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Biomedical subjects

A Robbins

Publications and source records attributed to A Robbins.

At least 55 records · Page 3Linked to original sources
PubMed1992

Challenging official health cost estimates: an alternative view that incorporates the behavioural and economic effects of policy changes.

Cost estimates of health care policy changes are extremely important. Historically, however, the US government has done a poor job in projecting the actual cost of new health care programmes. These projections have been inaccurate primarily because government forecasters use 'static' methods that fail to incorporate the change in people's behaviour as a direct result of a new policy. In contrast, 'dynamic' forecasts incorporate the behavioural effects of policy changes on individuals and the economy. Static and dynamic estimates can lead to different results for 4 areas of US health policy: (a) the Medicare Catastrophic Coverage Act; (b) mandated health benefits; (c) health insurance tax subsidies; and (d) national health insurance. Improving health care policy requires the adoption of dynamic estimation practices, periodic appraisals evaluating the accuracy of official estimates in relation to actual experience, and clear presentation of proposed policy changes and estimates to policymakers and the general public.

Financing, Government↗
PubMed1991

Cardiovascular changes in response to uterine stimulation.

These experiments examined cardiovascular responses to uterine horn distension in anesthetized rats. Changes in blood pressure and heart rate following distension of the uterine horn were compared in estrous and diestrous rats. In the estrous rats, there was a significant decrease in both heart rate and blood pressure following uterine horn pressure of 150 mmHg or greater. This depressor and bradycardia response did not reliably occur in the diestrous rats. To determine the afferent limb of this uterine-cardiovascular reflex, the pelvic and hypogastric nerves were cut consecutively and the effect of uterine horn distension was tested after each nerve cut. Following hypogastric, but not pelvic nerve transection, the cardiovascular responses to uterine horn distension were eliminated or severely attenuated. The importance of hypogastric afferent nerve fibers was further demonstrated by recording single unit activity in these fibers to uterine horn distension. The units responded with a pressure-dependent increase in firing rate, at uterine pressure levels of 50 mmHg and higher. To determine the efferent limb of the reflex, the cardiovascular responses were measured before and after vagus nerve transection. Elimination of this parasympathetic neural activity did not affect the inhibitory cardiovascular responses to uterine horn distension, suggesting that these fibers may not be responsible for the decrease in heart rate and blood pressure. Recordings of multi-unit activity from sympathetic efferent fibers in the renal nerve, a vasoconstrictor nerve, showed a decrease to uterine horn distension. A decrease in renal nerve efferent activity was observed at uterine horn pressures of 150 mmHg or greater and the time course of the renal nerve response paralleled the cardiovascular response.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Responses of hypogastric nerve afferent fibers to uterine distension in estrous or metestrous rats.

The response of afferent fibers in the distal end of the cut hypogastric nerve to distension of the uterus to various pressure levels was investigated in anesthetized virgin female rats on two different days of the estrous cycle (estrus or metestrus). Whereas relatively intense levels of uterine distension produced an increase in afferent activity in a pressure-dependent manner in both stages of the estrous cycle, the minimal pressure necessary to activate the fibers was significantly less on the day of estrus. These results suggest that hypogastric nerve afferent fibers are more likely to respond to potentially damaging uterine stimuli during the time when such responsiveness would be most important for reproductive success.

Action Potentials↗
PubMed1990

Ascending and descending projections to medullary reticular formation sites which activate deep lumbar back muscles in the rat.

The purpose of this study was to determine ascending and descending afferents to a medullary reticular formation (MRF) site that, when electrically stimulated, evoked EMG activity in lumbar deep back muscles. In anesthetized female rats, the MRF was explored with electrical stimulation, using currents less than 50 microA, while EMG activity was recorded from the ipsilateral lateral longissimus (LL) and medial longissimus (ML). MRF sites that evoked muscle activity were located in the gigantocellular nucleus (Gi). At the effective stimulation site, the retrograde fluorescent tracer, Fluoro-Gold (FG), was deposited via a cannula attached to the stimulating electrode. In matched-pair control experiments, FG was deposited at MRF sites that were ineffective in producing EMG activity in LL and ML, for comparison of afferent projections to effective versus ineffective sites. Labeled cells rostral to FG deposition at effective MRF sites were located in the preoptic area, hypothalamus, limbic forebrain and midbrain, with particularly high numbers in the ipsilateral midbrain central gray, tegmentum, paraventricular nucleus and amygdala. At medullary levels, there was a heavy projection from the contralateral Gi. FG labeled cells were also located in the contralateral parvocellular reticular nucleus, and lateral, medial and spinal vestibular nuclei. Labeled cells with ascending projections were observed in greatest number in the rostral cervical spinal cord, with fewer cells at mid cervical levels and even fewer in the lumbar spinal cord. These labeled cells were located primarily in lamina V, VII, VIII and X. Locations of labeled cells following FG deposition at ineffective MRF sites were similar. However, there was a striking difference in the number of cells retrogradely labeled from the effective MRF sites compared to ineffective MRF sites. Significantly greater numbers of labeled cells were observed in the contralateral MRF, the midbrain, and the cervical spinal cord from the FG deposition at effective stimulation sites. These results suggest that one characteristic of MRF sites that activate epaxial muscles is a larger amount of afferent input, from the midbrain central gray and from contralateral Gi, compared to ineffective MRF sites. Ascending and descending inputs converge at the effective MRF sites, and the larger number of descending projections suggests a more powerful contribution of these afferents to deep lumbar back muscle activation.

Animals↗
PubMed1990

Functional properties of afferent fibers supplying reproductive and other pelvic organs in pelvic nerve of female rat.

1. Electrophysiological techniques were used to characterize responses of afferent fibers in pelvic nerve of adult, virgin female rats to mechanical or chemical stimulation of internal reproductive organs and to mechanical stimulation of other pelvic organs. 2. In an in vivo barbiturate-anesthetized preparation, pelvic nerve afferent fibers responded to a wide variety of mechanical stimulation applied to restricted regions of the vaginal canal, caudal uterus (body and cervix), bladder, ureter, colon, or anus. 3. Single-fiber mechanoreceptive fields were invariably confined to a single organ. Notably, responses could be evoked not only by gentle stimulation of the unit's receptive field directly on the organ itself, but also by stimulating the field indirectly with intense stimulation through the appropriate part of a contiguous organ. This innervation feature is consistent with the separability of pelvic organ functions under innocuous conditions but their confusion under noxious ones. 4. Receptive fields on the reproductive organs extended from the caudal edge of the vagina to the uterine body (including the cervix) but were most often located in the fornix (vaginocervical junction). Most units had no or low levels of spontaneous activity. Their responses to mechanical stimuli were usually slowly or moderately adapting and time-locked to the stimulus. 5. Fibers with vaginal receptive fields (including the fornix) responded best either to vaginal distension with a balloon or, more often, to a probe moving along the internal vaginal surface in a direction toward the cervix. They were observed most frequently during the proestrus stage of the rat's estrous cycle. These fibers, therefore, seem particularly suited for relaying information about stimuli that occur during mating. 6. Fibers with receptive fields on the uterine cervix and body responded best to static pressure and were observed less frequently than those with vaginal fields, regardless of estrous stage. They were, however, sensitized by hypoxia. In addition, irritation of the uterus increased the probability of observing them. These fibers, therefore, may exert their primary function during reproductive conditions different from those of virgin rats, such as parturition. 7. Response activity of most of the mechanoreceptive afferent fibers supplying reproductive organs increased as the stimulus intensity increased into the noxious range; i.e., into a range in which the stimulus momentarily produced ischemia at the stimulus site. In addition, in an in vitro preparation, pelvic nerve fibers responded in a dose-dependent manner to injections through the uterine artery of bradykinin (BRAD) as well as to other algesic chemicals, 5-hydroxytryptamine (5-HT) and KCl.(ABSTRACT TRUNCATED AT 400 WORDS)

Adnexa Uteri↗
PubMed1988

Neural inputs from the uterus to the paraventricular magnocellular neurons in the rat.

Extracellular action potentials were recorded from antidromically identified, tonically firing cells in the hypothalamic paraventricular nucleus (PVN) of ovariectomized, estrogen-treated female rats under urethane anesthesia. Genital or somatic sensory stimuli, or electrical stimulation of the nerves innervating the pelvis were applied. Uterine horn or vaginal distension each excited 33% of the neurons tested. Probing of the cervix had no effect. Hindpaw pinch produced excitation in 39% and inhibition in 11% of the neurons tested. Non-noxious somatic stimuli had no effect. Stimulation of the uterine afferent nerves, the hypogastric and pelvic nerves, excited 55% and 30% of the neurons tested, respectively. Stimulation of a somatic nerve of the hindleg, the sciatic nerve, activated 80% of the neurons tested. These results indicate that specific sensory afferents arrive at the PVN from the uterus; in addition, somatic afferents converge in this hypothalamic nucleus.

Afferent Pathways↗
PubMed1988

Afferent fibers supplying the uterus in the rat.

1. In the present three-part study electrophysiological techniques were used to characterize responses of afferent fibers in the rat hypogastric nerve to mechanical or chemical stimulation of the uterus, and anatomical techniques were used to identify the spinal segments through which uterine afferent fibers enter the spinal cord. 2. In an in vivo barbiturate-anesthetized preparation, hypogastric afferent fibers responded in a time-locked manner to mechanical stimulation confined to restricted regions of the uterus and adjacent ligament. Receptive fields were most often located on the uterine body, particularly over the cervix. The few located on the uterine horn were usually near regions irritated during preparative surgery. Effective mechanical stimuli (pressure, stretching, squeezing, probing, rarely contractions) were typically greater than 5 g and simultaneously accompanied by transient ischemia around the probe or contracted area. Distension, unless extreme, was not an effective stimulus. Retrospective analysis of the data indicated that fibers may be more sensitive to uterine stimulation when rats are in vaginal estrus/proestrus than in diestrus/metestrus. 3. In an in vitro preparation, hypogastric afferent fibers responded in a dose-dependent fashion to injections into the uterine artery of the algesic chemicals bradykinin, 5-hydroxytryptamine, and KCl. They also responded to high doses of CO2 (in saline) and NaCN, but rarely to lower doses. Nearly all fibers responded to more than one chemical with response characteristics unique to each chemical (e.g., latency, duration, peak rate). 4. Injections of horseradish peroxidase into the uterine body and small portions of the adjacent horns in rats in vaginal estrus consistently labeled a small number of cells in the L1-S1 dorsal root ganglia, with peaks at L2 and L6. Virtually no cells were labeled in rats whose estrous cycle had been disrupted (by inadvertently keeping them in constant light conditions for several weeks). 5. These results indicate that uterine afferent fibers travel to the central nervous system through both the hypogastric (e.g., L1-L4 ganglia) and pelvic (e.g., L5-S1 ganglia) nerves in the rat, and that hypogastric fibers are capable of conveying fairly precise information about temporal and spatial aspects of uterine mechanical and chemical stimulation. The results also encourage future research into the possibility that the responses of these fibers vary as a function of estrous stage or other aspects of the condition of the uterus (e.g., its irritation).(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗
PubMed1987

Site-specific insertion of DNA into a pseudorabies virus vector.

A simple, efficient method for introducing recombinant DNA into a herpesvirus vector and retrieving it at a later time has been developed. By using the Cre-lox site-specific recombination system of coliphage P1, DNA can be readily inserted in vitro into a pseudorabies virus (PRV) vector containing the lox recombination site. The vector PRV42 contains a lox site within the nonessential gIII gene, which encodes a virion envelope glycoprotein. Incubation in vitro of PRV42 DNA with Cre protein and a circular plasmid containing a lox site generates approximately 5% recombinant molecules having the plasmid integrated into the PRV genome at the lox site. Transfection of the reaction mixture into cultured cells allows recovery of the infectious recombinant virus, which is readily identified by a nondestructive "black-plaque assay" using a gIII-specific monoclonal antibody. PRV42 plaques stain black when treated with the gIII monoclonal antibody and a peroxidase-linked second anti-antibody because the lox site placed within the gIII gene of PRV42 does not destroy the gIII epitope. However, Cre-mediated integration of heterologous DNA at the lox site disrupts the gIII epitope so that the resulting recombinant virus produces white plaques. The recombinant virus is infectious, stable, and grows as well as the parental PRV42 vector. The inserted plasmid can be efficiently excised (greater than 50%) from viral DNA by Cre and recovered by transformation of Escherichia coli.

Coliphages↗
PubMed1987

Measuring physicians' humanistic attitudes, values, and behaviors.

This paper describes the reliability and validity of 10 easily administered and scored self-report measures of physicians' humanistic attitudes, values, and behaviors. This research also provides evidence that evaluations of physicians' humanistic behavior made by their outpatients, and non-physician staff with whom they worked, and the faculty physicians supervising them on inpatient ward rotations were positively and significantly correlated with one another. The potential usefulness of a multi-modal approach in evaluating humanistic physician attributes in which self-report measures are combined with direct feedback from all of those who interact with physicians is discussed.

Attitude of Health Personnel↗