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Biomedical subjects

D Causey

Publications and source records attributed to D Causey.

18 recordsLinked to original sources
PubMed2002

Method of application of tylosin, an antibiotic for American foulbrood control, with effects on small hive beetle (Coleoptera: Nitidulidae) populations.

The method of application of the antibiotic tylosin (Tylan) for control of oxytetracycline-resistant American foulbrood (Paenibacillus larvae White) was tested in honeybee (Apis mellifera L.) colonies. A powdered sugar mixture with tylosin, applied as a dust, was efficacious in eliminating American foulbrood symptoms at a rate of 200-mg Tylan per 20 g of powdered sugar, applied at weekly intervals for 3 weeks. A second method of treatment consisting of Tylan mixed with granulated sugar and vegetable shortening and applied once as a patty, at an equivalent total dose as the dust method, to diseased colonies also effectively eliminated symptoms of disease. In all colonies treated with patties, however, small hive beetle (Aethina tumida Murray) populations significantly increased, compared with the powder sugar method or untreated controls. Bee populations in patty-treated colonies also were significantly reduced, most likely the result of the invasion and proliferation of adult and larval small hive beetles. Such reduction in colony strength was not seen in dust-treated colonies. Because of the obvious damaging populations of small hive beetles, concerns about development of disease resistance, unknown risks of residues, and lack of support by regulatory agencies for the use of the patty method, the use of the dust method of tylosin is greatly favored over the patty method.

Animals↗
PubMed2001

Validity of the pediatric inpatient behavior scale in an inpatient psychiatric setting.

Standardized assessment of children's behavior during psychiatric hospitalization is increasingly important for evaluation, chart documentation, treatment planning, and outcome monitoring, yet little research has been done to validate the use of behavior checklists developed specifically to assess in-hospital behavior. The Pediatric Inpatient Behavior Scale (PIBS) was evaluated for its validity as a measure of behavior of children hospitalized on a psychiatric unit. Nurses completed the PIBS for 41 children, based on behavior observed during the first week of hospitalization. DSM-IV diagnoses and major symptoms were coded based on chart review, and children completed self-report measures of depression and anxiety. The Pediatric Inpatient Behavior Scale subscale scores were related significantly to diagnosis, as well as to major symptoms, correctly classifying 75 to 85% of cases. The Pediatric Inpatient Behavior Scale subscale scores also significantly correlated with self-reported symptoms of depression, but not symptoms of state anxiety. Results support the use of the PIBS as a behavioral instrument for hospitalized children with severe psychopathology.

Adolescent↗
PubMed1995

Comparison of the nicotine pharmacokinetics of Nicoderm (nicotine transdermal system) and half-hourly cigarette smoking.

Nicoderm, a nicotine transdermal system (NTS), provides a continuous, transdermal delivery of nicotine and is used as an aid to smoking cessation. In contrast, cigarette smoking yields nicotine concentrations in plasma that rise and fall with each cigarette. The primary objective of this study was to compare nicotine pharmacokinetics after treatment of subjects with either the NTS or controlled smoking. Fourteen healthy adult male smokers, who smoked at least 30 cigarettes per day, were entered into a randomized crossover design trial that compared the NTS, 21 mg/day applied for 24 hours, with half-hourly smoking during the day. Subjects abstained from smoking for 2 days, and were treated for 5 days with either the NTS (daily) or controlled smoking (30 cigarettes at half-hourly intervals on days 1 and 5; ad libitum smoking on days 2-4). Blood samples were obtained frequently on days 1 and 5 for analysis of nicotine and cotinine. Pharmacokinetic comparisons showed that nicotine Cmax, area under the curve (AUC)inf, and Cavg for the NTS were lower than corresponding values for controlled smoking; Cmax and Cavg values were approximately half those of smoking. Cmax and Cavg values for cotinine were similarly lower for the NTS compared to controlled smoking. For both treatments, plasma nicotine concentrations were higher on day 5 compared to day 1. Thus, the NTS provides concentrations of nicotine that are lower than smoking.

Administration, Cutaneous↗
PubMed1994

Phase II dose-ranging trial of foscarnet salvage therapy for cytomegalovirus retinitis in AIDS patients intolerant of or resistant to ganciclovir (ACTG protocol 093). AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Diseases.

OBJECTIVE: To document response to foscarnet salvage therapy in patients with cytomegalovirus (CMV) retinitis who are intolerant of or resistant to ganciclovir. METHODS: Patients with AIDS and CMV retinitis who had documented hematologic intolerance or resistance to ganciclovir therapy received an induction course of foscarnet, 60 mg/kg every 8 h for 14 days, and subsequent chronic maintenance foscarnet therapy at a daily dose of 60, 90 or 120 mg/kg/day. The first 87 patients were randomly assigned to receive maintenance foscarnet at a dose of 60 or 90 mg/kg/day; all subsequent patients were assigned a maintenance dose of 120 mg/kg/day. RESULTS: A total of 156 evaluable patients were enrolled. Median time to retinitis progression and survival did not differ significantly among groups assigned to different maintenance foscarnet doses. Among patients with retinitis progression documented ophthalmologically occurring at < or = 2 week intervals, despite optimal doses of ganciclovir, time to progression on foscarnet therapy was a median 8 weeks at all doses studied. By dose assignment, there were no significant differences in serious drug-associated toxicity, although trends toward increased renal and hypocalcemic adverse events were observed at higher maintenance doses. CONCLUSION: In patients intolerant of ganciclovir, salvage foscarnet therapy resulted in a longer time to retinitis progression than reported previously in historic controls who terminated ganciclovir therapy. In patients who exhibited clinical resistance to ganciclovir, foscarnet appeared to have efficacy in controlling retinitis. No significant differences in either efficacy or toxicity were observed in the range of foscarnet maintenance doses studied.

AIDS-Related Opportunistic Infections↗
PubMed1994

Pharmacodynamic relationship of pharmacokinetic parameters of maintenance doses of foscarnet and clinical outcome of cytomegalovirus retinitis.

The pharmacodynamic relationship between a range of foscarnet exposure measurements obtained from studying nine patients receiving ongoing maintenance therapy for cytomegalovirus retinitis and a range of efficacy values (days to retinitis progression) obtained by independent examination of serial retinal photographs from the same nine patients was analyzed. In the resulting proportional hazards models, the foscarnet area under the concentration-time curve approached statistical significance (P = 0.11) as a predictor of decreased risk of retinitis progression.

Acquired Immunodeficiency Syndrome↗
PubMed1993

A dose-ranging study of daily maintenance intravenous foscarnet therapy for cytomegalovirus retinitis in AIDS.

Thirty-two patients with AIDS and previously untreated cytomegalovirus retinitis completed an induction course of foscarnet, 60 mg/kg every 8 h for 14 days, had retinitis stabilize, and were then randomly assigned to receive foscarnet maintenance as either a 90- or 120-mg/kg/day infusion administered over 2 h. Median survival was 157 and 336 days for the 90- and 120-mg/kg/day groups, respectively (P < .001). In an independent, masked analysis of retinal photographs, median time to progression of retinitis was 31 versus 95 days (P = .13). Daily intravenous foscarnet at a dose of 120 mg/kg (adjusted for renal function) resulted in significantly longer survival and tended to increase time to retinitis progression compared to the standard 90-mg/kg/day maintenance dose. Although a substantial increase in the risk of serious toxicity at the 120-mg/kg/day dose was not observed, the small sample size in this trial limited the power to detect differences that might be clinically important.

AIDS-Related Opportunistic Infections↗
PubMed1991

A two-year longitudinal study of stressful life events, social support, and social problem-solving skills: contributions to children's behavioral and academic adjustment.

We investigated the contributions of stressful life events and resources (social support and social problem-solving skills) to predicting changes in children's adjustment. At Time 1, 361 third through fifth graders completed measures of social support and social problem-solving skills. Their parents completed a stressful life events scale and a child behavior rating measure. The children's teachers provided ratings of behavioral and academic adjustment. 2-year follow-up data (Time 2) were obtained for approximately half of the sample on the same measures. Time 1 stressful life events and resources showed some significant but modest zero-order correlations with the Time 2 adjustment indices. Hierarchical multiple regressions revealed prospective effects for Time 1 social support on later teacher-rated competencies and grade-point average. In addition, increases over time in social support and social problem-solving skills (a composite score) were significantly related to improvement in behavioral and academic adjustment, whereas stressful life events were not predictive of adjustment.

Achievement↗
PubMed1991

Concomitant ganciclovir and zidovudine treatment for cytomegalovirus retinitis in patients with HIV infection: an approach to treatment.

Cytomegalovirus (CMV) retinitis is the most common cause of blindness in patients infected with human immunodeficiency virus (HIV). Ganciclovir, a guanosine nucleoside, has been found to be effective in the short-term treatment of CMV retinitis and in the delay of progression to recurrence of the disease. However, ganciclovir has no intrinsic activity against HIV, and patients with the acquired immune deficiency syndrome often require treatment with zidovudine, the only currently approved therapy for HIV infection. Both agents have been associated with dose-limiting granulocytopenia in such patients, and death from sepsis in the setting of profound decreases in absolute granulocyte counts has been reported. However, recent investigation suggests that with careful patient selection and monitoring, relatively safe concomitant therapy may be possible. This article reviews the toxicity issues that influence the decision to employ concomitant therapy with ganciclovir and zidovudine. An approach to dosing ganciclovir, including a schema for modifying or interrupting the zidovudine dosage based on hematologic status, is also presented. A prospective study is presently under way to determine whether combined therapy in selected patients leads to prolonged survival and a decreased incidence of recurrence of active CMV retinitis.

Cytomegalovirus Infections↗
PubMed1991

Effect of transdermal nicotine delivery as an adjunct to low-intervention smoking cessation therapy. A randomized, placebo-controlled, double-blind study.

To assess the smoking cessation efficacy of transdermal nicotine patches as an adjunct to low-intervention therapy, we conducted a double-blind, placebo-controlled trial in 158 smokers. Participants were randomly assigned to one of the following three study regimens that required daily application of two 15-cm2 patches: (1) 24-hour nicotine delivery, (2) nicotine delivery during wakeful hours only, and (3) placebo. The impact of the three regimens on smoking cessation rates and tobacco withdrawal symptoms was examined. During the last 2 weeks of the trial, 39% of the 24-hour nicotine regimen delivery group, 35% of those on wakeful hour nicotine regimens, and 13.5% of the placebo treatment group achieved abstinence. Self-reported quit rates for the two nicotine patch-wearing regimens, as compared with that for the placebo group, continued to be significantly higher at 6 months. Moreover, compared with placebo, the transdermal nicotine patches significantly reduced tobacco withdrawal symptoms during the first few weeks of quitting. The differences in quit rates and tobacco withdrawal symptoms between the two active groups were not statistically significant. The patches were well tolerated both topically and systemically. We concluded that transdermal nicotine, when used as an adjunct to low-intervention therapy, significantly reduced tobacco withdrawal symptoms and enhanced smoking cessation rates.

Administration, Cutaneous↗
PubMed1990

A controlled clinical trial to assess the effect of a calcium channel blocker on the progression of coronary atherosclerosis.

To determine whether calcium channel blockers influence the progression of coronary atherosclerosis, 383 patients age 65 years or less with 5-75% stenoses in at least four coronary artery segments were selected at random within 1 month of coronary arteriography to participate in double-blind therapy with a placebo or nicardipine 30 mg three times daily. Coronary events (5 deaths, 22 myocardial infarctions, and 28 unstable anginas) occurred in 28 of 192 nicardipine patients and 23 of 191 placebo patients (p = NS). At 24 months coronary arteriography was repeated in 335 patients. Progression, defined as a 10% or more worsening in diameter stenosis, measured quantitatively, was found in 147 of 1,153 lesions (12.7%) in 168 nicardipine patients and in 170 of 1,170 lesions (14.5%) in 167 placebo patients (p = NS). Ninety-two nicardipine patients (55%) and 95 placebo patients (57%) had progression at one or more sites (p = NS). Regression, that is, an improvement by 10% or more in diameter stenosis, was seen in 140 of 2,323 lesions (6.0%) overall, with no significant intergroup difference. Among the 217 patients with 411 stenoses of 20% or less in the first study, such minimal lesions progressed in only 15 of 99 nicardipine patients compared with 32 of 118 placebo patients (15% versus 27%, p = 0.046). In this subgroup, 16 of 178 minimal lesions in nicardipine patients and 38 of 233 minimal lesions in placebo patients progressed (p = 0.038). By stepwise logistic-regression analysis, baseline systolic blood pressure (p = 0.04) and the change in systolic blood pressure between baseline and 6 months (p = 0.002) correlated with progression of minimal lesions. This suggested blood pressure reduction may account for the beneficial action of nicardipine. These results suggested nicardipine has no effect on advanced coronary atherosclerosis but may retard the progression of minimal lesions.

Adult↗
PubMed1989

A clinical, histopathologic, and electron microscopic study of Pneumocystis carinii choroiditis.

We studied the clinical and histopathologic features of Pneumocystis carinii choroiditis in three patients with acquired immunodeficiency syndrome. In two cases, a provisional diagnosis of disseminated P. carinii infection was made by ophthalmologic examination. The characteristic fundus changes in this infection consisted of numerous slightly elevated, plaque-like, yellow-white lesions located in the choroid and unassociated with signs of intraocular inflammation. The diagnosis was confirmed by postmortem examination of the eyes and other organs. Histopathologically, the globes showed many choroidal infiltrates that were eosinophilic, acellular, vacuolated, and frothy. Several such infiltrates were noted within the choroidal vessels and choriocapillaries. Gomori's methenamine silver stain demonstrated many cystic and crescentic organisms. Electron microscopy disclosed thick-walled cystic organisms and large numbers of trophozoites.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Pressure control inverse ratio ventilation as a method to reduce peak inspiratory pressure and provide adequate ventilation and oxygenation.

Nineteen patients with ARDS or pneumonia who were ventilated with PcIRV on the Siemens-Elema Servo 900 C were retrospectively reviewed. The PcIRV reduced peak airway pressure, PEEP, increased Paw, and improved ventilation and oxygenation in these patients. When these patients were compared with themselves on prior conventional IPPV, all had a decrease in PIP, an increase in Paw and most had a decrease in VE, with no change in PaCO2 and an increase in PaO2. The increase in Paw may have contributed to this improved arterial oxygenation. High levels of PIP and PEEP during IPPV have been identified as risk factors in the development of barotrauma and residual parenchymal pulmonary damage. We propose that PcIRV allows for adequate ventilation and oxygenation with decreases in PIP, extrinsically added PEEP and inspired O2 concentration. This mode of ventilation may decrease the morbidity associated with IPPV utilizing high PIP and PEEP.

Adolescent↗
PubMed1987

Prevalence, pathophysiology, and treatment of rhegmatogenous retinal detachment in treated cytomegalovirus retinitis.

Seventeen patients with the acquired immune deficiency syndrome and cytomegalovirus retinitis were treated with the antiviral drug ganciclovir (9-[1,3-dihydroxy-2-propoxy-methyl]-guanine, DHPG). Eight eyes of five patients developed rhegmatogenous retinal detachment after initiation of treatment. Multiple breaks in areas of peripheral, healed, atrophic retina accounted for the detachments. All seven eyes that underwent surgery had extensive retinal detachments that were reattached with vitrectomy and silicone oil. Retinotomy and retinal tacks were necessary in two cases that were complicated by severe proliferative vitreoretinopathy. In the fellow eye of one patient, laser treatment was used prophylactically to wall off a peripheral patch of healed retinitis. Endoretinal biopsies and culture were taken in five eyes; evidence of persistent cytomegalovirus was seen in two cases despite concurrent and clinically effective antiviral therapy.

AIDS-Related Complex↗
PubMed1987

Cytomegalovirus retinitis as the initial manifestation of the acquired immune deficiency syndrome.

We studied eight patients in whom cytomegalovirus retinitis was an initial manifestation of AIDS. Six of these patients had cytomegalovirus retinitis alone at the time of diagnosis and two patients had simultaneous cytomegalovirus retinitis with other AIDS associated diseases (Kaposi's sarcoma in one patient and cytomegalovirus colitis in one patient). Treatment with ganciclovir (dihydroxy propoxymethyl guanine), a new antiviral medication related to acyclovir, resulted in regression of retinitis in all five patients treated with this drug. Our study shows that cytomegalovirus retinitis may be the initial manifestation of AIDS and that ganciclovir is a clinically effective antiviral agent for cytomegalovirus.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Azidothymidine associated with bone marrow failure in the acquired immunodeficiency syndrome (AIDS).

Four patients with the acquired immunodeficiency syndrome, and a history of Pneumocystis carinii pneumonia developed severe pancytopenia (hemoglobin, less than 85 g/L; granulocytes, less than or equal to 0.5 X 10(9)/L; platelets, less than or equal to 30 X 10(9)/L) 12 to 17 weeks after the initiation of azidothymidine (AZT) therapy. The bone marrow was markedly hypocellular in three patients and moderately hypocellular in the fourth. Partial bone marrow recovery was documented within 4 to 5 weeks in three patients, but no marrow recovery has yet occurred in one patient during the more than 6 months since AZT treatment was discontinued. Azidothymidine should be used cautiously, with close monitoring of blood values.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Bilateral diaphragmatic paralysis.

Ventilatory failure developed insidiously in a patient due to bilateral diaphragmatic paralysis from bilateral phrenic neuropathy. The ventilatory failure progressed to respiratory arrest. We assessed the patient's diaphragmatic function by fluoroscopy, transdiaphragmatic pressure measurements during maximal inspiration, measurement of abdominal paradoxic motion, and electrical conduction measurements of the phrenic nerves. He improved and was discharged. A rocking bed was recommended for sleep after appropriate measurements of various respiratory support apparatuses. A history of supine breathlessness and a clinical observation of paradoxic abdominal wall motion during breathing in the supine position should suggest this possible cause.

Aged↗
PubMedDate not supplied

[Effects of transdermal nicotine as an adjunct in smoking cessation therapy. A double-blind randomized study controlled with placebo].

To assess the smoking cessation efficacy of transdermal nicotine patches an adjunct to low-intervention therapy, we conducted a double-blind, placebo-controlled trial in 158 smokers. Participants were randomly assigned to one of the following three study regimens that required daily application of two 15-cm2 patches: 1) 24-hour nicotine delivery, 2) nicotine delivery during wakeful hours only, and 3) placebo. The impact of the three regimens on smoking cessation rates and tobacco withdrawal symptoms was examined. During the last 2 weeks of the trial, 39% of the 24-hour nicotine regimen delivery group, 35% of those on wakeful hour nicotine regimens, and 13.5% of the placebo treatment group achieved abstinence. Self-reported quit rates for the two nicotine patch-wearing regimens, as compared with that for the placebo group, continued to be significantly higher at 6 months. Moreover, compared with placebo, the transdermal nicotine patches significantly reduced tobacco withdrawal symptoms during the first few weeks of quitting. The differences in quit rates and tobacco withdrawal symptoms between the to active groups were not statistically significant. The patches were well tolerated both topically and systemically. We concluded that transdermal nicotine, when used as an adjunct to low-intervention therapy, significantly reduced tobacco withdrawal symptoms and enhanced smoking cessation rates.

Administration, Cutaneous↗