Biomedical subjects
Publications and source records attributed to J D Moore.
From more woes for managed-care firms to continued hospital mergers, particularly among not-for-profits, the staff of Modern Healthcare makes its predictions for the healthcare industry in the new year. And--which should come as no surprise to seasoned executives--1998 should turn out to be memorable, possibly invigorating and most certainly full of change.
A case is described in which coarctation of the aorta develops following coil occlusion of a patent ductus arteriosus with a single Gianturco coil. This finding has yet to be reported in children undergoing this procedure and demonstrates the possibility of its occurrence and brings into question the need for and the duration of antibiotic prophylaxis following coil deployment.
Vitellogenin (Vtg) is a yolk protein produced in the liver of oviparous animals in response to estrogen. Vitellogenesis is normally observed only in sexually mature females, but it can be induced in male and juvenile animals by exposure to exogenous estradiol (E2) or substances that mimic estrogens. The abnormal production of Vtg by males can, therefore, be used as a biological indicator for exposure to xenoestrogens. In this study, an enzyme-linked immunosorbent assay (ELISA) for measuring Vtg in English sole (Pleuronectes vetulus) was developed and validated. Plasmatic Vtg was purified from E2-injected male English sole using DEAE ion-exchange and Sepharose size-exclusion chromatography, and polyclonal antibodies against the purified Vtg protein were generated in rabbits. In this assay, a competition for the Vtg antibody was established between Vtg coated onto microtiter plate wells and free Vtg. Detection of adsorbed antigen-antibody complexes was achieved using a horseradish peroxidase conjugated anti-rabbit secondary antibody whose enzyme activity was revealed with 3,3',5,5'-tetramethyl benzidine (TMB) substrate. Assay conditions provided a detectable Vtg range of 10-450 ng ml-1 (85-20% of binding) of diluted sample. Plasma dilution curves from vitellogenic female and E2-treated male English sole showed parallelism with the standard dilution curve. We are presently conducting field and laboratory studies to investigate estrogenic and anti-estrogenic activity resulting from exposure to contaminants.
A current trend in medicine involves establishing collaborative problem solving between patients and physicians in order to involve patients more in their own care. Neither diagnosis nor therapy can be completely successful unless the patient and the doctor understand each other and collaborate with each other in an effort to gauge the other's requests, needs and concerns. This is made even more difficult by the fact that there is often a big difference between the doctors and patients in terms of expectations, vocabulary used, and other factors. For diagnosis of many disorders, a detailed description of the problem and of the patient's history are required. For therapy, patients must understand how and when to take prescribed drugs, what changes to make in diet, exercise, or lifestyle and why they are important. This paper describes a model of asynchronous collaboration between people with very different knowledge of medicine in which a computer framework attempts to mediate between patients and physicians and reduce some of the differences in communication. It allows patients to pace themselves in familiarizing themselves with the relevant domain terms, some of the medical factors underlying the conditions under question, and the justifications and implications of the prescribed treatment plan. It also allows physicians to request more information of patients and gives patients contextual information to help them understand the underlying reasons for the questions. This framework has been partially implemented in the domain of migraines. As described in the paper, not only is the system designed to cooperate with the patient, but using the system also results in better mutual understanding between the doctor and the patient, thus leading to better collaboration between them.
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Look around at the next conference of top-level healthcare executives. Chances are, the faces will appear mostly white. While there might be a few women, it's likely the number of blacks and Latinos will be minimal. Years of effort to increase the diversity has made some progress, but most in the industry agree there's a long way to go. Keith Brady (left), one of the few black CEOs who has made it in the private, for-profit sector, cites the influence of mentoring.
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