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Biomedical subjects

J H Price

Publications and source records attributed to J H Price.

At least 19 recordsLinked to original sources
PubMed2003

Efficacy of cervical intrarepithelial neoplasia (CIN) treatment by cold coagulation.

Our objective was to evaluate the efficacy of cold coagulation in the treatment of cervical intraepithelial neoplasia. The study design consisted of a retrospective review of case records of all women treated with cold coagulation from the colposcopy clinics inception in 1980 to 1994. A total of 725 women received treatment with cold coagulation. All grades of CIN were treated. 632 (87.1%) had long term negative follow up. 93 (12.6%) of patients had abnormal cytological follow up, but only 45 (6.2%) required re-treatment. Within the first year after treatment 52 (7.1%) patients presented with persistent cytological abnormalities, 32 (4.4%) required repeated treatment for persistent dyskaryosis. 41 (5.6%) of patients had recurrent cytological abnormalities, 13 (1.8%) required repeated treatment. Recurrence developed between two and 12 years from initial treatment. One case of cervical carcinoma following treatment with cold coagulation was recorded. Our data suggest that cold coagulation appears to be safe, efficient treatment for cervical intraepithelial neoplasia.

Adolescent↗
PubMed2002

Morphological effects of chemotherapy on ovarian carcinoma.

AIMS: Traditionally, advanced stage ovarian carcinoma is treated by debulking surgery followed by chemotherapy. However, in some circumstances preoperative chemotherapy may be given before optimal surgical debulking. This study aims to describe the morphological features found in ovarian carcinoma after chemotherapy because these have not been detailed previously. METHODS: Histological sections were examined from 18 cases of ovarian carcinoma that had been treated by preoperative chemotherapy. The morphology was compared with any pre-chemotherapy biopsies that had been performed. Tumours were classified as showing morphological features suggesting a good response to chemotherapy (n = 14) or as showing little or no response (n = 4). Serum CA125 values before and after chemotherapy were compared. In all cases, the mitotic activity index (MAI), volume percentage of epithelium (VPE), and mean nuclear area (MNA) of tumour cells were calculated. RESULTS: The preoperative biopsies were all typical ovarian serous or endometrioid adenocarcinomas. Morphological features present in the group responding to chemotherapy included the presence of small groups or single tumour cells in a densely fibrotic stroma. Tumour cells were characterised by both nuclear and cytoplasmic alteration, making accurate tumour typing and grading impossible. Nuclear features included the presence of bizarre enlargement with hyperchromatism, irregularity of outline, and chromatin clumping or smudging. Cytoplasmic alterations included intense eosinophilia, vacuolation, or foam cell change. There were pronounced stromal changes of fibrosis, inflammation, collections of foamy histiocytes, cholesterol cleft formation, haemosiderin deposition, fat necrosis, and dystrophic calcification, including the presence of many free psammoma bodies. There was no correlation between morphological response and biochemical response, as determined by serum CA125 values. In all nine cases in which pre-chemotherapy and post-chemotherapy biopsies were available, the MNA increased post-chemotherapy (p = 0.007, paired Wilcoxon test) and in six of nine cases the MAI decreased (p = 0.093). CONCLUSIONS: Because preoperative chemotherapy is being used increasingly in the management of ovarian cancer, pathologists should be aware of the resultant morphological effects. Accurate tumour typing and grading is impossible. In some cases, it may be difficult to confirm the presence of residual tumour, making it imperative that pre-chemotherapy tissue biopsies are obtained. Definite confirmation of residual tumour may require the examination of multiple histological sections from areas showing pronounced stromal changes, sometimes with multiple levels and immunohistochemistry. In the absence of definite residual tumour, the report should state that the features are consistent with the prior presence of tumour.

Adenocarcinoma↗
PubMed2001

Public perceptions of child abuse and neglect in a midwestern urban community.

This study found that the majority of urban adults did not believe that any of the characteristics of children posed to them predisposed a child to abuse. In contrast, 40% of respondents claimed child abuse could not occur in a family like the one in which they grew up. The majority perceived only one characteristic, alcohol abuse, as a characteristic of child abusers. Few respondents (10%) believed that child abusers could not be helped, and 25% were not sure. Adults' perceptions of child abuse and abusers varied by sex, age, socioeconomic status, and whether the respondents had children. The data indicate that there are significant deficits in the respondents' knowledge of child abuse and neglect.

Adult↗
PubMed2001

Nurses' perceptions of complementary and alternative medical therapies.

The purpose of this study was to identify the perceptions of nurses toward the effectiveness and safety, as well as their recommendations for and personal use of complementary and alternative medical therapies. A, random sample of 1000 nurses throughout the United States were surveyed using a three-wave mailing. About half of the respondents perceived there was conclusive evidence or preponderance of evidence that five therapies were effective: biofeedback, chiropractic, meditation/relaxation, multi-vitamins, and massage therapy. The same amount of nurses also perceived five therapies as definitely safe: hypnotherapy, chiropractic, acupressure, acupuncture, and healing touch. However, the nurses were most likely to recommend (regularly or periodically) four therapies: multivitamins, massage, meditation/relaxation, and pastoral/spiritual counseling. The vast majority (79%) of nurses perceived their professional preparation in this area to be fair or poor.

Adult↗
PubMed2001

Psychiatrists' knowledge and attitudes about costs of commonly prescribed treatments in psychiatry.

A survey was conducted to assess psychiatrists' knowledge and attitudes regarding the costs of various psychiatric treatments. Psychiatrists (n = 500) were randomly selected from the membership of the Ohio Psychiatric Association. The survey explored several aspects of psychiatrists' knowledge of costs, including estimated prices of 24 specific psychiatric treatments (frequently used psychotropic medications, laboratory tests, and inpatient and outpatient procedures) as well as their level of confidence in their estimates. The survey also asked a series of attitude/opinion questions and specific demographic data. The psychiatrists (n = 265, 59% response) perceived that knowing the costs of treatments was an important consideration when choosing a particular treatment. Psychiatrists' actual knowledge of the costs of treatment was inconsistent with their beliefs of the importance of knowing the costs as well as their reported confidence in their knowledge of costs. Information about the costs of psychiatric treatments is an important clinical consideration and a program to improve clinicians' knowledge of the costs of psychiatric treatment could occur during residency training.

Adult↗
PubMed2001

Evaluation of atypical glandular cells of undetermined significance: is age important?

OBJECTIVE: Our purpose was to assess the effect of age on the incidence of significant pathologic findings in patients with atypical glandular cells of undetermined significance. STUDY DESIGN: This retrospective study evaluated nonreferred patients with Papanicolaou smears showing atypical glandular cells of undetermined significance over a 5-year period. RESULTS: Two hundred eighty-one women (91%) with Papanicolaou smears showing atypical glandular cells of undetermined significance were available for follow-up. Significant abnormality was found in 90 subjects (32%), including 31 women (11%) with cancer. Older patients (> or =50 years old) have lower odds of high-grade cervical dysplasia (odds ratio = 0.21; 95% CI: 0.32-0.40) and higher odds of uterine cancer (odds ratio = 12.88; 95% CI: 1.78-567.60) compared with younger patients. CONCLUSIONS: Women with Papanicolaou smears showing atypical glandular cells of undetermined significance have a 1 in 3 chance of having significant abnormality. Evaluation includes colposcopy, endocervical curettage, and appropriate cervical biopsies. Patients >45 years require endometrial biopsies.

Adult↗
PubMed2001

Primary adenocarcinoma of the vagina arising in endocervicosis.

Endocervicosis is a rare condition, being one of the triad of non-neoplastic secondary mullerian lesions. This report describes a primary vaginal adenocarcinoma arising in endocervicosis. Histologic examination showed a mucin-secreting adenocarcinoma admixed with benign mucin-containing endocervical-type glands with a transition from dysplastic glands to obvious adenocarcinoma. There were bilateral groin lymph node metastases at presentation and the tumor recurred locally 9 and 12 months after treatment. This is the second reported case of vaginal endocervicosis and the first documented report of adenocarcinoma arising in endocervicosis at any site.

Adenocarcinoma↗
PubMed2001

Primary grade teachers' knowledge and perceptions of head lice.

This study examined primary grade teachers' knowledge of head lice, perceived self-efficacy in dealing with head lice, and preferred resources of additional information on head lice. Survey data from a three-wave mailing (M = 292; 60%) found that teachers needed more knowledge regarding head lice and were significantly more knowledgeable as teaching experience increased. A plurality (46%) had high efficacy expectations scores regarding their ability to control the spread of head lice. Most (71%) primary teachers reported they received most of their head lice information from school nurses. Most (63%) said they would like more information on how to prevent head lice infestation, and they wanted the information in the form of videotapes (68%) and brochures (51%). Only 23% provided yearly instruction regarding head lice.

Adult↗
PubMed2001

Selected ethical issues in research and publication: perceptions of health education faculty.

A national random sample of 195 university health education faculty at graduate degree-granting programs completed a 31-item survey with regard to their perceptions of ethical issues in research and publishing. Most respondents were male (57%), tenured (75%), had graduate faculty status (92%), had presented original research at conferences (85%), and had published articles in health education journals (89%). Faculty members were requested to assess whether 21 scenarios dealing with ethical issues in research and publishing were ethical, unethical, questionable, or not an ethical issue. Of the scenarios, 3 were considered ethical and 7 unethical by the majority of respondents. The perceptions of how ethical the remaining 11 scenarios were varied considerably. Perceptions of the ethical scenarios did not differ among respondents by sex, academic rank, years taught as a faculty member, whether the department taught units/classes on research ethics, or whether the respondents were from doctoral-level versus master's-level programs.

Analysis of Variance↗
PubMed2001

The Electronically Activated Recorder (EAR): a device for sampling naturalistic daily activities and conversations.

A recording device called the Electronically Activated Recorder (EAR) is described. The EAR taperecords for 30 sec once every 12 min for 2-4 days. It is lightweight and portable, and it can be worn comfortably by participants in their natural environment. The acoustic data samples provide a nonobtrusive record of the language used and settings entered by the participant. Preliminary psychometric findings suggest that the EAR data accurately reflect individuals' natural social, linguistic, and psychological lives. The data presented in this article were collected with a first-generation EAR system based on analog tape recording technology, but a second generation digital EAR is now available.

Activities of Daily Living↗
PubMed2001

How physician assistants use and perceive complementary and alternative medicine.

The use of complementary and alternative medicine (CAM) is growing in the United States. Patients and their health care providers are increasingly accepting of complementary and alternative therapies. The purpose of this study was to identify physician assistants' (PAs') attitudes, beliefs, knowledge, training, recommendations for, and personal use of CAM. A random sample of 500 practicing PAs was sent a four-page, 78-item survey investigating their personal use of, recommendations for, and perceptions of the efficacy and safety of complementary and alternative therapies. Of PAs eligible to complete the survey, 50% responded. Chi-square analyses found a significant relationship between knowledge level and recommendation for CAM; status of use and belief that CAM exerts a placebo effect; status of use and recommendation for CAM; and source of information on CAM and recommendation for CAM. With the increasing prevalence of use of CAM, PAs need to be informed regarding CAM therapies.

Adult↗
PubMed2000

Ultra-rare-event detection performance of a custom scanning cytometer on a model preparation of fetal nRBCs.

BACKGROUND: The performance of a fully automated scanning cytometer incorporating previously reported high-precision autofocus and accurate image segmentation was evaluated for the detection of "ultra-rare" cells using a model of fetal nucleated red blood cells (fnRBCs) in the maternal circulation. These distinctive scanning cytometry techniques were expected to markedly improve sensitivity and specificity. METHODS: Normal adult blood and fetal red blood cells were stained with fluorescein isothiocyanate-conjugated anti-fetal hemoglobin and 4,6-diamidino-2-phenylindole, a nuclear dye. Adult cells were spiked with fetal cells to create ratios of about 1 fnRBC in 10(7) nucleated cells and deposited in monolayers on slides using centrifugal cytology. Rare-event performance parameters were reviewed, formalized, and applied to test the new instrument using this cell model. RESULTS: Fifteen slides were analyzed to establish performance by comparison with manual detection, and four sets of four slides each were then scanned to explore the limit of detection. Results were an average sensitivity of 91%, an average specificity error of 12.3 false-positives per million cells, and repeatability of 100% at a cell analysis rate of 862 Hz. With addition of a quick interactive step subsequent to scanning, the false-positive rate dropped to a total of only one artifact over the 15 experiments. The instrument succeeded at locating 1 fnRBC in 20 million adult cells, the lowest limit of detection tested. CONCLUSION: This consistently high performance, coupled with the capability of scanning arbitrarily large numbers of cells, validates the considerable potential of precise high-speed autofocus and accurate real-time image segmentation for ultra-rare event detection.

Adult↗
PubMed2000

Attitudes and perceptions of fitness professionals regarding obesity.

The purpose of this study was to assess perceptions of exercise professionals regarding obesity. A three page, 25-item survey was mailed to a random sample of 500 certified Health Fitness Instructors, Exercise Test Technologists, and Exercise Specialists from a certification list provided by the American (College of Sports Medicine (ACSM). The return rate was 66%. Most exercise professionals (74%) supervised or worked directly with obese clients in an exercise/fitness setting. The majority of exercise professionals believed that normal weight is very important to a person's health, that physical activity is very important in the treatment of obesity, that they should be role models by maintaining normal weight, that they are obligated to counsel obese persons concerning the health risks of obesity, that they are very competent to prescribe exercise programs for weight loss, and that counseling obese persons on exercise for weight loss is professionally gratifying. The majority of exercise professionals also believed sedentary lifestyles, poor eating behavior, excessive calorie consumption, and psychological problems play a major role in most obesity. Exercise professionals reported that they received most of their information on weight control from textbooks, college classes, scientific journals, workshops/seminars, and past experience.

Adult↗