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Biomedical subjects

R Jenkins

Publications and source records attributed to R Jenkins.

At least 217 records · Page 12Linked to original sources
PubMed1979

Diagnostic yield of transbronchoscopic biopsies.

Transbronchoscopic biopsies of lung (transbronchial) or bronchus (endobronchial) have a high diagnostic of yield when performed by a single expert bronchoscopist or a small group of expert bronchoscopists. This procedure's diagnostic yield was evaluated in a general hospital where biopsies are performed by a diverse group of individuals. One hundred fifty-one consecutive biopsies were reviewed, including 53 transbronchial biopsies and 98 endobronchial biopsies. Only 44% of endobronchial biopsies and 21% of transbronchial biopsies were diagnostic. The diagnostic yield was significantly greater in patients with suspected neoplasms (48%) than in patients with suspected infections (13%). Of 97 patients who ultimately had definitive diagnoses established, 43 (44%) had negative biopsy results, including 36% of those with cancers and 80% of those with infections. Failure to obtain alveolar parenchyma by transbronchial biopsy (probably related to the absence of fluoroscopic control) and failure to obtain multiple tissue fragments during each procedure contributed to the low diagnostic yield. The especially disappointing results of transbronchial biopsy for diagnosis of infection suggest that, in this hospital setting, open lung biopsy may be the procedure of choice when infection is suspected.

Biopsy↗
PubMed1975

The epidemiology and interrelationship of cervical dysplasia and type 2 herpesvirus in a low-income housing project.

This report examines the association between cervical dysplasia and herpes simplex virus type 2 antibodies in a low-income housing project, Atlanta, Georgia. We established a clinic in this project at which women could receive a breast examination and Papanicolaou smear and have blood drawn to be tested for herpesvirus type 2 antibodies. Prevalence of herpesvirus rose sharply as age increased. There was a significant absence of antibodies in young, nulliparous women. Dysplasia showed a tendency to be related to age, age at first pregnancy, and total number of pregnancies. None of these associations was significant. The major finding of the study was that the 15- to 24-year-old women with herpesvirus had a relative risk of 5.44 of having cervical dysplasia compared to women without herpesvirus antibodies. these data are consistent with the concept that herpesvirus infections may be etiologically related to the initiation of cervical neoplasia. However, a cohort study is needed to determine whether herpes infection precedes or follows the earliest neoplastic changes.

Adolescent↗
PubMed1975

Cervical neoplasia in residents of a low-income housing project: an epidemiologic study.

In 1969, a published report estimated that the incidence of cervical cancer in a low-income housing project in Atlanta, G Georgia, might be of epidemic proportion. In 1971, we surveyed this housing project to determine if the prevalence rate of cervical neoplasia was unusually high during the period January, 1969, through September, 1971. From the survey we determined the number of women at risk for cervical neoplasia, and we determined the number of women who had cervical neoplasia from the Tumor Registry at Grady Memorial Hospital. The over-all cervical dysplasia rate was 63/1,000. The over-all prevalence rate of cervical carcinoma in situ was 11/1,000. These rates were compared with rates in two studies which also dealt with the prevalence of cervical neoplasia in low-income black populations. The rates in all three studies were comparable. We conclude that the high rates do not necessarily signify an epidemic, but we suspect that the prevalence of cervical neoplasia in low-income black women is much higher than previously estimated.

Adolescent↗
PubMed1975

Distribution of electrophoretic mobilities of mouse thymocyte subpopulations in the presence of tumour cells.

Analysis of the electrophoretic mobility of mouse thymus cells has showed two main populations, with mean mobility values of 0-77 +/- 0-023 mum s-1 V-1cm and 0-99 +/- 0-015 mum s-1P1cm; these absolute values varied slightly from one strain to another. Implantation of tumour cells caused the relative proportions of these two populations to change dramatically within 48 hours, when an increase in the fast-moving 'immunocompetent' thymocytes was observed. The ratio of slow to fast cells changed from 9:1 in the normal BALB/c animal to 2:1 in the presence of the tumour cells and this 2:1 ratio persisted throughout the remainder of the animal's life. However, inoculation of histocompatible spleen cells from a normal individual evoked only a brief response in the host's thymus. This change in ratio of slow to fast cells in thethymus was interpreted as an increased production of immunocompetent cells in response to the presence of the tumour cells.

Adenocarcinoma↗
PubMedDate not supplied

Antibiotics for upper respiratory tract infections. Follow-up utilization and antibiotic use.

OBJECTIVES: To examine the effects of antibiotic prescribing during an initial visit for viral respiratory tract infections on future care seeking and the cost of care. MATERIALS AND METHODS: Retrospective analysis of recorded visits for viral respiratory tract infections (N = 49,862) between January 1, 1995, and December 31, 1997, to practices in a large network of affiliated practices that use the same electronic medical record. RESULTS: Patients receiving antibiotics at the initial visit were less likely to return for a second visit, but this difference was small (15.4% vs 17.4%, P < .001). When returning for the second visit, those who received an antibiotic on the initial visit were prescribed more expensive antibiotics than those who had not received an antibiotic on the initial consultation. Overall, cost from initial antibiotic use outweighed any benefit from reduced utilization in adults and children. CONCLUSIONS: Antibiotic prescribing at an initial contact for a viral respiratory tract illness may reduce the likelihood that an individual will return for a subsequent visit, but adds substantial costs to care for the initial antibiotic and for more expensive antibiotics used on subsequent visits.

Adolescent↗
PubMedDate not supplied

Does drug treatment of patients with acute bronchitis reduce additional care seeking? Evidence from the Practice Partner Research Network.

BACKGROUND: Considerable discussion has focused on treatment methods for patients with acute bronchitis. OBJECTIVE: To examine whether antibiotic or bronchodilator treatment is associated with differences in follow-up visit rates for patients with acute bronchitis. METHODS: A retrospective medical chart review was conducted for patients with a new episode of acute bronchitis over a 3-year period in the Practice Partner Research Network (29,248 episodes in 24,753 patients). Primary outcomes of interest were another visit in the next 14 days (early follow-up) or 15 to 28 days after initial treatment (late follow-up). RESULTS: Antibiotics were used more commonly in younger patients (<18 years), whereas older patients (>65 years) were more likely to receive no treatment. Younger patients treated with antibiotics were less likely to return for an early follow-up visit, but no differences were seen in adults and older patients. Late follow-up rates were not affected by the initial treatment strategy. When patients did return for a follow-up visit, no new medication was prescribed to most (66% of younger patients and 78% of older adults). However, compared with patients who did not receive an antibiotic at their first visit, patients initially treated with an antibiotic were about 50% more likely to receive a new antibiotic at their second visit. CONCLUSIONS: Initial prescribing of an antibiotic reduces early follow-up for acute bronchitis in younger patients but seems to have no effect in adults. However, reductions in future follow-up visits might be outweighed by increases in antibiotic consumption because patients who return for a follow-up visit seem to receive additional antibiotic prescriptions. Arch Fam Med. 2000;9:997-1001

Acute Disease↗