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Biomedical subjects

J Roll

Publications and source records attributed to J Roll.

8 recordsLinked to original sources
PubMed2000

Comparison of patient self-reports and urinalysis results obtained under naturalistic methadone treatment conditions.

This study examined under naturalistic assessment conditions the validity of self-reported opiate and cocaine use among 175 veterans enrolled in methadone treatment, and factors related to self-report validity, such as stage in treatment and drug of abuse. Veterans were interviewed by clinical staff about past 30-day drug use with the addiction severity index (ASI), and urinalysis results were obtained for the same 30-day interval assessed with the ASI. Analysis revealed that urinalysis generally produced higher rates of substance use than patient self-report, and with the exception of reported opiate use among new patients presenting for treatment, validity of patient self-reported drug use generally was poor with patients under-reporting both opiate and cocaine use. The findings are in marked contrast to those obtained in other studies in which participants are ensured confidentiality regarding their self-reports. Further, the results raise questions about the utility of self-report measures of substance use to assess patient progress or methadone program performance.

Adult↗
PubMed1997

Diagnosis and treatment of Helicobacter pylori infection among California Medicare patients.

BACKGROUND: Antibiotic treatment of Helicobacter pylori infection in active peptic ulcer disease has been demonstrated to speed ulcer healing, reduce the risk of rebleeding, and prevent long-term recurrence. The objective of this study was to determine whether Medicare patients with peptic ulcer disease who are admitted to acute care hospitals are being tested or treated for H pylori infection as recommended by a National Institutes of Health consensus panel. METHODS: The study was designed as a retrospective medical records survey. From the Medicare National Claims History File, all persons 65 years and older admitted to California fee-for-service hospitals for peptic ulcer disease in 1994 were identified. A random sample of 600 claims was selected for review. After exclusions, 524 patients were eligible for study. The main outcome measures were (1) the proportion of patients who were tested for H pylori infection by 1 of the 5 available methods (histopathologic study, urease assay, microbiologic culture, serum antibody testing, or urea breath test) and (2) the proportion who were treated with antibiotics (amoxicillin, tetracycline, clarithromycin, or metronidazole) for H pylori infection. RESULTS: Thirty-nine percent of patients with peptic ulcer disease were tested for H pylori infection and 3% were treated empirically. Only 47% of the patients who had a positive diagnostic test result for H pylori were treated with antibiotics. CONCLUSION: Because diagnosis and treatment of H pylori infection has been demonstrated to improve outcomes and decrease expenses, the data indicate a substantial opportunity to improve the care of elderly Medicare patients with peptic ulcer disease.

Aged↗
PubMed1993

Putting a price tag on children.

"This chapter shows that...there are many different aspects to the cost of a child and...many different measures have been developed. The chapter...argues that theories of fertility need to specify carefully the definition of child costs and that the assumptions underlying existing measures need to be made plain.... The review is divided into three major sections: babies, childcare and children. The sources covered range from popular magazines and Mothercare catalogues to the only large-scale official [U.K.] survey of maternity and its costs, undertaken in 1946. The items covered range from the price of babies' essentials to the fees at schools...as well as the costs of maintaining a child at university."

Adolescent↗
PubMed1990

RPC technical report #18: information that should be included in every patient's radiotherapy treatment record (external beam).

The Radiological Physics Center (RPC) has frequently been asked to develop a model daily treatment record. It became obvious that there was some minimum information that must be in patient records. However, equally obvious was the fact that practices at institutions could be very different, so organization of information in records was different. We have compiled a list of data that must be in a patient's treatment record to assure that the radiation treatment can be reconstructed at a later date. The ordering of this information in forms and records is left to the discretion of the institution.

Forms and Records Control↗
PubMed1990

The requirement of IHF protein for extrachromosomal replication of the Escherichia coli oriC in a mutant deficient in DNA polymerase I activity.

It is shown here that plasmids containing the replication origin of Escherichia coli (oriC) cannot replicate in an extrachromosomal state in E. coli cells with the polA1hip3 double mutation. This E. coli mutant is deficient in the polymerizing function of DNA polymerase I (Pol I) and is unable to produce functional IHF protein. The inability of the oriC minichromosomes to replicate in the absence of IHF is dependent on the absence of Pol I; cells with the polA+himA- or polA+hip- mutation, which are deficient in the alpha and beta subunits of the IHF heterodimer, respectively, can support replication of the oriC replicons. We propose that IHF-deficient cells utilize an alternative pathway of the DNA replication in which Pol I is required. In vitro DNA binding assays revealed that the IHF binding site resides between the oriC coordinates 110 and 122 and is adjacent to the DnaA "box" 1. Within the area protected by IHF we found at least 1 out of 11 GATC methylation sites present in oriC. The consequences of lack of IHF protein binding to the oriC and the indirect effects of the IHF deficiency on the oriC replication are discussed.

Bacterial Proteins↗
PubMed1983

The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis.

To determine the life expectancy of patients with primary biliary cirrhosis, we analyzed survival data from 280 patients with either symptomatic (243) or asymptomatic (37) disease. Patients were followed for up to 19 years (mean, 6.9 years). The average length of survival was 11.9 years--nearly twice that reported in other studies. In contrast, over a 12-year period the survival of the asymptomatic patients after diagnosis did not differ from that of a control population matched for age and sex. Jaundice, weight loss, hepatomegaly, splenomegaly, and ascites were each associated with a poor prognosis. Prognosis also correlated with the histologic stages of hepatic fibrosis, cholestasis, and periportal-cell necrosis. A multivariate analysis of clinical features revealed that at the onset of disease, age, hepatomegaly, and elevated levels of serum bilirubin were independent discriminators of a poor prognosis. A histologic finding of fibrosis limited to portal areas improved this discrimination, correlating with prolonged survival. No other factors enchanced the prediction of risk.

Ascites↗
PubMed1979

Is appendicitis familial?

A family history of appendicectomy was sought in two groups of children admitted to Llandough Hospital over sixteen months. The study group consisted of 29 children with histologically confirmed acute appendicitis, while the control group consisted of 29 children admitted for reasons unrelated to abdominal pain. A history of appendicectomy was elicited in first-degree relatives--that is, siblings and parents of 20 of the children in the study group and of four of the controls--a statistically significant difference. The results obtained from this study suggest that a familial predisposition to appendicitis exists.

Acute Disease↗