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Biomedical subjects

T Mann

Publications and source records attributed to T Mann.

At least 37 records · Page 2Linked to original sources
PubMed2000

HIV healthcare provider-patient interaction: observations on the process of providing antiretroviral treatment.

The meeting during which healthcare providers and newly infected HIV+ patients discuss treatment options is a critical stage in patients' care. We describe 10 interactions between healthcare providers and HIV+ patients at two clinics. Two observers coded each of the 10 interactions for the content of the topics discussed and for communication-relevant behaviors. The interactions followed one of two general patterns, according to whether combination antiretroviral treatment was recommended or deferred. Features of the interactions are described. These features include: (1) the presentation of a single-treatment option, (2) a discussion of whether patients have the will to begin therapy and the skills to adhere to treatment regimens, and (3) organizational pressures to include patients in clinical trials.

Adult↗
PubMed2000

Left internal mammary artery intervention: the left radial approach with a new guide catheter.

Coronary intervention involving left internal mammary bypass grafts is an increasingly common challenge for the interventionalist. Although successful in a high percentage of patients, the femoral approach may be technically challenging. The shorter, more direct approach from the left radial artery has potential advantages in these cases. The present study evaluated our experience using a new left transradial internal mammary guide catheter. Angiography alone was successfully performed with the catheter in 40 patients. In an additional 10 patients, internal mammary artery interventional procedures were performed. Angioplasty alone was performed in five patients. Five patients underwent coronary stenting within the internal mammary artery or native left anterior descending artery. Guide catheter backup was satisfactory and angioplasty catheters and/or stents could be advanced to the target lesion with minimal difficulty. No procedural complications occurred. The left radial artery access site is an excellent approach for left internal mammary intervention.

Angioplasty, Balloon, Coronary↗
PubMed1999

A synthesis of psychological interventions for the bereaved.

Several interventions have been implemented to address the adverse psychological and physical consequences associated with bereavement. In this review, we summarize four major theories of bereavement, present a qualitative review of bereavement intervention studies, and assess the overall effectiveness of bereavement intervention studies in a quantitative meta-analysis. Summaries of the theories are drawn from published theoretical works. The qualitative and quantitative reviews were based on searches of Medline, PsychINFO, and Dissertation Abstracts International databases using the keywords "bereaved" and "bereavement." Overall, the interventions were largely methodologically flawed, rarely specified what theory of bereavement they were testing, and slowed surprisingly weak effect sizes. Possible interpretations for the small effect sizes are discussed, and future directions are outlined.

Bereavement↗
PubMed1999

Amphetamine use and its correlates among youths living with HIV.

Amphetamine use and its correlates are examined among youths living with HIV (YLH) to determine whether its use is associated with increased transmission acts and poor health. Amphetamine use, other HIV-related risk acts, T-cell counts, emotional distress, coping style, and symptoms of HIV are examined in 337 YLH. One third of YLH engaged in amphetamine use in their lifetime, and 21% of youths reported current use (i.e., in the last 3 months). Compared with those who never used, users initiated other drug use at younger ages, used more types of drugs, reported more emotional distress, and employed escape coping significantly more often. Compared with those who have never used (never-users), users also had more sexual partners and more sexual encounters. Although users and never-users do not differ on physical symptoms or whether they have been diagnosed with AIDS, users of amphetamines report significantly higher T-cell counts than never-users. Despite poor psychosocial functioning, amphetamine users have higher T-cell counts than other YLH; future research must examine longitudinally if a quadratic relationship exists between amphetamine use and health status. The continued high-risk profile of transmission acts among users suggests that preventive interventions must target specific drugs used by YLH.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites.

OBJECTIVES: The purpose of the present study was to compare the radial approach with the femoral approach for coronary stenting in patients with acute coronary syndromes. BACKGROUND: Aggressive anticoagulation in patients with acute coronary syndromes increases the risk of femoral vascular complications. The transradial approach has the potential to significantly reduce the incidence of access site bleeding complications in this group of patients. METHODS: One hundred forty-two patients with acute coronary syndromes undergoing coronary stenting were prospectively randomized to have their procedure performed from either the radial or femoral access site and the results compared. RESULTS: Nine of 74 patients randomized to the radial group crossed over to the femoral group (6 negative Allen tests, 3 access failures). Patient demographics were the same in both groups. Primary success was identical: 96% radial, 96% femoral, ns. There were no procedural myocardial infarctions or deaths, and no patient was referred for emergency bypass surgery. There were no access site bleeding complications in the radial group as opposed to 3 (4%) in the femoral group, p < 0.01. Postprocedure length of stay, days (1.4+/-0.2 radial vs. 2.3+/-0.4 femoral, p < 0.01) as well as total hospital length of stay (3.0+/-0.3 radial vs. 4.5+/-0.5 femoral, p < 0.01) were significantly reduced in the radial group. Total hospital charge was also significantly lower in the radial group ($20,476+/-811 radial versus $23,389+/-1,180 femoral, p < 0.01). CONCLUSION: Coronary stenting from the radial approach is efficacious in patients with acute coronary syndromes. Access site bleeding complications are less, and early ambulation results in a shorter hospital length of stay. There was a 15% reduction in total hospital charge in the radial group.

Aged↗
PubMed1998

Number of pregnancies, outcome expectancies, and social norms among HIV-infected young women.

In this descriptive study, researchers examined pregnancies, sexually transmitted diseases (STDs), and sexual behaviors among 67 HIV-infected young women, as well as the women's outcome expectancies and peer and partner norms regarding pregnancy. Many of the women (69%) had been pregnant; 42% had been pregnant at least once since learning their HIV status, with 71% choosing to carry to term, resulting in 25% (N = 5) of the babies infected. The women had positive outcome expectancies related to pregnancy, which were significantly correlated with peer and partner social norms. Lack of knowledge regarding infant transmission, high rates of STDs, and inconsistent condom use all indicate a need for improved intervention regarding pregnancy and decision-making. Suggestions for better methods of providing information to HIV+ young women are provided.

Adolescent↗
PubMed1998

Sensorineural hearing loss in ECMO survivors. Extracorporeal membraneous oxygenation.

Survivors of extracorporeal membraneous oxygenation (ECMO) treatment are at risk for serious neurodevelopmental disorders or neurologic sequelae, but little has been reported about the prevalence of sensorineural hearing loss in these patients. Of 123 ECMO survivors born between 1987 and 1996, at least 30 survivors have confirmed sensorineural hearing loss. Progressive hearing loss has been confirmed in 10 subjects.

Evoked Potentials, Auditory, Brain Stem↗
PubMed1997

Differential serological diagnosis of HTLV-I and HTLV-II infection by external membrane protein peptide-based enzyme immunoassays.

BACKGROUND: HTLV antibody screening assays detect both antibodies to the etiological agent of adult T-cell leukemia and tropical spastic paraparesis HTLV-I and to the less pathogenic HTLV-II. It is critical to make a differential diagnosis of the two viruses. OBJECTIVES: To design and evaluate synthetic core and envelope-derived peptide enzyme immunoassays (EIA) for serological differential diagnosis. STUDY DESIGN: Peptide EIAs were evaluated with a panel of 202 plasma samples comprised of HTLV antibody positive, serologically classified as confirmed, indeterminate, or non confirmed, characterized as HTLV-I, HTLV-II or neither by genomic amplification. The peptide EIA with the best performance was further used to differentiate between HTLV-I and HTLV-II antibodies in 807 samples from 18 countries in four continents and to provide ratios between the two infections. RESULTS: The gp46 peptide EIA correctly identified 96.5% of HTLV-I and 98.6% of HTLV-II antibody-confirmed samples. HTLV-I was found exclusively in Japan and Caribbean countries; almost exclusively in Africa. HTLV-II represented 10-25% of samples from Canada, Chile and Venezuela and was predominant in the US. CONCLUSIONS: Differential diagnosis between HTLV-I and HTLV-II can be reliably performed using specific peptides from the gp46 envelope protein of each virus.

Antigens, Viral↗
PubMed1997

Are two interventions worse than none? Joint primary and secondary prevention of eating disorders in college females.

Prevention programs for eating disorders attempt to simultaneously prevent new cases from arising (primary prevention) and encourage students who already have symptoms to seek early treatment (secondary prevention), even though ideal strategies for these 2 types of prevention may be incompatible with each other. In the present study, an eating disorder prevention program was evaluated in a simple of female college freshmen. In the intervention, classmates who had recovered from eating disorders described their experiences and provided information about eating disorders. At follow-up, intervention participants had slightly more symptoms of eating disorders than did controls. The program may have been ineffective in preventing eating disorders because by reducing the stigma of these disorders (to encourage students with problems to seek help), the program may have inadvertently normalized them.

Adaptation, Psychological↗
PubMed1997

Transradial Coronary Stenting: A United States Experience.

Coronary stenting is associated with increased vascular complications and prolonged length of stay compared to balloon angioplasty. One strategy to address these concerns is performing the coronary stent procedure via the radial artery access site. The current study reviews the results of transradial coronary stenting in 300 patients in a United States hospital setting. All patients who underwent transradial coronary stent implantation at our center were included in the study. Procedural success, clinical events, vascular complications, post-procedure length of stay, and hospital charges were evaluated. Transradial coronary stenting was successfully performed in 283 of 300 patients (95%), although a significant learning curve was present. Nine complications occurred in the first 100 patients with only two in the last 100 patients. Unsuccessful procedures were due to inability to cross lesion in 3 patients (1%), emergency CABG in 6 patients (2%), stent embolization in 7 patients (2.3%), and 1 death (0.3%). Only one minor vascular complication occurred. The study confirms that transradial coronary stenting is feasible and safe, although new operators should be aware of potentially serious complications of the bare stent technique. Findings support the use of this alternative access site for coronary stenting in selected patients.

Journal Article↗
PubMed1996

Improving text memory by organizing interfering text at retrieval.

We provide evidence that information that organizes interfering text after learning improves recall of original text to which the organizing information does not pertain. Subjects learned two text passages. The second passage was difficult to understand without the aid of a picture that provided the necessary clarifying context. Using the picture as an organizing cue for the second passage (just before retrieval of the first passage) improved recall of the first passage. We address and rule out an alternate explanation that is based on the difficulty of the task immediately preceding recall. These results contradict several traditional hypotheses about interference, and they are difficult to explain with several current models of memory. Implications for learning are discussed.

Adult↗
PubMed1993

Complete nucleotide sequence of HTLV-II isolate NRA: comparison of envelope sequence variation of HTLV-II isolates from U.S. blood donors and U.S. and Italian i.v. drug users.

The entire nucleotide sequence of human T-cell lymphotropic virus type II (HTLV-II) from a previously described isolate of patient NRA (HTLV-IINRA) was determined. Clones encoding the 5' LTR and gag, pol, env and tax/rex open reading frames were subcloned and sequenced on both strands. The provirus consisted of 8957 nucleotides and showed 95.2% homology with the HTLV-IIMo prototype at the nucleotide level. Less than 5% amino acid variation between HTLV-IINRA and HTLV-IIMo was observed for coding regions. Although isolate HTLV-IINRA had an additional 25 amino acids at the 3' end of tax/rex, this region was 96% homologous with the 5' end of HTLV-IIMo 3' LTR. To further investigate HTLV-II variability, a portion of the env gp46 gene derived from 9 HTLV-II infected persons was amplified by polymerase chain reaction and sequenced. Sequence was obtained for 320 nucleotides corresponding to HTLV-IIMo positions 5291 to 5610. Isolates similar to the HTLV-IIMo and HTLV-IINRA prototypes were identified, and sequences were highly conserved.

Amino Acid Sequence↗
PubMed1992

Vertebral deformity in men.

Vertebral fracture is the most prevalent manifestation of osteoporosis in women, but there is very little information concerning vertebral fracture in men. These studies begin to determine the prevalence, radiographic character, and relationship to bone mineral density of vertebral deformity in men. A group of 144 white men aged 34-94 years (83% between 50 and 80 years) were studied. Thoracic and lumbar spine radiographs were obtained using standardized techniques, and morphometric measures of vertebrae (T6-L5) were obtained using a computerized digitization pad. Vertebral deformities (wedge, midbody, and crush) were identified using several criteria. In addition, a skeletal radiologist independently identified vertebral deformities, as well as vertebrae affected by epiphysitis (Scheuermann's disease), using classic radiographic criteria. Bone mineral density was measured at lumbar spine and proximal femoral sites using dual-photon absorptiometry. The prevalence of vertebral deformity was related to the criteria used for their identification. Utilizing vertebral-specific criteria (anterior/posterior or midbody/posterior vertebral height more than 3 SD below vertebral specific mean), 10% of subjects had vertebral deformity. Wedge deformity occurred primarily in thoracic vertebrae and were more common than midbody deformity, which occurred more commonly in lumbar vertebrae. Crush deformities were not observed. Evidence of vertebral epiphysitis was present in 9% of subjects but was not responsible for vertebral deformity sufficient to be falsely identified using the more than -3 SD criterion. Bone mineral density in subjects with vertebral deformity was clearly reduced at both vertebral (p = 0.003) and proximal femoral (p = 0.002) measurements sites. The number of vertebral deformities was negatively correlated with vertebral bone mineral density.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Improving recall by recoding interfering material at the time of retrieval.

Our experiments demonstrate that interference of an interpolated list of items with recall of an original list can be substantially reduced by forming Ss just before testing how to reorganize and simplify the interpolated material. In Experiments 1 and 2, Ss better recalled an initial serial list of letters when informed at testing that an interpolated list spelled a certain phrase backward. Similarly, in Experiments 3 and 4, Ss better recalled an initial list of cities when told that the interpolated cities were also names of former U.S. presidents. Control experiments rule out several simple explanations. In contrast to an editing hypothesis, the postorganizing clue helped recall even when problems of list differentiation were minimized. Current memory models appear unable to explain this benefit of a postlearning clue that enables Ss to segregate the interpolated material from the to-be-remembered material.

Adult↗
PubMed1992

H2O2 increases expression of pulmonary artery endothelial cell platelet-derived growth factor mRNA.

Endothelial cells subjected to cell injury are capable of producing platelet-derived growth factor (PDGF), a mitogen for the stimulation of fibroblast and smooth muscle cell proliferation. Cultured bovine pulmonary artery endothelial cells were exposed to low concentrations of H2O2 for 30 min. Total cell RNA was isolated and subjected to Northern analysis with use of a v-sis PDGF cDNA probe. Results demonstrate a fourfold increase in cell PDGF mRNA immediately after exposure of bovine pulmonary artery endothelial cells to 50 microM H2O2. Evidence of expression of PDGF was sought in samples of cell supernatant collected 48 h after exposure. No evidence of PDGF activity or PDGF antigen could be demonstrated in those supernatants. Although the biologic activities of PDGF suggest that PDGF production by endothelial cells may contribute to the pulmonary pathology associated with acute lung injury, our results suggest that posttranscriptional events may prevent expression of PDGF under the experimental conditions of this investigation.

Animals↗
PubMed1992

Medical audit and quality of care--a new English initiative.

In 1989 the Government in the UK announced a fundamental review of the financing of the National Health Service (NHS). Before the review, health authorities were responsible for both establishing need and providing services. Health Authorities are now allocated resources with which they commission services from managerially independent provider units. In the discussion that preceded the review concern was expressed about standards of clinical care given by doctors. It was recognised that these were professional issues which could not be directly addressed through the commissioning process, therefore within its NHS review proposals, the Government made clear its expectation that all doctors working in the NHS should participate in medical audit. This was defined as a systematic peer review of their work, including procedures used for diagnosis and treatment, the use of resources and the resulting outcome for patients. Managers should be provided with regular general reports of audit activity. These proposals for medical audit have been well received by the medical profession, who are now working closely with the Government to put them into practice.

Health Policy↗
PubMed1992

Some of my patients use drugs. Pregnancy/substance abuse and the physician.

Services to 4,539 newborns prenatally exposed to drugs were provided by the State of Florida in 1990; an estimated 5,911 did not receive services. The number of substance-abusing women identified during pregnancy has risen each of the last three years. As more are identified, receive prenatal care, and are referred for treatment, the low birth weight of these newborns has decreased from 55% in 1988/1989 to 26% in 1990. Women who abuse drugs during pregnancy are considered high risk and have priority in receiving prenatal care and drug treatment.

Female↗