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Biomedical subjects

J Daugherty

Publications and source records attributed to J Daugherty.

16 recordsLinked to original sources
PubMed1999

Use of nonsteroidal anti-inflammatory drugs and incidence of colorectal cancer: a population-based study.

BACKGROUND: Previous observational studies have provided limited information on the effect of specific nonsteroidal anti-inflammatory drugs (NSAIDs) and different patterns of use (duration and dose) on the incidence of colorectal cancer. OBJECTIVE: To determine how patterns of use (duration, dose, and specific drug) of NSAIDs affect incidence of colorectal cancer. DESIGN: Population-based retrospective cohort study. SETTING: Tennessee Medicaid Program, 1985-1992. SUBJECTS: Enrollees (n = 104217) aged 65 years or older with at least 5 years of enrollment. MAIN OUTCOME MEASURES: Incident histologically confirmed colorectal cancer. RESULTS: Users of nonaspirin NSAIDs for at least 48 months of the previous 5 years had a relative risk (RR) of 0.49 (95% confidence interval [CI], 0.24-1.00) for colon cancer when compared with those with no use of NSAIDs. Among those with more than 12 months of cumulative use, those using NSAIDs in the past year (recent users) had an RR of 0.61 (95% CI, 0.48-0.77), whereas those with no recent use had an RR of 0.76 (95% CI, 0.50-1.15). No specific NSAID offered a unique protective effect and low doses of NSAIDs appeared to be at least as effective as higher doses. Protection was most pronounced for right-sided lesions. The RR among recent users with more than 12 months of cumulative use was 0.81 (95% CI, 0.49-1.32) for rectal cancer, 0.77 (95% CI, 0.55-1.08) for left-sided colon cancer, and 0.48 (95% CI, 0.34-0.68) for right-sided colon cancer. CONCLUSIONS: In this elderly population, long-term use of nonaspirin NSAIDs nearly halved the risk of colon cancer. This study was consistent with previous studies that suggest that duration of use but not daily dose of NSAIDs is an important factor for chemoprevention. Our data also suggest that the protective effect is shared by most NSAIDs, and not confined to a small number of these drugs.

Aged↗
PubMed1999

Effects of practice on the ability to perform lumbar stabilization exercises.

STUDY DESIGN: Randomized pretest-posttest control group design. OBJECTIVES: To determine the intratester and intertester reliability of a modified isometric stability test and to use this test to evaluate the effects of practice following a 4-week stabilization exercise program with weekly reinstruction. BACKGROUND: Although "stabilization" exercise programs are commonplace in the clinic, the reliability to a tool capable of measuring changes in the ability to perform increasingly difficult stabilization exercises has not, to our knowledge, been reported. In addition, it is not clear if practice improves the ability to perform stabilization exercises. METHODS AND MEASURES: A convenience sample of 44 asymptomatic subjects was pretested using a pressure transducer placed beneath the lumbar spine to detect motion (+/- 4 mm Hg). A series of 7 exercises was attempted, which required increasing levels of muscular control of the lumbar spine for stability. Subjects received a pass or fail for each exercise level based on the pressure gauge readings and the absence of movement compensations. Subjects were assigned randomly to exercise and nonexercise groups, and posttest measurements were taken after 4 weeks. The control group did not receive additional instruction. RESULTS: The weighted kappa coefficient of 0.61 for intratester and 0.62 for intertester represents good agreement. The median level of exercise attainment increased for the exercise group but not for the nonexercise group. CONCLUSION: These results suggest that the modified isometric stability test was reliable and that a 4-week lumbar stabilization exercise program, with weekly intervals of reinstruction and testing, improves the ability to perform progressively difficult lumbar stabilization exercises.

Adult↗
PubMed1999

Salmonella Thompson associated with improper handling of roast beef at a restaurant in Sioux Falls, South Dakota.

In October 1996, we investigated an outbreak of Salmonella serotype Thompson infections associated with Restaurant A in Sioux Falls, South Dakota, and conducted two cohort studies among persons who ate at luncheons catered by Restaurant A. Fifty-two Salmonella Thompson infections were identified between 29 September and 14 October 1996. Infections occurred among employees and patrons at Restaurant A and among attendees at three luncheons catered by the restaurant on 7 October. Roast beef cooked at Restaurant A was the only food item significantly associated with illness. Cooking times and storage temperatures for roast beef were inadequate to prevent multiplication of Salmonella, and the chefs were unaware of proper cooking and storage temperatures. We conclude that improper handling of roast beef probably caused this outbreak of Salmonella Thompson infections. Better knowledge of food safety practices by the cooking staff at Restaurant A, through required food safety education, might have prevented the outbreak.

Adolescent↗
PubMed1998

Evolution of spore release mechanisms in the saprolegniaceae (Oomycetes): evidence from a phylogenetic analysis of internal transcribed spacer sequences

Classical studies on spore release within the Saprolegniaceae (Oomycetes) led to the proposition that different mechanisms of sporangial emptying represent steps in an evolutionary transition series. We have reevaluated this idea in a phylogenetic framework using internal transcribed spacer sequences of four genera. These data were compared with the response to osmotic stress exhibited by each taxon. Saprolegnia emerges as the most basal genus, sister to Achlya, Thraustotheca, and Dictyuchus. Achlya and Thraustotheca are most closely related, while Dictyuchus appears to have evolved along a separate evolutionary lineage. The resulting phylogenetic framework is consistent with the idea that the mechanism of sporangial emptying exhibited by Saprolegnia represents the plesiomorphic condition from which the other mechanisms were derived independently. These alternative mechanisms of spore release may have resulted from a small number of mutations that inhibited axonemal development and altered the temporal and spatial expression of lytic enzymes that degrade the sporangial wall. Copyright 1998 Academic Press.

Journal Article↗
PubMed1995

Immunization coverage among infants enrolled in the Tennessee Medicaid program.

OBJECTIVES: To determine immunization coverage of infants receiving Medicaid in Tennessee and to identify risk factors for failure to complete recommended vaccinations by 24 months of age. DESIGN: Retrospective cohort study. SUBJECTS: A total of 33,615 children born in one of three urban Tennessee counties from 1980 through 1989 who were enrolled in Medicaid throughout their first 24 months of life. MAIN OUTCOME MEASURES: Receipt of four diphtheria-tetanus-pertussis, three oral polio, and one measles-mumps-rubella vaccines by 24 months of age (up-to-date), as recorded in computerized county immunization records and Medicaid billing files. RESULTS: Overall, 45% of infants enrolled in Medicaid in the three urban counties completed the recommended vaccinations by 24 months. The proportion of infants up-to-date peaked at 50% for those born in 1982 and 1983, and decreased to 44% for those born in 1989. The only strong independent predictors of immunization completion were number of prior births for the mother, timing of the first immunization, and county of birth. The proportion up-to-date was 56% for first-born children compared with 27% for those whose mothers had at least three prior births; 55% for those whose first immunization was on time compared with 22% for those with a delay in the first immunization; and 63%, 52%, and 37% for infants born in the three respective counties. Maternal age, education, race, and marital status predicted immunization completeness only weakly or not at all. CONCLUSIONS: Of infants born in the three counties in the 1980s who were enrolled in the Tennessee Medicaid program, fewer than half completed their recommended childhood vaccinations by 24 months of age. The large differences in immunization levels between infants enrolled in the Medicaid program in the three counties, not accounted for by differences in demographics, suggest that factors related to the health care and vaccine delivery system have important effects on achieving adequate immunization of these infants.

Child, Preschool↗
PubMed1994

The effects of insurance benefits coverage on functional and psychosocial outcomes after spinal cord injury.

This retrospective study examined the effects of type of payor (ie, catastrophic, Medicaid, and private) and extent of benefits and independent living (IL) resources received on functional and psychosocial outcomes after spinal cord injury (SCI). One hundred seventy SCI persons with dates of injury from 1985 to 1990 and who were on average 4 years after their initial discharge from rehabilitation participated in the study. Benefits and resources received from discharge to 2 years post-injury in housing, transportation, personal care assistance (PCA), and equipment were assessed. Outcome variables included measures of psychological distress, self-esteem, and participation in physical and work/school activities. Extent of benefits received after SCI was found to be both a function of source of payor and of subject's neurological classification. While an effect of total benefits received could not be detected on SCI subjects post-discharge physical activity, and benefits paid by self only were associated with physical activity. Transportation benefits received and type of payor were positively associated with work/school outcomes. Younger subjects, sponsored by private payors, and with incomplete injuries were more likely to be working or going to school after SCI. Benefits and payor were also associated with psychological distress. Privately sponsored subjects were less distressed, whereas those sponsored by Medicaid were most distressed. Extent of benefits received was found to be inversely associated with distress and self-esteem. Persons with lower self-esteem received more postdischarge benefits, whereas those who paid for their own benefits and those who received communication equipment benefits paid by insurance, reported higher self-esteem. Implications for possible policy changes based on these results are discussed.

Activities of Daily Living↗
PubMed1994

Aging of women alters S-verapamil pharmacokinetics and pharmacodynamics.

Pharmacokinetics and pharmacodynamics of S-verapamil were studied in 25 healthy nonsmoking women ranging in age from 23 to 33 years (young) and from 63 to 79 years (elderly) after 15-minute intravenous infusions of 0.10 to 0.11 mg/kg. S-Verapamil clearance decreased in an age-related manner (15.7 +/- 3.5 ml/min/kg in young women versus 12 +/- 1.5 ml/min/kg in elderly women; p < 0.0004) and elimination half-life values increased in an age-related manner from 347 +/- 97 minutes in young women to 453 +/- 153 minutes in elderly women (p < 0.05). Neither volume of distribution beta, steady-state volume of distribution, nor protein binding were altered by age. S-Verapamil decreased blood pressure (p < 0.0001), increased PR intervals during sinus rhythm (p < 0.0001), and transiently increased heart rate (p < 0.0001) in both young and elderly subjects. Age-related differences in responses were seen for mean (p < 0.03) and systolic blood pressure (p < 0.002) (greater decreases in the elderly), heart rate (less increase in the elderly; p < 0.0001), and PR intervals during sinus rhythm (less prolongation in the elderly; p < 0.0001). In summary, aging alters S-verapamil pharmacokinetics and pharmacodynamics in women.

Adult↗
PubMed1994

Determining differences in post discharge outcomes among catastrophically and noncatastrophically sponsored outpatients with spinal cord injury.

This study tested differences in functional independence status, level of psychologic distress and extent of handicap experienced after discharge from inpatient rehabilitation among a group of 125 outpatients with spinal cord injury (SCI) sponsored by one of three types of rehabilitation insurance payors: catastrophic (Michigan Automobile No-Fault and Workers' Disability Compensation), Medicaid and third-party privates. Outcome measures included the functional independence measure, the brief symptom inventory and the Craig handicap assessment reporting technique. Insurance data was obtained via medical chart reviews and interviews that were conducted either face-to-face or by telephone, using the benefits coverage inventory. No differences in terms of post discharge functional independence across subjects sponsored by the three payors was found when controlling for neurologic status. However, SCI subjects sponsored by different payors reported receiving different amounts of benefits. Subjects also differed on the extent of psychologic distress experienced after discharge and the extent of their handicaps. SCI subjects sponsored by Medicaid reported receiving fewer benefits, being more distressed and experiencing greater handicap in comparison to others. Third-party privately sponsored subjects, conversely, experienced less handicap and distress than did the study's other subjects.

Activities of Daily Living↗
PubMed1994

Professional representation and the free-lance medical illustrator.

We researched factors related to the success or failure in working relationships between free-lance medical illustrators and artist's representatives. In the fall of 1992, surveys were mailed to 230 medical illustrators; 105 (46%) completed surveys were returned. Respondents were divided into three categories: 1) medical illustrators currently represented, 2) medical illustrators previously represented, and 3) medical illustrators who had never been represented. Comparisons made among illustrators from the three groups included business practices, clientele, experience, and self-promotion techniques. These comparisons revealed notable differences and similarities between the three groups and were subsequently analyzed to identify the characteristics of medical illustrators who would benefit from professional representation.

Medical Illustration↗
PubMed1993

Insurance benefits coverage for persons with spinal cord injuries: determining differences across payors.

This investigation represents a preliminary step in determining differences in benefits coverage among three types of rehabilitation insurance payors (Catastrophic payors, which include Automobile No-Fault and Workers' Disability Compensation; Medicaid; and Third-party private payors). Subjects in this study were 122 spinal cord injury (SCI) outpatients who received their initial rehabilitation at the University of Michigan Medical Center and at the Rehabilitation Institute of Michigan. Insurance benefits received by them were examined across the following areas: accessible housing, transportation, personal attendant care services, professional outpatient services and adapted equipment. Results indicated differences across the three payors, with catastrophically-sponsored SCI outpatients receiving more benefits than SCI outpatients sponsored by public Medicaid or by private third-party insurance. Implications and recommendations for further studies are briefly discussed.

Adult↗
PubMed1987

Thromboxane A2 biosynthesis in human disease.

Thromboxane A2 (TxA2), the predominant cyclooxygenase product of human platelets, is a potent vasoconstrictor and platelet agonist. Although its biological properties are readily appreciable in vitro, it has been difficult to define its biological importance in vivo. To a large extent this reflected the problems associated with efforts to monitor biosynthesis of this eicosanoid and the lack of selective pharmacological probes that prevented the synthesis of TxA2 or antagonized its biological action in vivo. Recently the analysis of urinary metabolites of TxB2 has become simplified so that the methodology is readily applicable to clinical studies. This provides a noninvasive, time-integrated index of Tx biosynthesis. Although one cannot definitively establish a tissue of origin for metabolites measured in urine, indirect evidence suggests that urinary TxB2 derives primarily from the kidney whereas its dinor metabolite predominantly reflects platelet biosynthesis under physiological conditions. Although plasma concentrations of TxB2 are readily confounded by platelet activation ex vivo, the enzymatic metabolites formed from TxB2 have recently been identified and appear to bypass this problem. Combined analysis of long-lived (e.g., 11-dehydro-TxB2) and short-lived (e.g., 2,3-dinor-TxB2) metabolites in plasma promise to more accurately localize phasic increases in the biosynthesis of TxA2 and have been paralleled by the development of antagonists of the TxA2/prostaglandin endoperoxide receptor and their study of humans. The use of such specific probes in conditions characterized by abnormal biosynthesis of TxA2 promises to define the biological role of this mediator for humans.

Arachidonic Acid↗
PubMedDate not supplied

Patient teaching to promote behavioral change.

Nurses are taught that patient teaching is an essential component of their professional role. This article describes the research on which effective patient teaching should be based.

Behavior Therapy↗