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Biomedical subjects

D Holmes

Publications and source records attributed to D Holmes.

At least 109 records · Page 6Linked to original sources
PubMed1991

Somatostatin analogues inhibit angiogenesis in the chick chorioallantoic membrane.

The mechanism responsible for alterations in tumor growth following administration of somatostatin analogues is unknown. Somatostatin analogues, SMS 201-995 and RC-160, have demonstrated the potential to inhibit both tumor growth and vascularity, in vivo and in vitro. We hypothesized that SMS and RC-160 inhibit angiogenesis and this inhibition may alter tumor growth. To test this hypothesis, 2 mm methylcellulose disks containing concentrations of SMS 201-995 and RC-160 at 0, 0.5, 2.5, or 50 micrograms per disk, were implanted on the chorioallantoic membrane (CAM) of 6- to 7-day-old shell-less chick embryos. Inhibition of blood vessel growth in the region of the disk was visually assessed 24-36 hr following disk implantation and graded (0-4) based on the radius of the zone of inhibition from the center of the disk. The overall incidence of inhibition for the somatostatin analogues at concentrations of 0.5, 2.5, and 50 micrograms per disk was 13, 56, and 61% for SMS and 27, 49, and 68% for RC-160, respectively. Overall incidence of inhibition for the positive (inhibitory) control was 70.5% and those for buffer (negative) controls were 3-14%. Somatostatin analogues were associated in a dose-related fashion with both a greater percentage of inhibition of blood vessel growth and an increased grade of inhibition. Inhibition of angiogenesis may be a mechanism responsible for the tumor regression observed in vivo following SMS or RC-160 therapy.

Allantois↗
PubMed1991

Factors differentiating hospital transfers from long-term care facilities with high and low transfer rates.

This paper examines the factors that account for differences among nursing homes in terms of the rates at which they transfer patients to hospitals. Data from nursing staff and charts were collected on the 286 most recent transfers from 10 nursing homes. Discriminant function analyses indicated that from relatively equivalent patient populations, high-rate facilities tended to transfer the more chronically ill, physically frail patients; patients with infection (a potentially treatable condition within the long-term care facility); and to make transfers because of lack of resources such as a lab and X-ray equipment. Lack of IV therapy, while a frequently cited primary nonmedical reason for transfer, did not discriminate between high- and low-transfer-rate facilities.

Female↗
PubMed1991

No evidence for a susceptibility locus predisposing to manic depression in the region of the dopamine (D2) receptor gene.

Recent reports of cytogenetic abnormalities linked to psychiatric illness and the localisations of the genes for the dopamine (D2) receptor and tyrosinase on the long arm of chromosome 11 have suggested that susceptibility loci for schizophrenia and manic depression might be situated in this region. We could find no evidence for linkage in five Icelandic pedigrees between manic depression and markers in this region, and we have excluded candidate genes coding for the D2 receptor and tyrosinase. We conclude that mutations at loci in this region are not a common cause of manic depression in the population studied.

Adult↗
PubMed1991

Parotitis in a three-year-old.

Facial swelling cannot routinely be attributed to dento-alveolar infections until a thorough head, neck and oral examination has been completed. Facial swelling from parotitis is not commonly encountered in the pediatric patient. The purpose of this report was to document a case of unilateral parotid gland infection presumably secondary to traumatic obstruction of Stenson's duct. The parotitis resolved following a course of oral penicillin VK and lemon juice to stimulate salivary flow. Several parotid gland disorders which involve facial swelling were discussed.

Child, Preschool↗
PubMed1991

Traumatic avulsion of the mandibular right primary lateral incisor and cuspid.

Premature loss of the primary mandibular cuspid has been considered rare. When this occurs, however, space maintenance should be considered to prevent distal drifting of the lateral incisor. The purpose of this case report was to document traumatic avulsion of the mandibular right lateral and cuspid. A lingual arch appliance with a spur was fabricated to maintain space and prevent movement of the mandibular incisors. Sequelae of premature loss of primary teeth is presented.

Child, Preschool↗
PubMed1990

Impacts associated with special care units in long-term care facilities.

This study is a comprehensive, longitudinal assessment of the characteristics of special care patients. Demented patients in special care units (SCUs) within four nursing homes were compared with their demented counterparts in the same facilities who were not placed in SCUs. Results of this preliminary study suggest that the two groups differ in level of cognitive impairment, in behavior, and in functional and physical status. No deleterious or beneficial effects were associated with SCU residence during a 6-month period.

Cognition Disorders↗
PubMed1990

Bopindolol for the treatment of chronic stable angina pectoris--a clinical study of the relationship between dose and effect.

Following a 4-week placebo period, 19 patients (12 male, average age 62.3 years) with chronic stable angina pectoris and a positive exercise test were treated with the beta-adrenoceptor antagonists bopindolol at increasing doses of 0.5, 1 and 2 mg, each being given once daily for 4 weeks. For the final 4 weeks of the study, active treatment was replaced by placebo. Maximum tolerated exercise (bicycle ergometry, performed 24 h after drug administration) increased dose-dependently from 519 +/- 59 s (baseline) to 758 +/- 95 s with 2 mg (p less than 0.001) and fell again to 508 +/- 48 s (placebo). The frequency of anginal attacks also fell dose-dependently from an average of 5.4 per week (baseline) to 0.5 with 2 mg (p less than 0.001) and rose again to 5.1 per week when active treatment was stopped.

Adrenergic beta-Antagonists↗
PubMed1989

Informal versus formal supports for impaired elderly people: determinants of choice on Israeli kibbutzim.

Among 269 functionally impaired elderly people residing on 53 Israeli kibbutzim, those cared for principally by informal caregivers were compared with those cared for principally by formal caregivers. The major findings were that the variables differentiating between primary reliance on formal versus informal care are similar to those that have been found in other studies, and that the availability of formal resources was not accompanied by withdrawal of informal supports.

Aged↗
PubMed1989

Factors relating to institutional risk among elderly members of Israeli kibbutzim.

Characteristics of 269 functionally impaired elderly persons and their primary caregivers were examined in relation to long-term care planning. Contrary to expectation, there were no differences in rates of institutional risk between those elderly residents of Israeli kibbutzim cared for primarily by formal caregivers and cared for by informal caregivers. Lack of informal caregivers emerged as an important risk factor for institutional risk, even in the service-rich environment of kibbutzim.

Aged↗
PubMed1989

One-year follow-up results of the 1985-1986 National Heart, Lung, and Blood Institute's Percutaneous Transluminal Coronary Angioplasty Registry.

In 1,801 patients in the 1985-1986 Percutaneous Transluminal Coronary Angioplasty Registry, overall 1-year mortality was 3.2%, the 1-year myocardial infarction rate was 7.2%, and the 1-year coronary artery bypass surgery rate was 13.2%. In the 78% of the cohort with all lesions successfully dilated and without major procedural complications (successful patients), the corresponding rates were 1.9%, 2.6%, and 6.4%. Nearly 20% of all deaths, 40% of all infarctions, and 25% of all bypass operations occurred in the small subset of patients (6.8%) who sustained periprocedural occlusion. Event rates were higher in patients with multivessel disease than in those with one-vessel disease. At 1 year, angina-free status was reported by approximately three fourths of all surviving patients, regardless of initial success. However, compared with successful patients, unsuccessful patients underwent intervening bypass surgery (42% vs. 6%) to achieve asymptomatic status more frequently. Comparison of the 1-year event rates in the 1985-1986 registry with those in the 1977-1981 registry indicated reductions in all major untoward events. These reductions became apparent after controlling for the more extensive disease of the 1985-1986 registry patients. In contrast, use of repeat angioplasty has increased by 50%. We conclude that the improved initial results reported in the 1985-1986 registry cohort were maintained at 1-year follow-up.

Angina Pectoris↗
PubMed1988

Percutaneous transluminal coronary angioplasty in 1985-1986 and 1977-1981. The National Heart, Lung, and Blood Institute Registry.

In August 1985, the Percutaneous Transluminal Coronary Angioplasty Registry of the National Heart, Lung, and Blood Institute reopened at its previous sites to document changes in angioplasty strategy and outcome. The new registry entered 1802 consecutive patients who had not had a myocardial infarction in the 10 days before angioplasty. Patient selection, technical outcome, and short-term major complications were compared with those of the 1977 to 1981 registry cohort. The new-registry patients were older and had a significantly higher proportion of multivessel disease (53 vs. 25 percent, P less than 0.001), poor left ventricular function (19 vs. 8 percent, P less than 0.001), previous myocardial infarction (37 vs. 21 percent, P less than 0.001), and previous coronary bypass surgery (13 vs. 9 percent, P less than 0.01). The new-registry cohort also had more complex coronary lesions, and angioplasty attempts in these patients involved more multivessel procedures. Despite these differences, the in-hospital outcome in the new cohort was better. Angiographic success rates according to lesion increased from 67 to 88 percent (P less than 0.001), and overall success rates (measured as a reduction of at least 20 percent in all lesions attempted, without death, myocardial infarction, or coronary bypass surgery) increased from 61 to 78 percent (P less than 0.001). In-hospital mortality for the new cohort was 1 percent, and the nonfatal myocardial infarction rate was 4.3 percent. Both rates are similar to those for the old registry. The long-term efficacy of current angioplasty remains to be determined.

Age Factors↗
PubMed1988

Respiratory pattern at hospital discharge in asymptomatic preterm infants.

Pneumogram (PG) recordings were performed in 87 very low birthweight (VLBW) asymptomatic infants just prior to hospital discharge to determine the relationships between: 1) a prior history of apnea of prematurity (AOP) and cardiorespiratory pattern; and 2) cardiorespiratory pattern at hospital discharge and postconceptional age. Apnea density (A6/D%) and longest apnea were significantly greater in those with (n = 66), versus without (n = 21) a prior history of AOP (P less than 0.05 and P less than 0.01, respectively). Although PG values for the 21 VLBW infants without a prior history of AOP did not differ significantly from those of full-term infants, for the 66 VLBW infants with a prior AOP history A6/D% (P less than 0.01), episodes of periodic breathing (P less than 0.05) and longest apnea (P less than 0.001) were significantly greater compared with full-term infants. Postconceptional age was significantly less in the VLBW infants with A6/D% values above, compared with those within the 95th percentile for normal infants (median age, 36 and 37.5 weeks; P = 0.01). Therefore, respiratory pattern abnormalities in asymptomatic VLBW infants ready for hospital discharge are related to a prior history of AOP and may be significantly higher than in full-term infants at the postconceptional ages at which hospital discharge now tends to occur.

Apnea↗
PubMed1988

The physical well-being of old homeless men.

This study addressed a variety of issues related to the etiology, prevalence, and treatment of physical disorders among aging homeless men. The sample consisted of 195 nonstreet dwellers (177 residing in flophouses, 18 in apartments) and 86 street dwellers on the Bowery in New York City. The sample comprised men aged 50 and older. Bowery men scored worse than an aged-matched sample of community men on all physical health scales, with the greatest differences occurring in the respiratory, gastrointestinal, edema, hearing, hypertension, and ambulatory scales. Frequency of visits to doctors by the Bowery men was comparable to that of the community men, and the Bowery men rated their health substantially better than did their counterparts of two decades ago. Poor physical health often appeared to antedate arrival on the Bowery. However, a hierarchical regression analysis identified several variables--stress, unfulfilled needs, being relatively young, institutional/agency contacts--that were associated with current levels of poor health. Identification of these variables pointed to areas that warrant closer attention by clinicians and service providers.

Aged↗