Biomedical subjects

S Frederick

Publications and source records attributed to S Frederick.

9 recordsLinked to original sources

PubMed2000

Exercise-induced neurocardiogenic syncope: clinical data, pathophysiological aspects, and potential role of tilt table testing.

The evaluation of syncope occurring during exercise or occurring spontaneously in highly trained individuals presents a unique diagnostic challenge. It is of critical importance to exclude potential life-threatening disorders such as hypertrophic cardiomyopathy, long QT syndrome, right ventricular dysplasia, anomalous coronary artery distribution, valvular heart disease, myocarditis, or exercise-induced arrhythmia. This review is not directed towards identifying, treating, or determining athletic eligibility of individuals with such disorders. Rather, we endeavour to discuss the pathophysiology of exercise-induced neurocardiogenic syncope and to address the role of head upright tilt testing in evaluating syncope in athletic individuals in whom proper evaluation has excluded the presence of ischaemic heart disease or primary structural or electrical heart disease.

Electrocardiography↗

PubMed1998

Nortriptyline and cognitive-behavioral therapy in the treatment of cigarette smoking.

BACKGROUND: A history of major depressive disorder (MDD) predicts failure to quit smoking. We determined the effect of nortriptyline hydrochloride and cognitive-behavioral therapy on smoking treatment outcome in smokers with a history of MDD. The study also addressed the effects of diagnosis and treatment condition on dysphoria after quitting smoking and the effects of dysphoria on abstinence. METHODS: This was a 2 (nortriptyline vs placebo) x 2 (cognitive-behavioral therapy vs control) x 2 (history of MDD vs no history) randomized trial. The participants were 199 cigarette smokers. The outcome measures were biologically verified abstinence from cigarettes at weeks 12, 24, 38, and 64. Mood, withdrawal, and depression were measured at 3, 5, and 8 days after the smoking quit date. RESULTS: Nortriptyline produced higher abstinence rates than placebo, independent of depression history. Cognitive-behavioral therapy was more effective for participants with a history of depression. Nortriptyline alleviated a negative affect occurring after smoking cessation. Increases in the level of negative affect from baseline to 3 days after the smoking quit date predicted abstinence at later assessments for MDD history-negative smokers. There was also a sex-by-depression history interaction; MDD history-positive women were less likely to be abstinent than MDD history-negative women, but depression history did not predict abstinence for men. CONCLUSIONS: Nortriptyline is a promising adjunct for smoking cessation. Smokers with a history of depression are aided by more intensive psychosocial treatments. Mood and diagnosis interact to predict relapse. Increases in negative affect after quitting smoking are attenuated by nortriptyline.

Adult↗

PubMed1997

Antiglucocorticoid treatments in psychiatry.

A confluence of evidence indicates that alterations in hypothalamic-pituitary-adrenal regulation can have profound effects on the symptom picture of psychiatric illnesses and that therapeutic interventions directly targeted at corticosteroid metabolism may have clinical benefit. This paper reviews the varying lines of inference that support such a hypothesis and reviews work by our group and others utilizing the cortisol synthesis inhibitor, ketoconazole and, more recently, dehydroepiandrosterone (DHEA), as potential novel mood-altering agents. The data thus far suggest that antiglucocorticoid drug treatment may be useful in certain subgroups of depressed patients and may offer a theoretical rationale for alternative drug design.

Dehydroepiandrosterone↗

PubMed1994

The need for health care reform in Nebraska.

This paper has identified some of the major health care problems in Nebraska. Although Nebraska does not face as many serious challenges as some other states, there is clearly a need for reform. For example, the health of our population is generally good, but many serious gaps exist, particularly for minority population groups. Per capita health care costs in Nebraska are only slightly below the national average, and out-of pocket costs for the average Nebraska family rank among the highest in the nation. In addition, Medicaid costs are exploding and create serious challenges to balancing the state's budget. Nearly 140,000 Nebraskans lack health insurance coverage and at least 90,000 others are underinsured. Many insurance policies limit or deny coverage to individuals with pre-existing medical conditions, deny coverage to individuals employed in certain occupations, and limit coverage for preventive services. "Cost shifting" continues to become more widespread, which significantly increases the number of small businesses that drop or reduce health insurance coverage for their employees. Finally, rural areas face some unique challenges related to their ability and capacity to provide services. There is a serious shortage of primary care physicians, mid-level practitioners, and many other allied health professionals. As a result, individuals, including a large elderly population, must travel long distances to obtain care. Many rural hospitals are under severe financial stress and some will close during the next five years. There appears to be an adequate supply of nursing home beds in rural areas, but many communities lack adequate in-home services.

Female↗

PubMed1991

The perioral muscular phenomenon: Part I.

More than twenty-five years of studying the perioral musculature, clinical observation of the dental and peridental tissues of hundreds of patients, and examining seven anatomy books--have revealed that there is a serious deficiency in our knowledge of this musculature and its effects on the dental tissues and this part of the face. Believed to be of no unusual significance, it has been almost ignored through the years. One hears vague terms such as lip pressure and cheek pressure; but no comprehensive studies of this musculature, how it functions and the effects of these functions are to be found in literature. By its actions, this musculature effects many phases of dentistry, directly or indirectly; and orthodontics is affected most of all. By its manipulations of the dental tissues, the alveolar bone and gingiva, it ultimately determines the position of the teeth. Almost every person is a live laboratory specimen in which pressure signs or damage to the tissues can be observed. By reading these signs, the strength and physical configuration of the pertinent parts of the musculature can be determined. This ability to 'read the signs' should be actively developed to fine tune the diagnosis. The perioral musculature phenomenon is a significant aetiological factor in many malocclusions.

Alveolar Process↗

PubMed1991

The perioral muscular phenomenon: Part II.

Over twenty-five years of studying the perioral musculature, clinical observation of the dental and peridental tissues of hundreds of patients, and examining seven anatomy books--have revealed that there is a serious deficiency in our knowledge of this musculature and its effects on the dental tissues and this part of the face. Believed to be of no unusual significance, it has been almost ignored through the years. One hears vague terms such as lip pressure and cheek pressure; but no comprehensive studies of this musculature, how it functions and the effects of these functions are to be found in literature. By its actions, this musculature effects many phases of dentistry, directly or indirectly; and orthodontics is affected most of all. By its manipulations of the dental tissues, the alveolar bone and gingiva, it ultimately determines the position of the teeth. Almost every person exhibits pressure signs or damage to the tissues. The only exceptions are babies. By reading these signs, the strength and physical configuration of the pertinent parts of the musculature can be determined. This ability to 'read the signs' should be developed since it helps fine tune the diagnostic process. Only by this means may the correct surgical procedures be carried out. A representative sample from over 1200 cases treated in this manner in more than twenty years will be shown.

Adolescent↗

PubMed1991

An introduction to research: a primer for the nurse anesthetist.

The goals of this article are to provide an overview of the research process and highlight some of the most important aspects. In the process, the definition of research and some general terminology will be reviewed. Discussions of how to define a problem, reviewing the literature, types of study designs, sampling, types of measurement, reliability and validity, limitations and assumptions, data analysis, ethical concerns with human subjects, and time management are included, as are examples of published research.

Data Collection↗

PubMed1990

A controlled trial of ivermectin and diethylcarbamazine in lymphatic filariasis.

Ivermectin is a new antifilarial drug that can be given in a single oral dose. To compare the efficacy and side effects of ivermectin with those of diethylcarbamazine, the standard antifilarial treatment, we conducted a randomized, double-blind trial in 40 South Indian men with lymphatic filariasis caused by Wuchereria bancrofti. Patients were randomly assigned to one of three treatments: a single low dose of ivermectin (mean [+/- SE], 21.3 +/- 0.7 micrograms per kilogram of body weight; n = 13) followed by placebo for 12 days; a single high dose of ivermectin (mean, 126.2 +/- 3.7 micrograms per kilogram; n = 13) followed by placebo for 12 days; or diethylcarbamazine for 13 days (6 mg per kilogram per day for 12 days preceded by 3 mg per kilogram for 1 day; n = 14). Eleven patients were initially assigned to receive placebo and after five days were reassigned to one of the three treatment groups. At day 12 there was complete clearance of microfilariae from the blood in all 26 men who took ivermectin and in 11 of the 14 men who took diethylcarbamazine. At six months the numbers of detectable microfilariae (as a percentage of the pretreatment values) were 18.3 percent after low-dose ivermectin and 19.5 percent after high-dose ivermectin, as compared with 6.0 percent after diethylcarbamazine (P less than 0.05). The side effects were confined to the first five days and were similar in the three treatment groups. We conclude that in lymphatic filariasis, the clinical response to a single dose of ivermectin compares favorably with that after the standard 12-day course of diethylcarbamazine. Given the practical advantages of single-dose administration, ivermectin should become a useful medication for the control of bancroftian filariasis.

Adult↗

PubMed1990

A beginner's guide to research.

The purpose of this article is to provide an overview of the research process and highlight some of the most important aspects. The definition of research and some general terminology are reviewed. Included in this article are discussions of the following: defining a problem, reviewing the literature, types of study designs, sampling, types of measurement, reliability and validity, limitations and assumptions, data analysis, ethical concerns with human subjects, and time management. Examples of published research are used to illustrate the points where necessary. A supplemental bibliography is provided to direct the interested reader to more in-depth discussions of the various aspects of the research process.

Data Interpretation, Statistical↗