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Biomedical subjects

J Risser

Publications and source records attributed to J Risser.

8 recordsLinked to original sources
PubMed2006

A retrospective study to determine the impact of medical- and lifestyle-based contraindications to a prescribed HAART regimen on clinical outcomes and adherence.

OBJECTIVE: To determine whether patients who are prescribed a highly active antiretroviral therapy regimen, that minimizes medical and lifestyle contraindications, will be better able to adhere to their drug regimens and will have better clinical outcomes, than patients who do not have such a regimen. METHODS: A retrospective chart review of patients' prescription renewals and changes in viral load and CD4(+) count and a comparison of these changes with patients' self-identified contraindications. Contraindications were identified by a questionnaire with 35 questions relating to medical history/concurrently prescribed medication and 16 questions on lifestyle. Main outcome measures are adherence assessed by prescription renewals, change in plasma HIV-1 RNA viral loads, and change in CD4(+) T-lymphocyte counts. Logistic and linear regression and student t-test were used to identify associations between outcome measurements and number of contraindications. RESULTS: A total of 203 patients (72% male, 74% African-American, 7% Hispanic) completed the questionnaire. Seventy-four per cent of the patients had at least one medical/drug contraindication and 78% had at least one lifestyle contraindication. Increases in CD4 counts were reduced by an average of 13 cells/mm(3) (P = 0.033) for each medical/drug contraindication and viral load decreases was significant even with one medical contraindication vs. none (P = 0.042). Patients with fewer lifestyle contraindications were more likely to have at least a 1 log drop in viral load (P = 0.036). For each increase in the number of contraindications, there was a corresponding 2% decrease in the rate of adherence (P = 0.048). CONCLUSIONS: The results suggest that using a patient administered questionnaire it is possible to identify contraindications in prescribed regimens that impact on adherence and on treatment effects on viral load and CD4 counts.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Grating visual acuity in eyes with retinal residua of retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group.

OBJECTIVES: To compare grating visual acuity of eyes with varying severity of retinal residua of retinopathy of prematurity to grating visual acuity of eyes that did not have acute-phase retinopathy of prematurity, showed no ocular abnormalities on follow-up, and were from patients who passed neurodevelopmental screening questions. DESIGN: Monocular grating visual acuity was measured by means of the Teller acuity card procedure when children reached 1, 2, 3 1/2, and 4 1/2 years of age. PATIENTS: A total of 1398 children with birth weights less than 1251 g whose acute-phase retinopathy of prematurity was documented as part of the Multicenter Cryotherapy for Retinopathy of Prematurity Study and who participated in follow-up visual acuity testing. RESULTS: Eyes with no or mild residua of retinopathy of prematurity showed a mean visual acuity similar to that of the comparison group. Eyes in a subgroup with abnormally straightened temporal retinal vessels showed a mean visual acuity approximately 1 octave below that of the comparison group. Mean visual acuity scores from eyes with macular heterotopia ranged from 1 octave (at 1 year) to more than 2 octaves (at 4 1/2 years) below the mean visual acuity of the comparison group. Mean visual acuity scores for the few eyes in the retinal fold or partial detachment group that had quantifiable visual acuity were well below the means for the comparison group. CONCLUSIONS: Acute-phase retinopathy of prematurity that regresses without retinal residua produces no deficit in grating visual acuity between 1 and 4 1/2 years of age. In contrast, eyes with macular heterotopia show a visual acuity deficit, and the deficit is greater at older than at younger ages. Eyes with retinal fold or partial detachment that have measurable visual acuity show large visual acuity deficits at all ages.

Acute Disease↗
PubMed1990

Computer-assisted detection and intervention in adolescent high-risk health behaviors.

Because adolescents avoid bringing sensitive issues, such as substance abuse, suicide, and sexual activity, to pediatricians, and may fail to realize that they need health education or services, a computer program was designed to facilitate reporting of high-risk psychosocial and health behaviors and to provide specific health advice and referral for timely professional intervention. Computer printouts done anonymously by a random sample of 265 adolescents after a physical examination were compared with those of a matched group of 294 who were predirected to share the printout with the clinician at their examinations. The former elicited more positive responses to sensitive health problems, but both computer groups responded significantly more often about most high-risk issues than a matched written questionnaire group of 251. Almost all adolescents said that they reported true information to the computer and read all the information it printed. Experience with 3327 teenagers demonstrated that 89% preferred the computer over a questionnaire or personal interview, but nearly all were willing to share the printout with the pediatrician, which should facilitate clinical evaluation. The nonjudgmental computer can identify problem areas and deliver automated medical advice and referral. Automated health assessment and education may become a useful adjunct for addressing adolescent health issues.

Adolescent↗
PubMed1989

[Ambulatory anesthesia in intravenous digital angiography in children. 340 cases].

Immobility in intravenous digital angiography (ANIV) plays a leading part for high-quality results. Three hundred forty children (mean age 30 months, mean weight 12 kg) had an intravenous digital angiography in day-hospital's conditions. Intravenous general anesthesia with or without short neuromuscular blockade is able to help immobility in children. Method described requires a perfect synchronization with the radiologist. Anesthesia mean life was 6 minutes. No incident or fatal accident was observed. Many observations either confirmed the diagnosis or decided a surgical intervention. Determinant character of obtained investigations incite us to accept risks inherent in the technique.

Ambulatory Care↗
PubMed1980

Effect of maternally administered methadone on discrimination learning of rat offspring.

Shape discrimination learning by four groups of 150-day-old Sprague-Dawley rats was studied. The groups were the offspring of mothers on the following schedules: (1) prenatal and postnatal methadone, (2) prenatal methadone and postnatal saline, (3) prenatal and postnatal methadone, and (4) prenatal and postnatal saline. The hypothesis investigated was that the methadone groups would show a deficit in learning when compared to the saline-control group. This hypothesis was upheld for the prenatal methadone group and the postnatal methadone group.

Animals↗
PubMedDate not supplied

Handgun injuries to the foot: treatment of low-velocity, high-energy wound types.

The authors present several cases of gunshot injury to the foot. Classification of wounds according to weapon type and caliber is discussed, as well as treatment rationale. Emphasis is placed on the need for detailed wound history and classification as precursors to adequate therapy. The low-velocity, high-energy wound type is introduced, and its variation from the current low- and high-velocity classifications discussed.

Adolescent↗