PubMed Health⌕ Search

Biomedical subjects

J Schmier

Publications and source records attributed to J Schmier.

At least 19 recordsLinked to original sources
PubMed2003

Development and validation of a disease-specific treatment satisfaction questionnaire for gastro-oesophageal reflux disease.

BACKGROUND: Currently, no disease-specific, patient-based, treatment satisfaction instruments related to gastro-oesophageal reflux disease exist. AIM: To develop and validate a treatment satisfaction questionnaire for gastro-oesophageal reflux disease (TSQ-G). METHODS: A new questionnaire was developed from patient focus groups, clinician input and literature review. A validation study was conducted in treated gastro-oesophageal reflux disease patients. Ancillary measures included the Medical Outcomes Study Short Form-36, Quality of Life in Reflux and Dyspepsia, Gastrointestinal Symptom Rating Scale, Socially Desirable Response Scale, Patient Satisfaction Questionnaire-18 and physician and patient measures of symptoms and satisfaction. Statistical analyses included exploratory factor analysis, Cronbach's alpha, intra-class correlations, analyses of variance and t-tests. RESULTS: A total of 198 gastro-oesophageal reflux disease patients participated in the study, with a mean age of 50.7 years, 68% female and 84% Caucasian. The physician-rated severity of gastro-oesophageal reflux disease was mild (32%), moderate (50%) and severe (18%); 83% were on proton pump inhibitors. The final TSQ-G consisted of 28 items with seven sub-scales; Cronbach's alpha ranged from 0.58 to 0.94. Correlations with the expected sub-scales of the ancillary measures were moderate to strong. The TSQ-G sub-scales discriminated significantly between levels of physician-rated disease severity, symptom days and patient and physician ratings of satisfaction. CONCLUSIONS: The TSQ-G has excellent reliability and construct validity and appears to be a useful tool for the evaluation of treatment satisfaction in gastro-oesophageal reflux disease patients.

Female↗
PubMed2000

Antimicrobial treatment patterns, resource utilization, and charges associated with acute sinusitis in asthma patients.

Antimicrobial treatment patterns, resource utilization, and charges associated with acute sinusitis in patients with asthma were studied. Asthma patients with at least one claim for acute sinusitis were identified by International Classification of Diseases, 9th Revision code in data for 1992-1994 from a large health care insurer in New England. A sinusitis episode was defined on the basis of the pattern of antimicrobial prescribing. Antimicrobials used to treat sinusitis, rates of resource utilization, and overall charges for therapy were determined. A total of 2,633 sinusitis episodes were identified in the records of 34,348 asthma patients. The most frequently prescribed antimicrobial for initial treatment of acute sinusitis was amoxicillin trihydrate (32.2% of patients). Initial therapy was successful in 2,199 episodes (83.5%), initial therapy failed in 250 episodes (9.5%), and relapse occurred in 184 episodes (7.0%). Successfully treated patients had fewer outpatient visits on average (1.42 per episode) and fewer laboratory and diagnostic tests (0.046) than did patients in whom initial therapy failed (1.76 and 0.056 per episode, respectively) or patients who relapsed (1.68 and 0.049). The mean total charge for sinusitis care was $147.61 per episode for successfully treated patients, $242.95 per episode for patients unresponsive to treatment, and $205.49 per episode for patients who relapsed. Antimicrobial treatment of acute sinusitis varied widely in patients with asthma. Resource utilization was associated with the success of treatment.

Acute Disease↗
PubMed1998

Health care CBA and CEA from 1991 to 1996: an updated bibliography.

OBJECTIVES: This article updates, through 1996, a previously published bibliography of health-care cost-benefit and cost-effectiveness analysis, which described the literature from 1979 to 1990. METHODS: A systematic search of MEDLARS databases was conducted for all articles falling under the medical subject headings "cost-benefit analysis" (which includes cost-effectiveness analysis) and "costs and cost analysis," as well as any article with the term "cost" in the title or abstract. All titles and abstracts were scanned to determine whether articles pertained to personal health services and whether both costs and consequences were assessed. If both criteria were met, the article was included in the bibliography. RESULTS: This search resulted in 3,539 eligible cost-benefit/cost-effectiveness analysis publications from 1991 through 1996. Publications were subdivided into two major categories: reports of studies and "other" publications, including reviews, descriptions of methodology, letters, and editorials. Reports of studies and "other" publications were classified into approximately 250 different topic areas. Studies were further classified by parameters such as study type, publication vehicle, and medical function. This article describes the results of this classification and describes trends during 1991 to 1996 as compared with 1979 to 1990. OVERVIEW OF CONTENTS: The entire bibliography is reproduced in Appendix A. The classification of study reports and "other" publications into topic areas is presented in Appendix B, with numbered references to all bibliography entries. Detailed tables of findings are presented in Appendix C, and the results are illustrated graphically in Appendix D.

Bibliographies as Topic↗
PubMed1982

[Pretreatment with heparin in experimental trauma and haemorrhagic shock].

A severe shock is produced in 18 mongrel dogs by standardized bone trauma and haemorrhagic shock. Impairment of microcirculation is demonstrated by acidosis, reduced oxygen uptake and disseminated intravascular coagulation (DIC). Further, a specific increase in pulmonary vascular resistance--independent of the reduction in blood flow--is evoked, concomitantly with the occurrence of microthrombi, oedema and haemorrhage in lung tissue. Pretreatment with heparin inhibits disseminated intravascular coagulation and reduces impairment of microcirculation and the consecutive damage of intestinal organs. However increase of pulmonary vascular resistance is unchanged and pulmonary haemorrhage is pronounced. Therefore heparin pretreatment enhances pulmonary histologic impairment after trauma and haemorrhagic shock.

Acidosis↗
PubMed1976

Experimental coronary artery bypass operation. Myocardial blood flow, ventricular performance and regional myocardial function.

Myocardial blood flow and ventricular function was studied in seven dogs with chronic myocardial ischemia before and after coronary bypass grafting. Restoring blood flow in an area of 25% of the anterior wall of the left ventricle did not significantly improve overall ventricular function. Assessment of intramyocardial pressure as an index of regional myocardial function revealed a consistent enhancement of myocardial contraction at rest, and under pharmacological stress of the heart.

Animals↗
PubMed1976

[Myocardial blood flow and ventricular function in dependence on the size of myocardial infarct].

In eight dogs three branches of the left anterior descending coronary artery were occluded by successive ligations. Each time coronary flow reserve was measured by injecting dipyridamole (0.4 mg.kg-1). After an infarction of 13% of the left ventricle there was a significant decrease of Vmax and dp/dtmax (p less than 0.05). Measurements of regional myocardial blood flow detected an infarction of 5% of the left ventricle, whereas the total myocardial blood flow was reduced significantly when 17% of the left ventricle was infarcted.

Animals↗
PubMed1976

[Pulmonary hemodynamics, coagulation and morphological changes in the lung after thrombocyte aggregation inhibition and intravasal coagulation in experimental trauma and hemorrhagic shock].

26 mongrel dogs are subjected to a standardized bone trauma followed by a hypotonic hemorrhagic shock. Compared with a control and heparin group prophylactic treatment with Dipyridamol and Acetylsalicylic Acid decreases pulmonary vascular resistance significantly. After an initial period of hyperocagulability secondary fibrinolysis develops. The decrease of the fibrinogen level and the fall of total platelet count after trauma and hemorrhage can partly be prevented by the application of heparin, likewise the development of pulmonary microthrombosis. Histological examination shows a markedly diminished pulmonary microthrombosis.

Airway Resistance↗
PubMed1976

Influence of cinepazide, a vasoactive substance, on canine coronary circulation after acute constriction of the left anterior descending coronary artery.

The left anterior descending coronary artery was variably constricted mechanically in nine dogs. Blood flow in the left anterior descending (LAD) and circumflex coronary arteries (CCA), aortic pressure and peripheral, i.e. post-stenotic coronary pressure were measured. Myocardial perfusion was determined from the clearance of radioactive xenon injected at a depth of 7 mm into the underperfused area supplied by the LAD artery. The vasoactive drug 1-(pyrrolidinyl-1-carbonyl)-methyl-4-(3,4,5-tri-methoxycinnamoyl)piperazine-maleate (cinepazide) was given at doses of 5-10 mg/kg by i.v. route. 1. Blood flow in the LAD was decreased stepwise to 50% of its initial value. There was practically no more coronary reserve. After drug injection, diastolic aortic pressure, that normally falls, was kept constant by clamping. Heart rate, perfusion pressure, post-stenotic pressure, and blood flow and resistance in the LAD showed practically no change. In the CCA, blood flow increased significantly (p less than 0.005) and flow resistance decreased (p less than 0.001). 133Xe clearance showed an increased myocardial perfusion (p less than 0.02) in the territory supplied by the LAD artery. 2. The lumen of the LAD was narrowed by 53%, i.e., coronary reserve was decreased. This constriction was followed by no haemodynamic reaction. After injection of cinepazide, mean and diastolic aortic pressure (p less than 0.02) and post-stenotic coronary pressure (p less than 0.005) decreased. Blood flow increased by 41% in the CCA and by 31% in the LAD. Coronary resistance in these vessels decreased (p less than 0.001 and 0.005, respectively). Here, too, the 133Xe clearance curve showed an increase in myocardial perfusion in the territory supplied by the LAD artery (+78%).

Animals↗
PubMed1976

[Effects of dextran, gelatine and homologous plasma on circulation in shock caused by severe anemia in the dog].

Irreversible shock is produced in 28 anaesthetized mongrel dogs by withdrawal of erythrocytes and substitution by dextran, gelatine or plasma to an average Hb of 4.5g%. In contrast to other shock models cardiac output and perfusion pressure are not decreased by this preparation. In order to maintain arterial blood pressue above 90 mm Hg significantly more gelatine than dextran or serum has to be infused. There is no difference in hemodynamic responses after treatment with dextran or gelatine respectively. Both groups treated with colloidal solutions have the same survival rate of 38%. In the serum substituted dogs, however,survival rate is significantly greater (83%). Very likely this is due to a greater buffer capacity preventing severe acidosis, which is observed in the animals treated with colloidal solutions.

Anemia↗
PubMed1975

[Regional myocardial blood flow and left ventricular function in critical coronary stenosis and after coronary artery bypass grafting in the dog (author's transl)].

In 7 mongrel dogs myocardial ischemia is produced by means of an ameroid constrictor placed on the left circumflex coronary artery (CCA). Myocardial blood flow (MBF) is diminished by 56% in an area of 25% of the anterior wall of the left ventricle. A decrease in dp/dtmax suggests a small depression of left ventricular function. After bypass operation the slight changes in EDP, dp/dtmax and Vmax indicate no significant improvement of total ventricular function. MBF increases from 42 +/- 10 ml/100 g/min to 67 +/- 21 ml/100 g/min (p smaller than 0.02) in the area supplied by the bypass. In this region intramyocardial pressure rises significantly suggesting improvement of regional myocardial function.

Animals↗
PubMed1975

[Effect of coronary bypass surgery on myocardial pressure and ventricular function in the dog].

In 7 dogs a severe stenosis of the left circumflex coronary artery (CCA) is produced in the course of 18 days. The influence of myocardial revascularization on left ventricular function and on intramyocardial pressures in the areas supplied by the CCA and by the left anterior descending coronary artery is studied. Neither under control conditions nor during acute left ventricular pressure load does opening a bypass graft between the carotid artery and CCA induce a significant change in total ventricular function (dp/dtmax, Vmax, left ventricular enddiastolic pressure). However, immediately after opening the graft intramyocardial pressure rises in the CCA area indicating a regional improvement of myocardial function.

Animals↗
PubMed1975

[Significance of intravascular coagulation and acidosis on increase of pulmonary vascular resistance following trauma and hemorrhagic shock].

24 anesthetized mongrel dogs are subjected to a standardized trauma followed by a hypotonic hemorrhagic shock. Compared with the control group (n equals 8) prophylactic treatment with heparin in the second group (n equals 8) reduces the rise of pulmonary vascular resistance only insignificantly. The correction of the metabolic acidosis with Tris does not prevent a rise of PVR in third group (n equals 8).

Acidosis↗
PubMed1975

[Coronary-angiographic demonstration of the dilating effect of dipyridamole on coronary arteries and its inhibition by caffeine (author's transl)].

Selective coronary cineangiographies are performed repeatedly in 13 mongrel dogs. The contrast medium itself has no demonstrable dilating effect upon the vessels. After the first injection of 0.2 mg/kg of dipyridamole the left anterior coronary artery is significantly (p less than 0.001) dilated, which is in contrast to some results described in literature. Immediately after an injection of high doses of caffeine (10 mg/kg) the previously enlarged coronary diameter decreases significantly (p less than 0.001). During the action of caffeine subsequent infections of dipyridamole result in a very small, or no change in coronary diameter. The coronary-dilating effect of dipyridamole can be inhibited by high doses of caffeine (10 mg/kg).

Angiocardiography↗
PubMed1975

[Effects of amantadine on heart and circulation].

The effect of amantadine-hydrochloride on heart and circulation is studied in 7 anesthetized, otherwise normal dogs with a mean body weight of 27.2 kg and in 8 heart-lung preparations of dogs. Arterial blood pressure, right atrial pressure, cardiac output and heart rate are measured and continuously monitored. Stroke volume and peripheral resistance are calculated. Left ventricular peak- and enddiastolic pressure, the rate of rise of intraventricular pressure and t-dp/dt are additionally measured in the heart-lung-preparations. Below 3 mg with kg(-1) in anesthetized dogs and 10 mg in the heart-lung preparation, respectively, a positive inotropic effect of amantadine is observed. This effect is caused by a liberation of catecholamines. Higher dosage of amantadine decreases cardiac contractility significantly. Therefore the negative inotropic influence of the drug itself has to be distinguished from the indirect sympathomimetic effect resulting from local release of myocardial catecholamines. Cardiac arrhythmias which occur in several experiments, can mostly be eliminated with propranolol or other drugs like lidocaine or sparteinsulphate.

Amantadine↗