PubMed Health⌕ Search

Biomedical subjects

J Halstead

Publications and source records attributed to J Halstead.

11 recordsLinked to original sources
PubMed2001

Risk factors for asthma morbidity and mortality in a large metropolitan city.

Morbidity and mortality due to asthma continues to increase despite advances in understanding the pathophysiology and treatment of the disease. We evaluated the potential risk factors for asthma morbidity and mortality in a large metropolitan city (St. Louis, MO) using small area geographic analysis. We found that the risk of hospitalization for children with asthma was 8.4 times greater (95% confidence interval [CI] 7.0-9.9) in lower socioeconomic zip code areas and 5.3 times greater (95% CI 4.7-5.9) in those zip codes with a higher percentage of African Americans. Similarly, the risk of death due to asthma was 6.4 times greater in the lower socioeconomic zip code areas (95% CI3.4-12.1). Lower socioeconomic status and African American race are strong risk factors for hospitalization and mortality from asthma. Public policy and healthcare resources need to be organized and directed more efficiently to this population.

Adult↗
PubMed2000

Conservative surgical treatment of valvular injury after blunt chest trauma.

BACKGROUND: Blunt injury to the cardiac valves leads to progressive ventricular failure often requiring surgical management. Most frequently, prosthetic replacement is the chosen management. METHODS: Three consecutive patients presenting to one surgeon with blunt traumatic valve lesions formed the study group. RESULTS: At operation, the valvular pathology was assessed, and reparative techniques were used to correct the defects. All the patients had an excellent outcome at follow-up periods of 2 to 3 years. CONCLUSIONS: Conservative operation to repair traumatic valve lesions is feasible and has potential advantages over replacement.

Adult↗
PubMed1999

Sleep problems in emergency department patients with injuries.

OBJECTIVES: To assess trauma patients' frequency of sleep problems, to evaluate their injuries in the context of their sleep habits, and to determine how often ED health care workers (HCWs) inquire about sleep complaints. METHODS: This was a prospective observational study of patients evaluated in the ED for unintentional trauma. Patients answered a "sleep survey" that was reviewed for the amount and timing of sleep in the preinjury period and for indications of a sleep problem. Preinjury sleep characteristics were compared with the individual's usual habits, and the group's sleep features were compared with "normal" sleep and the prevalence of sleep problems in historical controls. RESULTS: Seventy patients were surveyed. Mechanisms and types of injury included motor vehicle collisions (MVCs), falls, lacerations, bruises, sprains, and fractures. The mean total sleep time in the preinjury period (6.9 hours) was significantly shorter than that obtained during usual weekday and weekend sleep. Twenty-four patients (34.3%) were at high risk for a sleep problem. Few patients thought a sleep problem contributed to the injury. No other ED HCW asked about the patient's sleep habits. CONCLUSIONS: Acute sleep deprivation in the preinjury period, and chronic sleep deprivation with a variety of other sleep problems are found in this patient population. Despite the association of sleep problems and certain types of injury (e.g., MVC), ED HCWs do not inquire about sleep in their initial ED evaluations. This important issue may be overlooked in trauma risk assessment and prevention.

Adolescent↗
PubMed1996

Outcomes of time-limited psychotherapy in applied settings: replicating the Second Sheffield Psychotherapy Project.

In a replication and extension of the Second Sheffield Psychotherapy Project (SPP2), a collaborative psychotherapy project (CPP) was carried out at 3 sites within the National Health Service of the United Kingdom. Clients (N = 36) stratified at 3 levels of severity of depression were randomly assigned to one of 2 treatment approaches (psychodynamic-interpersonal or cognitive-behavioral) of 2 time-limited durations (8 or 16 sessions). Gains in both treatment approaches were approximately equivalent and were similar for CPP and SPP2 clients when measured at the end of treatment. However, CPP patients did not maintain their gains to the extent that the SPP2 clients did at 3-month and 1-year follow-up assessments. In the CPP, clients given 16 sessions showed a statistically significant advantage over clients given 8 sessions on some measures at some assessments; in the SPP2, similar effects were noted only among some subgroups of clients.

Adult↗
PubMed1995

Evidence for involvement of phosphatidylcholine-phospholipase C and protein kinase C in transforming growth factor-beta signaling.

Transforming growth factor-beta (TGF-beta) is a multifunctional peptide that elicits a wide variety of responses in cells. TGF-beta binds to cell surface receptors that contain cytoplasmic serine/threonine kinase domains. Here we provide evidence that both phospholipase C and protein kinase C (PKC) are involved in the TGF-beta activation of transcription and luciferase expression from the p3TP-Lux plasmid. Down-regulation of PKC prevents TGF-beta 1 induction of luciferase expression. Staurosporin and Calphostin C, inhibitors of PKC, block the ability of TGF-beta 1 to initiate transcription of the luciferase gene. Further, D609, an inhibitor of phosphatidylcholine-phospholipase C (PC-PLC), and secondarily PKC also blocks TGF-beta 1-induced transcription of the transgene in A549 cells while the phosphatidylinositol-PLC pathway inhibitor U73122 is without effect. TGF-beta elevates steady-state mRNA levels for the endogenous PAI-1 and fibronectin genes. Treatment of cells with calphostin C or D609 prevents the TGF-beta-induced increase in these mRNAs. Together, these results suggest that PC-PLC and PKC are in a TGF-beta signaling pathway that results in elevated gene expression.

Alkaloids↗
PubMed1995

The genetic advantage hypothesis in cystic fibrosis heterozygotes: a murine study.

1. The delta F508 mutation of the cystic fibrosis (CF) gene is of high frequency in man (1 in 25) and in homozygotes causes cystic fibrosis. It is suggested that cystic fibrosis heterozygotes withstand secretory diarrhoea better than normal individuals and so are genetically advantaged. This hypothesis has been examined by measuring electrogenic chloride secretion in gut epithelia of normal and heterozygous CF mice. 2. Chloride secretory responses of normal and heterozygous colonic epithelia to forskolin, vasoactive intestinal polypeptide (VIP), isoprenaline, cholera toxin, heat-stable enterotoxin (STa), guanylin, carbachol and lysylbradykinin were examined. No significant differences in responses of tissues of the two genotypes were found. 3. Responses of normal and heterozygous ileal epithelia to forskolin and glucose were investigated. Heterozygous tissues responded as well as normal tissues. 4. Frusemide (furosemide) caused virtually identical inhibition of the chloride secretory responses to forskolin in colonic epithelia of both genotypes. 5. No evidence to support the genetic advantage hypothesis in ileal or colonic epithelia of the null CF mouse has been found, at least for acute responses. If the hypothesis is true then either (a) other non-cystic fibrosis transmembrane conductance regulator (non-CFTR) transport processes are involved, (b) prolonged exposure to secretagogues is required, or (c) delta F508 CFTR is responsible for the protective effect.

Animals↗
PubMed1979

Revascularization of the right coronary artery.

This study was undertaken to evaluate revascularization of the right coronary artery with regard to factors that enter into the decision to graft less significant lesions, such as graft flow, graft patency and progression of proximal disease. The results of grafting the right coronary artery were studied in 23 patients with lesions reducing luminal diameter by less than 50 percent (Group 1), 35 patients with luminal narrowing of 50 to 70 percent (Group 2) and 112 patients with greater than 70 percent luminal narrowing (Group 3). At operation there was no significant difference in saphenous vein graft flows among the three groups. Postoperatively the mean follow-up period was 20, 27 and 26 months, respectively. Graft patency was not significantly different among the three groups. Progression of the proximal lesion was studied and compared with that in 71 ungrafted right coronary arteries, 60 with less than 50 percent stenosis and 11 with more than 50 percent stenosis. Among vessels with less than 50 percent narrowing, the proximal lesion showed progression in 26 percent of the ungrafted vessels and in 83 percent of the grafted vessels (P less than 0.005); progression to total occlusion occurred in 3 percent of the former and in 28 percent of the latter (P less than 0.005). Progression to total occlusion was more frequently associated with a patent than with an occluded graft (P less than 0.05). The occurrence of significant progression in ungrafted vessels and the lack of effect on graft patency of the severity of the proximal disease suggest that revascularization of less significant lesions may be of value. However, the resultant increase in progression of proximal disease makes the patient dependent on the long-term patency of the vein graft.

Cardiac Catheterization↗
PubMedDate not supplied

Evaluation of a prepared childbirth program.

A study was undertaken to ascertain what effects on the outcome of labor and delivery could be attributed to a prepared childbirth program. Three tables are included setting forth statistical relationships. The basic conclusion was that more than five hours of structured prenatal education has a positive impact on maternal-child health.

Delivery, Obstetric↗
PubMedDate not supplied

Nursing student information network: fostering collegial communications using a computer conference.

This article describes the development and implementation of a student-based computer information network in a university setting. A computer conference was established as a pilot project on two campuses in a large multipurpose, multicampus university school of nursing, and it was used to communicate information and facilitate collegial interaction among students, faculty, academic counselors, and administrators. The project demonstrates that computer conferences can be used to disseminate information effectively to diverse and geographically distant student populations. Such networks have the potential to enhance opportunities for collaborative learning experiences and student-faculty communication.

Communication↗
PubMedDate not supplied

Psychosocial risk factors in near-fatal asthma and in asthma deaths.

BACKGROUND: A description of near-fatal asthma (NFA) and comparison with patients who died of asthma in an English health district between 1988 and 1995. METHODS: The hospital case notes of patients aged under 65 years with NFA, identified from the intensive therapy unit register, were reviewed using forms based on those of the East Anglian confidential asthma death enquiry. Details were compared with patients dying from asthma in the same population during the same period. RESULTS: Between 1988 and 1995, 19 patients suffered 23 episodes of NFA and 44 died from asthma. Those with NFA were significantly younger. There were more women in both groups. Two patients with NFA subsequently died of asthma. Significantly more patients with NFA had had a previous NFA episode than those who died. Five had a cardio-respiratory arrest. Thirteen required intermittent positive pressure ventilation (IPPV). PaCO2 ranged from 6.1 to 17.8 kPa; nine had PaCO2 > or = 10 kPa and three recovered without IPPV. Adverse psychological and social factors were similar in both groups. Denial was the commonest psychological factor and domestic, financial or employment stress, smoking or passive smoking the commonest adverse social factors; only two with NFA and seven who died had no recorded adverse psychological or social factors. CONCLUSIONS: NFA and deaths from asthma occur in asthmatics who have many psychosocial risk factors in common. Special attention needs to be directed at patients with these adverse psychosocial factors, emphasising that they need continued follow-up with support to help them manage their asthma according to currently recommended practice.

Acute Disease↗