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Biomedical subjects

J Sadler

Publications and source records attributed to J Sadler.

At least 19 recordsLinked to original sources
PubMed2001

Effect of digital image compression on screening for diabetic retinopathy.

BACKGROUND/AIMS: Digital imaging is widely used for diabetic retinopathy screening. The storage and transmission of digital images can be facilitated by image compression. The authors aimed to assess the effect of image compression on the accuracy of grading diabetic retinopathy. METHODS: Forty nine 35 mm transparencies (17 with no retinopathy, eight with background, five with preproliferative, and 19 with proliferative retinopathy) were digitised and subjected to JPEG compression by 90%, 80%, 70%, and 0%. The 196 images were randomised and graded on a portable computer. Two masked graders assessed the images for grade of retinopathy and image quality (0-10). The sensitivity and specificity of retinopathy grading were calculated with a weighted kappa for grading agreement between levels of compression. RESULTS: The sensitivity of retinopathy grading was reduced by JPEG compression. At 90%, 80%, 70%, and 0% compression the sensitivities were 0.38, 0.50, 0.65, and 0.72, respectively; the specificity results were 1.00, 1.00, 0.83, and 0.84, respectively; and the weighted kappa scores were 0.60, 0.75, 0.77, and 0.84, respectively. The quality scores for 90%, 80%, 70%, 0% compression were 2.9 (SD 1.1, 95% CI; 2.7-3.2), 4.6 (SD 1.1, 95% CI; 3.0-5.6), 5.8 (SD1.5, 95% CI 5.0-6.6), 6.3 (SD1.4, 95% CI; 5.4-7.2) (p<0.01 for each intergroup comparison). CONCLUSION: The results demonstrate significant loss of sensitivity to the features of diabetic retinopathy with JPEG compression; this was compounded by the thin film transistor (TFT) screen. The authors found the quality of uncompressed images on TFT screens too poor to give grading sensitivities which reach current guidelines for diabetic retinopathy screening.

Computer Terminals↗
PubMed2001

A survey of domestic violence in a university emergency department.

OBJECTIVES: To determine prevalence of domestic violence among female patients presenting to the department. METHODS: An anonymous survey distributed to female patients presenting over a 30-day period. RESULTS: Response rate was 12.5% (190 of 1,516). Forty-four percent of respondents reported being a victim of domestic violence in the past Seventy-nine percent knew where to get help, and 64% would report it. Eight percent reported their visit to the department resulted from domestic violence. CONCLUSIONS: Prevalence of domestic violence from the sample was similar to previously reported rates. Physicians and nurses generally inquired when patients presented resulting from domestic violence, but screening rates need improvement.

Adult↗
PubMed1994

Hospital-acquired infections in pediatric burn patients.

To determine the epidemiologic characteristics of hospital-acquired infections (HAI) in pediatric burn patients, we retrospectively reviewed hospital charts of pediatric burn patients from two similar burn units. All patients less than 18 years of age admitted to the burn unit from January 1, 1980 to July 10, 1988, were enrolled. Charts were analyzed for age, sex, burn injury (type, depth, burn surface area), and hospital course (burn wound therapy, use of indwelling catheters or tubes, infectious complications, antibiotic use, cause of death if patient died). Statistical analysis was done using a logistic regression model. Of the 224 children admitted, 32 (14%) had 58 infections during their stay in the burn unit. There was no significant difference in age, sex, race, burn type or use of wound excision between patients with or without infection. Patients who acquired an infection were more likely to have sustained a > or = 20% full-thickness burn (14/32 vs 3/192 without infection), a smoke inhalation injury (10/32 vs 8/192), or have an indwelling device (29/32 vs 77/192). Thirteen (22%) of the 58 infections were burn wound infections due to Staphylococcus aureus or Pseudomonas aeruginosa, 12 (21%) were urinary tract infections due to Enterobacteriaceae, 11 (19%) were pneumonias caused by S aureus, Streptococcus pneumoniae or Pseudomonas sp, and 10 (17%) were bacteremias caused by S aureus or coagulase-negative staphylococci. The infection rate in pediatric patients hospitalized for burn injury in our study was significantly lower than the infection rate described for adult burn patients. As in adult patients, burn wound infections, pulmonary infections, and catheter-associated bacteremias are the most common infections in burned children. However, urinary tract infections are more frequent in the pediatric population. Risk factors (> or = 20% full-thickness burns, indwelling devices) and causative organisms are similar in both age groups.

Adolescent↗
PubMed1992

How should parents be informed about major procedures? An exploratory trial in the neonatal period.

The current doctrine of informed consent in medical practice may require the provision of more information than is understandable or desired by some parents. We conducted an exploratory trial comparing: (1) detailed risk/benefit disclosure provided both verbally and in writing and (2) flexible disclosure consisting of a brief verbal description supplemented with detailed verbal and written disclosure if desired by the mother. Information about mechanical ventilation was presented to 26 mothers of newborns at risk for respiratory failure. Of the 13 mothers in the flexible disclosure group, seven (54%) desired only brief verbal disclosure. Despite poor recall of information, most mothers were satisfied with the information provided. There was no evidence that the detailed disclosure group had greater maternal satisfaction or less maternal anxiety. Flexible disclosure as evaluated in this study had no important disadvantages relative to detailed disclosure. Methods of providing information to better meet the wants and needs of parents deserve further study.

Adolescent↗
PubMed1989

A very modest proposal for 1990s C/L psychiatry.

The prediction that consultation-liaison psychiatry would play an integral role in the management of all medical/surgical patients in large hospitals has not come to pass. The primary reason is that no adequate funding mechanism has ever been found to support such a large endeavor. The economic climate as we enter the 1990s makes such funding even less likely. The authors suggest that C/L psychiatry accept a lesser role, largely confined to teaching hospitals. That role, which has been successful at a large public teaching hospital for nearly 10 years, encompasses serving as a primary psychiatric teaching site for medical students, a primary teaching site for psychiatry residents and other postgraduate physicians rotating through psychiatry, a source of innovative dispositions for medically ill psychiatric patients, and a source of opportunity for interdisciplinary research.

Education, Medical↗
PubMed1989

The effects of diet differing in fat, carbohydrate, and fiber on carbohydrate and lipid metabolism in type II diabetes.

This study was designed to determine the effects of varying the proportions of carbohydrate, fiber, and fat on metabolic control in Type II diabetes. Ten men, aged 50 to 69 years, with Type II diabetes participated. Four isocaloric diets were consumed for 2 weeks each, with a break of 6 to 14 weeks between diets to ensure no carryover effects. Two of the diets were high in carbohydrate (63% to 65% energy) and low in fat (10% to 12% energy) but differed in their fiber contents (20 vs. 45 gm/day). The other two diets were low in carbohydrate (23% to 27% energy) with either a low or a high fat content (15% vs. 55% energy) and a high or normal protein content (62% vs. 18% energy). The composition of the subjects' usual diets in the week before each of the experimental diets did not vary significantly: carbohydrate 47% to 50% energy, protein 22% to 25% energy, fat 27% to 31% energy, and fiber 24 to 25 gm/day. A 75-gm oral glucose tolerance test and a 12-hour metabolic profile in response to 3 meals typical of the particular diet were conducted before and at the conclusion of each 2-week dietary period. The most significant improvements in metabolic control (as assessed by the effects of the diets on fasting glucose and on lipids, and on the glucose and insulin responses to oral glucose and the mixed meals) were obtained with the high-fiber, high-carbohydrate, low-fat diet and with the low-carbohydrate, high-protein, low-fat diet. Metabolic control was not significantly affected by the low-fiber, high-carbohydrate, low-fat diet, but it deteriorated significantly on the low-carbohydrate, high-fat diet. The results of this study confirmed the importance of high fiber and low fat in improving metabolic control in Type II diabetes. In conclusion, if high-carbohydrate, low-fat diets are to be recommended to patients with diabetes, it is essential that the type of carbohydrate recommended be unrefined and high in fiber.

Blood Glucose↗
PubMed1987

A myeloproliferative disease in two infants associated with eosinophilia and chromosome t(1;5) translocation.

Two children are described who presented at the age of 5 and 7 months with anaemia, a high white cell count with eosinophilia and thrombocytopenia. Both children had an identical balanced translocation t(1;5)(q23;q33) and no evidence of a constitutional abnormality. The response to treatment of one child was poor, the other remains well on therapy. This translocation has not been previously reported and is likely to represent a subclass of myeloproliferative disorder analogous to the monosomy 7 syndrome, although less common. The previous literature of acquired chromosome abnormalities involving chromosomes 1 and 5 is reviewed.

Chromosomes, Human, Pair 1↗
PubMed1982

lac repressor-lac operator interaction: NMR observations.

We show here the changes in the NMR spectra of the Escherichia coli lac repressor when bound to isolated lac operator DNA. The observations focus on the aromatic residues--four tyrosines and a single histidine--in the amino-terminal DNA binding domain of the lac repressor. There is a good correlation between chemical shift changes seen by 19F NMR when compared with 1 H NMR of otherwise identical repressor--DNA complexes. The results suggest that the tyrosines do not intercalate in the DNA. The NMR spectral changes with similarly sized DNA fragments, not containing the lac operator DNA sequence, are different. Thus, the amino-terminal domain of the lac repressor is independently capable of discriminating between lac operator and nonspecific DNA sequences. There can be two amino-terminal fragments per operator in the specific complex.

Amino Acid Sequence↗
PubMed1980

Pharmacokinetics of bretylium in man after intravenous administration.

The pharmacokinetic profile of bretylium was studied in four normal male volunteers using a new sensitive EC-GC procedure for its quantitative in biological fluids. The plasma concentrations and urinary excretion rates following the constant i.v. infusion of a single 4 mg/kg dose of bretylium tosylate declined biexponentially and the data were fitted to a two-compartment model with a renal and a nonrenal route of elimination. The drug had a mean half-life (t1/2 beta) of 7.8 hr and apparent volume of distribution (Vd, beta) of 8.18 liters/kg. The renal clearance, which was 6 times that of the glomerular filtration rate, accounted for almost 84% of the total body clearance and correlated linearly with the subjects' creatinine clearance. The observed side effects of bretylium were mild and similar to those of other adrenergic blocking agents.

Adult↗