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Biomedical subjects

B R Rush

Publications and source records attributed to B R Rush.

33 records · Page 2Linked to original sources
PubMed1997

Immune therapy in respiratory disease.

Pharmacologic manipulation of pulmonary immunity plays an important role in primary and adjunct therapy for equine respiratory disease. Frequent exposure to respiratory viral pathogens, strenuous exercise, long distance transport, and inhalation of harmful substances destroy various aspects of the pulmonary defense system and predispose performance horses to development of infectious and noninfectious respiratory disease. Pulmonary immunity may be bolstered by nonspecific immunostimulants to combat primary or secondary immunodeficiency. State of the art technology improves active and passive-specific immunity for prevention of common infectious respiratory diseases in horses. Immuno-suppressive therapy can attenuate hyperreactive pulmonary immune responses in horses with allergic airway disease.

Animals↗
PubMed1995

Early intervention for alcohol use: family physicians' motivations and perceived barriers.

OBJECTIVE: To elucidate family physicians' motivations concerning early intervention for alcohol use and their perceived barriers to such intervention. DESIGN: Qualitative study with the use of focus groups and semistructured interviews. SETTING: Community-based, fee-for-service family-medicine practices in London, Ont. PARTICIPANTS: Twelve focus-group participants recruited through telephone contact by two family physicians on the project team. Participants were required to be physicians in family practice in London. Twelve interview participants recruited through a grand-rounds presentation at two local hospitals. Participants were required to be physicians in a community-based family practice in which primary care was not delivered by residents and to have agreed to participate in all phases (e.g., needs assessment, training and evaluation) of a training program on interventions to help patients reduce alcohol consumption or quit smoking. MAIN OUTCOME MEASURES: Motivations concerning early intervention for alcohol use and perceived barriers to such intervention, as identified by physicians. RESULTS: Physicians in the focus groups and those interviewed endorsed their role in helping patients to reduce alcohol consumption and cited several reasons for the importance of that role. There was strong support for viewing alcohol use as a lifestyle issue to be dealt with in the context of a holistic approach to patient care. Participants cited many barriers to fulfilling their role and were particularly concerned about the appropriateness of asking all adolescent and adult patients about alcohol use, even at visits intended to discuss other issues and concerns. Physicians gave several motivations for improving their work in reduction of alcohol consumption, including their current frustration with the lack of a systematic strategy or tangible materials to help them identify and manage patients. CONCLUSIONS: Interventions with patients who use alcohol should be framed in the context of a holistic approach to family medicine. Qualitative knowledge of the motivations and barriers affecting physicians can inform future research and educational strategies in this area.

Adult↗
PubMed1990

Specialized addictions assessment/referral services in Ontario: a review of their characteristics and roles in the addiction treatment system.

During the past nine years many specialized addiction assessment/referral services have been established in Ontario. These services are expected to receive referrals from all sources, to conduct thorough socio-behavioural assessments, to refer clients to appropriate community resources and to provide case management services appropriate to client needs. Although definitive statements concerning the assessment/referral services are considered premature, the available data suggests that they are generally similar to other types of addiction services with respect to referral sources and client characteristics. However, assessment/referral services are less likely to be restricted to particular types of clients, more likely to use structured assessment procedures and to make referrals to other services. There are significant differences between individual assessment/referral services, particular with respect to referral sources, client characteristics and operating procedures and the extent to which they also provide treatment. These differences partly reflect differences in operating environments. Most communities with assessment/referral services lack generally accessible outpatient services and it remains to be seen how assessment/referral services will evolve as more outpatient services become available. Data from a 1986 survey showed that assessment/referral services saw about 10% of all cases seen within Ontario's specialized addiction treatment system but they were not significant points of entry into this system.

Community Mental Health Services↗
PubMed1989

The use of family medical practices by patients with drinking problems.

The annual rate of consultation with family physicians was compared between 108 problem drinkers and a matched group of control subjects; the first group contacted physicians about twice as often as the second one, especially because of psychosocial problems and acute injuries. However, this increased rate among the problem drinkers was also due to a higher prevalence of other health-related problems for which they sought care at least once. The results are discussed in terms of the need for more definitive interventions to identify alcohol abusers, to decrease their consumption and to improve their psychosocial and physical status.

Acute Disease↗
PubMed1986

Alcohol availability, alcohol consumption and alcohol-related damage. I. The distribution of consumption model.

One of the major approaches to alcoholism prevention is referred to as the distribution of consumption model. This prevention model can be summarized as a causal model whereby the availability of alcoholic beverages has a direct causal effect on the aggregate level of alcohol consumption in the population and, in turn, an indirect effect on the incidence and prevalence of alcohol-related damage. This article summarizes an application of a statistical technique known as the analysis of linear structural relations (LISREL) to a set of Ontario data concerning alcohol availability, alcohol consumption and alcohol-related damage. Results substantiated the existence of specific causal paths consistent with the model. Several procedures for assessing the overall goodness-of-fit of the model suggested that it adequately fit the data. The results provide reasonable statistical evidence that government policies restricting the retail availability of alcoholic beverages will reduce the per capita rates of alcohol consumption and, in turn, reduce the level of alcohol-related mortality and morbidity in the general population.

Adult↗
PubMed1986

Alcohol availability, alcohol consumption and alcohol-related damage. II. The role of sociodemographic factors.

Based on the encouraging findings in part I of our study, and on the relevant research literature, several sociodemographic factors were added to the causal sequence proposed by the distribution of consumption model and corroborated by a statistical technique known as the analysis of linear structural relations (LISREL). The sociodemographic factors were added in two alternative fashions. Although neither approach proved to be significantly superior, the basic causal sequence identified in part I was maintained, and the sociodemographic factors were found to be intimately involved in the process that leads to alcohol-related morbidity and alcohol-related mortality in the general population. The findings are discussed with reference to their implications for prevention via public policy.

Adult↗
PubMed1986

Acceptability of nonabstinence treatment goals among alcoholism treatment programs.

The main objective of this study was to identify the number and type of alcoholism programs in the province of Ontario, Canada, which endorse treatment goals other than complete abstinence. A survey of all alcoholism programs in the province revealed that 36.7% of the programs found nonabstinence goals appropriate for at least some clients. Endorsement of nonabstinence goals was lowest for detoxication centers and residential treatment services, and highest for nonresidential programs and assessment-referral services. Endorsement of nonabstinence goals was higher among programs aimed at young people and those associated with the criminal justice system. Within a treatment program, the use of various kinds of assessment methods and treatment modalities did not appear to be closely associated with the endorsement of abstinence vs nonabstinence treatment goals.

Alcohol Drinking↗
PubMed1984

A comparison of disulfiram acceptors and refusers on selected demographic and clinical characteristics.

Male problem drinkers who accepted a treatment recommendation to take disulfiram were compared to those who refused the drug therapy. Subjects were drawn from a clinical population presenting to an outpatient alcoholism assessment service over a 3-year period. Both univariate and multivariate analyses were employed to investigate which client variables were associated with compliance to the disulfiram recommendation. The most important variable that distinguished the two groups was the percentage of other treatment recommendations adhered to by the client with the disulfiram acceptors being more likely to accept the other treatment recommendations. In addition, clients agreeing to take disulfiram were slightly younger and had higher scores on the Michigan Alcoholism Screening Test (MAST). Variables such as socio-economic status, previous treatment history, other drug use and drinking pattern were not associated with agreement to take disulfiram. The implications of these findings are discussed, particularly their relevance to research on the therapeutic effectiveness of disulfiram.

Adult↗
PubMedDate not supplied

Determination of synovial fluid and serum concentrations, and morphologic effects of intraarticular ceftiofur sodium in horses.

OBJECTIVES: To determine the serum and synovial fluid concentrations of ceftiofur sodium after intraarticular (IA) and intravenous (IV) administration and to evaluate the morphologic changes after intraarticular ceftiofur sodium administration. STUDY DESIGN: Strip plot design for the ceftiofur sodium serum and synovial fluid concentrations and a split plot design for the cytologic and histopathologic evaluation. ANIMALS: Six healthy adult horses without lameness. METHODS: Stage 1: Ceftiofur sodium (2.2 mg/kg) was administered IV. Stage 2: 150 mg (3 mL) of ceftiofur sodium (pHavg 6.57) was administered IA into 1 antebrachiocarpal joint. The ceftiofur sodium was reconstituted with sterile sodium chloride solution (pH 6.35). The contralateral joint was injected with 3 mL of 0.9% sterile sodium chloride solution (pH 6.35). Serum and synovial fluid samples were obtained from each horse during each stage. For a given stage, each type of sample (serum or synovial fluid) was collected once before injection and 12 times after injection over a 24-hour period. All horses were killed at 24 hours, and microscopic evaluation of the cartilage and synovium was performed. Serum and synovial fluid concentrations of ceftiofur sodium were measured by using a microbiologic assay, and pharmacokinetic variables were calculated. Synovial fluid was collected from the active joints treated during stage 2 at preinjection and postinjection hours (PIH) 0 (taken immediately after injection of either the ceftiofur sodium or sodium chloride), 12, and 24, and evaluated for differential cellular counts, pH, total protein concentration, and mucin precipitate quality. RESULTS: Concentrations of ceftiofur in synovial fluid after IA administration were significantly higher (P = .0001) than synovial fluid concentrations obtained after IV administration. Mean peak synovial fluid concentrations of ceftiofur after IA and IV administration were 5825.08 microg/mL at PIH .25 and 7.31 microg/mL at PIH 4, respectively. Mean synovial fluid ceftiofur concentrations at PIH 24 after IA and IV administration were 4.94 microg/mL and .12 microg/mL, respectively. Cytologic characteristics of synovial fluid after IA administration did not differ from cytologic characteristics after IA saline solution administration. White blood cell counts after IA ceftiofur administration were < or =3,400 cells/ML. The mean synovial pH of ceftiofur treated and control joints was 7.32 (range, 7.08-7.5) and 7.37 (range, 7.31-7.42), respectively. Grossly, there were minimal changes in synovium or cartilage, and no microscopic differences were detected (P = .5147) between ceftiofur-treated joints and saline-treated joints. The synovial half-life of ceftiofur sodium after IA administration joint was 5.1 hours. CONCLUSIONS: Synovial concentrations after intraarticular administration of 150 mg of ceftiofur sodium remained elevated above minimal inhibitory concentration (MIC90) over 24 hours. After 2.2 mg/kg IV, the synovial fluid ceftiofur concentration remained above MIC no longer than 8 hours. CLINICAL RELEVANCE: Ceftiofur sodium may be an acceptable broad spectrum antimicrobial to administer IA in septic arthritic equine joints.

Animals↗
PubMedDate not supplied

Peripheral blood lymphocyte subpopulations and immunoglobulin concentrations in healthy foals and foals with Rhodococcus equi pneumonia.

Infectious diseases are common in foals aged 1-5 months. The objectives of this investigation were to evaluate immunologic parameters in foals from birth to weaning to establish reference values for the proportion of circulating lymphocytes that were helper (CD4+) or cytotoxic (CD8+) T cells, or B cells; to measure serum immunoglobulin (IgM and IgG) concentrations; and to compare these immunologic parameters to values in foals with naturally occurring Rhodococcus equi pneumonia and in adult horses. Peripheral blood lymphocyte subpopulations were determined by flow cytometric analysis, and serum IgG and IgM concentrations were determined by radial immunodiffusion. Flow cytometric analysis of lymphocyte subpopulations suggested age-related changes in the cell-mediated immune system in horses. Absolute circulating CD4+ and CD8+ T lymphocytes and B cells increased linearly up to 3 months of age. Circulating B cell concentrations from birth to 6 months of age were greater than values in adult horses and the lymphocyte differences among the age groups are mainly due to variation in B lymphocytes. Both absolute and proportional B cell concentrations were greater in foals with R equi pneumonia than in healthy foals at the same age. The increase in absolute cell counts of each subpopulation was dependent on the increase of absolute peripheral blood lymphocyte count. Serum IgG concentration increased linearly from 1 to 3 months of age, and serum IgM concentrations increased from 1 to 6 months of age. These data suggest age-dependent cell-mediated and humoral development in young foals.

Actinomycetales Infections↗
PubMedDate not supplied

Trends in the characteristics of clients of alcohol/drug treatment services in Ontario.

This paper summarizes the major trends in the characteristics of clients of alcohol/drug treatment services in Ontario from 1979 to 1989. Data were obtained from all provincial treatment programs by surveys undertaken in 1980, 1983, 1986 and 1989. Supplementary archival data are included on the use of American treatment programs by Ontario residents. Across the period of analysis, there has been a rapid increase in the number of alcohol/drug programs and the total treatment case-load. Trends in client characteristics include increased representation of women in the treatment case-load and a shift towards greater drug involvement with or without concomitant alcohol use. In contrast, there has been a small decrease in the proportion of young or elderly clients. The utilization of American treatment services by Ontario residents may partially reflect needs of special target groups, such as adolescents, which are not being met within the Ontario treatment system.

Adolescent↗