Biomedical subjects
Publications and source records attributed to T Rogers.
Three cases of self-inflicted eye injuries are described and discussed. A review of the literature shows that several psychiatric diagnoses have been assigned to those who mutilate their eyes, and various unconscious mechanisms proposed to explain this unusual phenomenon.
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Methods of effective cardiovascular risk reduction that are suitable for use in clinical settings are needed. Several behavioral interventions were designed to be compatible with office-based medical practice, to be delivered by paraprofessional counselors, and to be of low intensity and low cost. Eighty-three hypercholesterolemic volunteers were assigned to one of three experimental conditions (face-to-face counseling, mail and telephone counseling, initial session only). Twenty-six nonrandomized subjects served as a no-contact group and were followed for 1 year. Participants in the first three groups received risk factor education, behavioral recommendations, and a packet of materials, while those in the face-to-face and mail/telephone counseling groups were contacted for five brief follow-up sessions over a 4-month period. At the 1-year follow-up evaluation, subjects in the face-to-face and mail/telephone counseling conditions showed decreases in plasma cholesterol of 6.2 and 4.6%, respectively (P less than 0.01), while the other two groups evidenced small increases. There were no differences by condition for plasma triglycerides, systolic or diastolic blood pressure, or weight. Low-intensity, low-cost behavioral interventions delivered by paraprofessionals can produce long-term decreases in a major cardiovascular risk factor. Physicians are encouraged to incorporate similar interventions into their practices.
Twenty-one clinical, biochemical, scan and tracer-kinetic parameters were documented in 76 patients with Graves' disease who had received a standard 5-mCi therapy dose of 131I. Linear discriminant analysis was then undertaken to determine what combination of variables best predicted outcome. One year after therapy, 40 patients were euthyroid, 11 were hypothyroid, and 25 were still thyrotoxic. Linear discriminate functions combining 24-h 131I uptake, the presence or absence of thyroid eye signs and a computer-derived measurement of thyroid cell mass best discriminated the three outcome groups. The proportion of patients correctly reclassified according to outcome using these functions was, however, only just over 50%. It is concluded that no single or combination of pretreatment variables predicts early outcome with sufficient confidence to justify a rigorously 'scientific' approach to the administration of 131I therapy for Graves' disease.
Previous measures of physical activity for epidemiologic studies were considered inadequate to meet the needs of a community-based health education trial. Therefore, new methods of quantifying the physical activity habits of communities were developed which are practical for large health surveys, provide information on the distribution of activity habits in the population, can detect changes in activity over time, and can be compared with other epidemiologic studies of physical activity. Independent self-reports of vigorous activity (at least 6 metabolic equivalents (METs) ), moderate activity (3-5 METs), and total energy expenditure (kilocalories per day) are described, and the physical activity practices of samples of California cities are presented. Relationships between physical activity measures and age, education, occupation, ethnicity, marital status, and body mass index are analyzed, and the reliabilities of the three activity indices are reported. The new assessment procedure is contrasted with nine other measures of physical activity used in community surveys.
Indirect, biochemical measures of cigarette use are valuable in confirming smoking status in both cross-sectional and cessation studies. This study compares two such biochemical markers, expired-air carbon monoxide (CO) and plasma thiocyanate (SCN), in a representative population sample of 2,237 adults (ages 18-74) from the baseline survey of the Stanford Five City Project. CO and SCN are both significantly higher in self-reported smokers than in nonsmokers and correlate well with number of cigarettes smoked per day. CO appears to be more sensitive and specific than SCN in comparison to self-report, and CO misclassifies a significantly smaller number of nonsmokers, regular smokers, and light smokers (less than 9 cigarettes per day) than does SCN. Together, CO and SCN better classify smokers and nonsmokers than do either alone. Neither biochemical is a reliable indicator in irregular smokers (no cigarettes in past 48 hr). Despite its much shorter metabolic half-life, CO is a better indicator of cigarette use than is SCN in this cross-sectional study. CO is generally simpler and less expensive to measure than is SCN, and CO may be a preferable indirect measure of smoking status in some studies of smoking cessation.
Behavioral obesity researchers are increasingly concerned with thorough assessment of obesity. The present report describes the preliminary testing and refinement of the Master Questionnaire (MQ), a true-false scale developed expressly for use in obesity research. It was initially divided into four subscales: Spouse Support, Energy Balance Habits, Cognitive Factors, and Energy Balance Knowledge, and was intended for use as an outcome measure and as a predictor of change in obesity status. Its stability, internal consistency, sensitivity to treatment-related change, and predictive validity were examined. Test-retest reliability and sensitivity to treatment-related change were each found to be acceptable for three out of four subscales. Two subscales, Energy Balance Knowledge and Cognitive Factors, predicted outcome. The major weakness of the subscales was a lack of unidimensionality which would limit their utility. Cluster and factor analyses were used to develop five new subscales with acceptable levels of internal consistency. While some additional development and validation is still needed, the available evidence suggests that we have the nucleus of a strong assessment tool for obesity research.
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A clinical isolate of Staphylococcus aureus was resistant to gentamicin, kanamycin, and tobramycin by virtue of the production of a drug-inactivating enzyme. Attempts to establish the cellular location of the genetic determinants for enzyme synthesis have given equivocal results.
Swiss-Webster white mice were intravenously infected with various doses of Candida albicans, and the viable units in their spleens, livers, lungs, and kidneys were determined at various intervals after challenge. The results showed that C. albicans multiplied to a greater extent in the kidneys of mice than in their spleens, lungs, or livers. The infection in mice was chronic; increasing numbers of C. albicans were observed in their kidneys until about 17 to 24 days postchallenge. Clearance of C. albicans from infected kidneys was not symmetrical, since the number of viable C. albicans in one kidney did not coincide with the viable counts observed in the opposite kidney of that same animal. Male and female mice did not differ in their overall susceptibility (50% lethal dose test) or in the number of viable C. albicans in the kidneys at various time intervals after infection. C. albicans also multiplied in the kidneys of germfree rats; however, the peak of the C. albicans infection in their kidneys occurred earlier than in those of conventional mice.
The renin-angiotensin-aldosterone system and electrolyte levels in 11 patients with heart failure controlled on digoxin and frusemide were investigated after separate periods of Slow K, spironolactone, and amiloride therapy. When spironolactone or amiloride replaced Slow K, distinct parallel increments in the levels of renin, angiotensin II, and aldosterone resulted. Though plasma potassium was generally higher after spironolactone and amiloride than after Slow K, exchangeable potassium was similar with the three regimens. There was no significant relation between plasma potassium and concurrent exchangeable potassium.
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