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Biomedical subjects

David Lee

Publications and source records attributed to David Lee.

At least 55 records · Page 3Linked to original sources
PubMed2005

The outcome consequences of defunding the Minnesota youth tobacco-use prevention program.

OBJECTIVE: To assess the immediate and intermediate outcome consequences of defunding a successful tobacco use prevention program. METHODS: A four-survey repeated cross-sectional design is employed. Two surveys were completed while the program was fully operational, one after program dismantling was initiated and another about 6 months after the campaign was completely dismantled. Survey to survey trends for five immediate and six intermediate outcomes are analyzed. Changes in measures are tested employing chi-square estimated using SAS 8. RESULTS: Each immediate outcome measure declined significantly from the third to the fourth survey except one, and this measure declined from the second to the third survey when it was eliminated. All intermediate outcomes showed significant change from the third or second to the fourth survey. These include two measures of openness to smoking, three attitude/belief scales and one measure of intention to smoke. CONCLUSIONS: Defunding a successful tobacco-use prevention campaign results in rapid erosion of program messages, parallel increases in susceptibility, a rapid and sharp re-emergence of pro-tobacco attitudes/beliefs and a marked rise in intentions to smoke.

Adolescent↗
PubMed2005

Comparison of flexible ureteroscopes: deflection, irrigant flow and optical characteristics.

PURPOSE: We measured and compared the deflection, irrigation flow rates, distortion, resolution and light transmission of new generation flexible ureteroscopes. MATERIALS AND METHODS: Multiple characteristics of 5 flexible ureteroscopes (ACMI DUR-8 Elite, Olympus URF-P3, Storz 11278AU1 [Flex-X], Wolf 7330.072 and Wolf 7325.172) commonly available in the market were measured and compared. Measured data included active deflection, irrigation flow rates and optical characteristics. Each ureteroscope was evaluated with an empty working channel and with various accessories. Optical characteristics, specifically resolution and distortion, were measured using test targets (Edmund Optics, Barrington, New Jersey). Light transmission was also measured from the ureteroscope tip at 50% and 100% intensity. All 5 flexible ureteroscopes were tested in a laboratory setting using a Storz OR 1 system to capture the images. RESULTS: For all 5 ureteroscopes the angle of deflection was most impaired by a 365 microm laser fiber probe and least impaired by a 2.2Fr nitinol basket. Among all 5 ureteroscopes irrigation flow rate was most impaired with a 3.0Fr basket and least impaired with 200 microm laser fiber. The Wolf 7325.172 had the highest observed resolution of 25.39 lines per mm and the Wolf 7330.072 had the lowest distortion at 11.9%. The Karl Storz Flex-X and the ACMI DUR-8 Elite had the highest light output at 374 and 364 mV, respectively. CONCLUSIONS: The various flexible ureteroscopes differ with regard to flow rates as well as degree of deflection with either an empty or an occupied working channel. The Wolf flexible ureteroscope with a slightly larger working channel and a fused quartz bundle provided for superior flow and better optical performance. However, the greatest amount of tip deflection and highest light output were found in the ACMI and Karl Storz flexible ureteroscopes.

Artifacts↗
PubMed2005

Development and characterization of microsatellite markers in Cynara cardunculus L.

Cynara cardunculus L. is a species native to the Mediterranean basin that comprises 2 crops, globe artichoke (var. scolymus L.) and cultivated cardoon (var. altilis DC), as well as wild cardoon (var. sylvestris (Lamk) Fiori). Globe artichoke represents an important component of the South European agricultural economy but is also cultivated in North Africa, the Near East, South America, the United States, and China. Breeding activities and molecular marker studies have been, to date, extremely limited. Better knowledge of the genome of the species might be gained by developing a range of molecular markers. Here, we report on the development of 14 microsatellites (simple sequence repeats (SSRs)) through a novel approach that we have defined as the microsatellite amplified library (MAL). The approach represents a combination of amplified fragment length polymorphism and a primer extension based enriched library, is rapid, and requires no hybridization enrichment steps. The technique provided a approximately 40-fold increase in the efficiency of SSR identification compared with conventional library procedures. The developed SSRs were applied for genotyping 36 accessions of C. cardunculus, including a core of 27 varietal types of globe artichoke, 3 accessions of cultivated cardoon, and 6 Sicilian accessions of wild cardoon. Principal coordinates analysis made it possible to differentiate both cultivated and wild forms from each other.

Cynara↗
PubMed2005

Comparative development and impact of transgenic papayas in Hawaii, Jamaica, and Venezuela.

We present data concerning the creation of transgenic papayas resistant to Papaya ringspot virus (PRSV) and their adoption by three different countries: the United States (e.g., Hawaii), Jamaica, and Venezuela. Although the three sets of transgenic papayas showed effective resistance to PRSV, the adoption rate in each country has varied from full utilization in Hawaii to aggressive testing but delay in deregulating of the product in Jamaica to rejection at an early stage in Venezuela. Factors that contributed to the rapid adoption in Hawaii include a timely development of the transgenic product, PRSV causing severe damage to the papaya industry, close collaboration between researchers and the industry, and the existence of procedures for deregulating a transgenic product. In Jamaica, the technology for developing the initial field-testing of the product progressed rather rapidly, but the process of deregulation has been slowed down owing to the lack of sustained governmental efforts to complete the regulatory procedures for transgenic crops. In Venezuela, the technology to develop and greenhouse test the transgenic papaya has moved abreast with the Jamaica project, but the field testing of the transgenic papaya within the country was stopped very early on by actions by people opposed to transgenic products. The three cases are discussed in an effort to provide information on factors, other than technology, that can influence the adoption of a transgenic product.

Amino Acid Sequence↗
PubMed2004

Age-dependent cerebral hemodynamic effects of indomethacin in the newborn piglet.

With recent discussions in the literature regarding prophylactic use of early (within the first 12 h after birth), low-dose indomethacin to reduce the incidence and severity of intraventricular hemorrhage, knowledge pertaining to the cerebral hemodynamic effects of indomethacin in this age group is of significant interest. The cerebral circulation is known to undergo significant changes during the first few days of postnatal life. In the present study, we have investigated the hypothesis that postnatal adaptive changes influence the cerebral hemodynamic response to indomethacin in an age-dependent manner. Near-infrared spectroscopy with indocyanine green was used to measure cerebral hemodynamics, cerebral metabolic rate of oxygen, and cerebral oxygen extraction fraction in 39 newborn piglets. Piglets were grouped by age and received either 0.2 mg/kg indomethacin (14 were <13 h of age and 12 were >13 h of age) or saline (8 were <13 h of age and 5 were >13 h of age) infusions. In a subgroup of indomethacin-treated piglets (9 less than and 7 greater than 13 h of age), Doppler flow ultrasound was used to diagnose and monitor the presence and persistence of patent ductus arteriosus. Age was a significant factor in the cerebral hemodynamic response to indomethacin with piglets <13 h of age exhibiting delayed increases in cerebral blood flow and cerebral blood volume at 150 min post-indomethacin infusion.

Adaptation, Physiological↗
PubMed2004

Progress towards mapping the universe of protein folds.

Although the precise aims differ between the various international structural genomics initiatives currently aiming to illuminate the universe of protein folds, many selectively target protein families for which the fold is unknown. How well can the current set of known protein families and folds be used to estimate the total number of folds in nature, and will structural genomics initiatives yield representatives for all the major protein families within a reasonable time scale?

Chromosome Mapping↗
PubMed2004

Outcome of acute ST-segment elevation myocardial infarction in diabetics treated with fibrinolytic or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: lessons from the GUSTO V trial.

OBJECTIVES: We studied the outcome of diabetics enrolled in the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) V trial to assess whether the combination of half-dose reteplase and abciximab provides any propitious benefits over standard fibrinolytic therapy in diabetic patients. BACKGROUND: Diabetics with acute ST-segment elevation myocardial infarction (MI) have a worse outcome compared with nondiabetics. Higher-risk patients are usually more likely to benefit from advances in medical therapy. METHODS: We analyzed diabetic patients enrolled in the GUSTO V trial to assess the outcome of those randomized to the combination of half-dose reteplase and abciximab versus those randomized to reteplase. We also evaluated whether any differences existed in presentation and outcome of MI among the diabetics versus the nondiabetics enrolled in the study. RESULTS: The trial enrolled 13782 nondiabetics and 2633 diabetics. Compared to nondiabetics, diabetics had a significantly higher mortality at 30 days (8.5% vs. 5.1%, p < 0.001) and at 1 year (12.7% vs. 7.5%, p < 0.001). Among the diabetic subset, no significant difference existed in the incidence of 30-day (8.8% vs. 8.2%, p = 0.52) or 1-year mortality (13.0% vs. 12.4%, p = 0.62) among patients randomized to reteplase compared to those receiving combination of abciximab and reteplase. The incidence of reinfarction (2.5% vs. 4.3%, p = 0.013), recurrent ischemia (11.8% vs. 14.9%, p = 0.017), and urgent revascularization (10.9% vs. 13.3%, p = 0.055) at seven days was lower in diabetics treated with the combination therapy. CONCLUSIONS: Compared to nondiabetics, diabetics continue to have a worse outcome with MI. Although combination therapy did not provide a survival benefit, nonfatal ischemic outcomes, including reinfarction, recurrent ischemia, and urgent revascularization, were substantially reduced.

Abciximab↗
PubMed2004

Communication with referring physicians in a palliative radiotherapy clinic.

GOALS: The rapid response radiotherapy program (RRRP) at Toronto-Sunnybrook Regional Cancer Center (TSRCC) provides quick access to palliative radiotherapy for patients with a life expectancy of less than 12 months. Patients then return to their referring physician for continued oncologic management. After the initial RRRP consultation, we fax an interim consultation report to the referring physician. The purpose of this study was to assess how useful referring physicians perceive this interim report and whether this report needs to be modified to meet their information needs. METHODS: Physicians who referred patients to the RRRP and who were faxed an interim consultation report were identified over a 4-month period. These physicians were then faxed a questionnaire that asked how useful the interim report was in patient management, about their satisfaction with the information provided, to critique the report format, and whether the RRRP physician and nurse were easily accessible by telephone. MAIN RESULTS: Forty physicians referred patients to the RRRP clinic over the 4-month study period. The response rate to our survey was 58% (23/40). The vast majority of physicians (95%) stated that the interim consultation report was useful in patient management. They felt that treatment details were adequately discussed in the report. The report format was perceived to be clear and concise. Referring physicians wished to be informed about any medication changes. RRRP physicians and nurse were perceived to be easily accessible by telephone if needed. CONCLUSIONS: Results showed that referring physicians found the faxed interim consultation report useful in patient management. Suggestions were made on how to improve the report, and they will be used to further enhance physician communication and ultimately patient care.

Cancer Care Facilities↗
PubMed2004

Race, ethnicity, insurance coverage, and preoperative status of hip and knee surgical patients.

Our objective was to examine the association between race/ethnicity and insurance type and the preoperative status of patients undergoing joint arthroplasty surgery. Quality of life and WOMAC measures were collected preoperatively in a consecutive series of patients undergoing primary hip or knee arthroplasties (n = 573). Non-Hispanic whites had lower preoperative pain and WOMAC scores and higher Quality Well Being Index and SF-36 scores compared with other racial/ethnic subgroups. Patients with Medicare/private insurance had better preoperative scores relative to patients with Medicaid or no insurance. Racial/ethnic status was generally more strongly associated with preoperative status than was insurance type. Hispanics, blacks, and patients without Medicare or private health insurance reach arthroplasty surgery with lower preoperative functional and health status.

Arthroplasty, Replacement, Hip↗
PubMed2004

Thigh pain in primary total hip arthroplasty: the effects of elastic moduli.

Thigh pain after uncemented total hip arthroplasty (THA) remains a controversial topic. Our objective was to assess the effect of material composition in the development of thigh pain after primary THA. A cohort of 241 primary THAs was followed for a minimum of 2 years. All patients received identically shaped tapered cementless femoral components; the first half received a Cr-Co-Mo implant and the other half an identical implant made of Ti-6Al-4V. There were no statistically significant preoperative differences in the 2 component groups except that the percentage of blacks in the Cr-Co-Mo group was larger than in the Ti-6Al-4V group (26% vs. 14%; P <.05). The overall 1- and 2-year incidence of thigh pain was 9.5% and 8.7%, respectively. Implant composition was unrelated to reported thigh pain 1 and 2 years postoperatively. However, patients receiving larger versus smaller stems irrespective of material composition were more likely to report thigh pain at year 1 (relative risk = 4.68; 95% confidence interval = 1.41, 15.50). Thigh pain reported at year 2 was also higher in patients with larger versus smaller implants; however, this difference was not statistically significant (RR = 1.73; 95% CI = 0.68, 4.43). Material composition of this tapered stem design is unrelated to the incidence of thigh pain.

Adolescent↗
PubMed2004

Divergent outcomes after percutaneous therapy for symptomatic renal artery stenosis.

OBJECTIVE: Percutaneous intervention for symptomatic renal artery atherosclerosis is rapidly replacing surgery in many centers. This study evaluated the anatomic and functional outcomes of endovascular therapy for atherosclerotic renal artery stenosis on a combined vascular surgery and interventional radiology service at an academic medical center. METHODS: This was a retrospective analysis of patients who underwent renal artery angioplasty with or without stenting between January 1990 and June 2002. Indications included hypertension (86%) and rising serum creatinine concentration (55%). One hundred forty-six patients (80 women; average age, 71 years [range, 44-89 years]) underwent 183 attempted interventions (64 to treat bilateral stenosis). Forty-five percent of patients had significant bilateral disease: 27% had greater than 50% bilateral stenosis, and the remainder had nonfunctioning, absent, or occluded vessels. RESULTS: Of 183 planned interventions, technical success (<30% residual stenosis) was achieved in 179 vessels (98%) with placement of 137 stents (75%). Thirty-day mortality was 0.7%. The major morbidity rate was 4%, and the procedure-related complication rate was 18%. Five-year cumulative patient mortality was 25%. Primary patency, assisted primary patency, and recurrent stenosis rates were 82% +/- 9%, 100% +/- 0%, and 30% +/- 7%, respectively, at 5 years. Within 3 months of the procedure, 52% of patients who received treatment of hypertension demonstrated clinical benefit (hypertension improved or cured), which was maintained in 68% of patients at 5 years. Serum creatinine concentration was lowered or stabilized in 87% of patients within 3 months of the procedure, but this benefit, including freedom from dialysis, was maintained in only 45% of patients at 5 years. CONCLUSIONS: Endovascular intervention for symptomatic atherosclerotic renal artery stenosis is technically successful. There were excellent patency and low recurrent stenosis rates. There is immediate clinical benefit for most patients, but divergent long-term functional outcomes. Endovascular interventions modestly enhance the care of the patient with hypertension, but poorly preserve long-term renal function in the patient with chronic renal impairment.

Academic Medical Centers↗
PubMed2004

The effect of music on preprocedure anxiety in Hong Kong Chinese day patients.

AIMS AND OBJECTIVES: To identify the effect of music on preprocedure anxiety levels of Hong Kong Chinese patients undergoing day procedures in a local community based hospital. DESIGN: Pre and post-test quasi experimental design with non-random assignment. METHOD: A total of 113 participants were assigned to the control group or intervention group depending on the day of their procedure. Participants' anxiety levels were measured objectively by comparing their vital signs and subjectively by the Spielberger State Trait Anxiety Scale. Participants' physiological parameters (blood pressure, pulse and respiration) and State Trait Anxiety Scale were measured at two time periods. The control group undertook the usual relaxing activities provided in the waiting room compared with the intervention group who listened to music of their own choice in reclining chairs while waiting for the procedure. RESULTS: The physiological parameters for both the control and intervention groups dropped significantly during the waiting period, however, only the intervention group had a significant reduction in reported anxiety levels. CONCLUSIONS: These results suggest that providing self-selected music to day procedure patients in the preprocedure period assists in the reduction of physiological parameters and anxiety, yet, a relaxing environment can assist in the reduction of physiological parameters. RELEVANCE TO CLINICAL PRACTICE: The administration of self-selected music to day procedure patients in the preprocedure period can be effective in the reduction of physiological parameters and anxiety.

Analysis of Variance↗