PubMed Health⌕ Search

Biomedical subjects

W C Nicholas

Publications and source records attributed to W C Nicholas.

At least 19 recordsLinked to original sources
PubMed2000

Organizational predictors of prenatal HIV counseling and testing.

OBJECTIVES: Efforts to prevent perinatal transmission of HIV include implementation of prenatal counseling and testing programs. The objective of this study was to assess organizational predictors of HIV counseling and testing. METHODS: Surveillance records were collected on 5900 prenatal patients from 9 hospital and community clinics in Connecticut. RESULTS: Some organizational factors (e.g., type of clinic, dedicated staff) that enhanced counseling rates had the opposite effect on test acceptance. For instance, patients were more likely to be counseled when counseling was conducted by providers; however, test acceptance was more likely when dedicated counselors were available. CONCLUSIONS: These results provide important information concerning clinic resources needed as HIV counseling and testing services continue to be incorporated into prenatal care.

AIDS Serodiagnosis↗
PubMed2000

Primary hypothyroidism presenting as a pituitary mass.

Pituitary enlargement secondary to primary hypothyroidism is a known but uncommon occurrence, which can be difficult to distinguish on computerized tomography (CT) and magnetic resonance imaging (MRI) from primary pituitary tumors. We describe a 33 year old female who was referred to a neurosurgeon for removal of a pituitary mass. The markedly elevated thyrotrophin stimulating hormone (TSH), absence of clinical features of hyperthyroidism, and low thyroid hormone values led to a diagnosis of pituitary enlargement secondary to primary hypothyroidism. The pituitary gland returned to normal size with thyroxine replacement therapy. Surgery was not indicated.

Adult↗
PubMed1995

Single daily dose of methimazole compared to every 8 hours propylthiouracil in the treatment of hyperthyroidism.

This study to compare single-dose and multiple-dose antithyroid therapy was prompted by a perceived lack of compliance in our University Medical Clinics by those patients using multidose regimens. Twenty-two hyperthyroid patients were randomly assigned to two therapy groups. Twelve received methimazole (Tapazole) 30 mg once daily in the morning; 10 received propylthiouracil 100 mg every 8 hours. Patients were seen every 4 weeks for 3 months and assessed clinically, as well as having the appropriate thyroid tests done. Univariate analysis revealed no difference in the two groups at baseline. Posttreatment assessment revealed the once-a-day methimazole therapy to be just as effective as propylthiouracil in improving thyroid indices and clinical markers. Compliance with methimazole was 83.3% compared to 53.3% with propylthiouracil. In conclusion, once-a-day methimazole was just as effective as propylthiouracil every 8 hours in this population. Compliance was also improved with the once-a-day therapy.

Drug Administration Schedule↗
PubMed1992

Estrogen replacement in middle-aged women: thermoregulatory responses to exercise in the heat.

Thermoregulatory, cardiovascular, and body fluid responses during exercise in the heat were tested in five middle-aged (48 +/- 2 yr) women before and after 14-23 days of estrogen replacement therapy (ERT). The heat and exercise challenge consisted of a 40-min rest period followed by semirecumbent cycle exercise (approximately 40% maximal O2 uptake) for 60 min. At rest, the ambient temperature was elevated from a thermoneutral (dry bulb temperature 25 degrees C; wet bulb temperature 17.5 degrees C) to a warm humid (dry bulb temperature 36 degrees C; wet bulb temperature 27.5 degrees C) environment. Esophageal (Tes) and rectal (Tre) temperatures were measured to estimate body core temperature while arm blood flow and sweating rate were measured to assess the heat loss response. Mean arterial pressure and heart rate were measured to evaluate the cardiovascular response. Blood samples were analyzed for hematocrit (Hct), hemoglobin ([Hb]), plasma 17 beta-estradiol (E2), progesterone (P4), protein, and electrolyte concentrations. Plasma [E2] was significantly (P < 0.05) elevated by ERT without affecting the plasma [P4] levels. After ERT, Tes and Tre were significantly (P < 0.05) depressed by approximately 0.5 degrees C, and the Tes threshold for the onset of arm blood flow and sweating rate was significantly (P < 0.05) lower during exercise. After ERT, heart rate during exercise was significantly lower (P < 0.05) without notable variation in mean arterial pressure. Isotonic hemodilution occurred with ERT evident by significant (P < 0.05) reductions in Hct and [Hb], whereas plasma tonicity remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1992

Severe hypertension associated with an intrarenal aneurysm.

A 26-year-old woman with regularly documented normal blood pressure had sudden onset of severe hypertension. Investigation revealed an intrarenal artery aneurysm involving the upper pole of the left kidney, as well as elevated levels of both renin and aldosterone. With ACE inhibitor therapy, blood pressure promptly returned to normal, and subsequent surgical removal of the upper pole of the involved kidney has resulted in normal blood pressure for 9 months of follow-up. Although uncommon, intrarenal aneurysms may lead to severe renal vascular hypertension that is relieved by surgery. This definitive procedure may not take place if one is not aware of the excellent response to ACE inhibitors in this situation.

Adult↗
PubMed1989

Medical and financial implications of discontinuing a statewide free insulin program involving 3,720 people.

In 1981 a statewide program supplying free insulin to 3,720 patients of state health clinics was discontinued. We attempted to assess whether this action had an adverse effect medically and financially on those concerned. A computer randomized sample of 351 patients (9%) was studied by personal interview and questionnaire. Information obtained focused on certain events that occurred 18 months before and after the program ceased. Measurements used to determine medical impact were number of hospitalizations, emergency room and physician visits, changes in weight and glucose levels, and episodes of ketoacidosis. Financial impact was measured by cost of hospitalization and physician visits. Our results revealed no significant changes in any of the medical parameters studied except for fasting serum glucose levels above 300 mg/dl, which occurred less frequently after the free insulin program was discontinued. There were fewer hospitalizations, more visits to physicians, and no change in number of emergency room visits after discontinuance of the free program. The overall cost saving was estimated to be +883,558 for the 18-month study period, in addition to the +550,000 the plan had been costing the state.

Blood Glucose↗
PubMed1983

Body composition, physical work capacity and physical activity habits at 18-month follow-up of middle-aged women participating in an exercise intervention program.

Thirty-six sedentary women (29-47 yr) participated in a 12-week, 4-d/week physical conditioning program (CP) involving 15-25 min/d of walking/jogging at a heart rate corresponding to 75 percent of aerobic capacity (VO2max). Twenty-three were classified obese (O, greater than 30 percent body fat, mean = 38 percent) and 13 normal (N, less than 30 percent body fat, mean = 25 percent). Significant post-CP changes included increased VO2max and decreased body fat. At 18 months post-CP a volunteer subgroup of the original 36 subjects (Ss) were re-evaluated, 19 being hydrostatically weighed, 21 exercise-tested and 28 interviewed to assess physical activity over the preceding eight quarterly periods. At CP termination 80 percent of N and 78 percent of O had intended to continue jogging, but by follow-up only 40 percent of N and 33 percent of O were so engaged, none at CP frequency, many at reduced duration and intensity. There was no significant difference between follow-up and pre-CP mean h/week of jogging for the entire follow-up group, even though eight of them (28 percent) increased their jogging over pre-CP levels. Follow-up VO2max and percent body fat means were also not significantly different from pre-CP values. It is suggested that the majority of middle-aged women participating in supervised walk-jog conditioning interventions may regress to pre-program physiologic status when left to exercise ad libitum.

Adult↗