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Biomedical subjects

R Olson

Publications and source records attributed to R Olson.

At least 37 records · Page 2Linked to original sources
PubMed1993

Medical students' exposure and immunity to vaccine-preventable diseases.

BACKGROUND: This study was conducted to assess medical students' immunity to vaccine-preventable diseases, their exposure to these diseases, and their attitudes toward immunity to vaccine-preventable diseases. METHODS: A cross-sectional, mailed survey was conducted of all 249 senior medical students in the 1991 graduating class at the University of Minnesota, Minneapolis. Two mailings were sent during the autumn of their senior year. RESULTS: The response rate was 77.5%. More than 90% of the students reported that they were immune to measles, mumps, rubella, and hepatitis B but only 23% were immune to influenza. Fewer than half of the students had ever been queried about their immune status prior to clinical clerkships. One third of the students had had a needlestick exposure during their clinical training (including 8% to a known hepatitis B carrier) and only 52% of these were reported by the student. Ten percent to 20% of the students felt that immunity to measles, mumps, and rubella was only somewhat or not very important. Less than one third of the students felt that immunity to influenza was important for themselves as health care providers. CONCLUSION: This study documented inadequate levels of immunity among medical students to certain vaccine-preventable diseases, that exposure to vaccine-preventable diseases was fairly common during clinical training, and that medical students often had inadequate attitudes about immunity to vaccine-preventable diseases. These findings have implications for medical school immunization policies and curriculum content.

Adult↗
PubMed1992

The availability of psychosocial interventions to children with cancer and their families.

Awareness of the need for and efficacy of psychosocial services for pediatric oncology patients and their families has increased greatly in the last decade. However, it is currently unknown to what extent these services are available. Therefore, a national survey of pediatric oncologists was conducted to determine the availability of the following services: psychological/psychiatric and social work consultation, support groups for patients and family members, nonpharmacological pain and anxiety management, and nonpharmacological treatment of anticipatory emesis. Results suggest that most centers offer social work consultation and support groups to parents. Fewer support groups are offered to patients and even fewer nonpharmacological services to assist patients in coping with anticipatory nausea and pain are offered. Results are discussed in terms of the pattern of service delivery and cost-effectiveness.

Cancer Care Facilities↗
PubMed1992

Personality factors in Psy.D. students: empirically derived comparisons between men and women.

A total of 180 students in a Doctor of Psychology program of an APA-accredited Professional School of Psychology (55 men and 125 women) took the MMPI for course requirements. A larger subgroup (43 men and 88 women) also completed the Adjective Check List. Men scored higher than women on the MMPI dimensions of Assertion (Pd), Organization (Pt), and Imagination (Sc). Women scored higher on the Ego Strength Scale (Es). Men scored higher on the Check List scale of Dominance. Data were compared with a previous report of MMPIs of Ph.D. students, and few differences were observed. Findings were discussed in terms of stereotypical role behaviors from which doctoral students are not yet immune.

Adult↗
PubMed1992

MMPI subtypes for cocaine abusers.

The MMPIs of 104 cocaine abusers in treatment were subjected to a hierarchical cluster analysis and two basic profile types emerged. Type I consisted of a spike on Pd and a subspike on Hyp, reflecting a rebellious, acting out character-disordered style with narcissistic traits. Type II consisted of a high-ranging, floating profile consisting of marked elevations on F, Sc, Dep, Pt, Pd, and Pa, reflecting a psychiatric patient who concurrently abused cocaine. These findings were contrasted to other MMPI typological studies, and the similarities and differences were discussed.

Adult↗
PubMed1991

Same-day surgery preparation: reduction of pediatric patient arousal and distress through participant modeling.

Twenty-six children (mean age = 5.5 years) were exposed to one of three surgery preparatory conditions: participant modeling alone (n = 9), participant modeling with mother (n = 8), and standard procedure control (n = 9). Children exposed to the modeling slide-tape without their mothers had significant reductions in physiological arousal after the slide-tape presentation, unlike children viewing the tape with their mothers and children exposed to the control condition. Both participant modeling groups exhibited significantly fewer distressful behaviors during recovery (postsurgery) than did control group children. Results are discussed with respect to previous medical preparation research. Implications of these findings concerning clinical application and future research are addressed.

Ambulatory Surgical Procedures↗
PubMed1990

Improvement in psychological functioning among drug abusers: inpatient treatment compared to outpatient methadone maintenance.

A total of 68 opiate and cocaine abusers, receiving hospital-based, multimodal treatment for drug abuse in a 14 to 21-day program, and 47 patients newly admitted to methadone maintenance were compared on changes in psychological functioning, using a pretreatment-posttreatment design. Psychological changes were assessed by the Adjective Checklist, measuring the construct of "need". Inpatient treatment resulting in abstinence was associated with positive, meaningful, and significant changes in need pattern that were internally consistent. An equivalent amount of time on methadone maintenance outpatient treatment produced no improvement in psychological functioning, except that these patients evidenced increased dependency needs. Implications are discussed.

Adaptation, Psychological↗
PubMed1990

Skin reactivity to codeine and histamine during prolonged corticosteroid therapy.

Corticosteroids, used in low to moderate doses for short time intervals, do not suppress immediate percutaneous skin test responses to allergens, compound 48/80, or histamine. During routine skin testing, in our clinic, intradermal injection of codeine (1 mg/ml) and histamine (0.02 mg/ml) are used as positive controls. We had noted that responses to codeine but not histamine are decreased in some patients with asthma who had been receiving prolonged corticosteroid therapy. Therefore, we retrospectively compared skin test responses to codeine and histamine between 25 adult subjects with asthma receiving steroids (group I) and 25 age-matched control subjects (group II). In group I, the mean wheal diameters, induced by codeine but not histamine, were significantly less than diameters in group II. This decreased skin test reactivity to codeine was not due to effects of theophylline also taken by group I subjects, since the skin test reactions of other subjects with asthma, treated with theophylline but not steroids (group III), were not significantly different from reactions in group II. We conclude that prolonged courses of corticosteroids do not appear to alter histamine-induced vascular reactivity in skin but may affect cutaneous mast cell responses by an undefined mechanism.

Adrenal Cortex Hormones↗
PubMed1990

Determinants of in vivo histamine release in cutaneous allergic reactions in humans.

To determine host factors influencing the magnitude of mediator release during ongoing cutaneous allergic reactions in humans, we compared, in 22 subjects, the first-hour, second- to fifth-hour, and total (0 to 5 hours) skin chamber histamine release to (1) the in vitro reactivity and sensitivity of basophils to antigen for histamine release and (2) skin test sensitivity and reactivity to antigen, histamine, and codeine. There was no significant correlation between the first-hour and second- to fifth-hour histamine release. With a combination of basophil, antigen, histamine, and codeine skin sensitivity and reactivity, 64% to 75% of the magnitude of the first-hour, second- to fifth-hour, and total (0 to 5 hours) skin chamber histamine release could be accounted for. We conclude that antigen-induced in vivo allergic responses are a complex phenomenon dependent, in part, on antigen sensitivity, basophil and mast cell reactivity, and end organ responsiveness to mediators.

Adolescent↗
PubMed1990

Pancreatic transplants: CT-guided biopsy.

With use of computed tomographic (CT) guidance, 10 biopsies of pancreatic allografts were performed in four patients to determine the cause of pancreatic dysfunction. All biopsies were performed with an 18-gauge biopsy needle and with use of a biopsy gun. On four occasions, simultaneous biopsies of the pancreatic head and tail were performed. In nine of the 10 biopsies, specimens obtained were adequate for diagnosis. In two of the four simultaneous procedures, important histologic differences were noted between specimens from the head and those from the tail of the allograft. No complications occurred. These findings demonstrate the ease, accuracy, and safety of CT-guided biopsies of pancreatic transplants with a biopsy gun. Simultaneous sampling of the pancreatic head and tail may provide important clinical information that may not be available when the usual cystoscopically guided biopsy of the pancreatic head is used.

Biopsy, Needle↗
PubMed1990

Maternal birthing positions and perineal injury.

A study to evaluate the relationship between maternal birthing position and perineal outcome was undertaken on 335 patients in a rural family physician's practice whose babies were delivered vaginally between December 1980 and December 1988. The most common birthing position used by the women was the semi-sitting position in the birthing bed (44%, n = 146). Ninety-four women (28%) gave birth from the conventional lithotomy position, 80 (24%) used the birthing chair, and less than 5% used a side-lying position. Almost 30% of the women gave birth with intact perineum; the incidence of episiotomy was 44%. The use of a particular position for delivery varied with parity, and multiparous women used the semi-sitting position in the birthing bed more frequently than did primiparous women. There was no statistically significant relationship between birthing position and perineal outcome for primiparous women. A statistically significant relationship between delivery position and perineal outcome was found for multiparous women. Multiparous women using the birthing bed were more likely to have less perineal trauma than women giving birth on the delivery table.

Adult↗
PubMed1989

Differences in organization of psychological needs between inpatient and outpatient opiate addicts.

A total of 117 inpatients and 114 outpatient drug addicts were administered the Adjective Check List; protocols were subjected to a hierarchical cluster analysis. Results showed two basic clusters for inpatients and one large cluster in the outpatient sample, each different in personality need organization. At discharge, patients who moved from Clusters I or II (inpatient) to Cluster III (outpatient) continued with outpatient treatment. None of the "independent" patients pursued outpatient treatment, while patients in the "emotionally dependent" cluster who pursued outpatient treatment eventually were placed on methadone maintenance. Results suggest that drug addicts who request inpatient or outpatient treatment may be a self-selected sample who differ in personality organization, which, in turn, may predict treatment follow-up in an aftercare setting.

Adult↗
PubMed1989

Self-regulation treatment to reduce the aversiveness of cancer chemotherapy.

In an A-B design, the effectiveness of a multicomponent intervention for reducing chemotherapy-associated nausea and emesis in an 11-year-old cancer patient was evaluated. A highly structured, time-limited, self-regulation treatment was implemented that consisted of patient and parent instruction in self-hypnotic methods, cue-controlled relaxation, and guided imagery. Practice of the self-regulation methods at home and in vivo (clinic setting) in the absence of chemotherapy infusion were emphasized to promote skill acquisition and cross-setting generalization. Dependent variables included self-reported nausea intensity and parental report of duration of the patient's sleep and vomiting frequency. Data were obtained before, during, and following chemotherapy for baseline and self-regulation treatment phases across five cycles of chemotherapy that occurred over a 5-month period. During the intervention phase, a marked and clinically significant reduction in self-reported nausea and parent-observed vomiting were noted as well as a concurrent increase in sleep duration. The integrity of patient self-report and parental observations were supported by clinic staff anecdotal data. Treatment limitations and cost-effectiveness are discussed as well as the use of this intervention with adolescent patients.

Antineoplastic Agents↗
PubMed1988

Role of computed tomography in screening for hepatocellular carcinoma in patients with cirrhosis.

One hundred patients with cirrhosis underwent abdominal computed tomography (CT) using a delayed contrast technique to determine liver and spleen volume. These scans were reviewed to screen this "at risk" population for hepatocellular carcinoma (HCC). Fifteen of the 100 screened patients had focal abnormalities suspicious for HCC. On biopsy, only 1 patient was shown to have HCC. The other 14 patients had either fatty infiltration or focal regeneration. In the same time interval, a total of 10 patients had histologically proven HCC. All presented with symptoms and died within 4 months of diagnosis. The results show that focal hepatic lesions can be detected by CT but in this population the lesions may not be due to HCC. The incidence of HCC was approximately 1%, probably reflecting a truly low incidence in this population.

Biopsy↗
PubMed1988

Acquired immunodeficiency syndrome-associated arthritis.

A subacute, oligoarthritic syndrome developed in four patients with human immunodeficiency virus (HIV) infection. Three had true acquired immunodeficiency syndrome (AIDS) and all had lymphocyte abnormalities. The arthritis was characterized by extreme pain and disability in three patients and moderate pain in one. Knees and ankles were affected. Symptoms developed over a one- to six-week interval; response to treatment was rapid, especially to intra-articular corticosteroids. Despite the clinical severity of the arthritis, synovial fluids were non-inflammatory and biopsy specimens revealed only mild chronic synovitis. A definite etiology could not be established. None of the patients had recognized infections predisposing to reactive arthritis, and the three patients who underwent tissue typing were HLA-B27-negative. A viral infection, including HIV, is a possible cause. In distinction to these four patients, arthritides with clearly established etiologies developed during this same time period in four other HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Gastric disconnection in the management of perforated giant duodenal ulcer.

Giant duodenal ulcer is the most severe variant of peptic ulcer disease. Currently, however, no technical recommendations exist for the surgical management of perforation of these lesions. Due to the often extensive loss of duodenal substance, plication is impossible, pyloroplasty is hazardous, and duodenal closure is tenuous at best. In the absence of surgical precedent, it was thought that an ideal procedure would embody three principles: (1) defunctionalization of the upper gastrointestinal tract; (2) minimization of suture lines; and (3) control of potential fistula sites with tube enterostomies. As it finally evolved, the procedure of gastric disconnection became truncal vagectomy and antrectomy, along with tube gastrostomy, duodenostomy, and jejunostomy. Restoration of gastrointestinal continuity was deferred for 3 to 4 weeks after recovery. Four consecutive patients have been successfully managed by this technique. Gastric disconnection is physiologically sound and may prove to be superior to alternative techniques in this difficult condition.

Adult↗
PubMed1987

[Congenital corneal opacity caused by thickening of Bowman's membrane].

Congenital corneal opacifications are rare, yet their causes are manifold. Only a few cases have been described in which the most striking histopathological feature is a thickening of Bowman's membrane. The authors found an isolated thickening of this membrane in the corneas of a baby who, shortly after birth, presented with corneal opacifications in both eyes. Only a few months after penetrating keratoplasty was performed the condition recurred. Bowman's membrane was found to be thickened in the graft as well.

Child, Preschool↗
PubMed1986

Proton secretion by the sodium/hydrogen ion antiporter in the human neutrophil.

The reducing equivalents used by the human neutrophil respiratory burst oxidase are derived from NADPH generated by the hexose monophosphate shunt. The CO2 generated by the HMP shunt is spontaneously hydrated and the protons (H+) are secreted upon the dissociation of carbonic acid. The mechanism and significance of H+ secretion by the resting and stimulated neutrophil was investigated. A basal rate of H+ secretion by resting neutrophils observed in a choline buffer was augmented with the addition of sodium (Na+) (Km for Na+ was 3.22 +/- 0.32 mM). Amiloride, a Na+/H+ antiporter inhibitor, reduced H+ secretion in Na+-containing buffers with a Ki = 1.02 microM. This Na+/H+ exchange mechanism was also operative in cells stimulated with a variety of agonists, and an increased H+ flux, relative to resting cells, was observed at higher Na+ concentrations. Cytoplasts incorporating acridine orange were also used to assess Na+-H+ flux. Cytoplasts were used to avoid alteration of the fluorescent pH probe by HOCl formed in intact neutrophils. Alkalinization of the cytoplasm was dependent on extracellular Na+ in concentrations similar to that found to augment H+ secretion in intact cells. Also, amiloride competitively inhibited H+ secretion by the cytoplasts. Both superoxide (O2-) production and lysozyme release in cells stimulated with opsonized zymosan or concanavalin A was significantly inhibited in the absence of Na+, restored to normal with the addition of Na+ in low concentrations, and inhibited again in the presence of amiloride. A Na+/H+ antiporter similar to that found in other cell types is present in the human neutrophil and appears linked to activation of the respiratory burst and degranulation.

Amiloride↗