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Biomedical subjects

S Callahan

Publications and source records attributed to S Callahan.

At least 19 recordsLinked to original sources

[Pregnancy and birth experiences in 12 women undergoing IVF].

OBJECTIVE: Medical interventions during the perinatal period are psychologically difficult for women and research has shown this is true as well for in-vitro fertilization procedures (IVF). This study examined the impact of IVF and different medical interventions, common to both non-pathological pregnancies and IVF, through the analysis of both quantitative and qualitative data. PATIENTS AND METHODS: Twelve women undergoing IVF evaluated their experience of pregnancy and birth using measures of post-partum depression, maternal self-esteem, and semi-directive interviews. RESULTS: The results showed that the number of medical interventions is correlated with higher scores of post-partum depression as well as lowered scores in maternal self-esteem. Qualitative analyses of interviews showed that IVF has a complex and unique psychological impact. DISCUSSION AND CONCLUSION: The results of this study underline the need for specific psychological support for women undergoing IVF treatment.

Delivery, Obstetric↗

About orlistat.

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Anti-Obesity Agents↗

Frequency of borderline personality disorder in a sample of French high school students.

OBJECTIVE: To estimate the frequency of borderline personality disorder (BPD) in French high school students. METHOD: A random sample of high school students (n = 1363) ranging in age from 13 to 20 years agreed to complete a questionnaire, the Screening Test for Comorbid Personality Disorders (STCPD); 107 of them volunteered to be interviewed. We assessed this group using the Revised Diagnostic Interview for Borderlines (DIB-R). We conducted a regression analysis to determine a cut-off for BPD diagnosis with the STCPD. RESULTS: We estimated the overall frequency of BPD to be 10% for boys and 18% for girls. After a peak of frequency at age 14 years for both sexes, the frequency increased significantly again in late adolescence. CONCLUSION: This study found a high frequency of BPD in French adolescents, which adds to questions regarding the validity of diagnosing this disorder in adolescents.

Adolescent↗

[Study of nicotine dependence among 342 adolescent smokers].

OBJECTIVE: This research evaluated nicotine dependence in adolescent smokers, their motivation to smoke and/or stop smoking, and their knowledge of how to stop smoking as well as the potential difficulties involved. METHOD: Three hundred forty-two high school students completed questionnaires using two measures of dependence (the Fagerstrom tolerance test and a visual-analog self-evaluation scale), a test to measure motivation to smoke (the Horn test), and a questionnaire exploring motivations to stop smoking, methods used to stop smoking, and the anticipated difficulties. RESULTS: On the Fagerstrom tolerance test, 14.6% of the students indicated strong dependence, whereas 32.3% indicated intermediate dependence. The Fagestrom score was strongly correlated to the self-evaluation test (r = 0.54, P < 0.001) and negatively correlated with the subjects' ages at the onset of smoking (r = -0.28, P < 0.001). The Horn test revealed that the main motivation to smoke is the search for relaxation and a decrease of negative emotions, indicating that cigarette smoking is primarily a means to manage stress and anxiety. Eighty-nine percent of the subjects stated that they would like to stop smoking, primarily because of the financial cost and health concerns. Among those subjects wishing to stop, 64.5% had previously tried to stop and had failed and 72% believed that it would be 'difficult' or 'very difficult' to stop. The main anticipated difficulties were an increase in stress and anxiety and, for the girls, weight gain. The anticipation of these difficulties was strongly correlated to dependence scores (r = 0.43, P < 0.001). Despite awareness of these difficulties, only 19.6% of the subjects wishing to stop smoking expected to seek medical assistance. For most of the measured variables, there was no difference between boys and girls. CONCLUSION: This study confirms the seriousness of tobacco consumption in adolescence. The results suggest the need for early programs aimed at preventing or delaying onset of use as well as the need to develop programs to aid high school students to stop smoking.

Adolescent↗

Comparison of albuterol delivered by a metered dose inhaler with spacer versus a nebulizer in children with mild acute asthma.

OBJECTIVE: In children with mild acute asthma, to compare treatment with a single dose of albuterol delivered by a metered dose inhaler (MDI) with a spacer in either a weight-adjusted high dose or a standard low-dose regimen with delivery by a nebulizer. STUDY DESIGN: In this randomized double-blind trial set in an emergency department, 90 children between 5 and 17 years of age with a baseline forced expiratory volume in 1 second (FEV1 ) between 50% and 79% of predicted value were treated with a single dose of albuterol, either 6 to 10 puffs (n = 30) or 2 puffs (n = 30) with an MDI with spacer or 0.15 mg/kg with a nebulizer (n = 30). RESULTS: No significant differences were seen between treatment groups in the degree of improvement in percent predicted FEV1 (P =.12), clinical score, respiratory rate, or O2 saturation. However, the nebulizer group had a significantly greater change in heart rate (P =.0001). Our study had 93% power to detect a mean difference in percent predicted FEV1 of 8 between the treatment groups. CONCLUSION: In children with mild acute asthma, treatment with 2 puffs of albuterol by an MDI with spacer is just as clinically beneficial as treatment with higher doses delivered by an MDI or by a nebulizer.

Adolescent↗

Hospitalization patterns in severe acute asthma in children.

We set out to determine associations between hospitalization and disease severity before and 2 hours after initiation of asthma therapy in the Emergency Department, and to describe the outcome of patients admitted and discharged. This is a retrospective review of data and charts from a randomized, double blind, placebo-controlled trial (R.C.T.) of 120 asthmatics 5-17 years of age with baseline forced expiratory volume in 1 second (FEV1) < 50% predicted, treated with 3 or 1 or 0 doses of nebulized ipratropium added to three albuterol nebulizations administered over 1 hour. None of the clinical parameters measured at baseline were associated with hospitalization. However, by 2 hours after initiation of therapy, both the FEV1 percent of predicted values (% pred.) and the total asthma score were associated with likelihood of hospital admission. Baseline O2 saturation < 92% indicated a longer hospital stay (75.3 +/- 51 hours vs. 43.0 +/- 24.4 hours, P = 0.015) and a later onset of infrequent nebulizations (46.7 +/- 35.1 vs. 26.6 +/- 17.4 hours, P = 0.006). By 2 hours, those with a post-treatment FEV1 % pred < or = 30% and an asthma score > or = 6 of 9 had a high likelihood of hospitalization (86 and 80%, respectively, combined probability 100%), whereas FEV1 % pred > or = 60% and total asthma score < 3 were associated with successful discharge (probability of 92 and 83%, respectively). We conclude that pre-treatment assessments were not associated with hospitalization, while patients with post-treatment FEV1 % pred < or = 30% and a score > or = 6 had high likelihood of hospitalization.

Administration, Inhalation↗

Efficacy of frequent nebulized ipratropium bromide added to frequent high-dose albuterol therapy in severe childhood asthma.

OBJECTIVE: The objective of this trial was to determine the efficacy of frequent nebulized ipratropium added to high-dose albuterol therapy in children with severe asthma. METHODS: One hundred twenty children (5 to 17 years) of age) with severe acute asthma (forced expiratory volume in 1 second (FEV1), < 50% of the predicted value) were enrolled into a randomized double-blind three-arm placebo-controlled trial comparing three groups: group 1, three doses of nebulized ipratropium bromide within 60 minutes (250 micrograms/dose); group 2, one dose of ipratropium; group 3, no ipratropium. All patients were also treated with three doses of nebulized albuterol within 60 minutes (0.15 mg/kg per dose). Pulmonary function and clinical measures were assessed every 20 minutes for up to 120 minutes. RESULTS: The groups were comparable at baseline. At 120 minutes, the mean percentage of predicted FEV1 improved from 33.4% to 56.7% in group 1, from 34.2% to 52.3% in group 2, and from 35.4% to 48.4% in group 3 (p = 0.0001). The differences between groups were larger in those children with a baseline FEV1 < or = 30% of the predicted value: FEV1 increased from 24.5% to 50.9% in group 1, from 25.0% to 39.8% in group 2, and from 25.9% to 36.5% in group 3 (p = 0.0001). In group 1, 38% of the patients were hospitalized after the study, 44% in group 2, and 46% in group 3 (p value not significant). However, in patients with FEV1 < or = 30%, the hospitalization rates were 27% in group 1, 56% in group 2, and 83% in group 3 (p = 0.027). There were no toxic effects attributable to ipratropium. CONCLUSION: The addition of repeated doses of nebulized ipratropium to frequent high-dose albuterol therapy in patients with acute severe asthma is both safe and more effective than albuterol alone; its use in patients with very severe asthma may reduce hospitalizations.

Acute Disease↗

Brain regional distribution of prion protein PrP27-30 in mice stereotaxically microinjected with different strains of scrapie.

Stereotaxic inoculation was used to examine the role of scrapie agent strain, inoculum, and injection site on the brain regional distribution of the prion protein, PrP27-30. Neither the type of inoculum nor the injection site influenced the distribution of PrP27-30 in brains of mice. Among the parameters examined, only the strain of agent affected the pattern of distribution and the yield of PrP27-30. Although mice injected into the cerebellum had the shortest incubation period, the cerebellum gave the lowest yield of the PrP27-30 among the seven brain regions examined. The positive correlation between PrP27-30 regional distribution and lesion profile (degree of vacuolation) reinforces the role of the PrPSC protein in scrapie pathogenesis.

Animals↗

Quality of life.

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Activities of Daily Living↗