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At least 19 recordsLinked to original sources
PubMed1992

Survival of hypertensive subjects identified on screening: results for sustained and unsustained diastolic hypertension.

Casual readings of blood pressure predict mortality and may reflect either the risk of sustained hypertension, additional components of 'white coat' hypertension or variable blood pressure. This study investigated mortality in 442 men and 360 women with a diastolic pressure (Phase IV) of 90 mmHg and over, unsustained on two subsequent monthly visits, followed for an average of 11 years and compared with a matched control cohort with an initial diastolic pressure (DBP) of less than 90 mmHg. Subjects were identified between 1975 and 1979 by screening 28,257 subjects aged 18-65 years on the lists of general practitioners in seven practices in the United Kingdom. Additionally, 912 men and 844 women with sustained hypertension (DBP > 90 mmHg on at least two out of three occasions) were identified and matched with normotensive controls. In men with sustained hypertension the relative risk (RR) for death from circulatory disease was 1.76, P < 0.01, 95% confidence interval 1.21, 2.58 and in women 1.85, P < 0.05, 95% confidence interval 1.06, 3.24 respectively, while in men with unsustained hypertension the RR = 1.52, P = 0.2, 95% confidence interval 0.81, 2.84. Few circulatory deaths occurred in women with transient hypertension or their controls (five and seven respectively). Despite the screening programme and further treatment, newly discovered subjects with sustained hypertension, both men and women, remain at high risk of cardiovascular mortality. The 95% confidence interval for men with transient hypertension does not exclude a similar adverse effect.

Adolescent↗
PubMedDate not supplied

Unwed adolescent primigravidas identify subject matter for prenatal classes.

The purpose of this descriptive study was to identify areas that the unwed 15- to 19-year-old primigravida felt should be included in prenatal classes. The sample consisted of 15 subjects, three from each year of age, 15 through 19. Data were collected by a structured interview. The findings revealed that these adolescents tended to select topics for prenatal classes that were self-oriented, the most important topic identified being the labor and delivery process. However, the other traditional prenatal class topics were not the major concerns of these adolescents. They preferred a group-discussion-oriented class. These findings could be useful for nurses teaching adolescent prenatal classes.

Adolescent↗
PubMed1990

Community cholesterol screening: medical follow-up in subjects identified with high plasma cholesterol levels.

Population screening or plasma cholesterol is an effective method of detecting hypercholesterolemia; however, follow-up and treatment are essential components of such a program. After a city-wide screening in 1987 of more than 19,872 persons, using a mailed survey with a response rate of 48%, we evaluated subsequent actions of 3,078 individuals with high plasma cholesterol levels. Slightly more than half the population was aware of high blood cholesterol levels prior to the time of screening and apparently used the program for follow-up. Overall, after the screening, 65% consulted a physician within 5 months of screening and blood cholesterol levels were remeasured in 80% of the sample. Procrastination and expense were cited as the primary reasons for failing to consult a physician. If screening is to be effectively utilized as a means of reducing the prevalence of high plasma cholesterol levels, diligent follow-up must be made of all individuals identified to be at increased risk on the basis of their initial values.

Adult↗
PubMed1990

[Interviews with HIV seropositive subjects identified at the time of blood donation: consequences for pre-donation interviews].

This study is based upon an interview with 31 individuals recently detected human immunodeficiency virus (HIV) seropositive through the systematic screening of blood donations. The location of the blood donation, the type of blood donor, the risk of HIV infection, were established. Questions dealt with the use of blood donation as a diagnosis test and on the notion of an oral or written self-exclusion before the blood donation. The majority of the individuals had a classical risk factor of HIV infection and had given blood for serological testing. This data can allow an adaptation of the medical interview preceding the blood donation to the present epidemiological context of HIV infection.

Adult↗
PubMed1991

Non-recurrent laryngeal nerves. The role of digital subtraction angiography to identify subjects.

Three cases of non-recurrence of the right recurrent laryngeal nerve are reported. In one, the predicted anomaly of dorsal origin of the right subclavian artery was confirmed by intravenous digital subtraction angiography (IVDSA). The surgical anatomy and embryology of this rare condition are discussed. Non-recurrent laryngeal nerves are at increased risk of injury, especially during re-operative thyroid surgery. It is, therefore, suggested that an IVDSA be performed in that small subset of patients in whom re-operative thyroid surgery is contemplated on the right, and in whom the nerve was not found at the previous operation.

Angiography, Digital Subtraction↗
PubMed1989

Automated determination of cholinesterase activity in plasma and erythrocytes by flow-injection analysis, and application to identify subjects sensitive to succinylcholine.

This automated spectrophotometric method for determination of cholinesterase activity in erythrocytes and plasma is based on measurement of the choline produced at 30 degrees C by the hydrolysis of acetyl-, butyryl-, or succinylcholine. Blanks, standards, and samples are prepared by a Gilson robotic unit. Use of flow-injection analysis for detection allows use of smaller volumes of reagent and sample. We applied this method to the study of 91 healthy subjects and members of two families with succinylcholine sensitivity. Results with use of the three different substrates for determination of activity in plasma correlated well (r greater than 0.94). Results for plasma and erythrocytes from healthy subjects are lower in women less than 50 years old than in women greater than 50 years or men. Values for plasma obtained with succinylcholine substrate (range: 31 to 100 U/L) allow detection of very sensitive subjects--AA phenotypes (less than 10 U/L)--but do not distinguish the UA from the UU phenotype.

Adult↗
PubMed1990

Concentrations of free thyroxin and free triiodothyronine in serum of patients with thyroxin- and triiodothyronine-binding autoantibodies.

Between 1982 and 1989 we identified 47 subjects with spuriously increased concentrations of free thyroxin (FT4) or free triiodothyronine (FT3) related to autoantibody interference in analog FT4 and (or) FT3 methods. The incidence of autoantibody interference observed during one year (1988) was 1 in 2460. In the subjects identified, 51% and 11%, respectively, showed an increased binding of radiolabeled T4 or T3 analog alone; 38% had an increased binding of both. Of 36 patients tested, 71% had autoantibodies to thyroglobulin and microsomal fraction of the thyroid, 19% to microsomal fraction alone, and 9.5% to thyroglobulin alone. In eight subjects, spuriously increased FT4 concentrations were reported with the following FT4 methods (in decreasing order of interference): Coat-A-Count, Amerlex-M, Amerlite, Seria, Magic Lite, Amerlex-MAB. In the same eight subjects, Amerlex-M and Seria reported spuriously increased concentrations of FT3.

Adolescent↗
PubMed1990

[Immunogenetic and functional study of first-degree relatives of patients with type I diabetes mellitus for identifying prediabetic subjects].

Insulin dependent diabetes mellitus is an autoimmune disease with HLA-related genetic susceptibility. There is a latent phase before overt disease. During this phase islet cell antibodies (ICA) as a marker of humoral autoimmunity are detected and i.v. glucose tolerance test (IVGTT) is decreased. The aim of our work was to correlate IVGTT, HLA typing and ICA testing in all siblings of IDDM patients in order to identify high risk subjects (HRS). IVGTT showed significantly lower insulin levels in siblings vs controls (P less than 0.0001). This phenomenon could be caused by HLA unrelated genetic predisposition to low insulin secretion. Insulin level values of ICA+ siblings were lower than those of ICA- siblings, even if the difference was not significant.

Autoantibodies↗
PubMed1988

Relationship between the discrimination of (w-r) and (t-d) continua and the identification of distorted (r).

The purpose of this study was to assess the extent to which listeners can perceive intraphonemic differences. In Experiment 1, subjects identified synthesized acoustic tokens of child-like speech that varied in second and third formant (F2 and F3) onset frequencies as (w), (r), or distorted (r) in two conditions: (a) with and without feedback of the group response choices, and (b) before and after training to identify the best examples of (w), (r), and distorted (r) based on their identification in the first condition. The results were: (a) some subjects consistently identified distorted (r) above criterion, and (b) feedback was more effective in increasing distorted (r) identification than was training. In Experiment 2, the same subjects participated in discrimination tasks using stimuli from a synthesized child (w-r) continuum that varied in F2 and F3 onsets and from a synthesized adult (t-d) continuum that varied in preconsonantal vowel duration. The results were: (a) perception was not categorical for both continua, (b) little relation was found between distorted-(r) identification and measures of (w-r) discrimination, and (c) a high and significant correlation was found between identification of distorted (r) and within-(d) discrimination. In Experiment 3, different subjects identified the child manifold stimuli and discriminated stimuli in a synthesized child (w-r) continuum and in a synthesized adult (t-d) continuum. The results were: (a) neither (w-r) or (t-d) perception was categorical although the former came closer than the latter in terms of individual subject performance, (b) there was a high and significant correlation between distorted-(r) identification and within-(r) discrimination of (w-r) stimuli, and (c) there were high and significant correlations between distorted-(r) identification and mean, cross-category boundary, and within-(t) discrimination of (t-d) stimuli.

Adult↗
PubMed1989

Assessment of AlbuSure and its usefulness in identifying IDDM subjects at increased risk for developing clinical diabetic nephropathy.

This study, which included 154 participants in a 10-yr follow-up study of diabetes complications, was conducted to evaluate AlbuSure (a qualitative test designed to detect urinary albumin concentrations greater than 0.03 g/L) for its ability to discriminate between albumin concentrations above and below the manufacturer's concentration threshold and to identify individuals at increased risk for developing diabetic nephropathy (i.e., those with albumin excretion rate [AER] greater than 0.0288 g/24 h). The reproducibility of AlbuSure results was also evaluated. The results of these evaluations were examined by three different types of urine collections (24 h, overnight, and timed postclinic) and overall. AlbuSure's validity was examined by comparing its results to immunonephelometrically measured concentrations and AER. When compared to albumin concentration, AlbuSure had an overall sensitivity of 81.8%, specificity of 94.8%, and positive predictive value of 90.6%. AlbuSure's sensitivity was lower (71.4%) when compared with AER; however, this was higher than the sensitivity achieved by dipsticks against AER (50.7%). On testing urine samples stored for 3 days at 4 degrees C, AlbuSure results were 100% reproducible after 1 day and had an overall reproducibility of 92% after 3 days. When urine was retested after 3 and 15 mo of storage at -70 degrees C, AlbuSure was greater than or equal to 90% reproducible, with some of the differing results attributable to corresponding changes in albumin concentration. The overnight sample appeared to be the sample of choice for testing with AlbuSure in that it showed excellent reproducibility and the highest sensitivity (compared to both albumin concentration and AER).

Agglutination Tests↗
PubMed1976

Frequency dependence of total respiratory resistance in early airway disease.

Patients who develop frequency dependence of lung compliance will theoretically have frequency dependence of pulmonary resistance. We investigated the ability of the simpler, noninvasive measurement of frequency dependence of total respiratory resistance to identify subjects with frequency dependence of compliance. Ten healthy nonsmokers, 14 asymptomatic smokers, and 6 patients with obstructive airway disease were studied. Frequency dependence of total respiratory resistance was determined by the superimposed oscillating airflow technique at 3 to 9 cycles per sec, and frequency dependence of lung compliance was determined by measurements at 10 to 80 breaths per min. Spirometry, airway resistance, closing volume, and closing capacity were also measured. Frequency dependence of lung compliance and total respiratory resistance were closely correlated (P less than 0.001, r = 0.82), but closing volume, closing capacity, spirometry, and airway resistance could not be used to identify subjects with abnormal frequency dependence of lung compliance. Measurements of frequency dependence of total respiratory resistance and lung compliance, total respiratory resistance at 3 cycles per sec, and closing volume minus expiratory reserve volume were able to distinguish significantly between the smokers and the nonsmokers, but spirometry, closing volume, closing capacity, and airway resistance could not. These data indicate that in asymptomatic smokers and subjects with obstructive airway disease, frequency dependence of lung compliance can be predicted from measurements of frequency dependence of total respiratory resistance. These two tests appear to have equivalent sensitivity and selectivity in detecting the uneven time constants in the airways of asymptomatic smokers.

Adult↗
PubMedDate not supplied

A study of diagnostic reasoning in pediatric nurses.

PURPOSE: To examine the data collecting and interpreting phases of the diagnostic reasoning process used by practicing pediatric nurses and to determine: (a) types of information deemed important for planning nursing care; (b) the functional health patterns addressed; and (c) frequency of validation of early hypotheses. METHOD: Thirty-four registered nurses who attended continuing education pediatric nursing workshops were asked to analyze a written simulated case study discussing maternal-infant interaction. Diagnostic cues in the case study were based on a framework that consisted of a clinical nursing model of maternal-infant interaction and selected nursing diagnoses. Open-ended questions were used to examine subjects' attention to and interpretation of these cues. FINDINGS: All subjects identified information related to the child's physical needs and the mother's responsibility to meet those needs as important for planning nursing care. There was less attention given to the interaction of mother and child. The most common response was identification of cues associated with five functional health patterns (29.4% of subjects). The functional health pattern, coping-stress tolerance, was addressed least often, although all nurses identified cues associated with role relationship. Only 38% of the subjects identified the need for validation of early hypotheses. CONCLUSION: The findings support the need for further research on the diagnostic reasoning of pediatric nurses. Recommendations include methods to enhance pediatric nurses' collection and interpretation of data specific to the pediatric clinical setting.

Clinical Nursing Research↗
PubMedDate not supplied

Experiences with diabetes mellitus and implantable insulin pump therapy: a summary of interview data.

A semistructured interview was used to elicit information from 23 implantable insulin pump recipients regarding their concerns about having diabetes mellitus, their decision to receive an implantable insulin pump, and their experiences with the pump. Findings indicated that subjects had present and future concerns about having diabetes mellitus and that they wanted an implantable insulin pump primarily to achieve better control of their diabetes. Subjects said their health generally improved after pump implantation and that the pump had minimal interference with their social lives. Although 16 subjects identified concerns about the pump, all subjects said they would decide again for pump implantation.

Adult↗
PubMed1985

Detection of early arterial disease: a study using Doppler waveform analysis.

Laplace transform analysis of arterial Doppler waveforms was examined for its potential in identifying subjects with early, pre-symptomatic arterial disease. Ninety men, aged 45 to 62, and with no history of cardiovascular disease, were selected from a population of 2300 involved in a longitudinal study of risk factors for cardiovascular disease. Forty-nine were selected on the basis of high values of Laplace delta, omega o, or both, and 41 were selected with "normal" values. Three years after initial screening examination, each was examined clinically and by exercise testing for evidence of arterial disease, and the waveform recordings were repeated. In the group with high waveform analysis values initially, 11 of 49 (22%) were found to have signs of arterial disease 3 years later, while among those with lower values only 2 of 41 (5%) had evidence of disease (p less than 0.05). Although variability of results obviates their use in monitoring the progress of individual subjects, this study supports the potential of Doppler waveform analysis for identifying a group of subjects with a high incidence of early arterial disease.

Arteriosclerosis↗
PubMed1991

Holding death at bay: the experience of the spouses of patients undergoing cardiovascular surgery.

This study utilized a grounded theory design to investigate the experiences related to being the spouse of a cardiovascular surgical patient during five subject-identified phases: a) finding out the surgery was necessary, b) waiting for surgery, c) waiting during surgery, d) the intensive care unit (ICU) experience, and e) the recovery period before hospital discharge. Data were collected from each of eight subjects via three unstructured, tape-recorded interviews conducted a) on the day of the patients' hospital admission, b) during the first 48 hours of the patients' ICU stay and c) just before the patients' hospital discharge. Holding Death at Bay was identified as the core category. Three main categories: uncertainty, helping commitment and reorganization emerged from the data and were apparent in each of the five subject-identified phases of the spouses' experience. Main categories and subcategories of the core category emerging from the data are described. Implications of this research for nursing practice and further nursing research are discussed.

Adaptation, Psychological↗
PubMed1990

Screening for thyroid disease in children with IDDM.

The aim of this study was to evaluate the usefulness of screening for thyroid disease by performing thyroid function tests and measuring thyroid autoantibodies in 371 children and adolescents with insulin-dependent diabetes mellitus (IDDM). We analyzed clinical data and results of serum thyroxine, triiodothyronine uptake, thyroid-stimulating hormone, and antibodies to thyroid microsomal antigen and thyroglobulin. Goiter was noted in 20% of subjects. Thyroid-specific autoantibody was positive in 19% of subjects. Twenty-seven subjects (7%) had thyroid dysfunction. Autoantibody testing identified subjects with thyroid dysfunction with a sensitivity of 50%, a specificity of 84%, a degree of misclassification of 17%, a positive predictive value of 13%, and a negative predictive value of 97%. We recommend that all children and adolescents be screened shortly after diagnosis of IDDM by determination of thyroid-stimulating hormone (measured by high-sensitivity assay) to identify thyroid dysfunction and by testing for antibody to thyroid microsomal antigen to characterize both risk of future thyroid dysfunction and the need for future testing.

Adolescent↗