Decreasing frequency of diabetic nephropathy.
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Blood Glucose Self-Monitoring↗
Biomedical subjects
D Smith
Publications and source records attributed to D Smith.
The relationship between the Millon Clinical Multiaxial Inventory and the MMPI in a private outpatient mental health clinic population.
The concurrent validity of the MCMI as compared to the MMPI was assessed by administering both tests to 106 newly admitted outpatients and calculating the intercorrelations between these two tests. Of the 20 MCMI scales, 12 were found to correlate with the MMPI in a manner that suggested that they do measure some degree of personality dysfunction, emotional disturbance, or specific psychological symptomatology. Eight of the MCMI scales failed to show correlations that would indicate that they effectively measure any of the pathological personality characteristics or clinically significant symptom patterns known to be measured by the MMPI.
Adolescent↗
Reversal by caffeine of triazolam-induced impairment of waking function.
Twelve, healthy normal men aged 21-25 years received each of four treatments (triazolam placebo plus caffeine placebo, triazolam 0.50 mg plus caffeine placebo, triazolam 0.50 mg plus caffeine 4 mg/kg, triazolam 0.50 mg plus caffeine 8 mg/kg), double blind, in a Latin-Square design. Triazolam or placebo was administered at 0830 and caffeine or placebo at 1000 and 1245. On two memory tasks, administered at 1015 with an immediate recall and a delayed recall at 1230 following a 90 min nap (1030-1200), both immediate and delayed recall was impaired by triazolam. Neither caffeine dose reversed the impairments. Sleep latency and sleep efficiency were improved by triazolam and not reversed by caffeine. On a performance battery presented at 1300 most measures of performance were impaired by triazolam; in general the caffeine dose of 4 mg/kg partially reversed the effect while the dose of 8 mg/kg completely restored performance.
Adult↗
Facilitation of brain stimulation reward by delta 9-tetrahydrocannabinol.
The present experiment explored whether delta 9-tetrahydrocannabinol (delta 9-THC), the psychoactive ingredient in marijuana, shares with other drugs of abuse the ability to facilitate brain stimulation reward acutely, as measured by electrical intracranial self-stimulation (ICSS). Laboratory rats were implanted with stimulation electrodes in the medial forebrain bundle, and trained to stable performance on a self-titrating threshold ICSS paradigm. delta 9-THC, at a dose believed pharmacologically relevant to moderate human use of marijuana, acutely lowered ICSS thresholds, suggesting that marijuana acts on similar CNS hedonic systems to most other drugs of abuse.
Animals↗
Determination of interchain crosslinkages in insulin B-chain dimers by fast atom bombardment mass spectrometry.
New methodology for identifying and locating crosslinkages in peptides is described. Pepsin is used to cleave insulin and B-chain dimers of insulin into fragments under conditions which retain the original peptide crosslinkages. After partial separation by HPLC, the peptides are analyzed by fast atom bombardment mass spectrometry (FABMS) to determine their molecular weights. The molecular weights of peptide fragments expected from the pepsin digests of human insulin and related model compounds are calculated from the amino acid sequence of the intact peptide. Digestion products are identified by matching their molecular weights, as determined by FABMS, with calculated molecular weights. Locations of interchain crosslinkages are deduced after the peptide fragments have been assigned to specific segments of the parent peptide. The validity of the method has been established by correctly identifying structurally important products in the pepsin digests of model compounds such as human, bovine, and porcine insulins. Procedures developed with the model compounds were used to identify crosslinkages in peptides of unknown structure isolated from an insulin A-chain/B-chain combination reaction mixture. Evidence is presented for formation of three different types of crosslinkages, disulfide, lanthionine, and sulfoxide.
Amino Acid Sequence↗
Collaboration in nursing research--a multi-disciplinary approach.
Research today is increasingly a very important segment of nursing and is one of the avenues for nurses in expanding their role. Nurses are now wanting to research more diverse problems and to observe clients in more than the traditional hospital systems. Gaining access to clients is not always an easy experience. In independent research, many nurses still have to rely on the physician or some other discipline for referral of clients especially in a specialty area such as psychiatry where the diagnosing of the client can be of particular importance and carry implications for the research process itself. Collaboration with other disciplines in research offers a practical solution to many of the resistances encountered in research. It offers access to patients who may otherwise be very difficult to encounter. It offers the opportunity to share and expand each other's ideas from the points of view of other disciplines. This prevents a focus from being too narrow and allows a broadening of viewpoint. Through collaborating with other disciplines, one can have a built-in consultation system. This has many advantages, the main one being access to information, such as diagnostic criteria and psychological testing. Collaboration allows others to be familiar with the expanded role of the nurse. Many nurses are researching concepts pertinent to a particular specialty area which may or may not be a measure of direct nursing action and its effect. To many disciplines, this is seen as an expanded role. Collaboration among faculties in a university system promotes collegial relationships and credibility that need not be limited to one's own faculty.(ABSTRACT TRUNCATED AT 250 WORDS)
Cooperative Behavior↗
The effect of concentrated hydrogen peroxide solutions on the surface morphology of human tooth enamel.
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Acid Etching, Dental↗
Sensitivity of cerebral glucose metabolism to age, gender, brain volume, brain atrophy, and cerebrovascular risk factors.
In 76 normal volunteers studied by positron emission tomography, with [18F]fluorodeoxyglucose, CMRglu was significantly lower in the elderly as compared with young subjects and significantly higher in females relative to males. However, in 58 of these subjects who also had magnetic resonance imaging scans, age and gender were found to be unrelated to CMRglu, when the effects of brain volume and brain atrophy on CMRglu were partialed out using covariate analyses. Individually, brain volume was found to have a significant effect on CMRglu, explaining approximately 17% of the variability in CMRglu measures and brain atrophy explaining approximately 8% of the variance in CMRglu. Together these two measures accounted for approximately 21% of the variance. Cerebrovascular risk factors in normal subjects were not found to affect mean CMRglu or the variability of CMRglu measures. In this study almost 80% of the variance in CMRglu could not be explained by any of the factors that had been considered. This implies a lack of sensitivity of absolute values of global CMRglu to the mild effects of brain dysfunction. Although some of the unexplained variance is probably methodological in origin, physiological factors that are difficult to quantify, such as the state of arousal, are likely to be contributory as well.
Adult↗
Influence of hyperinsulinaemia on intracellular amino acid levels and amino acid exchange across splanchnic and leg tissues in uraemia.
1. To examine whether insulin resistance in uraemia extends to amino acid metabolism, the effect of physiological hyperinsulinaemia on plasma amino acid concentrations was studied in 17 chronically uraemic and 28 healthy subjects by using the euglycaemic insulin clamp technique. 2. In six uraemic and seven control subjects, splanchnic and leg exchange of amino acids was quantified with hepatic and femoral venous catheterization, and in five uraemic and eight control subjects intracellular free amino acid concentrations were determined in muscle tissue obtained by needle biopsy. 3. In response to hyperinsulinaemia the plasma concentrations of all amino acids except alanine decreased by 10-50% in both uraemic and control subjects. Splanchnic alanine uptake declined by 20% and leg amino acid release tended to decrease in both groups. 4. The intracellular levels of all measured amino acids except alanine fell significantly and to a similar extent in uraemic and control subjects. 5. These results indicate that insulin-mediated alterations in regional amino acid exchange and in plasma and intracellular amino acid concentrations are similar in uraemic and control subjects. 6. It is concluded that tissue insensitivity to insulin in uraemia does not extend to uptake or release of amino acids and that resistance to insulin can be selective in its effect on different metabolic functions.
Adult↗
The psychological adjustment of enuretic children: a comparison of two types.
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Adaptation, Psychological↗
Comparison of active and combined passive/active immunization of Navajo children against Haemophilus influenzae type b.
In a high risk Navajo population we compared the immunogenicity of a new Haemophilus influenzae type b mutant-diphtheria toxic conjugate vaccine (HbOC) with simultaneous active (HbOC) and passive immunization with bacterial polysaccharide immunoglobulin prepared from adults immunized with H. influenzae b, pneumococcal and meningococcal vaccines. Only 7 of 26 (27%) 2-month-olds had an increase in H. influenzae b capsular polysaccharide antibody after a single dose of HbOC, a proportion similar to that of saline controls (9 of 25, 36%). After a second HbOC dose at 4 months 88% had antibody concentrations of 0.15 microgram or more, and after a third dose at 6 months all had antibody levels greater than or equal to 0.15 microgram/ml. The group receiving both HbOC and bacterial polysaccharide immunoglobulin at 2 months uniformly had H. influenzae b CP antibody concentrations of greater than or equal to 0.15 microgram/ml at 4 months (P less than 0.001 relative to "HbOC alone" group) and subsequently responded similarly to second and third doses of HbOC vaccine as did also the "HbOC alone" group. We conclude that combined passive/active immunization with bacterial polysaccharide immunoglobulin and HbOC at 2 months maintains antibody at concentrations thought to be protective (greater than or equal to 0.15 microgram/ml) without interfering with the active antibody response to second and third doses of HbOC at 4 and 6 months of age.
Bacterial Capsules↗
Complications of controlled tissue expansion in the pediatric burn patient.
All patients at the Burn Institute reconstructed with tissue expanders between June of 1984 and June of 1987 were included in this review. There were 122 expanders used in 77 patients. Complications were defined as "absolute" (23 of 122 expanders, 20 percent) if they resulted in loss of expanders or additional surgery or none of preoperative plan was satisfied or "relative" (14 of 122 expanders, 11 percent) if they included spotty alopecia or alopecia greater than 50 percent or the operative plan only partially satisfied, reflecting poor judgment. The most common absolute complication was prosthetic exposure secondary to wound dehiscence occurring in the scalp area. Complications relative to specific anatomic areas were neck and face, 2 of 20 (10 percent); lower extremity, 1 of 4 (25 percent); trunk, 0 of 6 (0 percent); and scalp, 20 of 92 (22 percent). We feel that this high complication rate in the use of tissue expanders may be unique to the pediatric burn patient. Knowledge of indications for use and potential complications is essential to add this entity to the armamentarium of the burn reconstructive surgeon.
Adolescent↗
Efficacy of the lateral decubitus position in preventing pneumothorax after needle biopsy of the lung.
We evaluated the efficacy of the lateral decubitus position in preventing the development of pneumothorax after percutaneous needle biopsy of a well defined lung lesion. Fifty patients had such a procedure and were immediately placed in the lateral decubitus position for ten minutes, with the biopsied lung below. A chest x-ray film was obtained after the ten minute period, four to six hours later, and on the following morning. The number of pneumothoraces and the type of treatment needed in each case were recorded. Results in these 50 patients were compared to those previously obtained in 132 patients who had had an identical procedure and follow-up during the preceding four years. In all patients included as controls, we did the biopsy using an identical technique and in accordance with a specific written protocol. Both groups of patients were closely comparable in age and sex distribution, baseline values for arterial blood gases, results of prebiopsy tests of pulmonary function, and type, size, location, and distance from the pleural surface of the pulmonary lesions. A postbiopsy pneumothorax developed in 21 of 50 (42%) study patients, and in 46 of 132 (35%) controls (P not significant). Specific therapy was needed in ten (48%) and 26 (56%) of these cases, respectively (P = NS). We conclude that placing patients in the lateral decubitus position is not effective in significantly reducing the incidence of postbiopsy pneumothorax or the proportion of patients who will require specific therapy for this complication.
Biopsy, Needle↗
Abnormalities of urine urobilinogen and urine bilirubin assays and their relation to abnormal results of serum liver function tests.
A prospective observational study of 324 cases was conducted in a busy ambulatory care setting to evaluate the sensitivity, specificity, predictive values, and accuracy of spot urine urobilinogen and urine bilirubin assays as screening tests for serum liver function test (LFT) abnormalities. High positive predictive values (88% for at least one abnormal LFT) make the evaluation of positive urine screens detected during routine health care maintenance examinations imperative. Because extraneous factors may influence both urine and serum test results, however, urine assays obtained as a screening parameter in clinical presentations (abdominal pain, jaundice, constitutional symptoms, etc) have only limited clinical utility. The high proportion of false-negative results for both urine assays renders their statistical properties unacceptable as screens in these clinical situations.
Adolescent↗
Prophylactic subcutaneous heparin does not increase operative blood loss in transurethral resection of the prostate.
A prospective randomised study of subcutaneous heparin compared with no heparin was performed in 60 patients undergoing transurethral resection of the prostate. Operative blood loss in the irrigation fluid was measured using a haemoglobinometer. Blood loss correlated with the amount of prostate resected and the duration of the procedure. Subcutaneous heparin had no significant effect on the measured blood loss in transurethral resection of the prostate and can be used as a safe means of prophylaxis against thrombo-embolic complications.
Administration, Cutaneous↗
Differences in black and white adolescents' perceptions about cancer.
This study determined if black and white adolescents differed significantly in cancer knowledge, attitudes, and beliefs. Using the Health Belief Model, a 97-item questionnaire was developed by the researchers and completed by 573 black and 297 white junior and senior high school students from a large, midwest school district. Chi-square analyses yielded nine significant differences (p less than .01) between blacks and whites on cancer knowledge (etiology, warning signs, and prevention techniques). Further significant differences were found when items comprising the separate Health Belief Model subscales were analyzed. Blacks and whites differed significantly on cues to action (one item), perceived susceptibility (two items), perceived severity (one item), perceived barriers (two items), perceived benefits (three items), and interpersonal relationships (three items). Blacks and whites received cancer information from the same sources, with the exception of books, which was reported more by blacks.
Adolescent↗
Detection of herpes simplex virus DNA from genital lesions by in situ hybridization.
Lesion specimens from 118 episodes of recurrent genital herpes were used to compare herpes simplex virus (HSV) isolation with a direct specimen test for in situ DNA hybridization utilizing a biotinylated probe. The frequency of detection of HSV was similar with both tests; HSV was isolated from 81% of vesicular lesions, 76% of pustules, and 67% of ulcers, while HSV DNA was detected in 77, 76, and 55% of lesions in these stages, respectively. Utilizing both methods, HSV was identified in 91, 94, and 79%, respectively. The sensitivity and specificity of the DNA probe in comparison to standard viral isolation in tissue culture were 92 and 63%, respectively. Seven DNA-positive, viral isolation-negative specimens were obtained from patients who had positive culture confirmation at some time subsequent or prior to enrollment, suggesting that these were true positive results. The sensitivity of the DNA probe was dependent on cellular content of the specimen, and 36 (28%) of the 127 submitted specimens had fewer than 20 nonsuperficial cells. The DNA probe was rapid and convenient; its major disadvantage was the lack of type-specific information. The performance of the probe in lower-prevalence populations and in asymptomatic shedding of HSV remains to be evaluated.
Cells, Cultured↗
Oxidative potential in developing rat diaphragm, EDL, and soleus muscle fibers.
To examine the effect of postnatal development on changes in oxidative potential of fibers of specific types (I, IIa, IIb, and IIc) in the rat diaphragm, determinations of succinate dehydrogenase (SDH) activity were made using microphotometric measures of optical density. Samples of the costal region of the diaphragm were extracted from 56 male Wistar rats ranging in age from 8 to 85 days and subgrouped into seven developmental periods (1, 2, 3, 4, 6, 9, and 12 wk). For type I fibers, increases of 17% (P less than 0.05) in SDH activity occurred during 2nd wk, remained elevated through 4th wk, and increased further (P less than 0.05) to 137% of 1-wk values by the end of 6th wk. No further increases were noted between 6 and 12 wk. A similar maturational trend was evident for type IIa fibers, although SDH activities remained higher throughout development when compared with type I fibers. In contrast, SDH in type IIb fibers, although increasing by 14% during the first two measurement weeks (P less than 0.05), declined from 6 to 9 wk before ultimately reaching a value similar to 3 wk. SDH activity was also assessed in a typical slow- (soleus) and fast-twitch (extensor digitorum longus, EDL) muscle of the hindlimb to contrast their development with that of the diaphragm. Generally, SDH in type I and IIa fibers was approximately 40 and 20% higher, respectively, in the diaphragm than in matched fiber types in the other muscles throughout development (diaphragm greater than EDL greater than soleus).(ABSTRACT TRUNCATED AT 250 WORDS)
Adenosine Triphosphatases↗