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Biomedical subjects

G M White

Publications and source records attributed to G M White.

At least 19 recordsLinked to original sources

Increased pollen flow counteracts fragmentation in a tropical dry forest: an example from Swietenia humilis Zuccarini.

Habitat destruction and the resultant fragmentation of the remaining forest are a common phenomenon in the tropics. Most investigations emphasize the potential dangers of fragmentation in isolating patches of forest and exposing populations to loss of species diversity through founder effects, genetic drift, inbreeding, and restricted gene flow. However, a limited number of studies have shown that gene flow may be extensive in tropical trees, suggesting that it may occur between forest fragments and also "isolated" remnant trees. There is an urgent need to quantify pollen flow within and between forest fragments to test the veracity of such views and determine the genetic value of such fragments for in situ conservation. Microsatellite markers are used to genotype individuals of Swietenia humilis from a highly fragmented forest mosaic to directly quantify pollen-mediated gene flow. Distances of pollen flow more than 10 times greater than previously reported were detected. Our results show that some tropical angiosperm tree species may be much more adaptable and resilient to habitat destruction and fragmentation than previously considered. The description of many remnant trees as isolated or "living dead" may be more a conditioning of human perception than a true reflection of their potential conservation value.

Ecology↗

Acne therapy.

Explore the source record for details and available documents.

Acne Vulgaris↗

Acne therapy.

Explore the source record for details and available documents.

Acne Vulgaris↗

Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris.

Acne affects between 40 to 50 million individuals in the United States. Recent findings regarding the multifactorial pathogenesis of acne have facilitated a reexamination of the classification of acne and acne-related disorders. Disorders without a microcomedo as the initial pathologic condition are no longer classified as "acne." Research has also identified that the clinical characteristics of acne vary with age, pubertal status, gender, and race. These findings may have implications for the clinical management of acne and acne-related disorders.

Acne Vulgaris↗

Using relative value units (RVUs) to develop your pricing schedule.

This article presents a methodology by which a practice, using published Medicare Relative Value Units, can develop a logical and consistent pricing structure which recognizes the difference between procedures and is of a similar methodology to that used by Medicare and many major third-party payors in reimbursing practices. This approach utilizes available published information and can be done with relative ease by all physician practices.

Electronic Data Processing↗

20 factors to consider when negotiating a managed care contract.

This article presents a checklist of 20 factors a practice should consider when negotiating a managed care contract. The negotiation of the contractual terms is at least as important as the capitation rate or fee schedule. With the advent of Medicare HMO Risk plans, the last bastion of patient choice is being eroded. Practices now are negotiating fees and terms with almost every plan. It is necessary for all practices to become knowledgeable in the intricacies of managed care contractual negotiation.

Contract Services↗

Analyzing practice costs utilizing Relative Value Units (RVUs).

"As Medicare pays based upon Relative Value Units and many managed care plans are transitioning their payment systems to an RVU-based system, it should be a long-term goal of the practice to eventually have the practice cost per RVU be at or below the Medicare conversion factor."

Costs and Cost Analysis↗

Two concentrations of topical tretinoin (retinoic acid) cause similar improvement of photoaging but different degrees of irritation. A double-blind, vehicle-controlled comparison of 0.1% and 0.025% tretinoin creams.

BACKGROUND AND DESIGN: The efficacy of topical tretinoin (all-trans-retinoic acid) in treating photoaging is well established. Questions that remain are (1) whether irritation causes all or part of the improvement; (2) the concentration of tretinoin that maximizes clinical response with minimal side effects; and (3) the effects of long-term treatment on components of the cutaneous immune system. To address these issues, 99 photoaged patients completed a 48-week study using 0.1% tretinoin cream (n = 32), 0.025% tretinoin (n = 35), or vehicle (n = 32) once daily in a double-blind manner. Before and after treatment, we assessed histologic features, keratinocyte expression of HLA-DR and intercellular adhesion molecule-1, numbers of epidermal Langerhans' cells and epidermal and dermal T lymphocytes, and vascularity as measured by dermal endothelial cell area. RESULTS: Both 0.1% and 0.025% tretinoin produced statistically significant overall improvement in photoaging of the face compared with vehicle; there were no clinically or statistically significant differences in efficacy between the two concentrations of tretinoin. After 48 weeks, 0.1% and 0.025% tretinoin produced similar statistically significant epidermal thickening (by 30% and 28%, respectively) compared with vehicle (11% decrease) and increased vascularity (by 100% and 89%, respectively) compared with vehicle (9% decrease). By various analyses, irritant side effects (erythema and scaling) were statistically significantly greater with 0.1% tretinoin than with 0.025% tretinoin. No significant changes occurred in any immunologic markers when tretinoin and vehicle treatments were compared. CONCLUSIONS: Tretinoin 0.1% and 0.025% produce similar clinical and histologic changes in patients with photoaging, despite significantly greater incidence of irritation with the higher concentration. The separation between clinical improvement and irritation suggests that mechanisms other than irritation dominate tretinoin-induced repair of photoaging in humans.

Aged↗

An approach to the treatment of moderate to severe psoriasis with rotational therapy.

BACKGROUND: There are four standard approaches for treating moderate to severe psoriasis: UVB plus tar, PUVA, methotrexate, and etretinate. Although patients with psoriasis receive these therapies for many years, there is no commonly accepted approach for the initial and subsequent selection of the alternatives. OBJECTIVE: Our purpose was to develop a theoretical and practical basis for using these treatments that will minimize the risks of their long-term toxicities and prolong their safe long-term use. METHODS: A review of the published side effects of the treatments and cumulative clinical experience are used to develop an approach for the treatment of severe psoriasis. RESULTS: It is proposed that patients receive each form of therapy for 1 to 2 years and then switch to the next form of treatment. By rotating each of the three or four treatments at these time intervals, it may well be 4 or 5 years before needing to return to the first therapy, thereby minimizing cumulative toxicity by long periods off each treatment. CONCLUSION: Rotation of available therapies for moderate to severe psoriasis may minimize long-term toxicity and allow effective treatments to be maintained for many years.

Combined Modality Therapy↗

Cyclosporine therapy for psoriasis: a cell cycle-derived dosing schedule.

BACKGROUND: Cyclosporine is effective in the treatment of psoriasis; however, potentially serious side effects limit its long-term use. On the basis of the 36-hour psoriatic keratinocyte cell cycle, a new dosing regimen was investigated. OBJECTIVE: The purpose of this study was to evaluate a 36-hour weekly dosing schedule with cyclosporine for the treatment of psoriasis, in an attempt to decrease side effects while maintaining efficacy. METHODS: Fifteen patients were studied by means of oral doses of cyclosporine taken at 12-hour intervals for three doses per week during a 10-week period. The initial dose, 2.5 mg/kg/dose (7.5 mg/kg/wk), was increased every 2 weeks by 2.5 mg/kg/dose to a maximum of 10 mg/kg/dose. RESULTS: The average improvement as assessed by the Psoriasis Area and Severity Index for all 15 patients was 61%. Six patients had a more than 75% improvement, three patients improved 50% to 74%, and six patients improved less than 50%. Three patients dropped out because of adverse side effects, and three others completed the study at a reduced dose. CONCLUSION: It is concluded that, although effective, this dosing regimen may not have an advantage over daily dosing, given its side effect profile and the need to go to relatively high doses every 24 hours.

Adult↗