and in a second location having recurrent mortality of 0.1-0.2%. The poults involved totaled 214,554.

Animals↗