Biomedical subjects

J Ostrander

Publications and source records attributed to J Ostrander.

3 recordsLinked to original sources

PubMed1999

Patient and physician agreement on abdominal pain severity and need for opioid analgesia.

Whereas controversy surrounds emergency department (ED) analgesia administration to patients with undifferentiated abdominal pain, few studies have addressed the level of patient-physician agreement on abdominal pain severity and need for opioid analgesia. This prospective study was undertaken to assess concordance between emergency physicians and patients on abdominal pain severity. Study subjects were a convenience sample of 30 adults seen in an urban university-affiliated tertiary care ED (annual census 65,000) who had undifferentiated abdominal pain meeting an initial severity threshold of 5 on a 10 cm visual analog scale (VAS) marked by the patient. Patients' and physicians' VAS scores, obtained in blinded fashion at presentation (t0) and at one (t1) and two (t2) hours into the ED stay, were compared with t test (VAS scores) and sign-rank (percent change in VAS scores) analyses. In addition, patients and physicians were asked at each assessment time, in blinded fashion, "Is the pain severe enough to warrant morphine?" The kappa statistic was used to characterize the degree of agreement between physician and patient assessments as to whether opioids were indicated. At t0, t1, and t2, patients' mean VAS scores (7.5, 6.7, and 5.1) were significantly (P < .05) higher than the corresponding physicians' VAS scores (5.3, 4.7, and 3.9). Though VAS scores for physicians started lower than those of patients, the percentage changes in scores from one assessment to the next were similar by Wilcoxon sign-rank testing (P > .50 for time intervals t0 - t1 and t1 - t2). Overall, patients and physicians agreed on the question of whether pain was sufficient to warrant opioids in 71 of 90 (78.9%) assessments; the corresponding kappa statistic of .57 indicated moderate agreement (P < .0001). These results, indicating that patients and physicians usually agree on whether opioids are warranted for abdominal pain, have important implications for further research on ED analgesia in this population.

Abdominal Pain↗

PubMed1977

Egg substitutes: use and preference--with and without nutritional information.

Three egg substitutes, plus fresh and dried whole eggs, were evaluated by a consumer panel before and after receiving information on cost and caloric and cholesterol content of the products, and before and after sensory evaluations. Initially, most of the thirty panelists believed that the egg substitutes would cost the same or less than fresh eggs. After receiving information on cost and caloric and cholesterol content, the panelists perceived no significant differences in the nutritional value of the products. Fresh whole egg was the preferred product. After tasting, the consumers judged the nutritional value of all of the products higher, but their preferences were lower for all products except the fresh whole egg. Presentation of information on the caloric and cholesterol content of the egg substitutes without explanation of possible benefit in current health problems appears insufficient to change consumers' perception of a fat-modified product.

Adult↗

PubMed1976

Egg substitutes: chemical and biologic evaluations.

The total lipid, cholesterol, phospholipid, and fatty acid content of dried whole egg (DWE), a refrigerated liquid egg substitute, a powdered egg substitute, and a commercial egg yolk replacer (EYR) were compared. All substitutes contained less total lipid, cholesterol, and phospholipid than DWE. The powdered substitute contained only half the total lipid content reported by the producers and only a fifth of the cholesterol of DWE, while the percentage distribution of fatty acids was similar to that of DWE. The liquid substitute and EYR had fatty acid distributions similar to soybean oil. Rat growth and lipid response were compared for diets containing either DWE or a mixture of EYR and egg white. Both diets were fed with and without vitamin and mineral supplements. Rat growth response was greatest on the DWE diets, either with or without the supplements, was intermediate on the supplemented EYR diets, and was least on the unsupplemented EYR diets. The consumption of DWE-containing diets, when compared with the EYR-containing diets, caused greater liver weight, greater liver total lipid and total cholesterol content, and slightly higher serum cholesterol.

Animals↗