Medicine and Health Sciences Commons^™

Effect Of Interval To Definitive Breast Surgery On Clinical Presentation And Survival In Early-Stage Invasive Breast Cancer, Olga Vujovic, Edward Yu, Anil Cherian, Francisco Perera, A. Dar, Larry Stitt, A. Hammond

Edward Yu

Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer. Methods and materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined …

Hdl-Cholesterol-Raising Effect Of Orange Juice In Subjects With Hypercholesterolemia, Elzbieta Kurowska, J. Spence, John Jordan, Stephen Wetmore, David Freeman, Leonard Piché, Paula Serratore

Leonard Piché

Background: Orange juice-a rich source of vitamin C, folate, and flavonoids such as hesperidin-induces hypocholesterolemic responses in animals. Objective: We determined whether orange juice beneficially altered blood lipids in subjects with moderate hypercholesterolemia. Design: The sample consisted of 16 healthy men and 9 healthy women with elevated plasma total and LDL-cholesterol and normal plasma triacylglycerol concentrations. Participants incorporated 1, 2, or 3 cups (250 mL each) of orange juice sequentially into their diets, each dose over a period of 4 wk. This was followed by a 5-wk washout period. Plasma lipid, folate, homocyst(e)ine, and vitamin C (a compliance marker) concentrations …

Improving The Health Of Diabetic Patients Through Resident-Initiated Group Visits, Chris Wheelock, Judith A. Savageau, Hugh Silk, Scott Lee

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Group visits have the potential to benefit patients with chronic illnesses. Our objective was to implement resident-run diabetic group visits that would improve patient education and help patients become more involved in their care. METHODS: We developed systems to promote, coordinate, and lead the visits. Residents' responsibilities were delegated through a preparation checklist. A standardized progress note was developed to encourage patient goal setting and to track relevant laboratory test results. To evaluate our program, we conducted surveys to determine patients' behavioral changes and satisfaction levels and assessed the effect on group visit participants' glycated hemoglobin (HbA1c) …

Community Dimensions And Hpsa Practice Location: 30 Years Of Family Medicine Training, Suzanne B. Cashman, Judith A. Savageau, Warren J. Ferguson, Daniel H. Lasser

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Our objective was to assess practicing family physicians' confidence and participation in a range of community-related activities. Additionally, we assessed the strength of the relationship between the physicians' reported medical school and residency training in community-related activities and their current community activities, as well as whether they were practicing in an underserved location. METHODS: All 347 graduates of the University of Massachusetts Family Medicine Residency were surveyed about practice location and type, involvement and training in community work, confidence in community-related skills, and sociodemographic characteristics. Analyses were conducted by residency graduation decade (1976-1985, 1986-1995, and 1996-2005). RESULTS: …

Lesson In A Pill Box: Teaching About The Challenges Of Medication Adherence, Darlene M. O'Connor, Judith A. Savageau, David B. Centerbar, Kimberly N. Wamback, Jennifer S. Ingle, Nicole J. Lomerson

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Medication mismanagement is a serious health issue affecting elders and people with disabilities, who often manage multiple medications. This project's goal was to educate medical and nursing students about the challenges patients face when managing complex medication regimens.

METHODS: A total of 104 first-year medical students and 40 second-year nursing students were randomly assigned to participate in a 1-week regimen of mock prescriptions or to read a description of the regimen and make predictions about what the experience would be like had they participated.

RESULTS: Quantitative results in combination with qualitative information suggest that the students taking …

Low-Cost Hiv-1 Diagnosis And Quantification In Dried Blood Spots By Real Time Pcr, Nishaki Mehta, Sonia Trzmielina, Bareng Nonyane, Melissa Eliot, Rongheng Lin, Andrea Foulkes, Kristina Mcneal, Arthur Ammann, Vindu Eulalievyolo, John Sullivan, Katherine Luzuriaga, Mohan Somasundaran

Rongheng Lin

BACKGROUND: Rapid and cost-effective methods for HIV-1 diagnosis and viral load monitoring would greatly enhance the clinical management of HIV-1 infected adults and children in limited-resource settings. Recent recommendations to treat perinatally infected infants within the first year of life are feasible only if early diagnosis is routinely available. Dried blood spots (DBS) on filter paper are an easy and convenient way to collect and transport blood samples. A rapid and cost effective method to diagnose and quantify HIV-1 from DBS is urgently needed to facilitate early diagnosis of HIV-1 infection and monitoring of antiretroviral therapy.

METHODS AND FINDINGS: We …

The Number Of Axillary Nodes Removed As A Predictor Of Regional Recurrence In Node Negative Breast Cancer, Olga Vujovic, Edward Yu, Anil Cherian, A. Dar, Larry Stitt, Francisco Perera

Edward Yu

Purpose: To determine if the number of axillary nodes removed is a predictor of recurrence in node negative breast cancer. Materials and methods: Five hundred thirty-six patients with T1-T2, N0 invasive breast cancer, treated with lumpectomy and axillary node dissection (AND), were reviewed from January 1, 1986 to December 31, 1992. Patients received radiation to whole breast only, without regional nodal radiation. There was no adjuvant chemotherapy or Tamoxifen given. Patients were grouped according to the number of axillary nodes dissected as follows: 1-5 nodes (91 patients), 6-10 nodes (225 patients) and > 10 nodes (220 patients). Hazard ratios and p-values …

Dual Task Performance In A Healthy Young Adult Population: Results From A Symmetric Manipulation Of Task Complexity And Articulation, Albert Armieri, Jeffrey Holmes, Sandi Spaulding, Mary Jenkins, Andrew Johnson

Andrew M. Johnson

The ability to execute and maintain gait while performing simultaneous cognitive, verbal, or motor tasks ('dual-tasking') is beneficial in many ways. It is well-documented, however, that dual-tasking can result in cognitive or motoric interference that results in diminished gait performance, and impaired secondary task performance. When manipulating cognitive load, it is common to have participants respond verbally to stimuli. While this is an ecologically valid way to measure the effects of cognitive load on gait, it ignores the additional demands inherent in the verbal aspect of the task. In the present study, we manipulated complexity and articulation within a single …