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Biomedical subjects

J Harris

Publications and source records attributed to J Harris.

At least 343 records · Page 19Linked to original sources
PubMed1989

Rey-Auditory Verbal Learning and Rey-Osterrieth Complex Figure Design performance in Alzheimer's disease and closed head injury.

Performance on the Rey-Auditory Verbal Learning (R-AVL) and Rey-Osterrieth Complex Figure Design (R-O CFD) tests was examined in patients (N = 94) with dementia of the Alzheimer's type (DAT) and closed head injury (CHI). On the R-AVL, DAT patients demonstrated considerably greater impairment than CHI patients, along with a flat learning/retention curve that showed negligible improvement with repeated trials, recency effects only, and an excessive number of word intrusions (confabulation) on the recognition trial. CHI patients demonstrated both a recency and primacy effect along with improvement over repeated trials (positive slope learning curve). Both groups demonstrated impairment R-O CFD recall; the DAT group again displayed substantially greater copying and recall deficits. Clinical guidelines are given for the use of the R-AVL and R-O CFD for these two patient populations.

Adult↗
PubMed1989

Use of contoured and stabilized conchal cartilage grafts for lower eyelid support: a preliminary report.

Lower lid stability can be affected by many conditions involving the lid directly, e.g. facial palsy, facial clefts, trauma, or tumors. Secondary stretching due to a poorly fitting orbital prosthesis can have the same effect. In 41 such eyelids, stability was obtained by inserting a large cartilage graft sutured to the tarsal plate and the infraorbital rim. Thirteen patients had tarsoconjunctival wedge resections, and 10 had lateral canthopexies performed at the same procedure. One graft was too small and was later replaced. There was one hematoma, which was evacuated. There were no other lid or visual problems. The follow-up is short, 21 months maximum, but so far the results are very satisfactory.

Cartilage↗
PubMed1989

Very high dose intravenous gammaglobulin in thrombocytopenia of pregnancy.

A 22-year-old woman with severe idiopathic thrombocytopenic purpura, complicating pregnancy, was unresponsive to high-dose corticosteroids and three separate infusions of high-dose intravenous immunoglobulin using the conventional schedule of 400 mg/kg/d for five days. A dramatic albeit transient, elevation of her platelet count followed a six day course of very high dose immunoglobulin (1000 mg/kg/d) thus allowing elective lower segment cesarean section to be performed without complications and with the delivery of a live, female infant. Two months later a further course of very high dose gammaglobulin was again effective in raising the patient's platelet count prior to elective splenectomy. No adverse reactions were seen to either infusion.

Adult↗
PubMed1989

Combination chemotherapy versus single agents followed by combination chemotherapy in stage IV non-small-cell lung cancer: a study of the Eastern Cooperative Oncology Group.

During the last decade, the Eastern Cooperative Oncology Group (ECOG) has studied a series of combination chemotherapy regimens in metastatic (stage IV) non-small-cell lung cancer (NSCLC). In January 1984, the ECOG activated a randomized study, EST 1583, which concluded the evaluation of combination regimens in phase III trials and initiated the evaluation of single agents exclusively in previously untreated patients. The treatment regimens in EST 1583 consisted of: (1) mitomycin, vinblastine, and cisplatin (MVP); (2) vinblastine and cisplatin (VP); (3) MVP alternating with the regimen cyclophosphamide, doxorubicin, methotrexate, and procarbazine (CAMP); (4) carboplatin followed by the MVP regimen at the time of progression; and (5) iproplatin followed by MVP at the time of progression. From January 1984 to July 1985, 743 patients were entered on this trial and 699 fulfilled the eligibility requirements. The following objective response rates (complete plus partial remissions) were observed: first-line MVP, 20%; VP, 13%; MVP/CAMP, 13%; carboplatin, 9%; iproplatin, 6%; and second-line MVP, 6%. First-line MVP produced a significantly higher response rate than the other treatments (P = .03) adjusted for prognostic variables. Using analyses that were adjusted for prognostic covariates, survival for patients treated on a given regimen was compared with survival for all remaining patients. These analyses showed that treatment with carboplatin was associated with longer survival (median survival time, 31.7 weeks; P = .008) while initial treatment with MVP was associated with a trend for shorter survival (median survival time, 22.7 weeks; P = .09). It should be noted that none of these regimens appear to have produced a clinically meaningful prolongation of survival. Similar analyses evaluating time to progression disclosed that carboplatin-treated patients had a significantly longer time to progression (median time to progression, 29 weeks) than all remaining patients (P = .01). Life-threatening and lethal toxicities (toxicity grades 4 and 5) were greater on the combination regimens than on the single agents (P less than .0001). Based on these results, current group-wide ECOG trials in stage IV NSCLC consist of randomized phase II trials evaluating single agents.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Focus groups improve billing practices, patient relations.

The billing process plays a key role in maintaining good patient relations. Recognizing this, one California hospital conducted focus groups to discover how recently discharged patients viewed its billing process. The former patients gave patient accounts staff high marks, but found the bills themselves difficult to understand. Another source of irritation was receiving separate bills from outside specialists for treatment provided in-house. The hospital is using the participants' suggestions to enhance its billing process.

Accounting↗
PubMed1989

Capital management helps hospitals face hard times.

Financial officers of healthcare organizations in severe financial distress must map out an effective capital management strategy to help their institutions avoid disaster. An executive's plan of action should include streamlining and restructuring the organization, studying long- and short-term assets to improve cash flow, and investigating ways to refinance debt. Healthcare organizations must develop warning signals for impending financial difficulties and contingency plans that address operating and capital responses to such a crisis. Learning to guide an organization through financial difficulties may be an executive's most important financial skill in the decade to come.

Accounts Payable and Receivable↗
PubMed1989

Nurse educators respond to the needs of the chronically mentally disabled.

A recurrent theme in the psychiatric literature is the paucity of educational programs and orientation programs for the nurse generalist that offer individualized content specific to the needs of the chronically mentally disabled (CMD) client. Concerned with the lack of educational content and the complexity of the needs of the CMD two nurse educators developed, implemented, and evaluated an educational module for preparing the novice psychiatric nurse to care for CMD clients in inpatient treatment settings. The module builds upon nurses' physical assessment skills, nursing diagnosis skills, and management of chronic and episodic illnesses, and bridges these skills with traditional psychiatric-mental health content. With an increased interest in nursing case management, the educational module presents educational support germane to the concepts inherent in supportive and rehabilitative case management. Moreover, the current political, social, and economic climates are mandating that nurses become actively involved in discharge planning. The educational module addresses such issues and identifies strategies for assuring nurse involvement.

Curriculum↗
PubMed1988

Epidermal growth factor (EGF) and hormones stimulate phosphoinositide hydrolysis and increase EGF receptor protein synthesis and mRNA levels in rat liver epithelial cells. Evidence for protein kinase C-dependent and -independent pathways.

Epidermal growth factor (EGF) stimulated the rapid accumulation of inositol trisphosphate in WB cells, a continuous line of rat hepatic epithelial cells. Since we previously had shown that EGF stimulates EGF receptor synthesis in these cells, we tested whether hormones that stimulate PtdIns(4,5)P2 hydrolysis would increase EGF receptor protein synthesis and mRNA levels. Epinephrine, angiotensin II, and [Arg8]vasopressin activate phospholipase C in WB cells as evidenced by the accumulation of the inositol phosphates, inositol monophosphate, inositol bisphosphate, and inositol trisphosphate. A 3-4-h treatment with each hormone also increased the rate of EGF receptor protein synthesis by 3-6-fold as assessed by immunoprecipitation of EGF receptor from [35S]methionine-labeled cells. Northern blot analyses of WB cell EGF receptor mRNA levels revealed that agents linked to the phosphoinositide signaling system increased receptor mRNA content within 1-2 h. A maximal increase of 3-7-fold was observed after a 3-h exposure to EGF and hormones. The phorbol ester, 12-O-tetradecanoylphorbol 13-acetate (TPA), which activates protein kinase C also stimulated EGF receptor synthesis. Pretreatment of WB cells for 18 h with high concentrations of TPA "down-regulated" protein kinase C and blocked TPA-directed EGF receptor mRNA synthesis. In contrast, the effect of EGF on EGF receptor mRNA levels was not significantly decreased by TPA pretreatment. Epinephrine-induced increases in EGF receptor mRNA were reduced from 4- to 2-fold. Similarly, 18 h TPA pretreatment abolished the effect of TPA on EGF receptor protein synthesis but did not affect EGF-dependent EGF receptor protein synthesis. The 18-h TPA pretreatment diminished by 30-50% the induction of receptor protein synthesis by epinephrine or angiotensin II. We conclude that in WB cells EGF receptor synthesis can be regulated by EGF and other hormones that stimulate PtdIns(4,5)P2 hydrolysis. In these cells, EGF receptor synthesis appears to be regulated by several mechanism: one pathway is dependent upon EGF receptor activation and can operate independently of protein kinase C activation; another pathway is correlated with PtdIns(4,5)P2 hydrolysis and is dependent, at least in part, upon protein kinase C activation.

Angiotensin II↗
PubMed1988

Human PC-3 prostate cell line DNA synthesis is suppressed by eicosatetraynoic acid, an in vitro inhibitor of arachidonic acid metabolism.

When human PC-3 cells derived from a metastatic prostatic adenocarcinoma were incubated for 15 min to 4 h with the in vitro inhibitor of eicosanoid biosynthesis, eicosatetraynoic acid (ETYA) at 10-80 microM, DNA synthesis was suppressed. No reduction in cellular viability occurred, as judged by exclusion of trypan blue or unaltered release of 51Cr-labeled proteins, and the inhibition was partially reversible. Indomethacin (to 12.5 micrograms/ml) did not inhibit DNA synthesis or alter the suppression of DNA synthesis by ETYA, suggesting a role for a lipoxygenase product in this effect. Addition of leukotriene B4 (LTB4) at 10(-8) M did not reverse the inhibition of DNA synthesis produced by ETYA, nor did arachidonic acid (10(-5) - 10(-9) M) incubated with control cells mimic the effect of that agent. 3H-arachidonic acid incubated with PC-3 cells was rapidly incorporated into phospholipids and this labeling was differentially inhibited by ETYA. Positive modulation of PC-3 cellular DNA synthesis by lipoxygenase products and inhibition of their synthesis by ETYA is one attractive hypothesis with which to account for these results. Other consequences of producing a selective deficiency of arachidonic acid in cellular membrane phospholipids and even the probable substitution of ETYA for arachidonic acid could also contribute to the inhibition of DNA synthesis by ETYA.

5,8,11,14-Eicosatetraynoic Acid↗
PubMed1988

Differentiation of U937 cells induced by 5,8,11,14-eicosatetraynoic acid, a competitive inhibitor of arachidonic acid metabolism.

5,8,11,14-Eicosatetraynoic acid, a competitive inhibitor of arachidonic acid metabolism, rapidly and reversibly inhibited DNA synthesis in U937 cells. This inhibition was not due to cytotoxicity, as judged by studies with trypan blue, release of 51Cr-labeled proteins, and its reversibility. When cells were cultured in the presence of ETYA for several days, morphologic, enzymatic, and functional changes consistent with differentiation occurred. Morphologic evidence of differentiation was evident by light microscopy. The cells enlarged, the ratio of cytoplasm to nuclei increased, secretory granules and vacuoles developed, the apparent activity of nonspecific esterase rose, and ingestion of latex particles increased. A morphology consistent with that of an immature monocyte was evident by electron microscopy. These features included the development of lobulated nuclei, a reduced nuclear to cytoplasmic ratio, increased complexity and development of the cytoplasmic components, and the disappearance of fimbriated plasma membrane structures. In addition, putative polyribosomes were less evident. When cells differentiated by ETYA were cultured in media free of the inhibitor, DNA synthesis reinitiated and the cell number increased; differentiation was phenotypic and not genotypic. To examine whether ETYA-induced differentiation was obligatorily related to its suppression of DNA synthesis, cells were incubated in 50 microM hydroxyurea and DNA synthesis was inhibited for 24 to 36 h without morphologic evidence of cellular differentiation. However, addition of ETYA to cells prevented from dividing by hydroxyurea and subsequent culture for 72 h induced morphologic evidence of differentiation. The effects of ETYA on cell division and cell differentiation are closely related but can be dissociated. The molecular events underlying these results remain to be established.

5,8,11,14-Eicosatetraynoic Acid↗
PubMed1988

The relationship between auditory sensitivity and ear asymmetry on a dichotic listening task.

Using an adaptive forced-choice procedure, the average absolute sensitivity of the right ears of a group of right-handed males was found to be slightly greater than that of their left ears. There was no ear difference in performance on a monaural syllable-identification task using easily detectable stimuli, however. The magnitude of the ear difference in absolute sensitivity was significantly correlated with performance on a dichotic-listening task. In a second experiment, the adaptive forced-choice procedure was used to assess differences in absolute sensitivity in a group of left-handed males. The right ears of those left-handers showing a right-ear advantage on the dichotic-listening task were slightly more sensitive than their left ears. The left ears of those left-handers showing a dichotic left-ear advantage were slightly, but not significantly, more sensitive than their right ears. The correlation of the ear differences in absolute sensitivity with performance on the dichotic-listening task for the left-handers was not significantly different from zero. Results of both experiments are discussed in terms of their implications for the nature of hemispheric asymmetry of function, and the interpretation of dichotic and monaural asymmetries.

Adult↗
PubMed1988

Phase discrimination in chromatic compound gratings.

Phase discrimination thresholds were measured for yellow/green isoluminant and non-isoluminant compound gratings in which the amplitude of the two components (f and 3f) was twice the detection threshold. The phase discrimination threshold at isoluminance was worse than in all the other conditions, which gave broadly similar threshold data. It is suggested that this is due to a positional uncertainty in the neural representation of the isoluminant stimuli.

Contrast Sensitivity↗
PubMed1988

Life: quality, value and justice.

The claim is questioned that QALYs (quality adjusted life years) provide an effective measure of beneficial health care and of cost-effective and or efficient health care and allow for a morally defensible way of distributing scarce health resources. It is argued the QALYs: (1) fallaciously value time lived instead of individual lives; (2) take an excessively narrow view of what quality of life might be; and finally and perhaps most importantly (3) they are unjust.

Economics↗
PubMed1988

Prevention of unexpected infant death. A review of risk-related intervention in six centers.

Over seventy percent of unexpected infant deaths are registered as SIDS. Over 85,000 infants have been screened at birth and one month of age for risk of unexpected death using the Sheffield Score system. Scores range from below 400 to over 800 points. Infants with scores over 800 are at more than 16 times greater risk than infants with scores below 400. Family doctors and health visitors were alerted to high-risk infants, who were examined at home and weighed naked at home five times in the first six months. Mortality in the high-risk group was reduced by more than 50% (p less than 0.02 in one area and p less than 0.05 in another). It is concluded that with few extra resources unexpected infant mortality can be reduced by 25% by this approach.

Child Health Services↗