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Biomedical subjects

J Dattilo

Publications and source records attributed to J Dattilo.

11 recordsLinked to original sources
PubMed2001

A long-term study of patient outcomes with pelvic muscle re-education for urinary incontinence.

PURPOSE: The purpose of this study was to determine the level of continence, satisfaction, and compliance with a maintenance pelvic muscle exercise program 12 months or more after discharge from a clinician-supervised pelvic floor muscle rehabilitation program. SETTING AND SUBJECTS: Forty-nine female patients diagnosed with stress, urge, and mixed etiology urinary incontinence were treated with pelvic muscle re-education and biofeedback. Treatment was performed in a urology clinic setting with sessions supervised by a registered nurse. METHODS: A retrospective chart review was performed for all female patients trained in pelvic muscle exercises from March 1997 through November 1997. Telephone interviews were conducted and questionnaires were administered to determine long-term efficacy of and compliance with pelvic muscle exercises 13 to 20 months after treatment. RESULTS: Fifty-three percent of patients maintained their posttreatment level of continence, and 38% had improved when evaluated 13 to 20 months following treatment (x macro = 16.6 months). Sixty-nine percent continued to perform pelvic muscle exercises once weekly or several times per week. CONCLUSIONS: Clinician-supervised pelvic floor muscle rehabilitation is effective in improving stress and urge incontinence in community-dwelling women with stress, urge, and mixed urinary incontinence. This effect is durable for a period of 16 months, and the majority of women continue to perform pelvic muscle exercises one or more times per week.

Adult↗
PubMed1997

Prognostic signs in the surgical management of plexiform neurofibroma: the Children's Hospital of Philadelphia experience, 1974-1994.

OBJECTIVES: To estimate the rate of progression of plexiform neurofibroma after surgery and to identify prognostic factors that predict progression. STUDY DESIGN: A retrospective review of the inpatient and outpatient records of 121 patients, who had 302 procedures on 168 tumors over a 20-year period at a single large pediatric referral center. Data on age, location, indication for surgery, and extent of resection was analyzed for prognostic significance. RESULTS: The overall freedom from progression was 54%. Children < 10 years old had a shorter interval of tumor control than older children (p = 0.0004). Tumors of the head/neck/face fared worse than tumors of the extremities (p = 0.0003). Less extensive resection predicted shorter interval to progression (p < 0.0001). Indication for surgery was not of prognostic importance. In multivariable analysis older age and location in the extremities were predictors of a better outcome. CONCLUSIONS: Tumor progression is a serious problem for children with plexiform neurofibroma. Younger children, children with tumors of the head/neck/face, and tumors that cannot be nearly completely removed are at particular risk. These data may be useful in helping clinicians decide which patients and which tumors are most likely to benefit from surgical intervention.

Adolescent↗
PubMed1996

Early results of infrageniculate arterial reconstruction using cryopreserved homograft saphenous conduit (CADVEIN) and combination low-dose systemic immunosuppression.

BACKGROUND: The search continues for the ideal conduit for infrageniculate arterial reconstructions when the autogenous vein is unsuitable or unavailable. Based on experimental observations in our laboratory demonstrating improvement in canine cryopreserved allograft vein patency using systemic immunosuppression (Imsup), and the remarkable clinical success achieved in older (greater than 60 years of age) solid organ transplant recipients using combination low-dose Imsup, we studied the effects of Imsup on patency of cryopreserved homograft saphenous vein (CADVEIN) used for infrageniculate arterial reconstructions. STUDY DESIGN: Under the Institutional Review Board protocol, 21 infrageniculate CADVEIN grafts were placed in 19 patients between July 1993 and August 1994 for limb salvage when autogenous veins were unavailable. An immunopharmacologic protocol consisting of low-dose cyclosporine A, azathioprine, prednisone, warfarin, aspirin, and vasodilators given orally was instituted. For various reasons, 15 patients in group 1 received Imsup; five patients never received Imsup, and one patient in group 2 received Imsup briefly. Follow-up examinations were completed using the time range of six to 18 months (mean, eight plus or minus one month). RESULTS: One patient died (5.3 percent) 30 days after emergency combined venous graft and bilateral CADVEIN bypass. The actuarial 12-month primary patency in group 1 was 59.4 percent compared with 16.7 percent in group 2 (p < 0.015, log-rank test). Cellular rejection was typically seen in explanted CADVEIN. Systemic morbidity related to Imsup was minimal. The CADVEIN morbidity rate was significant: three graft aneurysms and four early graft ruptures. Major amputations were necessary in eight of 12 patients with graft closure. CONCLUSIONS: The data suggest that Imsup significantly improves CADVEIN patency with limited systemic morbidity; however, complications related to the conduit itself occurred with greater frequency and cause greater morbidity than when the autogenous veins were used. Much has yet to be learned regarding the preservation characteristics of CADVEIN and the immunologic interactions in patients receiving CADVEIN grafts, before further clinical use of this conduit can be recommended.

Adult↗
PubMed1994

Understanding leisure services for individuals with mental retardation.

This paper was developed to promote understanding of the complex process of leisure service delivery for children and adults with mental retardation and encourage people to work together to enhance leisure opportunities in integrated settings. The meaning of several terms associated with leisure were clarified and limitations of past and existing leisure services presented. We discussed our belief that all individuals, including those with mental retardation, have the right to experience leisure. Suggestions were made for development of leisure services involving social integration with peers who do not have mental retardation, the facilitation of active participation, development of age-appropriate behaviors, provision of comprehensive leisure education services, encouragement of self-determined leisure participation, and systematic coordination and communication among practitioners and family members.

Humans↗
PubMed1992

Instructing facilitators to support the communication of people who use augmentative communication systems.

A single-subject multiple-baseline design, replicated across three dyads, was used to examine the efficacy of instructing facilitators (i.e, significant others) to promote communication with people who use augmentative and alternative communication (AAC) systems. Facilitators were instructed in four 1-hour sessions to decrease their conversational control and provide more opportunities for the participants using AAC systems to communicate. Following instruction, facilitators decreased their rates of turn-taking and initiations and increased the proportion of turns that were responsive. Participants using AAC systems increased the frequency of their initiations. Following intervention, turn-taking and initiation patterns in the dyads were more reciprocal. Generalization occurred to the natural environment. Results suggest that facilitator instruction is an effective and efficient means of promoting greater participation in daily interactions by people who use AAC systems.

Adolescent↗
PubMed1991

Facilitating conversation through self-initiated augmentative communication treatment.

We examined the conversational skills of 2 adult males with severe motor and speech deficits resulting from cerebral palsy. A multiple baseline design across subjects was used to determine the effectiveness of an intervention strategy designed to teach them to use an augmentative communication system (Touch Talker) independently. The dependent measure was the number of conversation initiations relative to conversation reactions during spontaneous communication across baseline and treatment. The treatment included specific training on using the augmentative system to participate in communication. Once the intervention began, the production of conversation initiations accelerated at a rapid rate. The treatment program was effective in training the subjects to use the augmentative system to increase conversation participation. These results demonstrate that training on the operation of the device alone is not sufficient to ensure improvement in conversation performance, and that it is important to incorporate direct conversational treatment when providing instruction on the use of augmentative communication systems for severely speech-impaired individuals.

Adult↗
PubMed1986

Single-subject evaluation in health education.

The utilization of single-subject methodology represents a means to improve evaluation efforts in health education. This article provides a rationale for the application of the methodology in health education evaluation. Two variations of the single-subject evaluation methodology (ABAB and multiple baseline) are described. Appropriate methods of data analysis are recommended. Applications of single-subject designs in health education settings are presented. Dilemmas in health education evaluation are identified and reviewed in light of the potential contributions of single-subject methodology.

Health Education↗
PubMed1986

Computerized assessment of preference for severely handicapped individuals.

An investigation was conducted to demonstrate the application of a computerized assessment procedure for determining the preferences of persons with severe handicaps. A computer program was designed to interpret subjects' microswitch activations to produce three distinct types of events (visual, auditory, and tactile). A combination of a multiple baseline design across subjects with a multiple treatment design involving three separate conditions was used. The data obtained from the computerized assessment procedure revealed idiosyncratic preference patterns for the three subjects. Results of the investigation demonstrated that the preferences of severely handicapped individuals can be systematically assessed and analyzed.

Child↗
PubMed1982

Chemical synthesis of urotensin II, a somatostatin like peptide in the caudal neurosecretory system of fishes.

In the goby, Gillichthys mirabilis, urotensin II (a bioactive neuropeptide present in the urophysis of teleost fish) has the dodecapeptide sequence, H2N-AGTADC-FWKYCV-OH, which is homologous with mammalian somatostatin at positions 1, 2 and 7-9. The Merrifield solid phase synthesis of Gillichthys urotensin II (UII) was accomplished by stepwise assembly from the carboxy terminus using N-alpha-tert, butyloxycarbonyl (Boc) amino acids containing benzyl-derived groups for protection of side-chain functionalities, Coupling of amino acids to the growing peptide was mediated by diisopropylcarbodiimide (DIC) in the presence of 1-hydroxybenzotriazole (HOBt). Residual alpha-amino groups remaining after coupling were blocked by acetylation with 1-acetylimidazole. Crude, synthetic UII was extracted from the HF-treated, protected peptide-resin product, reduced with dithiothreitol (DTT), reoxidized at high dilution with O2, and separated into its components using a single, preparative, reverse-phase HPLC step. The pure, synthetic UII, obtained in 7.6% yield from oxidized crude UII, was indistinguishable from pure, native UII in specific bioactivity, amino acid sequence, and retention time in each of two different HPLC systems.

Amino Acid Sequence↗