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Biomedical subjects

C A Rice

Publications and source records attributed to C A Rice.

17 recordsLinked to original sources

Impaired growth in the polychaete Armandia brevis exposed to tributyltin in sediment.

Juveniles of the opheliid polychaete, Armandia brevis, were exposed to sediment-associated tributyltin (TBT) for 42 days to evaluate toxicity and bioaccumulation. Growth in this species was inhibited in a dose-response fashion by increasing concentrations of TBT. Even though the biota-sediment accumulation factor (BSAF) for TBT declined for the higher sediment concentrations, the total butyltins in tissue increased over all sediment concentrations. At the highest sediment concentrations, polychaetes bioaccumulated less TBT than expected, which was most likely due to reduced uptake and continued metabolism of the parent compound. The less than expected BSAF values exhibited by animals at the exposure concentrations causing severe effects are an important finding for assessing responses in the field. It appears that severe biological effects can occur in long-term experiments without the expected high tissue concentrations; an observation likely explained by altered toxicokinetics. Analysis of variance determined the lowest observed effect concentration for growth to be 191 ng/g sediment dry wt. for 21 days of exposure and 101 ng/g sediment dry wt. at day 42, indicating that 21 days was insufficient for delineating the steady-state toxicity response. When based on regression analysis, the sediment concentration causing a 25% inhibition in growth at 42 days exposure was 93 ng/g dry wt. (total organic carbon = 0.58%). A dose-response association was also determined for polychaete net weight and TBT in tissue. The tissue residue associated with a 25% reduction in growth was 2834 ng/g dry wt. at day 42. A comparison of these results with previous work indicates that juveniles are approximately three times more sensitive than adults to TBT exposure. The sediment concentrations affecting growth in this species are commonly found in urban waterways indicating potentially severe impacts for this and other sensitive species.

Animals↗

Premature termination of group therapy: a clinical perspective.

Premature terminations are an inevitable if complex aspect of any therapy group, as they are of life. They can be destructive to the life of a group, and damaging to its members. It is possible, however, given proper preparation and thoughtful reflection, to make such premature endings effective. And sometimes, understanding the wish to leave may change potentially premature endings into turning points in a continuing therapy. I use two clinical events to illustrate these processes. Premature terminations are described as part of a continuum of endings that include dropouts, early endings, and good-enough terminations.

Adult↗

Using an encounter form to develop a clinical database for documenting nurse practitioner primary care.

A clinical database will enable nurse practitioners to document and improve characteristics of their practices. This information is vital if nurse practitioners expect to achieve success in the changing U.S. health care system. This article describes the process of creating an encounter form and a related clinical database. Changes made in a family practice clinic that were derived from using a clinical database are presented. Additional uses for a clinical database, such as quality assurance, clinical evaluation, and clinical research, are discussed.

Database Management Systems↗

The regressed inpatient group in a graded group treatment program.

This article describes the progress of severely regressed inpatients as part of a graded group treatment program. Leaders must actively initiate structure, formulate goals, and emphasize the eventual "graduation" of patients to higher-level groups. Essential qualities of the group leaders and countertransference issues are discussed.

Countertransference↗

Relationship of physician continuity to type of health problems in primary care.

The objective of this study was to determine if the level of continuity of medical care was related to the type of health problems (chronic or acute) presented by patients at four family health centers during a one-year period. Patients with chronic diagnoses encountered significantly fewer physicians and had a higher mean Continuity Index than patients with acute illness diagnoses, even though these two groups made the same number of health center visits for their respective problems during this period. These findings indicate that the prioritizing of clinical problems (whether planned or fortuitous) with respect to the importance of providing continuous care may already be taking place at these health centers. These activities are appropriate if one accepts the premise that, other things being equal, longer illnesses are treated more effectively if there is a consistent knowledge base about a patient and his/her illness, and that this consistency of knowledge is related to the number of providers encountered by that patient.

Acute Disease↗

Family practice in Massachusetts: a comparison of residency trained family physicians with the general practitioner experience of 1967-1968.

An analysis of data collected from a one-year survey of the activities of seven residency trained family physicians practicing in Massachusetts was carried out. These data were compared to a study of activities of Massachusetts general practitioners done in 1967-1968, and to the Virginia Study of 1976. Both hospital and health center encounters were analyzed. The age distribution of the practices paralleled that of the general practitioners, particularly the younger general practitioners. The sex distribution was also comparable. However, over one third of all health problems recorded during the study were for preventive or non-illness visits. This represented a significant percentage increase over the general practitioners as well as the family physicians in the Virginia Study. The site of activity was also different in showing a ten percent increase in office visits over 1967-1968. Women's health issues, which include maternity and family planning care, represented a larger percentage of the practices of the residency graduates than was the case in the Virginia Study. Educational and health manpower implications of the study are discussed.

Adolescent↗

Methodological, technical, and ethical issues of a computerized data system.

This report examines some methodological, technical, and ethical issues which need to be addressed in designing and implementing a valid and reliable computerized clinical data base. The report focuses on the data collection system used by four residency based family health centers, affiliated with the University of Massachusetts Medical Center. It is suggested that data reliability and validity can be maximized by: (1) standardizing encounter forms at affiliated health centers to eliminate recording biases and ensure data comparability; (2) using forms with a diagnosis checklist to reduce coding errors and increase the number of diagnoses recorded per encounter; (3) developing uniform diagnostic criteria; (4) identifying sources of error, including discrepancies of clinical data as recorded in medical records, encounter forms, and the computer; and (5) improving provider cooperation in recording data by distributing data summaries which reinforce the data's applicability to service provision. Potential applications of the data for research purposes are restricted by personnel and computer costs, confidentiality considerations, programming related issues, and, most importantly, health center priorities, largely focused on patient care, not research.

Computers↗

Correlations in mortality data involving cancers of the colorectum and esophagus.

Massachusetts vital event data for 1969--1972 were used to develop correlations between mortality rates for malignant diseases and other causes of death over the 34 health planning subdivisions of the state. A significant correlation was found between the mortality rates for cancer of the colon and rectum and ischemic heart disease. The association between the mortality figures for cancer of the esophagus and cancer of the lung and cirrhosis of the liver was also investigated. The objective was not only to learn more about the etiology of these conditions, but also to investigate the socioeconomic and other factors which are of importance in developing preventive programs. The need for neighboring states to use their data to confirm or refute findings is stressed.

Colonic Neoplasms↗

Laboratory prediction of the carrier state in hemophilia B: role of replication of assays.

The authors studied the effect of averaging replicated assays of Factor IX coagulation activity and Factor IX antigen on each plasma specimen in improving the ability to detect carriers of hemophilia B. The improvement resulting from this procedure is particularly marked in tests depending on the linear regression of one characteristic on another to diagnose the carrier state. The effects of averaging assays on the ratio of Factor IX coagulation activity to Factor IX antigen were also explored. The benefits of averaging replications were not greatly increased by use of more than four replications.

Blood Coagulation Tests↗

From sediment bioassay to fish biomarker--connecting the dots using simple trophic relationships.

Two common problems in applying and interpreting invertebrate bioassays and fish biomarkers in sediment toxicology are the wide gap between significant effects concentrations determined by these two approaches, and a general lack of ecological context. We have devised an exposure system that is able to reconcile much of the disparity between invertebrate bioassay and fish biomarker results by incorporating realistic ecological processes based on deposit feeding and predator-prey interactions. This system relates the disturbance of interest (sediment contamination) to biologically meaningful effects in a resource of interest (marine flatfish) via a realistic contaminant vector (a deposit-feeding polychaete worm). In this pilot study, polychaetes (Armandia brevis) were exposed for 28 days to clean sediments supplemented with benzo(a)pyrene (BaP), para-para dichlorodiphenyldichloroethylene (pp'DDE), Aroclor 1254, or field sediments collected from two sites in Puget Sound, Washington, contaminated predominantly with polcyclic aromatic hydrocarbons (PAHs) or chlorinated compounds. Exposed worms were then fed live to juvenile English sole (Pleuronectes vetulus) for 10 or 12 days. At the end of the exposure period, fish were measured for length and weight, sacrificed, and preserved for either routine histopathology and immunohistochemical analysis of cytochrome P450 1A induction, or 32P post-labeling determination of hepatic PAH-DNA adducts. Growth of predatory flatfish was lower than reference in all but one of eight groups fed contaminant-exposed polychaetes; however, statistically significant reductions in growth were only observed in three of these eight groups, at least in part due to low statistical power. Juvenile sole from all contaminant-exposed groups showed increased expression of CYP1A, and fish exposed to BaP-exposed worms showed clear evidence of hepatic PAH-DNA adducts. This method allows the concurrent evaluation of sediment contamination at multiple biological and ecological levels. These results indicate that sediments determined to be nontoxic by common invertebrate bioassays may have the potential to cause adverse effects at higher trophic levels.

Animals↗

Computed tomography and ultrasonography of carcinoma in duplication cysts.

The CT and ultrasound findings of malignancy arising in walls of alimentary tract duplication cysts are previously unreported. We describe two cases where identification of both cyst and tumor nodule and separation of the mass from other visceral organs was achieved. We review the English literature reporting this unusual condition and suggest that CT and ultrasound are of great value in accurate preoperative diagnosis.

Adenocarcinoma↗