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Biomedical subjects

C Frederick

Publications and source records attributed to C Frederick.

At least 19 recordsLinked to original sources
PubMed2004

Effect of the oral contraceptive pill on patients undergoing controlled ovarian hyperstimulation.

This is a retrospective analysis of 89 patients who were undergoing controlled ovarian hyperstimulation for in vitro fertilization and embryo transfer in the Fertility Management Unit of the Department of Obstetrics, Gynaecology and Child Health, The University of the West Indies. Twenty-eight patients (Group A), who did not receive oral contraceptive pills prior to controlled ovarian hyperstimulation (COH) were compared with 61 patients in Group B treated with oral contraceptive pills for two months prior to undergoing COH assisted reproduction using the long protocol. The number of follicles, oocytes, estimated oestradiol levels on the day of administration of human chorionic gonadotrophin (hCG), pregnancy rates, miscarriage rates and the incidence of patients who developed ovarian hyperstimulation syndrome (OHSS) were the main outcome measures. The mean age and haematocrit were the same in each group. The number of follicles retrieved tended to be higher in Group A than in Group B (median 8 versus 6, p = 0.06) with significantly more oocytes being retrieved in Group A than Group B (p < 0.05). There were no statistically significant differences between the two groups in oestradiol levels, the proportion of patients with polycystic ovarian disease, the proportion of women who developed ovarian hyper-stimulation syndrome or pregnancy outcomes. There was no difference between the groups in measures of clinical severity of OHSS. In a logistic regression model the significant predictors of OHSS were haematocrit and oestradiol levels. There appeared to be no significant clinical benefit in administering oral contraceptive pills for two months to patients prior to COH.

Adult↗
PubMed2002

Operative morbidity and reproductive outcome in secondary myomectomy: a prospective cohort study.

BACKGROUND: This prospective study was designed to evaluate the operative morbidity and reproductive outcome in patients who had secondary myomectomy for recurrent symptomatic uterine fibroids. METHODS: A total of 58 women were subjected to a secondary myomectomy via the abdominal route. The operative morbidity such as blood loss, presence of adhesions and febrile index were estimated and the pregnancy outcome over a 2-4 year period of follow-up. RESULTS: The mean age and standard deviation (+/- SD) of the women was 35 (+/- 2.4) years. Nineteen patients (33%) had a postoperative temperature vertical line 100 degrees F and the estimated blood loss ranged from 159-2500 ml (median 700 ml). Seven patients (12%) required blood transfusion and one had a hysterectomy due to haemorrhage. Nine women (15.5%) became pregnant but only five (56%) had live births. Those with successful pregnancies tended to be younger with a mean age of 31.8 (+/- 2.6) years versus 35 (+/- 1.8) years, (P = 0.08, non-significant) and had fewer uterine leiomyomata; median with range values, 2 (1-6) versus 7 (6-15). The variables which best predicted the postoperative likelihood of pregnancy were; age, presence of tubal adhesions and the number of uterine fibroids. CONCLUSION: This prospective study showed a high operative morbidity and a poor fertility outcome after a repeat myomectomy. The factors affecting successful outcome in a logistic regression model were age, tubal adhesions and number of uterine fibroids.

Adult↗
PubMed2001

Form-specific visual priming in the left and right hemispheres.

Word fragment completion performance was examined for items that were presented in the same or different letter case at study and test. During the study phase words and nonwords were presented at central fixation, then during the test phase a divided visual field technique was used in which word fragments were presented briefly to the right hemisphere (left visual field) or the left hemisphere (right visual field). Previous research using the word stem completion task indicated that only the right hemisphere was sensitive to case changes in words from study to test. In contrast, the current results indicate that in the fragment completion task the priming effects for the test items presented to either hemisphere were greater when the fragments were in the same compared to different letter case at study and test. These results indicate that both hemispheres are capable of supporting form-specific visual implicit memory.

Brain↗
PubMed2001

In vitro fertilization. The Jamaican experience.

In June 2000, twenty-eight infertile couples were treated by in vitro fertilization and embryo transfer at our initial assisted reproduction programme carried out in conjunction with Midland Fertility Services, Aldridge, Birmingham, England. A pre-requisite for treatment was that on day 3 of the menstrual cycle the levels of follicle stimulating hormone (FSH) and oestradiol (E2) should be < 10 i mu/l and < 100 pg/ml respectively in the female partner. The ages of the women ranged from 26 to 42 years with a mean age of 35.5 years. Down regulation was carried out by using buserelin acetate 0.5 microgram subcutaneously from day 21 of the cycle for 21 days. This process was completed when the ovaries and pituitary gland were quiescent and the endometrial thickness < 4 mm in diameter. On completion of down regulation the gonadotrophin hormone, pergonal (dosage of 150-450 units) was used for ovarian hyperstimulation. A total of 294 oocytes (mean of 10.5, range 2-45) were retrieved of which 138 were fertilized (mean of 4.9, range of 0-28). Twenty-four patients each received a mean of two embryos. Five patients (20.8%) had positive pregnancy tests. Three patients (0.1%) developed ovarian hyperstimulation syndrome (OHSS), one had the severe, and two, the mild form of the syndrome. All three cases were treated successfully. The success at the initial IVF controlled ovarian hyperstimulation augers well for the future of infertile couples seeking treatment at the Fertility Management Unit, The University of the West Indies, Jamaica.

Adult↗
PubMed1999

Attitudes of veterinary medical students, house officers, clinical faculty, and staff toward pain management in animals.

OBJECTIVE: To determine whether animal factors and level of professional veterinary medical training were associated with attitudes toward pain management in animals. DESIGN: Exploratory, descriptive survey. SAMPLE POPULATION: Students in the College of Veterinary Medicine and Biomedical Sciences professional veterinary medical curriculum (approx 540) and clinical faculty (approx 50), house officers (approx 25), and support staff (approx 100) in the Colorado State University Veterinary Teaching Hospital. PROCEDURE: A descriptive survey including demographic, descriptive, and case-based questions was distributed to participants. Participation was voluntary and survey results were anonymous. RESULTS: 357 of 720 surveys were completed and returned (31 by faculty, 29 by staff, 18 by house officers, and 279 by students). There was a high degree of concordance among survey participants regarding the overall importance of treating pain in animals. The extent to which pain should be alleviated and animal factors, such as breed, behavior, and clinical circumstances, accounted for much of the discordance among survey groups. Fourth-year veterinary students indicated that they were occasionally less likely to treat animals for pain than were second- or third-year veterinary students. CLINICAL IMPLICATIONS: The diversity of opinions regarding the necessity or desirability of treating pain in animals, the apparent decrease in the likelihood of senior veterinary students to treat animals for pain under certain circumstances, and evidence of knowledge deficits regarding analgesic treatments among all groups contribute to the likelihood that pain in animals will neither be consistently recognized nor appropriately treated.

Analgesia↗
PubMed1998

Changing practice patterns for children with heart disease: a clinical pathway approach.

BACKGROUND: Pediatric cardiac care is costly and requires extensive resources. We studied the effect of clinical pathways on practice patterns and patient care outcomes in infants and children hospitalized for cardiac surgery. METHODS: In consecutive patients admitted for selected cardiac surgical procedures before (n = 69) and after (n = 173) implementation of clinical pathways, outcomes including hospital length of stay, days in the ICU, time to extubation, ordering of blood studies, costs, and readmissions were compared. Data were analyzed for each of five cardiac surgical procedures: repair of an atrial septal defect, repair of a ventricular septal defect, division of a patent ductus arteriosus, repair of tetralogy of Fallot, and neonatal arterial switch operation to correct transposition of the great arteries. RESULTS: A significant reduction in length of hospital stay, including days in the ICU (decreased 1 to 2 days per admission), was achieved after the clinical pathway was implemented. Reductions in average duration of mechanical ventilation ranged from 28% for repair of a ventricular septal defect to 63% for repair of tetralogy of Fallot. The number of blood studies ordered decreased 20% to 30%. A significant reduction in hospital costs for each procedure, ranging from 16% to 29%, was also achieved with no adverse effects on patients' outcomes. CONCLUSIONS: Use of clinical pathways with children hospitalized for cardiac surgery can shorten length of stay in the hospital, reduce use of resources, and improve cost-effectiveness with beneficial outcomes for patients.

Cardiac Surgical Procedures↗
PubMed1997

Comparison of the Chiron Quantiplex branched DNA (bDNA) assay and the Abbott Genostics solution hybridization assay for quantification of hepatitis B viral DNA.

Several assays for quantification of DNA have been developed and are currently used in research and clinical laboratories. However, comparison of assay results has been difficult owing to the use of different standards and units of measurements as well as differences between assays in dynamic range and quantification limits. Although a few studies have compared results generated by different assays, there has been no consensus on conversion factors and thorough analysis has been precluded by small sample size and limited dynamic range studied. In this study, we have compared the Chiron branched DNA (bDNA) and Abbott liquid hybridization assays for quantification of hepatitis B virus (HBV) DNA in clinical specimens and have derived conversion factors to facilitate comparison of assay results. Additivity and variance stabilizing (AVAS) regression, a form of non-linear regression analysis, was performed on assay results for specimens from HBV clinical trials. Our results show that there is a strong linear relationship (R2 = 0.96) between log Chiron and log Abbott assay results. Conversion factors derived from regression analyses were found to be non-constant and ranged from 6-40. Analysis of paired assay results below and above each assay's limit of quantification (LOQ) indicated that a significantly (P < 0.01) larger proportion of observations were below the Abbott assay LOQ but above the Chiron assay LOQ, indicating that the Chiron assay is significantly more sensitive than the Abbott assay. Testing of replicate specimens showed that the Chiron assay consistently yielded lower per cent coefficients of variance (% CVs) than the Abbott assay, indicating that the Chiron assay provides superior precision.

DNA, Viral↗
PubMed1997

On energy, personality, and health: subjective vitality as a dynamic reflection of well-being.

In this article, we examine subjective vitality, a positive feeling of aliveness and energy, in six studies. Subjective vitality is hypothesized to reflect organismic well-being and thus should covary with both psychological and somatic factors that impact the energy available to the self. Associations are shown between subjective vitality and several indexes of psychological well-being; somatic factors such as physical symptoms and perceived body functioning; and basic personality traits and affective dispositions. Subsequently, vitality is shown to be lower in people with chronic pain compared to matched controls, especially those who perceive their pain to be disabling or frightening. Subjective vitality is further associated with self-motivation and maintained weight loss among patients treated for obesity. Finally, subjective vitality is assessed in a diary study for its covariation with physical symptoms. Discussion focuses on the phenomenological salience of personal energy and its relations to physical and psychological well-being.

Adult↗
PubMed1995

Genotoxicity in the rodent urinary bladder.

Elucidation of the mechanisms by which a chemical may induce urinary bladder tumours in rodents can be expected to provide insight into the relative risk from that agent. The methodologies for exploring whether tumour induction may be a response to direct genotoxic effect of the compound have been successfully applied to the bladders of both mice and rats. Thus, with experimental approaches that utilize adduct detection through the use of immunochemical and postlabelling techniques, unscheduled DNA synthesis and mutagenicity as studied with transgenic animals it is possible to obtain fundamental information on the genotoxic potential of carcinogens in the target bladder. Application of these experimental approaches to carcinogens for which the mechanisms of action are not known should permit assessment of the likelihood that genotoxic or non-genotoxic mechanisms are involved in the tumour induction process. Moreover, such studies may provide knowledge of the molecular pathways that are involved in the action of genotoxic agents, thus enabling judgements to be made as to whether humans are subject to tumour induction by the chemical.

Animals↗
PubMed1995

Decoding mystifying signals: translating symbolic communications of elusive ego states.

Traditionally, Ego-state Therapy has been conducted with parts of the personality that have been activated hypnotically and that present themselves for verbal interaction. This paper presents two cases in which ego states communicate through symbolic and sensory signals at significant points in therapy. Recognition of the meaning and usefulness of these phenomena allows otherwise enigmatic material to provide crucial information about the patient's deepest struggles. Failure to identify this material can often precipitate therapeutic stalemates when the patient's most creative expressions go unnoticed. Effective utilization of these states can often bring about dramatic resolution of inner conflict and achieve symptom relief.

Adult↗
PubMed1995

Essential components of growth and development.

The Joint Commission on Accreditation of Healthcare Organizations' standards require that documentation of age-appropriate care be done when a child or adolescent is treated, with particular attention given to growth and development, socialization, and other issues. The principles of growth and development from infancy to adolescence are discussed, including physical, psychological, and psychosocial needs. Nursing implications are presented to improve understanding of growth and developmental stages as well as provision of nursing care.

Adolescent↗
PubMed1994

Noninvasive mechanical ventilation with the iron lung.

Use of the iron lung as a method of ventilatory support is making a comeback. This article demonstrates the effectiveness of continuous negative-pressure ventilation in a patient with neuromuscular disease and severe chest wall deformity. This noninvasive device not only corrected the patient's ineffective breathing pattern and averted intubation, but its continued home use after discharge improved his overall quality of life.

Adult↗
PubMed1993

Inner strength and other techniques for ego strengthening.

For most therapists who employ hypnoanalytic techniques, ego strengthening stands as the bedrock upon which other techniques are structured. Much ego strengthening takes place indirectly, and its effects are often perceived as improved therapeutic alliance, heightened insight, increased clarity of thinking, and/or improved self-esteem on the part of the patient. Since Hartland introduced ego-strengthening techniques, most therapists have placed emphasis on formal ego-strengthening procedures, both sentences and visualizations. More recently age-progression procedures have been used for ego strengthening. In this paper we introduce the concept of "Inner Strength" as a helpful ego state, and we review three ways of helping the patient get in touch with inner resources in a way that strengthens the ego. We discuss relevant cases and present the appropriate scripts provided for implementing these techniques.

Adult↗
PubMed1993

From strength to strength: "inner strength" with immature ego states.

The ego-strengthening literature concentrates on the use of hypnotic techniques with the entire or total personality. Ego-state therapy conceptualizes the ego as a system of subpersonalities or ego states that have shifting energies. At any particular time the ego state with the most energy is dominant or executive. Any technique that can be used with an individual patient can also be used with an identified ego state. The "inner-strength" hypnotic technique has been used for ego strengthening and mobilization of inner resources. In this paper the "inner-strength" technique is used with ego states that have been identified as responsible for specific symptoms. We will discuss indications for the appropriate use of this technique in ego-state therapy and the mechanisms of its role in the resolution of symptoms in the cases presented.

Adult↗
PubMed1992

The use of hypnotic age progressions as interventions with acute psychosomatic conditions.

Patients with the physical manifestations and physiological disturbances engendered by serious psychosomatic conditions often present with special needs in therapy. On a conscious level, these patients may have pessimistic views of the future, including the specter of imminent death, which, for some, is a real possibility. In this paper we review four clinical cases in which hypnotic age progressions reveal the patients' deepest positive hopes for survival and serve as ego-strengthening, integrating, and prognostic tools in the face of ominous symptoms of physical distress.

Adult↗
PubMed1992

The use of hypnotic age progressions as prognostic, ego-strengthening, and integrating techniques.

Age progression as a hypnotherapeutic technique is mentioned infrequently in the literature when compared with its counterpart, age regression. In this paper we explore the use of progressions, or "views of the future," as prognostic indicators of therapeutic progress and as valuable tools for ego strengthening and for the integration of clinical material. Age progressions vary in the types of suggestions given and can be used to promote growth on multiple levels, facilitating treatment goals and deepening the working-through process. We present six cases in which we used different types of age progressions, and we discuss the significance of the progressions used in each case, within the context of relevant clinical material. We conclude from our observations that the use of hypnotic progressions can be a sustaining, valuable aspect of hypnotherapy, particularly in providing an index of the current direction and progression of the therapy process itself.

Abreaction↗