PubMed Health⌕ Search

Biomedical subjects

S McDermott

Publications and source records attributed to S McDermott.

At least 19 recordsLinked to original sources
PubMed2006

Interrater reliability of filling cystometrogram interpretation in a multicenter study.

PURPOSE: As part of a continuous quality control effort to measure the interrater reliability of urodynamic studies performed at multiple centers, we compared agreement levels for urodynamic studies between central and local physician reviewers. We report interrater reliability findings for the filling cystometrogram. MATERIALS AND METHODS: Following a satisfactory interrater reliability study among 4 central physician reviewers in 33 tracings 36 urodynamic study tracings from 9 Urinary Incontinence Treatment Network continence treatment centers and 13 Urinary Incontinence Treatment Network certified urodynamic study testers were randomly selected for review. These tracings were originally interpreted by 11 local physician reviewers using standardized Urinary Incontinence Treatment Network interpretation guidelines. Each of the 4 central physician reviewers reviewed 9 randomly assigned tracings and none reviewed tracings from his or her center. Local and central physician reviewers were instructed to categorize values as invalid if specified technical quality assurance standards were not met or the signal pattern suggested implausible values because of technical deficiencies. An intraclass correlation coefficient was calculated for continuous (numerical) variables and a kappa statistic was calculated for qualitative values with acceptable agreement defined a priori as an intraclass correlation coefficient of greater than 0.6. RESULTS: Filling cystometrogram baseline pressure, Valsalva leak point pressure, and volume and pressure measurements at maximum cystometric capacity had excellent intraclass correlation coefficients of 0.74 to 0.99. There were no significant differences between local and central physician reviewer means, indicating excellent agreement. CONCLUSIONS: With proper quality control measures in place and a set of standardized interpretive guidelines excellent interrater reliability between local and central physician reviewer can be achieved for numerical cystometrogram variables.

Diagnostic Techniques, Urological↗
PubMed2003

Antimicrobial susceptibility and genetic relatedness of Salmonella serovars isolated from animal-derived dog treats in the USA.

OBJECTIVES: The objectives of this study were to determine the potential risk of dog treats in transmitting Salmonella to humans in the USA, and to characterize genetic relatedness and antimicrobial resistance among the isolates. METHODS: A total of 158 dog treats derived from pig ears and other animal parts were randomly collected nationwide and assayed for the presence of Salmonella. The Salmonella isolates were characterized using serotyping, pulsed-field gel electrophoresis (PFGE) and antimicrobial susceptibility testing. RESULTS: Forty-one percent (65/158) of samples were positive for Salmonella. Eighty-four Salmonella isolates, comprising 24 serotypes, were recovered from the 65 positive samples. Fourteen samples were contaminated with more than one Salmonella serotype. PFGE analysis of 78 Salmonella isolates yielded 64 patterns. S. Infantis with PFGE patterns indistinguishable from those of strains identified in Canadian outbreaks in 1999 were recovered in several dog treat products. The majority of Salmonella isolates were susceptible to the antimicrobials tested; however, resistance was observed to tetracycline (26%), streptomycin (23%), sulfamethoxazole (19%), chloramphenicol (8%) and ampicillin (8%). Twenty-eight (36%) Salmonella isolates were resistant to at least one antimicrobial and 10 (13%) isolates displayed resistance to four or more antimicrobials. Two isolates were identified as S. Typhimurium DT104 with the characteristic penta-resistance phenotype (ampicillin, chloramphenicol, streptomycin, sulfamethoxazole and tetracycline). One S. Brandenburg isolate was resistant to eight antimicrobials. Seven Salmonella isolates also contained class I integrons encoding resistance genes to aminoglycosides, beta-lactam and streptothricin antimicrobials. CONCLUSIONS: The study indicates that animal-derived dog treats in the USA could be a potential source of animal and human infections with Salmonella, including multidrug-resistant Salmonella strains.

Animal Feed↗
PubMed2001

The isolation of antibiotic-resistant salmonella from retail ground meats.

BACKGROUND: Salmonella is a leading cause of foodborne illness. The emergence of antimicrobial-resistant salmonella is associated with the use of antibiotics in animals raised for food; resistant bacteria can be transmitted to humans through foods, particularly those of animal origin. We identified and characterized strains of salmonella isolated from ground meats purchased in the Washington, D.C., area. METHODS: Salmonella was isolated from samples of ground chicken, beef, turkey, and pork purchased at three supermarkets. The isolates were characterized by serotyping, antimicrobial-susceptibility testing, phage typing, and pulsed-field gel electrophoresis. The polymerase chain reaction and DNA sequencing were used to identify resistance integrons and extended spectrum beta-lactamase genes. RESULTS: Of 200 meat samples, 41 (20 percent) contained salmonella, with a total of 13 serotypes. Eighty-four percent of the isolates were resistant to at least one antibiotic, and 53 percent were resistant to at least three antibiotics. Sixteen percent of the isolates were resistant to ceftriaxone, the drug of choice for treating salmonellosis in children. Bacteriophage typing identified four isolates of Salmonella enterica serotype typhimurium definitive type 104 (DT104), one of DT104b, and two of DT208. Five isolates of S. enterica serotype agona had resistance to 9 antibiotics, and the two isolates of serotype typhimurium DT208 were resistant to 12 antibiotics. Electrophoretic patterns of DNA that were indistinguishable from one another were repeatedly found in isolates from different meat samples and different stores. Eighteen isolates, representing four serotypes, had integrons with genes conferring resistance to aminoglycosides, sulfonamides, trimethoprim, and beta-lactams. CONCLUSIONS: Resistant strains of salmonella are common in retail ground meats. These findings provide support for the adoption of guidelines for the prudent use of antibiotics in food animals and for a reduction in the number of pathogens present on farms and in slaughterhouses. National surveillance for antimicrobial-resistant salmonella should be extended to include retail meats.

Animals↗
PubMed2001

Perinatal risk for mortality and mental retardation associated with maternal urinary-tract infections.

OBJECTIVE: The researchers analyzed the relationship between fetal exposure to maternal urinary tract infections (UTIs) and mental retardation or developmental delay and fetal death. STUDY DESIGN: A retrospective cohort design was used to explore the risk for fetal death and mental retardation or developmental delay associated with exposure to maternal UTI during pregnancy. POPULATION: Matched maternal-child pairs from the National Collaborative Perinatal Project (NCPP) from the decades of 1960 and 1970 were compared with a previous analysis of the South Carolina Medicaid Reimbursement System (Medicaid) for 1995-1996. Both data sets are representative of poor women and their children. OUTCOMES MEASURED: The outcomes measured were fetal death and mental retardation or developmental delay in the live-born children. RESULTS: There was an increased relative risk (RR) for mental retardation or developmental delay in the third trimester of pregnancy (RR=1.40; 95% confidence interval [CI], 1.01-1.95) in the NCPP, and there was a similar risk in the Medicaid data. The third trimester relative hazard for fetal death associated with maternal UTI was 2.23 (95% CI, 1.40-3.55). CONCLUSIONS: The findings support an association between maternal UTI and fetal death and mental retardation or developmental delay. These results confirm the importance of diligent diagnosis and treatment of maternal UTI by prenatal care providers.

Adolescent↗
PubMed2001

Urinary tract infections during pregnancy in South Carolina.

This study presents evidence that over 20 percent of pregnant women with a UTI in South Carolina did not have an antibiotic pharmacy claim within 14 days of diagnosis. Untreated maternal UTI in pregnancy was associated with a 22 percent increased risk for MR/DD in the infant compared to the risk for women who had a UTI and a pharmacy claim for an antibiotic and 31 percent increased risk compared to women who did not have a UTI. The importance of medications compliance should be emphasized in the care of pregnant women.

Anti-Infective Agents, Urinary↗
PubMed2000

Urinary tract infections during pregnancy and mental retardation and developmental delay.

OBJECTIVE: To investigate the association between urinary tract infections during pregnancy and mental retardation or developmental delay in infants. METHODS: An inception cohort design was used to analyze Medicaid maternal and infant-linked records and vital records for 41,090 pregnancies from 1995-1998. RESULTS: The relative risk (RR) for mental retardation or developmental delay among infants of mothers with diagnosed urinary tract infections but no antibiotic claims was 1.31 with a 95% confidence interval (CI) of 1. 12, 1.54 compared with the group without urinary tract infections. The RR for infants of mothers with urinary tract infections without antibiotic claims was 1.22 (95% CI 1.02, 1.46) compared with infants of mothers with urinary tract infections and antibiotic claims. The RR was significant in the first trimester (1.46, 95% CI 1.07, 1.99) and third trimester (1.41, 95% CI 1.11, 1.79) after controlling for race and gestational age at birth. CONCLUSION: There was a statistically significant association between maternal urinary tract infections without evidence of antibiotics and mental retardation or developmental delay in infants. The relationship persisted when we assumed that over 30% of women who had antibiotic claims filled but did not take the medicine, and 40% of the women who did not have antibiotic claims did take the medication.

Adolescent↗
PubMed1999

What individual, provider, and community characteristics predict employment of individuals with mental retardation?

Characteristics influencing employment of individuals with mental retardation were analyzed to evaluate employment rates for county providers. Participants in the sample (N = 11,743) earned at least $50 per week for a 6-month period. Good physical and emotional health, being male, age between 18 and 49, IQ between 50 and 75, and good adaptive skills were associated with employment. Eighteen percent of the variability in employment rates was explained by the ratio of individuals served by the Boards to the county population and the percentage of the county population living in rural settings. Median income, unemployment rates, and poverty explained 22% of the variance in noncompetitive employment rates. Results suggest that health promotion programs could help individuals with mental retardation obtain and sustain employment.

Adolescent↗
PubMed1998

Bladder tumor markers: need, nature and application. 1. Nucleus-based markers.

Urothelial tumors are common: their diagnosis and long-term management represent a large part of most urologists' workload. The majority of such tumors are 'superficial' and are mostly managed by repeated cystoscopic surveillance and treatment. A smaller but significant group of patients either start with, or subsequently progress to, more invasive disease, thus requiring an alternative and more invasive treatment. Maximizing the benefit/risk ratio of the diagnosis and the various treatment options of bladder tumors requires the availability of a reliable tumor marker. The concept of tumor markers encompasses the utilization of any detectable deviation from normality that is indicative of neoplasia. For bladder cancer, most of these markers are present in urine. In this part of the review we examine, from the clinician's point of view, the literature verdict on older techniques such as cytology and cytometry, as well as the current status of new nucleus-based tests such as P53, telomerase, NMP22 and Ki67.

Biomarkers, Tumor↗
PubMed1998

Bladder tumor markers: need, nature and application. 2. Tumor and tumor-associated antigens.

Despite the diversity of the available markers, none is truly specific to transitional epithelium, let alone its tumors. Some of the markers used, such as hCG and CEA, are far better known in other fields and seem to be expressed in only a minority of urothelial tumors. The majority of the available markers are tumor associated and should perhaps be considered as by-products of the process of malignancy in the urinary tract. Newer tests which are simple, rapid and easy to use have a practical advantage. These are currently the Bard BTA, BTA Stat and Aura-Tek FDP tests. So far, these markers have achieved only an arguable and marginal role in daily clinical practice, challenging the role of cytology and helping decide the type of cystoscopy. A more substantial role awaits a test with higher and more consistent sensitivity and specificity, together with the capability to provide independent diagnostic and/or prognostic information. In this part of the review we examine the literature view of the above-mentioned tests, as well as other new and some older tests such as blood group-related antigens, Lewis antigen, cytokeratins and others.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1997

Do behavior changes herald physical illness in adults with mental retardation?

A longitudinal study of 62 individuals with profound mental retardation was conducted to determine if direct care staff can identify behavior change prior to identifying symptoms of acute illness. Results indicate that staff were able to notice changes in sluggishness prior to the onset of illness. Self-care behavior was of borderline significance and there was no significant change in eight behavior dimensions (vocalizations, peer conflict, stereotypy, aggression, self injurious behavior, restlessness, distractibility, and depression). This finding should alert physicians and caregivers to the importance of prompt response to symptoms. Reliance on behavioral observation of direct care staff is not always sensitive enough to pick up changes in health status in less restrictive residential environments.

Activities of Daily Living↗
PubMed1997

Parents of adults with mental retardation living in-home and out-of-home: caregiving burdens and gratifications.

Interviews with parents of adult children with mental retardation were conducted to identify differences in caregiver burdens and gratifications, based on in-home and out-of-home placement. Parental responses indicate that caretakers of adult children with mental retardation are worried and feel responsibility for their care regardless of residential placement of the adult child.

Activities of Daily Living↗
PubMed1997

The performance characteristics of the bladder tumour antigen test.

OBJECTIVE: To evaluate the specificity and sensitivity of the Bard bladder tumour antigen (BTA) (Bard Inc, Covington, USA) test. PATIENTS AND METHODS: The performance of the BTA test was assessed prospectively in 98 patients (30 women and 68 men, mean age 64 years, median 67, SD 14.8) undergoing cystoscopy for various indications. The urine of the patients was assessed using the BTA test, cytology, culture and a dipstick test for haematuria, and the results compared with those from cystoscopy as the 'standard'. RESULTS: The overall specificity for the BTA test was 79% and the sensitivity 37%. The sensitivity was higher than for urine cytology (33%) but less than for the dipstick test (59%). The specificity was less than for cytology (100%) but higher than for the dipstick test (66%). CONCLUSION: The BTA test is a rapid, non-invasive qualitative test identifying degradation products of the basement membrane of the transitional cell epithelium. It represents an advance in the search for a 'tumour marker' for carcinoma of the bladder. The specificity is acceptable but the sensitivity relatively low, which limits its value in everyday practice. Further research and development are needed to improve sensitivity.

Antigens, Neoplasm↗
PubMed1997

Are individuals with mental retardation at high risk for chronic disease?

BACKGROUND AND OBJECTIVES: Family physicians are responsible for the health and illness care of individuals with mental retardation (MR) in many community practices. Therefore, it is important to determine the special disease patterns for this group. This study determined if individuals with MR are at increased risk for selected chronic diseases. METHODS: We analyzed 366 individuals, living in the community, with a primary diagnosis of MR. The two comparison groups without MR were 427 individual Medicaid recipients and 746 privately insured individuals. RESULTS: Individuals with MR had higher rates of neurophysical conditions (eg, seizures, central nervous system conditions, and sensory loss) compared to the other two groups. However, they had lower rates of some chronic conditions and health behaviors (eg, hypertension, migraines/chronic headaches, diabetes, depression or anxiety, obesity, substance abuse, and smoking) compared to other Medicaid and insured patients. CONCLUSIONS: Individuals with MR have lower rates of many chronic conditions, compared with other Medicaid recipients. This finding should reduce concerns among family physicians that treatment of this special population involves higher rates of chronic illness.

Chronic Disease↗
PubMed1996

A population-based analysis of behavior problems in children with cerebral palsy.

Used the National Health Interview Survey, Child Health Supplement for 1981 and 1988, to analyze parent-reported behavior problems of children, ages 4-17 years, with cerebral palsy (n = 47), with mental retardation (n = 50), with other chronic conditions (n = 6,038), and with no known health problem (n = 5,930), using the Behavior Problem Index (developed by Zill & Peterson). Behaviors with scores greater than the 90th percentile of the entire sample were considered problem behaviors. Parent-reported behavior problems were 5 times more likely in children with cerebral palsy (25.5%) compared with children having no known health problem (5.4%). The adjusted odds ratio for behavior problems of children with cerebral palsy without mental retardation was 4.9 and of children with mental retardation without cerebral palsy was 7.9. Specific behaviors that were most problematic for children with cerebral palsy were identified as dependency, headstrong, and hyperactive.

Adolescent↗
PubMed1996

The results of water fluoridation in Ireland.

The visit of Dr. Trendley Dean to Dublin in the mid-1950s helped accelerate the decision to introduce water fluoridation as a public health measure in the prevention of caries in the Republic of Ireland. A challenge to the constitutional validity of the Health (Fluoridation of Water Supplies) Act 1960 failed and in 1964 the water supplies of Dublin city were fluoridated. Over the next seven to eight years all the major urban communities in the Republic of Ireland were fluoridated. Currently, 67 percent of the 3.5 million people in the country reside in fluoridated communities. Studies conducted over the last 20 years show that residents of fluoridated communities have better dental health than those in nonfluoridated communities--the mean dmft is lower in children and the number of natural teeth present in adults is higher.

Adolescent↗
PubMed1996

Preventable fraction of mental retardation: analysis based on individuals with severe mental retardation.

Reduction in the prevalence of mental retardation has been identified as a national goal since 1971. President Nixon proposed the year 2000 as a benchmark, by which time the prevalence of severe mental retardation should be reduced by as much as 50%. An analysis to determine the fraction of severe mental retardation that could be prevented with strategies currently available indicates that the goal will not be met. Knowledge of the causes of severe mental retardation is fundamental to developing prevention strategies. Increased diagnostic capability-clinical and laboratory-must be dramatically increased if a 50% reduction in the prevalence of severe mental retardation is to be achieved in the foreseeable future.

Adolescent↗
PubMed1996

Water fluoridation in Ireland.

The basis for the constitutional challenge to the Health (Fluoridation of Water Supplies) Act 1960 in the Republic of Ireland and the judgements of the High Court and Supreme Court are described. Pre-fluoridation baseline surveys and various surveys conducted over the last 30 years in the Republic of Ireland show, that amongst of fluoridated communities, children experience lower levels of dental caries and adults retain more of their natural teeth when compared with residents of non-fluoridated communities.

Adolescent↗