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Biomedical subjects

J Hanley

Publications and source records attributed to J Hanley.

At least 19 recordsLinked to original sources
PubMed1992

The feasibility of using a double blind experimental cross-over design to study interventions for sick building syndrome.

Methodological problems have limited scientific investigation of the causes of and solutions for sick building syndrome. The feasibility of using an experimental double blind cross-over study to resolve many of these methodological problems was assessed in a pilot study. The experimental intervention was to vary the amount of outdoor air from 10 cubic feet per minute per person (cfmpp) to 20 cfmpp or 50 cfmpp by central manipulation of the building heating, ventilation and air-conditioning (HVAC) system. Over 6 consecutive study weeks, 2 trials of rates were administered in random order. Study subjects and investigators of the study were blinded to intervention sequence. Unblinding, office environment rating and symptom occurrence were measured weekly. Of 305 eligible workers, 254 participated. Problems were encountered in delivering the lowest dose of ventilation due to building leakage. The prevalence of symptoms diminished steadily over the 6 study weeks, time trends which could be controlled by recommended design modifications. Blinding to the intervention was successfully maintained. Weekly non-response did not introduce a response bias but reduced the number of subjects available for analysis by one-third for each trial. We conclude that this design, with certain modifications, is feasible to evaluate many proposed interventions for sick building syndrome.

Adult↗
PubMed1991

Effects of formula change on intestinal hydrogen production and crying and fussing behavior.

To determine whether incomplete carbohydrate absorption plays a role in mediating the effects of formula change on babies' crying, breath hydrogen excretion and behavior were measured in 17 normal formula-fed infants who entered a feeding trial at 28 days of life. The trial permitted two comparisons between (1) lactose and reduced lactose soy-based formulae, and (2) the infant's usual pretrial formula and the subsequent soy-based variable-carbohydrate formulae. Reduced lactose formula was associated with a small reduction in H2 excretion (from a mean of 15 to 7 ppm, p = .07) but no difference in crying or fussing. However, compared with their usual pretrial formula, the change to soy-based variable-carbohydrate formulae was associated with a substantial and sustained reduction in H2 excretion (mean 32 to 11 ppm, p less than .03) and a modest 21% decline in fussing (90.4 to 71.5 min/24 hr, p less than .08). By 8 days after the formula change, there was a 40% decline (90.4 to 53.9 min/24 hr) in fussing. These results suggest that, although behavioral changes due to differences in carbohydrate content are unlikely in normal infants, formula changes involving protein and carbohydrate can reduce colonic gas production and may have some effect on crying. Such effects may be implicated when feeding changes occur in normal infants, but their potential role in treatment of crying problems (colic) is yet to be demonstrated.

Bottle Feeding↗
PubMed1990

The effect of early experience on water maze spatial learning and memory in rats.

In the first of two experiments on spatial competence, groups of light-reared (LR) and dark-reared (DR) rats were compared using a "latent learning" variation of the Morris Water Maze task. On their initial test, the LR rats benefited more than DR rats did from viewing the room/pool from a platform in the correct location. Further, visually experienced rats remember the location of the platform more than DR rats when retested one month later. In a second experiment, in which a proximal cue as well as location was varied from trial to trial. LR rats again proved to be more competent than their DR counterparts. This second task also revealed significant benefits related to stimulation history in the case of a third group of animals raised in enriched or complex environment (CR) conditions. The results are discussed in terms of the nature of the impact of early experience on the ability to acquire and remember spatial concepts.

Animals↗
PubMed1989

Risk factors for stroke and other embolic events in patients with nonrheumatic atrial fibrillation.

Factors associated with stroke and other cardiac embolic events in subjects with nonrheumatic atrial fibrillation were examined in a retrospective study of 91 patients from a teaching hospital clinic. There were 28 first strokes during 355 person-years of follow-up (7.9 per 100 person-years). Patients who had experienced one or more previous events were approximately 2.3 times more likely to have a subsequent event (hazard ratio 2.3, 95% confidence interval 1.5-3.4) than patients who had experienced no events. A univariate analysis of factors associated with a first stroke of any cause or other embolic event showed that age of greater than 75 years (hazard ratio 2.5) and systolic blood pressure of greater than 160 mm Hg (hazard ratio 6.4) were significant factors. After adjusting for the effect of age and systolic blood pressure, previous events still carried an increased risk for subsequent events. Subject with nonrheumatic atrial fibrillation who have had one or more embolic events are at high risk of further emboli. They require special consideration when treatment is being planned.

Aged↗
PubMed1989

Mortality patterns among a Native American population in New York State.

This study investigated patterns of mortality among a Native American tribe, the Seneca Nation of Indians (SNI). The names of 962 tribal members reported to have died in New York State between 1955 and the end of 1984 were identified through a review of tribal roll books maintained by the Seneca Nation. Positive matches were obtained for 796 (83%) of these individuals using New York State mortality files for the period under investigation. Standardized Proportionate Mortality Ratios (PMR) were computed for major causes of death based on cause-specific mortality patterns in the New York State population for each sex during the same time period. Significantly elevated risks of mortality were observed for all infectious diseases, tuberculosis, diabetes mellitus, cirrhosis, and accidents. Depressed mortality ratios were noted for deaths due to all cancers combined, and for cancers of the lung, pancreas, breast, and lymphatic/hematopoietic cancers. Changes in mortality risks over time were also observed.

Cause of Death↗
PubMed1989

Interdisciplinary activity between occupational therapists and speech language pathologists.

The interdisciplinary activities between occupational therapists (OTs) and speech language pathologists (SLPs) were studied by conducting a national mail survey. Analysis of data gathered from 344 OTs and 262 SLPs (n = 1250 and n = 1130, respectively), indicated strikingly similar responses. Results showed that OTs and SLPs in the medical setting had frequent informal contacts, but interdisciplinary activity was not typical of formal job descriptions. According to 84% of OTs and 91% of SLPs, the most common activity involved exchange of diagnostic information, while 66.6% of both groups identified cooperative planning as typical of their interactions. Only 33.3% of each professional group responded that team treatment characterized interactions. Approximately 50% of the respondents felt that interactions were self-motivated and that the amount of interdisciplinary activity was satisfactory. The data suggested improvement needs are primarily qualitative rather than quantitative, and the primary limiting factors reported by both groups included staff shortages, financial constraints, and physical locations.

Adult↗
PubMed1989

Cigarette smoking in Cree Indian school children of the James Bay region.

A survey of cigarette smoking habits of Cree Indian school children in the James Bay region of northern Quebec was carried out. Out of 689 questionnaires completed by students in grades 6 through Secondary V (approximately ages 11 through 18), 13.2% were nonsmokers, 35.4% were exsmokers, and 51.4% were current smokers. 65% of the smokers were daily smokers and they averaged 7 cigarettes per day. Factors positively associated with being a current smoker were age, female sex, having a mother who smoked, and having a best friend who smoked.

Adolescent↗
PubMed1988

Problems in radiographic estimation of response to chemotherapy and radiotherapy in small cell lung cancer.

Assessment of the response to therapy in small cell lung cancer requires serial tumor measurements with chest radiographs before and after treatment. Those lesions that are not measurable may be evaluated for response using subjective criteria. We studied interobserver variability in tumor measurement in 21 patients with small cell lung cancer. In addition, we analyzed the effect that the variability in measurement had on the estimation of response to combination chemotherapy with and without chest radiotherapy. Half the readers agreed that pretreatment radiographs were measurable. Posttreatment, they were more often unmeasurable. Starting from a base of 100%, representing all measurable pretreatment films, posttreatment measurability rates fell to 78% and 53% on the 2-month and 4-month films. After radiotherapy, changes particularly reduced the readers' ability to measure the tumors. There was also less interobserver agreement on response after radiotherapy. The intraclass correlation coefficient for partial or complete response versus no response was 0.42 where no chest radiotherapy had been administered and 0.17 after radiotherapy. A measurable lesion on the initial radiograph was important in improving the consistency of evaluation of complete versus partial response particularly in films taken after chemotherapy alone. These data indicate that there is only fair agreement as to whether tumors were measurable and whether a response had occurred. More consistent results were seen in films taken before administration of radiotherapy. A measurable pretreatment film was important in improving interobserver consistency in differentiating a complete from a partial response.

Carcinoma, Small Cell↗
PubMed1988

Factors predisposing to difficult labor in primiparas.

Why do some women have difficult labor whereas other women have relatively easy labor? A study of possible predisposing factors was conducted in 398 and 383 primiparas admitted for uncomplicated spontaneous labor at two hospitals. Psychosocial factors, notably anxiety about childbirth, and physical factors, especially maternal height and body mass index, were measured before the onset of labor. Difficult labor was defined in primiparas admitted to the hospital for spontaneous uncomplicated labor as (1) prolonged labor that was longer than 15 hours from admission until full dilation with vaginal delivery or (2) cesarean section. Anxiety about childbirth as self-reported before the onset of labor did not predispose to difficult labor at either hospital. Short height and heavy body mass index predisposed to difficult labor. Further work is needed to elucidate psychosocial factors predisposing to difficult labor.

Anxiety↗
PubMed1988

Efficacy of sequential cyclical hormonal therapy in endometrial cancer and its correlation with steroid hormone receptor status.

Forty-six eligible women with metastatic endometrial cancer were randomly allocated to receive monthly cycles of either CAF (cyclophosphamide, adriamycin, 5-fluorouracil) or CAF plus Provera 200 mg daily for 3 weeks followed cyclically by Tamoxifen 20 mg daily for 3 weeks. Overall response rates of 15 and 43% were seen with CAF and CAF plus hormonal therapy. Using a multivariate analysis of the results, this difference is significant (P value 0.05). In 8 patients with operable endometrial cancer, negative estrogen receptor concentration (ER less than 15 fmole/mg protein) and Grade 3 disease, the clinical course was aggressive in 4 patients with systemic and local relapse. In 10 other similar patients (negative ER and Grade 3) who received adjuvant cyclical hormonal therapy only 1 relapsed and the other 9 are disease-free for an average of more than 31 months. Sequential cyclical hormonal therapy with ER and progesterone receptor analysis has a place in the management of endometrial carcinoma.

Adenocarcinoma↗
PubMed1988

Detection of pilus subunits (pilins) and filaments by using anti-P pilin antisera.

P pilus filaments are important in binding to globoside through an adhesin located at the tip of the pilus. There is considerable antigenic variation among P pili, and the immunologic response is usually serotype specific. We purified denatured pilin subunits and used them as immunogens to prepare more broadly cross-reactive antisera. Although antifilament antisera (AFA) detected predominantly the homologous strain, antisubunit antisera (ASA) prepared from two different strains detected P pili in 16 of 16 and 14 of 16 P-piliated strains by Western blotting (immunoblotting). The binding of ASA to the homologous pilus filament was inhibited by only 3 of 17 strains. ASA agglutinated only two of nine heterologous strains and immunoprecipitated pili from one of three heterologous strains. By immunoelectron microscopy ASA was seen to bind to pilus filaments but not as strongly as AFA. Antiserum raised to the denatured pilin subunit was not substantially more reactive with pilus filaments derived from heterologous strains than was AFA. ASA was, however, a very useful probe for detecting most P pilins.

Agglutination Tests↗
PubMed1988

The human antibody response to uropathogenic Escherichia coli: a review.

Urinary tract infections caused by Escherichia coli are associated with a local and systemic antibody response. We have studied the serum and urine antibody responses to Escherichia coli in men and women with pyelonephritis, cystitis, and asymptomatic bacteriuria. Protein immunoblots consistently demonstrated serum antibody response to lipopolysaccharide (LPS). Anti-LPS antibody titres rose significantly and progressively when comparing acute with convalescent sera in those who have had their first urinary infection. For those with repeated infections, high titre LPS antibodies were present and did not change significantly between acute and convalescent sera. Antibody responses to the major outer membrane proteins were present but did not differ significantly when compared with normal human serum. A specific anti-P pilus antibody response was demonstrated by immunoblotting. Anti-P pilus antibody was quantitated using ELISA and the titres were found to be very low. Three other techniques were also used to demonstrate the presence of serum antibody. Antibody was detectable by immunofluorescence, but the antigenic specificity of the antibody was more difficult to ascertain. Immunoprecipitation was more specific for determining the nature of the antibody response. Lastly, immunoelectron microscopy was valuable in demonstrating antipilus and antiflagellar antibodies. Immunoelectron microscopy and immunoblotting provided evidence that human antiserum to P pili was modestly cross-reactive and could bind heterologous P pili. These studies indicated that the major antibody response in humans occurs after pyelonephritis and is directed against LPS. An anti-P pilus response is frequently present and is cross-reactive to some extent with other P pili.

Animals↗
PubMed1988

Visits to physicians before and after exposure to urea formaldehyde foam insulation.

The average number of visits to a physician made by a sample of 351 residents of homes insulated with urea formaldehyde foam insulation in Montreal in the one year period before exposure was 5.25, and in the year following 5.62, an increase of 7 per cent (odds ratio 1.07, 95% CI = 1.00, 1.15). The increase in visits in the post insulation year was limited to subjects who had the product installed in the winter (OR = 1.48, 95% CI = 1.18,1.85), and was not seen for study subjects who insulated their homes during other seasons of the year.

Construction Materials↗
PubMed1987

Trial of a geriatric consultation team in an acute care hospital.

A controlled trial was conducted to examine the effects of superimposing an interdisciplinary geriatric consultation team upon the conventional patterns of care in medical wards of an acute care hospital. Two hundred and twenty-two patients, aged 69 years of age or older, admitted from the emergency room to two trial wards and 182 similar patients admitted to two control wards where the team did not work, were followed. Evaluations at admission, two and four weeks, and three and six months postadmission by independent evaluators allowed comparisons between the care groups with reference to survival, length of stay, disposition, physical, mental, and social functional levels, and use of services after discharge. Data from charts and treatment logs allowed the care processes to be compared. Findings determined that patients in the two groups were alike on socio-demographic and clinical characteristics at entry. Results demonstrated that patients in the trial and control groups fared similarly on the outcome measures at each evaluation point, although a trend toward better survival among team patients was noted. It was concluded that the addition of a consultative geriatric team to the medical wards failed to show a significant impact on patient outcomes.

Aged↗
PubMed1987

A survey of the younger chronic sick and disabled living in the community in Lothian Region.

A postal survey of households was carried out in Lothian Region to try to determine the number of physically disabled people aged between 16 and 64 living in the community. More information was gained by interviewing those who identified themselves as disabled. It was estimated that there were between 20,000 and 24,000 people aged between 16 and 64 living in the community in Lothian who felt that their activities were restricted by physical impairment, but only about 2500 of those were restricted to the extent that they scored 80 or less on the Barthel index.

Activities of Daily Living↗
PubMed1987

Double blind randomized prospective trial of levamisole/placebo in stage I cutaneous malignant melanoma.

One hundred and fifty-six Stage I, Clark's Level III, IV, and V cutaneous malignant melanoma patients were randomized, 83 to Levamisole and 73 to placebo. One hundred and thirty-seven patients were evaluable. Their median follow-up time was 5 years. The 2 groups were comparable in terms of patient characteristics, except for a slightly higher percentage of Clark's level III in the placebo group (57.8 vs 52%). Severe toxicity leading to discontinuation of the medication occurred in 32 patients in the Levamisole arm, versus 10 in the placebo arm. Thirty per cent of patients receiving Levamisole have recurred in comparison with 26% of those on placebo treatment, and despite a trend in the delay of appearance of distant metastasis in the patients receiving Levamisole (30 months versus 9 months in the placebo patients), this drug does not appear to be effective in altering the disease-free survival or the survival of Stage I patients in the dosage schedule utilized in this study.

Adult↗
PubMed1986

Measurability of non-small-cell lung cancer on chest radiographs.

Response rates to various drug regimens are determined in multi-center trials by radiographic measurement of tumor dimensions before and after treatment. The way in which lesions are measured may affect the reported results. Lesions due to primary lung cancer may be more difficult to assess than rounded peripheral metastases. No previous study has assessed the variability of tumor measurements in patients with primary lung cancer. Nineteen radiographs from 12 patients with non-small-cell lung cancer (NSCLC) were shown to 25 experienced readers on two separate occasions. Pre- and post-treatment (combined chemotherapy and radiotherapy) radiographs were first shown separately, unidentified and in random order. Three months later, they were shown side by side with the facility for comparison. A decrease in tumor size of greater than or equal to 50% was considered as a "response." Viewing paired films together increased the viewers ability to measure tumors compared with reading each film of the radiographic pair individually. Fifty-one percent of unmeasurable pairs became measurable when read together, whereas 13% of previously measurable pairs now became unmeasurable. The interobserver variation in measurements was 10% to 265%, while the intraobserver variation was 4% to 10%. The correlation between responses calculated on the first and second readings often was no better than chance alone. Subjective impressions of degree of improvement showed no good correlation with response rates measured objectively. Because of the large variation in measurements and consequently in response rate, we recommend that all radiographs be reviewed by a single observer for any particular study, and pre- and post-treatment radiographs be evaluated together.

Antineoplastic Combined Chemotherapy Protocols↗