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Biomedical subjects

C Stout

Publications and source records attributed to C Stout.

At least 19 recordsLinked to original sources
PubMed1996

Evaluation of individualized asthma self-management programs.

We compared the effectiveness of personalized asthma self-management recommendations with that of a group self-management program. We assigned each of 34 asthma patients randomly to one of three conditions: individualized asthma self-management, group asthma self-management, and control. We derived individualized self-management recommendations from patient recordings of asthma occurrence, asthma precipitants, and peak expiratory flow rate made during a 3-month period. The group program we used was the Wheezers Anonymous program. As compared to a control group of patients who received no self-management training, the patients in both the individualized and group condition evidenced improvement of pulmonary function, as measured daily with a home peak flow meter. The improvement was equivalent for patients in the two conditions. Patients in the individualized condition also exhibited a drop in frequency of asthma attacks, but patients in the group condition did not. We concluded that individualized asthma self-management is effective in reducing symptoms of asthma.

Adult↗
PubMed1995

A self-management program for adult asthma. Part I: Development and evaluation.

BACKGROUND: We developed and evaluated a self-management program for adult asthma. In developing the program, we considered questions of format and behavior control. The format we selected included components known to be effective in educational settings. We regulated asthma management behavior through the introduction of environmental cues. METHODS: Seventy-six subjects, whose asthma was generally under medical control, were assigned randomly to either a treatment group or a waiting-list control group. Those in the treatment group were exposed to a 7-week program that incorporated proven features of providing effective training and establishing behavioral control. Subsequently, subjects in the control group received the treatment. Short-term evaluation of the treatment was made after the subjects in the experimental group were trained but before the control subjects were trained. Long-term evaluation was conducted after both groups of subjects were trained. RESULTS: Over the short term, self-management training led to fewer asthma symptoms and physician visits and improvement in asthma management skills and cognitive abilities. Over the long term, self-management training was related to lower asthma attack frequency, reduced medication use, improvement in cognitive measures, and increased use of self-management skills. CONCLUSIONS: The program improved asthma management in patients whose conditions were already under good medical control. The effects of the program were apparent a year after the conclusion of self-management training.

Adult↗
PubMed1995

Neonatal enterovirus infection.

A neonate who had a nonfatal echovirus 11 infection with severe hepatitis, hepatic necrosis, disseminated intravascular coagulation, and thrombocytopenia was seen at the University of Tennessee Medical Center (UTMC) in Knoxville. Clinical data from this neonate were examined and compared with clinical data from histories of 8 other cases of neonatal enteroviral infections seen at UTMC, Knoxville, during a 3-year period. The purpose of our study was to increase awareness of the clinical presentations of neonatal enteroviral infections, especially in summer months. The patients in our study presented with various clinical manifestations of disease, including overwhelming systemic infection characterized by severe hepatic dysfunction and coagulopathy with possible disseminated intravascular coagulation and central nervous system infection. Myocarditis was sometimes manifested as well. In agreement with findings from other studies, our study concluded that most enteroviral infections in neonates resulted from perinatal transmission during delivery where the mothers had experienced recent, febrile, viral-like illness prior to or during delivery. One uncommon finding in our study was that the cases were strikingly seasonal, with 8 of the 9 infants hospitalized during late summer or early fall (July through September).

Age of Onset↗
PubMed1994

Randomized double-blind, placebo-controlled evaluation of oral ondansetron in the prevention of nausea and vomiting associated with fractionated total-body irradiation.

PURPOSE: To evaluate oral ondansetron in the prevention of total-body irradiation (TBI)-induced nausea and vomiting. METHODS: Twenty patients who received 4 days of TBI as part of their preparative regimen before bone marrow transplantation were randomized to receive either 8-mg oral doses of ondansetron or placebo. Administration of drug was double-blinded. Initial rescue therapy consisted of intravenous (i.v.) ondansetron 0.15 mg/kg following two or more emetic episodes between successive fractions of TBI or five total emetic episodes during the 4 days of therapy. If, after receipt of i.v. ondansetron, patients had two or more emetic episodes between fractions of TBI or five total emetic episodes, additional antiemetics were administered. RESULTS: Patients who received oral ondansetron had significantly fewer emetic episodes compared with those who received placebo (P = .005) over the entire 4-day study period. Oral ondansetron was also significantly superior to placebo with respect to the time of onset of emesis or rescue (P = .003). Six of 10 patients treated with oral ondansetron completed the study without additional antiemetic therapy, while none of 10 patients who received placebo completed the study without rescue antiemetic therapy. Six placebo patients who received initial rescue therapy with i.v. ondansetron required no additional antiemetics. No relationships were apparent between peak ondansetron concentration (Cmax) or area under the concentration versus time curve (AUC) and number of emetic episodes. CONCLUSION: Oral ondansetron is an effective therapy for the prevention of emesis induced by TBI.

Administration, Oral↗
PubMed1993

Improving recognition of respiratory sensations in healthy adults.

In two discrimination training studies, we noted improvements in the ability of healthy individuals to discriminate between respiratory sensations. We trained individuals to discriminate between respiratory sensations elicited during inspiration in Experiment 1 and during expiration in Experiment 2. We elicited respiratory sensations by having participants breathe through circuits that differed in their resistance to air flow. Training, in both experiments, was conducted within the context of a task in which individuals judged which member of a series of respiratory circuit pairs was easier to breathe through. To improve the accuracy of judgments, we gave participants feedback of their performance, and we faded air flow resistance. The latter procedure consisted of presenting circuit pairs in order of increasing similarity. Individuals who received performance feedback with fading of air flow resistance demonstrated reliable improvements in discrimination from pre- to posttraining in both experiments, but controls, who received either performance feedback or practice in discrimination did not. These findings may contribute to improving awareness of respiratory sensations in asthma patients, and thereby bolster efforts to manage asthma.

Adolescent↗
PubMed1993

The Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire.

The Knowledge, Attitude, and Self-Efficacy Asthma Questionnaire (KASE-AQ) is a paper-and-pencil instrument that was developed to allow physicians, behavioral scientists, and other health care personnel to assess asthma patients' knowledge regarding asthma, their attitudes about their asthma (including their willingness to cooperate with the physician in managing asthma), and their self-efficacy regarding their perceived ability to control the disorder. The KASE-AQ assesses changes in these patient variables following a particular intervention. The KASE-AQ proved to be reliable and internally consistent, and a factor analysis revealed presence of three subscales in the questionnaire (knowledge, attitude, and self-efficacy about asthma). Following asthma education and self-management training, experimental group subjects showed significant improvements in knowledge, attitude, and self-efficacy. Waiting-list control subjects showed similar improvements following training. Both groups' scores at 3-month follow-up remained significantly higher than their baseline scores on all 3 variables.

Adult↗
PubMed1991

Predicting asthma in individual patients.

The degree to which asthma attacks were related to seven environmental variables was determined for each of 17 individuals. Using stepwise regression procedures, cladosporium mold, ragweed pollen, and a change in temperature were significant predictors of asthma attacks in 5 of 17 individuals. The information provided by these analyses could prove useful in helping some individuals manage their asthma.

Adult↗
PubMed1989

Evaluation of a monoclonal antibody pool for rapid diagnosis of respiratory viral infections.

A pool of monoclonal antibodies (MAbP) was evaluated both as a method of cell culture confirmation and as a rapid diagnostic screen for viral infection in respiratory secretions. The MAbP was used in a two-step fluorescent staining procedure on cells harvested from cultures (phase 1) and on exfoliated nasopharyngeal or tracheal cells (phase 2). Antibodies in the MAbP were directed against respiratory syncytial virus, adenoviruses, parainfluenza virus types 1, 2, and 3, and influenza viruses A and B. Individual antiviral antibody stains were used to identify specific viruses from MAbP-positive specimens. In phase 1 (cell culture confirmation only), 241 respiratory specimens were tested. MAbP sensitivity and specificity were 91 and 94%, respectively. In phase 2, 376 respiratory specimens were evaluated by direct staining of exfoliated cells, and these results were compared with results of cell culture isolation. The sensitivity and specificity of the MAbP used in direct specimen testing were 69 and 97%, respectively. These results indicate that the MAbP is highly specific and fairly sensitive for detection of seven different respiratory viruses in one testing procedure. The MAbP is a rapid screening technique for respiratory secretions and is potentially a cost-effective approach to viral detection.

Adenoviruses, Human↗