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Biomedical subjects

C H Goldsmith

Publications and source records attributed to C H Goldsmith.

At least 109 records · Page 6Linked to original sources
PubMed1989

Cost-effectiveness of inpatient and intensive outpatient treatment of rheumatoid arthritis. A randomized, controlled trial.

Women with active rheumatoid arthritis who were judged to be in need of hospitalization were assigned at random to receive inpatient therapy (n = 35) or intensive outpatient therapy (n = 36). All relevant costs of treatment were measured. At 19 weeks, clinical outcomes, as summarized in a pooled index, were significantly better in the inpatient group (pooled index units: inpatient 0.72, outpatient 0.25; F[1,69] = 10.9, P = 0.002). Inpatient therapy produced a sustained three-fold increase in efficacy, at a 2.5-fold increase in cost to society.

Adolescent↗
PubMed1989

T lymphocytes in genital lymph nodes protect mice from intravaginal infection with herpes simplex virus type 2.

Herpes simplex virus type 2 (HSV-2) is a human venereal pathogen that causes lethal neurological illness after intravaginal inoculation into BALB/cJ mice. Intravaginal vaccination of mice with an attenuated strain of HSV-2 rapidly induces immunity to a lethal intravaginal challenge with wild-type HSV-2. This resistance is transferrable to syngeneic mice with genital lymph node (GLN) cells but not with cells from other lymphoid sources. Here we demonstrate that minimal numbers of HSV-2-stimulated GLN T lymphocytes are required for resistance to genital infection by HSV-2 and that such cells migrate preferentially into HSV-2-infected genital tissue. Furthermore, the results suggest that HSV-2-specific cytotoxic T lymphocytes from the GLN may be one effector cell population participating locally in genital immunity to the virus. These findings indicate that mucosal immunity to genital HSV-2 infection requires the antigen stimulation of migratory T cells in the GLN.

Animals↗
PubMed1989

Home blood pressure-measuring devices: a comparative study of accuracy.

Self monitoring of blood pressure by hypertensive patients has been shown to be of value and is increasingly popular. However, the accuracy and ease of use of at least some of the equipment for home use is questionable. We tested 23 pairs of home blood pressure devices, using static methods, trained observers with volunteer subjects and hypertensive patients. Eleven (48%) of the 23 pairs of devices tested were found inconsistent with their duplicate and failed the standards for automated devices of the Association for the Advancement of Medical Instrumentation. Several of the devices, all sold for home use by lay people, contained no instructions whatsoever and even patients using those machines with instructions required further training in blood pressure measurement. While home blood pressure monitoring is useful in certain circumstances, care must be taken in the choice of device, and training is required for all devices.

Blood Pressure Determination↗
PubMed1988

Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

Within the context of a double blind randomized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs, we validated WOMAC, a new multidimensional, self-administered health status instrument for patients with osteoarthritis of the hip or knee. The pain, stiffness and physical function subscales fulfil conventional criteria for face, content and construct validity, reliability, responsiveness and relative efficiency. WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials.

Aged↗
PubMed1987

Expression of immunity to intravaginal herpes simplex virus type 2 infection in the genital tract and associated lymph nodes.

Herpes simplex virus type 2 is a human venereal pathogen which causes lethal neurological illness after intravaginal inoculation into BALB/cJ mice. In the present studies, we demonstrate that intravaginal vaccination with an attenuated strain of this virus, which possesses a partial deletion of the thymidine kinase gene, rapidly induced durable immunity to lethal intravaginal challenge with wild-type virus. Such immunity was characterized by a dramatic hyperplasia of genital lymph nodes and a significant reduction in wild-type virus replication and spread from the genital tract following lethal challenge. Of greater importance, immunity to lethal wild-type virus challenge in the genital tract was transferrable to non-immune mice with genital lymph node cells prepared 1 week after intravaginal vaccination but was not transferrable with serum or cells from other lymphoid organs tested at this time. The adoptive transfer of anti-viral immunity to wild-type challenge was also characterized by a diminution in wild-type virus replication and spread from the genital tract. These results suggest that an important component of cellular immunity to genital pathogens may be antigenic stimulation of genital lymph nodes.

Age Factors↗
PubMed1987

The total assessment of rheumatoid polyarthritis--evaluation of a training program for physiotherapists and occupational therapists.

We evaluated a training program for physiotherapists and occupational therapists in the total assessment of patients with rheumatoid polyarthritis. Close agreement was seen between the active joint counts of the rheumatologists and 36 therapists (p2 = 0.23). In the 7 quality variables for bedside case workups, a statistically significant learning effect was seen over the 6 week period (p2 = less than 0.005). In the 10 quality variables for the case presentations at Week 6, judged at the graduate medical trainee level, mean global scores achieved were 72.5%. Therapists reported a high level of satisfaction with all components of the program.

Arthritis, Rheumatoid↗
PubMed1986

Respiratory function of children in homes insulated with urea formaldehyde foam insulation.

A study was carried out to assess the respiratory function of children living in homes insulated with urea formaldehyde foam insulation (UFFI). A large data base on the effect of environmental variables on the respiratory function of 3500 children in the Hamilton, Ont., area had been collected from 1978 to 1980. From this data base 29 children who lived in UFFI-insulated homes were identified, and each was matched with 2 controls according to nine variables that had been shown to be strongly predictive of respiratory function. Reported respiratory symptoms and results of pulmonary function testing in the year immediately following installation of UFFI were examined. No significant differences in any variable were found between the subjects and controls. A power calculation indicated that the study had adequate power to detect clinically important changes. The authors conclude that there was no evidence of respiratory problems resulting from UFFI in the sample studied.

Child↗
PubMed1986

A three-year cohort study of the role of environmental factors in the respiratory health of children in Hamilton, Ontario. Epidemiologic survey design, methods, and description of cohort.

The relative importance of the effect of outdoor environmental factors (suspended particulates, sulphur dioxide) and indoor environmental factors (parental smoking, gas cooking), on the respiratory health of children is still unclear. To answer these questions, a 3-yr cohort analytic study has been conducted in Hamilton, Ontario between 1978 and 1981. The prevalence of respiratory symptoms and indoor environmental factors was determined by an interviewer-administered questionnaire. Pulmonary function measures included both the forced expiratory maneuver and the single- and multiple-breath nitrogen washouts. Outdoor air quality was measured by a comprehensive network of suspended particulate and sulphur dioxide monitors. There were 3,345 children 7 to 10 yr of age studied in the first year, a response rate of 95.4%, 3,727 in the second year, and 3,168 in the third year; 75.6% of the initial cohort were studied in both Year 2 and Year 3. Comprehensive quality control in the study included measurement of the repeatability of both the questionnaire and pulmonary function data. Repeatability was acceptable except for variables derived from the single-breath nitrogen washout (correlation between initial and repeat closing volume vital capacity was 0.14). Cigarette smoking in Year 3 was reported in 4.8% of the children. The distribution of other covariables was not uniform, and the prevalence of parental smoking and gas cooking was greatest in the industrial area with the highest particulate pollution. Future analysis of these data will require the effect of these covariables to be distinguished from that caused by outdoor air pollution.

Air Pollution↗
PubMed1986

Patient, observer and instrument variation in the measurement of strength of shoulder abductor muscles in patients with rheumatoid arthritis using a modified sphygmomanometer.

We describe the use of a modified sphygmomanometer to measure the strength of shoulder abductor muscles. Using a 5 x 5 Greco-Latin square design we compared the measurements of 5 physical therapists taken on 5 patients with rheumatoid arthritis with 2 cuff adaptations. The design variables explained 96.4% of the pressure readings, with patients accounting for 76.6%. There was no significant variation due to order of testing, cuff preparations or observers. The method is simple, portable, inexpensive, comfortable and safe to use. It can also be applied to 26 different muscle groups.

Adult↗
PubMed1986

Is enflurane hepatotoxic?

We evaluated 88 cases of hepatic injury that followed, and were attributed to, enflurane anesthesia. In 30 of the cases, data were insufficient to assess the role of enflurane vs other variables as causal factors. In 43 ("unlikely") patients, factors known to produce hepatic injury were clearly present; in the remaining 15 ("possible"), such factors were not evident. No consistent pathologic change was found in liver specimens from either the unlikely or the possible group of cases. A syndrome suggested to be associated with enflurane-induced hepatic injury was present in both groups and did not differ between groups. We conclude that the data do not demonstrate a causal relationship between enflurane anesthesia and subsequent liver injury and that if severe injury is caused by enflurane anesthesia, it is an extremely rare event.

Adult↗
PubMed1985

Reliability of amniotic fluid volume estimation from ultrasonograms: intraobserver and interobserver variation before and after the establishment of criteria.

This study assesses levels of intraobserver and interobserver agreement for the determination of decreased and normal amniotic fluid volumes, both before and after the development of criteria. Good to excellent levels of agreement were obtained. Agreement may be higher after the development of criteria and may be higher for more experienced ultrasonographers.

Amniotic Fluid↗
PubMed1985

Epidemiology of musculoskeletal disorders (complaints) and related disability in Canada.

Data on musculoskeletal disorders (complaints), collected as part of the Canada Health Survey were analyzed. Sixteen percent of those sampled reported having arthritis, rheumatism or back, limb or joint disorders with a greater prevalence among females and in the older population. In 21% this was associated with limitation of activity with an average of 11 disability days/person/year. Serious back disorders were reported in 4.4% of the population. While the majority of health consultations (53%) were with a physician, a substantial number (34%) were with chiropractors.

Adolescent↗
PubMed1984

Measurements of spinal mobility in the sagittal plane: new skin contraction technique compared with established methods.

A new skin contraction (10 cm segment) method for measuring segmental and "total" spinal movement in the sagittal plane is described and compared with the modified Schober test, finger-floor distance and goniometry. Three consecutive 10 cm segments are marked out along the spine from the lumbosacral junction with the patient in full flexion. The amount of contraction occurring within each segment is measured after maximal spinal extension. Skin contraction correlated significantly with comparable measurements by other methods. Interobserver variation was not significant. Mean patient measurement time (+/- SD) was 124 +/- 59 seconds. The 10 cm segment method was found to be more sensitive than other available clinical techniques for detecting loss of spinal mobility in ankylosing spondylitis.

Humans↗