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Biomedical subjects

Robert Davis

Publications and source records attributed to Robert Davis.

8 recordsLinked to original sources
PubMed2003

A longitudinal evaluation of adolescent depression and adult obesity.

BACKGROUND: Prior studies have had conflicting results regarding the relationship between adolescent depression and adult obesity. OBJECTIVE: To test the hypothesis that depression in adolescence would increase the risk for obesity in early adulthood. METHODS: We used data from a longitudinal study of a birth cohort of children born between April 1, 1972, and March 31, 1973, in Dunedin, New Zealand (N = 1037). These data included regular diagnostic mental health interviews and height/weight measurements throughout childhood and adolescence. We performed logistic regression analyses to assess the relationship between major depression in early or late adolescence and the risk for obesity at 26 years of age. RESULTS: Major depression occurred in 7% of the cohort during early adolescence (11, 13, and 15 years of age) and 27% during late adolescence (18 and 21 years of age). At 26 years of age, 12% of study members were obese. After adjusting for each individual's baseline body mass index (calculated as the weight in kilograms divided by the square of height in meters), depressed late adolescent girls were at a greater than 2-fold increased risk for obesity in adulthood compared with their nondepressed female peers (relative risk, 2.32; 95% confidence interval, 1.29-3.83). A dose-response relationship between the number of episodes of depression during adolescence and risk for adult obesity was also observed in female subjects. The association was not observed for late adolescent boys or for early adolescent boys or girls. CONCLUSIONS: Depression in late adolescence is associated with later obesity, but only among girls. Future studies should address reasons for these age and sex differences and the potential for intervention to reduce the risk for adult obesity in depressed older adolescent girls.

Adolescent↗
PubMed2003

Severe chronic neutropenia: treatment and follow-up of patients in the Severe Chronic Neutropenia International Registry.

Severe chronic neutropenia (SCN) is defined as an absolute neutrophil (ANC) of less than 0.5 x 10(9)/L, lasting for months or years. Congenital, cyclic, and idiopathic neutropenia are principal categories of SCN. Since 1994, the Severe Chronic Neutropenia International Registry (SCNIR) has collected data to monitor the clinical course, treatments, and disease outcomes for SCN patients. This report summarizes data for 853 patients, almost all treated with daily or alternate-day recombinant human granulocyte colony-stimulating factor (G-CSF or Filgrastim). G-CSF treatment increased the ANC overall from 0.34 x 10(9)/L +/- 0.018 pre-treatment to 3.70 x 10(9)/L +/- 0.18 during the first year of treatment. For most patients, the responses were durable with patients remaining on the same dose of G-CSF for many years. Long-term hematological observations showed stable mean leukocyte and neutrophil counts and gradually increasing hemoglobin levels. Thrombocytopenia developed in 4% of patients. As of January 1, 2000, myelodysplasia (MDS) or acute myelogenous leukemia (AML) has occurred in 35 of 387 patients with congenital neutropenia with a cumulative risk of 13% after 8 years of G-CSF treatment. This event occurred without a predictable relationship to the duration or dose of G-CSF treatment. No patients with cyclic or idiopathic neutropenia developed MDS or AML. Other important adverse events included hepatomegaly, osteoporosis, vasculitis, glomerulonephritis, and deaths in 4 of 14 cases requiring splenectomy. Growth and development and the outcome of pregnancy appeared to be unaffected by G-CSF treatment. These data indicate that congenital, cyclic, and idiopathic neutropenia can be effectively treated with long-term G-CSF. The risk of leukemia, osteoporosis, other potentially adverse events, and pregnancy outcome need to be further evaluated with continuing long-term observations.

Adolescent↗
PubMed2003

Clear cell adenocarcinoma in a female urethral diverticulum.

Primary urethral carcinoma is an uncommon diagnosis, and carcinomas arising from within a urethral diverticulum are rare. Because of the limited number of diagnosed cases, optimal treatment guidelines are not available. However, patients require an aggressive treatment approach to provide the best chance for cure.

Adenocarcinoma, Clear Cell↗
PubMed2003

Reduction in antibiotic use among US children, 1996-2000.

BACKGROUND: High rates of antibiotic prescribing to children contribute to antibiotic resistance in the community. The Centers for Disease Control and Prevention, in collaboration with other national and state level organizations, have actively promoted more judicious prescribing for children. OBJECTIVE: We sought to assess changes in the rate of antibiotic prescribing from 1996-2000 in 9 US health plans, patterns of diagnosis and treatment responsible for these trends, and changes in the use of first-line antimicrobial agents. DESIGN/METHODS: We analyzed claims data for dispensed medications and physician visits from 9 health plans. Each provided data on 25,000 children aged 3 months to <18 years enrolled between September 1, 1995, and August 31, 2000. Antibiotic dispensings were linked with an ambulatory visit claim to assign diagnosis. Antibiotic dispensings per person-year (antibiotics/p-y) were calculated for the age groups 3 months to <3 years, 3 years to <6 years, and 6 years to <18 years. The contribution of each diagnosis to changes in the overall rate of antibiotic use was determined. Generalized linear mixed models were used to test for trend and assess differences in rates by site. RESULTS: From 1996-2000, antibiotic rates for children 3 months to <3 years decreased from 2.46 to 1.89 antibiotics/p-y (24%); for children 3 years to <6 years from 1.47 to 1.09 antibiotics/p-y (25%); and for children 6 to <18 years from 0.85 to 0.69 antibiotics/p-y (16%). The reduction varied among health plans from 6% to 39% for children 3 months to <3 years. A decrease in prescriptions for otitis media accounted for 59% of the total decrease, and was primarily accounted for by a decrease in the rate of diagnosis of this condition. The proportion of first-line penicillins increased from 49% to 53%, with health plans with the lowest initial rates increasing most. CONCLUSIONS: Antibiotic prescribing decreased significantly between 1996 and 2000, concurrent with decreased frequency of diagnosis of potential bacterial infections, especially otitis media. Attention by public health and professional organizations and the news media to antibiotic resistance may have contributed to changes in diagnostic thresholds, resulting in more judicious prescribing.

Adolescent↗
PubMed2002

Immunogenically fit subunit vaccine components via epitope discovery from natural peptide libraries.

Antigenic peptides that bind pathogen-specific Abs are a potential source of subunit vaccine components. To be effective the peptides must be immunogenically fit: when used as immunogens they must elicit Abs that cross-react with native intact pathogen. In this study, antigenic peptides obtained from phage display libraries through epitope discovery were systematically examined for immunogenic fitness. Peptides selected from random peptide libraries, in which the phage-displayed peptides are encoded by synthetic degenerate oligonucleotides, had marginal immunogenic fitness. In contrast, 50% of the peptides selected from a natural peptide library, in which phage display segments of actual pathogen polypeptides, proved very successful. Epitope discovery from natural peptide libraries is a promising route to subunit vaccines.

Amino Acid Sequence↗
PubMed2002

Ocular emergencies: a quick reference.

Sight is precious, considered by many to be the most essential of the five senses. Children's eyesight is especially important, because good vision is related to learning. Regular eye examinations are needed to maintain proper eye health, since some serious eye disorders produce no early warning symptoms. Although prevention is the best defense, eye problems or injuries still occur suddenly and unexpectedly. When they do, recognizing their signs and symptoms and knowing what to do is vital to preserving sight.

Burns, Chemical↗
PubMedDate not supplied

The experiences of people with developmental disability in Emergency Departments and hospital wards.

The aim of this study was to determine whether needs of people with developmental disability were met during visits to Emergency Departments and stays in hospital. Responses to a questionnaire were obtained from 328 clients of three Victorian organizations. Of 119 respondents who had attended a hospital within a year of completing the questionnaire, most indicated that their needs were met in the areas of hydration and nutrition, medication, mobility and discharge. There were significant associations between getting enough to drink and being able to move from a bed, and having a support person stay with the patient. These results suggested a great reliance on support people during hospitalizations. Issues raised in the questionnaire were explored in follow-up interviews with 11 respondents or their support people. Reliance on support people emerged as a strong theme in interview transcripts, as did hospital staff's negative attitudes, and lack of skills and knowledge in developmental disability. These results are discussed in light of recent literature and the need to address issues in the larger context of the needs of support people and hospital staff.

Adult↗