Ethics past, present and future.
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Ethics, Nursing↗
Biomedical subjects
A J Davis
Publications and source records attributed to A J Davis.
The effects of relaxin on the response of intramammary pressure and mammary blood flow to exogenous oxytocin in the goat.
Lactating goats were given relaxin (50 micrograms) by close-arterial infusion into one mammary gland. The increase in intramammary pressure and in mammary blood flow elicited by exogenous oxytocin i.v. was attenuated by relaxin in goats during pregnancy and early lactation but not in a group studied during the oestrous cycle. Intramammary pressure in both mammary glands was affected at the dose of relaxin used. It is concluded that a change in responsiveness of the mammary myoepithelium to oxytocin is one possible effect of relaxin, acting directly or indirectly, circulating systemically during pregnancy and produced locally by the mammary gland at the onset of and during lactation.
Animals↗
Bradykinin B1 and B2 receptor mechanisms and cytokine-induced hyperalgesia in the rat.
The involvement of bradykinin (BK) B1 and B2 receptors in cytokine-induced hyperalgesia has been studied in the rat. Intraplantar injections of interleukin (IL) 1 beta and tumor necrosis factor alpha (TNF alpha) induced thermal hyperalgesia, with in the the case of IL-1 beta, contralateral hyperalgesia also present. Subsequent to administration of IL-1 beta, but not after TNF alpha, des-Arg9-BK reduced the withdrawal latency in both ipsi- and contra-lateral paws. Mechanical hyperalgesia was also induced by IL-1 beta, IL-2, and IL-8 when injected into rat knee joints, whereas IL-6 and TNF alpha were without effect. Coadministration of des-Arg9,Leu8-BK prevented the development of the cytokine-induced hyperalgesia for the duration of the experiment (6 h), but HOE-140 only reversed the hyperalgesia for the 1st h. At 3.5 h after IL-1 beta, IL-2, or IL-8, administration of des-Arg9,Leu8-BK or HOE-140 (iv) completely reversed the hyperalgesia. Twenty-four hours after pretreatment with IL-1 beta, injection of des-Arg9-BK into the joint produced opposite effects, depending on the dose: at 50 pmol the hyperalgesia was reversed, but at 0.5 nmol there was further hyperalgesia. Both responses were blocked by B1 but not B2 receptor antagonists. These data suggest that both B1 and B2 receptors are involved in the induction and maintenance of cytokine-induced hyperalgesia. B1 receptors appear to play a more important role than B2 receptors in the development of mechanical hyperalgesia.
Animals↗
Home care for the urban chronically ill elderly in the People's Republic of China.
This study examines the home care situation of seventy-five urban chronically ill men and women and their caregivers in three cities in the People's Republic of China. It documents the type of home care provided, the severity of illness, and the dependency in activities of daily living in order to appreciate the complexity of these care situations. The findings reveal that women serve as the caregivers in the majority of the cases and often they are elderly spouses with health problems of their own. The physical, social, psychological, and financial problems experienced by these patients create an enormous burden for the caregivers whether spouses or younger family members coming home from work to a second shift. If alternatives to home care, such as nursing homes, were available, 54 percent of these caregivers would be willing to institutionalize their elderly relative. All caregivers express the need for more assistance in providing home care. This study raises questions regarding the role of the family, the state, and specifically the health care system in caring for the elderly chronically ill in light of their increasing numbers in the population.
Activities of Daily Living↗
Contraceptive choices: the adolescent years.
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Adolescent↗
Comparison of the sensitivity of the caudal fold skin test and a commercial gamma-interferon assay for diagnosis of bovine tuberculosis.
A study to determine and compare the sensitivity of the caudal fold tuberculin test (CFT) and a commercial gamma-interferon (gamma-IFN) assay for diagnosis of bovine tuberculosis was conducted. A dairy herd with approximately a third of the cattle infected with Mycobacterium bovis was chosen for this study. All cattle from this herd were slaughtered, and tissue specimens for bacteriologic culturing and histologic examination were collected. Results of the CFT and gamma-IFN assay were compared with results of bacteriologic culturing and histologic examination to determine test sensitivity. Results were analyzed, using each of the following 4 standards to classify cattle as infected: positive test result by bacteriologic culturing only; histologic examination only; bacteriologic culturing and histologic examination; and bacteriologic culturing or histologic examination. Sensitivity of the CFT ranged from 80.4 to 84.4%, depending on the standard of comparison. Sensitivity of the gamma-IFN assay ranged from 55.4 to 97.1%, depending on the standard of comparison and on the method of interpretation. The CFT was significantly (P < 0.001) more sensitive than the gamma-IFN assay for diagnosis of bovine tuberculosis when the gamma-IFN assay was conducted and interpreted as instructed by the manufacturer. Maximum overall sensitivity was achieved when results of the CFT and gamma-IFN assay were interpreted in parallel.
Animals↗
Ethics of nursing and midwifery: responding to change.
Nurses and midwives are taking an increasing interest in ethical matters in their professions. Although the conditions in which they work vary immensely and are undergoing rapid change, it is possible to detect certain basic notions of patient care which transcend cultural, socioeconomic and technological differences.
Ethics, Nursing↗
Proportion of patients with isolated systolic hypertension who have burned-out diastolic hypertension.
In a community survey of 3242 subjects, 1663 did not initially have isolated systolic hypertension (ISH) and were re-screened an average of 8 years later. ISH developed in 53 (22%) of untreated patients with previous diastolic hypertension. Similarly, 8% of subjects with transient hypertension and 8% of normotensive controls developed ISH. Of all cases of ISH, 16% had previous diastolic hypertension. These subjects were more likely to have continued to smoke (P = 0.01) and lost more weight (P = 0.001) than patients with ISH who did not have burned-out diastolic hypertension.
Adolescent↗
[Caring for the urban elderly at home in China].
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Aged↗
Induction of B1 receptors in vivo in a model of persistent inflammatory mechanical hyperalgesia in the rat.
The induction of mechanical hyperalgesia by B1 and B2 receptor agonists following an inflammatory insult has been studied in the rat. Intra-articular injection of bradykinin, but not desArg9 bradykinin, into naïve joints induced mechanical hyperalgesia with a reduction of up to 38% in load tolerated by the treated leg. Following intra-articular injection of Freund's complete adjuvant (FCA) the load tolerated by the treated leg was depressed for three days. The development of FCA-induced hyperalgesia was reduced by desArg9Leu8BK or Hoe 140. Bradykinin, desArg9BK and the metabolically stable B1 receptor agonist SarDPhe8desArg9BK were all hyperalgesic upon intra-articular administration 3 days after FCA administration. The hyperalgesia induced by desArg9BK and SarDPhe8desArg9BK was prevented by co-administration of desArg9Leu8BK but not by Hoe 140. At low doses (< 10 nmol) bradykinin-induced hyperalgesia was presented by Hoe 140 but not by desArg9Leu8BK. At higher doses of bradykinin (> 100 nmol) the hyperalgesia was reduced by both Hoe 140 and desArg9Leu8BK. These data suggest that following an inflammatory insult both bradykinin B1 and B2 receptor mechanisms are involved in the accompanying hyperalgesia.
Animals↗
The role of hormonal contraception in adolescents.
Most pregnancies in women under age 20 years, as well as more than half of the pregnancies in the United States, are unintended. Contraceptive use is especially poor in adolescents, for whom the socioeconomic and educational consequences are great. A 1988 study indicated that more than 8% of sexually active adolescents had two or more sexual partners within the previous 3 months, higher than any other age group. The reasons why adolescents do not use contraception effectively fall into two categories: lack of access to contraceptive information and noncompliance with contraceptive recommendations. Studies have demonstrated that educational programs incorporating decision-making and communication skills, self-esteem enhancement, and peer influence can result in a decrease in the rate of adolescent sexual activity and pregnancy. Knowledge-based programs alone do not correlate with postponement of sexual activity or the use of contraceptives. In a survey of more than 4000 sex education teachers, 80% replied that they are in need of "factual information, materials, and strategies. In a true/false examination given to educators on contraception, few correct answers were recorded regarding potential side effects of oral contraceptives. Effective counseling and communication with adolescents require an understanding of adolescent development.
Adolescent↗
Cultural aspects of nondisclosure.
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Adult↗
Dietary threonine imbalance alters threonine dehydrogenase activity in isolated hepatic mitochondria of chicks and rats.
Experiments were conducted on chicks and rats to determine whether hepatic threonine dehydrogenase activity is modified by the consumption of a threonine-imbalanced diet and to determine the tissue distribution of this enzyme. Threonine imbalances were created by supplementing basal diets with branched-chain amino acids (6 g/100 g diet for chicks) or a mixture of indispensable amino acid (5.6 g/100 g diet for chicks and 5.4 g/100 g diet for rats). Chicks fed threonine-imbalanced diets consistently had twice the hepatic threonine dehydrogenase activity of those fed the basal diet when measured in one experiment at 24 h and in two experiments at 216 h (P < 0.05). Rats received the experimental diets for 12 or 24 h in one experiment and for 12, 24, 72 or 168 h in another experiment. In the first experiment, rats fed the threonine-imbalanced diet had significantly greater hepatic threonine dehydrogenase activity (P < 0.05) at 12 h but not at 24 h. In the other rat experiment, threonine dehydrogenase activity in the rats fed the threonine-imbalanced diet was significantly greater than in controls at 72 h, but tended to be lower at 168 h, which coincided with the adaptation of the rats to the imbalanced diet. Threonine dehydrogenase activity was widespread in tissues of both species. The results indicate that alterations in hepatic threonine dehydrogenase activity occur in chicks and rats subjected to threonine imbalance.
Acetone↗
The involvement of bradykinin B1 and B2 receptor mechanisms in cytokine-induced mechanical hyperalgesia in the rat.
1. Interleukin-1 beta (IL-1 beta), IL-2 and IL-8 induced a mechanical hyperalgesia following intra-articular (i.artic.) injection into rat knee joints, whereas IL-6 and tumour necrosis factor alpha (TNF-alpha) were without effect. 2. Co-administration of IL-1 receptor antagonist (0.1 micrograms) with IL-1 beta (1 mu), IL-2 (10 mu) or IL-8 (0.1 mu) prevented the subsequent development of the hyperalgesia. 3. Co-administration of desArg9Leu8BK (0.5-5 nmol) with IL-1 beta (1 mu), IL-2 (10 mu) or IL-8 (0.1 mu) reduced the level of hyperalgesia at 1, 4 and 6 h post administration, whereas Hoe 140 (5 pmol) antagonized the hyperalgesia only at the 1 h time point. 4. Intravenous administration of desArg9Leu8BK (10 nmol kg-1) or Hoe 140 (100 pmol kg-1) following IL-1 beta (1 mu), IL-2 (10 mu), or IL-8 (0.1 mu) reversed the subsequent hyperalgesia. 5. Administration of desArg9BK into joints 24 h after pre-treatment with IL-1 beta (1 mu) produced analegsia at low doses (50 pmol) and hyperalgesia at a higher dose (0.5 nmol). Both these effects were blocked by desArg9Leu8BK (0.5 nmol). 6. Administration of desArg9BK (0.5 nmol i.artic.) to animals 24 h after pre-treatment with IL-2 (1-100 mu) or IL-8 (0.1-10 mu) had no effect on the load tolerated by the treated joint. 7. Administration of indomethacin (1 mg kg-1, s.c.) prior to IL-1 beta (1 mu i.artic.) prevented the development of hyperalgesia. Administration of desArg9BK (5 pmol-0.5 nmol, i.artic.) to animals 24 h after indomethacin and IL-1 beta pretreatment had no effect on the load tolerated by the treated joint. 7. Administration of indomethacin (1 mg kg-1, s.c.) prior to IL-1beta (1 u i.artic.) prevented the development of hyperalgesia. Administration of desArg9BK (5 pmol-0.5 nmol, i.artic.) to animals 24 h after indomethacin and IL-1 beta pretreatment had no effect on the load tolerated by the treated joint.8. These data suggest that both bradykinin B1 and B2 receptors are involved in the induction and maintenance of cytokine-induced hyperalgesia. They also show that the induction of B1 receptor-mediated hyperalgesia requires both cyclo-oxygenase products and IL-1 in vivo.
Animals↗
Unilateral control of ovarian oxytocin release and the facilitatory effects of insulin-like growth factor-I in sheep.
Prostaglandin F2 alpha (PGF2 alpha)-induced release of ovarian oxytocin was investigated to determine whether the effect in vivo was local. [3H]PGF2 alpha infused downstream into a single ovarian lymphatic was transferred into the adjacent ovarian vasculature (estimated transfer 1.1 and 1.7%, two experiments). When unlabelled PGF2 alpha was infused in a similar manner (76 pmol min-1), there was a prompt eightfold increase in ovarian oxytocin release from the adjacent ovary containing a corpus luteum, but no effect on the opposite corpus luteum, showing that the effect was local. Instillation of 2% lignocaine into the ovarian vascular pedicle did not affect PGF2 alpha-induced oxytocin release, supporting the idea that neural mechanisms are not involved. Repeated doses of PGF2 alpha given close-arterially produced a successive reduction in oxytocin release. This effect was prevented by a prior infusion of insulin-like growth factor-I (IGF-I), which itself gave a small, but significant, increase in oxytocin release. The results show that PGF2 alpha in ovarian lymphatics acts locally and directly to stimulate ovarian oxytocin secretion, that repeated exposure of the corpus luteum to pulses of PGF2 alpha can result in tachyphylaxis, and that this latter effect can be ameliorated by IGF-I infused in vivo.
Animals↗
The induction of des-Arg9-bradykinin-mediated hyperalgesia in the rat by inflammatory stimuli.
1. The B1 receptor agonist des-Arg9-BK does not induce mechanical hyperalgesia when injected into the rat knee joint at 1-100 nmol, or thermal hyperalgesia when injected intravenously up to 1 mumol/kg. 2. Bradykinin (BK), administered into the joint, (1 nmol-1 mumol) induces a mechanical hyperalgesia, which is maximal by 4 h. Co-administration of BK with Hoe 140 (5 pmol) blocked development of the hyperalgesia, whereas des-Arg9-Leu8-BK (0.5 nmol) had no effect. Intravenous BK had no effect on thermal paw withdrawal latencies up to 1 mumol/kg. 3. Following joint inflammation induced by local Freund's complete adjuvant, intraarticular injection of des-Arg9-BK (0.05-10 nmol) and BK (0.5-100 nmol) caused a reduction in tolerated load. Co-administration of des-Arg9-Leu8-BK (0.5 nmol) with des-Arg9-BK (0.5 nmol) blocked development of the hyperalgesia, whereas Hoe 140 (5 pmol) had no effect. BK (1 nmol)-induced hyperalgesia was blocked by Hoe 140 but not des-Arg9-Leu8-BK. 4. Following UV irradiation of the paw, intravenous des-Arg9-BK and BK reduced paw withdrawal latencies to a noxious thermal stimulus indicating thermal hyperalgesia. The latency reduction induced by des-Arg9-BK and BK was prevented with co-administration of des-Arg9-Leu8-BK 200 nmol/kg, but not with Hoe 140 0.5 mumol/kg. 5. After interleukin-1 beta pre-treatment (1 unit into the joint or paw) des-Arg9-BK induced both thermal and mechanical hyperalgesia. Co-administration of des-Arg9-Leu8-BK 0.5 nmol with des-Arg9-BK 0.5 nmol into the joint prevented development of hyperalgesia and co-administration of des-Arg9-Leu8-BK (200 nmol/kg, iv) with des-Arg9-BK 10 nmol/kg prevented reduction of thermal withdrawal latencies. 6. These data suggest that after an inflammatory insult B1 receptors may play a role in the transduction of nociceptive information.
Animals↗
Mandatory HIV testing: a position paper.
This article takes the position that mandatory testing of health workers for HIV is unethical because it is a misuse of resources. This is an ethical dilemma in distributive justice. Six facts are detailed to support this position.
AIDS Serodiagnosis↗
Generation of substance P carbamate in neutral aqueous solution. Relevance to inflammatory joint diseases.
High-field proton (1H) nuclear magnetic resonance (NMR) spectroscopy has been employed to evaluate the formation of substance P carbamate in aqueous solution. Equilibration of substance P with physiologically relevant concentrations of bicarbonate (2.50 x 10(-2) mol.dm-3) at pH 7.00 generated a new multiplet signal centred at 4.13 ppm in its NMR spectrum, characteristic of the alpha-proton of peptide carbamate species. High-field 1H NMR spectroscopy also demonstrated that the model dipeptide, Arg-Gly, formed a carbamate in neutral aqueous solutions containing 2.50 x 10(-2) mol.dm-3 HCO3-. The physiological significance of these results is discussed in view of the central roles of vasoactive neuropeptides in human joint diseases and the hypercapnic environment of the inflamed rheumatoid joint.
Arthritis, Rheumatoid↗