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PubMed2002

Drug use and suicide attempts: the role of personality factors.

This study on suicide attempts is part of a large research project on dependent behavior in adolescents and young adults. 228 subjects aged 14-25 (107 "drug abusers," 121 controls) from the French speaking part of Switzerland were evaluated on the basis of a semi-structured interview (Mini International Neuropsychiatric Interview), enabling a DSM-IV diagnosis, and self-reports (SSS by Zuckermann, MMPI-2, IDI by Hirschfeld). 31.5% of "drug abuser" males and 41.2% of "drug abuser" females committed one or more suicide attempts. The results of a logistic regression show that the significant factor explaining suicide attempts in drug users is emotional reliance for males and experience-seeking for females.

Adolescent↗
PubMed2003

Willingness to participate in complementary and alternative medicine clinical trials among patients with craniofacial disorders.

OBJECTIVES: The Oregon Center for Complementary and Alternative Medicine (OCCAM) conducted focus groups with participants to determine willingness to join a complementary and alternative medicine (CAM) research study, and to aid in the design of three clinical randomized controlled trials (RCTs) of CAM and craniofacial disorders. SETTING/LOCATION: Center for Health Research, Kaiser Permanente, in Portland, Oregon. SUBJECTS: Kaiser Permanente health plan members meeting RCT inclusion criteria. DESIGN: Twelve (12) focus groups were conducted with a total of 85 participants. Six (6) of the focus groups were with members who self-identified as users of CAM therapies. Focus groups explored participants' experiences of CAM for temporomandibular disorder (TMD) and periodontal disease, and their reactions to proposed aspects of the trials. Trained facilitators led the focus groups, which lasted approximately 2 hours and were audiotaped for future transcription. Researchers then coded the transcripts to identify responses to specific questions and to capture emergent themes. RESULTS: Acupuncture, chiropractic, and massage were most frequently accessed and reported as helpful by participants. Participants who had not used CAM treatments for their condition expressed interest and openness to experiencing CAM treatments through a research study. In general, participants expressed willingness to be randomly assigned to (rather than choose) a CAM treatment arm. Travel to practitioners' offices and frequent (> 1 per week) visits were acceptable to most participants, if there was flexibility in appointment scheduling. CONCLUSIONS: Findings indicate considerable willingness to engage in CAM trials, even among individuals who have not used CAM. Participants' willingness to engage in CAM studies was influenced by the nature of their condition, their prior experiences with conventional and CAM treatments, and the possibility of experiencing CAM "for free" through participation in the trial. Their acceptance also was tempered by concerns about particular modalities and the possibility of having to give up aspects of their current health routine. Researchers engaging in CAM studies should take these factors into consideration as they design studies.

Adult↗
PubMed1979

Algorithm-derived, computer-generated interpretive comments in the reporting of laboratory tests.

The volume of laboratory and other data that physicians encounter daily is more than most can mentally process without oversight or error. Routine use of computer-generated reminders is one solution to this problem that is now widely suggested. We report our experience with the daily use of a user-written program of algorithm-derived, computer-generated comments in the reporting of chemical profiles and routine thyroid function tests in a busy medium-sized privately owned independent clinical laboratory.

Blood Chemical Analysis↗
PubMed2005

NCBI GEO: mining millions of expression profiles--database and tools.

The Gene Expression Omnibus (GEO) at the National Center for Biotechnology Information (NCBI) is the largest fully public repository for high-throughput molecular abundance data, primarily gene expression data. The database has a flexible and open design that allows the submission, storage and retrieval of many data types. These data include microarray-based experiments measuring the abundance of mRNA, genomic DNA and protein molecules, as well as non-array-based technologies such as serial analysis of gene expression (SAGE) and mass spectrometry proteomic technology. GEO currently holds over 30,000 submissions representing approximately half a billion individual molecular abundance measurements, for over 100 organisms. Here, we describe recent database developments that facilitate effective mining and visualization of these data. Features are provided to examine data from both experiment- and gene-centric perspectives using user-friendly Web-based interfaces accessible to those without computational or microarray-related analytical expertise. The GEO database is publicly accessible through the World Wide Web at http://www.ncbi.nlm.nih.gov/geo.

Animals↗
PubMed1995

Historical overview of non-steroidal anti-inflammatory drugs.

Non-steroidal anti-inflammatory drugs (NSAIDs) are efficacious in the control of arthritis symptoms and have become the mainstay of arthritis therapy. While NSAIDs' chief mechanism of action has long been assumed to be the inhibition of prostaglandin synthesis, further investigation has implicated additional mechanisms, and shed light upon additional side-effects. Adverse renal effects and effects on bone and cartilage metabolism are counted among worrisome NSAID-induced side-effects, but gastrointestinal side-effects represent the greatest threat to chronic NSAID users. It is important that we combine documented experience of side-effect risk with our growing knowledge of potential risk to frame a prescriptive approach to the arthritis patient that encompasses symptom management as well as patient protection.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1998

The production of English inflectional morphology, speech production and listening performance in children with cochlear implants.

OBJECTIVE: To compare how children who use either cochlear implants (CIs) or hearing aids (HAs) express English inflectional morphemes during conversation, i.e., with voice, with sign, or with both. A secondary objective was to investigate the relationship between morpheme use in pediatric CI users and their speech perception skills, length of experience with the device, and accuracy of phoneme production. DESIGN: Group 1 consisted of 25 children who used CIs, and Group 2 consisted of 13 children who used HAs. All children were prelingually deafened and all used simultaneous communication. A 12 minute spontaneous conversation was elicited, transcribed and coded. Between group comparisons were performed to evaluate differences in modality and number of morphemes used. Additionally, use of morpheme endings was related to length of CI experience, accuracy of phoneme production, and closed-set speech recognition performance. RESULTS: Children who had CI experience produced significantly more English inflected morphemes than children in the HA group. CI participants also expressed the inflected endings by using voice-only mode 91% of the time, whereas HA participants used voice-only mode 1% of the time. In the CI group, a strong relationship was found between number of morpheme endings used and speech recognition scores, length of CI experience and accuracy of phoneme production. The results of this study indicate that input from the CI facilitates children's ability to perceive and comprehend bound morphemes.

Adolescent↗
PubMed2002

Association of attention-deficit/hyperactivity disorder symptoms with levels of cigarette smoking in a community sample of adolescents.

OBJECTIVE: Research on the association of attention-deficit/hyperactivity disorder (ADHD) with cigarette smoking has primarily occurred within samples of clinically referred youths. This paper reports the association of ADHD symptoms with smoking practices in a community sample of adolescents. METHOD: Confidential self-report surveys were completed by 1,066 tenth-grade students enrolled in five public high schools who were taking part in a longitudinal study of biobehavioral predictors of adolescent smoking adoption. A well-standardized measure of ADHD inattention and hyperactivity-impulsivity symptoms, as well as demographic and social risk factors, were examined in relation to three levels of cigarette smoking: (1) never having smoked, (2) ever having smoked, and (3) current smoking (having smoked a cigarette within the past 30 days). RESULTS: Regarding lifetime cigarette use, approximately 43% of students had ever smoked. Among those who had ever smoked, approximately 31% of students were current smokers. Ever having smoked was associated with family (odds ratio [OR] = 2.49, confidence interval [CI] = 1.85, 3.36) and peer smoking (OR = 4.05, CI = 3.07, 5.33) and clinically significant ADHD inattention symptoms (OR = 3.39, CI = 1.53, 7.54). Current smoking was also associated with peer smoking (OR = 2.99, CI = 1.72, 5.20) and clinically significant ADHD inattention symptoms (OR = 2.80, CI = 1.20, 6.56). CONCLUSION: Clinically significant ADHD symptoms should be taken into account when identifying adolescents at risk to smoke, since those with problematic inattention may be more likely to experiment with smoking and to become regular tobacco users.

Adolescent↗
PubMed2005

The effect of RANTES chemokine genetic variants on early HIV-1 plasma RNA among African American injection drug users.

HIV-1 plasma RNA is a prognostic indicator of HIV-1, and increased levels of HIV-1 plasma RNA are associated with rapid progression to AIDS. Because chemokines and chemokine receptors are involved in the binding and entry of HIV-1, possible effects of host genetics on viral RNA levels should be visible in early infection. HIV-1 plasma RNA was measured within 2 years of seroconversion in 198 seroincident injection drug users followed in the AIDS Link to Intravenous Experience cohort. Genetic variants were identified in the chemokine receptors (CCR2, CCR5, and CCR5 promoter) and the chemokine RANTES using TaqMan and restriction fragment length polymorphism assays. Linear regression of RANTES haplotypes on early HIV-1 plasma RNA identified individuals homozygous for the RANTES R1 haplotype as having a lower viral load by almost one-half log10 unit compared with those bearing non-RANTES R1 haplotypes (-0.43, 95% confidence interval: -0.74, -0.12). Genetic variants in RANTES may downregulate RANTES gene expression and increase early HIV-1 plasma RNA. Because RANTES is a critical chemokine and competitively inhibits HIV-1 by binding to its receptor CCR5, treatment to enhance RANTES expression may assist in delaying the progression of AIDS by decreasing the initial viral load.

Acquired Immunodeficiency Syndrome↗
PubMed2004

A user's guide to enhancing geriatrics in an undergraduate medical school curriculum: the ten-step model to winning the "geriatric game".

In 1999, the University of Rochester School of Medicine and Dentistry committed to major restructuring of its undergraduate medical school curriculum. A distinguishing feature of this reform was the planned emphasis on and integration of several core topics or themes throughout the 4 years of the curriculum. One of these curricular themes was aging. The faculty in geriatrics was presented with an unparalleled opportunity to develop a geriatrics curriculum of major proportions through the development of an aging theme. Through a user's guide approach based on the authors' experience to date, this article identifies the 10 steps necessary to "win the geriatric game" successfully integrating an aging theme into an undergraduate medical school curriculum. Since the initiation of the aging theme, several new courses, cases, and conferences have been added or enhanced, affecting all 4 years of the curriculum. Key operational challenges included successful engagement of course directors, tracking the actual experience of the aging theme, and evaluation of students' attainment of learning objectives and eventual career choices. The authors' experience suggests that an aging theme can successfully enhance the geriatrics curricular content of undergraduate education and strongly affect students across all 4 years. This 10-step approach may serve as a model for other universities committed to integrating geriatrics across the full undergraduate medical curriculum.

Aged↗
PubMed1999

Effects of stimulation mode on threshold and loudness growth in multielectrode cochlear implants.

The effect of increasing the separation between the two members of a stimulating electrode pair was studied in four users of the Nucleus-22 cochlear implant. Two experiments were performed. In experiment 1, detection threshold for a 200-ms, 500-pulses/s biphasic pulse train was measured as the spatial separation between the active and return electrodes was increased. In experiment 2, loudness-growth functions were measured as the electrode separation was increased. The results of experiment 1 indicate that (a) threshold decreases monotonically toward an asymptote (monopolar threshold) as the electrode separation is increased and (b) the threshold versus electrode separation function is similar across subjects and electrode location. The results of experiment 2 indicate that loudness L is related to the current amplitude I by a simple exponential function: L = e beta I, where beta, the exponent of the loudness function, is, to a first approximation, linearly related to the separation between the electrodes of the stimulating pair. Thus, dynamic range and the shape of loudness growth can be directly linked to the spatial separation between active and return electrodes.

Auditory Threshold↗
PubMed2006

Preliminary report of a gas conditioner to improve operational reliability of cryotherapy in developing countries.

BACKGROUND: Cryotherapy is a safe, affordable, and effective method of treatment for cervical intraepithelial neoplasia. In some low-resource settings, environmental conditions or qualities of the refrigerant gas can lead to blockage of cryotherapy equipment, terminating treatment. A prototype of a gas conditioner to prevent operational failure was designed, built, and field tested. METHODS: The prototype conditioner device consists of an expansion chamber that filters and dries the refrigerant gas. Users in Peru and Kenya reported on their experience with the prototype conditioner. In Ghana, simulated cryotherapy procedures were used to test the effects of the prototype conditioner, as well as the commonly used "cough technique." RESULTS: Anecdotal reports from field use of the device were favorable. During simulated cryotherapy, the prevalence of blockage during freezing were 0% (0/25) with the device alone, 23.3% (7/30) with the cough technique alone, 5.9% (1/17) with both, and 55.2% (16/29) with neither (Pearson's Chi square = 26.6, df = 3, p < 0.001 (comparison amongst all groups)). CONCLUSION: This prototype design of a cryotherapy gas conditioner is a potential solution for low-resource settings that are experiencing cryotherapy device malfunction.

Journal Article↗
PubMed1999

Are nonproper chopstick holders clumsier than proper chopstick holders in their manual movements?

To examine the working hypothesis that a lack of childhood training in the fine-detailed finger movements illustrated by learning to use chopsticks properly as a child has later rendered such individuals clumsier in the execution of other more adult-like motor movements, four experiments were conducted. Groups of proper and nonproper users (both males and females) performed a task of picking up rice grains (Exp. 1), a pin-down task (Exp. 2), a task of unfastening nuts from bolts (Exp. 3), and a knot-tying task (Exp. 4). Only on the rice-grain transfer task and the knot-tying task, proper chopstick users showed better performance than nonproper users. On the pin-down task and the nuts-and-bolts task, no difference was found between groups. These results suggest that there is no clear evidence to support the hypothesis that a lack of early training for proper chopstick use makes such individuals more clumsy as adults in at least some motor movements.

Adult↗
PubMed1977

Experimental heroin users: an epidemiologic and psychosocial approach.

An interview study was conducted on a sample of experimental heroin users involved in an adolescent heroin epidemic. Results showed that heroin use patterns varied, with high users stabilizing at a low frequency of use over a long period of time. Results also showed that experimental users were more likely to occur in the late phase of a local heroin outbreak. Psychosocial data indicated that high users differed from low users in that they had less supportive family experiences, more experience with the criminal justice system, and less positive feelings about self and future.

Adolescent↗
PubMed1989

[A multi-purpose voice recording and encoding device using a micro computer].

A device for recording and encoding voice stimuli was developed with the NEC-PC 9801 micro computer. Sampling times are 100 microseconds (10 kHz), and one recording time can be lasted up to 15 s. The sound stimuli are monitored on the computer display. These stimuli could be edited directly by the cursor and saved onto a floppy disk. A multi purpose program was also developed for this apparatus. This program allows the user to manipulate the stimuli for various auditory experiments such as dichotic listening tests etc.

Acoustic Stimulation↗
PubMedDate not supplied

Details on demand: consumers, cancer information, and the Internet.

An increasing number of patients and their families have Internet access and use it to make sense of their cancer experience. Search engines and subject guides take Internet users to cancer-related Web sites that contain information of varying quality and accuracy. Several organizations have attempted to create evaluation tools for cancer information on the Internet. They are, for the most part, untested, but they can serve as a practical guide for coaching patients and family members on the use of the Internet. Evaluating Internet information with guidelines, dealing with Internet-savvy patients and families, and the use of e-mail in clinical practice are discussed.

Access to Information↗
PubMed1992

[N2 cryotherapy and excision. Indications and limits in eyelid basalioma].

Some ophthalmic surgeons have preferred N2-cryosurgery for many years. Others feel that only excisional surgery should be used. In this article both possibilities are discussed in an effort to facilitate a well-balanced choice. A total of 262 basalioma patients treated by cryosurgery from 1979 to 1988 were evaluated to assess the indications for cryosurgery. The histological findings were taken into consideration, as were the results of other authors. The comparison with histopathologically controlled excisions was based on discussions with users of the Mohs technique, literature, and personal experience. No other technique permits as much healthy tissue to be saved as N2-cryosurgery; this is especially important in the areas of the lid margin and lacrimal pathways. Complete involvement of the tumor edges can be achieved by generous extension of the treatment area and biopsies taken beyond the expected tumor margins and tumor base (subsequent to tunneling and cryosurgery from the basal side). In excisional surgery, the Mohs technique is required. Its advantage is that biopsies can be taken all around the tumor for histology and its disadvantage is prolonged operation time (in ad hoc frozen sections) or delayed wound closure (second or third surgical procedure several days later). This can be avoided in tumors that are suitable for cryosurgery. The Mohs technique, however, is mandatory in deeply infiltrating tumors in which cryosurgery is not indicated. The two methods complement one another. This is supported by the long-term results.

Basal Cell Carcinoma↗
PubMedDate not supplied

Home care for life-supported persons: the French system of quality control, technology assessment, and cost containment.

Home care for persons who require the prolonged use of life-supportive medical technology is a reality in several nations. France has had more than a quarter of a century of experience with providing home care for patients with chronic respiratory insufficiency and with a system to evaluate the patients' outcomes. The French approach features decentralized regional organizations which offer grassroots involvement by the beneficiaries who participate directly in the system. Since June 1981, a national organization has provided patients, professionals, and others concerned with direct access to national funding authorities and governmental officials and has created a data base for evaluation of the experience. This system permits direct input by current users of the services and creates informed opinion among members of the general public, governmental officials, and others involved (health care professionals and service providers). This is essential for the development of responsive public policy and for the determination of the relevancy of programs. In the United States, increasing demands are being made upon expensive hospital services by patients with diseases such as AIDS and other catastrophic, long-term care conditions. Cost-saving, community-oriented home care models serving complex medical-societal needs abroad are worthy of study to discern possible applications to health and social problems in our nation.

Financing, Government↗