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Biomedical subjects

David J Martin

Publications and source records attributed to David J Martin.

13 recordsLinked to original sources
PubMed2006

Returning to work with HIV/AIDS: a qualitative study.

In addition to being an outcome, workforce reentry is a process: People with HIV/AIDS attempting to go back to work must make initial decisions to engage in such an attempt, they then must go through a series of steps that may include re-education or retraining, job searches, résumé development, and other activities. Sustaining employment, in turn, entails its own set of activities. People attempting workforce reentry may also experience barriers on their journeys back to work, they may employ certain strengths to reach their goals, and they may use resources to facilitate preparation for work. Few studies have attempted to study this process. This study was designed to provide an initial attempt to study the process of workforce reentry. Abstracted information from the progress notes of 104 people with HIV/AIDS attempting workforce reentry was qualitatively analyzed using a grounded theory approach to identify themes. Three major themes emerged with reliability: Barriers to workforce reentry, staff-identified strengths, and resources used in workforce-reentry efforts. Although none predicted successful workforce reentry, participants in the study experienced substantial barriers in their workforce-reentry efforts, staff identified significant strengths, and participants used appropriate resources in their efforts to go back to work. Implications for workforce-reentry programs for people with HIV/AIDS are discussed.

Adult↗
PubMed2006

Workforce reentry for people with HIV/AIDS: intervention effects and predictors of success.

Treatment that prolongs the lives of people with HIV/AIDS and improves their quality of life is relatively recent and little is known about factors that may predict their successful re-entry to the workforce. No data exist concerning the effectiveness of programs to assist people with HIV/AIDS in their efforts to return to work. We used logistic regression and Kaplan-Meier survival curves to predict return to work using data from 126 individuals who participated in an HIV/AIDS return to work program. Results from the 24 month follow-up revealed that program participation, general health, benefits status, and gender, predicted successful re-entry to the workforce. We discuss these findings in the context of the need for more explicitly-defined interventions, as well as the need for additional information on factors that may hinder or facilitate workforce re-entry among people with HIV/AIDS.

Adult↗
PubMed2005

The influence of gender on parasympathetic vasodilatation in the submandibular gland of the rat.

Parasympathetic vasodilatation in the rat submandibular gland is mediated by nitric oxide-dependent and -independent mechanisms (prostacyclin and endothelium-derived hyperpolarizing factor (EDHF)). The purpose of this study was to determine the influence of gender on the relative contributions of each pathway to nerve-stimulated vasodilatation. Absolute increases in perfusion (laser Doppler flowmetry) were similar in male and female rats (in arbitrary perfusion units: 6159+/-4530 and 5601+/-3877 at 2 Hz; 15645+/-6830 and 14848+/-6118 at 5 Hz; and 22418+/-7660 and 18878+/-5864 at 10 Hz). However, expressed as a percentage increase above resting values, stimulated perfusion was higher in males than in females (P<0.05). In males both Nomega-nitro-L-arginine methyl ester (L-NAME) and indomethacin partly blocked parasympathetic vasodilatation at all frequencies tested (P<0.05). In female rats significant reductions in nerve-stimulated perfusion were observed only at 2 and 5 Hz, but the effects of L-NAME were greater than in males (-64 compared with -45% at 2 Hz and -45 compared with -33% at 5 Hz, P<0.05). Indomethacin by itself had no apparent effect in females. The combined effects of L-NAME and indomethacin were dependent on the order of administration and on gender. Following L-NAME, indomethacin had no further effect in males or females. L-NAME reduced indomethacin-resistant vasodilatation in males and females, but the added effect of indomethacin was more pronounced in males. Finally, atropine-resistant vasodilatation was partly blocked by L-NAME, and the remaining vasodilatation was abolished by spantide I (substance P receptor antagonist). We conclude that NO, products of cyclo-oxygenase activity and EDHF all play a role in parasympathetic vasodilatation, but that NO and EDHF are the major endothelium-derived vasodilators in the rat submandibular gland. In addition, when other pathways are blocked EDHF makes a greater contribution in females. Lastly, both vasoactive intestinal peptide and substance P contribute to the atropine-resistant vasodilatation.

Animals↗
PubMed2005

The relationship between plasma viral load and neuropsychological functioning in HIV-1 infection.

Plasma viral load is helpful in monitoring systemic HIV infection but the relationship between plasma viral load and CNS functioning remains unclear. Equivocal results have been reported on the relationship between plasma viral load and cognitive functioning. The present study tested cognitive functions with a standardized neuropsychological battery consisting of 28 test scores. Participants (N=140) were grouped into undetectable (<400 copies), low (401-10,000 copies), or moderate (10,001-100,000 copies) viral load groups. Statistical analyses (MANOVA and MANCOVA) revealed no differences in neuropsychological test performance between the viral load groups. Fairly healthy patients with moderate plasma viral loads do not appear to show increased neuropsychological dysfunction. CSF viral load may be more helpful in evaluating cognitive correlates of HIV encephalitis.

Adult↗
PubMed2005

Brachial artery transection associated with closed and open dislocation of the elbow.

Acute dislocations of the elbow complicated by brachial artery involvement are rare but serious injuries. Rapid assessment and a high index of suspicion are essential to facilitate prompt treatment, as delay in diagnosis is associated with a poorer outcome. We present two cases of brachial artery transection after closed and open dislocation of the elbow, and discuss the appropriate management of such patients.

Adult↗
PubMed2005

The utility of screening renal ultrasonography: identifying renal cell carcinoma in an elderly asymptomatic population.

OBJECTIVE: To evaluate the efficacy and utility of screening renal ultrasonography (RUS) in older patients with a high prevalence of risk factors for renal cell carcinoma (RCC), as with the widespread use of advanced imaging techniques the identification of incidental RCC has increased, and although previous studies in low-risk groups reported little use for screening RUS, its utility in high-risk groups is unknown. PATIENTS AND METHODS: From 1993 to 1997, screening RUS was completed for 6678 consecutive patients in conjunction with the Aneurysm Detection and Management study. Patient demographics, medical and social history were recorded for each patient. Screening RUS was completed by one ultrasonographer using a 3.5-MHz sector scanner. A urologist verified any abnormalities identified by RUS during consultation. Additional imaging tests were obtained selectively and intervention was recommended based on the results of the genitourinary evaluation. RESULTS: From the screened population of 6678 patients, 817 (12.3%) renal anomalies were found, including a solid renal mass in 22 (0.32%), simple renal cysts in 627 (9.4%), hydronephrosis in 21 (0.31%), renal calculi in 121 (1.8%), or other abnormalities in 24 (0.36%). Treatment was completed for 15 renal cancers; 13 were organ-confined on pathological review. At a mean follow-up of >55 months, 12 of the 15 patients with RCC survived. CONCLUSIONS: In this older cohort, retroperitoneal RUS was an effective tool for case-finding by detecting significant findings in an asymptomatic population. The prevalence of solid renal masses (0.32%) was higher than reported with other screening protocols. Although probably not the best method for generalized primary screening, the use of RUS may still be beneficial for 'secondary' screening in a more selected patient population.

Aged↗
PubMed2003

Perceived employment barriers and their relation to workforce-entry intent among people with HIV/AIDS.

As treatments have improved health and quality of life for people with HIV/AIDS, many have contemplated workforce reentry. Workforce reentry rarely occurs among people with illness-related disability. The authors mailed a survey that included workforce-entry-related concerns to 1,991 HIV/AIDS clients. Factor analysis extracted 6 areas of concern (benefits loss, work-related health, job skills, discrimination, personal health care, workplace accommodation). Levels of concern generally increased with HIV acuity level and time since last worked. Work-related health concerns predicted consideration of workforce entry, and work-related health concerns and benefits-loss concerns predicted estimated time to return to work. Findings provide quantitative validation of intuitive categories of workforce-entry concerns among people with HIV/AIDS and suggest that concerns may shift with progress toward workforce entry.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Transdermal application of verapamil gel to the penile shaft fails to infiltrate the tunica albuginea.

PURPOSE: There currently exists no universally accepted pharmacotherapy for Peyronie's disease. Recently interest has grown in transdermal agents, including verapamil. We evaluated the ability of a commercially available verapamil gel applied to the penile skin to infiltrate the tunica albuginea. MATERIALS AND METHODS: In men scheduled to undergo penile prosthesis surgery for erectile dysfunction verapamil gel was applied to the penile shaft the night before and morning of surgery. Urine was obtained at the commencement of the implant operation and tunical samples were excised from each corporeal body intraoperatively. Verapamil quantification was performed in all specimens using high pressure liquid chromatography. RESULTS: All patients tolerated verapamil gel application without any adverse events. A mean of 1.1 gm. tunical tissue was excised. Mean verapamil concentration in the urine was 46 ng./ml. No verapamil was detected in any tunical specimens. CONCLUSIONS: These data indicate that applying transdermal verapamil gel to the penile shaft results in a small amount of systemic absorption but the gel does not infiltrate the tunica albuginea. Based on these findings the use of transdermal verapamil for Peyronie's disease has no scientific basis.

Absorption↗
PubMed2002

Pediatric hernias.

Indirect inguinal hernias, hydroceles, and umbilical hernias are extremely common in infancy and childhood. Less commonly encountered are femoral, direct inguinal, epigastric, and Spigelian hernias. Patient history and physical examination are usually sufficient for the diagnosis of a hernia. If the diagnosis is uncertain, ultrasound examination or herniograms are occasionally employed. Magnetic resonance imaging may be useful in diagnosing abdominal wall hernias in obese patients for whom physical examination is difficult.

Child↗
PubMed2002

A meta-analysis of the neuropsychological sequelae of HIV infection.

This meta-analysis summarizes the broad spectrum of neuropsychological research on HIV disease across a sample of 41 primary studies and an aggregate of 8,616 participants for 10 major neuropsychological ability areas. Analyses of the course of cognitive decline within and across Centers for Disease Control classifications reveals statistically significant cognitive deficits from asymptomatic HIV to AIDS. Effect sizes (Cohen, 1988) were calculated to reflect between-group (asymptomatic, symptomatic, AIDS) differences in each neuropsychological domain. Relatively small effect sizes were obtained for the asymptomatic (0.05-0.21) patients, and generally small to moderate effect sizes were obtained for symptomatic (0.18-0.65) HIV+ patients, with motor functioning exhibiting the greatest effects in this later disease stage. The most notable deficits in cognitive functioning were found in the AIDS group with moderate (attention and concentration) to large (motor functioning) effect sizes with values ranging from 0.42-0.82. Comparison of cognitive functioning as a function of disease progression revealed that motor functioning, executive skills, and information processing speed were among the cognitive domains showing the greatest decline from early to later stages of HIV. These findings indicate that cognitive deficits in the early stages of HIV are small and increase in the later phases of the illness, and that specific patterns of cognitive deficits can be detected with disease progression. These results and their clinical utility are further discussed.

AIDS Dementia Complex↗
PubMed2002

GLK gene pairs regulate chloroplast development in diverse plant species.

Chloroplast biogenesis is a complex process that requires close co-ordination between two genomes. Many of the proteins that accumulate in the chloroplast are encoded by the nuclear genome, and the developmental transition from proplastid to chloroplast is regulated by nuclear genes. Here we show that a pair of Golden 2-like (GLK) genes regulates chloroplast development in Arabidopsis. The GLK proteins are members of the GARP superfamily of transcription factors, and phylogenetic analysis demonstrates that the maize, rice and Arabidopsis GLK gene pairs comprise a distinct group within the GARP superfamily. Further phylogenetic analysis suggests that the gene pairs arose through separate duplication events in the monocot and dicot lineages. As in rice, AtGLK1 and AtGLK2 are expressed in partially overlapping domains in photosynthetic tissue. Insertion mutants demonstrate that this expression pattern reflects a degree of functional redundancy as single mutants display normal phenotypes in most photosynthetic tissues. However, double mutants are pale green in all photosynthetic tissues and chloroplasts exhibit a reduction in granal thylakoids. Products of several genes involved in light harvesting also accumulate at reduced levels in double mutant chloroplasts. GLK genes therefore regulate chloroplast development in diverse plant species.

Amino Acid Sequence↗
PubMed2002

Protein S deficiency manifesting as spontaneous aortic thrombosis in a neonate.

PURPOSE: This article describes a neonate with protein S deficiency who presented with life-threatening thrombosis of the aorta. This is the first case report of a neonate with protein S deficiency presenting with aortic thrombosis. PATIENTS AND METHODS: A 9-day-old boy presented with a history of dark colored urine, vomiting, and apnea. The clinical examination was consistent with a coarctation of the aorta. An echocardiogram showed a normal arch of the aorta. An abdominal ultrasound done revealed an incompletely occluding thrombus in the aorta starting between the celiac axis and superior mesenteric artery to the aortic bifurcation. The patient was started on recombinant tissue plasminogen activator along with heparin and fresh frozen plasma. RESULTS: With tissue plasminogen activator, we were able to reestablish flow across the obstruction within a week. The patient had hypertension and renal failure that still requires dialysis. CONCLUSION: Protein S deficiency should be considered in a neonate with aortic thrombosis, and it can be treated successfully with a combination of high-dose tissue plasminogen activator and heparin followed by long-term heparin use.

Journal Article↗