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Biomedical subjects

J Reardon

Publications and source records attributed to J Reardon.

18 recordsLinked to original sources
PubMed2005

Health indicators among low income women who report a history of sex work: the population based Northern California Young Women's Survey.

OBJECTIVES: We examined differences in demographic characteristics, HIV related risk behaviour, prevalence of sexually transmitted infections (STI), and HIV and other health concerns among women with and without a history of sex work. METHODS: A secondary analysis of a population based, cross sectional survey of young, low income women in northern California. RESULTS: Of the 2543 women interviewed, 8.9% reported a history of sex work. These women reported more lifetime male sexual partners, were more likely to use drugs before sex, and were more likely to have a history of having sex with partners at high risk for HIV (that is, men who have sex with men, inject drugs, or were known to be HIV positive). They were significantly more likely to have positive serology for syphilis, herpes simplex virus type 2 (HSV-2), and hepatitis C regardless of their personal injecting drug use history; however, they were no more likely to have HIV, chlamydia, gonorrhoea, hepatitis A or hepatitis B infection compared to women without a history of sex work. Women with a history of sex work were significantly more likely to have a history of sexual coercion and tobacco use. CONCLUSIONS: These data measure the population prevalence of sex work among low income women and associated STI. Women with a history of sex work have health concerns beyond STI and HIV treatment and prevention.

Adolescent↗
PubMed2004

Antineutrophil cytoplasmic antibody-associated necrotizing crescentic glomerulonephritis in a patient receiving treatment with etanercept for severe rheumatoid arthritis.

Etanercept is a tumor necrosis factor inhibitor used in the treatment of rheumatoid arthritis and, increasingly, in a range of other diseases. We report a case of necrotizing crescentic glomerulonephritis, associated with a positive antineutrophil cytoplasmic antibody, causing acute renal failure in a woman receiving treatment with etanercept for severe rheumatoid arthritis. Our patient was treated with steroids and cyclophosphamide following withdrawal of etanercept, with a good clinical response. Although reports of vasculitis in patients receiving treatment with etanercept are rare, this drug has been shown to up-regulate some aspects of immune function, and the possibility that this agent may precipitate or exacerbate vasculitis in some individuals has to be considered.

Adult↗
PubMed2001

Histamine poisoning associated with eating tuna burgers.

CONTEXT: Histamine poisoning occurs when persons ingest fish in which bacteria have converted histidine to histamine, a process that usually can be controlled by storage at low temperatures. From 1994 to 1997, North Carolina averaged 2 cases annually; however, from July 1998 to February 1999, a total of 22 cases of histamine fish poisoning were reported. OBJECTIVES: To examine the increase in histamine case reports, identify risk factors for poisoning, and develop recommendations for prevention. DESIGN AND SETTING: Case series evaluated in North Carolina from July 1998 to February 1999. SUBJECTS: Reported case-patients with 2 of the following symptoms within 2 hours of eating tuna: rash, facial flushing, vomiting, diarrhea, dyspnea, a tight feeling in the throat, headache, or a metallic or peppery taste in the mouth. RESULTS: Twenty cases occurred during 5 outbreaks, and there were 2 single occurrences. Of the 22 persons affected, 19 (86%) sought emergency medical care. All case-patients ate tuna: 18 ate tuna burgers, 2 ate salad containing tuna, and 2 ate filets. Tuna samples (available from 3 outbreaks) had histamine levels above the Food and Drug Administration regulatory level of 50 ppm (levels were between 213 and 3245 ppm). In 19 cases, the tuna used to prepare burgers or salads was frozen and thawed more than once before serving. Violations of recommended temperature controls were identified in 2 of the 5 restaurants, accounting for 14 (64%) cases. CONCLUSIONS: Tuna burgers, a relatively new menu item in restaurants, were associated with an increase in histamine poisoning cases in North Carolina. Tuna ground for burgers can be susceptible to both temperature fluctuations and bacterial contamination.

Animals↗
PubMed1994

The effect of comprehensive outpatient pulmonary rehabilitation on dyspnea.

To evaluate the effect of outpatient pulmonary rehabilitation (OPR) on dyspnea, we measured this symptom using a visual analogue scale during graded treadmill exercise testing and with baseline and transitional dyspnea indices (TDI). The latter measure overall dyspnea in three spheres: functional impairment, magnitude of task, and magnitude of effort. Twenty patients with COPD referred for OPR were randomly assigned to either a treatment group (T, n = 10), with dyspnea evaluated at baseline then shortly following a 6-week OPR program, or a control group (C, n = 10), with dyspnea evaluated at baseline then following a 6-week waiting period. No significant change in maximal exercise performance from baseline to repeated testing was observed in either group. Dyspnea at maximum treadmill workload (Dmax), which did not significantly change in C, decreased from 74.4 +/- 18.9 percent at baseline to 50.5 +/- 23.2 percent post-OPR in T (p = 0.006). The Dmax related to minute ventilation (Dmax/VEmax) and oxygen consumption (Dmax/VO2max) also significantly decreased following OPR. The reduction in exertional dyspnea was apparent by the second minute of exercise. Additionally, TDI focal scores were significantly higher in T than C (2.3 +/- 1.06 vs 0.2 +/- 1.75 units, p = 0.006), indicating decreased overall dyspnea following OPR. These results point to significant improvements in both exertional and clinically assessed dyspnea following OPR.

Aged↗
PubMed1993

Are HIV-infected injection drug users taking HIV tests?

OBJECTIVES: Knowledge of infection is essential for human immunodeficiency virus-type 1 (HIV-1) treatment initiation and epidemic control. This study evaluates infection knowledge among infected injection drug users and acceptance of confidential testing among injection drug users, particularly those infected with HIV-1. METHODS: A total of 810 injection drug users entering treatment in Contra Costa County, Calif, were examined. Clients were tested with unlinked (blinded) tests and simultaneously counseled and offered voluntary confidential HIV-1 antibody testing. Data on confidential testing acceptance, previous testing, drug use, and demographic information were collected. RESULTS: Of the 810 tested, 105 (13.0%) were infected. The current confidential test was accepted by 507 (62.6%). HIV seroprevalence in the unlinked survey was four times greater than in the voluntary survey (13% and 3.5%, respectively). HIV-1 infection was associated with refusal of a confidential test largely because most infected injection drug users (n = 58; 55.2%) already knew of their infection. Of the 47 injection drug users who were not aware of their infection, 12 (25.5%) accepted the test. Although African-American injection drug users presented with a higher infection rate (37.3%), they were three times less likely to know of their infection. CONCLUSIONS: "In-clinic" HIV-1 testing is highly accepted, and most infected clients in treatment will learn their status. Nevertheless, voluntary testing data are likely to yield considerable underestimates of the true rate of infection among injection drug users.

AIDS Serodiagnosis↗
PubMed1989

The development of a novel immunoassay amplification system and its use in viral detection.

A novel amplification system has been developed for the detection of free or antibody-conjugated alkaline phosphatase. The amplification system provides a 100 fold enhancement in the detection of the enzyme, compared to direct detection with chromogenic substrates. The key to the amplification system is the dephosphorylation of a potent phosphorylated inhibitor, and the visualization of this inhibitor using a second, indicator, reaction. This system is shown to provide increased sensitivity for immunoassays detecting either herpes simplex virus or respiratory syncytial virus in clinical samples. In addition, this general concept for amplification may be applicable to a variety of other hydrolytic enzymes, and is demonstrated for the enhanced detection of beta-galactosidase.

Alkaline Phosphatase↗
PubMed1975

Interocular transfer of the motion after-effect in normal and stereoblind observers.

The extent of interocular transfer of the motion after-effect was measured in 4 stereoblind subjects and in 19 subjects having varying degrees of stereopsis. Stereoblind individuals failed completely to show any interocular transfer of this after-effect, while subjects with good stereopsis exhibited between 55 and 82 percent transfer (mean 73 percent). Furthermore, normal subjects who manifested a clear eye dominance tended to show greater transfer from the dominant to the nondominant eye than vice versa. Individuals who either had a history of a strabismus or possessed some other early impediment to clear binocular vision tended to show less transfer. Overall there was a significant positive correlation of 0.75 between the extent of interocular transfer and the subject's stereoacuity. It is argued that the extent of interocular transfer of this after-effect provides a measure of the proportion of the total number of visual cortical neurons that are binocular. Thus stereoblind humans, who show no transfer whatsoever may, like cats and monkeys deprived of concordant binocular visual input early in life, suffer from a lack of binocular neurons.

Depth Perception↗
PubMedDate not supplied

One year's experience using a rotating filter for therapeutic plasma exchange.

The authors previously demonstrated the feasibility of using a rotating filter system for therapeutic plasma exchange. They now report on the technical details of a 1 year clinical experience. Seventeen patients underwent 188 treatments. Hemoaccess was provided by antecubital veins (147 Rx), femoral catheters (37 Rx), or an a-v fistula (3 Rx). Blood flows ranged from 75 to 100 ml/min. Net plasma removed per treatment was 3,231 +/- 53 ml (mean +/- SE, n = 188). Mean plasma removal rate per treatment was 40.2 +/- 0.6 ml/min; mean treatment time was 83 +/- 2 min. Platelet counts before and after treatment revealed a 15 +/- 4% decline (n = 46 Rx). Despite filtration fractions up to 86% there was no evidence of significant membrane plugging or hemolysis. For semiselective removal of cholesterol, the rotating filter was used in a cascade system with a secondary filter. Eighty percent of processed plasma was returned to the patient, but the treatment time was prolonged by 37% and the total cholesterol removed was 26% less when compared with the single pass system. The authors conclude that an inexpensive rotating filter can provide a highly efficient plasma exchange. The inherent efficiency of this system must be considered when evaluating its use with secondary filtration techniques.

Cholesterol↗
PubMedDate not supplied

High flux plasma exchange using a modified rotating membrane system.

The results of increasing blood flow capability in a modified system for plasma exchange with a rotating filter are reported. There were 742 treatments performed with the authors' original system (OS), limited to blood flows of 100 ml/ min, and 327 treatments performed with the updated system (US), allowing for blood flows of 150 ml/min. Blood flows for OS were 98 +/- 5 ml/min (mean +/- SD) vs 145 +/- 12 ml/min for US (p < 0.001). Plasma flows were 65 +/- 7 ml/min for OS vs 98 +/- 12 ml/min for US (p < 0.001). Plasma removal rate was 42 +/- 8 ml/min for OS vs 61 +/- 14 ml/min for US (p < 0.001). Mean treatment time was reduced from 76 +/- 23 min for OS to 52 +/- 17 min for US (p < 0.001) in spite of providing a similar amount of plasma removed per treatment (3,113 +/- 577 ml/Rx for OS vs 3078 +/- 797 ml/Rx for US; p = 0.48). Despite statistical significance, there were only small differences in filtration fractions (65 +/- 12% for OS vs 62 +/- 11% for US; p < 0.001) and patient hematocrits (34 +/- 6% for OS vs 33 +/- 6% for US; p < 0.001). In conclusion, modification of the OS to allow for increased blood flow has resulted in a substantial improvement in procedure efficiency and a clinically useful decrease in treatment time.

Biocompatible Materials↗
PubMedDate not supplied

The history and impact of worksite wellness.

Employers now pay an estimated 30% of the national health care bill. Wellness is defined as "a composite of physical, emotional, spiritual, intellectual, occupational, and social health; health promotion is the means to achieve wellness." Worksite wellness programs have developed largely in response to cost-containment efforts combined with the worksite health promotion movement. Worksite wellness efforts require the use of a model that targets reversible or alterable behaviors such as smoking, weight management, blood pressure monitoring, and stress management. Most employers in the health care arena are seen as doing too little to promote wellness among its own employees.

Cost Control↗