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Biomedical subjects

E Charney

Publications and source records attributed to E Charney.

At least 37 records · Page 2Linked to original sources
PubMed1988

Use of health services by black children according to payment mechanism.

The use patterns of approximately 2,600 black children, categorized according to type of insurance (Medicaid, private health insurance or no insurance), were analyzed. All children were enrolled in an urban pediatric primary care program that attempted to increase access to health care by poor children. Medicaid recipients used health-care services more than their counterparts who had private or no insurance. All groups received significant levels of preventive care. The percentage of health care received in the emergency room did not vary significantly among the groups. These results suggest that special delivery systems can be effective in reaching poor children and eliminating usage differentials according to income.

Black or African American↗
PubMed1988

Childhood physical fitness tests: predictor of adult physical activity levels?

Regular physical activity has both short- and long-term health benefits in adults. No study has investigated childhood determinants of adult physical activity patterns, however. In a nonconcurrent prospective study, the physical activity levels of 453 young men, 23 to 25 years of age, were compared with their physical fitness test scores as children (10 to 11 years of age and 15 to 18 years of age). The physically active adults had significantly better childhood physical fitness test scores than did the inactive adults. In 224 children, 2 years of fitness test results were available. The risk of physical inactivity in young adulthood was linearly related to the number of low scores on the 548.6-m (600-yd) run and sit-ups tests as children (P less than .001). In stepwise multivariate discriminant analysis, the childhood 548.6-m run score was the best discriminator between currently physically active and inactive adults. Reported parental encouragement of exercise, level of education, participation in organized sports after high school, and reported spousal encouragement of exercise also contributed significantly to the discriminant function. These results demonstrate that physical fitness testing in boys facilitates the identification of those at increased risk of becoming physically inactive young adults.

Adolescent↗
PubMed1987

Structure of A-DNA in solution.

The structure of DNA in aqueous trifluoroethanol solutions containing more than 70% (vol/vol) trifluoroethanol, where it has been proposed to have the A-conformation, has been studied by the technique of electric linear dichroism. The data demonstrate that both linear phi X174 DNA [5386 base pairs (bp) long] and a 172-bp fragment of sea urchin 5S RNA gene are in the double-helical A-form in the alcoholic solution and that two of the important structural parameters, the base tilt and the base-pair translation along the helical axis, are the same as in the A-form structure of crystalline double-helical d(GGTATACC). Despite its molecular length, the limiting reduced dichroism (-1.41) of the phi X174 DNA in low-salt aqueous solution is near the theoretical limit (-1.50) for DNA with base planes perpendicular to the helical axis. Transformation of this DNA and also of the 172-bp fragment to the A-structure in alcohol solutions reduces the experimental value of the dichroism to about -1.04, which agrees almost exactly with the value of -1.03 calculated for the A-form crystal. The base-pair translation along the helical axis was determined from relaxation of the DNA dichroism when the electric field is turned off. The 172-bp fragment is found to have a base-pair translation of only 2.6 A in the A-structure and is thus the same as in A-DNA fibers and in the A-form oligomers crystals. We conclude from the coincidence of the base-pair translation and the apparent values of the base tilt that the A structures are identical or nearly so in the solution and solid states. Comparison of the phi X174 data with data on smaller DNA fragments and with the data on the 172-bp sea urchin gene fragment unambiguously confirms that, in aqueous solution, the experimental reduced electric dichroism of B-DNA is highly dependent on molecular length, while the dichroism of the A-DNA form in alcoholic solutions is independent of molecular length at least in the range from 172 to 5386 bp.

Base Composition↗
PubMed1987

Neurobehavioral sequelae of minor head injuries in children.

The incidence of neurobehavioral sequelae in children who have sustained minor head injury is controversial. Following an emergency room visit, behavioral symptoms in 247 children with mild head injuries were compared to those in 280 children with trauma to other regions of the body. Serial telephone interviews showed that complaints of irritability, clinging behavior and sleep disturbances were common in both groups, though headaches were a more frequent problem in the head-trauma patients. Virtually all symptoms were transient. Our results demonstrate a high incidence of behavioral sequelae in children after minor head injury and suggest that physicians should counsel parents about this brief functional morbidity.

Adolescent↗
PubMed1986

A randomized trial of oral iron on tests of short-term memory and attention span in young pregnant women.

Recent studies suggest that infant behavior and psychological test performance are impaired by iron deficiency and may be improved by iron. Comparable studies have not been performed in older populations. Young women early in pregnancy whose nutritional intake may be impaired by poverty constitute a high-risk population. Women aged 14-24 years coming for prenatal care at or before 16 weeks gestation whose hematocrits were greater than or equal to 31% were randomized in a double-blind trial to receive vitamins supplemented with iron (experimental group) or vitamins alone (controls). Hematologic status and tests of short-term memory and attention span were assessed at entry and conclusion of the one-month treatment period. The experimental group showed significant improvement on the most sensitive measure of short-term memory and three subtests. On comparison of the change between initial and final scores, the experimental group showed significant or borderline greater improvement than controls on three tests. These results indicated a beneficial effect of iron therapy on psychometric test-score performance.

Adolescent↗
PubMed1986

Hydrocephalus, cervical cord lesions, and spinal deformity.

Twenty-six children (4-16 years) had hydrocephalus and spinal deformity; 22 children had scoliosis over 50 degrees, and five children had kyphosis over 100 degrees. Twenty-one children had metrizamide enhanced cord CT scans, and 12 had additional head scans. Two children died, and one was autopsied. Three children had intracranial pressures monitored during spinal surgery. All children had Type I and II Arnold-Chiari malformations, 58% had cord cavitation (syringo/hydromyelia), 67% had cord tethering. The anatomic study showed extensive fibrosis and scarring of the upper cord and brain stem, but intraoperative studies showed that there is free transmission of fluid pressure wave from the cord across the foramen magnum with a consequent rise in intracranial pressure. This study documents frequent coexistence of spinal deformity and central nervous system lesions (hydrocephalus, Arnold-Chiari malformation, cord tethering with atresia, and cord cavitation). It supports the theory that the Arnold-Chiari malformation is a primary developmental deformity and that cord cavitation noted in these patients is primarily syringomyelia formed on the basis of ischemic necrosis within the cord. The free transmission of a fluid pressure wave from the cord to the lateral ventricle supports the Williams theory of propagation of syringomyelic cavities once they have developed. It is conjectural but likely that the CNS lesions cause spinal deformity by disrupting coordinating control of spinal musculature by the normal postural reflex mechanisms. Hydrocephalic patients who develop spinal deformity require thorough investigation for CNS lesions with head scans, CT scans, and metrizamide enhanced CT scans. NMR technology, however, may supplant techniques currently employed.

Adolescent↗
PubMed1985

Neonatal screening and genetic counseling for sickle cell trait.

In a newborn screening program for abnormal hemoglobins, 91 infants were found to have hemoglobin AS or AC. Their parents were informed and offered genetic counseling, but only 35% accepted. We tested parents' knowledge of sickle disorders before and after the session. The tests were repeated when their babies were 4 to 8 months old; parents of babies with normal hemoglobin and those with sickle trait who had not been counseled were also tested at this time. Parents who received counseling showed an increase in knowledge and retained it until the second interview although 27% did not recall the original session. Uncounseled parents of "trait families" also had knowledge of the condition; in general, trait families knew more about the condition than normals' families. Newborn hemoglobin screening programs prove helpful for certain families but not necessarily for all who may be eligible.

Anemia, Sickle Cell↗
PubMed1985

Analysis of ground-foot reaction forces in patients with myelomeningocele.

This paper describes a system for evaluation of ground-foot reaction forces in which multiple 1 centimeter diameter metal coated points transmit pressure to a photoelastic sheet. The pressure generates circular interference patterns, the diameters of which are linearly related to the pressure applied. The system permits the computerized construction of a three-dimensional contour map which can be compared to a pedobarograph. The qualitative/quantitative assessment system can identify areas on the plantar aspect of the foot at risk for skin breakdown. This information will permit treatment to proceed on a more rational basis than has been possible heretofore.

Biomechanical Phenomena↗
PubMed1985

The flexibility of alternating dA-dT sequences.

The flexibility of alternating poly (dA-dT) has been investigated by the technique of transient electric dichroism. Rotational relaxation times, which are very sensitive to changes in the end-to-end length of flexible polymers, are determined from the field free dichroism decay curves of four, well defined fragments of poly (dA-dT) ranging in size from 136 to 270 base pairs. Persistence lengths, calculated from the results of Hagerman and Zimm (Biopolymers (1981) 29, 1481-1502), are in the range 200-250 A. This makes alternating dA-dT sequences about twice as flexible as naturally occurring, "random" sequence DNA. Considering a bend around a nucleosome, for example, this difference in persistence length translates to an energy difference between poly (dA-dT) and random sequence DNA of 0.17 kT/base pair or 1 kcal per 10 base pair stretch. This energy difference is sufficiently large to suggest that dA-dT sequences could serve as markers in DNA packaging, for example, at sites where DNA must tightly bend to accommodate structures.

Base Sequence↗
PubMed1985

A successful city-wide smoke detector giveaway program.

Each year, 5,000 Americans die and 300,000 are hospitalized as a result of 2.8 million residential fires. Almost all house fires allow time for safe exit if an early warning is given. Smoke detectors are an effective, reliable, and inexpensive method of providing such warning. After an upsurge of deaths related to fires in 1982, Baltimore City gave away 3,720 smoke detectors to households that requested them. This study addressed two questions: (1) Did the households that received the smoke detectors install them? (2) Was the population reached by this giveaway program a population at high risk from fire? A survey of 231 randomly selected households among those requesting smoke detectors was conducted 8 to 10 months after the giveaway program. At that time, smoke detectors were installed in 92% (212/231) of the homes and 88% (187/212) of the installed smoke detectors were operational. Households requesting smoke detectors were in census tracts at higher risk from fire. The correlation coefficient between the rate of requesting a smoke detector and the risk of death or injury related to fires was r = .90, P less than .001. The 231 surveyed households had more personal fire risk factors than the general population. The success of this smoke detector giveaway program is notable in that it required the active participation of a high-risk population.

Accidents, Home↗
PubMed1983

Childhood lead poisoning. A controlled trial of the effect of dust-control measures on blood lead levels.

Lead-contaminated house dust is one factor in childhood lead poisoning; however, most lead-reduction programs do not emphasize the control of house dust. We studied whether lead-reduction plus dust-control measures would lower blood lead levels in children with Class II or III poisoning (blood lead levels, 30 to 49 micrograms per deciliter) more effectively than lead reduction alone. An experimental group of 14 children and a control group of 35 children whose homes had already been treated were studied. In experimental homes, sites with elevated lead levels (greater than 100 micrograms per 930 cm2) were wet-mopped twice monthly and families were encouraged to clean and to wash the child's hands frequently. After one year blood lead levels fell an average of 6.9 micrograms per deciliter in the experimental group, as compared with 0.7 micrograms per deciliter in controls (P less than 0.001). Children in the experimental group with the highest blood lead levels had the most marked reduction. Four children in the control group (and none in the experimental group) required chelation therapy for blood levels greater than 50 micrograms per deciliter. These results show that a focused dust-control program can reduce blood lead levels more than standard lead removal in the home.

Child↗
PubMed1983

After-hours telephone use in urban pediatric primary care centers.

Controversy exists regarding use of after-hours telephone systems by families unaccustomed to formal call systems. Our study compared the use of these systems by patients from two urban pediatric health centers with that by enrollees from three suburban private practices. The age-adjusted call rates were similar for all practices. However, a significantly higher proportion of health center calls came late at night and resulted in examination of the child. For all practices, call rates varied with age, from 6.0 calls per night per 1,000 patients for infants to 0.2 call per night per 1,000 patients for teenagers. Calls concerning younger children and late-night calls were more frequently judged inappropriate. Parents using health centers communicated their concerns as effectively as those using private practices and were similarly satisfied. Of all health center patients seeking advice after hours, 80% properly followed established pathways.

Adolescent↗