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Biomedical subjects

J Adam

Publications and source records attributed to J Adam.

At least 55 records · Page 3Linked to original sources
PubMed1991

Testing various methods of introducing health charts into medical records in family medicine units.

OBJECTIVE: To test three methods of introducing health charts into the medical records of six family medicine units. DESIGN: Quasi-experiment. PARTICIPANTS: The staff physicians and family medicine residents in all six units and the nurses in two units. INTERVENTIONS: Group 1 (minimal intervention): health charts, a user's guide and one training session. Group 2 (intermediate intervention): same intervention as for group 1 plus two feedback sessions at 3 and 6 months. Group 3 (maximum intervention): same intervention as for group 2 plus promotion of the team concept (nurses were included). The intervention phase lasted from September 1987 to August 1988. OUTCOME MEASURES: The frequency with which the health charts were used, the item scores of each preventive care activity and the overall unit scores. Data were gathered through chart audits at baseline and at the end of the intervention phase. RESULTS: The frequency with which the health charts were used varied from 3.9% to 26.9%. The greatest increases in item scores were observed in the use of mammography (20.0%), counselling on lifestyle (19.4%) and breast examination (17.2%). Although the overall improvement in the unit scores was statistically significant (p less than 0.05) the hypothesis of an increasing gradient of effect across the three intervention groups could not be tested because of the variation in scores across the units. CONCLUSION: Health charts and other similar tools are useful; however, they are not sufficient to change practice behaviours. The support of a "champion" on the health care team might well be a determining factor of success for the delivery of preventive services in primary care practice.

Adult↗
PubMed1991

DNA methylation changes in the IL-1 (2F) chromosomal region of some radiation-induced acute myeloid leukaemias carrying chromosome 2 rearrangements.

Acute myeloid leukaemias (AML) arising in irradiated CBA/H mice frequently have breakpoints in the F region of chromosome 2. The closely linked cytokine genes interleukin (IL)-1 alpha and beta map to this region, and the beta gene is deregulated in some AMLs. Using pulsed-field gel electrophoresis techniques, we show here that an 800 kb 2F region encoding IL-1 alpha and beta is not obviously rearranged in six leukaemias carrying chromosome 2 abnormalities. However, changes in IL-1 region DNA methylation in three leukaemias may be consistent with loss of hypermethylated sequences from one chromosome copy. These possible 2F region losses are discussed in relation to genomic imprinting and its potential role in murine myeloid leukaemogenesis.

Acute Disease↗
PubMed1991

Peritonitis rates for CAPD patients using the SCD 210 (Inpersol sterile connecting device): a Canadian survey.

A retrospective study was conducted in 20 Canadian hospitals to assess peritonitis rates of CAPD patients utilizing the SCD 210 patient assist device during a 30 month study period. A total of 175 patients having a cumulative SCD experience of 1,494 patient months were included in the survey. Sixty-eight patients experienced 116 episodes of peritonitis, i.e., one episode every 12.9 patient months (pt mo). Patients that had used the SCD for their entire CAPD experience had a significantly lower peritonitis rate (1/15.2 pt mo) compared to patients who had used other CAPD systems (1/10.1 pt mo). Peritonitis rates for diabetic study patients or patients with impaired vision and/or dexterity were not significantly greater than non-diabetic or non-impaired study patients. Staphylococcus epidermidis and Staphylococcus aureus were the most frequent causative microorganisms, accounting for 27.7% and 16.0% of peritonitis episodes caused by single organisms, respectively. The proportion of peritonitis caused by skin commensals was consistent across all study patients, regardless of impairment of vision and/or dexterity. The study results demonstrate the successful application of this patient assist device in a CAPD population that consisted of a large proportion of high risk patients.

Bacteria↗
PubMed1990

The IL-1 alpha and beta genes are closely linked (less than 70 kb) on mouse chromosome 2.

The murine IL-1 alpha and IL-1 beta genes encode structurally and evolutionarily related cytokines that exert a regulatory role in numerous physiological processes including hemopoiesis. Previous studies have shown these genes to be closely linked in the F region of mouse chromosome 2. Here we show, using pulsed-field gel electrophoresis, that the IL-1 alpha and beta genes of the CBA/H mouse are very closely linked and contained within a SmaI genomic fragment of approximately 70 kb. From conventional and PFGE analyses we suggest that IL-1 beta lies 5' to IL-1 alpha and that the two genes are in the same orientation and separated by approximately 50 kb. The apparent clustering of such hemopoietic genes is discussed in relation to evolutionary tandem gene duplication and possible associations with chromosomal fragile sites and leukemogenesis.

Animals↗
PubMed1990

Complications of microwave hyperthermia treatment of psoriasis.

Three healthy men with psoriatic plaques unresponsive to tar, anthralin, and UVB were treated with 2450 MHz microwave heating for 30 minutes at 42 degrees C. Two patients had plaques over bony prominences. Pain developed in both patients, and one had a hypotensive episode during the first treatment. The third patient, whose plaque was greater than 2 cm and was not located over a bony prominence, completed the 5 weeks of biweekly treatments with complete resolution of the plaque and no complications.

Adult↗
PubMed1990

Predicting arterial oxygenation during one-lung ventilation with continuous positive airway pressure to the nonventilated lung.

Forty patients undergoing elective thoracotomy were studied to assess the possibility of predicting PaO2 during one-lung ventilation (OLV) when continuous positive airway pressure (CPAP) was applied to the nondependent lung. The first 20 patients were studied retrospectively and the three most significant independent variables that correlated with PaO2 during OLV with CPAP were: side of operation (P = 0.04), FEV1/FVC ratio (P = 0.01), and the intraoperative PaO2 during two-lung ventilation (P = 0.0002). By the method of multiple linear regression, these three variables were used to construct a predictive equation for PaO2 during OLV with CPAP. The second 20 patients were studied prospectively and the predicted PaO2 correlated significantly with the observed PaO2 during OLV with CPAP (r = 0.86, P less than 0.001). Therefore, it is concluded that the PaO2 during OLV with CPAP can be predicted using routinely available data.

Aged↗
PubMed1990

Individual-differences assessment of the relationship between change in and initial level of adult cognitive functioning.

Methodological factors may have been partially responsible for the inconsistency in findings from previous investigations into the relationship between change in, and initial level of, adult cognitive functioning. An alternative data-analytic procedure is proposed and applied to data from 277 men (25-76 years of age at initial testing) over 3 measurement occasions (interwave intervals of 6.7 years). Performances on both the Benton Revised Visual Retention Test (BVRT) and the Wechsler Adult Intelligence Scale (WAIS) Vocabulary subtest were analyzed. The findings demonstrate that the significant negative relationships between change and initial status, found on both tests, were partially a function of measurement error. Once adjustments were made for errors of measurement, the previously significant negative relationship for the BVRT data became significantly positive, whereas for the WAIS the relationship remained significantly negative, although to a lesser degree. The importance of accounting for errors of measurement is discussed.

Adult↗
PubMed1990

The gel test: a new way to detect red cell antigen-antibody reactions.

A new process for the detection of red cell (RBC) antigen antibody reactions is described. It is applicable to most of the tests performed in blood group serology. The procedures are standardized and easy, and they provide clear and stable reactions that improve the interpretation of results. The process uses special microtubes filled with a mixture of gel, buffer, and reagent. Depending on the test to be carried out, the test uses a neutral gel containing no reagents (reagents are added to top of gel) or a specific gel containing reagents (e.g., antiglobulin serum or anti-A, -B, -D, etc.). A suspension of RBCs (for typing or the direct antiglobulin test) or a mixture of RBCs and serum (for reverse ABO typing or antibody characterization) is centrifuged through the gel under precise conditions. In negative reactions, the RBCs pass through the gel and pellet in the bottom of the tube, whereas, in positive reactions, they are trapped in the gel and the reaction may be read for hours afterwards. The test is easy to perform, sensitive, and reproducible. The antiglobulin tests can be performed without washing of the RBCs. There should be a reduction of risk from biohazardous materials.

Antibodies↗
PubMed1990

[Quantitative scales for measuring neurological deficit in cerebrovascular diseases].

The development of quantitative scales for the measurement of neurological deficit is a complex process involving the assessment of both validity and reliability. The steps required in the validation and reliability assessment are outlined in this paper. Each component of the process is illustrated using the results of the validation of the Canadian Stroke Scale (CNS).

Cerebrovascular Disorders↗
PubMed1990

What about the relatives?

Dealing with a relative or friend's terminal illness is an extremely stressful experience. How well are patients' relatives and friends cared for by healthcare staff?

Adaptation, Psychological↗
PubMed1990

[Progress in biostatistics correlated with the development of computer technics].

The development of computers has positively influenced both Biostatistics and Medical Informatics. Close cooperation between Physicians, Biostatisticians and Experts of Medical Informatics is necessary. The leading role has to play the medical question, the medical problem to be solved, and not one of the cooperating disciplines. Both Biostatistics and Medical Informatics are parts of Medicine and must therefore taught as natural-scientific basic discipline of Medicine.

Biometry↗
PubMed1989

Interleukin-1 beta gene deregulation associated with chromosomal rearrangement: a candidate initiating event for murine radiation-myeloid leukemogenesis?

The incidence of acute myeloid leukemia (AML) in CBA/H mice following exposure to single acute doses of ionizing radiation has previously been determined. A high proportion of these AMLs are characterized by rearrangement of murine chromosome 2 in the C2 and/or E5-F regions, and there is evidence that these events are a direct consequence of radiation damage to multipotential hemopoietic cells. Using a combination of in situ chromosome hybridization and mRNA analyses, we show that the cytokine gene interleukin-1 beta (IL-1 beta) is encoded in the chromosome 2 F region and is translocated in a chromosome 2---2 rearrangement in an x-ray-induced AML (N36). Also, IL-1 beta is specifically deregulated in N36 and in two other chromosome 2-rearranged AMLs but not in a fourth, which has two cytogenetically normal chromosome 2 copies. We suggest that radiation-induced specific chromosome 2 rearrangement associated with IL-1 beta deregulation may initiate murine leukemogenesis through the uncoupling of normal proliferative control mechanisms in multipotential hemopoietic cells.

Animals↗
PubMed1989

The relative effectiveness of analogues of cisplatin in the experimental chemotherapy of human non-small-cell lung cancer and neuroblastoma grown as multicellular spheroids.

We compared cisplatin (cis-DDP) and two of its analogues, carboplatin (JM8, CBDCA) and iproplatin (JM9, CHIP) for their ability to retard the growth of multicellular tumour spheroids. The spheroids were derived from two human tumours, a neuroblastoma and a non-small-cell lung cancer. To produce a given level of regrowth delay in lung cancer spheroids, carboplatin and iproplatin were required at concentrations approximately 10 times that of cis-DDP. In the neuroblastoma spheroid experiments, iproplatin and cis-DDP produced the same level of regrowth delay when iproplatin was present at a concentration greater than 10 times that of cis-DDP. Carboplatin also required much higher concentrations than cis-DDP to produce equivalent regrowth delay in neuroblastoma. The dose-response curve produced by carboplatin on neuroblastoma spheroids displayed a pronounced shoulder in the low-dose region; this phenomenon was not seen with cis-DDP. These findings may have implications for the clinical use of these drugs and in particular would support a role for carboplatin in the treatment of lung cancer, since total free-drug exposure of patients to carboplatin may be up to 16-fold greater than with cis-DDP. However, one must be cautious about generalizing on the basis of results from only two cell lines as well as applying in vitro data to clinical situations.

Carboplatin↗
PubMed1989

Delayed diagnosis of gynecologic tumors in elderly women: relation to national medical practice patterns.

PURPOSE: To evaluate the hypothesis that less aggressive cancer screening practices might result in later diagnosis of cancer in the elderly, we analyzed the stage of diagnosis of tumors by age in the Connecticut Tumor Registry. PATIENTS AND METHODS: Using Registry data from 1960 to 1975 and 1976 to 1983, we compared the proportion of tumors that were diagnosed at a localized stage among white women of various age groups. Thirteen specific tumor sites were analyzed, accounting for 55,688 tumors between 1960 and 1975 and 38,715 tumors between 1976 and 1983. RESULTS: Only gynecologic cancers demonstrated a significant inverse relationship between the relative proportion of tumors that were diagnosed at a localized stage and advancing patient age during both time periods. Specifically, when the youngest women (aged 25 to 34) were compared with the oldest women (aged 85 and over), between 1960 and 1975, the relative proportion of localized cervical, uterine, and ovarian cancer dropped from 98 percent to 59 percent, 92 percent to 77 percent, and 59 percent to 27 percent, respectively. Similar declines were also seen between the intermediate-age groups, and data from 1976 to 1983 demonstrated identical age-related trends. CONCLUSION: Our study reveals that the probability of diagnosing cancer of the cervix, uterus and ovaries at a localized and potentially curable stage decreases with advancing age. Published national health practice patterns demonstrated a similar age-related decline in gynecologic examinations and Pap smears even after adjustment for the exclusion of women who would have undergone previous hysterectomy. This decreasing use of gynecologic examinations may in part explain the age-related decline in localized gynecologic cancers.

Adult↗
PubMed1989

The Canadian Neurological Scale: validation and reliability assessment.

The Canadian Neurological Scale (CNS) was designed to monitor mentation and motor functions in stroke patients. We assessed its validity and reliability on a group of 157 patients with a diagnosis of acute cerebrovascular accident. We determined validity by (1) correlating scale items and total score with the standard neurologic examination; (2) exploring the scale's predictive power with different end points at 6 months--the initial CNS was a significant predictor of outcome; (3) showing that the CNS had higher correlation coefficients with the initial neurologic examination than the Glasgow Coma Scale; and (4) assessing the responsiveness of the scale to change in the neurologic status of stroke patients. Interobserver reliability, measured by kappa statistics on each scale item, was good. Accordingly, we established the validity and reliability of the CNS for its use in clinical studies and in the care of stroke patients.

Central Nervous System↗
PubMed1988

Patterns of haemopoietic recovery after stress--II. Treatment with fluorouracil.

The mouse haemopoietic system is not permanently damaged by repeated injections of cytotoxic fluorouracil. It contains approximately normal numbers of nucleated femoral and spleen colony-forming cells (CFUs) after seven monthly injections of the drug and normal numbers of high proliferation potential colony-forming cells (HPP-CFC) after five serial injections. Furthermore, the mouse is fully fertile after seven injections of fluorouracil. The mouse recovers quickly after treatment because it regenerates from cells which were not killed by the drug. Within 14 days of treatment with fluorouracil there are almost twice the normal number of femoral macrophage and high proliferation potential colony-forming cells (M-CFC and HPP-CFC). These numbers then fall but are returning to normal 6 weeks after the drug was administered. In this quick recovery the response of the haemopoietic system differs from its response to the loss of blood cells caused by sub-lethal irradiation, or lethal irradiation, or treatment with busulphan. When mice are treated twice with fluorouracil, the second injection 14 days after the first, the number of femoral M-CFC two days after the second injection, is 16-fold the number in controls, but the number of femoral HPP-CFC is only twice the number in controls. When the interval between the two injections is 21 days, the number of femoral M-CFC is almost 8% of that of mice treated once, but the number of HPP-CFC is 67%. The characteristic response of each type of cell to repeated treatment with fluorouracil is probably due to the number of its precursors which are killed by the drug and to the interval between successive injections. A second injection of fluorouracil, 28 days after the first, speeds the growth rate of HPP-CFC. Their doubling time is 6 h shorter than that of mice treated once. Haemopoietic tissue from mice treated repeatedly with fluorouracil can only outgrow normal marrow under certain conditions. The nature of these conditions and the mechanisms involved are discussed in the light of contradictory findings.

Animals↗