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Biomedical subjects

S Seaman

Publications and source records attributed to S Seaman.

At least 19 recordsLinked to original sources
PubMed2001

Estimating the relative incidence of heroin use: application of a method for adjusting observed reports of first visits to specialized drug treatment agencies.

In this paper, the authors propose a method for estimating the incidence of heroin use by adjusting reported numbers of heroin users visiting drug treatment agencies for the time lag between onset of heroin use and first treatment request (lag distribution). The adjusted incidence is relative, since it represents the number of individuals beginning heroin use in each year whose cases will be reported within 8 years of starting use. Users with longer lag times or whose cases are never reported are excluded. Utilizing data from southeastern England (1991--1998), the authors analyzed the effects of covariates (sex, age group, ethnic group, route of consumption, and year of onset of drug use) on the lag distribution. Trends in the adjusted incidence of heroin use were very different for injectors and noninjectors: Incidence among injectors seemed to be stable, while in noninjectors it increased twofold between 1991 and 1996--1997. These results must be interpreted cautiously, especially in relation to the wider context of underlying trends in the population. Potential biases derive from underreporting and from changes in the proportion of heroin users in treatment. The lag correction method adds substantially to the value of routine treatment data, at least for heroin use, and is potentially the best method for obtaining estimates of incidence.

Adolescent↗
PubMed2000

Stereotactic radiosurgery and the risk of haemorrhage from cavernous malformations.

Eighteen patients with cerebral cavernous malformations were treated with single dose of cobalt 60 source stereotactic radiosurgery. All had suffered at least one haemorrhage prior to treatment with six suffering 2, four suffering 3 and one suffering 4. Mean follow-up was 4.5 years. A total of 36 pretreatment haemorrhages occurred in 139 patient years. The first haemorrhage each patient suffered was taken as the start of observation and not included in the rehaemorrhage rate calculation. Three posttreatment haemorrhages occurred in 81 patient years of observation. The annual haemorrhage rate thus fell from 13% before to 3.7% after treatment. The odds ratio was thus 0.29 with a 95% confidence interval of (0.08-0.97), but this must be interpreted with caution because of the prereferral selection of this group of patients. Three patients developed complications of radiosurgery, two of them recovered fully.

Adolescent↗
PubMed2000

Considerations for the global assessment and treatment of patients with recalcitrant wounds.

Many factors, both intrinsic and extrinsic, may contribute to wound recalcitrance. For example, arterial circulation may be impaired by atherosclerosis, vasospastic disorders, microemboli, thromboangiitis obliterans, vasculitis, sickle cell anemia, and antiphospholipid syndrome, all of which may impair healing. Inflammatory disorders that may lead to recalcitrance include pyoderma gangrenosum and necrobiosis lipoidica. Chronic venous insufficiency, infection, diabetes mellitus, systemic malignancy, malnutrition, and exposure to pressure and shear prolong the healing process. Wounds secondary to primary skin carcinoma will not heal. Calciphylaxis, a life-threatening metabolic disorder, leads to multiple ulcerations that are especially difficult to heal. Knowledge of common factors that lead to wound recalcitrance is essential to the wound care clinician, as accurate diagnosis results in appropriate treatment. To arrive at the diagnosis, the wound care clinician must perform a thorough history and physical examination and order relevant investigative studies. Treatment is based on correction of the identified underlying condition. By utilizing a systematic approach in the management of each patient with a chronic wound, the wound care clinician increases the probability of achieving wound closure.

Bandages↗
PubMed2000

Simplifying modern wound management for nonprofessional caregivers.

Nonprofessional caregivers currently are participating in managing pressure ulcers at home. As this can be a stressful experience, innovative and easy-to-use products are needed to support caregiver confidence. A multicenter, randomized clinical trial was conducted to compare clinical performance and case of instruction of a change indicator dressing (SIG) and a hydrocolloid alginate dressing (HAD) in the management of pressure ulcers in the home and long-term care settings. SIG and HAD were randomized to 17 and 18 partial- or full-thickness pressure ulcers respectively. During five dressing changes, wound area, dressing application, maintenance, appearance, removal, wear time, ease of teaching, and caregiver understanding of each dressing's instructions were measured. Both dressings were rated highly regarding ease of teaching, ease of use, appearance, maintenance, and helpfulness in signaling the need for dressing change by both professional and nonprofessional wound caregivers. Average dressing wear time was 3.2 days for SIG and 2.7 days for HAD. Of these wounds managed in a moist environment, 6 of 17 (35%) subjects whose wounds were dressed with SIG, and 1 of 18 (6%) dressed with HAD healed during the course of the study (alpha < 0.04). Percent wound reduction in area per day of care was also greater for SIG (alpha < 0.01). Innovative dressings may help caregivers provide consistent quality pressure ulcer care and improve wound-healing outcomes.

Aged↗
PubMed1996

Basic ostomy management: assessment and pouching.

Home healthcare nurses have tremendous impact on how a patient adapts to a new ostomy. This article increases the nurse's knowledge regarding basic ostomy management by reviewing common ostomy surgical procedures, assessment of the stoma, ostomy supplies, and appliance application and by providing helpful hints for helping the patient incorporate the ostomy into everyday life.

Activities of Daily Living↗
PubMed1994

Obstructive sleep apnea.

Humans spend one-third of their lives sleeping, yet the role of this phase of the circadian rhythm is not clear. Theories postulating the purpose of sleep include the restorative theory and the humeral theory. Both theories have identified weaknesses. What is known is that chronic disruption of sleep and/or sleep deprivation causes significant physiological and psychological symptoms. These include fatigue, lethargy and daytime somnolence accompanied by irritability, memory loss, decrease in judgment and paranoia. Obstructive sleep apnea (OSA) imposes another, more life-threatening dimension for the client.

Humans↗
PubMed1993

Sleep: a reality or dream for the hospitalized adult?

Nursing research literature is examined to determine the extent of sleep loss for the hospitalized adult. Research from the patient's perspective, nurses' assessment of patient's sleep and somnographic studies are considered. Although these three methods are inconsistent in the exact extent of sleep loss, all suggest that hospitalized patients experience less sleep than their normal pattern. Reasons for patients losing sleep are explored. Environmental factors in critical care areas are the most cited reason for loss of sleep yet other reasons are suggested. Consequences of sleep loss are explored. Some nursing interventions offered in the existing literature are examined for their feasibility. Finally, directions for future research are offered from this review of the literature.

Adult↗
PubMed1989

Differences between caries levels in 5-year-old children from fluoridated Anglesey and non-fluoridated mainland Gwynedd in 1987.

Using standard epidemiological techniques, several indicators of dental health showed significantly lower levels of caries experience in 5-year-old children from fluoridated Anglesey compared with a similar group from non-fluoridated mainland Gwynedd. The mean dmft was 0.80 in Anglesey and 2.26 in mainland Gwynedd. The mainland Gwynedd children had suffered more toothache and experienced more dental extractions. This study showed that fluoridation of water supplies remains an effective and relevant public health measure, and illustrates the value of a parental questionnaire in epidemiological surveys of younger children.

Child, Preschool↗
PubMed1984

On-line combination of high-performance liquid chromatography and total N-nitroso determination apparatus for the determination of N-nitrosamides and other N-nitroso compounds, and some recent data on the levels of N-nitrosoproline in foods and beverages.

A simple high-performance liquid chromatographic chemiluminescence detection method has been developed for the quantitative determination of N-nitrosamides and is based on post-column denitrosation of the compounds with hydrogen bromide-acetic acid or hydrogen iodide-acetic acid, followed by detection of the liberated NO by a chemiluminescence detector (TEATM). The method was used for the simultaneous analysis of DiazaldR, N-nitroso-N-methylurea, N-methyl-N'-nitro-N-nitrosoguandine and streptozotocin standards, and for N-methyl-N-nitrosourea extracted from model-system reaction mixtures and spiked, cured meats. The minimum detection limit of N-methyl-N-nitrosourea was about 0.5 ng. The method for the determination of N-nitrosarcosine and N-nitrosoproline in foods and beverages has been improved by replacing diazomethane with a mixture of BF3-methanol as the esterifying reagent and by simplifying the clean-up technique for purifying the prepared methyl esters. The average levels of N-nitrosoproline detected in 11 malts, 37 beers, 11 samples of fried bacon and 18 cured-meat products were found to be 24.1 micrograms/kg (5-113), 1.7 micrograms/kg (undetectable-6.0), 19.0 micrograms/kg (0.9-67.5), and 3.2 micrograms/kg (undetectable-21.6), respectively.

Amino Acids↗
PubMed1984

Volatile N-nitrosamines in baby bottle rubber nipples and pacifiers. Analysis, occurrence and migration.

A simple direct extraction method has been developed for rapid determination of volatile N-nitrosamines in rubber nipples and pacifiers. It consists of overnight extraction of the sample with dichloromethane in the presence of ascorbyl palmitate for N-nitrosation inhibition, filtration of the extract and rinsing of the samples with dichloromethane, concentration of the extract using a Kuderna-Danish concentrator, and final analysis by gas-liquid chromatography-Thermal Energy Analyser. The method gave excellent (80-100%) recoveries of various volatile N-nitrosamines that had been added to cut nipples or pacifiers at 20-80 micrograms/kg levels, and gave comparable or lower values than those obtained with another published method. The method is recommended for rapid screening purposes. A survey of 30 samples of various nipples and pacifiers indicated the presence of the following N-nitrosamines: N-nitrosodimethylamine (up to 70 micrograms/kg), N-nitrosodiethylamine (up to 88 micrograms/kg), N-nitrosodi-n-butylamine (up to 2796 micrograms/kg), N-nitrosopiperidine (up to 180 micrograms/kg), and N-nitrosomorpholine (up to 86 micrograms/kg). A more recent study, however, indicated a general decline in the levels of various volatile N-nitrosamines in these products. These N-nitrosamines were shown to migrate easily from the rubber products to liquid infant formula, orange juice and simulated human saliva.

Humans↗
PubMed1982

Gas-liquid chromatographic-thermal energy analyzer determination of N-nitrosodimethylamine in beer: collaborative study.

The GLC/TEA method for N-nitrosodimethylamine (NDMA) in beer was studied collaboratively by 13 laboratories from 7 countries. Collaborators were asked to analyze a total of 10 randomly labeled samples of beer consisting of the following duplicates: a naturally contaminated commercial beer; a beer extremely low (ca 0.1 ppb) in NDMA; and the low NDMA beer spiked with 0.5, 1.9, and 5.0 ppb NDMA. The pooled repeatability and reproducibility coefficients of variation (CV) for all samples were 17% and 27%, respectively. However, when data from 2 laboratories (outliers) were omitted, the corresponding CV values improved considerably (11% and 15%, respectively). Variance analysis showed the presence of a significant laboratory-sample interaction when all data were used for analysis, but this interaction disappeared when data from the 2 outlying laboratories were excluded. The pooled percent recovery of the overall method (omitting outliers) was 101.4 +/- 3.5. All the laboratories detected NDMA in the low NDMA beer. The method was adopted official first action.

Beer↗
PubMed1982

A rapid and sensitive method for the determination of non-volatile n-nitroso compounds in foods and human urine: recent data concerning volatile N-nitrosamines in dried foods and malt-based beverages.

Methods are described for the rapid screening of various foods for the presence of nitrosamino acids (mainly NPRO and NSAR) and of hydroxylated nitrosamines (mainly BHBN, NHPYR and NDELA). Rapid screening methods (HPLC-TEA and GC-TEA) are also described for the determination of the above mentioned nitrosamines in human urine. Recent monitoring data indicate that, in Canada, the NDMA levels in both malt and beer have decreased significantly during the last two years. Contrary to published reports, no volatile nitrosamines could be detected in vegetable oils or pasteurized milk. A new method, based on oxidation of nitrosamines and nitramines and reanalysis by GC-TEA, is described for the confirmation of low microgram/kg levels of volatile nitrosamines in foods.

Beer↗