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Biomedical subjects

S Hendrix

Publications and source records attributed to S Hendrix.

11 recordsLinked to original sources
PubMed1999

Oral administration of interferon-alpha induces a transient decline in oral mucosal immunoglobulins and an increase in interleukin-5.

Although administration of interferon-alpha (IFN-alpha) via the oral-mucosal route has shown efficacy in a variety of human and animal diseases, the mechanism of action of orally administered IFN is not clearly understood. To assess the possibility that IFN-alpha given via a lozenge alters the local mucosal immune system, immunoglobulins (Ig) and cytokines were measured in salivary secretions. Volunteers were given low doses of IFN-alpha and saliva was collected over a 24-h period. IgA and precursor IgM were measured by sandwich enzyme-linked immunosorbent assay (ELISA). Salivary concentrations of interleukin-5 (IL-5), the T helper cytokine primarily responsible for the switch from IgM to IgA, were also determined. After oral administration of IFN-alpha, there was an initial decline in IgM and IgA followed by a return to baseline levels by 8-24 h. This change in Ig concentration was associated with a gradual increase in IL-5, consistent with the return of Ig to baseline as a result of modulation by Ig-mediating cytokines.

Administration, Oral↗
PubMed1999

Firearm presence in households of patients with Alzheimer's disease and related dementias.

OBJECTIVE: Attention has recently been drawn to the potential dangers of firearm use among patients with dementia. However, little is known about the actual prevalence of firearms in households with demented family members. This study seeks to determine the prevalence and loaded status of firearms in households with a demented family member in a sample of outpatients at a University memory disorders clinic. DESIGN: Utilizing a cross-sectional design, subjects underwent a structured NINCDS-ADRDA criteria comprehensive evaluation to assess dementia and were also administered a questionnaire to assess level of mood disturbance. Family members were administered a behavioral checklist and surveyed about the number and loaded status of firearms in the patient's household. SETTING: The study took place in an outpatient Medical University memory disorders clinic in the Southern United States. PATIENTS: Subjects were 106 consecutive outpatients referred for symptoms suggestive of dementia. MAIN OUTCOME MEASURES: Firearm presence was coded as "present," "not present," and "unsure." In cases where firearms were present, the number and loaded status were collected. Other outcome measures included the Clinical Dementia Rating of each patient, the Yesavage Mood Inventory, and the Revised Memory and Behavior Problems Checklist. RESULTS: A high prevalence of firearm prevalence in households with demented family members was revealed (60.4%). Gun ownership was equally prevalent in households regardless of the severity of the dementia (chi-square, P = .426), severity of behavioral disturbance (ANOVA P = .88), or depressive symptoms (ANOVA P = .37). In households with firearms, 44.6% of the families reported that the guns were kept loaded; 38% reported that they did not know whether the guns were loaded. Only 16.9% of the families reported that guns were maintained in an unloaded state. CONCLUSIONS: This study suggests that many family members living in households in which there are demented patients do not take appropriate action to remove or unload firearms in their households, regardless of the severity of dementia, behavioral disturbance, or depression. These findings suggest that clinicians need to ask families specifically about the presence of firearms and advocate for their removal.

Alzheimer Disease↗
PubMed1998

Life review: preventing despair in newly relocated nursing home residents short- and long-term effects.

Relocation to a nursing home places frail elders at risk for developing depression and suicide ideation. This study followed two hundred and fifty-six newly relocated nursing home residents for five years. Using a Solomon Four research design, participants were divided into four groups, two control and two experimental, one each with pretesting and all with posttesting. Participants in the control groups received a friendly visit and those in the experimental groups received the intervention of life review. Immediate short-term results showed the life review to be an effective preventive intervention for clinical depression (p = .05). Additionally, when looking at long-term effects at one year, there were significant decrease in depression (p = .05), hopelessness (p = .01), and psychological well-being (p = .02) with measurable increases in life satisfaction (p = .08). These findings support the hypothesis that life review prevents despair in frail elders newly admitted to a nursing home.

Adaptation, Psychological↗
PubMed1996

The quality of cervical cancer screening: a primary care perspective.

The bulk of cervical cancer screening is performed by primary care providers; mostly nurses and physicians. The literature regarding the quality of this screening is largely described from three perspectives; clinical, laboratory, and public health. This article describes the primary care perspective regarding issues of quality in cervical cancer screening and suggests areas for improvement. The authors discuss how effectiveness of the test, sampling methods, interpretation by the laboratory, and reporting results impact on the quality of cervical cancer screening. Other factors which influence the quality of screening such as access to care, recall intervals, communication with the patient, costs of testing, and organizational issues are also reviewed.

Communication↗
PubMed1994

Cervical smears.

Explore the source record for details and available documents.

Family Practice↗
PubMed1981

Factitious Hymenoptera allergic emergency: a report of a new variant of Munchausen's syndrome.

We report of the case of a young woman with three hospitalizations and six emergency room visits for treatment of bronchospasm and angioedema first thought to be the result of Hymenoptera venom allergic reactions. Because several features of her illness were not consistent with the usual course of Hymenoptera anaphylaxis and because of a known history of anaphylactic-type reactions following aspirin ingestion, a presumptive diagnosis of factitious anaphylaxis was considered, the medical staff was alerted to evaluate this possibility, and the diagnosis was established. Serologic testing supported the diagnosis. This variant of Munchausen's syndrome is a third type described as an allergic emergency. The others are peanut anaphylaxis and self-induced laryngeal stridor.

Adult↗
PubMed1980

Polymerized insoluble bee venom.

Using a polymerization process previously used for ragweed allergens, honeybee venom was polymerized. Instead of soluble polymers, an insoluble precipitate, polymerized insoluble bee venom (PIBV), is the result. A major allergen of honeybee venom, 125I phospholipase A (PL-A) incorporated into PIBV, was shown to have decreased dissemination from subcutaneous injection sites. After thorough mixing, samples of PIBV can be withdrawn from a vial with a syringe with no more than 10% error. Approximately 90% of PL-A was incorporated with PIBV. The soluble PL-A was removed during subsequent washing of the PIBV and this soluble PL-A was shown to be polymerized mainly to high-molecular weight PL-AS. PIBV (20 mg) injected in each of six rabbits resulted in formation of precipitating antibody in all rabbits. The rabbit antisera bound 125I PL-A and reacted with PL-A in whole been venom. These physical and immunologic characteristics of PIBV suggest further study of its potential for human use.

Absorption↗
PubMedDate not supplied

Characteristics and quality of Papanicolaou smears obtained by primary care clinicians using a single commercial laboratory.

BACKGROUND: Few data are available on factors associated with the quality of Papanicolaou smears performed in primary care. OBJECTIVE: To identify the patterns and proficiency of cervical cancer screening among different primary care specialties. MATERIALS AND METHODS: Clinical and cytologic data from 21,833 Papanicolaou smears, submitted to a single large commercial laboratory by 176 clinicians during a 7-month period, were correlated with individual clinician and specialty characteristics according to indexes of specimen quality. RESULTS: Obstetrician-gynecologists, nurse practitioners, and physician assistants provided screening to a younger population of women compared with family physicians, internists, and general practitioners. Factors positively associated with a greater probability of a "satisfactory" smear or the presence of endocervical cells (as a marker of adequate sampling) were increasing patient age, use of the cytobrush, and the specialty of the obstetrician-gynecologist. Satisfactory smears were not associated with any increased identification of cytologic abnormalities compared with "limited" smears. In contrast, smears with endocervical cells showed a higher proportion of abnormalities compared with specimens without such cells. CONCLUSIONS: Differences in the performance of obtaining Papanicolaou smears exist between primary care specialties, but need further clarification. The use of the cytobrush and the presence of endocervical cells are criteria that reflect clinician proficiency more realistically than the laboratory criterion of satisfactory smear.

Age Factors↗
PubMedDate not supplied

Perceptions and opinions on the performance of Pap smears: a survey of clinicians using a commercial laboratory.

Office-based clinicians play a major role in cervical cancer screening in the United States, but little is known about their specific knowledge and understanding of the technical aspects of obtaining an adequate Pap smear. We surveyed 186 office-based clinicians using a major commercial laboratory for cytology services to obtain their opinions regarding the technical adequacy of Pap smears, collection procedures, and methods of communicating test results to patients. There was an 80.1% response rate. Two thirds of the respondents were men. Cytobrush use was reported significantly more by female clinicians. Respondents varied in reported rotation of the cytobrush, from 90 degrees to greater than 360 degrees. More female than male clinicians appropriately indicated that inflammation and heavy vaginal discharge caused sampling difficulties. Approximately half of the respondents believed that errors in cervical screening most often resulted from sampling the cervix or preparation of the Pap smear. Nineteen percent reported that ectocervical cells were not necessary for an adequate smear to be reported. Just over 25% of respondents indicated they did not report normal Pap smear results to the patient. The results indicate differences between clinicians by gender and specialty in reported knowledge, understanding, and technique in cervical cancer screening. The differences suggest that targeted education in this population may be important to improve the quality of cervical cancer screening. Medical Subject Headings (MeSH): screening; neoplasms, cervical; Papanicolaou smear; diagnosis, laboratory.

Adult↗
PubMedDate not supplied

Recall and treatment decisions of primary care providers in response to Pap smear reports.

INTRODUCTION: Although the frequency of cervical cancer screening has been extensively studied, little is known about how clinicians decide to screen or recall patients for Pap smears. This study reports the management decisions made by office-based clinicians for 10 different Pap smear reports describing adequacy limitations and cytological diagnoses. METHODS: We surveyed 186 clinicians using a commercial laboratory in the southeastern United States and analyzed results by frequency and comparison statistics. RESULTS: Our respondents were 148 clinicians (79.6% response rate) from different specialties. There was variation in reported management of inflammation, atypia, and low-grade abnormalities (LGSIL), in regard to recall for repeat or routine testing as well as arranging colposcopy. In only 3 of 10 Pap smear results did more than 50% of respondents agree on a specific test recall interval. CONCLUSIONS: The variation in responses from office-based clinicians suggests either uncertainty or different opinions in making recall and treatment decisions for smears of limited quality even when associated with cytologic abnormalities. These differences may have relevance to outcomes, clinician workload, and costs of care in cervical cancer screening.

Adult↗