Biomedical subjects

David B Johnson

Publications and source records attributed to David B Johnson.

7 recordsLinked to original sources

PubMed2006

Phase III trial of gabapentin alone or in conjunction with an antidepressant in the management of hot flashes in women who have inadequate control with an antidepressant alone: NCCTG N03C5.

PURPOSE: Despite the utility of newer antidepressants for alleviating hot flashes, antidepressants do not work adequately enough in many patients. Gabapentin is a nonhormonal agent that also can reduce hot flashes. No data have been available to address whether the combination of both agents would more effectively alleviate hot flashes, compared with gabapentin alone, in patients with inadequate hot flash control with an antidepressant alone. PATIENTS AND METHODS: This was a randomized trial in which 118 patients with inadequate hot flash control on an antidepressant were randomly assigned to receive both an antidepressant and gabapentin versus being weaned off the antidepressant and receiving gabapentin alone. Patients were observed for 5 weeks (including a baseline week in which patients continued on their current antidepressant without gabapentin) during which time they completed validated daily hot flash diaries. RESULTS: Ninety-one patients provided complete data at the 5-week assessment. Regardless of whether or not the antidepressant was continued when gabapentin was started, there was an approximately 50% median reduction in hot flash frequencies (54%; 95% CI, 34% to 70% for combined treatment v 49%; 95% CI, 26% to 58% for gabapentin alone) and scores (56%; 95% CI, 26% to 71% for combined treatment v 60%; 95% CI, 33% to 73% for gabapentin alone). CONCLUSION: Gabapentin seems to decrease hot flashes by approximately 50% in women with inadequate hot flash control who were using an antidepressant. This study saw no significant additional hot flash reduction from continuation of the antidepressant.

Adult↗

PubMed2005

Depression, anxiety and neuropsychological test scores of candidates for coronary artery bypass graft surgery.

The effect of depression and anxiety upon neuropsychological test scores of candidates for coronary artery bypass graft (CABG) surgery was examined. Sixty patients were administered the Beck Depression Inventory II and the State-Trait Anxiety Inventory, along with a battery of neuropsychological tests. Regression analyses were conducted in which the neuropsychological test scores were predicted using age, education, depression, anxiety, and combined depression-anxiety scores. While age and education were significant predictors of several neuropsychological test measures, no significant regression analysis results were obtained for the depression, anxiety and combined depression-anxiety scores. Similarities and discrepancies between this research and previous studies are discussed. It appears that low levels of preoperative depression and anxiety states do not affect neuropsychological functioning among CABG candidates.

Aged↗

PubMed2004

Cancer in Micronesia.

Between November 1998 and December 1999, trained medical record abstractors visited the Micronesian jurisdictions of Chuuk, Kosrae, Pohnpei, and Yap (the four states of the Federated States of Micronesia), as well as the Republic of Palau (Belau), the Republic of Kiribati, the Republic of the Marshall Islands (RMI), and the Republic of Nauru to review all available medical records in order to describe the epidemiology of cancer in Micronesia. Annualized age-adjusted, site-specific cancer period prevalence rates for individual jurisdictions were calculated. Site-specific cancer occurrence in Micronesia follows a pattern characteristic of developing nations. At the same time, cancers associated with developed countries are also impacting these populations. Recommended are jurisdiction-specific plans that outline the steps and resources needed to establish or improve local cancer registries; expand cancer awareness and screening activities; and improve diagnostic and treatment capacity.

Developing Countries↗

PubMed2004

Cancer epidemiology in the freely associated U.S. Pacific Island jurisdictions: challenges and methodologic issues.

The health care systems of the U.S.-associated Pacific Island jurisdictions, especially the three freely associated states (Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Belau), are faced with problems similar to developing countries such as malnutrition and infectious diseases, as well as diseases relating to westernization such as diabetes, heart disease, and cancer. Although cancer has emerged as an important cause of morbidity and mortality in the Pacific, little population-based data are currently available. This paper addresses some of the practical and methodological challenges to obtaining accurate and reliable cancer data in these jurisdictions. This paper discusses the use of annualized period prevalence to allow for some measurement of cancer burden when cancer incidence cannot be accurately calculated. This method, however, has its own limitations as cancer prevalence relates to both incidence and duration of illness, and numerous factors impact survival potential (i.e., preexisting diseases, lifestyle practices, and access to treatment). In addition, under-ascertainment and data quality issues will impact any cancer morbidity or mortality measurements. Thus, improvement in the health care systems, including the creation and ongoing support of active cancer registries would be the optimal approach to better delineating cancer occurrence and risk for the populations of these Pacific Island jurisdictions.

Delivery of Health Care↗

PubMed2004

Native Hawaiians mortality, morbidity, and lifestyle: comparing data from 1982, 1990, and 2000.

This paper shares 2000 data on Native Hawaiian health and compares the 2000 data with data from 1982 and 1990. The findings suggest that Native Hawaiians continue to die at younger ages than Hawai'i residents in other ethnic groups, have a higher prevalence of hypertension, diabetes, and asthma than other ethnic groups, and have higher rates of smoking, drinking, and being overweight. Compared to earlier years, however, smoking and drinking prevalence has decreased, and more Native Hawaiians are getting physical exams and other screening exams. These improvements may be related to increases in Native Hawaiian health professionals, supported by the Native Hawaiian Health Scholarship Program, and to increased access to health education and to care through outreach programs such as the Native Hawaiian Health Care Systems and the Breast and Cervical Cancer Control Program. If these programs are allowed to continue and to expand, we should see an improvement in overall health status of Native Hawaiians.

Adolescent↗

PubMed2002

Outcome after induction chemotherapy for older patients with acute myeloid leukemia is not improved with mitoxantrone and etoposide compared to cytarabine and daunorubicin: a Southwest Oncology Group study.

Complete remission and long-term survival rates are low for older adults treated for acute myeloid leukemia (AML). Because of favorable phase 2 data using mitoxantrone and etoposide, we conducted a phase 3 study (SWOG-9333) in which patients over 55 years of age with previously untreated AML were randomized to receive mitoxantrone (10 mg/m(2) per day x 5) and etoposide (100 mg/m(2) per day x 5) [ME], or cytarabine (200 mg/m(2) per day x 7) and daunorubicin (45 mg/m(2) per day x 3) [AD] as induction therapy. The randomization was stratified by age, onset of leukemia, and multidrug resistance phenotype. Over a 4-year period, 328 eligible patients from 66 institutions were enrolled. The complete remission rate was 34% (95% confidence interval [CI] 26%-41%) for patients in the ME and 43% (CI 35%-51%) for patients in the AD treatment arm (one-tailed P value.96). The rates of resistant disease were 43% (CI 35%-51%) and 34% (CI 27%-42%), respectively, for the 2 treatment arms (one-tailed P value.95). The estimated overall survival at 2 years was 11% (CI 6%-15%) and 19% (CI 12%-25%) for patients randomized to ME and to AD induction therapy, respectively (one-tailed P value.99). After accounting for the independent prognostic factors associated with survival (karyotype, performance status, age, white blood cell count), exploratory analysis suggested there was a worse survival for patients who received ME compared with AD induction therapy (2-tailed P value.0066). We conclude that the results of our study do not demonstrate any benefit to the use of ME induction chemotherapy instead of AD in older patients with AML.

Acute Disease↗

PubMed2002

Modeling medical content for automated summarization.

Medical information is available from a variety of new online resources. Given the number and diversity of sources, methods must be found that will enable users to quickly assimilate and determine the content of a document. Summarization is one such tool that can help users to quickly determine the main points of a document. Previous methods to automatically summarize text documents typically do not attempt to infer or define the content of a document. Rather these systems rely on secondary features or clues that may point to content. This paper describes text summarization techniques that enable users to focus on the key content of a document. The techniques presented here analyze groups of similar documents in order to form a content model. The content model is used to select sentences forming the summary. The technique does not require additional knowledge sources; thus the method should be applicable to any set of text documents.

Automation↗