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Biomedical subjects

K D Rogers

Publications and source records attributed to K D Rogers.

At least 19 recordsLinked to original sources
PubMed1993

Intra- and interobserver variability in interpretation of DMSA scans using a set of standardized criteria.

A set of criteria was developed to standardize assessment of DMSA renal scintigraphy which were performed to evaluate children for acute pyelonephritis and renal scarring. This study was undertaken to assess intra- and interobserver variability in the interpretation of DMSA renal scintigraphy using these criteria. Renal contours and parenchyma were assessed in three zones. Contours were assessed as normal or abnormal and parenchymal defects were evaluated in terms of character, shape and degree in three regions (upper and lower pole and midzone). Two nuclear medicine physicians blindly reviewed 57 DMSA scintigraphy on two occasions each. Disagreement of each observer's evaluation of the same scintigraphy on two different occasions was described as intraobserver variability, and the comparison between readings by each of the two observers was described as interobserver variability. High levels of intra- (95.9% and 90.6% respectively, p < 0.05) and interobserver agreement (84.4%, p < 0.05) were demonstrated. There were minor differences in inconsistencies between the two kidneys or different kidney zones. We conclude that standardization of criteria resulted in higher intra- and interobserver consistency in interpretation of DMSA scintigraphy.

Acute Disease↗
PubMed1990

Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement. Results of parallel randomized and nonrandomized trials.

We studied the efficacy of adenoidectomy in 213 children who had received tympanostomy-tube placement because of persistent and/or recurrent otitis media and had again developed otitis media after tubal extrusion. Ninety-nine of the children were assigned randomly to either an adenoidectomy group or a control group; in a separate trial, 114 children whose parents withheld consent for randomization were assigned according to parental preference. In both trials, control group outcomes appeared to have been biased favorably by the withdrawal of certain severely affected subjects from control status to receive adenoidectomy. Nonetheless, in both trials, adenoidectomy group outcomes were more favorable than control group outcomes during the first 2 follow-up years. Statistically significant differences were found mainly in the randomized trial, where during the first and second years, respectively, adenoidectomy subjects had 47% and 37% less time with otitis media than control subjects and 28% and 35% fewer suppurative (acute) episodes than control subjects. We conclude that adenoidectomy is warranted on an individualized basis for children who develop recurrent otitis media after extrusion of tympanostomy tubes.

Adenoidectomy↗
PubMed1990

Disability from bicycle-related injuries in children.

Bicycle crashes are a major cause of injuries in childhood. The goal of this study was to determine the long-term disabilities caused by bicycle-related injuries, and to clarify the long-term treatment priorities of injured children. Hospital records of 372 children (ages 2-15 yr, median 9 yr; 232 boys and 140 girls) admitted with bicycle-related injuries from 1979 through 1986 provided clinical information, social service visits, in-hospital and outpatient rehabilitative interventions, and physical status at discharge. More complete evaluations were made by contacting parents by telephone (82 children), and by personal interview and physical examinations (27). Head injuries predominated (69.1%). Twelve (3.2%) died, all from major head injuries. Four suffered permanent severe impairment from cervical spinal injuries and head injuries and remain institutionalized (1.4%). One third had a persistent disability noted at the time of discharge in the medical record (33.6%), reported by telephone interview (31.7%), or confirmed by physical examination (37.0%). Still, only 11.0% received physical therapy consultations during hospitalization, and 22.8% received social service assistance. Only 39.0% were seen by a surgeon or pediatrician after discharge, and few (7.3%) received outpatient physical therapy. Cognitive or behavior changes were noted in 31.7%, many noting changes in school performance (worse in 20.7%), behavior (13.4%), and sleep, particularly nightmares (34.1%). Recurrent injuries occurred in 52 children (14.4%), of whom ten (2.8%) required further hospital admission. Bicycle-related injuries cause significant short- and long-term disabilities among children.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Status of scrap (recyclable) dental amalgams as environmental health hazards or toxic substances.

This article presents information garnered after an investigation by the Environmental Protection Agency in 1987 of dentists and others who had sold scrap dental amalgam to refiners who had "arranged for the disposal or treatment ... of hazardous substances," and were responsible for adverse consequences associated with their subsequent management and refining. Information about the health hazard status of scrap dental amalgams was obtained by: interviews with toxicologists, review of published lists of toxic and hazardous materials, and survey of biomedical publications (1977 through 1987) concerning toxicity or health hazards associated with dental amalgams. The conclusions were that scrap dental amalgam is not: a waste substance to be disposed of, but is a product of commercial value; identified or regulated by the Environmental Protection Agency, the Occupational Safety and Health Administration, the Department of Transportation, the Food and Drug Administration, the National Institute of Occupational Safety and Health, the US Public Health Service, or the Centers for Disease Control as an environmental health hazard or toxic substance; identified by toxicologists and persons responsible for solid waste regulation as a toxic substance or environmental health hazard; nor proved by scientific study to be toxic or hazardous in the manner and form in which it is collected and stored by dentists and subsequently sold to metal refiners.

American Dental Association↗
PubMed1987

Variation in repeat rates between 18 radiology departments.

A comprehensive analysis of repeat rates has been obtained from an observational study of radiological practice in diagnostic X-ray departments throughout Wales. Interdepartmental and intradepartmental repeat rates are investigated for chest, abdomen, pelvis, sinus, lumbar spine, cervical spine and intravenous pyelographic examinations. The confounding effects upon observed repeat rates of trainee practitioners and automatic exposure control devices are also considered. The overall proportions of total film cost and patient exposure attributable to repeat radiographs are estimated to be 10% and 14% respectively.

Hospital Departments↗
PubMed1986

School performance characteristics preceding onset of smoking in high school students.

The cigarette smoking status of 1,442 high school students was determined by questionnaire. Of the respondents (smoking and nonsmoking), 60% had been enrolled in the same school system during elementary school. Thus, records were available of school absence, grades, achievement tests, and IQ tests during elementary school, prior to the time when the smokers had commenced the practice. Smoking in high school was significantly related to high absence rates, low achievement test scores, and low grade point averages during elementary school years, prior to the onset of smoking. The IQ was not significantly different in the third grade among pupils who became smokers in high school and those who did not, but sixth-grade IQ scores were significantly lower in students who later identified themselves as smokers. Although smokers demonstrated these characteristics prior to beginning smoking, the differences were not large enough to predict which elementary school students would become high school smokers. The findings support the view that smoking and these school-related characteristics may both be part of a "smoker life-style."

Absenteeism↗
PubMed1986

Physical maturity and outcome of pregnancy in primiparas younger than 16 years of age.

The association of complications and adverse outcomes of early teenage pregnancy with physical growth maturation of mothers was studied in subjects identified from review of medical records in a Pittsburgh obstetrical hospital from 1970 through 1977. Five groups were used to categorize the subjects: (1) 449 primiparas younger than 16 years of age, (2) 347 primiparas 20 to 24 years of age, pair-matched with subjects in group 1 by race, hospital service status, sex of infant, trimester of first prenatal visit, and year of delivery within 5 years, (3) 139 group 1 mothers at the time of their second delivery, (4) 104 group 1 primiparas whose postmenarcheal age was less than or equal to 2.6 years at delivery, and (5) 108 group 1 primiparas whose postmenarcheal age was greater than or equal to 4.1 years at delivery. Subjects in groups 1 and 2, first and second pregnancies of subjects in group 3, and subjects in groups 4 and 5 were compared for prepregnancy weight and height, weight gain during pregnancy, complications of pregnancy, birth weight and gestational age of infant, and perinatal morbidity and mortality. Although primiparas younger than 16 years of age had not achieved mature height and weight, no relationship between mother's physical growth maturation and adverse pregnancy course or outcome was demonstrated.

Adolescent↗
PubMed1985

Neonatal characteristics of maltreated infants and children.

We compared selected neonatal characteristics of 40 children who were abused and neglected (34) or who failed to thrive (six) and 40 nonabused, thriving children individually matched by hospital of birth, gender, mother's welfare status, race, and age at which abuse or failure to thrive was manifested. The populations were preponderantly lower-class, black, and male. The following characteristics were overrepresented in the study population: birth order second or later, low birth weight, admitted to neonatal intensive care unit, and discharged from hospital after mother. The higher incidence of full-term infants who were small for gestational age for the study population (20%) than for the control population (3%) was of borderline significance. The lower distribution of birth weights in relation to expected birth weights for the full-term study subjects, however, was highly significant.

Black or African American↗
PubMed1984

Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials.

We studied the efficacy of tonsillectomy, or tonsillectomy with adenoidectomy, in 187 children severely affected with recurrent throat infection. Ninety-one of the children were assigned randomly to either surgical or nonsurgical treatment groups, and 96 were assigned according to parental preference. In both the randomized and nonrandomized trials, the effects of tonsillectomy and of tonsillectomy with adenoidectomy were similar. By various measures, the incidence of throat infection during the first two years of follow-up was significantly lower (P less than or equal to 0.05) in the surgical groups than in the corresponding nonsurgical groups. Third-year differences, although in most cases not significant, also consistently favored the surgical groups. On the other hand, in each follow-up year many subjects in the nonsurgical groups had fewer than three episodes of infection, and most episodes among subjects in the nonsurgical groups were mild. Of the 95 subjects treated with surgery, 13 (14 per cent) had surgery-related complications, all of which were readily managed or self-limited. These results warrant the election of tonsillectomy for children meeting the trials' stringent eligibility criteria, but also provide support for nonsurgical management. Treatment for such children must therefore be individualized.

Adenoidectomy↗
PubMed1984

A community medicine clerkship on the Navajo Indian reservation.

An elective clerkship in community medicine for medical students has been conducted for 16 years on the Navajo Indian reservation. An important part of the clerkship is a project in which most students select a health problem which they investigate using epidemiological methods of assessment and for which they seek a solution. The requisites for the projects are that real health problems are involved, scientifically sound methods are used, usable information is provided, and data collection can be completed within the clerkship tenure. Topics for the projects are selected jointly by the students and the faculty members from several general subject areas; this allows the work of individual students to be carried out as independent subprojects of larger projects, and this, in turn, produces more information about and has more impact on the problems addressed. Other clerkship objectives also are achieved through investigative projects that may involve students in planning, organization, and evaluation of health care and in public health practice.

Adolescent↗
PubMed1983

Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial.

In a double-blind, randomized trial of 553 infants and children who had otitis media with effusion ("secretory" otitis media), we compared the efficacy of a four-week course of an oral decongestant-antihistamine combination (pseudoephedrine hydrochloride, 4 mg per kilogram of body weight per day, and chlorpheniramine maleate, 0.35 mg per kilogram per day) with that of placebo. Among patients with initially unilateral disease, resolution of middle-ear effusion occurred at four weeks in 38 per cent of those treated with placebo and 34 per cent of those treated with drug (P = 0.74). Among patients with initially bilateral disease the corresponding proportions were 19 and 21 per cent, respectively (P = 0.67). Side effects were reported more often among drug-treated than placebo-treated patients. Decongestant-antihistamine combinations do not appear to be indicated for the treatment of otitis media with effusion in infants and children.

Child↗
PubMed1980

Injuries in high school physical education classes.

Suburban high school pupils participating in physical education classes sustained 3.6 injuries per 100 participants per year that were noted on official school accident reports, and 5.4 injuries per 100 for which pupils visited the school nurse. These latter injuries were minor. The official school accident reports indicated that injuries occurred at approximately equal rates in boys and girls; most were due to accidents that did not involve another participant or a piece of sports equipment, and, although usually not severe, were referred by the school nurse for further evaluation or treatment in some cases. Sprains were the most common type of injury and the ankle was the most commonly injured area. No particular set of conditions was identified wherein preventive measures could be taken to decrease the injury rate.

Adolescent↗
PubMed1980

Racial differences in intraocular tension and glaucoma surgery.

A total of 4678 persons participated in an Allegheny County, Pennsylvania glaucoma screening program in 1977. Black participants had higher mean intraocular pressures, more frequent pathologic disc changes and more new cases of glaucoma discovered than a sample of white participants matched for sex and age. The same year, in a younger population of 2127 health center employees, the higher prevalence of pathologic disc changes was confirmed, although differences in mean intraocular pressures were variable. Blacks accounted for 23% of hospitalizations for chronic open-angle glaucoma during a three-year period (1975-1977) in 10 Pennsylvania counties, rather than the expected 6.3%. Among those hospitalized for open-angle glaucoma or having anterior chamber surgery, blacks were younger than whites.

Adolescent↗