Biomedical subjects

D Slymen

Publications and source records attributed to D Slymen.

10 recordsLinked to original sources

PubMed2001

Promoting sun safety among zoo visitors.

BACKGROUND: Each year, millions of children visit zoological parks, where they are exposed to long bouts of ultraviolet radiation (UVR). We conducted a study in the winter and replicated it in the summer to evaluate an intervention for reducing UVR exposure during the zoo visit. METHODS: Each study used a nonequivalent control group design: one zoological site received the intervention and a second received evaluation only. Key outcome measures consisted of observed prevalence of hat use by exiting children (N = 8,721 and 8,524, respectively, in winter and summer studies) and purchase rates of sunscreen and hats in zoo gift shops. Intervention consisted of tip sheets for parents, children's activities, prompts, and discounts off the price of sunscreen and sun-protective hats. RESULTS: In the summer study, sales of both sunscreen and target hats increased significantly at the intervention site relative to the control site, whereas in the winter study, only sunscreen sales at the intervention site had a significant (relative) increase. Children's hat use increased significantly at the intervention site, but only in the winter study. CONCLUSIONS: The multicomponent program was effective in promoting purchases of sun-safe items, but its impact on children's hat use was inconclusive.

California↗

PubMed2001

Ability of fat and fat-free mass percentages to predict functional disability in older men and women.

OBJECTIVES: Previous studies suggest an association between body composition and declining functional ability in older people. This study examined the relation between functional disability and percentage of fat mass (FM) and percentage of fat-free mass (FFM) in older men and women. DESIGN: Cross-sectional and prospective. SETTING: Rancho Bernardo, California. PARTICIPANTS: Subjects consisted of 1,051 ambulatory, community-dwelling Caucasian men and women, age 55 to 92, who attended a clinic visit between 1988 and 1992 and a subsequent clinic visit between 1992 and 1996. MEASUREMENTS: Measured at both visits, percentage of fat mass and percentage of lean body mass were estimated by bioelectric impedance analysis and functional disability was ascertained by self-administered questionnaire. Functional disability was dichotomized into those having any difficulty with a set of tasks versus those having no difficulty with the tasks. Two measures of functional disability were used: "lower body" disability, consisting of two lower motor tasks (walking 2-3 blocks and climbing up 10 stairs) and "overall" disability, consisting of nine tasks representing upper and lower body function and mobility. RESULTS: Compared with men, women were more likely to report both lower body and overall functional disability (P=.001). Cross-sectionally, a significant positive association was shown between fat mass and overall functional disability and a significant negative association was shown between FFM and overall functional disability in both men and women. Prospectively, increased percentage of body fat and decreased percentage of FFM were significantly associated with decreased functional ability in both women and men. All results were adjusted for age, smoking, alcohol use, physical activity, current estrogen use, depression, chronic disease, and education. CONCLUSION: Increased percentage of fat mass and decreased percentage of FFM are associated with greater functional disability in older men and women. Further research is needed to assess the relative importance of decreasing fat percentage or increasing fat-free percentage to preserve or improve functional ability in older people.

Adipose Tissue↗

PubMed1999

The risk of appendiceal rupture based on hospital admission source.

OBJECTIVE: To determine whether admission source is a potential risk factor for appendiceal rupture. METHODS: Administrative data were obtained from the California Office of Statewide Health Planning and Development for all patients in San Diego County with the primary diagnosis of appendicitis during 1993. The appendiceal rupture ratio was defined as those coded as ruptured (ICD-9-CM codes 540.0 and 540.1) divided by both ruptured and non-ruptured cases (540.9). The odds ratio of appendiceal rupture from routine outpatient office or clinic venues vs those admitted through the ED were calculated using multivariate logistic regression analysis to adjust for age, sex, race, comorbidity, insurance status, and home address to hospital proximity. RESULTS: There were a total of 1,906 patients, of whom 663 (34.8%) had appendiceal ruptures. Of the 1,360 (71.4%) admitted from the ED, 422 (31.0%) had ruptures, compared with 211 (43.3%) of the 487 admitted from outpatient sources (p < 0.0001). Patients with appendicitis directly admitted from outpatient sources were more likely to be complicated by appendiceal rupture than were those admitted through the hospital ED (adjusted odds ratio 1.62, 95% CI = 1.28 to 2.05, p < 0.0001). CONCLUSION: Patients with appendicitis admitted from outpatient sources are more likely to have appendiceal rupture than are those admitted from the ED.

Adolescent↗

PubMed1987

Neoadjuvant therapy for advanced head and neck cancer with allopurinol-modulated high dose 5-fluorouracil and cisplatin. A phase I-II study.

The combination of cisplatin (100 mg/m2) and 5-fluorouracil (5-FU) by continuous infusion (1 g/m2/day for 5 days) has been reported to produce a high response rate as neoadjuvant therapy for advanced squamous cell head and neck cancer. We sought to improve the response rate by increasing the dose of 5-FU to 1.5 g/m2/day and 2.0 g/m2/day with allopurinol modulation to reduce toxicity. The overall response rate in the 30 patients who received three courses of chemotherapy was 100% with a 50% complete response (CR) rate. A 50% CR rate was observed in patients with T3 (six of 12) and N3 (four of eight) disease. Six patients (four with CR) did not complete subsequent treatment as planned. Seven of 11 (63.6%) chemotherapy complete responders and three of 12 (25%) partial responders (one lost to follow-up) who received all planned treatment are free of disease. The major toxicity encountered was stomatitis (severe in 32%) followed by leukopenia. The maximum tolerated dose of 5-FU in this combination with allopurinol protection was 1.5 g/m2/day. Cisplatin plus high dose 5-FU does not appear to be associated with a higher CR rate than that reported with conventional doses of 5-FU and is more toxic.

Adult↗

PubMed1987

Spontaneous variability of ventricular arrhythmias in patients at increased risk for sudden death after acute myocardial infarction: consecutive ambulatory electrocardiographic recordings of 88 patients.

The Cardiac Arrhythmia Pilot Study, sponsored by the National Heart, Lung, and Blood Institute, is a multicenter, prospective, randomized, double-blind trial designed to identify patients having 10 or more ventricular premature complexes (VPCs) per hour within 6 to 60 days of acute myocardial infarction. The present investigation selected patients after acute myocardial infarction who had ambulatory electrocardiographic qualifying arrhythmia for CAPS. An additional baseline electrocardiogram was recorded before enrollment in the study to assess baseline spontaneous variability of VPCs. A total of 88 patients (15 women, 73 men, aged 57 +/- 10 years) were studied. The 43 patients (49%) receiving beta-blocking drugs were included because the dose was not altered between the 2 consecutive electrocardiographic recordings. This investigation shows that a 95% reduction in VPCs is required to document a significant drug effect rather than variability alone if 1 day of control and 1 day of treatment electrocardiographic recording are compared. Similarly, based on 1 day of electrocardiographic recording before and after antiarrhythmic therapy, 1,780% increase in VPC frequency is required to establish "arrhythmia aggravation" from an antiarrhythmic drug rather than from variability alone based on a 95% confidence interval. Variability of ventricular arrhythmias is independent of left ventricular function, whereas patients taking beta-blocking therapy tend to have greater VPC variability (p = 0.052), even though VPC frequencies were lower (59 +/- 19 vs 138 +/- 31 VPCs/hour, p less than 0.006) than those not taking beta-blocking drugs.

Adrenergic beta-Antagonists↗

PubMed1983

A family study of panic disorder.

In a family study of panic disorder, we collected data on 278 first-degree relatives of 41 probands with panic disorder and 262 relatives of 41 control probands. The morbidity risk for panic disorder was 17.3% in the first group, and an additional 7.4% were categorized as having probable panic disorder. Both rates were significantly higher than the respective rates in the control relatives, 1.8% and 0.4%. The risk of panic disorder in female subjects was twice that in male subjects. The rate of generalized anxiety disorder was the same in both groups of families. No other psychiatric disorders were increased in the families of patients with panic disorder. In a preliminary genetic analysis, we tested the single major locus and the multifactorial polygenic transmission models. Neither model was excluded by the data. We conclude that panic disorder is a familial disease that affects women twice as frequently as men and is not associated with an increased familial risk of other psychiatric conditions. Its method of transmission remains uncertain.

Adult↗

PubMed1980

Analysis of bladder tumor recurrence in 178 patients.

The identification of bladder tumor characteristics which may affect tumor recurrence has been of interest to the clinician for a long time. Previous attempts to identify predictive factors of recurrence involved comparisons based on the twelve-month recurrence rate in a prospective clinical investigation of bladder tumor patients observed over a five-year period. A statistical regression model known as the proportional hazards model was employed to identify these factors using the disease-free interval as the outcome variable. Prior bladder cancer history, age at admission, initial tumor stage, grade, number, size, shape, and site were examined. The results confirm that a patient's prior history of bladder cancer must be considered in evaluating his likelihood of tumor recurrence. The analysis then focuses on patients with no prior history for predictive factors of recurrence.

Aged↗

PubMed1980

Factors influencing the recurrence rate of bladder cancer.

A prospective analysis was done on 318 patients with bladder cancer observed during a 4-year period. We examined the predictive value for tumor recurrence of the initial grade, stage, number and size of bladder tumors. None of the observed parameters alone or in combination could predict tumor recurrence. Cystoscopy and cytology, as well as random bladder and tumor biopsies, were part of the diagnostic studies.

Biopsy↗

PubMed1978

Longitudinal study of bladder cancer with cytology and biopsy.

A study of urinary cytology and selected mucosal biopsies in conjunction with cystoscopy provided additional information of value in the management of 318 patients with bladder cancer. These procedures were especially helpful in patients with no visible lesions on follow-up cystoscopies in assessing the bladder epithelium, the behaviour of which may be unpredictable in that no further tumours may occur, or they may arise at irregular intervals.

Animals↗

PubMedDate not supplied

Tympanometric screening in elementary school children.

The revised ASHA (American Speech Language Hearing Association, 1990) hearing screening guidelines were developed to decrease over-referrals for middle ear disorders through amended tympanometric measurements. These guidelines also recommended a large-scale normative study be done with tympanometric measures to further reduce the over-referral rate. Seven hundred and fifty ears from 392 kindergarten through third-grade children were tested. Normative values of Peak Ytm and tympanometric width were calculated by grade. For increasing grade level, there was an orderly increase in the mean Peak Ytm and a decrease in the mean tympanometric width. Sensitivity and specificity were calculated at 65 and 80% respectively, with a prevalence of 11%. Suggestions for improving sensitivity and specificity are discussed.

Acoustic Impedance Tests↗