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Biomedical subjects

J Hinson

Publications and source records attributed to J Hinson.

17 recordsLinked to original sources
PubMed1997

melphalan, single-fraction total-body irradiation and allogeneic bone marrow transplantation for acute leukemia: review of transplant-related mortality.

Causes of treatment-related death were studied amongst 138 patients with acute myeloid (n = 90) or lymphoblastic (n = 48) leukemia allografted from HLA-identical siblings in first (n = 107) or second (n = 31) remission after a conditioning regimen comprising 110 mg/m2 melphalan and 1050 cGy single-fraction total-body irradiation (TBI) prescribed as maximum lung dose. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine (n = 78) or cyclosporine-methotrexate (n = 60). Eighty-one patients died of causes other than relapse 16-2917 days (median 77) after transplantation. The actuarial probability of non-relapse mortality was 62% at 5 years. The major primary causes of death were pneumonitis (n = 38, 47%), GVHD (n = 18, 22%), and sepsis (n = 11, 14%). Pneumonitis contributed to 42 of the deaths (52%), and its etiology was infective (n = 27), idiopathic (n = 14), or a combination of the two (n = 1). On multivariate analysis, GVHD prophylaxis with cyclosporine alone was associated with a higher overall toxic death rate. The use of cyclosporine alone and a low infused cell dose (<2.5 x 10(8) total nucleated cells/kg or <0.6 x 10(8) mononuclear cells/kg) were associated with a higher risk of death from pneumonitis. We conclude that the use of cyclosporine alone as GVHD prophylaxis is associated with increased transplant-related toxicity, and the addition of methotrexate and infusion of a higher number of cells decrease the incidence of fatal pneumonitis.

Acute Disease↗
PubMed1997

The impact of screening for risk factors associated with postnatal depression at the first prenatal visit.

Although 10-15% of Australian women suffer from postnatal depression (PND), few efforts have been made, prenatally, to predict which women may develop the condition. The objective of this study was to evaluate the impact on patients, staff and services of an intervention designed to identify women at risk for PND. Women were screened at their first prenatal visit for factors associated with PND, and were asked to complete a questionnaire at their next clinic visit to assess the impact of the screening questions and the usefulness of a PND information kit. To assess the impact of the intervention on the prenatal clinic routine, all staff associated with the intervention were interviewed individually and their responses were tape recorded and analysed for themes. Patients reported a high level of satisfaction with the intervention. Staff responded well to the new procedure and offered constructive comments to improve the process.

Attitude of Health Personnel↗
PubMed1997

An erbium:YAG laser to obtain capillary blood samples without a needle for point-of-care laboratory testing.

BACKGROUND: Needlestick injury poses an occupational hazard to health care workers that will increase with the increasing availability of point-of-care testing using capillary blood obtained with a lancet. OBJECTIVES: To demonstrate the safety and efficacy of a portable pulsed erbium:yttrium-aluminum-garnet (Er:YAG) laser in obtaining a blood sample from patients in a clinical setting and to determine whether the laser radiant energy alters the level of various components of blood, resulting in misleading laboratory results. DESIGN: Comparison of laboratory values of blood samples obtained with the laser and conventional lancet and comparison of patient and user preferences by questionnaire. PATIENTS AND METHODS: One hundred patients with diabetes mellitus attending a diabetes clinic were randomized to have capillary blood sampling from the fingertip performed either by the laser or a conventional lancet first, then with the other device. MAIN OUTCOME MEASURES: A comparison of pain, healing, hematocrit, and glycosylated hemoglobin (HbAlc), blood urea nitrogen, sodium, potassium, bicarbonate, and glucose levels. RESULTS: Adequate blood was obtained with both devices 97% of the time. Blood flow was greater with the laser perforation, resulting in higher operator preference. Although patients felt greater pain and experienced slower healing with the laser, these were not serious problems. Modification of the laser energy output led to a reduction in pain. Possibly owing to hemolysis, the potassium level in the blood obtained with the laser was significantly elevated and unsuitable for clinical decision making in many cases. None of the other measurements were similarly affected. CONCLUSIONS: We conclude that the laser device has the potential to obtain a blood sample for routine tests without a needle. This needle-free method will decrease the risk of bloodborne infections caused by needlestick injuries and thus lead to considerable cost savings and public health advantages. Further work is needed to alter the laser energy so that hemolysis can be decreased, thus enabling a more reliable potassium estimation.

Bicarbonates↗
PubMed1996

Recovery of function after brain damage: differential effects of blocking calcium uptake during the recovery of a learned behavior and the performance of the recovered behavior following neocortical brain injury.

The recovery of a learned behavior following brain damage is typically considered to have occurred when the brain-injured individual reattains the performance criterion that defined original preoperative learning. While this is obviously correct from an operational point of view, it does not necessarily mean that the consequences of the brain injury have been reversed, particularly with regard to the sustained performance of the supposedly recovered behavior. The present research attempted a more comprehensive evaluation of the behavioral effects of localized neocortical injury by investigating how a calcium channel blocker would effect (a) the original preoperative acquisition, (b) the initial postoperative recovery, and (c) the subsequent long-term performance of a brightness discrimination learned by rats subjected to injuries of their visual neocortex. The results demonstrated that notwithstanding the brain-injured rat's ability to reattain the performance criterion used to define preoperative learning, its long-term performance of this recovered behavior was significantly inferior to that of a normal rat. More importantly, the present data suggest that there are important differences between the initial postoperative recovery of a behavior and its long-term performance since the same drug that will facilitate initial recovery has just the opposite effect with respect to the animals long-term postoperative performance of the behavior.

Analysis of Variance↗
PubMed1993

Functional characterization of the cloned human ACTH receptor: impaired responsiveness of a mutant receptor in familial glucocorticoid deficiency.

The putative ACTH receptor gene has been identified on the basis of its tissue specific expression, structure, and limited expression data. We have expressed this gene in COS-7 cells and measured cAMP production in response to ACTH. An EC50 of 5.5 x 10(-9) M for ACTH (1-24) was determined. The S74I mutant ACTH receptor gene that associates with the syndrome of familial glucocorticoid deficiency had an EC50 of 67 x 10(-9) M. This discrepancy is consistent with the clinical data, and supports the hypothesis that this point mutation could account for the syndrome.

Adrenocorticotropic Hormone↗
PubMed1993

Airway resistance and work of breathing in tracheostomy tubes.

Recommendations for sizing of tracheostomy tubes are generally based on anatomic considerations with the largest fitting tube most commonly placed. Once in the tracheostomy site, the tube assumes the new role of the upper airway. Consideration of the airway resistance of each tracheostomy tube and change in work of breathing are important in maintaining the respiratory system homeostasis. The airflow dynamics of neonatal, pediatric, and adult tracheostomy tubes were studied. Flow rates were plotted against change in pressure for inspiratory and expiratory flows and resistances for each tube were calculated. The expiratory resistances were larger for the neonatal tubes and pediatric tubes 0 and 00, while inspiratory resistances were the limiting factor in the adult tubes and the larger pediatric tubes. Comparison of calculated resistances of the tracheostomy tubes was made with known physiologic airway resistances. Adult tubes 8 and 10 most closely simulated the upper airway resistance of adults and neonatal tube 0 appeared most appropriate for the newborn. Work of breathing was determined for each tracheostomy tube. Increasing tube diameter as well as decreasing tidal volume and respiratory rate decreased the amount of work required to maintain a given flow.

Adult↗
PubMed1988

Neuropeptide Y stimulates inositol phospholipid hydrolysis in rat brain miniprisms.

Neuropeptide Y (NPY) stimulates the hydrolysis of inositol phospholipid in rat brain miniprisms. The stimulation was two-fold in the frontal cortex and in the hippocampus, and 1.5-fold in the striatum. NPY produced no significant effects on basal inositol monophosphate levels in hypothalamic miniprisms. However, those basal levels were much higher than in the other brain regions.

Animals↗
PubMed1988

Combined modality preoperative therapy in poor prognostic rectal adenocarcinoma.

Between 1976 and 1986, 64 patients with rectal adenocarcinoma who were considered unresectable or had prognostic signs suggestive of high risk for local failure received preoperative adjuvant therapy. They were treated with pelvic irradiation (40 Gy) combined with 5-fluorouracil (5-FU) and mitomycin-C, followed by surgery. All had definitive resections resulting in 12.5% of operative specimens free of tumor and only 26.5% containing nodal metastases. The projected 5-year disease-free survival rate is 64% with an actuarial survival of 68%. No mortality or severe morbidity has been observed. Combined modality therapy is a safe and effective regimen for those rectal tumors in the high risk category.

Adenocarcinoma↗
PubMed1987

CT staging of early rectal carcinoma.

Of 43 rectal carcinomas, initially presumed to be modified Dukes' stage A or B-1, 42 were examined with computed tomography (CT) prior to endocavitary treatment or surgery in 40 cases. The CT correctly showed 28 patients to have early stages and incorrectly showed 2 to have perirectal extension. Three patients had anal neoplasms. The remaining 10 patients had disease stage B-2 or higher and CT was not good for staging them. A CT scan can fairly accurately stage rectal carcinomas stage A and B-1 grouped together, and is doing better in predicting the prognosis than digital palpation when histologic sections show well or moderately well-differentiated adenocarcinoma of the rectum.

Adenocarcinoma↗
PubMed1987

ACTH and adrenal aerobic glycolysis. I: Effects of O-nitrophenylsulphenyl and other ACTH analogues, vasoactive intestinal peptide and human parathyroid hormone(1-34) on lactic acid, steroid and cyclic AMP production by mouse adrenocortical cells.

The structural requirements in the ACTH molecule for evocation of the glycolytic response in suspensions of mouse adrenal cells were investigated by examining the effects of analogues containing modifications at positions 8, 9 and 10 and of peptides containing homologies with the amino-terminal segment of ACTH. Introduction of a nitrophenylsulphenyl (NPS) group into the tryptophan moiety at position 9 of ACTH(1-24) greatly reduced both the potency and the capacity for maximal glycolytic response. It also virtually abolished cyclic AMP formation. In contrast, the capacity for a maximal steroidogenic response remained unimpaired in the NPS derivative, although steroidogenic potency was reduced to 0.4% of that of ACTH(1-24). Replacement of the tryptophan moiety with phenylalanine had intermediate inhibitory effects on glycolysis and steroid output; replacement with alanine virtually abolished both these responses. Replacement of arginine in position 8 with lysine in the Phe9 analogue caused a fifty-fold increase in glycolytic potency, but rendered it steroidogenically inactive. Cyclic AMP production was abolished in the Ala9 analogue and greatly impaired in the Phe9 and Lys8,Phe9 analogues. Replacement of the glycine moiety in position 10 with L-alanine, D-alanine, beta-alanine or alpha-aminoisobutyric acid had little or no effect on steroidogenic or glycolytic capacity, although potency was reduced with all substitutions excepting L-alanine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex↗
PubMed1987

ACTH and adrenal aerobic glycolysis. II: Effects of aminoterminal peptide fragments on lactic acid and steroid production by mouse adrenocortical cells.

The effects of shortening the ACTH molecule from either end of the peptide chain on adrenal glycolysis and steroidogenesis were examined in mouse adrenal cell suspensions. Shortening the (1-24) sequence to (1-17), (1-16) and (1-14), thereby interfering with the basic tetrapeptide (15-18) assigned to the address message, progressively reduced both glycolytic and steroidogenic potencies by four, six and ten orders of magnitude respectively, without impairing the capacity for maximal excitation. The glycolytic potency of the (1-18) sequence, which was amidated at the C-terminal, equalled that of ACTH (1-24), but the steroidogenic potency was reduced by an order of magnitude. The (1-13) sequence of alpha-MSH, which contains substitutions at both terminals, had glycolytic and steroidogenic potencies intermediate between those of ACTH(1-16) and ACTH(1-17). Deletion of Ser1,Tyr2 from ACTH(1-18)-NH2 reduced both potencies by an order of magnitude. ACTH(11-24) and (7-38) were inactive or inhibitory. The capacity for excitation was further examined by comparing responses to peptide fragments (1-4), (1-10), (1-13), (4-10), (4-11), (5-10), (5-14), (7-13) and (11-24) at a concentration of 1 mmol/l. All fragments, excepting (1-4), (5-10) and (11-24) were active. The activities of fragments (5-14) and (7-13), as opposed to (5-10), suggest that the requirements for methionine in position 4 may be replaced by the (11-13) tripeptide.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex↗
PubMed1985

Lactic acid and steroid production by intact mouse adrenal glands and cell suspensions: effects of nucleotide derivatives and substrates.

The effects of the dibutyryl derivatives of cyclic GMP and cyclic AMP on lactic acid and steroid production were compared in intact mouse adrenal glands at concentrations of 0.5-1 mmol/l and in mouse adrenal cell suspensions at concentrations of 0.01-1 mmol/l. The dibutyryl derivative of cyclic GMP had little or no effect on lactic acid production in either tissue preparation. It caused a slight stimulation of corticosteroid output in intact glands at a concentration of 1 mmol/l, amounting to one-tenth of the response observed with 1 mM-dibutyryl cyclic AMP. Dose-dependent increases in lactic acid and steroid production were obtained with dibutyryl cyclic AMP in cell suspensions. AMP and GMP increased lactic acid but not steroid production. All the substrates tested (glucose, glucose-6-phosphate, fructose, fructose-6-phosphate, fructose-1,6-diphosphate, 10 mmol/l; pyruvate and glycerol, 20 mmol/l) stimulated basal glycolysis in intact glands and cell suspensions and none affected basal steroid production significantly. By far the greatest increase in lactic acid production was noted with fructose-1,6-diphosphate. However, only glucose and, in unsectioned glands, pyruvate exerted a potentiating effect on the glycolytic response to ACTH. Glucose potentiated the steroidogenic response to ACTH also, but only in intact glands. The relative ineffectiveness of dibutyryl cyclic GMP is in accord with the species-dependent differing responses to the free form of the cyclic nucleotides noted in mouse and rat adrenal glands. The substrate requirements are in keeping with a rate-limiting role of phosphofructokinase and an action of ACTH at some site between the entry of glucose into the cell and the formation of fructose-1,6-diphosphate.

Adrenal Glands↗
PubMed1982

Strategies for suicide intervention by telephone.

Within the authoritative role, the telephone counselor engages the caller in realistic talk of dying in an effort to reinstate control. Anxiety reduction is accomplished through problem clarification. Narrowing down open negative statements reduces diffuse anxiety, while reinterpreting events reduces energized anxiety. To provide hope, care can be proven as genuine implicitly by using the caller's name, filling conversation with emotive gestures, and extending "why" questions. Explicit proof can be in the form of active listening, tolerance of dispositions, and involvement such as suggesting milk, tissues, or calling on significant others. To further provide hope and to reinstate control, allowance is given for manipulation such as the caller setting the initial mood of conversation. A model is presented for pursuing alternatives and a technique of interrogative restating to broaden resources. Time-outs are posited for stymied intervention, detective work for discovering critical information, and guilt inducement as a means of recourse. To close the call, promises are extracted from and reinforcement statements are administered to the caller.

Counseling↗
PubMedDate not supplied

Placental abruption associated with cocaine use: case report.

The medical problems associated with cocaine ingestion, most notably cardiovascular side effects, have become evident as its use has become epidemic in the United States. Its effects on pregnancy and the developing fetus are similarly being recognized as more women of childbearing age are abusing cocaine. A case of placental abruption at 33 weeks' gestation following cocaine use is reported. A review of the pharmacodynamics, medical complications, teratogenic potential and effects in pregnancy is included.

Abruptio Placentae↗
PubMedDate not supplied

Hypertension education: an important and neglected part of the diabetes education curriculum?

This review highlights the important role of hypertension education in reducing the impact of hypertension on the development and progression of diabetes-related complications. Hypertension is commonly associated with diabetes mellitus and can significantly affect the progression of the complications of diabetes. Lifestyle changes similar to those recommended for diabetes management can result in a lowering of blood pressure and can be maintained on a long-term basis to benefit patients with diabetes and mild hypertension. Recently, a team approach in a hypertension clinic model similar to the team approach for diabetes treatment was shown to be effective in diabetes management. Increased awareness of hypertension education may contribute greatly to reducing the complications of diabetes. Hypertension education should be an important component of the diabetes education curriculum.

Antihypertensive Agents↗