Search PubMed⌕ Search

Biomedical subjects

D Sullivan

Publications and source records attributed to D Sullivan.

142 records · Page 8Linked to original sources
PubMedDate not supplied

Borderline personality disorder and bone marrow transplantation: ethical considerations and review.

Bone marrow transplantation (BMT) is rapidly becoming a part of conventional cancer treatment. However, it remains a 'last-ditch' treatment option for patients who have exhausted other treatment modalities. Patients experience a significant amount of emotional distress during all stages of the BMT process. Patients with personality disorders experience even more emotional distress than average and their behavior is often detrimental to effective patient-staff interactions. A case of a borderline patient is presented with a discussion of the ethical issues involved in the evaluation of these patients and the determination of their appropriateness for transplant.

Adaptation, Psychological↗
PubMedDate not supplied

Hepatotoxic bile acids increase cytosolic Ca++ activity of isolated rat hepatocytes.

Effects of bile acids on cystolic Ca++ activity and cell viability of isolated rat hepatocytes were studied to test the hypothesis that bile acids may produce hepatotoxicity by increasing cystolic Ca++ activity. Changes in cystolic Ca++ activity were calculated from time-dependent changes in fluorescence of quin-2 loaded hepatocytes. Release of lactate dehydrogenase and changes in propodium iodide fluorescence were used to assess cell viability. Bile acids studied were unconjugated and taurine-conjugated cholate, chenodeoxycholate (and taurochenodeoxycholate), deoxycholate (and taurodeoxycholate) and lithocholate (and taurolithocholate). With the exception of cholate and taurocholate, bile acids increased cystolic Ca++ activity within 10 to 30 sec in a concentration-dependent fashion (0.05 to 1.0 mM) and in the order lithocholate = taurolithocholate greater than chenodeoxycholate = taurochenodeoxycholate = deoxycholate = taurodeoxycholate. The initial increase in cystolic Ca++ activity by bile acids was not due to cell damage, since bile acid-induced decreases in cell viability were not significant until 2 to 3 min. At higher concentrations of unconjugated bile acid, there was a secondary increase in quin-2 fluorescence corresponding temporally to the increase in propodium iodide fluorescence, indicating cell damage after the initial increase in cystolic Ca++ activity. The ability of conjugated and unconjugated bile acids to increase cystolic Ca++ activity was abolished and decreased (60 to 90%), respectively, in the absence of extracellular Ca++, indicating that extracellular Ca++ is the major source of the bile acid-induced increase in cystolic Ca++ activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Scintigraphy, ultrasound and CT scanning of the liver.

Isotope examination of the liver depends on the functional activity of the liver phagocytes, while ultrasound and CT scanning display the anatomical structure. Cold areas on an isotope scan may be due to impaired function or space-occupying lesions. The method is nonspecific and does not differentiate between cysts, abscesses and metastases. Both ultrasound and CT scanning can differentiate space-occupying lesions with a high degree of accuracy so that both techniques can be used to improve the accuracy and specificity of the radioisotope examination. CT scanning of the liver is limited by relatively slow data acquisition and the small differences in X-ray absorption within soft tissues unless contrast agents are used. In comparison, ultrasonic data are rapidly collected and displayed and liver consistency is imaged without contrast media or ionizing radiation. Diffuse abnormalities of the liver, such as cirrhosis, cannot be detected by CT scanning but are apparent on ultrasound examination. In addition, equipment purchase and maintenance costs for ultrasound are a fraction of those for CT scanning. Experience to date at Yale indicates that ultrasound and CT scanning are complementary and supplementary to isotope examination of the liver but that ultrasound in most patients produces better resolution and enhanced tissue differentiation at considerably less cost.

Ascites↗
PubMedDate not supplied

Stress fractures in 51 runners.

A prospective study was initiated in 1976 to investigate runners who are at risk for incurring stress fractures and how these fractures can be prevented. Fifty-one runners incurred 57 stress fractures. Tibial fractures were most common (25), followed by fibula (12) and metatarsal (8). Seven runners had previously sustained stress fractures, and six developed two stress fractures simultaneously. Five women over 30 years old had pelvic stress fractures. Stress fracture development was positively correlated with the presence of pes planus, weekly training distances greater than 20 miles, hard training surfaces, and training regimen modifications. The incidence did not correlate with generalized musculoskeletal laxity or tightness. Forty-four of 51 patients had initially positive roentgenograms. Five of five bone scans were positive. The average duration of rest before running was resumed was 7.4 weeks.

Adolescent↗
PubMedDate not supplied

Points to consider about prescription drug prices: an overview of federal policy and pricing studies.

Pharmaceutical prices in the United States are under evaluation as policy makers decide how to reduce health care expenditures and public subsidy of the pharmaceutical industry. Furthermore, evidence of higher drug prices in the United States, compared with those in other countries, fuels the prescription drug price debate. These issues are not new to the public forum and much can be learned from prior debates and policies. This paper begins by reviewing the pricing debate with the Kefauver hearings on monopolies held during the late 1950s and early 1960s and continues with the current price debate. Government reports and academic studies are discussed, addressing the methodological differences and their implications to policy makers. Finally, the literature review includes foreign government prescription drug programs with their respective prescription drug expenditures. Evidence provided by academics about the pricing practices of the drug manufacturers indicates product quality and price information would force firms to compete on the price level, thus reducing pharmaceutical product pricing to the "true" market price.

Drug Costs↗