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Biomedical subjects

J Cornell

Publications and source records attributed to J Cornell.

31 records · Page 2Linked to original sources
PubMed1995

Effect of depression on dementia presentation: qualitative assessment with the Qualitative Evaluation of Dementia (QED).

Two novel, bedside, dementia assessment instruments, the Executive Interview (EXIT) and the Qualitative Evaluation of Dementia (QED) were used to examine the effects of DSM-III-R major depressive episodes on the clinical presentation of patients diagnosed with NINCDS "possible" AD. Intergroup comparisons were made of the various bedside cognitive measures given to 102 of 118 consecutive patients presenting to a university geriatric assessment clinic and consultation service. The assessment instruments used were: (1) the EXIT: a 15-minute, 25-item bedside interview for the assessment of executive control function (ECF); (2) the QED: a brief, clinically based checklist that operationalizes the approach of a geriatric psychiatrist to the qualitative assessment of dementing illnesses (when QED scores are mapped against EXIT scores, a qualitative picture of dementia typology emerges); and (3) the Mini-Mental State Exam (MMSE): a familiar bedside measure of cognitive function. Depressed and nondepressed patients differed significantly on the QED. There was no overlap in the QED scores of patients with probable AD versus those with depression. The QED discriminated between depressed and nondepressed patients with possible AD. Possible AD patients with depression could not be qualitatively distinguished from those with depression alone, although they could be discriminated by the EXIT. Only 44% of possible AD cases fall within the EXIT x QED 90% confidence limits for probable AD. No differences were found on either the QED or the MMSE between depressed non-AD patients and nondepressed patients exhibiting "dementia with no cortical features." The MMSE was insensitive to cognitive impairment in non-AD cases. NINCDS "possible" AD is a qualitatively heterogeneous group.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Biomaterials for the dental market.

There are a number of products and improvements in existing products desired by the dental industries. However, it is important to realize that the dental marketing system is changing and uses different criteria than those which influenced the marketing in the last decade. More integrated systems are being marketed to the dentists, and the consumers are more interested in products which will help them maintain their teeth and gums. Fluoridation and other changes have helped in retaining the teeth, usually for the whole lifetime. This progress will change the way dentists practice, and will change the materials and equipment they need.

Biocompatible Materials↗
PubMed1983

Neural tube defects in the Cape Town area, 1975-1980.

During the period 1975-1980, 105 infants out of a total of 116 859 delivered at selected hospitals in the Cape Town area had a neural tube defect. The combined incidence of spina bifida and anencephaly in Whites was approximately 1/300 births, which is similar to that generally encountered in the UK. However, the incidence in other ethnic groups was appreciably lower at 1/1250 and 1/2000 births for the Coloured (mixed ancestry) and Black groups respectively.

Anencephaly↗
PubMed1978

Study of otitis media and malaria among pyrexic attender of an under-fives clinic.

All 138 children attending two under-five clinics with a rectal temperature of 100 degrees F or over had their ears examined and a blood film taken for malaria parasites. Twenty-eight per cent were found to have otitis media and 37 per cent to have malaria. No symptom was found to be sufficiently discriminating for a diagnosis to be made on history alone in either condition.

Child, Preschool↗
PubMedDate not supplied

Primary care physicians' approach to depressive disorders. Effects of physician specialty and practice structure.

BACKGROUND: Because primary care physicians (PCPs) are the initial health care contact for most patients with depression, they are in a unique position to provide early detection and integrated care for persons with depression and coexisting medical illness. Despite this opportunity, care for depression is often suboptimal. OBJECTIVE: To better understand how to design interventions to improve care, we examine PCPs' approach to recognition and management and the effects of physician specialty and degree of capitation on barriers to care for 3 common depressive disorders. METHODS: A 53-item questionnaire was mailed to 3375 randomly selected subjects, divided equally among family physicians, general internists, and obstetrician-gynecologists. The questionnaire assessed reported diagnosis and treatment practices for each subject's most recent patient recognized to have major or minor depression or dysthymia and barriers to the recognition and treatment of depression. Eligible physicians were PCPs who worked at least half-time seeing outpatients for longitudinal care. RESULTS: Of 2316 physicians with known eligibility, 1350 (58.3%) returned the questionnaire. Respondents were family physicians (n = 621), general internists (n = 474), and obstetrician-gynecologists (n = 255). The PCPs report recognition and evaluation practices related to their most recent case as follows: recognition by routine questioning or screening for depression (9%), diagnosis based on formal criteria (33.7%), direct questioning about suicide (58%), and assessment for substance abuse (68.1%) or medical causes of depression (84.1%). Reported treatment practices were watchful waiting only (6.1%), PCP counseling for more than 5 minutes (39.7%), antidepressant medication prescription (72.5%), and mental health referral (38.4%). Diagnostic evaluation and treatment approaches varied significantly by specialty but not by the type of depression or degree of capitation. Physician barriers differed by specialty more than by degree of capitation. In contrast, organizational barriers, such as time for an adequate history and the affordability of mental health professionals, differed by degree of capitation more than by physician specialty. Patient barriers were common but did not vary by physician specialty or degree of capitation. CONCLUSIONS: A substantial proportion of PCPs report diagnostic and treatment approaches that are consistent with high-quality care. Differences in approach were associated more with specialty than with type of depressive disorder or degree of capitation. Quality improvement efforts need to (1) be tailored for different physician specialties, (2) emphasize the importance of differentiating major depression from other depressive disorders and tailoring the treatment approach accordingly, and (3) address organizational barriers to best practice and knowledge gaps about depression treatment.

Capitation Fee↗
PubMedDate not supplied

Bedside assessment of frontal degeneration: distinguishing Alzheimer's disease from non-Alzheimer's cortical dementia.

Two instruments, the Executive Interview (EXIT) and the Qualitative Evaluation of Dementia (QED), that are useful in the evaluation of frontal system failure are discussed. The ability of these instruments to discriminate frontal-type dementia (FTD) from Alzheimer's disease (AD) and the dementia of major depression (DMD) was examined in 100 consecutive elderly dementia patients presenting to a multidisciplinary geriatric clinic. All groups showed executive impairment by the EXIT, and 46% of the FTD patients were found to be unimpaired by the Mini-Mental State Examination (MMSE). The AD and FTD groups differed significantly from the DMD group on the QED. The QED alone could not distinguish AD from FTD cases. However, mapping of EXIT scores against MMSE (errors) scores revealed that AD and FTD follow very different regression lines.

Aged↗