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Biomedical subjects

C L Walker

Publications and source records attributed to C L Walker.

85 records · Page 5Linked to original sources
PubMedDate not supplied

Uterine leiomyomas: mechanisms of tumorigenesis.

Uterine leiomyomas, also called fibroids, are the most common reproductive tract neoplasm and the leading indication for hysterectomy in premenopausal women. The discovery and development of medicinal therapies for uterine leiomyoma have been hampered by a lack of understanding regarding the etiology and molecular mechanisms underlying the development of these lesions. Although the estrogen responsiveness of uterine leiomyoma is well established, the impact of environmental estrogens and their contribution to the development of these tumors is currently unknown. The Eker rat model of uterine leiomyoma has proven useful for addressing these issues and understanding the pathophysiology of this disease. The Eker rat is the only animal model that develops spontaneous uterine leiomyomas, and these tumors share many characteristics with those found in humans. The availability of tumor-derived cell lines from these rats has made this a valuable in vitro/in vivo model system for experimental studies to investigate molecular mechanisms of disease and to design interventional and preventative strategies for this clinically relevant tumor.

Animals↗
PubMedDate not supplied

Prednisonephobia.

The use of chronic systemic corticosteroids in allergic diseases should be restricted to cases where these agents are essential. Potentially fatal asthma and idiopathic anaphylaxis are examples of essential need for prednisone. The usual dose requirements on an alternate day regimen are often modest in these diseases, and complications of steroid therapy are minimal and are of no major concern particularly when the alternative may be a fatality. In spite of these facts, certain patients have a phobic response to the requirement for prednisone therapy. We report seven cases of prednisonephobia and classify this phobia as interpersonal, iatrogenic, bibliophilic, or parental. Some of these phobic reactions may seriously interfere with medical management or patient survival. An information sheet is included which may help certain of these patients.

Adolescent↗
PubMedDate not supplied

Influenza vaccination: a successful outpatient program.

We initiated a program to evaluate patient reasons for refusing immunization in an allergy clinic. A general medicine clinic was studied for comparison. For the Northwestern University Allergy Service (NUAS) there were five full-time salaried and seven voluntary physicians. In the general medicine clinic there was one part-time salaried physician. Four hundred eighty-eight NUAS patients and 48 general medicine patients were evaluated. Ninety-five percent of the patients agreed to vaccination. Egg allergy, the only valid contraindication to influenza vaccination, was reported by three (< 1%) patients. Transient mild symptoms consisting of fatigue, myalgias, rhinitis and/or diarrhea were reported in 20% of the patients who received vaccination. No severe systemic reactions were reported. No significant difference in the vaccination acceptance rate was noted between the subspecialty and primary care outpatient clinics. The importance of influenza immunization in patients with asthma and in other high-risk populations deserves emphasis, and high success rates are achievable when emphasized by physicians.

Aged↗
PubMedDate not supplied

Preclinical evidence for therapeutic efficacy of selective estrogen receptor modulators for uterine leiomyoma.

OBJECTIVE: Uterine leiomyoma are the most common gynecologic neoplasm and a primary cause of hysterectomy in premenopausal women. Preclinical studies were conducted in the Eker rat model to investigate the potential efficacy of selective estrogen receptor modulators (SERMs) as therapeutic agents for this tumor. METHODS: Twelve-month-old Eker rats were randomized into five treatment arms including tamoxifen, placebo, LY 326315, vehicle, and no treatment. Additional animals received ovariectomy or sham surgery at 4 months of age to determine the effect of ovarian ablation on tumor development. The study was terminated after 2 to 4 months of treatment, and tumor incidence, size, proliferative and apoptotic indices were determined. Size and incidence data were subjected to chi-square analysis. One-way analysis of variance and Fisher's least significant difference tests were used to compare proliferative and apoptotic indices. RESULTS: Ovariectomy virtually ablated leiomyoma development, indicating that these tumors were dependent on ovarian hormones for growth and development. Treatment with tamoxifen or raloxifene analog LY 326315 reduced leiomyoma incidence by 40-60% and reduced the size of remaining tumors. The effect of SERMs on leiomyomas was mediated by a decrease in cell proliferation without a decrease in apoptotic index. CONCLUSION: SERMs have been shown to be therapeutically efficacious against breast cancer and to reduce tumor incidence in women at increased risk for this disease. The present data indicate that therapeutic efficacy may also be extended to uterine leiomyoma and demonstrate the utility of this animal model for preclinical studies to identify new therapeutic modalities.

Animals↗
PubMedDate not supplied

Siblings of children with cancer.

The psychosocial concerns of siblings of children with cancer have been studied for more than 30 years. This article reviews the research and clinical literature on the major stressors affecting siblings of pediatric patients with cancer with particular focus on the coping process. The coping process includes adaptive and maladaptive coping strategies used by the children. Negative and positive sibling psychosocial responses to the diagnosis and treatment of a malignancy are detailed with suggested nursing interventions.

Adaptation, Psychological↗
PubMedDate not supplied

Stress and coping in siblings of childhood cancer patients.

The purpose of this study was to identify and describe cognitive and behavioral coping strategies used by siblings of pediatric oncology patients. Fifteen families with 26 siblings between 7 and 11 years of age were studied. Parent data were obtained from an open-ended interview and a questionnaire. Sibling data included open-ended interviews using psychosocial assessments through puppet play, kinetic family drawings, cartoon story telling, a sentence completion test, and a limited number of direct questions. Content analysis of sibling data revealed major stressor themes of loss, fear of death, and change. Further analysis of sibling data pertinent to coping efforts led to the development of a taxonomy of cognitive and behavioral coping efforts.

Adaptation, Psychological↗