Is there sex bias in the management of coronary artery disease?
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Coronary Disease↗
Biomedical subjects
W R Smith
Publications and source records attributed to W R Smith.
Timing of insemination in dairy heifers.
Data representing 676 AI of 372 virgin dairy heifers during 1984 to 1987 at the University of Illinois were analyzed by analysis of variance to determine the effect of timing of AI on conception rate. Standing to be mounted, bawling, and attempting to mount were the three criteria used for determining the presence of estrus. More than 90% of the observations were conducted by one herdsperson between 0700 and 1600 h daily. Heifers were artificially inseminated with frozen semen from 58 bulls by one of two technicians. Conception rate on first AI was 56%, determined by return to estrus or 33- to 50-d rectal palpation for pregnancy. Conception rate to second and later AI was near 40%. Eighty-six percent of the heifers conceived during the trial. The average interval between first observation of standing estrus and AI was 10.5 h; the range was 15 min to 33 h. The model discussed contained six variables: time interval between first observation of standing estrus and AI (group), breed, sire within breed, year bred, season bred, and inseminator. The analysis of variance of conception to first AI showed timing of AI and service sire as the two most significant effects. Conception to first AI was worst when AI occurred 13.5 to 33 h after first observation of estrus. No factors considered were significant sources of variation for second or later AI.
Animals↗
Prevalence of hearing loss in adults with sickle cell disease.
Hearing status in 75 adult subjects with sickle cell disease was examined. Thirty-one (or 41%) of the subjects failed the hearing screening. When examined by hemoglobin type, it was found that persons with sickle cell C disease had the greatest incidence of hearing loss, although all subject groups exhibited greater prevalence rates than the general population. The results suggest that routine audiologic assessment be incorporated into the regular medical examination for adults with sickle cell disease.
Adolescent↗
Hearing disorders in sickle cell disease: cochlear and retrocochlear findings.
The auditory system was assessed in 34 adult subjects with sickle cell disease using standard audiometric test techniques. The study results indicate that patients with sickle cell disease are at risk for retro-cochlear as well as cochlear dysfunction of the auditory system. However, there is no consistent audiometric pattern that is pathognomonic of sickle cell disease. The test results indicate that auditory status should be carefully monitored in all adult patients with sickle cell disease.
Acoustic Impedance Tests↗
Mathematical analysis of perifusion data: models predicting elution concentration.
System models are constructed and analyzed for combined convective flow and for dispersion in distorting concentrations of a chemical signal as it passes through a packed column. We derive general analytical solutions for these models. The results have applications to analyses such as in biological experiments involving hormonal stimulation of perifused cells, elution chromatography, adsorption columns, and studies of groundwater flow. The models reveal that the column distorts an incoming signal (such as a change in solute concentration in the flowing liquid) at the inlet. This distortion is greatest at low values of the Peclet number of the flow and is small at larger values. We explore the effects of the approximations inherent in the mathematical models of the system. Specification of the boundary conditions of the problem are shown to be particularly important. With the use of incorrect models, it is possible to obtain accurate interpolations to data obtained from perfusion experiments. However, the parameters derived (in particular the dispersion constant and the peak concentration of a solute concentration pulse) may be considerably in error. This may lead to errors when these parameter estimates are used to predict results in other experimental situations.
Animals↗
Quality of life of patients on in-center hemodialysis versus continuous ambulatory peritoneal dialysis.
This study compared chronic hemodialysis and CAPD patients on several quality of life variables: dietary adherence, self-esteem, hope, wellbeing, marital happiness, perceived control over life, marital status, number of emotional support persons, and participation in social, recreational, and work activities. Statistically significant differences in the quality of life variables due to treatment modality or demographic variables were not found. However, CAPD patients did engage in significantly more social and recreational activity, though not more work activity, than did hemodialysis patients. It is noted that 73% of the CAPD patients were Caucasian and that 72% of the hemodialysis patients were of black origin. Similarly skewed racial compositions in preceding research comparing patients on CAPD and hemodialysis suggest that 1. choice of treatment is occurring on the basis of some set of patient characteristics, or 2. systematic assignment is occurring on the basis of race, sex, and/or education. However, given no significant race/demography differences for variables used in this research, it appears that quality of life across racially different groups of hemodialysis and CAPD patients is comparable.
Black or African American↗
A 70-kDa apolipoprotein designated ApoJ is a marker for subclasses of human plasma high density lipoproteins.
A new apolipoprotein, termed apolipoprotein J (apoJ), was purified from human plasma by immunoaffinity chromatography. ApoJ is a glycoprotein consisting of disulfide-linked subunits of 34-36 and 36-39 kDa. Each subunit is glycosylated and has a pI range of 4.9-5.4. ApoJ exists in the plasma associated with high density lipoproteins (HDL) and specifically with subclasses of HDL which also contain apoAI and cholesteryl ester transfer protein activity. Immunoaffinity purified apoJ-HDL subclasses have apparent molecular masses of 80, 160, 240, 340, and 520 kDa, as determined by gradient gel electrophoresis. By negative staining electron microscopy, apoJ-HDL range in diameter from 5 to 16 nm. Fractionation of plasma by vertical gradient density centrifugation revealed apoJ-HDL in HDL2 (d 1.063-1.125 g/ml) with the majority overlapping HDL3 (d 1.125-1.21 g/ml) and very high density lipoprotein (d 1.21-1.25 g/ml). The bimodal density distribution of apoJ-HDL suggests that these subclasses have a unique metabolic relationship and may play a role in the transport of cholesterol from peripheral tissues to the liver.
Antibodies, Monoclonal↗
Analysis of binding in macromolecular complexes: a generalized numerical approach.
In this work, we introduce a generalized, global numerical methodology for analysis of binding phenomena in complex macromolecular assemblies. On the basis of a numerical algorithm (EQS) to solve systems of simultaneous free energy equations, binding profiles of simple to highly complex interacting systems can be analyzed over any concentration region without any need to generate an analytical form to describe the data. The output of the numerical algorithm is the concentration of each individual species in solution, allowing the generation of all possible binding profiles of the system (e.g., protein saturation by ligand). We present here the application of this approach to the DNA-protein subunit-ligand interactions of the trp repressor system as a typical example. From a practical point of view, the analysis program is capable of the rapid and simultaneous analysis of multiple binding profiles in terms of internally consistent sets of free energies. Given both the enormous complexity, as well as the underlying subtlety, involved in the regulation of biological function, the present generalized approach to analyzing macromolecular binding should find wide applications.
Algorithms↗
Decision making at the bedside: lessons for clinical policy development.
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Decision Making↗
Health perceptions and medical care opinions of inner-city adults with sickle cell disease or asthma compared with those of their siblings.
Inner-city adults (n = 108) with a chronic disease (sickle cell disease or asthma) and their unaffected siblings (n = 50) were interviewed and ratings of health perceptions and opinions about medical care were compared. Persons with a chronic disease reported unfavorable ratings of their health (P less than .001). Their siblings reported moderately favorable health perceptions but much worry and concern about their health. When compared with the asthma subgroup, persons with sickle cell disease reported more adverse ratings of health outlook susceptibility to illness, sickness orientation, humaneness of medical care, and satisfaction with medical care (P less than .05). These observations demonstrate low health perceptions in adults with two chronic medical conditions and more negative perceptions in persons with sickle cell disease. They indicate possible opportunities for improving medical care for patients with these conditions to achieve better perceptions of health, outlook, and medical services.
Adolescent↗
Captopril-associated acute interstitial nephritis.
A 57-year-old male with mild impairment of renal function secondary to diabetic glomerulosclerosis developed acute renal failure (creatinine 32.4 mg/dl) associated with a generalized desquamative skin rash and peripheral eosinophilia shortly after initiation of antihypertensive therapy with captopril. An acute interstitial nephritis was demonstrated on renal biopsy, and improvement was temporally related to initiation of therapy with prednisone. A review of the literature revealed 5 similar cases in whom acute deterioration of renal function occurred following initiation of captopril and in whom there were features of a hypersensitivity reaction, including skin rash, fever, eosinophilia, azotemia, eosinophiluria, and a Coombs-positive hemolytic anemia. Renal biopsy, where available, revealed an acute interstitial nephritis. Observations from these cases suggest that, of the angiotensin-converting enzyme inhibitors, this syndrome appears to be specific for captopril, begins within the 1st month of therapy, is not dose-dependent, and generally resolves on cessation of therapy. Steroids may hasten recovery, but sufficient data are not available to confirm their efficacy.
Acute Kidney Injury↗
Effects of a smoking ban on a general hospital psychiatric service.
After a private general hospital announced plans to ban smoking inside the hospital, the authors initiated a study on the psychiatric units to identify anticipated and actual patient-related problems associated with the ban and to assess staff and patient attitudes toward the ban. Data were obtained through pre- and post-ban surveys of medical and nursing staff and predischarge interviews with patients. The findings showed that staff anticipated more smoking-related problems than actually occurred and that patients who smoked were able to reduce their tobacco use during their hospital stay. No evidence was found to suggest that hospitalized psychiatric patients are less capable of cutting down on smoking than the general population.
Adaptation, Psychological↗
A cadaveric study of the anatomic variations of the recurrent motor branch of the median nerve.
Anatomic dissections were performed in 72 cadaveric upper extremities from 36 cadavers to determine the incidence of anomalous variations in the course of the median nerve and its branches. The classic recurrent motor branch anatomy was demonstrated in 86% of the dissections (62/72). Of the 10 variations noted (14% of all upper extremities), all were transretinacular branches that pierced the transverse carpal ligament 2 to 6 mm proximal to the distal edge. Of the six cadavers with anomalous branching, four (67%) had bilateral anomalies and two (33%) had unilateral branching.
Cadaver↗
Rocky Mountain spotted fever (American tick typhus)
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Adult↗
MMPI-based personality types among juvenile sexual offenders.
The MMPIs of 262 adolescent males who committed sexual offenses were categorized by means of cluster analysis into four distinct groups. Each of these groups was found to contain different two-point code types. Referral offense, historical and clinical data were compared for each of the four cluster groups and for each of the two-point code types; the latter provided more reliable discrimination among groups. The four modal personality types suggested by the cluster analysis indicate, contrary to previous research, that juvenile sexual offenders are a heterogeneous group who represent a wide variety of personality traits and levels of adaptation.
Adolescent↗
Adult age differences in the use of story structure in delayed free recall.
Thirty-six young adults (M age = 24.3 years) and 36 old adults (M age = 71.8 years) listened to four double-episode stories having either standard, interleaved, or scrambled structure. Two days later they were asked to recall the stories. Analysis of the mean number of nodes recalled revealed no age differences in the recall of standard and scrambled stories with both groups recalling the standard stories equally well and the scrambled stories equally poorly. However, for interleaved stories, young adults followed their pattern of recall for standard stories while old adults followed their pattern for scrambled stories. Also, the age groups differed in their pattern of additions and distortions, with old adults giving more for standard stories and young adults giving more for scrambled stories. Results appear to support models of age-related differences in memory processes and/or strategies when material must be reorganized or hierarchized. Possible metacognitive differences were also discussed; i.e., old adults may aim to tell the story interestingly, while young adults aim to tell it accurately.
Adolescent↗
Qualitative mathematical models of endocrine systems.
Some qualitative dynamical models of endocrine systems are considered and analyzed, with the reproductive endocrine system as an example. The models considered are systems of nonlinear ordinary differential equations describing the rates of change of the hormonal concentrations with time. This type of general approach, which requires only the incorporation of the basic qualitative features of the interactions present in the underlying system into the model, is a potentially powerful tool for elucidating possible mechanisms for observed qualitative patterns of hormonal dynamics.
Animals↗
The diagnostic laboratory tests for histoplasmosis: analysis of experience in a large urban outbreak.
Of 495 patients reported in a large urban histoplasmosis outbreak, we studied 276 whose serologic tests were done in a single laboratory. Serologic test results were positive in 96% of these patients (compared with less than 5% of controls from an endemic area), cultures were positive in 22%, and special stains in 19%. The immunodiffusion test results were negative in 13% of patients who had positive findings by complement fixation, and 1% had positive results only by immunodiffusion. The complement fixation test was almost twice as sensitive as the immunodiffusion test in patients with subclinical infection. The serologic response differed significantly among the clinical syndromes with higher titers in cavitary and lower titers in disseminated disease. Factors associated with titers of 1:64 or greater to both antigens were black race and immunocompetence. High mycelial titers were also associated with more intense exposure, and high yeast titers were associated with age less than 36 years. No prognostic significance could be proved for fourfold titer rises or falls or persistence of precipitins.
Adolescent↗