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Biomedical subjects

T Ashikaga

Publications and source records attributed to T Ashikaga.

At least 91 records · Page 5Linked to original sources
PubMed1984

Probability of surviving postoperative acute renal failure. Development of a prognostic index.

Sixty-five patients who developed postoperative acute renal failure requiring hemodialysis were retrospectively analyzed to identify variables that could be used to predict outcome. Our aim was to identify patients who would have an unfavorable outcome despite hemodialysis and to identify those factors that might be altered to improve outcome. A linear discriminant function capable of segregating survivors from nonsurvivors in the retrospective analysis was subsequently validated in a prospective fashion using a second patient population. Variables used were age, sex, number of transfusions, interval from onset of acute renal failure to dialysis, type of surgery, preoperative hypotension, and the presence of cardiac failure. Scores were formulated for each patient and then segregated into three groups: patients with no precedence for survival, patients with an intermediate risk of dying, and patients with low risk of dying. Based on the univariant analysis, the interval from onset of acute renal failure to first dialysis and the maximum serum creatinine prior to first dialysis were the only factors that might be altered to change mortality. The prognostic index we have developed enables one to select patients without a chance of survival.

Acute Kidney Injury↗
PubMed1983

Evidence of prior pelvic inflammatory disease and its relationship to Chlamydia trachomatis antibody and intrauterine contraceptive device use in infertile women.

A total of 204 infertile women attending the Infertility Clinic of the Medical Center Hospital of Vermont were studied for the possible role of Chlamydia trachomatis and intrauterine contraceptive device (IUCD) use as factors related to their infertility. All patients had had at least 1 year of involuntary infertility. All but one woman had negative cultures for C. trachomatis, but a highly significant correlation (p less than 0.001) was evident between evidence of prior pelvic inflammatory disease (PPID) as documented by hysterosalpingograms and/or laparoscopy and the prevalence of chlamydial antibody. Furthermore, a significant (p = 0.01) correlation could be shown between the prevalence of the antibodies and adnexal adhesions. IUCD use could also be shown between the prevalence of the antibodies and adnexal adhesions. IUCD use could also be shown to correlate significantly (p less than 0.001) with PPID, and a detailed statistical analysis indicated that the two factors, antibody to C. trachomatis and a history of IUCD use, were independently related to PPID. Only about one third of the patients with PPID could ever recall having had an illness consistent with PID. Subsequent to the infertility workup, 76 of these women became pregnant and there was a significant (p less than 0.001) correlation between the occurrence of ectopic pregnancy and antibody to C. trachomatis. A significant (p = 0.01) correlation was also noted between a history of IUCD use and subsequent ectopic pregnancy. From these data it appears that antecedent infection with C. trachomatis, as measured by antibody prevalence, and a history of IUCD use are important factors in infertility of tubal origin and are also related to ectopic pregnancy.

Adult↗
PubMed1983

Topically administered acyclovir in the treatment of recurrent herpes simplex genitalis: a controlled trial.

Eighty-eight patients with culture-proven recurrent herpes simplex genitalis were entered into a collaborative, randomized, placebo-controlled, double-blind trial to evaluate the efficacy and toxicity of a topical formulation of acyclovir. Patients entered the study within 48 hr of the onset of lesions, and the study medication was applied six times daily for five days. The duration of virus shedding from lesions present at the time of entry into the study was significantly reduced for men who received acyclovir compared with men who received placebo (P less than 0.05). There were no significant differences between the acyclovir- and placebo-treated groups of either sex in time to crusting of lesions, time required for lesions to heal, time to cessation of pain, or in frequency with which new lesions developed during the course of therapy. Mild, transient burning or pain associated with application of the study medication was a common complaint.

Acyclovir↗
PubMed1983

Medical information management: improving the transfer of research results to presurgical evaluation.

We designed a medical information management (MIM) system to 1) identify high-risk patients (with cardiopulmonary dysfunction or undergoing major surgery), and 2) augment traditional mechanisms for referring high-risk patients to respiratory specialists. We define MIM as the combination of techniques that solicit, record, transfer, analyze, and distribute patient data according to designated protocols. A randomized trial compared 247 control subjects with 272 surgical patients assisted by information management. Data analysis focused on patients with cardiopulmonary impairment. The results showed that the MIM assisted patients received (1) more preoperative respiratory assessments (83.2 per cent vs. 9.2 per cent) than controls, 2) more preoperative respiratory therapy (37.9 per cent vs. 8.0 per cent) and 3) fewer postoperative respiratory complications (8.4 per cent vs. 16.1 per cent) than controls. These findings suggest that a MIM system can be an effective auxiliary mechanism for improving presurgical care.

Adult↗
PubMed1983

Transcutaneous muscle stimulation to retard disuse atrophy after open meniscectomy.

Immobilization of an extremity inevitably results in disuse muscle atrophy. The effectiveness of transcutaneous muscle stimulation by a portable device in preventing atrophy has been determined. Ten patients treated by open meniscectomy and given the usual isometric training were matched with ten patients in whom electrostimulation, consisting of a strong, tetanizing, five-second sustained muscular contraction about 400 times/day, was used for two weeks. Muscular strength and leg circumference were measured before surgery and four weeks after surgery. The electrically stimulated group had a significantly smaller loss of muscle volume and muscle strength, were able to walk earlier without crutches, had a greater range of knee motion, had much less postoperative knee swelling, and used significantly less pain medication. Transcutaneous electrical stimulation may prevent muscle atrophy due to immobilization, thereby shortening rehabilitation time.

Adult↗
PubMed1982

Controlled trial of oral acyclovir in the therapy of recurrent herpes simplex genitalis. A preliminary report.

A randomized, placebo-controlled, double-blind study was performed to evaluate the efficacy and toxicity of orally administered acyclovir in the treatment of patients with recurrent herpes simplex genitalis (HSG). A total of 107 patients from centers in Burlington, Vermont, and San Diego, California, were entered into the study within 48 hours of the onset of lesions. Patients who received acyclovir shed virus for 1.8 +/- 0.6 days (mean +/- SEM) compared with 2.8 +/- 1.2 days for those who received placebo. The duration of shedding from genital lesions of patients in the acyclovir-treated group was significantly less than from lesions of patients who received placebo (p = 0.016 by a logrank test). An analysis of the toxicity of the drug was performed in 52 of the study participants. Acyclovir was well-tolerated and no alterations were observed in measurements of bone marrow, liver, or kidney function. Orally administered acyclovir is a promising antiviral compound for the treatment of recurrent HSG.

Acyclovir↗
PubMed1982

Transcutaneous muscle stimulation as a method to retard disuse atrophy.

Thirty healthy, young adults (18 to 25 years of age), were volunteers in a three-group study to determine the efficacy of transcutaneous electrostimulation as a means of preventing atrophy of normal musculature on wearing a long-leg cast. Each group of ten subjects (five males and five females) were chosen by lot: Group I, nonisometric, Group II, isometric, Group III, TMS electrostimulated thigh and calf muscles. There was little difference in the findings in Groups I and II, and each lost an appreciable amount of muscle mass and power after just two weeks of immobilization. However, in the electrostimulated group muscle atrophy was one-half that of the other groups in the thigh area and one-fifth that of the others in the calf area. In addition, the calf musculature retained its bulk and power with actual increase in a few of the less athletic individuals. Trancutaneous muscle stimulation offers great promise for surgically treated or impaired extremities, enabling early return to activity with optimal function.

Adolescent↗
PubMed1981

Comparative pulmonary surfactant-inducing effect of three corticosteroids in the near-term rat.

Equivalent doses of dexamethasone, prednisolone, and betamethasone were given intraperitoneally to pregnant rats on day 20. Six dosage levels were selected: 0.4, 0.8, 1.6, 3.2, 6.4, and 12.8 mg/kg. Corticosteroids were diluted in saline solution containing 300 microCi of 3Hcholine. Twenty-four rats (18 experimental, six control) were killed on day 21, four viable fetuses were removed from each, and the four pairs of fetal lungs from each rat were pooled. Phospholipids were extracted and separated by thin-layer chromatography. Incorporation of 3Hcholine represented amounts of newly induced pulmonary lecithin and sphingomyelin. Results were expressed in terms of percentage change from control. Betamethasone appeared to be the most potent, with a statistically significant greater effect at the 6.4 mg/kg dosage level (two-factor analysis of variance, p = 0.03). There appeared to be a suppressive effect of all corticosteroids at the 12.8 mg/kg dosage level. If similar responses were observed in primates, the results would suggest that higher dosage levels of betamethasone (up to four times the presently recommended dose of approximately 0.34 mg/kg) might be more efficacious.

Animals↗
PubMed1981

Pulmonary function status of workers exposed to hardwood or pine dust.

Wood dusts may have substantial health impacts beyond those of nuisance dust. This project reports results linking pulmonary function changes with exposure to maple and pine dust. A cross-sectional survey of 1157 woodworkers was conducted in 1978 in accordance with NHLBI standards for respiratory epidemiologic surveys. Area dust levels were determined, permitting definition of groups exposed to estimated high, medium or low cumulative levels of dry hardwood or softwood dust. Prevalence of reduced (lower fifth percentile of normal) pulmonary function was ascertained, using prediction equations, for Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC and Maximal Mid-expiratory Flow Rate (MMEFR). Relationships between pulmonary impairment and dust exposure were examined, adjusting for smoking status by means of the log odds ratio method. The results support an association between dry hardwood or softwood dust exposure and reduced pulmonary flow rates. The odds ratios for reduced pulmonary function, comparing low and high hardwood (maple) dust exposure, were 3.12 for FEV1/FVC and 2.14 for MMEFR. Comparing low and medium hardwood exposure, the odds ratios were 2.61 for FEV1/FVC and MMEFR. Comparison of low and high softwood (pine) dust exposure yielded odds ratios of 4.03 for FEV1/FVC and 2.45 for MMEFR. The ratios noted are significant at p less than .05.

Adult↗
PubMed1980

Epidemiological survey of foot problems in the continental United States: 1978-1979.

Questionnaire cards were sent to 45,000 family shoe store customers; 15,000 cards were completed and returned, thereby permitting a broad statistical base in respect to the incidence and types of foot problems encountered in the United States. The incidence of corns, calluses, warts, ingrown toenails, bunions, hallux rigidus, hammer toes, cavus, and pes planus were correlated with age, sex, race, and demographic background, along with the incidence of surgery, conservative treatment, or no treatment. The extrapolated data indicated that 40% of the population have foot problems, of which 12% had surgery and 7% have been untreated.

Adolescent↗
PubMed1980

Quantification of the expanded role of the nurse practitioner: a discriminant analysis approach.

Graduates of a family nurse practitioner program and a sample of nonpractitioner nurses were compared in terms of their professional roles and concomitant attitudes. The stepwide discriminant analysis technique used in the study permitted adjustments for variables that affect nursing roles and provided a method for quantifying differences between the two groups of nurses. Role differences were characterized by the nurse practitioners' more frequent performance of functions relatively new to the nursing profession, such as physical assessment and prescription of medications, as well as functions more traditional to nursing. Among the latter were several dimensions of patient education and counseling. Attitudes of the nurses toward their own role also differed between the two groups and may reflect a commitment to professional growth on the part of the nurse practitioners which is not as prominent among their nonpractitioner counterparts.

Adult↗