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Biomedical subjects

L Grant

Publications and source records attributed to L Grant.

At least 19 recordsLinked to original sources
PubMed1992

Psychotropic drug use in long-term care facilities: a review of the literature.

We reviewed 19 studies of psychotropic drug use for residents of long-term care facilities, located through a MEDLINE search of the literature published between 1978 and 1990. The review compares each study in terms of its sample, research design, and findings. The studies reviewed found that a substantial proportion of nursing home residents are taking psychotropic drugs on a regular, long-term basis and this usage is accompanied by prescribing and monitoring problems and many potential adverse risks.

Aged↗
PubMed1991

Sources and magnitude of job stress among physicians.

Research has suggested that physicians' jobs are more stressful than many other types of work, but sources of job stress for physicians have rarely been measured systematically. Interview data from 204 young physicians (57 women, 147 men) were used to construct four scales of sources of job stress: patient relationships, business/financial issues, time pressures, and competence concerns. The latter is a stronger source of stress for doctors in early practice. Sources and intensity of job stressors do not vary significantly by gender, but medical practice problems are more stressful in nonprofit than in for-profit practices. Early-career doctors appeared to experience only moderate levels of stress, and stressors were not related to impaired mental health.

Adaptation, Psychological↗
PubMed1991

Acute back pain: a psychological analysis.

A cross-sectional evaluation of 117 people who sustained acute back injuries was undertaken within 15 days of the first report of the pain. The subjects showed no discal or neural signs and had not experienced previous episodes of back or neck pain. All subjects were given a structured interview and filled in a series of psychological evaluation instruments. Results show acute pain reactions to be comparable to those seen in chronic pain groups. The predominant emotion is one of frustration rather than anxiety or depression and considerable behavioural disruption is evident from this early point. The extent to which these data undermine the model of gradual evolution of chronic back pain problems is discussed.

Acute Disease↗
PubMed1991

The evolution of chronic back pain problems: a longitudinal study.

A longitudinal evaluation of the recovery from an acute back pain episode was undertaken on 117 sufferers, with assessments at the onset, 3 and 6 months. The number of individuals still reporting pain at 6 months, and therefore qualifying for 'chronic pain', was considerably higher than expected (40%). At 6 months, the persisting pain problems were found to be moderate to severe in intensity in approx. 20% of cases. Despite the pain, the chronic sufferers showed gradual continuing adjustments to it, re-establishing activities despite pain. Most of the change in the pain components (cognitive, subjective, behavioral, depression, anxiety) occur in the first 3 months, after which considerable stability is evident in the residual problem. In contrast, the impact of the pain and the consequent disability decline more markedly and continue to do so right up to the 6 month point. There was no evidence of chronic pain evolving and growing, but rather of a persistence of the acute presentation.

Adult↗
PubMed1991

The prevention of chronic pain and disability: a preliminary investigation.

A preliminary investigation was undertaken on 117 acute back pain cases, to assess the utility of counseling at the acute stage upon the course of recovery over the subsequent 6 months. In addition, the extent to which psychological reactions to acute injury would allow the 'tagging' of individuals at risk for chronic pain problems, was studied. The minimal rehabilitation counseling proved inadequate to effect the course of recovery, but remarkably accurate predictions were possible at the sub-chronic point (3 months) as to who would make complete recoveries.

Adult↗
PubMed1990

Detection of Chlamydia trachomatis antigens in urine as an alternative to swabs and cultures.

By using commercially available spectrophotometric and immunofluorescent immunoassays, Chlamydia trachomatis antigens were detected in first-void urine (FVU) sediments from 224 men attending a sexually transmitted disease clinic at a frequency of 81.6%-86.8% compared with 86.8% (33/38) positive by urethral swab culture (P less than .05). Endocervical cultures from 228 women attending a gynecology clinic yielded 92.3% (12/13) positive compared with 61.5%-76.9% for urine samples in three antigen-detection assays. Culturing urine from either gender yielded low positivity rates (23.7% for men, 15.4% for women). Defining truly infected patients as positive by culture or by any two of the three antigen tests, all assays were 100% specific. Immunodiagnostic testing of male FVU sediment appears to be a reliable, rapid, nontraumatic method for diagnosing chlamydia infection.

Adult↗
PubMed1989

Diagnosis of Chlamydia trachomatis genital infections by cell culture and two enzyme immunoassays detecting different chlamydial antigens.

The enzyme-amplified immunoassay IDEIA (CellTech Diagnostics), which measures lipopolysaccharide antigen, and Chlamydiazyme (Abbott Laboratories, North Chicago, Ill.), which measures several antigenic components of Chlamydia trachomatis, were compared for specimens from urethral swabs from 235 men attending a clinic for sexually transmitted diseases (culture prevalence of 14.9%) and 458 endocervical swabs from women attending planned parenthood and obstetrics-gynecology clinics (culture prevalences of 5.9 and 7.7%, respectively). Compared with cell culture, the percent sensitivites, specificities, and positive and negative predictive values for IDEIA were 62.5, 99.5, 95.2, and 94.3%, respectively, for specimens from men and 96.3, 97.9, 74.3, and 99.8%, respectively, for specimens from women; results for Chlamydiazyme for specimens from men were 81.8, 99.5, 96.4, and 97.1%, respectively, and for specimens from women, results were 85.2, 99.3, 88.5, and 99.1%, respectively. Although the specificities of IDEIA and Chlamydiazyme were comparable, the sensitivity of IDEIA appeared higher for women (96.3%) than for men (67.5%), while the sensitivities of Chlamydiazyme were similar for men (81.8%) and women (85.2%). Western blot (immunoblot) analysis of the detector reagents from the two immunoassays indicated that the differences in performance observed for the two immunoassays may be due to measurement of different antigens.

Adolescent↗
PubMed1989

State Medicaid reimbursement for ICF-MR facilities in the 1978-1986 period.

Medicaid policies for Intermediate Care Facilities for the Mentally Retarded (ICF-MR) are important because of rapid expenditure growth. Our study of 1978-1986 state Medicaid ICF-MR reimbursement policies showed massive shifts from traditional retrospective reimbursement methods, paralleling changes in reimbursing skilled nursing facility and ICF care. Meanwhile, Medicaid per diem ICF-MR reimbursement rates increased about 67%. Regression analysis showed that personal income, population percentage in poverty, unionization, and percentage of ICF-MR beds in government facilities influenced rates positively, whereas prospective class and combination reimbursement methods negatively affected rates. Thus, within the context of economic factors, government involvement in care and the reimbursement methodology are policies found to affect rates.

Humans↗
PubMed1988

Bicarbonate-based dental powder, fluoride, and saccharin inhibition of dental caries associated with Streptococcus mutans infection of rats.

The effects of NaHCO3-based dental powder containing NaF and sodium saccharin on dental caries and Streptococcus mutans recoveries in rats were studied. Weanling specific-pathogen-free Osborne-Mendel (SPFOM) rats were inoculated with S. mutans NCTC-10449S. Four infected groups were topically treated with either demineralized water (DW), a dental powder suspended such that there was 1 part solid per 2 parts DW, 0.073% NaF, or a combination of 0.073% NaF and 0.5% Na-saccharin (Nas). NaF-supplemented DW (at 10 ppm F-) was provided to a 5th group of infected rats as a positive treatment control, but this group was otherwise untreated. A sixth but uninfected group was topically treated with DW. All topical treatments were given once for 1 min daily per rat, for 5 days per week. Animals' teeth were swabbed for recovery of 10449S and total recoverable flora. Recoveries of 10449S were lower from powder-treated rats than from DW-treated rats. This difference approached but did not reach statistical significance. Total caries scores were 51% lower for the dental powder, 36% lower for the topical NaF, 34% lower for the combined NaF-Nas, and 54% lower for the NaF-supplemented drinking water group, all p less than 0.001. While all of the treatments inhibited smooth-surface caries, the dental powder effects, like those for the combined NaF-Nas, and NaF drinking water, were evident in fissure tooth surfaces as well.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Study of pressure of the normal anterior tibial compartment in different age groups using the slit-catheter method.

Using the slit-catheter method, the pressure of the anterior tibial compartment was studied in thirty volunteers, whose ages ranged from seventeen to eighty-five years, at rest and during and after exercise. The average resting pressure was +5.1 millimeters of mercury. There was a wide variation between subjects, although 95 per cent of them had a resting pressure of less than twelve millimeters of mercury. This pressure was not consistently or significantly affected by age. The pressure increased with exercise, but in an average of 3.4 minutes after the exercise was stopped it returned to within one millimeter of mercury of the resting pressure. The resting pressure was also found to be affected by the positions of the lower extremity and the trunk during measurement. To reduce this effect, it is recommended that for measurement of pressure in the lower extremity the patient should be lying supine and the big toe should be pointing vertically upward.

Adolescent↗
PubMed1987

Effects of bicarbonate-based dental powder, fluoride, and saccharin on dental caries and on Streptococcus sobrinus recoveries in rats.

The effects of NaHCO3-based dental powder containing NaF and sodium saccharin on dental caries and Streptococcus sobrinus recoveries in rats were studied. Weanling specific-pathogen-free Osborne-Mendel (SPFOM) rats were inoculated with S. sobrinus 6715-13WT. One of six infected groups was topically treated with either demineralized water (DW), a dental powder suspended such that there was 1 part solid per 2 parts DW, 0.073% NaF, 0.5% Na-saccharin (Nas), or a combination of NaF and Nas at the same concentrations. NaF-supplemented DW (at 10 ppm F-) was provided to the 6th group of infected rats as a positive treatment control, but this group was otherwise untreated. A seventh but uninfected group was topically treated with DW. All topical treatments were given once for one min daily per rat, for five days per week. Animals' teeth were swabbed for recovery of 6715-13WT and total recoverable flora. At 37 days after start of treatment, S. sobrinus recoveries were lower only for those rats topically treated with the dental powder (p less than 0.05) by comparison with recoveries from the infected, topical DW-treated group. Caries scores, however, were 42% lower for the groups receiving the dental powder (p less than 0.005), 30% lower for those treated with the combined NaF-Nas (p less than 0.005), and 47% lower for the NaF-supplemented drinking water group (p less than 0.005). The dental powder effects, like those for the combined NaF-Nas and NaF drinking water, were evident on both smooth and fissure tooth surfaces. Both the 10 ppm F- drinking water and the dental powder significantly (p less than 0.005) reduced fissure caries scores below the level elicited by the indigenous mutans-free flora in the DW-treated uninfected rats; however, these reduction were not significantly different from one another. Thus, the 10 ppm F- drinking water and the dental powder equally inhibited not only the S. sobrinus-attributable component of caries but probably also the component of caries attributable to the indigenous oral flora.

Administration, Topical↗
PubMed1986

Abdominal distension in Kaufman-McKusick syndrome.

A female infant with Kaufman-McKusick syndrome redeveloped respiratory distress and abdominal distention at 5 weeks of age. Ultrasonography demonstrated recurrence of peritoneal cysts and hydrometrocolpos. It is postulated that refluxing vaginal secretions may contribute to the abdominal distention seen in many infants with Kaufman-McKusick syndrome.

Abdomen↗
PubMed1986

Combined premedical-medical programmes: programme structure and student outcomes at four universities.

Many American universities now support combined premedical-medical programmes which shorten and integrate the education of doctors. This paper reviews combined baccalaureate-MD programmes at four institutions: Boston University, the City College of New York, The University of Michigan-Ann Arbor, and the University of Missouri-Kansas City. In comparison to most US medical schools, the combined programmes have admitted and educated larger portions of women students. In addition, some have had large proportions of graduates choosing primary-care careers.

Boston↗
PubMed1985

A double blind placebo controlled trial of ascorbic acid in obesity.

A double blind placebo controlled trial of ascorbic acid was carried out in 41 severely obese subjects. 38 patients completed the 6 week trial. 19 received 3g of ascorbic acid per day, 19 received placebo. The weight loss during the trial was small in both groups but was significantly greater in the ascorbic acid treated group.

Ascorbic Acid↗
PubMed1977

St. Louis encephalitis in southern Ontario: laboratory studies for arboviruses.

The first reported outbreak of St. Louis encephalitis in Canada occurred in the summer of 1975 in southern Ontario -- in the Windsor-Sarnia-Chatham area, the Niagara region and the city of Toronto. Hemmagglutination inhibition and complement fixation testing of serum samples collected during the outbreak confirmed that St. Louis encephalitis virus was the etiologic agent. Furthermore, this virus was isolated from brain tissue of a patient who died. This outbreak was probably an extension of the outbreak that occurred in the United States that summer. It was the first outbreak of arbovirus encephalitis in the province of Ontario.

Antibodies, Viral↗