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Biomedical subjects

S Lemon

Publications and source records attributed to S Lemon.

At least 19 recordsLinked to original sources
PubMed2001

The silent consumer: women's reports and ratings of abortion services.

BACKGROUND: Abortion is one of the most common surgical procedures performed on women in the United States, and its safety has been demonstrated. Little research has focused, however, on women's reports and ratings of the service. OBJECTIVES: This study explored the association of demographic factors, medical outcomes, and client ratings of service dimensions with global satisfaction. RESEARCH DESIGN: For this cross-sectional study, permission to access clinic medical records was obtained. Surveys were distributed after the procedure, with instructions to return by mail. SUBJECTS: Study subjects were 797 women who underwent an outpatient surgical abortion at 1 of 2 New England health centers in 1996 and 1997. MEASURES: Demographic data, pregnancy history, and information on the procedure were collected from medical records. Survey items measured reports of access, medical outcomes, and satisfaction ratings with service domains. RESULTS: Women with positive ratings of staff sensitivity and of the counseling process and information received and those who had the procedure at a younger gestational age were less likely to report that care could be better. Although very few women reported a medical complication, this was associated with agreement that care could have been better, as was reporting agreement that the wait between the preexamination visit and the procedure was too long. CONCLUSIONS: Satisfaction with abortion services is high. Education and counseling play very important roles. Survey items could routinely be used to monitor services.

Abortion, Induced↗
PubMed2001

Colorectal cancer screening participation: comparisons with mammography and prostate-specific antigen screening.

OBJECTIVES: The relation of personal characteristics, health and lifestyle behaviors, and cancer screening practices to current colorectal cancer (CRC) screening was assessed and compared with those factors' relation to current mammography screening in women and prostate-specific antigen (PSA) screening in men. METHODS: A cross-sectional random-digit-dialed telephone survey of 954 Massachusetts residents aged 50 and older was conducted. RESULTS: The overall prevalence of current CRC screening was 55.3%. Logistic regression results indicated that family history of CRC (odds ratio [OR] = 1.98; 95% confidence interval [CI] = 1.02, 3.86), receiving a regular medical checkup (OR = 3.07; 95% CI = 2.00, 4.71), current screening by mammography in women and PSA in men (OR = 4.40; 95% CI = 2.94, 6.58), and vitamin supplement use (OR = 1.87; 95% CI = 1.27, 2.77) were significant predictors of CRC screening. CONCLUSIONS: Health and lifestyle behaviors were related to increased current CRC, mammography, and PSA screening. Personal factors independently related to CRC screening were not consistent with those related to mammography and PSA screening. This lack of consistency may reflect different stages of adoption of each type of screening by clinicians and the public.

Aged↗
PubMed1998

Colorectal carcinoma survival among hereditary nonpolyposis colorectal carcinoma family members.

BACKGROUND: Patients with hereditary nonpolyposis colorectal carcinoma (HNPCC) reportedly have better prognoses than sporadic colorectal carcinoma (CRC) patients, but it has been unclear whether this could be due to differences in stage at diagnosis. The current study compared stage and survival in a retrospective cohort of HNPCC family members who developed CRC with the same factors in an unselected hospital series of patients with sporadic CRC. METHODS: This retrospective cohort study compared HNPCC cases (274 cases from 98 HNPCC families) with an unselected hospital series comprising 820 consecutive CRC cases. All patients were staged according to the TNM system of the American Joint Committee on Cancer and the International Union Against Cancer. Median follow-up among living patients was > 10 years and 8.5 years, respectively, for the two cohorts. Cox regression was used to compare survival in stage-stratified analyses of time from diagnosis to death. RESULTS: Compared with the unselected series, the HNPCC cases had lower stage disease (P < 0.001), and fewer had distant metastases at diagnosis (P < 0.001 in an analysis stratified by T classification). In stage-stratified survival analysis, the HNPCC cases had a significant overall survival advantage regardless of adjustment for their younger age. A conservative estimate of the hazard ratio (of HNPCC cases to the unselected series) was 0.67 (P < 0.0012). CONCLUSIONS: HNPCC patients had lower stage disease at diagnosis than the unselected CRC cases, mainly due to rarer distant metastases at diagnosis. They survived longer than unselected CRC patients with tumors of the same stage. The estimated death rate for the HNPCC cases, adjusted for stage and age differences, was at most two-thirds of the rate for the hospital series.

Adult↗
PubMed1997

Analysis of Ki-ras, p53, and MDM2 genes in uterine leiomyomas and leiomyosarcomas.

Uterine sarcomas are unusual neoplasms of the female genital tract whose molecular etiology is largely unknown. We examined 20 leiomyomas as well as 23 uterine leiomyosarcomas for the presence of mutations in the Ki-ras and p53 genes, and overexpression of the MDM2 gene. Codons 12, 13, and 61 from the Ki-ras gene were characterized for the presence of mutations by restriction enzyme polymorphisms using mismatched primers and nucleic acid sequencing as appropriate. Activated Ki-ras genes were identified in 3/20 leiomyomas and 0/23 leiomyosarcomas. The p53 gene was analyzed by SSCP, nucleic acid sequencing, and immunohistochemical staining. None of 20 leiomyomas and 6/23 leiomyosarcomas exhibited p53 abnormalities. The SSCP/sequencing results did not consistently correlate with the IHC staining. MDM2 overexpression occurred in 0/20 leiomyomas and 3/23 sarcomas. Clinical correlation suggested that tumors with p53 mutations have a higher histologic grade or stage at presentation. We conclude that leiomyomas and leiomyosarcomas have different patterns of molecular alterations and are separate biologic entities. In addition, p53 and MDM2 overexpression may play a role in the development of a subset of leiomyosarcomas.

DNA, Neoplasm↗
PubMed1996

Viral safety of a new highly purified factor VIII (OCTATE).

The inactivation of both transfusion-relevant and model viruses by modified pasteurisation (10 hours at 63 degrees C in solution) has been evaluated following the established guidelines of the EU CPMP Ad Hoc Working Party on Biotechnology/Pharmacy. This heat treatment was introduced into the manufacturing process of OCTAVI, a very high purity factor VIII concentrate stabilized only by von Willebrand factor, in the presence of a proprietary mixture of low molecular weight stabilizers. Both enveloped (human immunodeficiency virus, Sindbis virus, herpes simplex virus, pseudorabies virus) and nonenveloped viruses (poliovirus, Coxsackievirus, hepatitis A virus) were inactivated by this heating step by more than 4.7 log10. The combination of the solvent/detergent step used in the manufacture of OCTAVI with this modified pasteurization leads to a double virus-inactivated factor VIII concentrate (OCTATE) with a viral safety distinctly superior to monoinactivated products.

Animals↗
PubMed1996

Regulatory considerations for new stabilised poliovaccines.

As the least heat stable vaccine used by national immunization programmes, oral poliovaccine (OPV) is a target for improved stability. Dilution of OPV trivalent bulk vaccines meeting all international requirements in 87% deuterium oxide results in a significant stability increase of up to 1000-fold after incubation for one week at 45 degrees C. Regulatory considerations for a new formulation focus generally on the safety, potency and efficacy of the individual components (OPV and deuterium oxide) and ruling out any untoward and unexpected interactions between them. As the characteristics of OPV and deuterium oxide are well established, preclinical and clinica, data should address potential interactions. Because this stabilised vaccine is under development by two European manufacturers, initial regulatory discussions are being conducted with the European Medicines Evaluation Agency and its Committee on Proprietary Medicinal Products.

Child, Preschool↗
PubMed1996

Genetic counseling in hereditary nonpolyposis colorectal cancer: an extended family with MSH2 mutation.

OBJECTIVES: Molecular genetic advances have increased the demand for DNA testing. We describe DNA based genetic counseling in a hereditary nonpolyposis colorectal cancer (HNPCC) family. METHODS: This extended HNPCC family was found to harbor the MSH2 germline mutation. Family history, medical, and pathology documents enabled us to secure a high degree of verification that the kindred qualified as HNPCC. DNA testing revealed the MSH2 germline mutation that was verified independently in two laboratories. Genetic counseling was provided before DNA testing and disclosure of MSH2 findings. RESULTS: Genetic counseling revealed a variety of findings characterized by emotional stress in MSH2 germline mutation carriers. Concerns centered around reproductive issues, potential transmission of the deleterious gene to their progeny, and discrimination by insurance carriers and employers. More than one-half of the patients found to harbor the MSH2 mutation considered the option of prophylactic subtotal colectomy. CONCLUSION: DNA testing should be restricted to well-verified candidate families in which genetic counseling should be mandatory. HNPCC family members sought genetic risk assessment for their own health and that of their children. Contrasting emotional responses took place when told of their gene testing status and this required a sensitive empathetic listening ear. Patients have many concerns about their lifetime cancer destiny when told that they harbor the culprit MSH2 germline mutation.

Adult↗
PubMed1995

Almost the entire 5' non-translated region of hepatitis C virus is required for cap-independent translation.

To investigate which hairpin structures within the 5' untranslated region of hepatitis C virus (HCV) are necessary for cap-independent translation, mutants were constructed that lack one or more hairpin structures. Here we demonstrate, by constructing precisely defined hairpin deletion mutants, that with the exception of the most 5' located hairpin structure, which on deletion shows an increase on translation, each of the predicted hairpins is found to be essential for cap-independent translation. In addition, we demonstrate that HCV 5'UTR driven translation is stimulated by poliovirus 2Apro co-expression.

Animals↗
PubMed1995

Virus validation experiments on the production process of OCTAVI SDPlus.

The inactivation of both transfusion-relevant and model viruses by modified pasteurization has been evaluated following the established guidelines of the European Union Committee for Proprietary Medical Products Ad Hoc Working Party on Biotechnology/Pharmacy. This heat treatment in solution for 10 h at 63 degrees C was introduced into the manufacturing process of OCTAVI, a very high purity factor VIII concentrate stabilized by von Willebrand factor. It could be demonstrated that both enveloped (human immunodeficiency virus, herpes simplex virus, pseudorabies virus) and non-enveloped viruses (poliovirus, coxsackievirus, hepatitis A virus) were inactivated by this heating step with an efficacy of greater than 4.5 log10 TCID50. The combination of the solvent/detergent step already used in the manufacture with this modified pasteurization leads to a double virus-inactivated factor VIII concentrate (OCTAVI SDPlus) with a viral safety distinctly superior to monoinactivated products.

Antiviral Agents↗
PubMed1995

The association between alcohol and breast cancer: popular press coverage of research.

OBJECTIVES: This study was undertaken to examine popular press reports of the association between alcohol and breast cancer. METHODS: Articles from scientific journals and stories from newspapers and magazines published from January 1, 1985, to July 1, 1992, were retrieved from six on-line databases. Lay press stories were analyzed to determine which medical articles were publicized and what information was reported. RESULTS: Fifty-eight scientific articles on the relationship of alcohol and breast cancer were found, and 64 newspaper and 23 magazine stories were retrieved. The press cited 11 studies, 19% of those published during the study period. Three studies were featured in 77% of popular press stories. No scientific review articles were reported. Behavioral recommendations were given to the public in 63% of stories. CONCLUSIONS: The vast majority of scientific studies on alcohol and breast cancer were ignored in press reports. We encourage researchers and the popular press to give the public a broader understanding of public health issues.

Alcohol Drinking↗
PubMed1994

Dexterity testing as a predictor of oral care ability.

OBJECTIVE: To examine a spectrum of elderly people to determine if hand function/dexterity measures can predict oral care ability. DESIGN: A series of dental, hand function, and dexterity measures were assessed by blinded examiners. Plaque scores were used as the criterion standard to assess plaque removal ability. PATIENTS: A convenience sample of 52, predominately male, elderly patients were recruited from the patient population of the Portland Veteran Affairs Medical Center and a community nursing home. Entry into the study required that the patient be able to give consent, be age 65 or older, have a minimum of six contiguous teeth or a minimum of 12 teeth total, be medically stable, have grossly adequate vision, and be able to hear and understand spoken instructions. OUTCOME MEASURES: The primary outcome measure was plaque score, as defined by the Turesky modification of the Quigley-Hein index. This was related to four dexterity tests (Jebsen-Taylor Hand Function test, Nine-hole Peg test, Box and Block test, Toothbrushing Ability test), a grip strength measure, and a cognitive measure (Allen Cognitive Level Test). RESULTS: Oral hygiene was significantly impaired among institutionalized elderly compared with outpatient elderly (P < 0.001), as was dexterity (P < 0.001). All dexterity tests correlated significantly with plaque score (Spearman rho: 0.49-0.77; P < 0.000). Forward stepwise regression analysis identified the Toothbrushing Ability Test (P < 0.0001) and the time spent brushing (P = 0.007) as the most significant predictors of plaque score. CONCLUSIONS: Results suggest oral hygiene ability is decreased among long term care residents, that dexterity tests can help identify patients unable to perform adequate oral self-care, and that these tests could be used to estimate brushing ability among elderly compromised patients.

Aged↗
PubMed1991

In vitro translation of hepatitis A virus subgenomic RNA transcripts.

A subgenomic cDNA clone from hepatitis A virus strain HM175, composed of the last eight nucleotides of the 5' non-translated region and the first 2248 nucleotides of the coding sequence (P1 region), was inserted into a vector under the control of the T7 promoter. Restriction enzyme digestion at sites within the structural region and subsequent transcription in vitro yielded RNA products which were translated efficiently in rabbit reticulocyte lysates to produce proteins of the predicted sizes. The translation products were specifically precipitated with antipeptide antisera; these reactions were not affected by denaturation of the antigens by boiling in 1% SDS. The translated proteins were also precipitated by antivirion antisera, but recognition was totally abolished following denaturation. Thus antivirion antisera recognized conformation-dependent epitopes expressed on the translated products exclusively.

Autoradiography↗
PubMed1991

Care of chronic neurotic out-patients by community psychiatric nurses. A long-term follow-up study.

Ninety-nine neurotic patients from a controlled trial of CPN v. psychiatric out-patient aftercare were followed up seven years later. Of the 92 survivors, 76 were successfully interviewed. Few differences were found between the groups. Chronic mild symptoms and moderate social disability persisted, and tended to worsen a little. Treatment patterns persisted for one to two years beyond the original study; the CPN group had more CPN contacts, fewer psychiatric out-patient contacts and less psychiatric care. Thereafter, more out-patients were discharged from psychiatric care and care patterns for the two groups became similar. Out-patients attended more non-psychiatric out-patient clinics than the CPN group, but it is possible that this reflected pre-existing differences. About a third of patients remained in contact with the psychiatric service during follow-up.

Activities of Daily Living↗
PubMed1991

Dental hygiene students' preparation for treatment of patients with mental illnesses.

The purpose of this study is to determine the scope of didactic and clinical experiences dental hygiene students received in 1987 in preparation for treating people with mental illnesses. A 22-item survey was mailed to 200 U.S. dental hygiene programs. The response rate was 69 percent. Sixty-one percent of respondents reported that didactic information on mental illnesses was included in their curricula however, 42 percent reported that the amount of time devoted to this subject was not satisfactory. Students from 57 percent of responding programs did not provide oral care to mentally ill patients; and only 17 percent of respondents believed that the dental hygiene needs of the mentally ill were adequately addressed in their communities. Responses from baccalaureate and certificate/associate degree programs were not statistically significantly different.

Curriculum↗