Medicine and Health Sciences Commons^™

Risk In Emergency Research Using A Waiver Of/Exception From Consent: Implications Of A Structured Approach For Institutional Review Board Review, Andrew Mcrae, Stacy Ackroyd-Stolarz, Charles Weijer

Charles Weijer

OBJECTIVE: To apply component analysis, a structured approach to the ethical analysis of risks and potential benefits in research, to published emergency research using a waiver of/exception from informed consent. The hypothesis was that component analysis could be used with a high degree of interrater reliability, and that the vast majority of emergency research would comply with a minimal-risk threshold.

METHODS: A Medline search and manual search were done to identify studies using a waiver of/exception from informed consent published between July 1996 and December 2000. A review panel of physicians and bioethicists independently classified nontherapeutic procedures in each study …

16s Rrna Gene Sequence And Phylogenetic Tree Of Lactobacillus Species From The Vagina Of Healthy Nigerian Women, Kingsley Anukam, Emmanuel Osazuwa, Ijeoma Ahonkhai, Gregor Reid

Kingsley C Anukam

Lactobacilli are ubiquitous in nature and in humans they play a very significant role in the general health maintenance of the host. Identification of Lactobacilli has previously been based on cultutre-dependent methods and recently molecular techniques involving gene sequencing are now the ‘gold standard’. Scarce information exists in Africa on the real identity of Lactobacillus species, albeit phylogenetic distances among the species present in the human vagina. 185 vaginal swabs were collected from healthy premenopausal women (18-48 years). Bacterial DNA was extracted, amplified using PCR, with group specific Lactobacillus primers, and processed by denaturing gradient gel electrophoresis (DGGE). DGGE bands …

Evaluation Of The Federal Government's Human Health Preparedness Plan Developed In Response To The H5n1 Threat., Chiehwen Ed Hsu

Chiehwen Ed Hsu

Dr. Hsu reacted to President Bush's Avian Flu Preparedness and Response Plan in a media briefing panel at the National Press Club, Washington DC.

Short- And Long-Term Cause-Specific Survival Of Patients With Inflammatory Breast Cancer, Patricia Tai, Edward Yu, Ross Shiels, Juan Pacella, Kurian Jones, Evgeny Sadikov, Shazia Mahmood

Edward Yu

Background: Inflammatory breast cancer (IBC) had been perceived to have a poor prognosis. Oncologists were not enthusiastic in the past to give aggressive treatment. Single institution studies tend to have small patient numbers and limited years of follow-up. Most studies do not report 10-, 15- or 20-year results. Methods: Data was obtained from the population-based database of the Surveillance, Epidemiology, and End Results program of the National Cancer Institute from 1975-1995 using SEER*Stat5.0 software. This period of 21 years was divided into 7 periods of 3 years each. The years were chosen so that there was adequate follow-up information to …

Evaluating Clinical Rating Scales For Evidence-Based Dermatology: Some Basic Concepts, Madhulika Gupta, Andrew Johnson, Mary-Margaret Chren

Andrew M. Johnson

Evidence-based dermatology has necessitated the development of rating scales that measure multidimensional and abstract constructs, such as quality of life. This article discusses some basic psychometric concepts, such as reliability, validity, standardization, and measurement precision, which need to be considered when choosing a clinical rating instrument. Also discussed is the impact of these parameters on increasing the statistical power of a clinical trial.

Meaningful Work As Due Inducement, Charles Weijer

Charles Weijer

No abstract provided.

Disclosure Of Research Result To Research Participants: Needs And Attitudes Of Adolescents And Parents, Conrad Fernandez, Shaureen Taweel, Eric Kodish, Charles Weijer

Charles Weijer

BACKGROUND: Researchers have a moral responsibility to offer to return research results to participants, but the needs and attitudes of parents and adolescents with cancer in paediatric oncology regarding the issue are relatively unknown.

OBJECTIVES: To explore the needs of potential research participants or their guardians with respect to the offer of a return of research results. METHODS: A questionnaire was used in a focus group and in telephone interviews with eight adolescents and 12 parents of children with cancer. The participants were asked to respond to the questions and to comment on the inclusiveness of the questionnaire.

RESULTS: The …

Does Sex Influence The Impact That Smoking, Treatment Interruption And Impaired Pulmonary Function Have On Outcomes In Limited Stage Small Cell Lung Cancer Treatment?, Gregory Videtic, Pauline Truong, Robert Ash, Edward Yu, Walter Kocha, Mark Vincent, Anna Tomiak, A Dar, Frances Whiston, Larry Stitt

Edward Yu

PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy. METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial. RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women. Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M …

Smooth Pursuit Neck Torsion Test In Whiplash Associated Disorders - Relationship To Self Reports Of Neck Pain And Disability, Dizziness And Anxiety, Julia Treleaven, Gwendolen Jull, Nancy Low Choy

Nancy Low Choy

Objective:
The smooth pursuit neck torsion test is thought to be a measure of neck afferent influence on eye movement control and is useful in assessing subjects with whiplash, especially those complaining of dizziness. Nevertheless, it is not known whether impairments identified relate only to abnormal cervical afferentation or are influenced by levels of anxiety or neck pain.

Design:
A prospective, 3-group, observational design.

Subjects:
One hundred subjects with persistent whiplash (50 complaining of dizziness, 50 not complaining of dizziness) and 50 healthy controls.

Methods:
The smooth pursuit neck torsion test was performed and analysed taking into account subjects' reported …

Minimum Follow-Up Time Required For The Estimation Of Statistical Cure Of Cancer Patients: Verification Using Data From 42 Cancer Sites In The Seer Database, Patricia Tai, Edward Yu, Gábor Cserni, Georges Vlastos, Melanie Royce, Ian Kunkler, Vincent Vinh-Hung

Edward Yu

Background: The present commonly used five-year survival rates are not adequate to represent the statistical cure. In the present study, we established the minimum number of years required for follow-up to estimate statistical cure rate, by using a lognormal distribution of the survival time of those who died of their cancer. We introduced the term, threshold year, the follow-up time for patients dying from the specific cancer covers most of the survival data, leaving less than 2.25% uncovered. This is close enough to cure from that specific cancer. Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database were …

Oral Probiotics For Maternal And Newborn Health, Gregor Reid, Kingsley Anukam, Vanessa James, Henny Van Der Mei , Christine Heinneman, Henk Busscher, Andrew Bruce

Kingsley C Anukam

The recent papers by Nishijima et al 1 and Morelli et al.2 not only confirmed our previous studies that orally administered lactobacilli can confer benefits on vaginal health, but began to uncover new concepts of disease prevention. Each day, over 7,000 women acquire HIV, a disease whose prevalence is significantly raised by absence of lactobacilli from the vagina3. In addition, over 23,000 babies (conservative 7% estimate) are born premature each day, and although it’s difficult to know how many are associated with bacterial vaginosis (BV), it could represent over 2,000 babies per day. Nishijima’s use of culture and failure to …

A Death In The Family: Reflections On The Terri Schiavo Case, Charles Weijer

Charles Weijer

No abstract provided.

Is Clinical Research And Ethics A Zero-Sum Game?, Charles Weijer

Charles Weijer

No abstract provided.

E-Public Health Information Systems: E-Technologies For Public Health. Preparedness And Surveillance., Chiehwen Hsu, Francisco Soto Mas

Chiehwen Ed Hsu

No abstract provided.

Cranio-Cervical Stabilization Of Traumatic Atlanto-Occipital Dislocation With Minimal Resultant Neurological Deficit, Pennie Seibert, P. Stridh-Igo, T. Whitmore, B. Dufty, C. Zimmerman

Pennie S. Seibert

Our purpose is to describe a case of atlanto-occipital dislocation and discuss treatment approaches to minimize subsequent neurological deficits. Traumatic atlanto-occipital dislocation, has traditionally been considered rare and lethal, due to resulting high levels of spinal cord injury. Outcomes are generally expected to be poor. However, recent case reports indicate that survival is increasing. Of patients who survive cranio-cervical dislocation, many endure resulting neurological deficits.

We present a rare case of a 23-year-old male, who sustained an atlanto-occipital dislocation in a motor vehicle accident. The patient presented with a Glasgow Coma Scale (GCS) of 11T. Lateral C-spine x-ray and thin-section …

Two Forms Of The Large Tumor Suppressor Gene (Lats1) Protein Expressed In The Vertebrate Retina, Novrouz B. Akhmedov, Clyde K. Yamashita, Dai Tran, Natik I. Piri, Gustavo D. Aguirre, Debora B. Farber

Gustavo D. Aguirre, VMD, PhD

How Well Does B-Type Natriuretic Peptide Predict Death And Cardiac Events In Patients With Heart Failure: Systematic Review, Jenny Doust, Eva Pietrzak, Annette Dobson, Paul Glasziou

Jenny Doust

Objective To assess how well B-type natriuretic peptide (BNP) predicts prognosis in patients with heart failure. Design Systematic review of studies assessing BNP for prognosis in patients with heart failure or asymptomatic patients. Data sources Electronic searches of Medline and Embase from January 1994 to March 2004 and reference lists of included studies. Study selection and data extraction We included all studies that estimated the relation between BNP measurement and the risk of death, cardiac death, sudden death, or cardiovascular event in patients with heart failure or asymptomatic patients, including initial values and changes in values in response to treatment. …

"Why Privatizing Social Security Is A Terrible Idea", Max Skidmore

Max J. Skidmore

No abstract provided.

The Proto-Oncogene C-Kit Maps To Canid B-Chromosomes, Alexander S. Graphodatsky, Anna V. Kukekova, Dmitry V. Yudkin, Vladimir A. Trifonov, Nadezhda V. Vorobieva, Violetta R. Beklemisheva, Polina L. Perelman, Daria A. Graphodatskaya, Lyudmila N. Trut, Fengtang Yang, Malcolm A. Ferguson-Smith, Gregory M. Acland, Gustavo D. Aguirre

Gustavo D. Aguirre, VMD, PhD

Long-Term Survival Rates Of Laryngeal Cancer Patients Treated By Radiation And Surgery, Radiation Alone, And Surgery Alone: Studied By Lognormal And Kaplan-Meier Survival Methods, Patricia Tai, Edward Yu, Ross Shiels, Jon Tonita

Edward Yu

Background: Validation of the use of the lognormal model for predicting long-term survival rates using short-term follow-up data. Methods: 907 cases of laryngeal cancer were treated from 1973-1977 by radiation and surgery (248), radiation alone (345), and surgery alone (314), in registries of Connecticut and Metropolitan Detroit of the SEER database, with known survival status up to 1999. Phase 1 of this study used the minimum chi-square test to assess the goodness of fit of the survival times of those who died with disease to a lognormal distribution. Phase 2 used the maximum likelihood method to estimate long-term survival rates …

From Perception To Execution In Parkinson’S Disease, Andrew Johnson, Quincy Almeida

Andrew M. Johnson

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects one’s ability to control voluntary movements. Typically, PD is considered a disease of motor output, without considering neuropsychological variables that might contribute to the impairment of movement. The goal of this chapter is to investigate issues of motor control, in addition to the observable motor symptoms found in PD from a perceptual and cognitive perspective. To this end, we divide movement into three components: perception, initiation, and execution. Perception is required initially, and throughout movement, and is generally used to define characteristics of a movement goal. Thus, in the earliest …

Standing Balance In Persistent Wad – Comparison Between Subjects With And Without Dizziness, Julia Treleaven, Gwendolen Jull, Nancy Low Choy

Nancy Low Choy

Objective:
Dizziness and unsteadiness, associated with altered balance, are frequent complaints in subjects suffering persistent whiplash associated disorders. Research has been inconclusive with respect to possible aetiology. This study assessed balance responses in subjects with whiplash associated disorders, taking into account several possible causes.

Design:
A prospective, 3 group, observational design.

Subjects:
100 subjects with persistent whiplash associated disorders, 50 complaining of dizziness, 50 not complaining of dizziness and 50 healthy controls.

Methods:

The Clinical Test for Sensory Interaction in Balance was performed in both comfortable and tandem stance. The sway trace was analysed using wavelet analysis.

Conclusion:
The results …

The Use Of A Writing Group To Enhance Voice And Connection Among Staff Nurses, Rosanna Demarco, Susan Roberts, Genevieve Chandler

Genevieve E. Chandler

The aim of this study was to pilot test a group-writing intervention to decrease negative workplace behaviors. The pilot test demonstrated that cohesive and supportive relationships developed and allowed nurses to talk about important topics. The participants suggested that a writing group would be a forum that could be used by staff development educators to encourage nurses to support each other and develop their voices.

Castration Inhibits The Exercise-Induced Accumulation Of Hsp70 In Male Rodent Cardiac Muscle Tissue, Kevin Milne, David Thorp, C.W. Melling, Earl Noble

Jamie Melling

Intense exercise leads to accumulation of the inducible member of the 70-kDa family of heat shock proteins, Hsp70, in male, but not female, hearts. Estrogen is at least partially responsible for this difference. Because androgen receptors are expressed in the heart and castration leads to decreases in calcium regulatory proteins and altered cardiac function, testosterone (T) or its metabolites could also be involved. We hypothesized that removal of endogenous T production through castration would reduce cardiac Hsp70 accumulation after an acute exercise bout, whereas castrated animals supplemented with 5α-dihydrotestosterone (DHT) would show the intact male response. Fifty-four 8-wk-old male Sprague-Dawley …

Changes In Calcineurin Expression Induced In The Rat Brain By The Administration Of Antipsychotics, W. Rushlow, Y. Seah, Daniel Belliveau, N. Rajakumar

Daniel J. Belliveau

Calcineurin (CN) was recently identified as a susceptibility gene for schizophrenia as well as showing altered RNA expression levels in the post-mortem brains of individuals with schizophrenia. CN knockout mice show a number of behaviours associated with schizophrenia, including deficits in sensorimotor gating, suggesting a link between CN and psychosis. Concurrently, we found, using genome screening techniques, that antipsychotics alter CN expression levels. Therefore, western blotting, in situ hybridization, immunocytochemistry and phosphatase assays were employed to determine what effect antipsychotics have on CN. The results indicate that clozapine, risperidone and haloperidol cause substantial reductions in the A subunit of CN …

Identifying Health Centers In Honduras Infested With Rhodnius Prolixus Using The Seroprevalence Of Chagas Disease In Children Younger Than 13 Years, Geoffrey Spurling, Romuald Lucas, Jenny Doust

Jenny Doust

The objective of this study is to determine if a Chagas disease protocol starting with a serological survey is as reliable at identifying insect-infested areas as one using the gold standard entomological survey. The study found that health center areas infested with Rhodnius prolixus were identified using a threshold seroprevalence of 0.1%. The serological survey took half the time and was 30% less expensive than the entomological survey. Developing countries with limited resources may find this strategy useful in combating Chagas disease. This strategy also identifies seropositive children, which facilitates their treatment.

Brain Nerve Conduction Velocity Is A Valid And Useful Construct For Studying Human Cognitive Abilities: A Reply To Saint-Amour Et Al, Andrew Johnson, T. Reed, Philip Vernon

Andrew M. Johnson

No abstract provided.

Nerve Growth Factor Increases Connexin43 Phosphorylation And Gap Junctional Intercellular Communication, P. Cushing, R. Bhalla, A. Johnson, W. Rushlow, S. Meakin, Daniel Belliveau

Daniel J. Belliveau

The function of gap junctions is regulated by the phosphorylation state of their connexin subunits. Numerous growth factors are known to regulate connexin phosphorylation; however, the effect of nerve growth factor on gap junction function is not understood. The phosphorylation of connexin subunits is a key event during many aspects of the lifecycle of a connexin, including open/close states, assembly/trafficking, and degradation, and thus affects the functionality of the channel. PC12 cells infected with connexin43 (Cx43) retrovirus were used as a neuronal model to characterize the signal transduction pathways activated by nerve growth factor (NGF) that potentially affect the functional …

The Use Of A Writing Group To Enhance Voice And Connection Among Staff Nurses, Genevieve Chandler, R. Demarco, S. Roberts

Genevieve E. Chandler

The aim of this study was to pilot test a group-writing intervention to decrease negative workplace behaviors. The pilot test demonstrated that cohesive and supportive relationships developed and allowed nurses to talk about important topics. The participants suggested that a writing group would be a forum that could be used by staff development educators to encourage nurses to support each other and develop their voices.

Evaluating Risks Of Non-Therapeutic Research In Children, Paul Miller, Charles Weijer

Charles Weijer

No abstract provided.