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Biomedical subjects

C Casey

Publications and source records attributed to C Casey.

At least 19 recordsLinked to original sources
PubMed2001

Perceptions about risk for HIV/AIDS among adolescents in juvenile detention.

Although progress has been made toward reducing risk-taking behavior among teens, adolescents confined in juvenile detention facilities and youths living in inner cities remain vulnerable. Reaching these populations with appropriate risk-reduction strategies continues to challenge health providers and educators. Crucial first steps in the design of relevant programs involve discovering how at-risk teens perceive risk and which risks and dangers within their communities occupy their attention. Participants in this study did not identify HIV/AIDS as a primary concern; instead, they described the dangers and risks they encountered in their home neighborhoods. Based on these findings, this discussion addresses the implications for the development of health education programs to empower teens for responsible behavior after release from detention.

Adolescent↗
PubMed1999

Evaluating the outcomes of parent-child family life education.

Conducted in diverse sociocultural communities in Los Angeles County, the project implemented and evaluated a family life education program designed to prevent the negative outcomes of risky sexual behavior. A sample of 251 male and female early adolescents 9 through 14 years of age participated with their parents in this abstinence-based adolescent pregnancy prevention program. The project sought to improve parent-child communications and delay the onset of sex-related behaviors through direct involvement of parents in the education process. Naturally occurring community groups were randomly assigned by site to treatment or delayed treatment conditions in a longitudinal quasi-experimental evaluation design. The evaluation demonstrated significant improvements in communication between parents and children immediately following the intervention; however, these improvements were no longer present 12 months postintervention. The process and outcome evaluation methods employed in the study triangulated qualitative and quantitative data collection and analysis procedures. This combination provided other sources of data than the traditional outcome measures used in most evaluation studies, thus addressing some of the gaps in present program evaluations. Descriptions of the process evaluation, integrated with the outcome data, are intended to heighten nurses' awareness of the importance of this component of research and the rich qualitative data it may yield. The qualitative process components in the project captured the experience of the investigators when they encountered many of the complex challenges that confront researchers who implement and evaluate family life education programs among early adolescents. This experience provided the basis for suggested strategies that nurse clinicians and researchers can use in their work with early adolescents and their parents in clinical-, school-, and community-based settings.

Adolescent↗
PubMed1994

Prognostic indicators of survival in advanced endometrial cancer.

Advanced endometrial cancer represents 14% of all stages but 54% of all deaths attributed to endometrial cancer. From 1973 to 1990, the charts of 137 patients with endometrial cancer (Stage III and IV) treated by the section of Gynecologic Oncology at Rush Medical College were retrospectively reviewed. The log rank method was used for univariate analysis and Cox proportional hazards regression was used for multivariate analysis. The patients were stratified as follows: Stage III, 92 (67.2%), Stage IV, 45 (32.8%); Grade 1, 15 (10.9%), Grade 2, 47 (34.3%), Grade 3, 67 (48.9%); adenocarcinoma, 93 (67.9%), adenosquamous, 18 (13.1%), adenoacanthoma, 2 (1.5%), clear cell, 1 (0.7%), papillary serous, 23 (16.8%). Using univariate analysis, median survival was 1.71 years for Stage III versus 0.68 years for Stage IV. Median survival based on treatment was as follows: radiotherapy (RT) only (n = 16), 0.89 years, surgery only (n = 36), 0.75 years, preoperative RT+surgery (n = 7), 2.5 years, surgery+postoperative RT (n = 56), 2.63 years, and other treatments (hormonal only n = 12, chemotherapy only n = 1, and no treatment n = 9), 0.6 years. Patients with vaginal extension survived a median of 0.82 years, versus 2.49 years without this factor (P = 0.002). Patients with clinically apparent parametrial involvement survived a median of 0.70 years versus 2.65 years without this factor (P = 0.0003). Multivariate analysis was possible via a surgical database (n = 99). Age > 60 (P = 0.01), parametrial involvement (P = 0.04), and abdominal metastases (P = 0.003) were significant prognostic indicators. Papillary or clear cell histology, advanced grade, and mode of treatment were not significant. Patients with abdominal metastases or parametrial extension of tumor have a significant decrease in mean survival.

Age Factors↗
PubMed1994

Vaginal prostaglandins for the ripe cervix.

OBJECTIVES: To assess the efficacy of vaginal prostaglandin (PGE2) tablets for induction of labor in the presence of a ripe cervix. METHODS: A randomized controlled trial was performed. Two hundred and nine consecutive women undergoing induction of labor with a Bishop Score > or = 5 were randomly assigned to (a). Study group receiving PGE2 tablets (n = 106) and (b). Control group having artificial rupture of membranes only (n = 103). The duration of labor, oxytocin and analgesia requirements, the mode of delivery, complications and duration of confinement were recorded. RESULTS: Mean duration of first stage of labor was shorter in parous patients in the study group (194 min v. 319 min), as was the mean induction delivery interval in primigravidas. Oxytocin was used in 75% of primiparas and 40% multiparas in the study group compared with 100% and 80%, respectively, in the controls. Epidural analgesics and instrumental delivery rates were also reduced. CONCLUSIONS: The use of vaginal PGE2 tablets for induction of labor with a ripe cervix is associated with a shorter first stage of labor and with reduced requirements for oxytocin, analgesia and instrumental delivery.

Administration, Intravaginal↗
PubMed1994

Calcium partitioning in human and bovine milk.

The partitioning of calcium in human milk was studied experimentally and compared with the distribution of calcium among the compartments of bovine milk. Care was taken to handle the milk samples to produce minimal disturbance of the milk fat globule membranes and the CO2 content. About 15% of the milk calcium was associated with casein in human milk; the remainder was in the aqueous phase. The equilibrium between ionized calcium and calcium complexes with smaller anions was examined. Ionized calcium varied between 2.3 and 4.0 mM across individuals (mean 3.0 +/- .1 mM) at 90 d of lactation. The remainder of the calcium in the aqueous phase was associated with citrate and phosphate. Changes in total calcium in human milk during lactogenesis and late lactation reflected changes in citrate and casein rather than alterations in ionized calcium.

Animals↗
PubMed1993

Inhibition of microtubule sliding by Ni2+ and Cd2+: evidence for a differential response of certain microtubule pairs within the bovine sperm axoneme.

Bovine sperm, extracted with 0.1% Triton X-100, frozen at -20 degrees C for 48-120 hours, and thawed, disintegrated by microtubule sliding when 1 mM MgATP was added. Microtubules and outer dense fibers (ODFs) were usually extruded in groups or "bundles". A total of 44.5% of the cells extruded two distinct bundles, one from each side of the connecting piece, exhibiting opposite curvatures. Only one bundle was observed in 46.2% of the cells, and 9.2% showed no signs of sliding. Transmission electron microscopy (T.E.M.) showed one group consisting of the 4,5-6,7 elements, with the 9,1,2 elements on the other side of the axoneme making up the other bundle. T.E.M. revealed that when only one side of the axoneme had extruded elements, they were always from the 4,5-6,7 group. The remainder of the axoneme (8,9,1,2,3 and the central pair) was left relatively intact, suggesting a difference in the sliding response of the nine pairs of axonemal microtubules. These results indicate a predisposition for sliding between elements 7 and 8 over that between doublets 2 and 3, perhaps due to a disparity in activation thresholds. Also, both Ni2+ and Cd2+ appear to selectively block activation of 2-3 interdoublet sliding. Incubation with 0.25 mM Ni2+ prior to adding MgATP modified the percentages of sliding patterns: 8.6% demonstrated two-sided extrusion, 58.2% showed one-sided, and 33.2% had no extruded bundles. Again, when half the axoneme was missing, it was always the 4,5-6,7 group. Ten micromolar Cd2+ altered the sliding pattern similarly to Ni2+, with 28% two-sided extrusion, 55.9% one-sided extrusion and 16.1% with no extruded bundles. Either pretreatment regimen impeded extrusion of the 9,1,2 group in a high percentage of cells, compared to untreated cells. This specific inhibition of the 9,1,2 side by Ni2+ or Cd2+ is especially significant since Ni2+ also inhibits spontaneous wave initiation in bull sperm (Lindemann et al.: Journal of Cell Biology 87:420-426, 1980), and both Ni2+ and Cd2+ reportedly block the flagellar Ca(2+)-response in rat sperm (Lindemann and Goltz: Cell Motility and the Cytoskeleton 10:420-431, 1988; Lindemann et al.: Cell Motility and the Cytoskeleton 20:316-324, 1991).

Adenosine Triphosphate↗
PubMed1991

Genomic structure of the human prion protein gene.

Creutzfeld-Jacob disease and Gerstmann-Sträussler syndrome are rare degenerative disorders of the nervous system which have been genetically linked to the prion protein (PrP) gene. The PrP gene encodes a host glycoprotein of unknown function and is located on the short arm of chromosome 20, a region with few known genes or anonymous markers. The complete structure of the PrP gene in man has not been determined despite considerable interest in its relationship to these unusual disorders. We have determined that the human PrP gene has the same simple genomic structure seen in the hamster gene and consists of two exons and a single intron. In contrast to the hamster PrP gene the human gene appears to have a single major transcriptional start site. The region immediately 5' of the transcriptional start site of the human PrP gene demonstrates the GC-rich features commonly seen in housekeeping genes. Curiously, the genomic clone we have isolated contains a 24-bp deletion that removes one of five octameric peptide repeats predicted to form a B-pleated sheet in this region of the PrP. We have also identified 5' of the PrP gene an RFLP which has a high degree of heterozygosity and which should serve as a useful marker for the pter-12 region of human chromosome 20.

Amino Acid Sequence↗
PubMed1990

Early detection of acute myocardial infarction: additional diagnostic information from serum concentrations of myoglobin in patients without ST elevation.

The value of the 12 lead electrocardiogram, serum total creatine kinase, creatine kinase MB isoenzyme, and myoglobin for the early detection of infarction was evaluated within one hour of admission to the coronary care unit in 82 consecutive patients with suspected myocardial infarction. The 51 patients in whom infarction was diagnosed during the first 24 hours after admission had a higher prevalence of ST elevation (64% v 11%), higher median serum myoglobin (136 micrograms/l v 34 micrograms/l), higher serum creatine kinase (77 IU/l v 34 IU/l), and higher MB isoenzyme (7 IU/l v 4 IU/l) than those in whom it was not. Stepwise logistic regression analysis in 70 patients in whom the electrocardiogram and serum myoglobin were suitable for analysis showed that serum myoglobin was the variable most closely associated with infarction, and contributed additional diagnostic information when ST elevation was entered into the model first. Serum myoglobin remained associated with myocardial infarction when patients who had had symptoms for less than six hours were analysed. An algorithm based on a rapid agglutination test for myoglobin and ST elevation on the electrocardiogram gave an accurate diagnosis in 82% of patients. This approach gave early and rapid recognition of acute myocardial infarction and warrants further examination.

Clinical Enzyme Tests↗
PubMed1989

An enzyme-linked immunosorbent assay (ELISA) for the measurement of serum antibodies to growth hormone. The Wessex Growth Study.

A solid-phase enzyme-linked immunosorbent assay for measuring antibodies to growth hormone (GH) was developed, with occasional use and long shelf-life in mind. With coating protein concentration optimised, the standard curve was linear over a 25-fold range of concentration. The interassay coefficient of variation ranged from 14.4% to 9.3%. The specificity of the assay was confirmed by the substitution of insulin for GH as coating protein and by preabsorption of sera with GH coupled covalently to Sepharose beads. There was no binding signal with insulin and absorption was dose dependent, maximum (greater than 80% complete) with 2 x 10(4) micrograms GH/ml undiluted serum. The assay was simple to perform, cheap and reliable.

Antibodies↗
PubMed1989

Delivery following cesarean section and perinatal mortality.

The perinatal mortality in 1498 patients with one or more previous cesarean section scars delivered between 1972 and 1982 was analyzed. Repeat elective cesarean section was performed in 654 (44%) patients and 844 (56%) were subjected to a "trial of scar." Successful vaginal delivery occurred in 702 (83%) patients and 142 (17%) had emergency repeat operations. There were 46 perinatal deaths, giving a perinatal mortality rate (PMR) of 30.3/1000. It was lowest in patients who electively had a cesarean section (10.6/1000). The corrected PMR was twice as high in the trial of scar group. The PMR for the overall hospital population (27,072 babies) during the study period was 22.5/1000. There were four perinatal deaths in association with dehiscence of the uterine scar. The PMR in trial of scar patients decreased from 40/1000 to less than 20/1000 without a major change in policy. Meanwhile the unit cesarean section rate increased from 5 to 10%, but the repeat section rate was consistent at around 38.5%. Regional analgesia was used in 192 patients, for repeat section in five and trial of scar in 187. Oxytocin was given to 546 (65%) patients. Scar rupture is considered the major contraindication to a trial of scar, but emphasis was not laid on the possible increased perinatal mortality with this procedure before the 1980s. In view of the improvement in the PMR and the added risk to the mother with cesarean delivery, we advocate a policy of trial of scar with informed consent in selected cases.

Cesarean Section↗