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Biomedical subjects

K Currie

Publications and source records attributed to K Currie.

12 recordsLinked to original sources
PubMed2001

Recombinant human chorionic gonadotropin (rhCG) in assisted reproductive technology: results of a clinical trial comparing two doses of rhCG (Ovidrel) to urinary hCG (Profasi) for induction of final follicular maturation in in vitro fertilization-embryo transfer.

OBJECTIVE: To compare the efficacy and safety of 250 microg and 500 microg of recombinant hCG with 10,000 U USP of urinary hCG in assisted reproduction technology. DESIGN: Open, comparative, randomized, prospective clinical study. SETTING: Twenty tertiary care U.S. infertility centers. PATIENT(S): Two hundred ninety-seven ovulatory infertile women undergoing a single cycle of assisted reproduction technology. INTERVENTION(S): Patients were randomized 1:1:1 to 250 microg of recombinant hCG SC, 500 microg of recombinant hCG SC, or 10,000 U USP urinary hCG IM after completing gonadotropin stimulation. MAIN OUTCOME MEASURE(S): Number of oocytes retrieved per patient receiving hCG. Also, measures of oocyte maturity, embryo development, and luteal function, as well as pregnancy and pregnancy outcome. Adverse safety events, laboratory changes, local tolerance, and immunogenicity were also assessed. RESULT(S): Mean numbers of oocytes retrieved per treatment group were equivalent, 13.6, 14.6, and 13.7 with 250 microg of recombinant hCG, 500 microg of recombinant hCG, and urinary hCG, respectively. The numbers of 2PN fertilized oocytes on day 1 after oocyte retrieval, and 2PN or cleaved embryos on the day of embryo transfer, were significantly higher with 500 microg of recombinant hCG than with the lower dose. However, the incidence of adverse events also tended to be higher with this dose. CONCLUSION(S): Recombinant hCG is effective and well tolerated in the induction of final follicular maturation and luteinization in women undergoing assisted reproduction technology. Recombinant hCG (250 microg) SC is equivalent to 10,000 U USP of urinary hCG in this indication.

Adult↗
PubMed2001

Leap for Life: innovative patient education to optimize outcomes among patients with cardiovascular disease.

OBJECTIVE: To evaluate the Leap for Life cardiovascular risk factor education program based on outcome measurements of self-reported hospital readmission, goal achievement, satisfaction, and educational model preference. SETTING: Four hospitals and one senior center of Baylor Health Care System in the Dallas, Texas, area. DESIGN: Administration of a satisfaction questionnaire and resurvey of participants by telephone at 3, 6, and 12 months. PATIENTS: 161 patients with cardiovascular disease enrolled in the Leap for Life program during calendar year 1997. Patients were primarily male (59%), with an average age of 66 years; they had an average of 4 cardiovascular disease risk factors. RESULTS: Of the 152 participants who took part in the telephone follow-up, 19% reported a hospital admission with a cardiovascular diagnosis during the 12-month follow-up period. Twenty-one percent reported meeting all of their goals; 56%, some of their goals; and 23%, none of their goals. All stated that the educational sessions met their informational needs, and 75% preferred the Leap for Life setting over other educational settings. CONCLUSION AND NEXT STEPS: These data provide initial validation of the program and are being used as a starting point for another assessment that involves individualized health enhancement measures and 6- and 12-month follow-up of participants using a survey designed to assess readiness, lifestyle changes, and quality of life.

Journal Article↗
PubMed2001

Consumer health information. What the research is telling us.

BACKGROUND: Consumer health information is a necessary component of patient care and consumer participation. OBJECTIVE: To outline the findings of the 'Assessing the Quality of Consumer Health Information Project' and discuss strategies for improving consumer information. DISCUSSION: The pamphlets identified in this study were not developed with consumer input with consequent deficits apparent. Providers and consumers appeared to use the information for very different purposes but both groups were critical of the ambiguous terminology and lack of quantified data. The provision of relevant information is a fundamental prerequisite of consumer participation in decision making in health care. Such information needs to be available, accurate, and understandable.

Australia↗
PubMed1997

Direct measurement of cutaneous pressures generated by pressure garments.

Pressure garments are the mainstay of burn scar management despite limited scientific evidence. This study demonstrates a simple method of directly measuring the cutaneous pressures generated by a pressure garment. The results show pressure garments generate an increase in subdermal pressures in the range 9-90 mmHg depending on the anatomical site. Garments over soft sites generate pressures ranging from 9 to 33 mmHg. Over bony prominences the pressures range from 47 to 90 mmHg. This method is believed to be more representative of the pressures generated than the interpositional techniques that measure garment-skin interface pressure, as it avoids garment distortion, the interference effect of the measurement device (size, conformation, area) and directly measures subdermal pressures. The method should be useful for larger research projects on pressure therapy and also for clinical management of pressure garments in the treatment of hypertrophic scar.

Bandages↗
PubMed1996

Current difficulties and the possible future directions in scar assessment.

The quantitative assessment of the results of burn management is notoriously difficult. With the focus changing from survival to cosmetic and functional outcome, the scar assessments are increasingly important. The scar is a sum of the injury and all subsequent interventions on the way to healing. As such it is a complex structure, abnormal in its colour, depth, contour and pliability. To develop a quantitative system we believe it is vital to be able to track accurately an area of injury through time. Further, that physiological data acquired by a number of measurement tools be fused accurately to the morphologically correct information.

Adolescent↗
PubMed1995

Community dwelling elderly are appropriate subjects for intensive dietary choice restriction studies.

There is a traditional belief that the elderly have difficulty coping with dietary change, and therefore have a diminished likelihood of successfully responding to nutritional interventions or restrictions. Using a controlled mild zinc-deficiency feeding study as a model for strict dietary intervention, we assessed psychological responses to severe dietary choice restriction in 15 Caucasian, elderly (66.12 +/- 4.43 years) males (n= 7) and females (n = 8). Participants completed the Medical Outcomes Study Short Form 36-Item Questionnaire (SF-36) as an index of QOL and the Multi-dimensional Health Locus of Control (MHLC) as a measure of health beliefs at pre-intervention baseline, post-intervention, and follow-up. No subjects dropped out nor were any meals missed during the entire 21-day feeding study period. No significant differences were detected across time on the MHLC (Internal F = 0.53, P = 0.6; Powerful Others F = 0.28, P = 0.8; Chance F = 1.1, P = 0.4.) by one-way ANOVA. Similarly, for the SF-36 no significant differences were found across time (F = 0.76, P = 0.5). Our results suggest that restricting dietary choices does not negatively impact older adult subjects and that they can cope well with dietary choice restriction and change. Older adults should not be overlooked for nutritional intervention solely due to age considerations.

Adaptation, Psychological↗
PubMed1994

Large tandem duplication associated with a Mu2 insertion in Zea mays B-Peru gene.

The b locus of Zea mays encodes a transcriptional activator of the anthocyanin biosynthetic pathway. The B-Peru allele is expressed in the aleurone layer of the seed, which results in dark purple pigmentation of this tissue. An unstable Mutator-induced B-Peru mutant allele, b-Perum220, displays weak, variable pigment and a high germinal reversion rate not characteristic of other Mutator insertions. Characterization of relevant regions of b-Perum220 revealed a Mu2 element insertion in one copy of a 534 bp sequence. This 534 bp sequence is tandemly triplicated in the progenitor B-Peru allele, upstream of the B-Peru transcription start site. In addition to the Mu2 insertion, the b-Perum220 allele contains a newly formed large tandem duplication of 4.0 kb, which includes the promoter region and the first three exons of the B-Peru gene. The Mu2 element does not reside at any of the duplication breakpoints. The molecular study of eleven independent germinal revertants revealed five structural classes including structures in which the 4.0 kb tandem duplication is partially or completely deleted, the Mu2 element is partially or completely deleted, or a combination of these events has occurred. We hypothesize that most of the revertants arose by unequal recombination between the duplicated regions. Based on these structural analyses, models are discussed to explain the reduced b gene expression in b-Perum220.

Alleles↗
PubMed1990

Constant infusion of morphine for intractable cancer pain using an implanted pump.

In the past, pain control for chronic pain syndromes using narcotic infusion has been carried out primarily via the intrathecal (subarachnoid) route. This report presents one of the first large series of terminally ill cancer patients with intractable pain treated with continuous epidural morphine infusions by means of implanted pumps and epidural spinal catheters. The purpose of the study was to demonstrate that the epidural route is effective with minimal complications, and that screening with temporary epidural catheter infusions results in a high rate of subsequent pain relief. A multidisciplinary team (neurosurgeon, anesthesiologists, psychiatrists, oncologists, and nurse clinicians) evaluated and treated all of the patients studied. Percutaneous placement of temporary epidural catheters for a trial assessment was performed by the anesthesiologists. Pain evaluations were conducted independently by psychiatrists using both verbal and visual analog scales. From 1982 to 1988, 41 (59.4%) of 69 patients evaluated for eligibility experienced good pain control during trial assessment and were subsequently implanted with Infusaid infusion pumps. Preinfusion pain analog values were 8.6 +/- 0.3 and postimplantation values at 1 month were 3.8 +/- 0.4 (p less than 0.001). Over this same 1-month period. requirements of systemic morphine equivalents decreased by 79.3% with epidural infusions as compared to preinfusion requirements (p less than 0.001). There were no instances of epidural scarring, respiratory depression, epidural infections, meningitis, or catheter blockage. One patient developed apparent drug tolerance and three patients required further catheter manipulations. This series strongly suggests that significant reductions in cancer pain can be obtained with few complications and a low morphine tolerance rate using chronic epidural morphine infusion. Anesthesiology and psychiatry input, along with temporary catheter infusion screening and quantitative pain evaluations using analog scales, are essential.

Adult↗
PubMed1988

First-trimester maternal serum alpha-fetoprotein screening for chromosome defects.

Low maternal serum alpha-fetoprotein values during the second trimester of pregnancy are associated with an increased risk of Down syndrome in the fetus. In this study a sensitive, monoclonal-based radioimmunoassay for alpha-fetoprotein was used to determine whether such an association also applies to the first trimester and if maternal serum alpha-fetoprotein screening could successfully detect a significant number of pregnancies in which the fetus had a trisomy or other chromosome disorder. Sera were obtained prospectively from 540 women just before chorionic villus sampling for prenatal diagnosis of chromosome defects (largely because of advanced maternal age) at 8 to 12 weeks' fetal age and assayed for alpha-fetoprotein under code without knowledge of the cytogenetic results. Eight of 27 (29.6%) of all serious chromosome defects were associated with low maternal serum alpha-fetoprotein values (less than or equal to 0.6 multiples of the median). Overall, 59 of 540 patients (10.9%) had maternal serum alpha-fetoprotein values less than or equal to 0.6 multiples of the median, eight of whom had a fetus with a serious chromosome defect. Women whose maternal serum alpha-fetoprotein value was less than or equal to 0.6 multiples of the median had one in eight odds of carrying a fetus with a trisomy and one in seven odds of the fetus having any serious chromosome defect. From this study of a group of women at higher risk, we conclude that first-trimester maternal serum alpha-fetoprotein screening for chromosome defects is feasible. A prospective study to determine detection efficiency is now required of a consecutive routine pregnancy population in whom gestational age is determined by menstrual dates as is usually the case in clinical practice.

Chromosome Aberrations↗
PubMed1984

Going up in smoke: the case of British American tobacco in Kenya.

Faced in the developed world by increasing restrictions on cigarette advertising and sales, and with declining markets, the tobacco transnationals are opening up new markets in developing countries, where they face few controls and little health education. As cigarette sales increase in the Third World, so does the evidence of an increasing incidence of smoking-related diseases. This paper considers the case study of BAT (Kenya) Ltd, a subsidiary of the London-based transnational, which since 1974 has encouraged both local leaf production and increased cigarette sales in Kenya. We examine: the relationship between BAT (K) and the Kenya state, the recruitment of farmers into the leaf growing scheme, how BAT (K)'s directorships interlock with those of other leading Kenyan firms and the implications of these for the company's power and influence; BAT (K)'s marketing strategies, how successful they have been, and how they compare with codes of conduct agreed in developed countries; and we estimate the likely success of possible strategies to combat the smoking hazard in Kenya. We conclude that although BAT (K) might make minor concessions to the "health lobby' in Kenya, it is sufficiently powerful, and the leaf growing programme is given sufficient Government support, as to make fundamental changes unlikely in the near future.

Advertising↗
PubMedDate not supplied

Early use of pressure masks to avoid facial contracture during the pregrafting phase.

This article introduces the concept of early application of pressure therapy as a form of splinting in the pregrafting phase. It is based on the principles of (1) the use of pressure therapy to reduce contraction and hypertrophic scar formation and (2) the knowledge that most wound contraction occurs within the initial few weeks of healing. This idea has most application in facial burns, where wound contraction can be disfiguring and functionally disabling, and in situations where unavoidable delay in debridement and grafting may be present. The idea is illustrated with a case report.

Adolescent↗