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Biomedical subjects

J L Carroll

Publications and source records attributed to J L Carroll.

At least 55 records · Page 3Linked to original sources
PubMed1994

Cardiorespiratory recordings from infants dying suddenly and unexpectedly at home.

OBJECTIVE: Little is known about the mechanism of death during sudden infant death. To study the mechanism, we obtained data on six infants who died while on a memory-equipped cardiorespiratory monitor. METHODS: Waveforms of respiration and heart rate trend were available for five infants; an alarm log only was available for the sixth. These printouts were reviewed with attention to mechanism and time to death. RESULTS: All infants were born prematurely; autopsies reported the cause of death as sudden infant death syndrome in three cases and bronchopulmonary dysplasia in the others. Bradycardia, which played a more prominent role than central apnea, was preceded by tachycardia in two deaths. Resuscitation occurred within 1 minute in four cases; no response to alarms occurred in the other two cases, apparently because the parents were desensitized by prior meaningless alarms. Five patients died within 20 minutes, whereas one death due to sudden infant death syndrome was prolonged. CONCLUSION: Bradycardia is an important feature in all six of these infant deaths. Although its etiology is unknown, hypoxemia or obstructive apnea may precede bradycardia. Home monitors equipped to detect these possible antecedents will yield further insight into sudden infant death.

Bradycardia↗
PubMed1993

Postnatal maturation of carotid chemoreceptor responses to O2 and CO2 in the cat.

This study aimed to characterize neural responses of the carotid chemoreceptors of the maturing cat to natural stimuli and to determine the time course of carotid chemoreceptor development from the neonatal period to adulthood. Carotid sinus nerve (CNS) responses to O2 and CO2 were studied in cats at 1, 4, and 8 wk of age and in adult cats (n = 6 at each age). Pentobarbital sodium-anesthetized cats were exposed to three levels of O2 (arterial PO2 = 40-45, 80-90, and > 300 Torr) at five levels of arterial PCO2 (22, 35, 48, 63, and 75 Torr) while the moving average of whole nerve output from the CSN was recorded. Ganglioglomerular nerves were sectioned. All cats at every age increased CSN activity during hypoxia. However, the CSN response to hypoxia was not sustained in some immature cats. Of the cats that sustained CSN activity during hypoxia, four of the six 1-wk-old cats showed a biphasic pattern of response, with an initial overshoot followed by a steady level of discharge. Older cats did not exhibit this pattern. CNS sensitivity to hypoxia was weakest in 1-wk-old kittens but increased to nearly adult levels by 4 wk of age. Carotid chemoreceptor responses to CO2 were also smallest in 1-wk-old kittens and increased with maturation. However, unlike hypoxia responses, CO2 sensitivity during hypoxia continued to develop between 8 wk and adulthood. O2-CO2 interaction did not become significant until after 4 wk of age. Thus, carotid chemoreceptor responses to both O2 and CO2 are weak in newborn cats and increase during postnatal development.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Respiratory compromise after adenotonsillectomy in children with obstructive sleep apnea.

A retrospective study of pediatric patients with obstructive sleep apnea who underwent adenotonsillectomy between 1987 and 1990 was undertaken to determine the frequency of postoperative respiratory compromise and to determine if risk factors for its development could be identified. Sixty-nine patients less than 18 years old had polysomnographically documented obstructive sleep apnea and were observed postoperatively in the pediatric intensive care unit. Of these, 16 (23%) had severe respiratory compromise, defined as intermittent or continuous oxygen saturation of 70% or less, and/or hypercapnia, requiring intervention. Compared with patients without respiratory compromise, these patients were younger (3.4 +/- 4 vs 6.1 +/- 4 years) and had more obstructive events per hour of sleep on the polysomnogram (49 +/- 41 vs 19 +/- 30). They were more likely to weight less than the fifth percentile for age (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.4 to 18.7), to have an abnormal electrocardiogram and/or echocardiogram (OR, 4.5; 95% CI, 1.3 to 15.1), and to have a craniofacial abnormality (OR, 6.2; 95% CI, 1.5 to 26). Multiple logistic regression analysis revealed the most significant risk factors were age below 3 years and an obstructive event index greater than 10. Children with obstructive sleep apnea are at risk for respiratory compromise following adenotonsillectomy; young age and severe sleep-related upper airway obstruction significantly increase this risk. We recommend in-hospital postoperative monitoring for children undergoing adenotonsillectomy for obstructive sleep apnea.

Adenoidectomy↗
PubMed1992

Impotence in the elderly. Evaluation of erectile failure in men older than seventy years of age. Jefferson Sexual Function Center.

A total of 102 patients over seventy years of age were evaluated in a multidisciplinary center for erectile dysfunction. The primary diagnosis was organic in 80 percent, but there were multiple associated factors. Erectile failure had persisted more than twenty-four months in 84 percent and the last successful intercourse was over one year prior to evaluation in 68 percent. There appears to be distinct differences in the pattern and etiology of erectile failure in elderly patients.

Aged↗
PubMed1992

Correlation between humorous coping style and health.

A significant correlation of -0.34 was found between scores on the Situational Humor Response Questionnaire and a measure of perceived physical health for 51 college students. Mean scores on the questionnaire were similar to those of the original standardization population.

Adaptation, Psychological↗
PubMed1991

An exploration of AIDS education and teaching methods.

The purpose of the present research was to examine the relationships between AIDS educational methodologies and learning/retention of medical students. The results suggest that certain teaching methods may be more effective in the development of positive attitudes about caring for persons with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Effect of oxygenation on breath-by-breath response of the genioglossus muscle during occlusion.

We investigated the effect of different levels of O2 tension (hypoxia, normoxia, and hyperoxia) on the breath-by-breath onset and peak electromyographic (EMG) activity of the genioglossus (GG) muscle during a five-breath end-expiratory tracheal occlusion of 20- to 30-s duration. GG and diaphragmatic (DIA) EMG activity were measured with needle electrodes in eight anesthetized tracheotomized adult cats. In response to occlusion, the increase in the number of animals with GG EMG activity was different during hypoxia, normoxia, and hyperoxia (P = 0.003, Friedman). During hypoxia, eight of eight of the animals had GG EMG activity by the third occluded effort. In contrast, during normoxia, only four of eight and, during hyperoxia, only three of eight animals had GG EMG activity throughout the entire five-breath occlusion. Similarly, at release of the occlusion, more animals had persistent GG EMG activity on the postocclusion breaths during hypoxia than during normoxia or hyperoxia. Breath-by-breath augmentation of peak amplitude of the GG and DIA EMGs on each occluded effort was accentuated during hypoxia (P less than 0.01) and abolished during hyperoxia (P = 0.10). These results suggest that hypoxemia is a major determinant of the rapidity of onset, magnitude, and sustained activity of upper airway muscles during airway occlusion.

Airway Obstruction↗
PubMed1991

Dynamic ventilatory responses to CO2 in the awake lamb: role of the carotid chemoreceptors.

In awake lambs we investigated the role of the peripheral chemoreceptors in producing dynamic ventilatory (VE) responses to CO2. The immediate VE response, within 15 s, to transient CO2 inhalation was studied in two groups: 1) five lambs before carotid denervation and 2) the same lambs after carotid denervation. The time course of VE responses during the first 60 s after a step change to 8% inspired CO2 was also studied in lambs after carotid denervation and in a group of six carotid body-intact lambs 10-11 days of age. Acute CO2 responses were assessed using step changes to various concentrations of CO2 + air and CO2 + O2, while VE was recorded breath by breath. Intact lambs exhibited a brisk VE response to step changes in CO2, beginning after 3-5 s. Hyperoxia altered but did not suppress the dynamic VE CO2 response when the carotid chemoreceptors were intact. Carotid denervation markedly reduced the VE response during the first 25 s after a CO2 step change, revealing the time delay required for the central chemoreceptors to produce an effective VE response. The residual VE response remaining after CD was thought to be mediated by the remaining aortic body chemoreceptors and was eliminated by adding O2 to the CO2 challenges. However, after carotid denervation, even with CO2 + hyperoxia, the onset of a small tidal volume response was apparent by 10-12 s.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Age-related changes in hormones in impotent men. Jefferson Sexual Function Center.

A total of 818 impotent men were evaluated in a multidisciplinary Sexual Function Center for reproductive hormone levels. Data are presented demonstrating an overall rate of endocrinopathy at 19.3 percent. Various age-dependent trends in the incidence of abnormal levels are noted. Hypogonadism as well as hyperpituitarism appear to increase in incidence with increasing age. Hyperprolactinemia, however, seems to be relatively constant in occurrence. Because of the likelihood of detecting endocrine abnormalities, a recommendation is made for routine hormonal screening of all patients complaining of impotence.

Adolescent↗
PubMed1990

Evaluation of sexual satisfaction in partners of men experiencing erectile failure.

The present study was designed to examine the impact of erectile failure on the partners of impotent men. Partners were sent detailed questionnaires to assess the impact of the erectile dysfunction on their relationship. Many women felt that their partners were withdrawing as a result of the sexual difficulties, and 41% felt that they were to blame for this. Personal reasons were given by many women as to why they felt responsible for the problems. This study lends support to a need for the treatment of the emotional and psychological problems which frequently occur in the dyadic relationship, regardless of the etiology of the erectile difficulties.

Adult↗
PubMed1990

Educational intervention as an adjunct to treatment of erectile dysfunction in older couples.

This study examined the effects of a sex and aging workshop highlighting permission and limited information on the sexual knowledge, attitudes, behaviors, and satisfaction of a group of older heterosexual couples experiencing erectile dysfunction. The workshop focused on disseminating information about the physiological and psychological changes that occur in the sexual response during the aging process. Twenty couples participated in this study: 10 attended a workshop and 10 served as controls. The study utilized a randomized control group pretest/posttest design. Workshop participants completed an evaluation form and were interviewed at the time of follow-up. Data analysis revealed that the workshop participants reported significant increases in knowledge levels and in sexual satisfaction. The workshop evaluations and follow-up interviews reinforced these quantitative results. This study lends support to educational intervention as an adjunct to treatment of erectile dysfunction in the elderly population.

Aged↗
PubMed1990

The use of PotenTest in the multidisciplinary evaluation of impotence: is it a reliable measure? Jefferson Sexual Function Center.

This study compares the findings of multidisciplinary evaluation to the three-night use of the PotenTest, a standardized stamp test for the evaluation of nocturnal penile tumescence, in 174 patients. An organic etiology was diagnosed in 54% of those evaluated. The PotenTest proved accurate as a screening device for organic disease. Among the 48 patients who did not break any of the stamps over the three nights, 40 were found to have an organic basis for their erectile failure, for a predictive value of 83%. Among the 68 patients who broke all of the stamps, 45 were found to have a psychogenic basis for their erectile failure, for a 66% predictive value. When one or two of the stamps were broken over the three nights, the predictive values as to the etiology of the erectile failure were considerably diminished and of no diagnostic value. Results for only one night of usage revealed that of the 73 patients who did not break the stamps, 56 (77%) were found to have an organic etiology. Of the 101 patients who broke the stamps on the first night, 63 (62%) were found to have a psychogenic etiology.

Adult↗
PubMed1990

Uses of humor in psychotherapy.

Given demonstrated usefulness in facilitating learning, aiding healing, and reducing stress, humor has gained recognition as a clinical tool. This article reviews some uses and potential misuses of humor in psychotherapy and suggests directions for practice and research.

Anxiety↗
PubMed1989

Snap-Gauge band vs multidisciplinary evaluation in impotence assessment.

This study compares the findings of multidisciplinary evaluation to the two-night use of the Snap-Gauge band in 100 impotent men. An organic etiology was diagnosed in 52 percent of those evaluated. The Snap-Gauge band proved accurate as a screening device for organic disease. If no elements were broken over the two-night period, this finding correlated with multisystemic diagnosis of organic etiology in 86 percent of cases. Among the 52 patients in whom an organic etiology was diagnosed, 32 broke no elements for a 62 percent sensitivity. When more than one element was broken, the predictive value as to etiology of the erectile dysfunction diminished.

Erectile Dysfunction↗