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Biomedical subjects

E Callahan

Publications and source records attributed to E Callahan.

7 recordsLinked to original sources
PubMed2001

Panel-based pain management in primary care. a pilot study.

Although pain is an extremely common symptom presenting to primary care physicians, it frequently is not optimally managed. The purpose of this feasibility study was to develop and pilot-test an efficient, rapid assessment and management approach for pain in busy community practices. The intervention utilized the Dartmouth COOP Clinical Improvement System (DCCIS) and a telephone-based, nurse-educator intervention. Patients from four primary care practices in rural New Hampshire and Vermont were screened by mail for the presence of persistent pain. Patients with mild to severe pain were randomized to either the usual care control group (n = 383) or the intervention group (n = 320). Patients who reported pain but no psychosocial problems received a summary of identified problems and targeted educational material via mail (DCCIS). Patients who reported pain and psychosocial problems received the DCCIS intervention and calls from a nurse-educator who provided pain self-management strategies and a problem-solving approach for psychosocial problems. Post-treatment evaluation revealed that patients in the intervention group scored significantly better on the Pain, Physical, Emotional, and Social subscales of the SF-36 and on the total score of the Functional Interference Scale, as compared to a usual care control group. Feasibility and acceptability of the approach were demonstrated; however, the conclusions based on analyses of the post-treatment outcomes were tempered by baseline imbalances across groups.

Feasibility Studies↗
PubMed1999

Pyoderma gangrenosum involving the foot. A case report.

Pyoderma gangrenosum is a rare and destructive inflammatory skin disease. The authors present a report of a patient with a classic case of pyoderma gangrenosum involving the foot. The diagnosis was made on the basis of clinical presentation and progression of the disease after differential diagnoses of common conditions were excluded. A brief overview of the disease process, its treatment, and its correlation with ulcerative colitis is provided.

Adrenal Cortex Hormones↗
PubMed1996

Analysis of Hispanic motor vehicle trauma victims in Illinois, 1991-1992.

OBJECTIVE: 1) To develop a profile of Hispanic motor vehicle trauma victims in Illinois, 2) to ascertain whether differences exist between Hispanic and general-Illinois-population motor vehicle trauma victims, and 3) to identify potential target areas for future injury intervention programs. METHODS: A retrospective analysis of Illinois motor vehicle trauma patients admitted from July 1991 to June 1992 was made. Participants were motor vehicle trauma victims (drivers and passengers) who presented to one of 73 level I or level II trauma centers throughout Illinois and were entered into the Illinois Trauma Registry (ITR) from July 1, 1991, through June 30, 1992. RESULTS: Of the 12,299 motor vehicle trauma victims in the ITR, 771 (6.3%) were Hispanic, 8,979 (73.0%) were white, 1,115 (9.1%) were black, and 1,434 (11.6%) were other. When compared with the other racial groups, the group of Hispanic victims were younger (25.2 vs 33.2 years), had higher male predominance (72.8% vs 60.9%), and had the lowest rate of safety equipment/occupant restraint use (21.7% vs 34.7%). A high alcohol use rate (30.7%) and high mean serum ethanol levels (44 mmol/L; 0.2 mg%) were noted. When contrasted with other racial/ethnic groups, the Hispanic victims had lower Injury Severity Scale scores (p < 0.001), but mean hospital charges tended to be higher, with fewer alternative sources of payment (p < 0.001). CONCLUSION: Using age-adjusted data from the ITR, Hispanic motor vehicle trauma victim features differ significantly from those of other racial groups. Effective health maintenance and injury prevention strategies should address the basis for these differences.

Accident Prevention↗
PubMed1978

The Behavior Observation Instrument: a method of direct observation for program evaluation.

The background and development of a multicategory direct observation system, the Behavior Observation Instrument (BOI), is described. This time-sampling procedure for recording the behavior of persons is demonstrated in several treatment settings and the results applied to issues of program evaluation. Elements that have prevented direct observation from being widely adopted, such as costs, manpower, and training requirements, are systematically analyzed. A basic psychometric analysis of the instrument is used to determine optimum frequency and duration of observation intervals as well as observer agreement. The results imply that direct observation methods, once assumed by some to belong to the special province of the single-subject design, can be used to assess the effects of programs on groups of psychiatric clients in an efficient and economic manner.

Activities of Daily Living↗
PubMed1976

Comparison of two naltrexone treatment programs: naltrexone alone versus naltrexone plus behavior therapy.

During a period of one year naltrexone was given to twenty-nine subjects. Fifteen of these subjects concurrently participated in a comprehensive behavior therapy program. The subjects in this naltrexone/behavior therapy group were maintanine on naltrexone for nearly twice as long as naltrexone group clients who received no therapy. If the chances for readdiction are reduced by increased time on naltrexone, then the data states the naltrexone should be dispensed as part of a broader therapeutic strategy. Follow-up data, which will be collected during the next year will test the validity of this hypothesis.

Adult↗
PubMed1975

Analysis of the requirements for parathyroid hormone action in renal membranes with the use of inhibiting analogues.

Two synthetic analogues of bovine parathyroid hormone (PTH) with NH2-terminal modifications, PTH-(3-34) and [desamino-Ala-1]PTH-(1-34), were found to lack agonist activity but to demonstrate antagonist properties when tested in the rat renal cortical adenylyl cyclase assay in vitro against the native hormone or against PTH-(1-34), the active synthetic NH2-terminal tetratriacontapeptide. The inhibition exhibited by these analogues was proportional in degree to the dose of inhibitor, abolished by oxidation of the analogue, reversible by addition of an excess of active hormone, and specific for parathyroid hormone-stimulated renal adenylyl cyclase. No inhibition of basal or sodium fluoride-stimulated renal adenylyl cyclase could be demonstrated. Two other synthetic bovine analogues, PTH-(13-34) and PTH-(1-26), were devoid of agonist and antagonist properties. The over-all results suggest that the requirements for receptor binding of parathyroid hormone are rather broad. Conformational factors or binding interactions involving specific residues, or both seem to require the entire sequence from residue 3 to residue 27 for receptor binding to occur. A dichotomy between receptor binding and adenylyl cyclase activation was demonstrated only by alterations or deletions involving the first 2 NH2-terminal residues of the hormone and emphasizes the importance of these residues in eliciting the biological activity of parathyroid hormone. The two antagonists, [desamino-Ala-1]PTH-(1-34) and PTH-(3-34), should be useful in further analysis of the initial steps in hormone action.

Adenylyl Cyclases↗