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Biomedical subjects

L Case

Publications and source records attributed to L Case.

16 recordsLinked to original sources
PubMed2001

Staging by positron emission tomography predicts survival in patients with non-small cell lung cancer.

BACKGROUND: Positron emission tomography (PET) scanning is used increasingly to detect and stage lung cancer, but the test performance characteristics and relationship of PET to patient outcomes remain undefined. OBJECTIVE: To determine the test performance characteristics and relationship of PET scanning stage to patient outcomes relative to the 1997 International System for the Staging of Lung Cancer. DESIGN: Survival analysis using pathologic staging as the criterion standard for comparison of survival as predicted by staging by PET and CT. SETTING: University-based hospital. PATIENTS: All consecutive patients undergoing PET scanning for the evaluation of possible non-small cell lung cancer (NSCLC) during a 5-year period. MAIN OUTCOME MEASURES: Long-term survival of patients with NSCLC after staging by PET. RESULTS: One hundred fifty-two thoracic PET scans were obtained for the staging of possible NSCLC during a 5-year period. One hundred twenty-three patients (81%) demonstrated increased (18)F-fluorodeoxyglucose uptake. The overall sensitivity and specificity of PET for detecting malignancy were 95% and 67%, respectively, compared with 100% and 27% for chest CT. PET and CT had similar accuracy for staging the overall extent of disease (91% and 89%, respectively). PET stage correlated highly with survival using either nodal location or overall stage (p = 0.003, p = 0.002), as did pathologic staging (p = 0.0001, p = 0.0001). CT scan results did not accurately predict survival (p = 0.608, p = 0.338). CONCLUSION: PET scanning is a highly sensitive technologic advance in detecting and staging of thoracic malignancy and may more accurately predict the likelihood of long-term survival in patients with NSCLC than chest CT does.

Carcinoma, Non-Small-Cell Lung↗
PubMed2000

Ethnic representation in a sample of the literature of applied psychology.

A number of authors have raised concerns over the external validity of psychological research. This study examined the extent to which empirical articles include human participants from diverse ethnic backgrounds. Articles published over a 5-year period in 14 selected journals representing 3 applied sub-disciplines of psychology were examined. Of the 2,536 articles coded, only 61% indicated the ethnicity of the participants. For those articles, the ethnic compositions approximated U.S. Census estimates, with the exception of an overrepresentation of African Americans and an underrepresentation of Hispanic Americans. The results imply that although the field is apparently adequately recruiting English speakers, representation of non-English speakers should be increased. To further enhance the external validity of psychological research, ethnicity of participants should be not only specified but also analyzed in relation to the results of a study.

Authorship↗
PubMed1999

Using self-instructional pictorial manuals to teach child-care skills to mothers with intellectual disabilities.

Children of parents with intellectual disabilities (i.e., IQs less than 80, labeled as having mental retardation) are at risk for neglect due to inadequate parenting abilities. Previous studies have shown that these parents are responsive to parent-training packages consisting of instructions, pictorial cues, modeling, feedback, and reinforcement. This study evaluated the effectiveness of self-learning pictorial-parenting manuals in teaching basic child-care skills (diapering, treating diaper rash, bathing, safety) to parents with intellectual disabilities who are monitored by child protection agencies. The manuals alone increased child-care skills (to levels seen in parents without disabilities) in 9 out of the 10 mothers in the study and in 12 of 13 child-care skills. The remaining skill was acquired with the full training package. Follow-up indicated that the acquired skills were maintained for up to 3 years. Mean correct performance with the manual was positively correlated with the trainer's rating of the mother's reading level and acceptance of the manual when the mother was first given the manual. Consumer satisfaction ratings of the manuals were high. These results indicate that many parents with intellectual disabilities may improve their child-care skills without intensive training and that self-instruction may be an easily disseminable and cost-effective way of reducing the risk of child neglect due to parenting skill deficiencies.

Child Abuse↗
PubMed1998

Discovery of MC-02,331, a new cephalosporin exhibiting potent activity against methicillin-resistant Staphylococcus aureus.

A systematic approach toward building activity against methicillin-resistant staphylococci into the cephalosporin class of beta-lactam antibiotics is described. Initial work focused on finding the optimal linkage between the cephem nucleus and a biphenyl pharmacophore, which established that a thio linkage afforded potent activity in vitro. Efforts to optimize this activity by altering substitution on the pharmacophore afforded iodophenylthio analog MC-02,002, which although highly potent against MRSA, was also highly bound to serum proteins. Further work to decrease serum protein binding showed that replacement of the iodo substituent by the positively-charged isothiouronium group afforded potent activity and reduced serum binding, but insufficient aqueous solubility. Solubility was enhanced by incorporation of a second positively-charged group into the 7-acyl substituent. Such derivatives (MC-02,171 and MC-02,306) lacked sufficient stability to staphylococcal beta-lactamase enzymes. The second positive charge was incorporated into the cephem 3-substituent in order to utilize the beta-lactamase-stable aminothiazolyl(oximino)acetyl class of 7-substituents. These efforts culminated with the discovery of bis(isothiouroniummethyl)phenylthio analog MC-02,331, whose profile is acceptable with respect to potency against MRSA, serum binding, aqueous solubility, and beta-lactamase stability.

Animals↗
PubMed1996

Phase I study of N-(phosphonacetyl)-L-aspartate with fluorouracil and with or without dipyridamole in patients with advanced cancer.

We conducted a combined biochemical modulation trial of N-(phosphonacetyl)-L-aspartate (PALA), dipyridamole (DP), and fluorouracil (5-FU) in patients with cancer. Eighty-eight patients with advanced cancer were entered into this Phase I trial. During the first part of the study, four doses of PALA (125, 250, 500, and 1000 mg/m2, administered on day 1) were evaluated to determine the PALA dose with maximal suppression of aspartate transcarbamylase (ATCase) activity that was clinically tolerable. Patients were randomized to receive DP (or no DP), 50 mg/m2, p.o. every 6 h on days 1-6, and all patients received 5-FU, 400 mg/m2, by bolus administration on days 2-5. Prior to and during therapy, WBCs were collected and assayed for ATCase activity. After the maximally tolerated PALA dose with 400 mg/m2 5-FU +/- 50 mg/m2 DP was defined, the 5-FU dose was escalated using the same administration schedule of 5-FU, PALA, and DP. The dose of 5-FU was escalated by 25% in each of the DP cohorts until dose-limiting toxicity was reached. ATCase activity was inhibited in a dose-dependent manner with PALA doses of 125, 250, 500, and 1000 mg/m2, resulting in 0, 13, 17, and 49% inhibition of ATCase activity. Only at the higher PALA doses (i.e., 500 and 1000 mg/m2) was ATCase activity suppressed during days 2-5, but the activity returned to pretreatment levels by day 15. Based on the clinical tolerance and significant suppression of ATCase activity, a PALA dose of 500 mg/m2 was selected for the 5-FU dose escalation phase. At a 5-FU dose of 625 mg/m2, dose-limiting toxicity (leukopenia, stomatitis, and diarrhea) occurred in both DP cohorts. We recommend that for this monthly treatment schedule, 500 mg/m2 PALA and 500 mg/m2 5-FU, with or without 50 mg/m2 DP, be used in subsequent Phase II trials.

Adult↗
PubMed1992

Teaching child-care skills to mothers with developmental disabilities.

The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.

Adult↗
PubMed1989

Parent education project. III: Increasing affection and responsivity in developmentally handicapped mothers: component analysis, generalization, and effects on child language.

We evaluated the effects of a parent training program consisting of verbal instruction, modeling, and feedback on the affection and responsivity of 3 developmentally handicapped mothers towards their children. The results indicated the following: First, the training package increased maternal physical affection, praise, and imitation of child vocalizations. These parenting skills increased to levels found in comparison groups of nonhandicapped mothers. Second, the training package was more effective than verbal instruction alone, the latter being the predominant method presently used by social service workers. Third, most maternal gains were maintained over a 3- to 18-month follow-up period, although one mother required a reinforced maintenance procedure. Fourth, instructing mothers to generalize served to increase the generalization of newly acquired skills from play times (the training context) to child-care tasks (e.g., diapering, feeding). Fifth, teaching the parents to imitate child vocalizations was related to gains in both the frequency and quality of verbal behavior of the two language delayed children as measured by standardized developmental tests and in vivo comparisons with age-matched children (who had nonhandicapped parents). These results show that behavioral instruction can improve important child-rearing skills of developmentally handicapped mothers, with corresponding benefits to their children.

Adult↗
PubMed1986

Parent education project II. Increasing stimulating interactions of developmentally handicapped mothers.

Two studies are reported on the assessment and training of parent-child interactional skills in developmentally handicapped mothers. Study 1 compared the interactions of eight developmentally handicapped versus eight nonhandicapped mothers during play with their young (6-25 months) children. Results showed that the former group generally interacted much less with their children and that they were less likely to praise appropriate child behavior and imitate child vocalizations. Study 2 attempted to remediate these deficits, using a training package consisting of discussion, modeling, feedback, social reinforcement, and self-recording. Results showed, first, that the training did increase the targeted skills to well within the range found for the nonhandicapped mothers. Second, training effects generalized from the group instructional setting to the mothers' own homes. Third, newly acquired skills were generally maintained at or above levels found for the nonhandicapped mothers over a 5- to 10-month follow-up period. Finally, all seven children showed increases in vocalizations concomitant with parent training. The results suggest that developmentally handicapped mothers can be taught to provide more effective and stimulating interactions to their young children.

Adult↗
PubMed1985

Parent Education Project. I: Development and nurturance of children of mentally retarded parents.

The development and home environments of 12, 2-year-old children raised by mentally retarded mothers were assessed using the Bayley Scales of Infant Development and the Caldwell Home Observation for Measurement of the Environment (HOME) Inventory. Results indicated that the children were at-risk for developmental delay, particularly in language. The child's cognitive development was significantly correlated with (a) whether the mother had a previous child removed from the home by child protection authorities and (b) HOME Inventory total scores. Analyses of HOME subscales revealed that mothers who were involved, responsive, and restrictive and punishing had children with higher Bayley Mental Development Index scores.

Adult↗
PubMedDate not supplied

Effectiveness of home-based early intervention on the language development of children of mothers with mental retardation.

The authors evaluated the effects of a home-based parent training program for mothers with mental retardation on the language development of their children who were at risk for language delay. The participants, 28 mothers labelled mentally retarded with children under 28 months of age, initially showed significantly fewer positive mother-child interactions and child vocalizations and verbalizations than did a comparison group of 38 families with children of similar age whose mothers were not mentally retarded. The 28 mothers with low IQ were then matched on child entry age and randomly assigned to either an interaction training or attention-control group (this group received training in safety and emergency skills unrelated to interactions). Interaction training consisted of verbal instruction, modelling, feedback, and tangible reinforcement. After training, the training group scores were no longer lower than those of the comparison group of mothers without mental retardation and were also significantly higher than the scores of the attention-control group on all maternal positive interactions, child vocalizations, verbalizations, and language and social domains of the Bayley Scales of Infant Development. Speech emerged significantly sooner in the training group as compared to the control group. The training group parents and children maintained improvements up to 82 weeks following training, and the attention-control group, when subsequently trained, replicated the original training group results. Thus, home-based parent training increased positive maternal interactions of mothers with mental retardation, which facilitated language development in their young children.

Child Abuse↗