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Biomedical subjects

M J Chesebro

Publications and source records attributed to M J Chesebro.

7 recordsLinked to original sources
PubMed1998

Understanding the guidelines for treating HIV disease.

In 1996 a panel of experts convened by the International AIDS Society-USA issued new guidelines for treating human immunodeficiency virus (HIV) infection, which have recently been updated. Quantitative plasma HIV-1 RNA concentration (viral load) and CD4+ lymphocyte levels are used to monitor disease progression, determine the need to initiate antiretroviral treatment, monitor effectiveness of treatment and evaluate the need to change medications. Multi-drug therapy with nucleoside analogs, nonnucleoside reverse transcriptase inhibitors and protease inhibitors can result in measurable improvement in clinical outcome in HIV-1 infected patients.

Anti-HIV Agents↗
PubMed1997

Using serum markers in the early diagnosis of myocardial infarction.

Because thrombolytic therapy can save lives and salvage left ventricular function after acute myocardial infarction, rapid and precise diagnosis is essential. Electrocardiographic changes, and the patient's history and physical examination may not confirm the diagnosis of myocardial infarction. Serum markers have specific advantages and disadvantages in confirming this diagnosis. An understanding of the advantages and disadvantages of using serum markers can enhance the clinician's ability to efficiently and accurately triage patients to appropriate care.

Biomarkers↗
PubMed1988

Passive smoking.

Absorption of harmful and irritative components of cigarette smoke by nonsmokers may result in both acute and long-term health problems. Persons with asthma or coronary artery disease are at particularly high risk of developing problems. Children living with smokers are at increased risk of persistent middle ear effusions and lower respiratory tract infections. Nonsmokers married to smokers have an increased risk of lung cancer.

Cotinine↗
PubMed1987

First year residency stress: sources and mediators.

This study expands on previous research on stress in the internship year by identifying potential sources of stress in the training requirements and faculty contacts of first year family practice residents. All first year residents completed the Profile of Mood States (POMS) and the Zung Self-Rating Depression Scale (SDS) once a month throughout the year. It was shown that specific training demands, such as the number of beeper calls, the number of nights on call, the amount of sleep, etc., correlated with the POMS and the SDS only in the early rotations. The residents' ratings of commitment to teaching, availability, and sensitivity of the faculty on each service, however, were consistently related to the residents' moods regardless of time of year. When residents rated faculty as low on these characteristics, they scored higher on the stress indicators, whereas when residents rated faculty as high on these characteristics, their stress scores were significantly reduced.

Adaptation, Psychological↗
PubMedDate not supplied

A cost-benefit analysis of colposcopy for cervical squamous intraepithelial lesions found on Papanicolaou smear.

BACKGROUND: We performed a cost-benefit analysis of a protocol for studying patients with squamous intraepithelial lesions (SIL) on Papanicolaou smears to determine whether it compared favorably with resources spent on other health programs for screening and treatment. METHODS: During a 3-year period, 424 patients with dysplastic Papanicolaou smears were examined, studied by biopsy, and treated. We calculated costs based on a model protocol and derived a cost per year of life saved for preventing death from invasive cervical carcinoma. A sensitivity analysis was performed on selected assumptions of the analysis. RESULTS: The marginal, or incremental, cost of colposcopic evaluation and treatment of Papanicolaou smears with low-grade SIL, high-grade SIL (moderate), and high-grade SIL (severe), depending on assumptions, ranged from $406 to $5746, $160 to $2263, and $85 to $1197 per year of life saved, respectively. Depending on the assumption of the rate of Papanicolaou smears with SIL in the screened population being 1.8%, 5.1%, or 11.5%, the estimated total cost of screening and treating the referral base was $1.3 million, $538,126, and $307,037, respectively. This results in the average cost per year of life saved to screen and treat low-grade SIL, high-grade SIL (moderate), and high-grade SIL (severe) to be $1105 to $68,909, $375 to $21,673, and $177 to $8831, respectively. CONCLUSIONS: Both marginal cost and average screening costs of evaluating and treating abnormal Papanicolaou smears by the protocol described in this article compare favorably with costs per year of life saved for other health care screening and treatment strategies for many assumptions. The marginal cost to perform colposcopy on patients with a Papanicolaou smear with low-grade SIL is so low that it is relatively a very effective strategy.

Adolescent↗