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Biomedical subjects

A Fink

Publications and source records attributed to A Fink.

At least 145 records · Page 8Linked to original sources
PubMed1982

Studies in geriatric education: I Developing educational objectives.

This study reports on the development of a comprehensive set of objectives for the education of undergraduates, graduates, and fellows in geriatric medicine. The objectives were derived from reviews of available educational materials and programs, and their significance was validated through consensus techniques that included over 100 workers with special expertise in geriatrics and gerontology from the United States. Canada, and the United Kingdom. A related and supplementary investigation, which also used consensus methods, uncovered ten general and disease-specific objectives considered to be essential outcomes of the education of geriatric fellows. Academic departments and specialty and subspecialty organizations should find the total set of objectives useful for planning and evaluating educational programs in geriatrics.

Canada↗
PubMed1982

An evaluation of clinical services: a case study.

The success of evaluation research rests largely in its usefulness. If the sponsors of an evaluation find the data meaningful, then the limitations that the problems of evaluation invariably impose on a study's scientific origin should not be given undue emphasis. In the case of MHMC, the evaluation results were used for program planning in the hospital and for explicating the content of testimony to the California legislature about pharmacy practice in the state. Of course, it would be unthinkable to advocate weak studies and unreliable data. The evaluator must assume the responsibility of determining if and when the balance between what can be done well is tipped in favor of unsound methods. The evaluator is also responsible for judging just how important the data from the study are. How many people will be affected? Are other data available to illuminate or be used with the evaluation?. As clinical pharmacy becomes more concerned with program evaluation, it will need to address ethical and political questions like these at the same time that it answers methodological ones.

California↗
PubMed1982

A new syndrome of symptomatic cutaneous mastocytoma producing vasoactive intestinal polypeptide.

An 8-mo-old male child presented with generalized flushing and apnea which followed irritation of a 1.5 x 0.5 cm cutaneous mastocytoma on the left upper arm. Peripheral venous blood samples were drawn before and after manipulation of the tumor, immediately after excision, and again 30 days later. The plasma vasoactive intestinal polypeptide level before excision was high (345 pg/ml) and was accompanied by low acid secretion (15.4 mEq/L) and hypergastrinemia (209 pg/ml), all of which returned to normal after excision of the tumor (50 pg/ml, 35.7 mEq/L, and 131 pg/ml, respectively). Serum histamine levels were undetectable. Histology of the tumor showed only mast cells and no enterochromaffin tissue. The immunoreactive vasoactive intestinal polypeptide content of the tumor was 28 ng/g wet wt and the extracted vasoactive intestinal polypeptide was immunologically indistinguishable from natural porcine vasoactive intestinal polypeptide. The child has remained asymptomatic postoperatively. We conclude that the symptoms associated with this mastocytoma may have been produced by oversecretion of vasoactive intestinal polypeptide and not histamine.

Apnea↗
PubMed1982

Assessing whether a clinical pharmacy program is meeting its goals.

An assessment of whether the clinical pharmacy program at Memorial Hospital Medical Center (MHMC), Long Beach CA, was meeting its goals is presented. MHMC is a 858-bed, nonprofit teaching hospital that initiated a clinical pharmacy program in 1967. The program's three foremost goals were to: (1) establish cohesive and standardized clinical services, (2) promote the acceptance of the roles and functions of clinical pharmacists by physicians and nurses, and (3) assure the provision of good quality care. The evaluation data were collected over a six-week period using questionnaire surveys of approximately 28 pharmacists, 146 physicians, and 389 nurses; pharmacist service reports from 5991 drug monitorings; 228 medical record audits for six drugs; 68 guideline compliance records for three drugs; interviews with 131 users of the drug information services; abd logs of 3946 pharmacist encounters with other health-care providers. Generally, the clinical pharmacy program was found to be meeting its goals. Most of the monitorings (81.6%) were initiated by pharmacists, and 20% resulted in changes in drug therapy. The pharmacists adhered to the pharmacy department's monitoring and dosing guidelines. There was unanimous satisfaction among users of the drug information service with the response received from pharmacists, and 99% satisfaction with the promptness of response and accuracy of the information. Sixty-eight percent of the pharmacists reported discussing general issues with physicians, and 72% answered patient-specific questions from physicians. The physicians (96%) and nurses (97%) thought that there was an improvement in the quality of patient care as a result of pharmacist involvement. Pharmacists at MHMC are providing useful clinical services.

California↗
PubMed1981

Needs assessment: selecting goals for a clinical program.

The application of a needs assessment technique to create a family practice program and residency in a major teaching hospital is described. The technique relies on selecting program objectives by providing health services that are considered important by the community, feasible to obtain within its resources, and not currently available.

Data Collection↗
PubMed1980

Lymphocyte cyclic nucleotide and prostaglandin content in psoriasis: a preliminary report.

Lymphocytes from psoriatic patients were found to contain reduced levels of adenosine 3':5'-cyclic phosphate, guanosine 5'-cyclic phosphoric acid, and prostaglandin E, as compared with lymphocytes from normal subjects. The difference in prostaglandin F levels between psoriatic and control subjects was not statistically significant. These results could point to an immunologic defect in the immune system in psoriasis.

Adult↗
PubMed1980

Results of a needs assessment strategy in developing a family practice program in an inner-city community.

The planners of an inner-city clinic and family practice residency program conducted a four-step needs assessment study to identify the importance, availability, and feasibility of local family practice services and objectives. Using mailout-mailback and supervised questionnaire data collection techniques, they contacted 1,020 consumers and providers. Those objectives rated most important and feasible and least available were given top priority for implementation, while the objectives rated important and unavailable but not currently feasible received research priorities.

California↗
PubMed1979

B-type cytochromes in plasma membranes isolated from rat liver, in comparison with those of endomembranes.

Fractions of plasma membranes, Golgi apparatus, endoplasmic reticulum (ER), and nuclear envelope were isolated from rat liver and were characterized by electron microsocpe and biochemical methods. The purity of the fractions was controlled by morphometry and by marker enzyme activities. Amounts of cytochromes b5, P-450, and P-420 were measured, as well as the NADPH- and NADPH-cytochrome c reductase activities. The pigments of the microsomal electron transport system were found in all membrane fractions in relatively high amounts, thus excluding an origin by microsomal contamination. Purified preparations of plasma membrane and Golgi apparatus contained approximately 30% of the cytochrome b5 and cytochrome P-450 + P-420 found in ER membranes. Plasma membranes were also characterized by a high ratio of P-420/450. Degradation of cytochromes P-450 and P-420 was relatively rapid in all fractions, except in the ER. Cytochrome b5 extracted from plasma membranes was spectrophotometrically and enzymatically indistinguishable from ER cytochrome b5. However, immunnlogical characterization with rabbit antibodies against the trypsin-resistant core of microsomal cytochrome b5 showed the presence of at least two types of cytochrome b5 in ER membranes, in contrast to the plasma membranes in which only one of these components was detected. This immunological differentiation also demonstrates that the plasma membrane-bound cytochrome b5 is endogenous to this membrane and does not reflect contamination by ER elements. We conclude that cytochromes b5, P-450, and P-420 are not confined only to ER and nuclear membranes but also occur in signficant amounts in Golgi apparatus and plasma membranes. The findings are discussed in relation to observations of similar redox components in Golgi apparatus, secretory vesicles, and plasma membranes of other cells.

Animals↗
PubMed1978

Demonstration of the display of components of the endoplasmic reticulum system by indirect immunofluorescence microscopy using antibodies against cytochrome b(5) from rat liver microsomes.

Antibodies against the purified fragment of cytochrome b(5) released by trypsin treatment from rat liver microsomes were raised in rabbits and used for the demonstration of membranes rich in cytochrome b(5), in particular the endoplasmic reticulum (ER) system, by indirect immunofluorescence microscopy. The method allowed the demonstration of ER not only in frozen sections of various tissues, including liver and lactating mammary gland from different species, but also in cultured cells of a diversity of species and cell types. In the cultured cells the structures most prominently decorated with the antibodies against cytochrome b(5) were the nuclear envelope and the ER system which in many cells could be recognized as a system of smoothly bending, branching threads, extending from the perinuclear cytoplasm toward the cell periphery. Changes in the display of such elements during mitosis and cell plating and possible influences of the specific fixations used are discussed.

Animals↗
PubMed1978

Association between thyrotoxicosis and thrombocytopenia. A case report and review of the literature.

In a young woman who presented with hyperthyroidism and autoimmune thrombocytopenic purpura, the platelet count returned to normal following successful treatment of the hyperthyroidism. Thromboagglutinins were present, the titer declining as the patient became euthyroid. A survey of the literature revealed 48 reports of hyperthyroidism and thrombocytopenia, these disorders coexisting in 37 patients and there being no apparent cause for the lowered platelet counts in 28 of them. The clinical features and response to treatment in the latter group and in our patient are reviewed, comprising a series of 29. Of 22 patients whose hyperthyroidism was adequately treated, platelet counts returned to normal in 18 (82%). In three patients the purpura remitted despite persistent thrombocytopenia. It is estimated that in 7% of patients with autoimmune thrombocytopenic purpura, thrombocytopenia responds to treatment of an underlying thyrotoxicosis and in many of these patients the thrombocytopenia will prove resistant to other forms of therapy.

Adult↗
PubMedDate not supplied

Work satisfaction and career aspirations of internists working in teaching hospital group practices.

This paper presents data on the characteristics, work activities, job-related stress, work satisfaction, and career aspirations of 150 faculty and 595 housestaff physicians who regularly provide continuous primary care in 15 teaching hospital-based group practices. The faculty were young, board-certified generalists; they had been recruited from local training programs and spent the majority of their time seeing patients and supervising housestaff. Job satisfaction among faculty and housestaff was generally high. Dissatisfaction occurred most often with aspects of work over which physicians had little control. Although work-related stress was common, it was not related to job satisfaction. Compared with housestaff in traditional residency programs, housestaff enrolled in special Primary Care Training Programs reported significantly greater job satisfaction. For all housestaff, satisfaction with work in the group practice was consistently associated with decreased interest in subspecialty training.

Aspirations, Psychological↗
PubMedDate not supplied

The Functional Status Questionnaire: reliability and validity when used in primary care.

A comprehensive functional assessment requires thorough and careful inquiry, which is difficult to accomplish in most busy clinical practices. This paper examines the reliability and validity of the Functional Status Questionnaire (FSQ), a brief, standardized, self-administered questionnaire designed to provide a comprehensive and feasible assessment of physical, psychological, social and role function in ambulatory patients. The FSQ can be completed and computer-scored in minutes to produce a one-page report which includes six summated-rating scale scores and six single-item scores. The clinician can use this report both to screen for and to monitor patients' functional status. In this study, the FSQ was administered to 497 regular users of Boston's Beth Israel Hospital's Healthcare Associates and 656 regular users of 76 internal medicine practices in Los Angeles. The data demonstrate that the FSQ produces reliable sub-scales with construct validity. The authors believe the FSQ addresses many of the problems behind the slow diffusion into primary care of systematic functional assessment.

Activities of Daily Living↗