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Biomedical subjects

A M Davis

Publications and source records attributed to A M Davis.

126 records · Page 7Linked to original sources
PubMed1989

Development of coronary prevention strategies by health authorities in the United Kingdom.

The United Kingdom has one of the highest coronary heart disease mortality rates in the world. However, over the last decade there has been a growing impetus in coronary prevention. In 1988 the Faculty of Community Medicine carried out a survey of all health authorities in the UK to assess the progress and problems with coronary prevention. This survey received a 92 per cent response rate and shows some interesting findings. The picture at present reveals a growing momentum in the last couple of years with half the health authorities at present claiming to have a programme. The main hindrances reported are lack of funding rather than lack of interest. The development and difficulties with nutrition and smoking policies, and with blood pressure screening are also described. The regional pattern of development of these programmes and policies is complex. Many authorities favour a general health promotion approach rather than a negative, disease oriented one; this conflict in approach requires further debate.

Coronary Disease↗
PubMed1988

Experimental charge measurement at leaving oxygen in the bovine ribonuclease A catalyzed cyclization of uridine 3'-phosphate aryl esters.

The title esters are demonstrated to be specific substrates of bovine pancreatic ribonuclease A (EC 3.1.27.5). The Brønsted dependence of kcat/Km at pH 7.50 for the enzyme-catalyzed cyclization versus the pKa of the leaving phenol exhibits two regression lines of almost identical slope for respectively 2-chlorophenols and 2,6-unsubstituted phenols: log kcat/Km = -0.20 pKa ArOH + 5.47 (n = 5, r = 0.957); log kcat/Km = -0.17 pKa ArOH + 5.79 (n = 4, r = 0.965). Comparison of the Brønsted beta 1g's with that for the standard reaction where imidazole catalyzes the cyclization (beta 1g = -0.59) indicates considerably less development of negative charge on the leaving oxygen in the enzyme case, providing experimental evidence for the hypothesis that electrophilic assistance is involved in catalysis. The existence of two essentially parallel Brønsted correlations is not reflected in the standard reaction of substrate with imidazole. Modeling studies indicate that the phenyl ring of the substrate can take up a range of positions away from the active site; the presence of ortho chloro substituents considerably restricts the motion of the phenyl leaving group.

Animals↗
PubMed1983

Severe hepatic damage after acetaminophen use in psittacosis.

A 63-year-old man with acute psittacosis had severe hepatic damage after ingesting about 10 g of acetaminophen over a 48 hour period. Transaminase levels showed striking elevation, with a serum glutamic-oxaloacetic transaminase level of over 15,000 IU/liter, and decreased rapidly, consistent with a toxic insult. No other etiologic agents were identified by history or serologic testing to explain this degree of damage. Liver histologic findings at autopsy showed severe central necrosis. Although psittacosis may infrequently cause a similar pattern of hepatic injury, disease of this severity has not been previously reported. It is postulated that acetaminophen may have accentuated hepatic disease produced by Chlamydia psittaci in this patient.

Acetaminophen↗
PubMed1983

Contextual sensitivity in young children's drawings.

Previous research has examined the characteristic errors made by young children when drawing from a three-dimensional array. The aim of the present research was to investigate the influence of context in copying tasks. In a series of three experiments children between the ages of 4 and 7 years were presented with contrasting models to copy. These included cups and sugar bowls in various combinations and orientations. In each experiment the children's copies were scored for inclusion or omission of the occluded handle on the model. The results showed that nearly one third of the children did not respond consistently by either copying accurately or by always including the occluded handle. Instead the findings pointed to a large group of children whose responses were directed by the type of context present within the arrays.

Age Factors↗
PubMed1981

Primary dysmenorrhea. Relationship to personality and attitudes in adolescent females.

Primary dysmenorrhea is experienced by 40-80% of adolescent females. Traditionally, the literature discussing the etiology and management of this entity has given greater weight to psychologic than to physiologic factors. However, four previous studies addressing psychosocial variables failed to show a relationship to primary dysmenorrhea. In this study, personality factors and certain attitudinal variables were not found to be significantly related to the presence of primary dysmenorrheic pain. Current evidence strongly suggests that uterine contractility, hormone variables, and prostaglandins are causative in most cases of primary dysmenorrhea. Therefore, it is recommended that primary dysmenorrhea be regarded and managed as a physiologic phenomenon in the majority of adolescent females.

Adolescent↗
PubMedDate not supplied

Patients' perceptions of their physician's role in smoking cessation by age and readiness to stop smoking.

BACKGROUND: Patients' perceptions of their physician's role in smoking cessation, using the 4As protocol (asking, advising, assisting, and arranging), were assessed with a focus on associations with age (18-29, 30-49, and > or = 50) and stage of readiness to stop smoking (precontemplation, contemplation, and preparation). METHODS: Self-administered questionnaires were completed by 524 smokers presenting for regularly scheduled appointments at six clinics of an HMO in the Chicago metropolitan area. RESULTS: Almost all patients said their physician should ask about their smoking status and advise them to quit. About half said their physician should assist them with quitting, and about two-thirds said their physician should follow up (arrange) on their smoking behavior. Bivariate associations were found for endorsement of the 4As with both age and stage. Multiple logistic regressions found age was the most consistent and strongest correlate of 4As endorsement, with younger smokers more likely than those age 50 or older to endorse the 4As protocol. CONCLUSIONS: A proactive health promotion orientation should be encouraged among physicians. Patients should be screened for stage of readiness to stop smoking so that health-care providers can emphasize aspects of the 4As protocol that are most appropriate for each patient. Age-tailored smoking cessation strategies should be employed within stages of readiness to stop smoking.

Adult↗
PubMedDate not supplied

Measuring disability of the upper extremity: a rationale supporting the use of a regional outcome measure.

OBJECTIVE: Many existing upper extremity outcome measures have been designed for a specific anatomic site (e.g., shoulder) or a specific disease entity (e.g., carpal tunnel syndrome). The purpose of this paper is to examine whether questionnaire items taken from very specific measures are considered relevant only to that specific region or are applicable to the whole extremity. METHODS: Fifteen practicing clinicians categorized a sample of 132 items from existing questionnaires according to whether the items reflected disability specific to an anatomic site or were relevant to the whole extremity. RESULTS: Seventy-two percent of the items were categorized as relevant to the extremity as a whole, while only 21% of the items were categorized as specific to an anatomic site. CONCLUSION: Items in existing specific upper extremity questionnaires are also relevant to other regions and conditions. This finding is in agreement with kinesiologic and biomechanical theories that the upper extremity acts as a single functional unit. Questionnaires designed for the whole extremity could provide a more practical and still valid measure of upper extremity disability.

Activities of Daily Living↗
PubMedDate not supplied

Is there a difference between leads and drugs? A historical perspective.

To be considered for further development, lead structures should display the following properties: (1) simple chemical features, amenable for chemistry optimization; (2) membership to an established SAR series; (3) favorable patent situation; and (4) good absorption, distribution, metabolism, and excretion (ADME) properties. There are two distinct categories of leads: those that lack any therapeutic use (i.e., "pure" leads), and those that are marketed drugs themselves but have been altered to yield novel drugs. We have previously analyzed the design of leadlike combinatorial libraries starting from 18 lead and drug pairs of structures (S. J. Teague et al. Angew. Chem., Int. Ed. Engl. 1999, 38, 3743-3748). Here, we report results based on an extended dataset of 96 lead-drug pairs, of which 62 are lead structures that are not marketed as drugs, and 75 are drugs that are not presumably used as leads. We examined the following properties: MW (molecular weight), CMR (the calculated molecular refractivity), RNG (the number of rings), RTB (the number of rotatable bonds), the number of hydrogen bond donors (HDO) and acceptors (HAC), the calculated logarithm of the n-octanol/water partition (CLogP), the calculated logarithm of the distribution coefficient at pH 7.4 (LogD(74)), the Daylight-fingerprint druglike score (DFPS), and the property and pharmacophore features score (PPFS). The following differences were observed between the medians of drugs and leads: DeltaMW = 69; DeltaCMR = 1.8; DeltaRNG = DeltaHAC =1; DeltaRTB = 2; DeltaCLogP = 0.43; DeltaLogD(74) = 0.97; DeltaHDO = 0; DeltaDFPS = 0.15; DeltaPPFS = 0.12. Lead structures exhibit, on the average, less molecular complexity (less MW, less number of rings and rotatable bonds), are less hydrophobic (lower CLogP and LogD(74)), and less druglike (lower druglike scores). These findings indicate that the process of optimizing a lead into a drug results in more complex structures. This information should be used in the design of novel combinatorial libraries that are aimed at lead discovery.

Combinatorial Chemistry Techniques↗
PubMedDate not supplied

Colorectal carcinoma. A staff model HMO's experience with screening and hospital use. ANCHOR Organization for Health Maintenance, Chicago, Illinois.

The authors present a staff model HMO's experience over an 18 month prospective period with the 35 cm flexible sigmoidoscopy (FS) and over a three year retrospective period of colorectal carcinoma related hospitalizations. In 735 asymptomatic patients receiving FS, 54 (7.3%) polyps and 5 (.68%) carcinomas (4 Dukes'A and 1 Dukes'B) were detected by FS. In asymptomatic patients who were fecal occult blood test (FOBT) positive, 3 (3.3%) carcinomas and 8 (8.9%) polyps were detected by FS. Additionally, one FOBT negative, FS negative patient had a Dukes' A carcinoma detected by screening air contrast barium enema. In a 3-year period, 35 carcinomas were diagnosed (18 symptomatic, 17 asymptomatic). Relative to asymptomatic patients, symptomatic patients averaged lower estimated 5-year survival rates (59% vs. 84%), longer initial hospitalizations (13.7 vs. 8.3 days), and significantly more advanced (non-Dukes'A) carcinomas (89% vs. 41%) (p less than .01), respectively. There were 7 deaths in 42 patients hospitalized during this study period. Estimated cost of screening and diagnostic evaluation in these 735 FS patients was $75,827 or $12,638/carcinoma detected. Two screening models are outlined with costs and benefits estimated for each model. From past experience and a review of the literature, the authors currently use seven guidelines for the early detection and prevention of colorectal carcinoma.

Chicago↗