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Biomedical subjects

C Houston

Publications and source records attributed to C Houston.

17 recordsLinked to original sources
PubMed2003

Variation in management of community-acquired pneumonia requiring admission to Alberta, Canada hospitals.

Previous studies have shown small area variation in the rate of admission to hospital for patients with community-acquired pneumonia. We determined the rates of admission and length of stay for patients with community-acquired pneumonia in Alberta and the factors influencing admission rates and length of stay. Using hospital abstracts, hospital admissions for community-acquired pneumonia from 1 April 1994 to 31 March 1999 were compared. We classified Alberta hospitals according to geographical regions, by the number of beds, and by number of community-acquired pneumonia cases. There were 12,000 annual hospital discharges for community-acquired pneumonia costing over $40 million per year. The overall in-hospital mortality rate was 12% and the 1 year mortality rate was 26%. Compared with rural hospitals, regional and metropolitan hospitals admitted patients with greater severity of illness as demonstrated by greater in-hospital mortality, cost per case and comorbidity. Age-sex adjusted hospital discharge rates were significantly below the provincial average in both urban regions. Hospital discharge rates for residents in all rural regions and 4 of 5 regions with a regional hospital were significantly higher than the provincial average. After adjusting for comorbidity, the relative risk for a longer length of stay was 22% greater in regional hospitals and about 30% greater in urban hospitals compared to rural hospitals. Seasonal variation in the admission rate was evident, with higher rates in the winter of each year. We conclude that rural hospitals would be likely to benefit from a protocol to help with the admission decision and urban hospitals from a programme to reduce length of stay.

Adolescent↗
PubMed2001

The relationship between parental modeling, eating patterns, and dietary intake among African-American parents.

OBJECTIVE: This article examines the relationship between the frequency with which African-American parents report modeling healthful dietary behaviors for their children and parental dietary intake. DESIGN: Cross-sectional, baseline data from a community-based dietary change study to reduce fat intake and increase fruit and vegetable consumption among African-American parents was analyzed to identify role-modeling behaviors. SUBJECTS/SETTING: Subjects were 456 African-American parents who participated in a dietary change study as part of a national parent education group. Participants completed the Parental Dietary Modeling Scale, an eating patterns questionnaire and a food frequency questionnaire. STATISTICAL ANALYSES PERFORMED: Descriptive statistics and stepwise multiple linear regression analyses were conducted. RESULTS: Parental modeling of healthful dietary behavior was associated with the performance low-fat eating patterns (r = 0.48; P < .001), lower dietary fat intake (r = -0.30; P < .001), and higher consumption of fruits and vegetables (r = 0.18; P < .001). APPLICATIONS: The frequency with which parents model healthful dietary behaviors may be associated with parental dietary intake and may have long-term implications for the development of childhood eating patterns. Dietetics professionals need to carefully assess parents' current dietary modeling behaviors and inform parents about how performance of these general behaviors may affect their child's ultimate nutrition health.

Adult↗
PubMed1994

Interactive use of models of health-related behavior to promote interdisciplinary collaboration.

This pilot study examined the use of models of health-related behavior as foci for interaction to promote interdisciplinary collaboration among students enrolled in a graduate-level course at Washington University in St. Louis, Missouri. The course is one component of a master's program developed to meet the needs of health professionals whose goals are to participate in interdisciplinary roles in a variety of health care settings. Abilities requisite to the development of positive attitudes toward interdisciplinary collaboration include: (1) understanding of the functional roles of each discipline within the team; and (2) respect and value for each discipline's input in the decision-making process of the health team. Focused interaction was effective in increasing participants' understanding of the functional roles of each discipline at the .05 level of significance.

Adult↗
PubMed1993

Acute mountain sickness in a general tourist population at moderate altitudes.

OBJECTIVE: To determine the incidence of acute mountain sickness in a general population of visitors to moderate elevations, the characteristics associated with it, and its effect on physical activity. DESIGN: A cross-sectional study. SETTING: Resort communities located at 6300 to 9700 feet elevation in the Rocky Mountains of Colorado. PARTICIPANTS: Convenience sample of 3158 adult travelers, 16 to 87 years old (mean age [+/- SD], 43.8 +/- 11.8 years). RESULTS: Twenty-five percent of the travelers to moderate elevations developed acute mountain sickness, which occurred in 65% of travelers within the first 12 hours of arrival. Fifty-six percent of those with symptoms reduced their physical activity. The odds favoring acute mountain sickness were 3.5 times as large for visitors whose permanent residence was below 3000 feet elevation as for those whose residence was above 3000 feet; 2.8 times as large for visitors with previous symptoms of acute mountain sickness; and twice as large in travelers younger than 60 years. Women, obese persons, those in poor or average physical condition, and those with underlying lung disease also had a higher occurrence of acute mountain sickness (P < 0.05). CONCLUSIONS: Acute mountain sickness occurs in 25% of visitors to moderate altitudes and affects activity in most symptomatic visitors. Persons who are younger, less physically fit, live at sea level, have a history of acute mountain sickness, or have underlying lung problems more often develop these symptoms.

Acute Disease↗
PubMed1993

Consumption of fruits and vegetables in Missouri.

High consumption of fruits and vegetables has been linked with a reduced risk of several important chronic diseases. The authors utilized telephone survey techniques to assess the level of fruit and vegetable consumption among adult Missouri residents. Only 28% of respondents reported consumption of five servings of fruits and vegetables per day. Older females had the highest rate of consuming five servings per day, while young males had the lowest rate. These findings, in conjunction with national data, show the need for increasing emphasis on the "5 A Day" campaign.

Adolescent↗
PubMed1991

A phase II trial of carboplatin and vinblastine in the treatment of advanced squamous cell carcinoma of the esophagus.

Cisplatin-containing regimens are active in the treatment of esophageal cancer, with response rates of 25% to 35% in advanced disease. Carboplatin is less toxic than cisplatin; as a single agent, several responses were seen against esophageal tumors. To better define the role of carboplatin in esophageal cancer, the authors treated 19 chemotherapy-naive patients with advanced squamous cell carcinoma of the esophagus with carboplatin and vinblastine. Carboplatin (450 mg/m2 intravenously [IV] on days 1, 29, 57, and every 6 weeks thereafter) was given with vinblastine (5 mg/m2 IV on day 1 and then every 2 weeks). No major responses were seen. No significant renal toxicity and only mild gastrointestinal toxicity (emesis, diarrhea) were observed. Hematologic toxicity was more severe in patients with prior radiation therapy (RT), with three of six patients with prior RT exhibiting Grade 4 hematologic toxicity. Although generally less toxic than cisplatin-containing regimens, carboplatin and vinblastine is also less active in the treatment of squamous cell carcinoma of the esophagus. Hematologic toxicity with this regimen was severe in patients who had received prior RT.

Adult↗
PubMed1990

Interferon alpha-2a and 5-fluorouracil for advanced colorectal carcinoma. Assessment of activity and toxicity.

Preclinical data showed that the cytotoxic effects of 5-fluorouracil (5-FU) are augmented by interferon (IFN). In a small study, 13 of 17 patients with advanced colorectal cancer responded to a regimen of 5-FU with IFN. Using the same dose and schedule as in this pilot study, 38 previously untreated patients with metastatic colorectal carcinoma were treated with continuous intravenous (IV) infusion of 5-FU 750 mg/m2 daily for 5 days, followed by weekly bolus 5-FU at 750 mg/m2 and subcutaneous IFN at 9 million units three times per week. Of 35 evaluable patients, nine (26%) had a partial response (95% confidence limit, 11% to 41%), with a median response duration of 7.5 months (range, 4.4 to greater than 11.7 months). Seven patients (20%) had a minor response, and ten (28%) had stable disease. The most common toxicities observed were stomatitis (52%) and diarrhea (43%). Neurotoxicity was seen in 34% of patients and consisted of gait disturbance, dizziness, confusion, memory loss, and dementia. Because of toxicity, 84% of patients required a reduction of the IFN dose by at least 50%, and 63% required reduction of the 5-FU dose by at least 25%. Although the combination of 5-FU and IFN in patients with advanced colorectal carcinoma has some activity, the regimen was toxic, and the observed response rate (26%) was not substantially superior to alternative 5-FU programs.

Adult↗
PubMed1990

The sleep electrocardiogram at extreme altitudes (Operation Everest II)

To evaluate the effect of sleep at extreme altitudes upon heart rate and rhythm, continuous sleep monitoring was performed in 8 normal young men during a 40-day simulated ascent of Mt. Everest in a hypobaric chamber. Recordings were made for 1 hour before sleep, during sleep and for 1 hour after awakening in all subjects at 760 torr (sea level), in 7 subjects at 390 torr (5,490 m), in 6 at 347 torr (6,100 m) and in 4 at 282 torr (7,620 m). The following results were obtained: periods of sinus bradycardia occurred during sleep in all subjects at 3 altitudes with a mean heart rate of 41 +/- 0.5 beats/min compared to a rate of 44 +/- 2 beats/min at sea level; cycling of the heart rate, presumably due to periodic breathing, occurred in 14 of 17 studies at altitude but not at sea level (cycles consisted of bradycardia [40 beats/min] for 13 seconds and tachycardia [120 beats/min for 5 seconds]; and arrhythmias were observed in all subjects during sleep and consisted of transient bradycardia (heart rates as low as 20 beats/min), sinus pauses frequently associated with escape rhythms and occasional blocked P waves. No arrhythmias were observed at sea level. Simultaneous records of respiration and the electrocardiogram at 12,500 feet (3,810 m) in 5 other normal subjects revealed tachycardia occurring during hyperpnea and bradycardia occurring during apnea. Data indicate that during sleep in normal young subjects at high altitude, cycling of the heart rate with periodic breathing is common, as are bradyarrhythmias. The mechanism of these arrhythmias has yet to be defined.

Adult↗
PubMed1979

Fibromuscular dysplasia of the external iliac arteries: surgical treatment by graduated internal dilatation technique.

A case of fibromuscular dysplasia of the external iliac arteries treated by graduated internal dilatation is presented. At follow-up extending to 7 years, the external iliac arteries are patent with no evidence of recurrent disease by arteriography, and the patient remains asymptomatic. The recently reported successes with percutaneous balloon catheter angioplasty offers a nonsurgical alternative in the treatment of external iliac fibromuscular disease. A consideration of balloon catheter angioplasty in future similar cases is suggested. If balloon catheter angioplasty is unsuccessful, the option of operation remains available.

Arterial Occlusive Diseases↗
PubMedDate not supplied

The feasibility of recruiting hospitalized patients with diabetes for a smoking cessation program.

The aims of this study were to identify hospitalized smokers with diabetes, assess the severity of their physical condition, and determine their willingness to participate in a postdischarge smoking cessation program. Hospitalized smokers with diabetes were identified through referrals from the Dietetics Department. Smoking status was determined via medical charts, healthcare staff, and patient self-report. Among all patients with diabetes who were identified (n = 314), smoking status was routinely recorded only for those with a primary cardiac diagnosis (41%). Smokers (n = 59) were significantly younger and reported multiple but fewer concomitant diagnoses than nonsmokers. Ninety-one percent of the smokers who were contacted refused to participate in a postdischarge smoking cessation program. We conclude that accurate methods are needed for identifying all smokers to facilitate cessation efforts. The severity and chronicity of the physical condition of hospitalized smokers with diabetes may limit willingness to participate in a postdischarge smoking cessation intervention.

Adult↗
PubMedDate not supplied

A community research partnership to improve the diet of African Americans.

OBJECTIVE: To describe a community research partnership in which a national parent education organization collaborated with academic institutions to develop a dietary change program for underserved African American parents. METHODS: Qualitative methods were used to characterize issues that impacted partnership operations. RESULTS: Data are reported on partnership activities including program development and implementation with African American parents. Lessons learned and strategies for improving the partnership are presented. CONCLUSIONS: Ongoing assessment and evaluation of how a partnership operates, especially in the context of multiple sites, are important to sustaining successful functioning.

Black or African American↗
PubMedDate not supplied

Automatic implantable defibrillator for the patient with recurrent refractory malignant ventricular arrhythmias: case report.

Clinically, the first line of treatment for patients experiencing potentially lethal arrhythmias includes antiarrhythmic medications and/or treatment of underlying causes such as ischemia or congestive heart failure. However, if the treatment is not successful in controlling the arrhythmia, the automatic implantable defibrillator is a viable alternative for the prevention of sudden death in these patients. The case report presents one example of how the automatic implantable defibrillator can supplement conventional medical therapy when success in suppressing recurrent arrhythmias cannot be obtained. This concept has been demonstrated in this 59-year-old woman who underwent several medication trials in an attempt to control her life-threatening arrhythmias.

Electric Countershock↗