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Hawkins MS, Pokutnaya DY, Duan D, Coughlin JW, Martin LM, Zhao D, Goheer A, Woolf TB, Holzhauer K, Lehmann HP, Lent MR, McTigue KM, Bennett WL. Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study. Sleep Health 2023; 9:767-773. [PMID: 37268482 DOI: 10.1016/j.sleh.2023.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/22/2023] [Accepted: 03/26/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To examine cross-sectional and longitudinal associations of individual sleep domains and multidimensional sleep health with current overweight or obesity and 5-year weight change in adults. METHODS We estimated sleep regularity, quality, timing, onset latency, sleep interruptions, duration, and napping using validated questionnaires. We calculated multidimensional sleep health using a composite score (total number of "good" sleep health indicators) and sleep phenotypes derived from latent class analysis. Logistic regression was used to examine associations between sleep and overweight or obesity. Multinomial regression was used to examine associations between sleep and weight change (gain, loss, or maintenance) over a median of 1.66 years. RESULTS The sample included 1016 participants with a median age of 52 (IQR = 37-65), who primarily identified as female (78%), White (79%), and college-educated (74%). We identified 3 phenotypes: good, moderate, and poor sleep. More regularity of sleep, sleep quality, and shorter sleep onset latency were associated with 37%, 38%, and 45% lower odds of overweight or obesity, respectively. The addition of each good sleep health dimension was associated with 16% lower adjusted odds of having overweight or obesity. The adjusted odds of overweight or obesity were similar between sleep phenotypes. Sleep, individual or multidimensional sleep health, was not associated with weight change. CONCLUSIONS Multidimensional sleep health showed cross-sectional, but not longitudinal, associations with overweight or obesity. Future research should advance our understanding of how to assess multidimensional sleep health to understand the relationship between all aspects of sleep health and weight over time.
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Affiliation(s)
- Marquis S Hawkins
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
| | - Darya Y Pokutnaya
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Daisy Duan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janelle W Coughlin
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Lindsay M Martin
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Attia Goheer
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas B Woolf
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Katherine Holzhauer
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harold P Lehmann
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle R Lent
- Department of Clinical Psychology, School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Kathleen M McTigue
- Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wendy L Bennett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Coughlin JW, Martin LM, Zhao D, Goheer A, Woolf TB, Holzhauer K, Lehmann HP, Lent MR, McTigue KM, Clark JM, Bennett WL. Electronic Health Record-Based Recruitment and Retention and Mobile Health App Usage: Multisite Cohort Study. J Med Internet Res 2022; 24:e34191. [PMID: 35687400 PMCID: PMC9233254 DOI: 10.2196/34191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/01/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To address the obesity epidemic, there is a need for novel paradigms, including those that address the timing of eating and sleep in relation to circadian rhythms. Electronic health records (EHRs) are an efficient way to identify potentially eligible participants for health research studies. Mobile health (mHealth) apps offer available and convenient data collection of health behaviors, such as timing of eating and sleep. OBJECTIVE The aim of this descriptive analysis was to report on recruitment, retention, and app use from a 6-month cohort study using a mobile app called Daily24. METHODS Using an EHR query, adult patients from three health care systems in the PaTH clinical research network were identified as potentially eligible, invited electronically to participate, and instructed to download and use the Daily24 mobile app, which focuses on eating and sleep timing. Online surveys were completed at baseline and 4 months. We described app use and identified predictors of app use, defined as 1 or more days of use, versus nonuse and usage categories (ie, immediate, consistent, and sustained) using multivariate regression analyses. RESULTS Of 70,661 patients who were sent research invitations, 1021 (1.44%) completed electronic consent forms and online baseline surveys; 4 withdrew, leaving a total of 1017 participants in the analytic sample. A total of 53.79% (n=547) of the participants were app users and, of those, 75.3% (n=412), 50.1% (n=274), and 25.4% (n=139) were immediate, consistent, and sustained users, respectively. Median app use was 28 (IQR 7-75) days over 6 months. Younger age, White race, higher educational level, higher income, having no children younger than 18 years, and having used 1 to 5 health apps significantly predicted app use (vs nonuse) in adjusted models. Older age and lower BMI predicted early, consistent, and sustained use. About half (532/1017, 52.31%) of the participants completed the 4-month online surveys. A total of 33.5% (183/547), 29.3% (157/536), and 27.1% (143/527) of app users were still using the app for at least 2 days per month during months 4, 5, and 6 of the study, respectively. CONCLUSIONS EHR recruitment offers an efficient (ie, high reach, low touch, and minimal participant burden) approach to recruiting participants from health care settings into mHealth research. Efforts to recruit and retain less engaged subgroups are needed to collect more generalizable data. Additionally, future app iterations should include more evidence-based features to increase participant use.
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Affiliation(s)
- Janelle W Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United States
| | - Lindsay M Martin
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Di Zhao
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United States.,Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Attia Goheer
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Thomas B Woolf
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Katherine Holzhauer
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Harold P Lehmann
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michelle R Lent
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Kathleen M McTigue
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jeanne M Clark
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United States.,Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Wendy L Bennett
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, United States.,Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Martin LM, Stöcker C, Sauerwein H, Büscher W, Müller U. Evaluation of inner teat morphology by using high-resolution ultrasound: Changes due to milking and establishment of measurement traits of the distal teat canal. J Dairy Sci 2018; 101:8417-8428. [PMID: 29935835 DOI: 10.3168/jds.2018-14500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/07/2018] [Indexed: 11/19/2022]
Abstract
The teat canal is important in the defense against invading pathogens, but its functional features can be impeded by the milking process. The objective of our study was to compare teat morphology before and after a standard milking procedure using high-resolution ultrasonography. Tissue changes were determined by measuring inner traits of teat morphology: teat width, teat end width, teat cistern width, diameter of the lower and upper teat wall, teat canal length, and teat canal diameter. Additionally, 3 traits describing the distal teat canal and its external orifice were established: diameter of the distal teat canal orifice, distal teat canal perimeter, and distal teat canal surface. In the first trial, we verified the repeatability of scanning over time with a mixed model. During the second trial, significant changes after milking were observed for all measured traits of teat morphology except teat end width. The traits from the distal teat canal and its orifice were remarkably changed by milking: distal teat canal orifice, +28.9%; distal teat canal perimeter, +25.0%; and distal teat canal surface, +41.5%. Comparing multiparous versus primiparous cows, higher values of teat width, teat end width, and teat canal length were observed in the older animals. Testing the effect of milk yield on teat dimensions, cows with milk yields >11.0 kg/afternoon milking were found to have larger teat widths, teat end widths, and cistern widths before attachment of the cluster. Furthermore, we observed associations of inner teat morphology toward bacterial counts in the appropriate milk. Regarding this udder health-related parameter especially, the newly established traits showed a connection. Teats in which milk showed bacterial growth had larger distal teat canal perimeters and distal teat canal surfaces. High-resolution ultrasonographic scanning of dairy teats allowed a detailed visualization of the inner morphology. The applied procedure can therefore serve as a useful tool for comparison and evaluation of different milking techniques by analyzing the resulting changes of the morphological traits. The thorough description of teat tissue can also be applied for drawing conclusions on the status of the teat canal's physical and mechanical defense function.
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Affiliation(s)
- L M Martin
- Institute of Animal Science, Department of Physiology and Hygiene, University of Bonn, Bonn 53115, Germany; Center of Integrated Dairy Research, University of Bonn, Bonn 53115, Germany.
| | - C Stöcker
- Institute of Animal Science, Department of Physiology and Hygiene, University of Bonn, Bonn 53115, Germany
| | - H Sauerwein
- Institute of Animal Science, Department of Physiology and Hygiene, University of Bonn, Bonn 53115, Germany
| | - W Büscher
- Institute of Agricultural Engineering, Department of Livestock Technology, University of Bonn, Bonn 53115, Germany
| | - U Müller
- Institute of Animal Science, Department of Physiology and Hygiene, University of Bonn, Bonn 53115, Germany; Center of Integrated Dairy Research, University of Bonn, Bonn 53115, Germany
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Martin LM, Bukoski AD, Whelchel DD, Evans TJ, Wiedmeyer CE, Black SJ, Johnson PJ. Pharmacokinetics of intravenous lithium chloride and assessment of agreement between two methods of lithium concentration measurement in the horse. Equine Vet J 2017; 50:537-543. [PMID: 29112289 DOI: 10.1111/evj.12778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 10/29/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pharmacokinetics of lithium chloride (LiCl) administered as a bolus, once i.v. have not been determined in horses. There is no point-of-care test to measure lithium (Li+ ) concentrations in horses in order to monitor therapeutic levels and avoid toxicity. OBJECTIVES To determine the pharmacokinetics of LiCl in healthy adult horses and to compare agreement between two methods of plasma Li+ concentration measurement: spectrophotometric enzymatic assay (SEA) and inductively coupled plasma mass spectrometry (ICP-MS). STUDY DESIGN Nonrandomised, single exposure with repeated measures over time. METHODS Lithium chloride was administered (0.15 mmol/kg bwt) as an i.v. bolus to eight healthy adult horses. Blood samples were collected pre-administration and at multiple times until 48 h post-administration. Samples were analysed by two methods (SEA and ICP-MS) to determine plasma Li+ concentrations. Pharmacokinetics were determined based on the reference ICP-MS data. RESULTS Adverse side effects were not observed. The SEA showed linearity, R2 = 0.9752; intraday coefficient of variation, 2.5%; and recovery, 96.3%. Both noncompartmental and compartmental analyses (traditional two-stage and nonlinear mixed-effects [NLME] modelling) were performed. Geometric mean values of noncompartmental parameters were plasma Li+ concentration at time zero, 2.19 mmol/L; terminal elimination half-life, 25.68 h; area under the plasma concentration-time curve from time zero to the limit of quantification, 550 mmol/L min; clearance, 0.273 mL/min/kg; mean residence time, 31.22 h; and volume of distribution at steady state, 511 mL/kg. Results of the traditional two-stage analysis showed good agreement with the NLME modelling approach. Bland-Altman analyses demonstrated poor agreement between the SEA and ICP-MS methods (95% limits of agreement = 0.14 ± 0.13 mmol/L). MAIN LIMITATIONS Clinical effects of LiCl have not been investigated. CONCLUSIONS The LiCl i.v. bolus displayed pharmacokinetics similar to those reported in other species. The SEA displayed acceptable precision but did not agree well with the reference method (ICP-MS). The Summary is available in Spanish - see Supporting Information.
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Affiliation(s)
- L M Martin
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - A D Bukoski
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - D D Whelchel
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - T J Evans
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - C E Wiedmeyer
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - S J Black
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - P J Johnson
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
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Martin LM, Espel-Huynh HM, Marando-Blanck S, Evans BC, Forman EM, Butryn ML, Baer RA, Wolever RQ, Herbert JD. Trusting homeostatic cues versus accepting hedonic cues: A randomized controlled trial comparing two distinct mindfulness-based intervention components. Journal of Contextual Behavioral Science 2017. [DOI: 10.1016/j.jcbs.2017.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Glassman LH, Martin LM, Bradley LE, Ibrahim A, Goldstein SP, Forman EM, Herbert JD. A Brief Report on the Assessment of Distress Tolerance: Are We Measuring the Same Construct? J Rat-Emo Cognitive-Behav Ther 2015. [DOI: 10.1007/s10942-015-0224-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Redgrave GW, Coughlin JW, Schreyer CC, Martin LM, Leonpacher AK, Seide M, Verdi AM, Pletch A, Guarda AS. Refeeding and weight restoration outcomes in anorexia nervosa: Challenging current guidelines. Int J Eat Disord 2015; 48:866-73. [PMID: 25625572 DOI: 10.1002/eat.22390] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 12/16/2014] [Accepted: 01/02/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Cohort study from February 2003 through May 2011 to determine weight restoration and refeeding complication outcomes for patients with anorexia nervosa (AN) treated in an integrated inpatient-partial hospital eating disorder program designed to produce rapid weight gain and weight restoration in the majority. METHOD Consecutive admissions (females and males, adolescents and adults; N = 361 patients, 461 admissions) at least 1.8 kg below target weight with AN or subthreshold variants were included. Main outcome measures were rates of hypophosphatemia, transfer to medicine, or death; rates of weight gain and percent achieving weight restoration. RESULTS Hypophosphatemia was present in 7.9% of cases at admission and in 18.5% at some point during treatment. Hypophosphatemia was mild to moderate. Lower admission body mass index (BMI), but not rate of weight gain, predicted hypophosphatemia [OR = 0.65; p < .00001 (95% CI 0.57-0.76)]. Five patients (1.1%) were transferred to medicine or surgery, none because of refeeding. There were no deaths. Mean inpatient weight gain was 1.98 kg/week; mean partial hospital weight gain was 1.36 kg/week. By program discharge, 71.8% of adults reached a BMI of 19, 58.5% a BMI of 20. For adolescents, 80.4% came within 2 kg of their target weight; 76.1% came within 1 kg. DISCUSSION Refeeding patients with AN using a hospital-based, behavioral protocol may be accomplished safely and more rapidly than generally recognized, weight restoring most patients by discharge. Helpful elements may include the program's integrated, step-down structure; multidisciplinary team approach emphasizing group therapy to effect behavior change; and close medical monitoring for those with BMI < 15.
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Affiliation(s)
- Graham W Redgrave
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Janelle W Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Colleen C Schreyer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lindsay M Martin
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
| | - Anne K Leonpacher
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Margaret Seide
- Department of Psychiatry, Staten Island University Hospital, New York
| | - Antonia M Verdi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Allisyn Pletch
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Angela S Guarda
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Arigo D, Schumacher L, Martin LM. Upward appearance comparison and the development of eating pathology in college women. Int J Eat Disord 2014; 47:467-70. [PMID: 24375614 DOI: 10.1002/eat.22240] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 11/26/2013] [Accepted: 12/14/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Body dissatisfaction and disordered eating behaviors are common among college women, yet only a subset of this population develops clinically significant disordered eating symptoms during college. Appearance-based social comparisons, particularly those made to others with "better" bodies (i.e., upward appearance comparisons), have demonstrated concurrent relationships with body dissatisfaction and disordered eating. Little is known about the value of these comparisons for predicting the development of eating pathology, however. METHOD The present study examined the predictive value of upward appearance comparisons, as well as established risk factors (e.g., body dissatisfaction, negative affect), for the onset of clinically significant eating pathology over one college semester. College women (N = 454) completed validated self-report measures at the beginning of one semester, and again nine weeks later. RESULTS Women who were newly above the clinical threshold for eating pathology at follow-up (n = 31) exhibited stronger baseline tendencies toward upward appearance comparisons than women who were below the threshold at both time points. In contrast, women who were already above the clinical threshold at baseline scored higher on established risk factors. DISCUSSION These findings suggest that the extent of upward appearance comparison may be useful for identifying college women at particular risk for developing clinically significant disordered eating symptoms.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
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Timko CA, Juarascio AS, Martin LM, Faherty A, Kalodner C. Body image avoidance: An under-explored yet important factor in the relationship between body image dissatisfaction and disordered eating. Journal of Contextual Behavioral Science 2014. [DOI: 10.1016/j.jcbs.2014.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Matsusaki T, Sakai T, Boucek CD, Abu-Elmagd K, Martin LM, Amesur N, Thaete FL, Hilmi IA, Planinsic RM, Aggarwal S. Central venous thrombosis and perioperative vascular access in adult intestinal transplantation. Br J Anaesth 2012; 108:776-83. [PMID: 22362673 DOI: 10.1093/bja/aes016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Venous access is crucial in intestinal transplantation, but a thrombosed venous system may prevent the use of central veins of the upper body. The incidence of venous thrombosis and the necessity to perform alternative vascular access (AVA) in intestinal transplant recipients have not been fully investigated. METHODS Records of adult patients who underwent intestinal transplantation between January 1, 2001, and December 31, 2009, were reviewed. Contrast venography was performed as pre-transplantation screening. Vascular accesses at the transplantation were categorized as I (percutaneous line via the upper body veins), II (percutaneous line via the lower body veins), and III (vascular accesses secured surgically, with interventional radiology, or using non-venous sites). Categories II and III were defined as AVA. Risk factors for central venous thrombosis and those for requiring AVA were analysed, respectively. RESULTS Among 173 patients, central venous obstruction or stenosis (<50% of normal diameter) was found in 82% (141 patients). AVA was required in 4.6% (eight patients: four in each category II and III). Large-bore infusion lines were placed via the femoral arteries in all category III patients without complications. Existing inferior vena cava filter and hypercoagulable states were identified as the risk factors for the use of AVA, but not for central venous thrombosis. Outcomes of patients who underwent AVA were similar to those of patients without AVA. CONCLUSIONS The majority of adult patients undergoing intestinal transplantation had at least one central venous stenosis or obstruction. The recipient outcomes were comparable when either standard vascular access or AVA was used for transplantation.
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Affiliation(s)
- T Matsusaki
- Department of Anesthesiology, University of Pittsburgh School of Medicine, UPMC Montefiore, 200 Lothrop Street, Pittsburgh, PA 15213, USA
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Langner MC, Kantner CLS, Chu YH, Martin LM, Yu P, Seidel J, Ramesh R, Orenstein J. Observation of ferromagnetic resonance in SrRuO3 by the time-resolved magneto-optical Kerr effect. Phys Rev Lett 2009; 102:177601. [PMID: 19518833 DOI: 10.1103/physrevlett.102.177601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Indexed: 05/27/2023]
Abstract
We report the observation of ferromagnetic resonance (FMR) in SrRuO3 using the time-resolved magneto-optical Kerr effect. The FMR oscillations in the time-domain appear in response to a sudden, optically induced change in the direction of easy-axis anisotropy. The high FMR frequency, 250 GHz, and large Gilbert damping parameter, alpha approximately 1, are consistent with strong spin-orbit coupling. We find that the parameters associated with the magnetization dynamics, including alpha, have a nonmonotonic temperature dependence, suggestive of a link to the anomalous Hall effect.
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Affiliation(s)
- M C Langner
- Department of Physics, University of California, Berkeley, California 94720, USA
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Abstract
Bone is highly dynamic and responsive. Bone location, bone type and gender can influence bone responses (positive, negative or none) and magnitude. Type I diabetes induces bone loss and increased marrow adiposity in the tibia. We tested if this response exhibits gender and location dependency by examining femur, vertebrae and calvaria of male and female, control and diabetic BALB/c mice. Non-diabetic male mice exhibited larger body, muscle, and fat mass, and increased femur BMD compared to female mice, while vertebrae and calvarial bone parameters did not exhibit gender differences. Streptozotocin-induced diabetes caused a reduction in BMD at all sites examined irrespective of gender. Increased marrow adiposity was evident in diabetic femurs and calvaria (endochondrial and intramembranous formed bones, respectively), but not in vertebrae. Leptin-deficient mice also exhibit location dependent bone responses and we found that serum leptin levels were significantly lower in diabetic compared to control mice. However, in contrast to leptin-deficient mice, the vertebrae of T1-diabetic mice exhibit bone loss, not gain. Taken together, our findings indicate that TI-diabetic bone loss in mice is not gender, bone location or bone type dependent, while increased marrow adiposity is location dependent.
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Affiliation(s)
- Lindsay M Martin
- Department of Physiology, Biomedical Imaging Research Center, Michigan State University, 2201 Biomedical Physical Science Bldg, East Lansing, MI 48824, USA.
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Affiliation(s)
- L M Martin
- Center for Liver Diseases, Inova Fairfax Hospital, Annandale, VA 22003, USA.
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Elouafi I, Nachit MM, Martin LM. Identification of a microsatellite on chromosome 7B showing a strong linkage with yellow pigment in durum wheat (Triticum turgidum L. var. durum). Hereditas 2002; 135:255-61. [PMID: 12152344 DOI: 10.1111/j.1601-5223.2001.t01-1-00255.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The objective of this study is to identify QTLs linked to yellow pigment content in durum wheat. A durum-dicoccoides genetic linkage map was constructed using 124 microsatellites, 149 amplified fragment length polymorphism (AFLPs), and six seed storage proteins (SSP) in a population of 114 recombinant inbred lines (F8). The population has been obtained from a cross between a durum cultivar Omrabi5 and Triticum dicoccoides600545 and backcrossed to Omrabi5. The map consists of 14-durum chromosomes plus an unknown group; and shows a good synteny to the previously published wheat maps. Yellow pigment was measured in the population in three different locations during 3 seasons. Analysis of QTLs was based on simple and simplified composite interval mapping (SIM and sCIM). Three QTLs for yellow pigment were detected on the chromosomal group 7 (7AL and 7BL telomeres) explaining 62% of the total variation. On 7BL, a major microsatellite (Xgwm344) explained by itself 53%, whereas on 7AL, the other two QTLs have contributed 13 and 6%. All determined QTLs showed a strong genetic effect and a weak QTL x E effect. The QTLs effect was consistent across all environments and showed a large effect. Consequently, promising QTLs will be used in the marker assisted breeding program to enhance the selection efficiency for yellow pigment.
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Affiliation(s)
- I Elouafi
- Cordoba University, Dept of Genetics, ETSIA Agronomos, Cordoba 14080, Spain
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Abstract
OBJECTIVES In this paper we describe the proportion of US adults who report receiving oral cancer screening and tobacco cessation counseling and assistance from dentists and other health professionals. METHODS Data from the 1992 National Health Interview Survey (NHIS) Cancer Control Supplement, a nationally representative sample of 12,035 adults 18 years of age and older, are analyzed. RESULTS In 1992, less than 10 percent of adults reported oral cancer screening by a dentist or hygienist within the past three years. White adults (10.1%, 95% CI = 9.3, 10.9) reported an oral cancer screening three times more frequently than black (3.2%, 95% CI = 1.9, 4.5) or Hispanic (3.4%, 95% CI = 2.1, 4.7) adults. About half of adult current smokers had seen a dentist within 12 months, and of those only 24.1 percent (95% CI = 21.7, 26.5) had been advised to quit smoking. Heavy smokers (two or more packs a day) were more likely to have been advised to quit than light (pack or less per day) or occasional smokers. A similar proportion (24.3%, 95% CI = 17.6, 31.0) of white adult men who reported using smokeless tobacco products had been told by a dentist to quit using tobacco. CONCLUSIONS Results from this population-based survey indicate that cancer screening and tobacco cessation advice are underutilized in the dental practice. Increased patient awareness and implementation of screening and tobacco cessation interventions could improve oral cancer incidence and mortality and have a public health benefit for other tobacco-related morbidity and mortality as well.
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Affiliation(s)
- L M Martin
- American Cancer Society, Atlanta, GA 30329, USA
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Crenshaw CC, Martin LM, Mains CR, Wright RD, Dart MG, Perkins RM, Purdy PH, Ericsson SA. The use of buck and ram extenders and two packaging systems to cryopreserve aoudad (Ammotragus lervia) spermatozoa. Theriogenology 2000; 54:69-74. [PMID: 10990348 DOI: 10.1016/s0093-691x(00)00325-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Because the aoudad has been hunted to near extinction, cryopreservation of their semen would be useful for DNA conservation and for the possible re-establishment of captive bred animals to their former ranges. This study was conducted to investigate the effectiveness of cryopreserving aoudad spermatozoa. Semen samples from four post-pubertal animals were collected using electro-ejaculation. Microscopic analysis was performed to assess the percentages of progressively and non-progressively motile spermatozoa as well as intact acrosomes in samples prior to freezing and post-thaw. Extended samples (0.2 mL) were frozen using 2 different extenders and packaging systems and stored in LN2 Post-thaw data were arcsine-transformed and analyzed using ANOVA, 2 x 2 factorial. Samples that were processed using the ram/straw method had a significantly higher percentage (P < 0.05) of spermatozoa with intact acrosomes than did any other system. In addition, samples that were processed with the buck/pellet system had significantly greater percentages (P < 0.05) of progressive and non-progressively motile spermatozoa than the samples processed using either extender and packaged in straws. This study illustrates that some aoudad spermatozoa may be cryopreserved using the extender/processing systems developed for the domestic buck and ram.
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Affiliation(s)
- C C Crenshaw
- Division of Range Animal Science, Sul Ross State University, Alpine, TX 79832, USA
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17
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Abstract
BACKGROUND Self-reported data are commonly used to estimate the prevalence of health conditions and the use of preventive health services in the population, but the validity of such data is often questioned. METHODS The Behavioral Risk Factor Survey (BRFS) was admin istered by telephone to a stratified, random sample of health maintenanc e organization (HMO) subscribers in Colorado in 1993, and self-reports w ere compared with HMO medical records for 599 adults aged >21. Sensitivity and specificity were calculated for three chronic conditions and use of six preventive services. RESULTS Sensitivity was highest for hypertension (83%), moderate for diabetes (73%), and lowest for hypercholesterolemia (59%); specificity was >80% for all three conditions. Sensitivity ranged from 86% to 99% for influenza immunization, clinical breast examination, blood cholesterol screening, mammography, Pap test, and blood pressure screening; specificity was <75% for all preventive services. CONCLUSIONS Self-reports are reasonably accurate for certain chronic conditions and for routine screening exams and can provide a useful estimate for broad measures of population prevalence.
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Affiliation(s)
- L M Martin
- Division of Public Health, Georgia Department of Human Resources, Atlanta, Georgia, USA.
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Abstract
PURPOSE To evaluate concordance between results obtained with the Heidelberg Retina Tomograph (HRT) (Heidelberg Engineering GmbH, Heidelberg, Germany) and those obtained with the high-pass resolution perimeter (HRP) in glaucoma diagnosis. METHODS A total of 217 patients from the glaucoma services at St. Erik Eye Hospital, Stockholm, Sweden (n = 107) and Sahlgrenska University Hospital, Göteborg, Sweden (n = 110) were included in the study. All patients were examined because of known or suspected glaucoma in at least one eye. The conventional indices presented by the instruments were used, i.e., glaucoma index from the HRT (negative values = abnormal, positive = normal) and combined deviation (upper normal limit 2.1 dB) from the HRP. RESULTS The concordance regarding the classification of normal or glaucomatous by the two instruments was 71% (153/217 eyes). The HRT indicated glaucoma but HRP findings were normal in 47 patients, and the reverse occurred in 17 patients. There was a significant difference in optic disc area between patients with abnormal HRT findings and normal HRP findings and in patients with normal HRT findings and abnormal HRP findings. The concordance could not be improved by adjusting for disc size. The correlation between combined deviation on HRP and the HRT glaucoma index was r = -0.53. CONCLUSION A significant correlation was found between the combined index given by HRP and the HRT glaucoma index in 217 patients examined for known or suspected glaucoma. Discordant findings were observed in 64 patients; in 22 this discordance was explained by the influence of disc size. No other reasons for differences in examination results could be detected.
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Affiliation(s)
- L M Martin
- Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden
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Abstract
PURPOSE To investigate the prospects for "shared care" by evaluating to what extent ophthalmic nurses are involved in ophthalmic care decision tasks in the management of glaucoma patients, how well prepared the nurses feel they are for these tasks and their level of satisfaction in those tasks they actually are performing. METHODS A questionnaire was sent to the ophthalmic nurses at 13 eye clinics in Sweden. The clinics were selected to represent different parts of Sweden as well as university clinics and smaller rural clinics. RESULTS A difference was found between clinics regarding the number of tasks independently performed by the ophthalmic nurses and a significant correlation was found between level of participation and satisfaction (p=0.008). The nurses felt prepared for (61/62) and satisfied (58/62) when performing the glaucoma management tasks, and a high and very significant correlation (r=0.96, p= 0.0001) was found between the mean preparedness and satisfaction scores for each of the 14 tasks. CONCLUSIONS The findings in the study show that the ophthalmic nurses feel prepared for their tasks and regard their involvement in glaucoma care as subjectively satisfactory. These observations support the idea of "shared care" in glaucoma management.
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Affiliation(s)
- L M Martin
- Department of Clinical Science, Karolinska Institute, Stockholm, Sweden
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20
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Abstract
Capillary zone electrophoresis (CZE or CE) with on-line UV detection was utilized to measure the binding constants between purified calf thymus DNA and a library of designed tetrapeptides which had been constructed using unnatural amino acids with thiazole ring side chains. Mixtures containing a constant amount of a tetrapeptide, the neutral marker (mesityl oxide), and varying concentrations of DNA were prepared and equilibrated at 8 degreesC for 12 h. CE was then utilized to separate unbound tetrapeptides from the DNA-peptide complex. The UV absorbance of the peak representing unbound tetrapeptide decreased incrementally as a result of increasing the concentration of DNA in the equilibrium mixture. The absorbance of the peak corresponding to the unbound tetrapeptide was obtained directly from the electropherogram and used in the calculation of the DNA-peptide binding constants. The binding constant for each tetrapeptide to calf thymus DNA was obtained from the negative slope of a Scatchard plot and a comparison of the binding constants for different peptides showed that the tetrapeptides in the library have DNA-binding affinities ranging from 10(2) to 10(6) M-1.
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Affiliation(s)
- C Li
- College of Pharmacy, University of Rhode Island, 41 Lower College Road, Kingston, Rhode Island 02881-0809, USA
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Martin LM, Donaldson-Hugh ME, Cameron MM. Cerebrospinal fluid hydrothorax caused by transdiaphragmatic migration of a ventriculoperitoneal catheter through the foramen of Bochdalek. Childs Nerv Syst 1997; 13:282-4. [PMID: 9224918 DOI: 10.1007/s003810050084] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cerebrospinal fluid hydrothorax is a very rare complication following ventriculoperitoneal shunting. The authors report a case of a 3-year-old girl who developed cerebrospinal fluid hydrothorax (caused by migration of the intra-abdominal catheter through the right vertebrocostal trigone of Bochdalek, the one most unlikely to be congenitally patent) and respiratory distress. The patient was successfully treated with thoracocentesis and shunt revision.
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Affiliation(s)
- L M Martin
- Division of Neurosurgery, Pinderfields General Hospital, Wakefield, West Yorkshire, UK
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Martin LM, Parker SL, Wingo PA, Heath CW. Cervical cancer incidence and screening: status report on women in the United States. Cancer Pract 1996; 4:130-134. [PMID: 8826141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE Population-based estimates of cervical cancer incidence and screening are described. DESCRIPTION OF STUDY Data from the Surveillance Epidemiology and End Results and from the 1992 National Health Interview Survey Cancer Control Supplement were used to examine differences in disease rates, stage at diagnosis, and screening practices among population groups. RESULTS The overall age-adjusted incidence rate for invasive cervical cancer was 8.5 per 100,000 women in 1988-1992. Rates for black women were 66% higher than those for white women. At the youngest ages, rates were similar for both races--about 2.0 per 100,000. At older ages, rates diverged, increasing to 17.2 for white women ages 60 to 64 and 47.0 for black women aged 85 and older. Most cervical cancers were diagnosed at the localized stage, and older women and minority women were more likely to be diagnosed with advanced stage disease. Almost 25% of women reported they had not had a Papanicolaou smear test within the past 3 years. Among women younger than 45, whites were more likely than blacks not to have been screened. Among black women, there were regional differences in the use of Papanicolaou test, with those who lived in the South most likely not to be screened. CLINICAL IMPLICATIONS Although rates for some groups appear to be converging, disparities still exist. Targeted approaches to screening, follow-up, and treatment are necessary to ensure that trends in cervical cancer incidence continue to improve.
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Abstract
Although cancer remains a major public health burden for African Americans, progress is being achieved. For both genders, stomach cancer mortality and mortality related to Hodgkin's disease showed large decreases over the past 30 years. Among African-American females, large decreases in cancer mortality occurred for nonmelanoma skin cancers, rectal cancers, and cervical and other uterine cancers. Tobacco use continues to decline among African Americans and, at present, is significantly lower among African-American youths than among their white counterparts. Despite these successes, additional work remains. Increased patient education regarding self-examinations and improved access to cancer screening are necessary to reduce the high percentage of cancers diagnosed at late stages among African Americans. Improved screening ultimately would increase survival and decrease cancer mortality. Some research has suggested that the increased morbidity and mortality in African Americans are related to poverty, lower education, and inadequate access to care as opposed to inherent racial characteristics. A recent study of black-white differences according to stage at diagnosis of breast cancer confirms some of these factors but also suggests that multiple factors may explain these differences, including mammograms, having a breast examination by a physician, and a history of patient delay. Such observations point to the importance of enacting broad social policies and establishing support mechanisms to diminish the impact of cancer in the African-American community.
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Affiliation(s)
- P A Wingo
- Department of Epidemiology and Surveillance, American Cancer Society, Atlanta, Georgia, USA
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Martin LM, Calle EE, Wingo PA, Heath CW. Comparison of mammography and Pap test use from the 1987 and 1992 National Health Interview Surveys: are we closing the gaps? Am J Prev Med 1996; 12:82-90. [PMID: 8777072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Using data from the National Health Interview Survey Cancer Control Supplements, we examined the trends in mammogram and Pap smear test screening between 1987 and 1992 and the demographic characteristics associated with the use of those screening tests in 1992. In 1992, 67% of women 40 years of age and older reported ever having had a mammogram compared with 36% in 1987. A mammogram within the past year was reported by 29% of women in 1992, an increase from 14% in 1987. Among women 18 and older, 91% had ever had a Pap smear test in 1992, and 43% had one within the past year, an increase from 89% and 38%, respectively, in 1987. These changes represented significant increases in the use of both mammograms and Pap smear tests between 1987 and 1992 (P < .05). Race was not significantly associated with underutilization of mammograms, but income showed a significant relationship, with a declining likelihood of mammogram use as income decreased (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.3, 0.6 for the income less than poverty level). Pap smear tests were less likely to be reported by older women ( > or = 65), widows, and never-married women, African-American women were more likely than Caucasian women to have had a Pap smear test, and women of other races were the least likely of any race/ethnic group to have ever had one (OR = 0.2, 95% CI = 0.1, 0.4). Women with less than 12 years of education had about a 40% decreased risk of having had a recent mammogram or Pap smear test. Women without a usual source of medical care also underutilized both screening procedures. Significant gains in the use of mammograms were found for all groups between 1987 and 1992. However, for the Pap smear test, some groups reported no differences during the five-year period. Although race and ethnic differences in the rates of screening use have been reduced somewhat, socioeconomically disadvantaged women and those with poor access to health care are still important target populations for increasing screening, particularly mammograms.
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Affiliation(s)
- L M Martin
- Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia 30329, USA
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25
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Abstract
This study investigated methods of improving the separation and identification of an IgA antibody, McPC603, and its pepsin fragments. The problem presented by purification of antibody fragments (Fabs) and the antibody light chain required accurate and informative analysis of highly hydrophobic proteins, which can polymerize and fold to form secondary structures. Capillary zone electrophoresis (CZE) permits the separation of peptides and small proteins by a method which is orthogonal to the traditional method of reversed-phase HPLC. To facilitate planned studies of the antibody's biological activity, our buffer composition was kept as simple as possible. During CZE analysis, if the buffer pH is below the isoelectric point of the protein, or the protein is large (with a heterogeneous distribution of surface charges), it can irreversibly blind to the capillary wall unless the capillary is coated. We found that C1-coatings in RP-capillaries at pH 9.5 adequately prevented the antibody fragments from binding to the wall. However, the coating did not remain stable at such high pH, so different conditions were sought. We achieved adequate separations in several buffers at nearly physiological pH, in a bare silica capillary which had been coated once with a soluble cationic polymer coating (Micro-Coat applied during column conditioning). Antibody electropherograms changed depending on the type of inorganic buffer salt used in a separation. Phosphate binds to the antigen-binding site of the IgA with low affinity, and interesting effects were observed in separations using phosphate buffer. These effects will de discussed.
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Affiliation(s)
- L M Martin
- Rockefeller University, New York, NY 10021, USA
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Serfaty MA, Martin LM, Lingham R, Ferrier IN. The effect of psychotropic medication on seizure duration during bilateral electroconvulsive therapy: a retrospective study. J Psychopharmacol 1996; 10:303-8. [PMID: 22302978 DOI: 10.1177/026988119601000408] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A five-year retrospective study investigating the effects of psychotropic medication on first seizure length was undertaken on 109 patients who received 131 courses of electroconvulsive therapy (ECT). Bilateral ECT was administered under methohexitone anaesthesia. Induction of a seizure was successful in 105 patients. Stepwise linear regression analysis showed that except for selective serotonin reuptake inhibitors (SSRIs) seizure length was not affected by psychotropic medication, SSRIs were associated with prolonged seizure length (p=0.0012). Less than one-third of the subjects had drugs with anticonvulsant properties omitted before treatment. Drugs with anticonvulsant properties did not shorten seizure length. Though this study suggests that SSRIs may prolong fit length, further clarification of the predictors for seizure duration is required.
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Affiliation(s)
- M A Serfaty
- University Department of Psychiatry, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NEI 4LP, UK
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27
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Abstract
OBJECTIVE To describe important aspects of the recognition and management of anxiety and depression in elderly patients. DESIGN We reviewed pertinent recent articles in the medical literature and compiled guidelines for diagnosing and treating anxiety and depression in the geriatric population. RESULTS Depression and anxiety are common in the elderly population. The development of depression in elderly subjects is associated with a higher risk of death from suicide than for any other age-group. Recognition of depression in elderly patients is often hampered by an inability or reluctance on the part of these patients to report depressive symptoms. In addition, anxiety and depression are often attributed to organic illness in this age-group. Pharmacotherapy is effective; however, older patients are probably more likely than young patients to experience adverse effects. Using medications at lower doses, choosing drugs with shorter half-lives, and avoiding drugs with potent anticholinergic side effects are often advisable. CONCLUSION Anxiety and depression are common conditions among the elderly population. Correct recognition, attention to underlying precipitating factors, and compassionate, supportive care can vastly improve the quality of the lives of these patients.
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Affiliation(s)
- L M Martin
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, Minnesota, USA
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28
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Abstract
Just as artists need to create their own art, so nursing instructors need to practise nursing. However, traditional educational settings and clinical placements limit the capacity of nursing instructors to practice nursing directly with clients. The creation of a nursing faculty practice model in Canada, whereby teaching roles and responsibilities are combined with clinical practice, is discussed within the context of a community college environment. A nurse-managed health centre is suggested as an innovative practice arena which is more in line with the changes in the health care system.
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Bohn U, Gonzalez JL, Martin LM, Casado A, Diaz-Rubio E, Aragoncillo P. Meningeal and brain metastases in primary malignant pericardial mesothelioma. Ann Oncol 1994; 5:660-1. [PMID: 7993848 DOI: 10.1093/oxfordjournals.annonc.a058946] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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30
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Abstract
The present paper describes tuberculosis in a family whose dog also presented the disease. The importance of animal epidemiological investigation in cases of tuberculosis in man is discussed.
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Affiliation(s)
- J Megid
- Departamento de Higiene Veterinária e Saúde Pública, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista, Botucatu, Brasil
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Abstract
The effects of carbogen breathing, nicotinamide injection and their combination on tumour radiosensitivity were correlated with changes in tumour O2 tension to determine the relationship between radiosensitivity and measured pO2. The radiosensitivity (in vivo-in vitro colony assay) and O2 tension (computerized pO2 histograph KIMOC 6650) of two human xenografted tumours (HRT18 and Na11+) and one murine tumour (EMT6) were measured under similar experimental conditions. A single dose of radiation was delivered (8 Gy for HRT18 and Na11+, 12 Gy for EMT6). Carbogen breathing, nicotinamide injection, and their combination all significantly increased radiosensitivity in the three cell lines (p < 0.05); the most efficient treatment was carbogen plus nicotinamide. The radiosensitization was optimum for EMT6 and Na11+. Mean and median pO2 increased with all three treatments, except for carbogen breathing in EMT6. Carbogen breathing had little effect on the proportion of low pO2 values, but induced pO2 values > 30 mmHg in all three tumour lines. Nicotinamide decreased the proportion of low pO2 values. This effect is larger with the combination carbogen plus nicotinamide. Almost all pO2 values < 2.5 mmHg were eliminated for HRT18 and EMT6. The relationship between radiosensitization and pO2 was significant when pO2 was expressed as the percentage of values below 7, 8, 9 and 10 mmHg for the three lines.
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Affiliation(s)
- L M Martin
- Laboratoire de Radiobiologie Cellulaire (Unité Inserm 247), Institut Gustave-Roussy, Villejuif, France
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Martin LM, le Pechoux C, Calitchi E, Otmezguine Y, Feuilhade F, Brun B, Piedbois P, Mazeron JJ, Julien M, le Bourgeois JP. Management of breast cancer in the elderly. Eur J Cancer 1994; 30A:590-6. [PMID: 8080672 DOI: 10.1016/0959-8049(94)90526-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The management of breast cancer in elderly women was analysed by a retrospective study of 150 women over 70 years old referred to our department between 1984 and 1988. 80 were T1-T2, 33 were T3 and 34 were T4. 107 were N0 and 43 were N1-N2. 16 women (11%) were in poor health, preventing conventional treatment. Treatment choice varied with age: 60% of the women aged 70-79 (group 1) and 23% of the oldest women (group 2) were treated conventionally. The use of surgery decreased with age and surgical procedures were conventional in only 85% of the group 1 women and in 56% of the group 2 women. Definitive radiation therapy was used more frequently in the oldest women, as was primary hormone therapy. Quality of follow-up also varied with age. Five-year survival rates were still high in both groups while relapses were frequent. Breast cancer was consequently a frequent cause of death. The increase in the proportion of elderly people with breast cancers over the next few years will require validated guidelines. Specific protocols and specific rules of management must be drawn up.
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Affiliation(s)
- L M Martin
- Département de Cancérologie, CHU Henri Mondor, Creteil, France
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Abstract
A family history of breast cancer potentially identifies women at high risk for whom mammography may be especially valuable. The authors examined the association of fatal breast cancer and family history in a large, prospective study of US adults. After 6 years of follow-up, 880 cases of fatal breast cancer were observed in a cohort of 604,412 women who were cancer free at interview in 1982. Cox proportional hazards modeling found that a family history of breast cancer in a mother or sister was significantly related to fatal breast cancer risk (rate ratio = 1.59, 95% confidence interval (CI) 1.29-1.95). The association was greatly modified by age; the rate ratio was 4.91 (95% CI 1.39-17.3) in women aged < 40 years at enrollment compared with 1.28 (95% CI 0.78-2.11) in women aged > or = 70 years. Among young (aged < 50 years) women, the risk associated with a positive family history was greatest if the relative was also young at the time of diagnosis (rate ratio = 5.22, 95% CI 3.00-9.11). These associations were not altered in multivariate analyses controlling for known breast cancer risk factors. In the authors' data, family history is strongly predictive of early fatal breast cancer, particularly when the disease is diagnosed before age 50 in the relative. Women with a family history of early breast cancer should receive special instructions regarding mammography and early detection.
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Affiliation(s)
- E E Calle
- Department of Epidemiology and Statistics, American Cancer Society, Atlanta, GA 30329
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Abstract
OBJECTIVES Proven screening technologies exist for both breast and cervical cancer, but they are underused by many women. We sought to evaluate the effect of demographic characteristics on the underuse of mammography and Pap smear screening. METHODS We analyzed responses from 12,252 women who participated in the 1987 National Health Interview Survey Cancer Control Supplement. Demographic profiles were produced to target severely underserved groups of women. RESULTS Low income was a strong predictor of mammography underuse, as was Hispanic ethnicity and other race, low educational attainment, age greater than 65, and residence in a rural area. A strong predictor of never having had a Pap smear was never having been married; however, the importance of this characteristic is difficult to interpret in the absence of data on sexual activity. Hispanic women and women of other races of all ages and all income levels underused Pap smear screening, as did older women, particularly older Black women. CONCLUSIONS The tendency of women to underuse screening technologies varies greatly across levels of basic demographic characteristics. The importance of these characteristics differs for mammography screening versus Pap smear screening.
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Affiliation(s)
- E E Calle
- American Cancer Society, Atlanta, GA 30329
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Abstract
Data collected from 1980 to 1989 by investigators at the Pittsburgh Otitis Media Research Center were examined to detect changes over time in the prevalence of bacteria isolated from middle ear effusions in patients with otitis media. The organisms isolated most commonly from the 7396 effusions cultured at the center were Streptococcus pneumoniae and Haemophilus influenzae. S. pneumoniae predominated in the subgroup of patients with acute otitis media, whereas H. influenzae was isolated most frequently from patients with otitis media with effusion. The most notable changes to occur during the 10-year period were a statistically significant increase in the prevalence of S. pneumoniae in patients with acute otitis media and a progressive rise in the percentage of beta-lactamase-producing strains of H. influenzae and Moraxella (Branhamella) catarrhalis. The latter finding suggests the need for therapeutic alternatives to amoxicillin, which is not active against beta-lactamase-producing organisms, when these organisms are suspected or cultured from the middle ear.
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Affiliation(s)
- C D Bluestone
- Otitis Media Research Center, University of Pittsburgh School of Medicine, PA
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Martin LM, Vono AZ, Pinheiro CE, Abdo RC, Bijella MF. [Effect of cetylpyridinium chloride on formation and metabolism of human dental plaque]. Rev Odontol Univ Sao Paulo 1990; 4:108-12. [PMID: 2135339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this work, the Cepacol (cetylpyridinium chlorid) diluted 1:2, when used for mouthwashes three time a day decreased the "in situ" formation of human dental plaque, however it didn't decreased neither the plaque fermentation, nor the IEP synthesis by the plaque. When the Cepacol was used for treating the "in vitro" dental plaque in both 1:10 and 1:20 dilutions, decreased the fermentation and the IEP synthesis of the "in vitro" plaque.
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Affiliation(s)
- L M Martin
- Faculdade de Odontologia de Bauru, Universidade de São Paulo, USP
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Martin LM. Nursing implications of today's burn care techniques. RN 1989; 52:26-33. [PMID: 2657985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Martin LM, Bourne RB, Rorabeck CH. Stress fractures associated with osteoarthritis of the knee. A report of three cases. J Bone Joint Surg Am 1988; 70:771-4. [PMID: 3392071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- L M Martin
- Division of Orthopaedic Surgery, University of Western Ontario, University Hospital, London, Canada
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Bourne RB, Bitar H, Andreae PR, Martin LM, Finlay JB, Marquis F. In-vivo comparison of four absorbable sutures: Vicryl, Dexon Plus, Maxon and PDS. Can J Surg 1988; 31:43-5. [PMID: 2827875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Absorbable sutures are initially equal or superior to nonabsorbable sutures in terms of tensile strength but are absorbed at variable rates by the action of hydrolysis. This study demonstrated that the in-vivo half-life tensile strength of the braided absorbable sutures polyglycolic acid (Dexon Plus) and polyglactin 910 (Vicryl) is 2 weeks, whereas those of the monofilament absorbable sutures polyglyconate (Maxon) and polydioxanone (PDS) are 3 and 6 weeks respectively. The addition of a single hitch or six knots reduced the in-vitro tensile strength by 30% to 35%. Polyglyconate (Maxon) suture demonstrated the best in-vitro knot security.
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Affiliation(s)
- R B Bourne
- Division of Orthopedic Surgery, University Hospital, University of Western Ontario, London
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Abstract
During a fourteen-month period, 497 men were evaluated for a primary complaint of erectile dysfunction. The initial evaluation consisted of a history taken in a conventional manner and supplemented by a patient-completed sexual function questionnaire, a physical examination, and serum testosterone, serum prolactin, and nocturnal penile tumescence studies. When appropriate, additional evaluations, including penile vascular studies, two-hour oral glucose tolerance tests, and psychiatric consultation were obtained. Abnormal glucose metabolism was present in 161 men (32%). Five men (1%) had insulin-dependent diabetes mellitus (IDDM), 80 men (16%) had noninsulin-dependent diabetes mellitus (NIDDM), 55 men (11.1%) had newly diagnosed noninsulin-dependent diabetes mellitus, and 21 men (4.2%) had impaired glucose tolerance tests. One hundred forty-seven of these men (91.3%) had organic pattern impotence, and 14 (8.7%) had psychogenic pattern impotence.
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Abstract
This survey reviewed 13 public buildings for accessibility to wheelchair-bound consumers in Utica, New York. Buildings were both private and government supported. The scale used was based on the 1971 specifications of the American National Standards Institute. Buildings surveyed represented those built before and after enactment of the Architectural Barriers Act of 1968 and were subject to various regulations or no regulations concerning accessibility. Results revealed a trend of improved accessibility in both privately and publicly supported facilities, with the most accessible buildings having been built since 1980. No facility was found to be 100% in compliance with standards.
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Affiliation(s)
- L M Martin
- Utica College of Syracuse University, New York 13502
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Martin LM. The evaluation of biomedical book reviews by academic health sciences librarians. Bull Med Libr Assoc 1986; 74:157-60. [PMID: 3708199 PMCID: PMC227813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Two hundred consecutive men presenting with a chief complaint of impotence have been evaluated with a protocol involving one or two outpatient visits. The initial evaluation for all patients consisted of a history taken in a conventional manner and supplemented by a patient-completed sexual function questionnaire, physical examination, serum testosterone and prolactin, and two-night nocturnal penile tumescence studies. Following the initial evaluation the patients were placed in one of three categories: (1) organic impotence, (2) functional impotence, (3) ambiguous impotence (mixed functional and organic impotence or organic impotence of undetermined etiology). Patients in the latter group underwent additional testing including penile vascular studies, two-hour oral glucose tolerance test, and psychiatric consultation. With this protocol, patients can be efficiently and effectively evaluated as outpatients with costs ranging from +250 to +450.
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Abstract
In a sequential clinical sample of 64 subjects exclusively diagnosed as either biogenically or functionally impotent, Minnesota Multiphasic Personality Inventory (MMPI) and California Psychological Inventory (CPI) standard scales and the Beutler, et al., MMPI signs were all found to be ineffective in reliably classifying patients into the correct diagnostic groupings. Specific item analysis of the MMPI and CPI did identify a significant number of significantly differentiating individual items. Most of these items were shown to be reliably characterizable as indicating either performance anxiety or somatic complaint. Using these classifications of the items, the performance anxiety items were shown, consistent with theory, to be clearly associated with the functional impotence group. The somatic complaint items were shown to be clearly associated with the biogenic impotence group, presumably reflecting the symptoms of physiopathology, such as diabetes, underlying the biogenic condition.
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Martin LM, Montague DK. Ejaculatory incompetence following penile prosthesis implantation in men with primary psychogenic impotence. Cleve Clin Q 1982; 49:93-6. [PMID: 7116631 DOI: 10.3949/ccjm.49.2.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Finlayson RE, Martin LM. Recognition and management of depression in the elderly. Mayo Clin Proc 1982; 57:115-20. [PMID: 7054623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Depression is probably the most common psychiatric disorder of the elderly. Societal stereotypes and atypical clinical features are contributing factors to inadequate diagnosis and treatment. Somatic complaints without an obvious mood defect and a syndrome of pseudodementia are commonly encountered. Treatment strategies rest firmly on a comprehensive evaluation that considers the biological, psychologic, and social factors involved. Psychotherapy is a valuable tool in some elderly persons. When antidepressant agents are used, it should be recognized that lower than usual dosage may be effective and that the elderly person is particularly sensitive to the autonomic side effects of these chemical agents. Electroconvulsive therapy remains a helpful and sometimes lifesaving resource when other methods have failed.
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Martin LM. Erectile impotence--it can be highly treatable. Geriatrics (Basel) 1980; 35:79-83. [PMID: 7429163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In brief, the treatment of impotence is the treatment of the underlying cause whenever possible. When irreversible organic impotence is found, however, penile prosthesis should be considered. Both hydraulic inflatable and semirigid rod types are available. Morbidity with the procedure is relatively low in experienced hands and patient satisfaction has been reported as quite high. Pharmacogenic impotence may require a change or reduction of medication. Depression usually responds to some combination of antidepressants, psychotherapy, or electroconvulsive therapy, while modern short-term sex therapy has proved effective in reversing many of the anxiety-related cases. Deep-seated, anxiety-based impotence may require extensive psychotherapy, but many cases of recent-onset psychogenic impotence can be managed quite successfully with education, reassurance, and the optional short-term use of testosterone.
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Montague DK, James RE, deWolfe VG, Martin LM. Diagnostic evaluation, classification, and treatment of men with sexual dysfunction. Urology 1979; 14:545-8. [PMID: 574673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
During a two-year period, 165 men were evaluated for sexual dysfunction. Most evaluations were conducted on an outpatient basis and required two separate visits. Fifty-one per cent, 47 per cent, and 2 per cent of the patients were found to have functional disorders, organic disorders, and incomplete evaluations, respectively. Treatment recommendations were tailored to each patient using information gathered during the diagnostic evaluation.
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Abstract
Certinen from 432 Choctaw Indians from Mississippi was classified as sticky or dry. The frequency of the autosomal recessive dry type was intermediate between that for Indians of western North America and that for Mayan groups of southern Mexico.
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