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Biomedical subjects

J C Thornton

Publications and source records attributed to J C Thornton.

At least 91 records · Page 5Linked to original sources

Neurophysiology.

Explore the source record for details and available documents.

Autonomic Nervous System Diseases↗

Spirometric "abnormality" in a normal male reference population: further analysis of the 1971 Oregon survey.

Conventional criteria for spirometric impairment (FVC and FEV1 less than or equal to 79% predicted, FEF25-75 less than or equal to 74% predicted, FEV1/FVC less than or equal to 0.69 for most ages) were applied to 507 healthy nonsmoking male subjects in the 1971 Oregon survey. Frequency of air flow impairment was higher than expected for a normal population. Of all subjects, 17.8% had an "abnormal" FEF25-75% and 19.7% an "abnormal" FEV1/FVC. "Decreased" lung volumes were seen in older subjects; of those over 55 years of age, 8.8% had a reduced FVC and 11.8% a reduced FEV1. These rates in a normal population may be used as a rough baseline for making inferences about a population under study. Similar rates were found in a cross-sectional survey of nonsmoking males representative of the population of a large industrial state. The major reason for these high rates of "abnormal" spirometry lies in the conventional definitions of abnormality. Tables showing cut-off points for abnormal spirometric values based on a 95% confidence interval for adult males of all ages and heights permit an alternative method for classification as abnormal.

Adolescent↗

Zinc protoporphyrin, blood lead and clinical symptoms in two occupational groups with low-level exposure to lead.

The results of cross-sectional clinical field surveys of 45 cable manufacturing workers and 90 telephone cable splicers are presented. Despite the rare occurrence of clinically overt lead poisoning among these occupational groups, high prevalence of lead-associated central nervous system symptoms and gastrointestinal symptoms was found. Hierarchical log-linear models for multidimensional contingency tables were fitted to those data and indicate that there is a partial correlation between reported symptoms and zinc protoporphyrin: individuals with high zinc protoporphyrin levels were more likely to report symptoms than those with low levels. No significant partial association was found between symptoms and blood lead. Because of the intermittent lead exposure encountered in one of the populations, individuals were identified with "normal" blood lead levels associated with "elevated" zinc protoporphyrin concentrations, thus indicating the difference in the biological significance between indicators of lead absorption (blood lead) and of biological response tests (ZPP). Suggestion is made that both types of diagnostic tests be utilized in the medical surveillance of lead-exposed workers.

Adult↗

Medicaid records and the psychiatric private sector.

The authors report a study or records maintained by private practitioners for their Medicaid patients. The quality of record keeping in general fell far short of Medicaid requirements. Board-certified or hospital-affiliated psychiatrists kept better charts than those who did not have these credentials. Educational background did not correlate with extent of record keeping.

Certification↗

Providers and receivers in the private psychiatric Medicaid system.

The authors investigated the credentials of foreign medical graduate (FMG) and U.S. medical graduate (USMG) psychiatrists providing a substantial amount of Medicaid care and compared them with those of a group of other psychiatric practitioners in New York City. USMGs were more likely to be Board certified, but FMGs were as likely to have APA membership, psychoanalytic training, medical school and hopsital affiliation, and fellowships. The credentials of the Medicaid psychiatrists and the group of New York psychiatrists were similar. Hispanic FMG psychiatrists provided a major service for the Spanish-speaking community, but the poor black population underused Medicaid services. Diagnosis did not appear to be influenced by racial bias.

Black or African American↗

Psychiatric diagnoses as reported to Medicaid and as recorded in patient charts.

This study was undertaken to address the issue of data reporting in the psychiatric sector of New York City Medicaid, the largest publicly financed psychiatric health care delivery system in the nation. Six outpatient psychiatric clinics in general hospitals, four with residency programs, and all 29 free standing psychiatric clinics in New York City were audited as were charts from 120 psychiatrists billing for 10 or more Medicaid patients. Overall agreement of chart and Medicaid diagnoses was 91% for psychiatrists, 79% for free-standing clinics, and 77% for hospital clinics. Agreement varied by diagnosis. Bias in the Medicaid diagnosis of Neurosis was found at the four hospitals having residency programs. Patients most likely to be misreported as having minimizing diagnoses were male, or between the ages of 18 and 29 years, or to have a prior history of psychiatric treatment. The errors in reporting in each provider sector would pose a methodological obstacle if Medicaid data were used in epidemiological research.

Adolescent↗

Effect of age on testicular function in patients with Klinefelter's syndrome.

Testicular function in the patient with Klinefelter's syndrome parallels the alterations seen with age in the normal subject. Significant decreases are seen in the Klinefelter group in the plasma level of testosterone and in the plasma testosterone/oestradiol ratio. Testicular function in the patient with Klinefelter's syndrome appears very much like that seen in a chronologically older subject.

Adolescent↗

Medicaid-funded private psychiatric care in New York City. The role of foreign-trained physicians.

Data were obtained from the tax records and the Professional Registry maintained by the New York City Department of Health as well as from the Biographical Directory of the American Psychiatric Association to determine which psychiatrists were providing care under the Medicaid Program and how they compare with the pool of psychiatric practitioners in New York City. The data reveal that psychiatrists educated in foreign medical schools provide disproportionately more care to Medicaid recipients than would be anticipated from their numbers, and are a majority of those who received more than +30,000 in payments in 1976. Furthermore, these psychiatrists account for 80 per cent of those delivering care at the two largest "shared health facilities," commonly referred to as "Medicaid mills." These findings indicate that although the Title XIX Program has facilitated the access of the poor to the private psychiatric sector, in New York City their access is biased toward treatment by foreign-educated psychiatrists.

Foreign Medical Graduates↗

Formaldehyde impairs memory, equilibrium, and dexterity in histology technicians: effects which persist for days after exposure.

Results of neurobehavioral testing in 305 histology technicians were studied by regression analysis with age, years of cigarette smoking, and hours per day of exposure to formaldehyde and to solvents as major independent variables. Increasing age was associated with poorer performance on visual memory, block design, trails, dexterity by pegboard, sharpened-Romberg, finger writing, as well as with longer choice reaction time. Increased daily hours of exposure to formaldehyde were correlated with reduced performance on story memory, visual memory, digit span, pegboard and sharpened-Romberg, as well as with errors on trails. Exposure to solvents was associated only with diminished recall of story.

Adult↗

Prediction equations for simple and visual two-choice reactions times in environmental neurotoxicology.

To provide preliminary prediction equations for simple visual and two-choice visual reactions times, timed from the appearance of the letter A or S on a computer screen to cancellation, we modeled 264 randomly selected subjects from voter registration rolls in Arizona and Louisiana. These predicted values, validated by comparison to observed values and coefficients, were compared with those from a second population in California. We tested ability to detect abnormality by measuring a trichloroethylene-exposed population aged 17-70 y. The natural logarithm of simple visual reaction time was independent of age and other factors. The natural logarithm of two-choice visual reaction time was increased by age. These equations predict performance of groups that are studied with respect to neurobehavioral effects of chemicals, and the equations distinguish exposure and nonexposure for the range of adult ages. To define abnormality of individual subjects, we suggest use of the predicted value, plus 1.5 standard deviations; in this study, 8% of the model group was selected as abnormal.

Adult↗