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Biomedical subjects

K A Frank

Publications and source records attributed to K A Frank.

At least 19 recordsLinked to original sources
PubMed2004

Does human immunodeficiency virus infection protect against preeclampsia-eclampsia?

OBJECTIVE: In view of recent suggestions that human immunodeficiency virus (HIV) infection may protect against preeclampsia, this study was done to evaluate whether untreated HIV-positive pregnant women have a lower rate of preeclampsia-eclampsia than HIV-negative women. METHODS: Subjects for this study were pregnant women from Soweto, South Africa, who gave birth from March to December 2002 at midwife-run clinics or at the Chris Hani Baragwanath Hospital and in whom the HIV status was known. A sample size calculation indicated that 2,588 subjects would be required to show statistical significance at P <.05 with a power of 80% for a reduction in the rate of preeclampsia from 8% to 5% with HIV seropositivity, assuming an HIV seroprevalence rate of 30%. Data collection was by record review from randomly selected patient files and birth registers. RESULTS: In the total sample of 2,600 women, 1,797 gave birth at the hospital and 803 at the midwife-run clinics. The HIV seroprevalence rate was 27.1%. Hypertension was found in 17.3% of women, with 5.3% having preeclampsia-eclampsia. The rates of preeclampsia-eclampsia were 5.2% in HIV-negative and 5.7% in HIV-positive women (P =.61). CD4 count results were available for only 13 women (0.5%). CONCLUSION: Human immunodeficiency virus seropositivity was not associated with any reduction in the risk of developing preeclampsia-eclampsia.

Adult↗
PubMed2000

Longitudinal effects of integrated treatment on alcohol use for persons with serious mental illness and substance use disorders.

A randomized experimental design was used to assign participants to an integrated mental health and substance use treatment program or to standard hospital treatment. A multilevel, nonlinear model was used to estimate hospital treatment effects on days of alcohol use for persons with serious mental illness and substance use disorders over 18 months. The integrated treatment program had a significant effect on the rate of alcohol use at 2 months postdischarge, reducing the rate of use by 54%. Motivation for sobriety at hospital discharge, posttreatment self-help attendance, and social support for sobriety were also found to reduce the rate of use during the follow-up period. Implications for mental health treatment and aftercare support are discussed.

Adult↗
PubMed1988

Sclerotium formation in an Aspergillus flavus wound infection.

A patient studied at autopsy was found to have a post-operative wound infection with Aspergillus flavus in which there was the formation of fungal structures resembling sclerotia. The ability of Aspergillus to form sclerotia in tissue appears to be rare and is related to the strain of Aspergillus flavus. Since sclerotia are considered as structures capable of withstanding dramatic shifts in the environment, the production of these in tissue may affect the efficacy of antifungal therapy.

Aged↗
PubMed1988

The surgical clerkship experience: self, departmental, and institutional assessment.

The purpose of this study was to investigate to what extent students' assessments of their clerkship experiences varied in relation to perceptions of self-improvement, the time of year in which the clerkship experience took place, and the origin of the assessment device (departmental versus institutional). All students enrolled in each of six surgery clerkship rotations over the course of 1 academic year (224 students) were administered two questionnaires on completion of the clerkship. One questionnaire was institutionally developed and supported, whereas the other was departmentally sponsored. Results of multiple regression analyses indicated that (1) when students felt their medical skills had improved as a result of clerkship participation, the clerkship was considered of high quality; (2) students' perceived improvement in communication skills decreased as the academic year progressed; and (3) students did not alter their responses to the questionnaires based on whether the instrument was institutionally or departmentally sponsored.

Clinical Clerkship↗
PubMed1988

Prune-belly syndrome with prostatic hypoplasia, bladder wall rupture, and massive ascites in a fetus with trisomy 18.

An association has been noted between trisomy 18 and genitourinary abnormalities, with six previous reports of the prune-belly syndrome occurring in patients with trisomy 18. We have observed a 120-g fetus of 18 weeks' gestational age at autopsy in whom there was severe prune-belly syndrome and trisomy 18. Serial histologic sections and reconstruction of the lower urinary tract demonstrated severe prostatic hypoplasia with a dilated, angulated prostatic urethra. Obstruction appeared to be present at the internal sphincter as a result of loss of prostatic support of the bladder. The bladder was distended and hypertrophic, and had a disruption of its wall near the apex. Massive ascites and intraabdominal urine accumulation had produced abdominal distention and pulmonary hypoplasia. The findings in this case lend support to the concept of prostatic hypoplasia as a cause of prune-belly syndrome and to the unexplained association between trisomy 18 and genitourinary anomalies including the prune-belly syndrome.

Ascites↗
PubMed1982

Type A behavior and the thallium stress test.

Several recent studies have examined the association between Type A personality and coronary artery disease (CAD) by coronary angiography. Most of these studies have reported a significant association. The present study is an attempt at further confirmation, using a new non-invasive technique for measuring CAD. Subjects were 53 patients undergoing routine exercise stress tests with concomitant thallium-201 myocardial perfusion studies. Five aspects of Type A behavior were assessed by the use of the Rosenman-Friedman Semistructured Interview, and each was rated on a three-point scale. Severity of CAD was independently estimated on a four-point scale. Pearson correlation coefficients were separately computed for patients with and without reported history of myocardial infarction (MI). For 37 patients without reported MI, CAD severity was significantly correlated with Overall Type A (r = -0.53), Vocal Characteristics (r = -0.53), Job Involvement (r = -0.36) and Aggressiveness (r = -0.48), but not Time Urgency (r = -0.25). For 16 patients with reported MI, CAD severity was significantly correlated with Job Involvement only (r = +0.49). The data are consistent with the association of Type A personality and coronary atherogenesis, but may also reflect Type A psychological and physiological characteristics. Future studies may be able to examine these and other aspects of Type A behavior using this noninvasive technique in more diverse patient populations.

Adult↗
PubMed1982

Psychological and behavioral responses after coronary artery bypass surgery.

One hundred consecutive patients who underwent coronary artery bypass surgery at the Columbia-Presbyterian Medical Center from December 1972 through February 1975 were evaluated at surgery and then followed for as long as 4 1/2 years to study their postoperative psychosocial and behavioral course. One patient died during the first 30 days. At 4 1/2 years, 23 patients were reported as deceased, 15 from cardiac causes. The majority of the long-term survivors had substantially less angina and greater exercise capacity; surgery did not increase the number of patients who were employed, but led to substantial improvements in the quality of life, including general pleasure, reduction of anxiety and depression and subjective improvement in job and family roles. Sexual adjustment improved the least; the frequency of sexual relations tended to decrease. Compliance with the medical regimen was relatively good for smoking and exercise, but not for diet or type A behavior, suggesting a need for psychological intervention.

Adult↗
PubMed1980

Type A behavior and blood pressure during coronary artery bypass surgery.

Systemic hypertension has been reported as common during coronary artery bypass surgery. The coronary-prone Type A behavior pattern has been associated with heightened reactivity of the sympathetic nervous system. Therefore, the possible relationships between the two was explored. Significant correlations were found between systolic blood pressure rise during surgery and interview ratings of overall Type A (p < 0.05), aggressive content (p < 0.01), and job commitment (p < 0.001). A statistically association was also found between diastolic pressure rise and the job commitment rating (p < 0.01). Significant correlations were still present after controlling for the role of physical predictors of blood pressure rise by statistical multiple regression analysis. The data suggest that patients with Type A behavior characteristics manifest an autonomic hyperactivity which is present under general anesthesia. This hyperactivity may contribute to the association of Type A behavior pattern and coronary heart disease.

Aggression↗
PubMed1979

Psychological intervention in coronary heart disease: a review.

Psychological intervention studies designed to reduce cardiac morbidity are reviewed. Preliminary findings suggest that various psychotherapeutic modalities may be effective. Such studies also provide an avenue through which the physical and psychological mechanisms involved in coronary heart disease and their interactions may be clarified. Implications for clinical interventions are also discussed.

Adaptation, Psychological↗
PubMed1978

Type A behavior pattern and coronary angiographic findings.

One hundred forty-seven consecutive patients scheduled to undergo coronary angiography were classified according to the type-A behavior pattern. Statistically significant correlations were found between diseases severity and the physical risk factors cholesterol, smoking, hypertension, sex, and age. The correlation of the behavior pattern with angiographic disease severity was of the same magnitude as that of the other risk factors except cholesterol, which was greater. The association between the behavior pattern and severity persisted after adjustments had been made for the effects of five other major risk factors.

Adult↗
PubMed1978

Delirium after coronary artery bypass surgery.

The incidence of postoperative delirium following coronary artery bypass surgery was 28%. This rate is comparable to that after open-heart surgery. However, of those variables which were previously found to correlate with delirium in the open-heart group, only severity of postoperative illness in the recovery room significantly correlated with delirium in patients having bypass. The relationship between personality type and delirium, previously found to be signficant, was suggestively associated in these patients. A history of myocardial infarction prior to surgery was significantly associated with delirium.

Adult↗