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Biomedical subjects

B D Weiss

Publications and source records attributed to B D Weiss.

At least 19 recordsLinked to original sources
PubMed1992

Inhibition of tumor implantation at sites of trauma by Arg-Gly-Asp containing proteins and peptides.

We report on the inhibition of wound implantation by TA3Ha mammary carcinoma cells by Arg-Gly-Asp containing proteins and peptides using a hepatic wedge resection model. Intravenously injected TA3Ha cells rarely form tumor in the liver of syngeneic mice, but after hepatic wedge resection, 45% (107/240) of the mice develop tumors in the hepatic wound. Hepatic wound implantation is significantly (P = 0.01) inhibited by pretreating the cells with whole mouse plasma, but not with fibrinogen-depleted plasma or serum. Tumor inhibition is also achieved by pretreatment of cells with fibrinogen (P = 0.05-0.0004), fibronectin (P = 0.007) and laminin, but not by albumin. The active domain appears to be the RGDS sequence since the deca- and tetrapeptides containing RGDS inhibit wound implantation (P less than 0.05). However, the tetrapeptide Arg-Gly-Glu-Ser has no such activity. None of these agents affects ascites tumor formation by the intraperitoneally injected cells, suggesting that anchorage independent growth of cells is not affected. We propose that proteins and peptides containing RGD occupy the binding sites and prevent the cells from interacting with cell adhesion proteins in healing wounds. Proteins and/or peptides containing RGD may be useful for preventing local recurrence in postsurgical cancer patients.

Animals↗
PubMed1992

Trends in bicycle helmet use by children: 1985 to 1990.

Research has demonstrated that helmets protect against head injury during bicycle crashes. Several investigators have shown that large-scale, community-wide programs can increase the rate of helmet use by children. The objective of this research was to determine whether helmet use had changed over a 5-year period in a community with no formal programs designed to increase the use of helmets. In 1985 and again in 1990, project staff observed student bicyclists arriving at four elementary schools, three middle schools, three high schools, and one university campus. The same schools were used both years. There was no significant increase in the percentage of students who used helmets at the middle schools (0 both years), the high schools (1.85% vs 1.45%), or the university (10.0% vs 4.0%). At the four elementary schools, helmet use increased from 1.85% in 1985 to 17.1% in 1990. Much of this increase was attributable to one school at which helmet use increased from 4.4% to 21.4%. This school, and no others, had begun teaching about helmet use in the classroom. The results suggest that (1) helmet use will not increase at the middle school level or higher without specific interventions and (2) simple, low-cost, classroom interventions can increase helmet use by elementary school children.

Adolescent↗
PubMed1991

The relationship between literacy and health.

In non-industrialized countries, populations with the lowest literacy rates have the poorest health status. In the United States, however, there is no published research on whether illiteracy, independently of other sociodemographic factors, is related to health status. There are numerous plausible mechanisms by which such a relationship could occur. For example, published reports indicate that most information handouts, consent forms, and other materials for patients are written at reading levels too difficult for most American adults. These and other findings may have important implications in the health care of underserved populations. Research is needed to determine the health effects of impaired literacy skills among Americans, and to develop non-literacy-dependent methods for providing patient education, obtaining informed consent, and administering diagnostic tests.

Educational Status↗
PubMed1991

Nonpharmacologic treatment of urinary incontinence.

Standard therapy for urinary incontinence often includes pharmaceutical agents that carry a risk of side effects or interactions with other drugs. As an alternative, several nonpharmacologic management approaches are available. Scheduled voiding regimens are effective for patients who have uninhibited detrusor contractions, even when cognitive impairment is present. In motivated patients, pelvic muscle exercise is effective for stress incontinence. These methods are safe and inexpensive, and studies indicate that they can be as effective as or more effective than pharmaceutical agents. Other nonpharmacologic approaches to management include biofeedback techniques and electrical stimulation therapy.

Behavior Therapy↗
PubMed1991

The cervical cap.

The cervical cap is a barrier contraceptive method with an efficacy similar to that of the diaphragm. It has several advantages over other barrier contraceptives. In particular, it can be left in place for up to 48 hours, and repeated applications of spermicide are not necessary, even if sexual intercourse occurs more than once. In addition, the side effects seen with other barrier methods do not occur with the cervical cap. In some women, Papanicolaou tests may become abnormal, especially during the first three months of cap use. Therefore, careful monitoring of cervical cap users is essential.

Contraceptive Devices, Female↗
PubMed1990

Patient satisfaction survey instrument for use in health maintenance organizations.

The objective of this research was to devise a survey instrument specifically applicable to prepaid health care plans that could accurately predict whether patients would disenroll from their current plan because of dissatisfaction when given the opportunity to do so. A "prequestionnaire" was sent to all employees at a southwestern university whose employee benefit package included the option of selecting one of several health maintenance organizations (HMOs) as a source of health care. The prequestionnaire included 90 variables reported in the literature as related to patient satisfaction. The prequestionnaire was mailed two months before "open enrollment," the time at which subjects would have the opportunity, if desired, to change HMOs. After open enrollment, a "postquestionnaire" was sent to the same subjects, asking whether or not they did change plans during open enrollment. There were 2,365 respondents enrolled in HMOs who formed the study population. Of these, 189 (8.0%) changed HMOs during open enrollment. Discriminant function analysis was used to identify prequestionnaire variables which were predictive that subjects had changed plans; 10 variables were identified. They were combined into a survey instrument, which can be scored to predict an individual subject's probability of changing plans.

Arizona↗
PubMed1990

Comprehensive geriatric assessment recommendations: adherence of family practice residents.

A study was performed to determine whether family practice residents followed recommendations made by a comprehensive geriatric assessment clinic. Of 109 consecutive consultations, 27 patients had follow-up visits with family practice residents who participated in the assessment and who subsequently served as their primary care physicians. Adherence of residents to 437 clinic recommendations was monitored for 90 days by medical record review. Although recommendations to begin or increase a medication were followed 85.4% of the time, residents followed recommendations to stop or decrease medications less than 65% of the time. Recommendations to order a specific laboratory test or x-ray examination were acted on 70.3% of the time. Preventive recommendations were followed only 54.3% of the time. Residents' adherence to team-based care plans varied widely by type of recommendation. Special efforts are needed to increase compliance with comprehensive geriatric assessment clinic recommendations, particularly those for preventive services.

Aged↗
PubMed1990

Publications by family physicians in non-family medicine journals.

Why do some family physician (FP) authors submit manuscripts to non-family medicine journals instead of to family medicine journals? This study identified all 32 FP-authored articles that were published in several widely read non-family medicine journals over a 4-year period. Twenty-nine (90.6%) of the FP authors thus identified responded to a questionnaire soliciting the article's publication history. Of the 29, only one author had initially submitted his article to a family medicine journal. The most common reason cited by the other authors for not submitting to a family medicine journal was a perception that the non-family medicine journals had wider readership and prestige than family medicine journals. Other authors indicated that institutional promotion and tenure committees give less weight to publications in family medicine journals and, therefore, these authors felt it was preferable to publish in non-family medicine journals.

Faculty, Medical↗
PubMed1989

No relationship between pregnancy complications and variations in blood glucose levels among nondiabetic women.

Research using high-risk pregnant women suggests that postprandial blood glucose levels at the high end of normal are associated with greater risk of adverse pregnancy outcomes than low-normal levels. The objective of this study was to determine the relationships between pregnancy complications and glucose levels in low-risk pregnant women. Based on 2-hour postprandial glucose testing at 27 to 33 weeks, 337 women with normal reproductive histories were divided into three groups: group A, glucose less than 5.6 mmol/L (100 mg/dL), group B, 5.6 to 6.6 mmol/L (100 to 119 mg/dL), and group C, 6.7 to 9.1 mmol/L (120 to 164 mg/dL). Women with glucose levels greater than or equal to 9.2 mmol/L (165 mg/dL) were excluded. The groups were compared to detect differences in rates of various maternal outcomes (preeclampsia, cesarean delivery, forceps delivery) and neonatal outcomes (macrosomia, Apgar scores, prematurity, fetal death, infant death, congenital anomalies). No significant differences were found. These data indicate that variations in maternal glucose tolerance (within the normal range) are not associated with adverse outcomes in normal pregnant women.

Adolescent↗
PubMed1988

Guidelines for using five new prenatal laboratory tests.

All physicians, even those not routinely involved in prenatal care, should be aware of the laboratory tests recently recommended for inclusion in prenatal care. All pregnant women should undergo blood glucose testing to detect gestational diabetes mellitus. Women at risk for hepatitis B, Chlamydia trachomatis infection, or human immunodeficiency virus infections should be tested. All women should also be offered alpha fetoprotein testing for detection of neural tube defects. If test results are abnormal, appropriate management and/or counseling should be provided.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Assessing the quality of data entry in a computerized medical records system.

A primary care university clinic discovered major errors in its medical records after instituting a computerized medical records system. A quality assessment tool was devised to measure the error rate and provide clues to the sources of these errors. During the implementation of this tool a marked reduction in data entry errors occurred suggesting its use had a positive impact on our medical record quality.

Arizona↗
PubMed1988

An unsuccessful experience with computerized medical records in an academic medical center.

Computerized medical records systems are used in only a small percentage of U.S. health care facilities, despite predictions that they would be widely used. The authors here report on their experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center. Although some equipment and computer resources were provided by the medical center, ongoing operations were financed by clinic revenues. After four months, use of the system was terminated because clinic revenues could not cover operating costs. The operating costs accounted for 17 percent of the average charge for an office visit. The major component of the operating costs was personnel expenses for data entry.

Academic Medical Centers↗
PubMed1988

First-year results of routine alpha-fetoprotein testing on prenatal patients in a family practice.

For one year all pregnant women presenting to a family practice clinic for prenatal care were routinely tested for maternal serum alpha-fetoprotein levels (MSAFP). Unexpectedly, 14 (15.7 percent) of 89 tested patients had low MSAFP levels. All 14 pregnant women underwent appropriate diagnostic workups because of the low MSAFP level and were subsequently followed until delivery. Although the literature reports that low MSAFP levels are associated with chromosomal anomalies, none of the 14 women were delivered of infants with anomalies. Reasons for the unexpectedly high rate of abnormal MSAFP levels were investigated. Investigation revealed that normal values for MSAFP tests had been derived from testing performed on high-risk pregnant women who had an inherently higher rate of abnormal pregnancies and, apparently, a different range for normal MSAFP levels than a population of unselected family practice patients. The results of this study demonstrate that it may not be appropriate to apply diagnostic algorithms based on data derived in high-risk subspecialty clinics to unselected patients in a family practice.

Adult↗
PubMed1988

Malaria: chemoprophylaxis and therapy.

Malaria should be considered in a patient with unexplained fever and a history of travel to an endemic area. Aggressive therapy must be started if Plasmodium falciparum infection is a possibility. Travelers must be educated about mosquito bite protection and appropriate chemoprophylaxis. Travelers can, however, acquire malaria despite chemoprophylaxis, and symptoms may appear up to one year after the trip.

Animals↗