PubMed Health⌕ Search

Biomedical subjects

S Cummings

Publications and source records attributed to S Cummings.

At least 37 records · Page 2Linked to original sources
PubMed1997

Osteoporosis clinical trials endpoints: candidate variables and clinimetric properties.

We reviewed evidence on endpoints used in osteoporosis clinical trials to assist in the development of a set of endpoints to be included in all trials. A MEDLINE search was conducted using the Cochrane Collaboration strategy for each endpoint. Additional published literature was obtained from content experts. A proposed list of endpoints was developed after consultation with experts in the field. Each endpoint was evaluated with respect to validity, reproducibility, redundancy, and feasibility. We classified the endpoints into 2 major categories: clinical health status outcomes and intermediate endpoints, and for each endpoint we present current evidence from the literature as pertains to defined methodologic criteria. Multiple endpoints have been used in osteoporosis clinical trials, and an agreement on a core set of measures needs to be evidence based with an emphasis on validity, reproducibility, and feasibility and to satisfy clinical credibility.

Biomarkers↗
PubMed1996

The politics of advanced practice.

Nurses have a unique opportunity to influence the future. Practice opportunities abound for advanced practice nurses in emerging health delivery models. Practice barriers, external as well as those created by nursing, must be addressed. Politically savvy nurses can use their understanding of power and politics to effect changes that can maximize advanced practice nurses' contributions to the health of our society.

Delivery of Health Care↗
PubMed1995

Prevalence of smoking among adult American Indian clinic users in northern California.

BACKGROUND: The American Indian Cancer Control Project is a 5-year program funded by the National Cancer Institute designed to promote smoking cessation among adult Indians living in Northern California. This article describes the result of our smoking prevalence survey. Our Indian-specific program combines the physician's anti-smoking message with the efforts of Indian Community Health Representatives, who have access to the Indian patients' families and communities. The study sites consist of 4 urban and 14 rural American Indian clinics in Northern California. This article reports on the results of the smoking prevalence study conducted in the first phase of the project. METHODS: A total of 1,369 adult Northern California Indian patients at 18 Indian health clinics completed a questionnaire designed to assess smoking rates and patterns as well as health problems. Participants were adult American Indians attending 1 of 18 Indian health care clinics in Northern California during 1991. The participants included patients waiting for appointments with the clinic physician, dentist, and nurses. RESULTS: Forty percent (37.35, 42.64; 95% confidence interval) of the adult population in the sample smoke cigarettes; they hold lenient attitudes toward smoking and began smoking at an early age. These patients rate obesity as the No. 1 health problem, followed by high blood pressure, arthritis/rheumatism, and problems with alcohol. The survey also found that the highest smoking rate was among the Sioux (62%), a non-California tribe. This was followed by high rates among native California tribes: Maidu (46%), Pit River (39%), Pomo (38%), Hupa (37%), and Yurok (32%).

Adult↗
PubMed1995

Speech production changes with the Nucleus 22-channel cochlear implant.

The speech production changes of a postlingually deaf child and adult with a multichannel cochlear implant were spectrographically analyzed over a period of time. The segmental analysis in both case studies included the measurement of vowel, fricative, and plosive burst duration; first and second vowel formant frequency relationship; and centroid frequencies of fricatives and plosive bursts. The suprasegmental analysis in the second case study (adult) investigated sentence duration, pitch variation, and word stress. Results of both case studies indicated an overall improvement in the accuracy of consonant and vowel productions following the multichannel cochlear implant, in terms of duration, centroid frequencies, and vowel formant frequency relationships. The suprasegmental analysis indicated an overall improvement with the use of the cochlear implant over time. These positive changes in speech production may be indicative of the improved auditory feedback information provided by the cochlear implant.

Adult↗
PubMed1995

A randomized, controlled trial of the influence of prenatal parenting education on postpartum anxiety and marital adjustment.

OBJECTIVE: The aim of this study was to measure the impact of two middle-trimester parenting communication classes on postpartum anxiety, marital adjustment, and postpartum adjustment. METHODS: Seventy primiparous, low-risk couples enrolled in prenatal classes in a large urban hospital were randomized to experimental and control groups. An educational intervention consisting of two second-trimester classes was facilitated by two social workers. The classes were based on a previous assessment of the educational needs of postpartum couples and contained didactic sessions, role-playing sessions, and values clarification exercises. The Spielberger State-Trait Anxiety Inventory and the Dyadic Adjustment Scale were administered to both groups prenatally in the second trimester and at 6 weeks and 6 months postpartum. A modified version of the O'Hara Postpartum Adjustment Questionnaire was administered at 6 weeks and 6 months postpartum. RESULTS: Both groups scored comparably in the prenatal period. The experimental group scored significantly lower on anxiety and higher on dyadic adjustment at both postpartum time periods than the control group. The experimental group also indicated a higher degree of postpartum adjustment. CONCLUSION: Prenatal parenting communication classes had a significant impact on postpartum anxiety, postpartum marital satisfaction, and postpartum adjustment.

Anxiety↗
PubMed1994

Corticotropin-releasing factor mRNA increases in the inferior olivary complex during harmaline-induced tremor.

This study reports that corticotropin-releasing factor (CRF) expression within the inferior olivary complex (IOC) of the cat is increased 8 h after administration of the tremor-inducing beta-carboline harmaline. Following harmaline treatment, hybridization of an oligodeoxynucleotide complementary to CRF mRNA increased significantly in the dorsal accessory olive, subnuclei A and C of the medial accessory olive and the dorsal cap of Kooy, a subnucleus thought previously to be unresponsive physiologically to harmaline. At this early time point, greater increases in CRF mRNA hybridization were present in the caudal than the rostral IOC. These results support published reports that harmaline-mediated effects are more profound within the caudal than the rostral IOC, but also suggest that harmaline mediates cellular responses in inferior olivary neurons which are not related to activation of rhythmic firing.

Animals↗
PubMed1994

Comparison of finasteride (Proscar) and Serenoa repens (Permixon) in the inhibition of 5-alpha reductase in healthy male volunteers.

A total of 32 healthy male volunteers (age range 20-30 years) were enrolled in a 1-week open, randomized, placebo-controlled study comparing finasteride (Proscar), a 5 alpha-reductase inhibitor, with Permixon, the plant extract of Serenoa repens. The objective of the study was to evaluate the effect of single and multiple doses of the drugs on the inhibition of 5 alpha-reductase as assessed by serum dihydrotestosterone level determination. Following baseline measurements on day 1, the subjects were randomized to finasteride 5 mg once a day (n = 10), Permixon 80 mg x 2 twice a day (n = 11), or to placebo once a day (n = 11) for 7 days. Serum testosterone and dihydrotestosterone levels, were determined on day 1 (baseline and 12 h) and on days 2 (24 h), 3 (48 h), 4 (72 h), 6 (120 h), and 8 (168 h). After 12 h, a single dose of finasteride 5 mg reduced the serum dihydrotestosterone level by 65% (p < or = 0.01). The decreases ranged from -52 to -60% with multiple doses of finasteride 5 mg once a day (p < or = 0.01). As in the placebo group, there was no effect of Permixon on the serum dihydrotestosterone level. No significant difference was detected between finasteride and Permixon or between finasteride and placebo with respect to serum testosterone, except on days 3 and 6, respectively (p < or = 0.05). However, the corresponding serum testosterone levels remained within the normal ranges. These data confirm the efficacy of finasteride as inhibitor of 5 alpha-reductase.(ABSTRACT TRUNCATED AT 250 WORDS)

5-alpha Reductase Inhibitors↗
PubMed1994

TRANSEPITHELIAL POTENTIAL AND ALKALIZATION IN AN IN SITU PREPARATION OF TOBACCO HORNWORM (MANDUCA SEXTA) MIDGUT

The midgut of larval lepidopteran insects rapidly raises the pH of the entering food from approximately neutral values to as high as pH 12 in some species (Waterhouse, 1949; Dow, 1984). These values are among the highest achieved by biological systems and are all the more remarkable in view of the high rate of food consumption relative to body mass in lepidopteran larvae. The isolated midgut of lepidopteran larvae secretes K+ at a high rate by an electrogenic mechanism that generates a transepithelial electric potential (TEP) which may initially exceed 100 mV in isolated preparations (Harvey et al. 1968). It has been suggested (Dow, 1984, 1992; Dow and Harvey, 1988) that alkalization is a secondary process driven by the TEP, although Dow (1992) recognized that an almost unrealistically high TEP would be required in vivo to account for measured H+ activity gradients of 3&shy;5 orders of magnitude in freshly dissected animals. Values for the TEP of the midgut in vivo of 'around 150 mV' (Dow and Harvey, 1988) or 'between 100 and 150 mV' have been described as 'accepted' (Dow, 1992). However, to our knowledge, no experiments supporting these values have been published. Alkalization has been studied using isolated tissues, but the pH gradients and rates of alkalization achieved by those preparations have been less impressive than those measured or estimated in vivo. In the work of Dow and O'Donnell (1990), the maximum pH gradient of an isolated, double-perfused preparation was about 2 pH units, a value not inconsistent with Nernstian equilibrium with the transepithelial potentials typical of such preparations. It should be emphasized that these measurements were from small volumes of solution in the microenvironment immediately adjacent to the epithelium. During hypoxic transitions, the pH gradients and transepithelial potential were lost within minutes of imposition of N2-hypoxia and recovered on approximately the same time scale as the recovery of the TEP, suggesting that H+ equilibrated readily across the gut epithelium under hypoxic conditions.

Journal Article↗
PubMed1994

Using mass media communication for health promotion: results from a cancer center effort.

Administrators at a cancer center initiated a program they hoped would reduce exposure to the sun, and therefore the incidence of skin cancer. They also hoped for association of the value of the program with their institution. Research measuring the impact of the program showed that it reached more than one million individuals in three cities, and that awareness of the program was associated with behaviors expected to reduce the risk of skin cancer. In its home city, the program was associated with the sponsoring hospital by 22 percent of those who said they were familiar with it; association in other cities was significantly lower.

Cancer Care Facilities↗
PubMed1994

Primary malignant mesothelioma of the pericardium. Case report and literature review.

Pericardial mesothelioma is a highly lethal and fortunately rare cardiac neoplasm. We present the clinical and pathologic features of a primary sarcomatoid mesothelioma. To better understand the clinical, radiographic, and pathologic features of this entity, we reviewed 27 cases described in the English literature from 1972 through 1992, which, together with our case, provided a total of 28 cases. Findings of the review include a male-female ratio of 2:1, a wide age range (12 to 77 years; mean, 47 years), and documented asbestos exposure in 4 of 28 (14%) patients. Commonly used imaging studies do not appear to offer great sensitivity, for a mass was detected by echocardiography in only 2 of 16 (12%) patients and by computed tomography in 4 of 9 (44%). Pathologic findings revealed a diffuse growth pattern in most cases (18 of 25, or 72%), together with an equal distribution between the biphasic, epithelioid, and sarcomatoid variants. Effusion cytology revealed malignant cells in only 2 of 10 (20%) cases. With or without therapy, prognosis was uniformly poor, since 24 of 27 patients were dead of the disease at the time the reports were published.

Adult↗
PubMed1994

Speech production changes with the use of a multichannel cochlear implant in a postlingually hearing impaired adult.

Profoundly deaf cochlear implant users provide an interesting population in which to assess the role of distorted auditory feedback in speech, since their electrically stimulated hearing is significantly different from normal hearing. The aim of the study was to evaluate, by means of spectrographic and listener analyses, the speech production changes in a postlingually deafened adult with the use of a multichannel cochlear implant over time, compared to that of hearing aids as well as no-amplification. The results indicated significant improvements in the use of suprasegmental speech features as well in the production of specific segmental features of speech.

Adult↗
PubMed1993

Reproductive correlates of bone mass in elderly women. Study of Osteoporotic Fractures Research Group.

Results from previous studies of reproductive factors and bone density have been conflicting; some demonstrate a beneficial effect, but others show a detrimental effect on bone density. The present study investigates the association of parity, lactation, and menstruation with radial bone density in 2230 white women, 65 years of age and older. Bone density was assessed by single-photon absorptiometry. Linear multiple regression was utilized to determine if reproductive factors were associated with radial bone density. The number of births, duration of menstrual bleeding, age at menarche, and years menstruating were significant independent predictors of postmenopausal bone density of the radius. A 1.4% increase in distal radius bone density was observed with each additional birth. Women who began menstruation at age 9 had 6.3% higher bone density than women who began at age 16. Women who menstruated for 3 days during each menstrual cycle had 2.8% less distal radius bone density than women who bled for 7 days. Each decade of menstruation was associated with a 2% greater distal radius bone density. No difference in bone density was demonstrated for women who breast-fed and women who did not. Length of the menstrual cycle, amount of menstrual flow, and irregularity of the menstrual cycle were not significantly associated with radial bone mineral density. In conclusion, pregnancy and menstruation are associated with postmenopausal bone density of the radius.

Abortion, Induced↗
PubMed1991

1,25-Dihydroxyvitamin D3 and muscle strength in the elderly: a randomized controlled trial.

An unexplained loss of muscle strength occurs with aging. Vitamin D deficiency can cause myopathy and administration of 1,25-dihydroxyvitamin D3 [1,25-(OH2)D3] to persons with low serum concentrations can improve strength. To test the hypothesis that the weakness associated with aging is in part due to inadequate serum concentrations of [1,25-(OH2)D3], we conducted a randomized, controlled, double blinded trial in 98 men and women volunteers over 69 yr old. Treatment consisted of 0.25 micrograms 1,25-(OH)2D3, orally, twice per day or identical placebo for 6 months. Leg muscle strength of the quadriceps was measured with an isokinetic dynamometer. There was no difference between the two groups at 1 week, 1 month, or 6 months of treatment in any of the measures of muscle strength. We conclude that oral administration of 0.5 micrograms 1,25-(OH)2D3/day does not improve muscle strength in older persons. Further research is needed to determine the etiology of the decline in muscle strength associated with aging.

Aged↗