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Biomedical subjects

C Perkins

Publications and source records attributed to C Perkins.

34 records · Page 2Linked to original sources
PubMed1993

Reliability of the Self-Administered Alcoholism Screening Test (SAAST) in psychiatric inpatients.

Identification of alcohol abuse in psychiatric patients is essential, since it can confuse the clinical picture and complicate treatment. The utility and reproducibility of the Self-Administered Alcoholism Screening Test (SAAST) was assessed in 236 acutely ill psychiatric patients. Both an initial SAAST given at admission, and a second SAAST given shortly before discharge, were completed by 173 (73%) patients; significant correlation (r = 0.85) was found between scores on SAAST 1 and SAAST 2. Only 41 (17%) patients were unable or refused to complete the initial SAAST and the majority of these received a schizophrenia diagnosis. SAAST scores were also significantly correlated with the clinical assessments and histories. Most (76%) patients with a current or past history of alcohol abuse scored in the "alcoholic" (> or = 8) range on one or both SAASTs. Men were almost twice as likely as women to have a history of alcohol abuse, and significantly more likely to score > or = 8 on the SAAST. The SAAST could be completed by the majority of acutely ill psychiatric patients even at admission, and was clinically useful in the diagnosis of alcohol abuse, especially when used in conjunction with the clinical interview.

Adolescent↗
PubMed1992

A double blind placebo controlled trial of recombinant tissue plasminogen activator in the treatment of digital ischemia in systemic sclerosis.

The treatment of digital ischemia in systemic sclerosis remains inadequate. We report a double blind, placebo controlled trial of recombinant tissue plasminogen activator (rtPA), a potent thrombolytic agent. Ten patients received rtPA. A potent, acute fibrinolytic effect was observed. During the infusion of rtPA, improvements in skin blood flow were seen. These improvements were shortlived.

Adolescent↗
PubMed1991

Design and methods for a survey of lead usage and exposure monitoring in California industry.

A probability sample of California workplaces in 1986 estimated the numbers of workers using lead and their coverage by biological and environmental monitoring. Study steps included (1) identifying 505 stand ard industrial classifications (SICs) with possible lead use; (2) creating an employer lis; (3) identifying for oversampling seven single SICs and a group of 165 SICs with documented high ambient air lead; (4) further stratification by workforce size; (5) prediction from National Institute for Occupational Safety and Health surveys the number of lead-using workers for each employer; (6) drawing facilities into the sample with selection probability proportional to the number of workers predicted to use lead; (7) adjusting the sample selection if an employer listing covered multiple facilities; (8) sending a first-stage telephone/mail questionnaire to identify lead users, who were sent a second questionnaire; (10)follow-up which, aided by statutory authority, resulted in completion rates over 90%; (11) ranking lead-using processes by intensity of exposure; and (12) analysis. Sources of error include random sampling error, misleadingly large standard errors because sampling was with replacement, gaps in the employer list, and inaccurate responses. As a measure for the probability proportional to size sampling, total work force count would have been superior to the predicted number of lead users. Restriction to a single hazard makes a questionnaire-based study feasible, but names of workers, rather than counts, should be requested and a subsample should be visited.

California↗
PubMed1991

Lead use in California industry: its prevalence and health implications.

An estimated 230,000 workers were reported to work in lead-using activities as a result of a 1986 statistical survey of employers in California. However, 68% of these workers worked in activities of relatively low hazard. This included 114,000 workers engaged in electronic soldering. Over 1800 workers were reported to work in battery manufacture, a relatively high-hazard activity, but with consistent monitoring and protection. In contrast, over 4300 workers were involved in radiator repair activities, a high-hazard activity with inconsistent monitoring and protection. Over 8% of construction workers were reported to work in lead-using processes. This sector is exempt from federal Occupational Safety and Health Administration (Fed/OSHA) and California Occupational Safety and Health (Cal/OSHA) lead standards, yet some of the most hazardous activities (welding, grinding, and cutting, etc.) occurred here. Comparison of projections from the National Occupational Hazard Survey of potential lead exposure in California with these survey results suggests consistent and reliable assessment of the major sources of potential occupational exposure to lead.

California↗
PubMed1990

White clot syndrome and continuous arteriovenous haemofiltration.

Severe heparin associated thrombocytopenia is a rare complication of heparin therapy. We report a patient who developed heparin associated thrombocytopenia during continuous arteriovenous haemofiltration and discuss its implications and alternative anticoagulant treatment.

Acute Kidney Injury↗
PubMed1990

Environmental and biological monitoring for lead exposure in California workplaces.

Patterns of environmental and biological monitoring for lead exposure were surveyed in lead-using industries in California. Employer self-reporting indicates a large proportion of potentially lead-exposed workers have never participated in a monitoring program. Only 2.6 percent of facilities have done environmental monitoring for lead, and only 1.4 percent have routine biological monitoring programs. Monitoring practices vary by size of facility, with higher proportions in industries in which larger facilities predominate. Almost 80 percent of battery manufacturing employees work in job classifications which have been monitored, versus only 1 percent of radiator-repair workers. These findings suggest that laboratory-based surveillance for occupational lead poisoning may seriously underestimate the true number of lead poisoned workers and raise serious questions regarding compliance with key elements of the OSHA Lead Standard.

California↗
PubMed1989

Testicular choriocarcinoma. An unusual presentation as occult gastrointestinal blood loss.

Choriocarcinoma is the rarest testicular germ cell tumor, occurring in less than 1% of cases. Gastrointestinal bleeding is not uncommon in cases of testicular choriocarcinoma and reflects metastatic disease. Typically, the patient presents with marked upper or lower gastrointestinal tract bleeding. A young adult male with metastatic testicular choriocarcinoma presented as a near-syncopal episode, with a hematocrit of 22% and hemoccult-positive stool. Endoscopy revealed a solitary bleeding lesion along the greater curvature of the stomach. His presentation suggested chronic, rather than acute, gastrointestinal blood loss. This case may represent the first case of testicular choriocarcinoma in which chronic gastrointestinal blood loss was the presenting manifestation of metastatic disease.

Adult↗
PubMed1988

Prospective surveillance of semen quality in the workplace.

We performed a prospective surveillance of semen quality among workers in the plant where 1,2-dibromo-3-chloropropane was first recognized as an occupational cause of impaired semen quality and of infertility. All male employees of the Agricultural Chemical Division were required to participate. Ninety-seven workers (92% participation) provided 258 semen samples over the 4 years of the program. Most samples were analyzed at the plant with a mini-laboratory designed for the study. Motility and shape measures were made objectively. Sixty-six subjects (68%) were non-azoospermic. Generalized multiple regression showed no significant predictors for any response, with the exception of the motility measures, which were reduced with longer times between ejaculation and assay. Between- and within-person standard deviations and correlations were calculated. Comparison of this population with fertile artificial insemination donors (16 men, 498 ejaculates) revealed generally higher ejaculate-to-ejaculate standard deviations in the worker samples. This is probably due to less well controlled conditions of sperm collection in the workplace setting. For cross-sectional studies, one ejaculate per worker is recommended as sufficient; for estimating an individual worker's mean, even three ejaculates may not provide enough precision.

Environmental Exposure↗
PubMed1986

Seven-year follow-up of workers exposed to 1,2-dibromo-3-chloropropane.

A follow-up report was done of workers exposed to 1,2-dibromo-3-chloropropane (DBCP) 7 years after termination of exposure. A 1977 study of male pesticide workers exposed to DBCP in a California agricultural chemical plant identified many who were azoospermic or oligospermic. Sperm concentration and serum follicle-stimulating hormone (FSH) levels in 44 of these workers were reassessed 5 to 8 years after exposure was terminated in 1977. Two of the eight originally azoospermic workers produced sperm during the follow-up, although only one had normal sperm counts. No increase in sperm production could be detected in men who had low sperm counts in 1977, and elevated serum FSH levels did not drop in oligospermic or azoospermic men. These results suggest that permanent destruction of germinal epithelium occurs in most DBCP-sterile persons.

Follicle Stimulating Hormone↗
PubMed1978

Gray scale ultrasonographic evaluation of hepatic cystic disease.

Eight patients with various forms of hepatic cystic disease studied with gray scale ultrasonography are described. Four had solitary cysts, two had multiple simple liver cysts, and two had congenital polycystic liver and kidney disease. The spectrum of ultrasonographic features in benign cystic disease of the liver is discussed. All eight patients were felt to have malignant disease in the liver prior to ultrasonographic evaluation. The value of gray scale ultrasound as a noninvasive means of differentiating cystic disease from suspected metastatic disease is emphasized.

Adult↗
PubMedDate not supplied

Effects of a parent-child communications intervention on young adolescents' risk for early onset of sexual intercourse.

CONTEXT: The quality of parent-child communications about sex and sexuality appears to be a strong determinant of adolescents' sexual behavior. Evaluations of interventions aimed at improving such communications can help identify strategies for preventing early onset of sexual behavior. METHODS: A school-based abstinence-only curriculum was implemented among 351 middle school students, who were randomly assigned to receive either the classroom instruction alone or the classroom instruction enhanced by five homework assignments designed to be completed by the students and their parents. An experimental design involving pretest and posttest surveys was used to assess the relative efficacy of the curriculum delivered with and without the parent-child homework assignments. RESULTS: In analyses of covariance controlling for baseline scores, immediately after the intervention, adolescents who received the enhanced curriculum reported greater self-efficacy for refusing high-risk behaviors than did those who received the classroom instruction only (mean scores, 16.8 vs. 15.8). They also reported less intention to have sex before finishing high school (0.4 vs. 0.5), and more frequent parent-child communications about prevention (1.6 vs. 1.0) and sexual consequences (1.6 vs. 1.1). In all significant comparisons, the direction of the findings favored adolescents who received the enhanced curriculum. Dose-response relationships supported the findings. CONCLUSIONS: Parent-child homework assignments designed to reinforce and support school-based prevention curricula can have an immediate impact on several key determinants of sexual behavior among middle school adolescents.

Adolescent↗