Biomedical subjects
Publications and source records attributed to A Paredes.
Physiologic changes after ingestion of alcohol were monitored in Chinese and white volunteers, and absorption rate, acetaldehyde concentration, facial flushing, and heart rate increases were correlated.
Benefit--cost analysis as a form of "social profitability analysis" can be a powerful tool in the overall evaluation of alcoholism treatment efforts. Alcoholism treatment potentially leads to a multiplicity of benefits in addition to sobriety. Benefit--cost analysis provides a methodology for converting many of these diverse benefits into a common metric (dollars), thereby allowing the comparison of aggregate benefits and treatment costs. The analysis thus leads to the expression of treatment outcome in terms of the return on investment. A benefit--cost analysis conducted on 3034 clients from the Oklahoma data base indicated a return to society of $1.98 for every $1 invested in alcoholism treatment. Such data may represent a critical portion of the information required for responsible resource allocation decisions.
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The association between therapeutic effort measured in terms of reimbursements for services and several treatment outcome variables was examined. A sample of clients regarded as definitely alcoholic was grouped into five categories according to the amount of money reimbursed for treatment in a fee-for-service arrangement. A systematic positive relationship was found between the amount of treatment measured in dollars and therapeutic outcome measured by remission rate and income. The data suggest that there may be an optimal cutoff for resource investment, above which no further treatment gains are achieved. Such information can provide a basis for program management decisions and suggests important implications for assumptions regarding alcoholism.
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Asked U.S., British, and Mexican male students of college age to discriminate among three affective displays presented by 10 schizophrenic and 10 normal U.S. women. Significant main effects for diagnostic category, nationality of judge and for the interaction of nationality and diagnostic category were obtained. Furthermore, U.S. judges did significantly better in judging normals as compared to schizophrenics, British judges tended in the same direction, and Mexican judges did not. Co-nationality and national similarity confer an advantage in judging normals as compared to schizophrenics. The data have relevance for questions about the effects of sending and receiving nonverbal emotional messages on communications or miscommunications between doctor and patient, doctors from different cultures and people including conference negotiators, from different national backgrounds.
In two experiments, independent groups of male social drinkers were administered equal doses of ethanol per unit of body weight (0.66 ml/kg) at different times during the day. Peak blood alcohol concentration (BAC) was achieved, and the time taken to return to a BAC of 20 mg/100 ml and the rate of ethanol metabolism per hour were determined.
Differences in tribal culture, history and settlement may explain why Indians in eastern Oklahoma have lower rates of alcohol-related arrests and deaths than do Indians in the western part of the state.
Seventy-nine high-risk children were immunized with either commercial, bivalent, split-product influenza A vaccine or purified hemagglutinin-neuraminidase bivalent influenza A vaccine, and 78 of these subjects were immunized with commercial, monovalent, influenza B split-product vaccine. The reactogenicity of all three vaccines was low, and there were no severe reactions. Twenty-nine subjects who received hemagglutinin-neuraminidase vaccine as their initial dose and commercial split-product vaccine as a booster dose had significantly lower antibody responses to influenza A/New Jersey/76 virus than subjects who received two doses of commercial split-product vaccine. The responses of the two groups to influenza A/Victoria/75 virus were comparable. Twenty-four subjects with malignancy who were receiving chemotherapy were compared with a group of subjects matched for age and vaccine preparation. Patients with cancer had significantly lower antibody responses to A/New Jersey/76 virus than patients without cancer. The ultimate responses of patients with cancer to A/Victoria/75 and B/Hong Kong/72 viruses were comparable to those of other patients, but early responses were lower.
The development of antibody in response to invasive infection with type III strains of group B Streptococcus was studied in sera from 31 infants and 4 adults by means of a quantitative radioactive antigen-binding assay. Low concentrations of antibody were consistently found in the acute sera of patients who developed clinical illness. Although adults with puerperal sepsis and infants with bone or joint infection uniformly demonstrated significant rises in serum antibody concentration after recovery, much lower levels of antibody were detected in convalescent sera from infants recovering from meningitis or sepsis. The median antibody concentration in sera from 43 parturients with type III strains of group B Streptococcus isolated from vaginal cultures whose neonates failed to develop symptomatic disease was significantly greater than that in sera from 29 mothers of infants with invasive, type III, group B streptococcal infection. Study of paired maternal and cord sera demonstrated a significant correlation between the antibody concentration in a mother's serum and that in her neonate.
In a double-blind, placebo controlled design in chronic schizophrenic inpatients using 50 mg. and 100 mg. LOX, an attempt was made to replicate the findings of a previous study and to establish the dose-level and duration of treatment optimal for this kind of patient. Multiple regression analysis adjusting for dose, age, duration of illness, and baseline values indicated that 100 mg. LOX was an effective dose as previously shown. In contrast to the previous study, significant response effects were found by the 4th week. In addition, the dose was linearly related to response on nearly all the variables. The principal side effects were drowsiness and extrapyramidal signs.
Group B streptococcal colonization of normal newborn infants increased from 22.5% within 20 hours of birth to 65.4% at the time of hospital discharge (P less than .001). In contrast, colonization in mothers did not change significantly between the time of admission to labor and delivery (27.7%) and the time of discharge (31.1%). Epidemiologic data suggested but did not prove that the mode of nosocomial transmission of group B streptococci among infants was cross colonization via personnel contact.
In a double-blind placebo controlled study of newly admitted chronic schizophrenics, an attempt was made to further evaluate the safety, acceptability, and effectiveness of BT in doses of 10, 20, and 40 mg. Significant dose related responses occurred on several behavioral variables by the first week of treatment. Maximum clinical response appeared to be at the 20-40 mg. dose level. Extrapyramidal signs occurred at all doses, but with greater severity at higher doses. Excessive daytime drowsiness occurred in all groups but with longer duration and greater intensity in the 20 mg. group. Rebound insomnia occurred after the abrupt withdrawal of BT at all dose levels suggesting the desirability of further study of its hypnotic properties.
Serial cultures were obtained from 12 patients being treated with a form of penicillin for group B streptococcal disease or asymptomatic colonization. These cultures were collected prior to initiation of therapy, during therapy, and at the end of the treatment period. Pencillin eradicated GBS from the involved system (blood, CSF, bone, and joint). Cultures remained positive from at least one of three carrier sites (throat, umbilicus, and rectum) in 70% of patients cultured between days one and eight of treatment and 66% between days 10 and 21. These data demonstrate the failure of penicillin to eradicate GBS from mucous surfaces of young infants.
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For more than 30 years, penicillin has been the agent of choice for pneumococcal infections. During this time the majority of strains of Streptococcus pneumoniae have been highly susceptible to penicillin. However, during the last ten years there have been sporadic reports of pneumococci with increased resistance to penicillin. The case report of an 18-month-old white boy with meningitis due to a strain of S. pneumoniae with increased resistance to penicillin is presented. The MIC of the organism to penicillin was 0.2 mug/ml and the MBC 0.39 mug/ml. The patient had normal immunity and no demonstrable sequestered focus of infection but failed to respond to appropriate doses of intravenous penicillin. Treatment with chloramphenicol caused a dramatic bacteriologic and clinical response. This experience reemphasizes the existence of pneumococcal strains of intermediate penicillin sensitivity and the importance of in vitro susceptibility tests.
The standard drug Stelazine (STEL), at a dose of 50 mg/day, exhibited therapeutic activity significantly different from placebo (PL) activity on several variables, most notably BPRS, attesting to the sensitivity of the experiment. On the other hand, the investigational drug, loxapine (LOX), in doses of 100 mg/day for four weeks, could be differentiated from PL as treatment in the described population on only one variable (NGI-Imp.) and one item of the BPRS. On several variables, positive trends were noted, but the differences from PL did not attain the critical values necessary for statistical significance at P smaller than 0.05. One might speculate that the relatively short duration of treatment in this study might account for the difference between these disappointing results and the more gratifying results of a previous loxapine study in chronic long-term institutionalized schizophrenics with the same oral dose.