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Biomedical subjects

C Taylor

Publications and source records attributed to C Taylor.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

Factors associated with emergency department utilization for nonurgent pediatric problems.

OBJECTIVE: To identify specific caretaker and utilization characteristics predictive of the use of the emergency departments (EDs) for nonurgent reasons. Each year more than 20 million children in the United States seek medical care in EDs. Between one third and one half of these visits are for nonurgent reasons. DESIGN: A descriptive study conducted during a 6-month period. SETTING: Two urban hospital EDs. MEASURE: A questionnaire was designed to elicit information about specific caretaker characteristics and their reasons for using the ED for their child's nonurgent medical care. SUBJECTS: Two hundred caretakers and children brought to the ED for nonacute medical care. Caretakers in this study included mothers (82%) with a mean age of 30 years, single caretakers (70%), and unemployed caretakers (60%). The average age of the children was 6.2 years. RESULTS: Most caretakers (92%) reported having a continuity physician for their children. Caretakers who reported being taken to the ED when they were children (P<.002) and those with Medicaid insurance (P<.001) were more likely to view the ED as the usual site of care. Being a single parent was a predictor for nonurgent visits (P<.05). CONCLUSIONS: Predicting which caretakers are at risk for using the ED for nonurgent care when their children are sick provides the primary care physician a means of identifying specific patients who may benefit from interventions designed to promote a more cost-effective approach to using medical resources. Arch Fam Med. 2000;9:1086-1092

Child↗
PubMedDate not supplied

'Wiring' of lactate oxidase within a low-redox potential electron-conducting hydrogel.

Lactate electrodes based on electron-conducting hydrogels made by cross-linking lactate oxidase and the redox polymer formed upon complexing polyvinyl imidazole with [Os(dmo-bpy)2Cl]+/2+ (dmo-bpy = 4,4'-dimethoxy-2,2'-bipyridine) on vitreous carbon electrode surfaces were investigated. The redox potential of the hydrogels was -69 mV, versus the standard calomel electrode (SCE), and their lactate electro-oxidation current reached a plateau at +50 mV (SCE). Urate and acetaminophen were not electro-oxidized at this potential at rates that would interfere with the lactate assays, but ascorbate was catalytically oxidized by the gel. At 6 mM lactate concentration, switching of the atmosphere from argon to O2, reduced the current by 40 percent, showing that the rate of electron transfer from the reduced enzyme to the gel was slow.

Cross-Linking Reagents↗
PubMedDate not supplied

Brain microdialysis and PK/PD correlation of pregabalin in rats.

Pregabalin [PGB, (S)-3-isobutyl GABA, CI-1008] is a derivative of the inhibitory neurotransmitter g-aminobutyric acid (GABA). It has shown anticonvulsant, analgesia and anxiety activity in animal models. In this report, blood-brain barrier (BBB) influx and efflux of PGB were investigated with microdialysis at efficacious doses in rats. BBB influx (CLin) and efflux (CLout) permeability for pregabalin were 4.8 and 37.2 microL/min/g brain, respectively, following an intravenous infusion to rats. The results indicate that PGB is brain penetrable, supporting its anti-epilepsy and other CNS pharmacology. Significant anticonvulsant action of PGB was detected between 2 and 8 hr post oral dose, which is lag behind ECF drug concentrations lees. A PK/PD link model was used to describe the counter-clockwise hysteresis relationship between pregabalin brain ECF concentration and the anticonvulsant effect in rats. The resulting Ce (concentration in effect compartment) versus effect profile exhibits a sigmoidal curve and the calculated ECe50 and Keo values were 95.3 ng/mL and 0.0092 min-1, respectively. The small Keo value suggests that the effect is not directly proportional to the amount of pregabalin in the ECF compartment possibly due to inherent delay.

Acetates↗
PubMedDate not supplied

Substance misuse and psychiatric comorbidity: an overview of the OPCS National Psychiatric Morbidity Survey.

There have been a number of national surveys of psychiatric morbidity which have included questions on drugs, alcohol and tobacco. These surveys have helped delineate the overlap between substance use and dependence and other psychological morbidity. There is a strong association reported between high substance consumption and other measures of psychological problems. This article provides an overview of a national household survey, a survey of institutional residents with psychiatric disorders and a national survey of a homeless population. All three surveys used comprehensive and complex sampling strategies and lay interviewers to conduct structured diagnostic interviews. The household survey included over 10,000 households, the institutional survey interviewed 755 individuals and the homeless survey of hostels, night-shelters, day centres and private-sector leased accommodation interviewed 1,061 individuals. This overview looks at patterns of nicotine, alcohol and other drug use in the different samples and examines interactions with other psychiatric morbidity. The survey reports that substance-related disorders are some of the commonest disorders in the community, with 5% of the household sample alcohol dependent, 7% alcohol dependent in the institutional sample and over 21% in the homeless sample recorded as alcohol dependent. Tobacco, alcohol and other drug use and dependence were dramatically higher in the homeless sample than in either of the other two samples. Substance use was significantly associated with higher rates of psychological morbidity as measured by the Clinical Interview Schedule Revised. Future service planning needs to take account of the striking disparity of prevalence of psychiatric disorders in different subsections of the population.

Alcohol Drinking↗
PubMedDate not supplied

The use of the rapid exchange grip test in detecting sincerity of effort, Part I: administration of the test.

A review of studies that utilize the rapid exchange grip (REG) test revealed that there is no standardized test protocol for administering the test. The purpose of this study was to investigate three factors that affect the result of the REG test: the hand switch rate, the number of grips performed during the test, and the comparative tests used in the interpretation of the REG test. The 146 uninjured subjects performed a series of randomized grip strength tests including the REG test, the maximal static grip test (MSGT), and the five-rung (5R) test while making maximal and submaximal efforts. Results revealed no significant differences in peak REG scores between hand switch rates of 45 and 60 rpm. Significant differences were found for peak REG scores obtained from three vs. five trials. Peak scores from the 5R test vs. the MSGT differed significantly for maximal efforts but not for submaximal efforts. These results led to the following recommendations for a standardized protocol for administering the REG test: 1) the REG maneuver may be administered at a rate of either 45 or 60 rpm; 2) at least five hand-grip exchanges must be performed; and 3) only one comparative test, either the MSGT or the 5R test, should be used consistently for comparison with the REG maneuver. The findings of the present study, however, did not verify which static grip test should be used for comparison with REG scores.

Adolescent↗
PubMedDate not supplied

The use of the rapid exchange grip test in detecting sincerity of effort, Part II: validity of the test.

The rapid exchange grip (REG) test was developed to identify patients exerting insincere effort. The premise of the REG test is that a maximal, sincere effort yields a "negative REG," in which peak static grip (SG) scores are greater than peak REG scores, and that a submaximal, insincere effort yields a "positive REG," in which REG scores are greater than SG scores. There is disagreement in the literature concerning what constitutes a positive REG test, suggesting that the REG may not be a valid measure of sincerity of effort. The purpose of the present study was to investigate the validity of the REG test by examining its premise as well as its sensitivity and specificity values. The 146 uninjured subjects performed a series of randomized grip strength tests, exerting both maximal and submaximal efforts. The tests included the REG at hand switch rates of 45 rpm (REG-45) and 60 rpm (REG-60), the maximal static grip test (MSGT), and the five-rung test (5R). Our findings supported the concept of a "negative REG" for both REG maneuvers and both comparative SG tests. The concept of a "positive REG," however, was supported only when peak REG scores were compared with peak 5R scores. The authors found relatively low sensitivity and specificity values, suggesting that the REG test may not be sensitive or specific enough to effectively detect sincerity of effort. The authors discuss the likelihood that mistakes will be made when the REG test is used to diagnose sincerity of effort and the possible consequences of making such mistakes.

Adolescent↗
PubMedDate not supplied

Identification of a pyridinium metabolite in human urine following a single oral dose of 1-[2-[bis[4-(trifluoromethyl)phenyl]methoxy]ethyl]- 1,2,5,6-tetrahydro-3-pyridinecarboxylic acid monohydrochloride, a gamma-aminobutyric acid uptake inhibitor.

Single-dose administration of 50 mg of 1-[2-[bis[4- (trifluoromethyl)phenyl]methoxy]ethyl]-1,2,5,6-tetrahydro-3- pyridinecarboxylic acid monohydrochloride resulted in temporary neurological and psychological symptoms in two subjects. Because of the nature of adverse effects, urine from a subject who received CI-966 orally was extracted to investigate the metabolism of CI-966 in man. An unknown urinary component was identified as a pyridinium metabolite of CI-966 based on HPLC-MS and 1H and 19F NMR. Structural confirmation was achieved by chromatographic and spectroscopic comparisons to a reference standard. In several in vitro screens and preclinical studies, the pyridinium metabolite appears to possess minimal pharmacological activity.

Administration, Oral↗
PubMedDate not supplied

Substance misuse and psychiatric comorbidity: an overview of the OPCS National Psychiatric Morbidity Survey.

There have been a number of national surveys of psychiatric morbidity, which have included questions on drugs, alcohol, and tobacco. These surveys have helped delineate the overlap between substance use and dependence and other psychological morbidity. There is a strong association reported between high substance consumption and other measures of psychological problems. This article provides an overview of a national household survey, a survey of institutional residents with psychiatric disorders, and a national survey of a homeless population. All three surveys used comprehensive and complex sampling strategies and lay interviewers to conduct structured diagnostic interviews. The household survey included over 10,000 households, the institutional survey interviewed 755 individuals, and the homeless survey of hostels, night shelters, day centres, and private sector leased accommodation interviewed 1,061 individuals. This overview looks at patterns of nicotine, alcohol, and other drug use in the different samples and examines interactions with other psychiatric morbidity. The survey reports that substance-related disorders are some of the commonest disorders in the community, with 5% of the household sample alcohol dependent, 7% alcohol dependent in the institutional sample and over 21% in the homeless sample recorded as alcohol dependent. Tobacco, alcohol and other drug use and dependence were dramatically higher in the homeless sample than in either of the other two samples. Substance use was significantly associated with higher rates of psychological morbidity as measured by the Clinical Interview Schedule Revised. Future service planning needs to take account of the striking disparity of prevalence of psychiatric disorders in different subsections of the population.

Alcoholism↗
PubMedDate not supplied

Nicotine, alcohol and drug dependence, and psychiatric comorbidity--results of a national household survey.

There is a well-recognized relationship between substance use disorders and other psychiatric disorders. This relationship has been well documented in a range of population-based studies. This study aims to report on consumption patterns of and dependence on nicotine, alcohol, and non-prescribed drugs and to report on the levels of psychiatric morbidity in these groups. A national household study of psychiatric morbidity was conducted in England and Wales. Psychiatric assessment was based on the Clinical Interview Schedule-Revised (CIS-R). Measures of nicotine, alcohol and drug use and dependence were obtained. This paper compares the levels of psychiatric morbidity in the non-dependent and the nicotine-, alcohol- and drug-dependent cases. Twelve per cent of the non-dependent population were assessed as having any psychiatric disorder compared with 22% of the nicotine-dependent, 30% of the alcohol-dependent, and 45% of the drug-dependent population. There is a clear relationship between dependence on nicotine, alcohol, and drugs and other psychiatric morbidity.

Adolescent↗
PubMedDate not supplied

Effects of thio-tepa and hydroxyurea on sperm production in Lakeview hamsters.

The spermatogenic cell sensitivity in the induction of sperm abnormalities by two antineoplastic agents, thio-TEPA and hydroxyurea in inbred Lakeview hamsters was studied and the results were compared with those of similar investigations with mice. Testis weights, epididymal sperm numbers, and body weights were also monitored up to 12 wk after treatment. Thio-TEPA administration increased sperm abnormalities and reduced testis weights as well as sperm numbers in a dose-dependent manner at wk 4 and 12 after treatment. Hydroxyurea administration was ineffective in inducing sperm abnormalities, but testis weights and sperm numbers were adversely affected dose-dependent changes in body weights after treatment with either agent were also recorded. The findings with thio-TEPA on sperm morphology agree with those reported for the mouse. However, unlike the results of the mouse studies, hydroxy-urea effects on sperm shape were not observed in the hamster.

Animals↗
PubMedDate not supplied

CT features of hemorrhagic malignant liver tumors.

Hemorrhage is a recognized occurrence in hepatocellular carcinoma but is infrequently seen with tumors metastatic to the liver. This complication was observed in three patients with primary hepatic malignancy and in four patients with hepatic metastases (melanoma, two; colon, one; breast, one) who were studied by CT. Hemorrhage occurred in the patient with metastatic colon carcinoma in the setting of anticoagulation. Definitive radiographic signs of hemorrhage were detected by CT in six of the patients, including hyperdense hepatic masses on noncontrast scans (four patients), high density peritoneal (one patient) and subcapsular fluid (one patient), and the hematocrit effect in peritoneal fluid (one patient). In three patients an irregular liver border adjacent to perihepatic fluid suggested the liver as the organ from which bleeding originated. There were four deaths, none of which was immediately related to the hemorrhagic complication.

Angiography↗