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Biomedical subjects

T Miller

Publications and source records attributed to T Miller.

At least 127 records · Page 7Linked to original sources
PubMed1995

Impact of parental smoking on the prevalence of wheezing respiratory illness in children.

To quantitatively assess environmental tobacco smoke exposure from parental smoking as a risk factor for asthma or wheezing in childhood, and to derive estimates of excess asthma/wheezing lower respiratory tract illness cases attributable to this risk factor, a cross-sectional analysis of the 1987 National Medical Expenditure Survey (a national probability sample of the civilian, noninstitutionalized US population) was undertaken. The National Medical Expenditure Survey included 7,578 children and youth less than 18 years of age in a stratified cluster sampling of US households. After using logistic regression analysis to control for sex, race/ethnicity, region of residence, population density, poverty status, maternal educational level, family size, and father's current smoking status, children whose mothers smoked at the time of the survey were more likely than children of nonsmoking mothers to experience wheezing respiratory illness (odds ratio = 1.36, 95% confidence interval 1.14-1.62). The association was greatest among children less than 2 years of age. The authors' estimate of the attributable risk in the US population indicates that maternal smoking is responsible for approximately 380,000 excess cases of childhood asthma/wheezing lower respiratory tract illness or 7.5% of the total number of such symptomatic children.

Adolescent↗
PubMed1995

Bacterial peritonitis in continuous ambulatory peritoneal dialysis: effect on dialysis on host defense mechanisms.

We have used an experimental model of continuous ambulatory peritoneal dialysis (CAPD) to investigate the effect of dialysis on host defense mechanisms in the peritoneal cavity. Laboratory rats undergoing regular dialysis were challenged with a single bolus of Staphylococcus epidermidis, Staphylococcus aureus, Candida albicans, and Pseudomonas aeruginosa. Intraperitoneal challenges with all four microbial strains underwent a rapid clearance during the first 4 hours, irrespective of whether the host was undergoing dialysis. Studies using S epidermidis showed that the rapid clearance was not mediated by the diaphragmatic stomata as might have been expected. Dialysis did, however, cause delays over the following 48 hours with all of the pathogens except C albicans. Bacterial clearance over a 10-day period was strain dependant, and microbial persistence was related to adhesion formation around the cannula. Again C albicans was an exception. Our conclusions are that dialysis does not affect the innate defense mechanisms involved in the early clearance of a bolus challenge to the peritoneal cavity but can cause delays in eradicating microorganisms that survive this phase. Because these experiments were carried out using a bolus inoculum, it may be necessary to reevaluate the effect of dialysis on host defenses in the peritoneal cavity under conditions in which the challenge more closely approximates a touch contamination event.

Animals↗
PubMed1995

Accuracy of presumed uveal melanoma diagnosis before alternative therapy.

AIMS/BACKGROUND: This study was performed to ascertain the diagnostic accuracy rate of non-invasive tests in patients with presumed uveal melanomas scheduled to be treated with either irradiation or cyclochoroidectomy. METHODS: One hundred consecutive patients who had non-invasive tests followed by fine needle aspiration biopsy (FNAB) as prior alternative treatment were analysed retrospectively. RESULTS: In 86 cases the diagnosis of uveal melanoma was confirmed on FNAB. In five cases false negative results were obtained. In nine patients a diagnosis other than a uveal melanoma was made on the basis of cytopathology. No significant morbidity and no evidence of tumour spread occurred. CONCLUSION: In presumed uveal melanomas eligible for treatment with alternative therapies, the diagnostic accuracy of non-invasive tests is not as good as with larger tumours that require enucleation. Fine needle aspiration biopsy data resulted in correct management of 9% of cases that were thought to have uveal melanomas on non-invasive tests, but had other lesions on cytopathological evaluation.

Biopsy, Needle↗
PubMed1995

Unreliability of the abdominal fat pad biopsy in the evaluation of nephrosis: report of 3 consecutive cases.

In the workup of unexplained nephrotic syndrome in the elderly patient, renal biopsy has shown amyloidosis to be the cause in 15-30% of the cases. Most of the cases of amyloidosis are primary and are, therefore, treatable with alkylating agents, albeit at a high level of toxicity. Abdominal fad pad biopsy has been suggested as a minimally invasive, low-cost method for diagnosing amyloidosis that is 100% specific. We report our experience with 3 consecutive cases of fat pad biopsy in the workup of unexplained nephrosis in the elderly patient: including the first false positive reported with respect to nephrotic renal disease, a false negative, and a true positive. We feel that in an elderly patient with unexplained nephrosis though the abdominal fat pad biopsy may be helpful, the patient should not be committed to a regimen with potentially very high toxicity on the basis of a positive fat pad biopsy alone. We recommend that the more invasive renal biopsy be performed should therapy with alkylating agents be contemplated.

Abdomen↗
PubMed1995

The precision of practice analysis results in the professions.

A practice analysis, in which an appropriate sample of professionals is asked to describe what they do in their practices, is considered an essential part of the content-related validity evidence for licensure and certification tests. This article examines the precision of estimates of the mean frequencies for categories of activities in an activity inventory administered on two occasions about 6 weeks apart. In particular, it explores the variability in estimates of the mean frequencies for categories due to the sampling of respondents, activity statements, and occasions. The results suggest that samples of 200 respondents, about 10 to 20 activity statements per category, and one occasion are adequate for estimating the mean frequency for each category.

Analysis of Variance↗
PubMed1994

Toward a comprehensive biomechanical injury cost model.

The proposed biomechanical injury cost model utilizes surrogate-based injury assessment functions to predict the probability of occurrence and the probable cost of specific injuries to the head, thorax, abdomen, and lower extremities. The resulting probability cost is a function of the number, location, and severity of injuries. As more precise injury assessment functions and more accurate cost estimates become available, the model will become an effective tool for comparing and classifying different injury patterns.

Abbreviated Injury Scale↗