Search PubMed⌕ Search

Biomedical subjects

J M Garrett

Publications and source records attributed to J M Garrett.

At least 37 records · Page 2Linked to original sources
PubMed1995

Activation of the Ras/cyclic AMP pathway in the yeast Saccharomyces cerevisiae does not prevent G1 arrest in response to nitrogen starvation.

Cells carrying mutations that activate the Ras/cyclic AMP (Ras/cAMP) pathway fail to accumulate in G1 as unbudded cells and lose viability in response to nitrogen starvation. This observation has led to the idea that cells carrying this type of mutation are sensitive to nitrogen starvation because they are unable to appropriately arrest in G1. In this study, we tested predictions made by this model. We found that cells with activating Ras/cAMP pathway mutations do not continue to divide after nitrogen starvation, show a normal decrease in steady state levels of START-specific transcripts, and are not rescued by removal of cAMP during nitrogen starvation. These findings are inconsistent with the idea that activation of the Ras/cAMP pathway prevents growth arrest in cells starved for nitrogen. Our finding that cells with an active Ras/cAMP pathway have dramatically reduced amino acid stores suggests an alternative model. We propose that cells at high cAMP levels are unable to store sufficient nutrients to allow return to the G1 phase of the cell cycle when they are suddenly deprived of nitrogen. It is this inability to return to G1, rather than a failure to arrest, which leaves cells at different points in the cell cycle following nitrogen starvation.

Amino Acids↗
PubMed1995

Medicare reimbursement for preventive care. Changes in performance of services, quality of life, and health care costs.

A randomized, controlled trial was conducted to assess the effects of a financial and office systems intervention to increase preventive care in physicians' offices for patients aged 65 years or older. A total of 1,914 patients from 10 primary-care medical practices in central North Carolina were randomized within practices to an intervention and a usual-care control group. The intervention consisted of full Medicare reimbursement to physicians for preventive care and health promotion packages (thus making these services free for patients), regular prompting of physicians to routinely schedule preventive care visits, a new office system in which nurses carried out many preventive procedures, and a form for charting preventive care. The performance of screening tests dramatically increased in the intervention group relative to control (P < 0.001), but there was evidence of lack of follow-up of abnormal findings by physicians. At the 2-year follow-up, there were minimal differences between intervention and control groups in health-related quality-of-life indicators. Relative to the $294 per patient 3-year cost to Medicare for waivered services, the intervention was reimbursed-cost neutral or slightly cost reducing ($190 over 3 years) for Medicare. It is concluded that adding reimbursement for preventive services to Medicare--even with the office systems changes made in this study--will not by itself lead to effective implementation of preventive services in community medical practices. To enhance patient benefit from preventive services, greater attention needs to be focused on an organized approach to patient follow-up.

Aged↗
PubMed1994

Gynecologists' sex, clinical beliefs, and hysterectomy rates.

This study determined how gynecologists' sex, beliefs, appropriateness ratings, and practice characteristics influence hysterectomy rates in North Carolina. Gynecologists who performed hysterectomies at higher rates were further from training, practiced in areas with fewer gynecologists, and had more patients with abnormal bleeding or cancer. Male gynecologists performed 60% more hysterectomies than female gynecologists, but this may have been because they were further from their training. Appropriateness ratings were affected by gynecologists' attitudes toward surgery, recency of training, and practice case mix, and by patients' expressed desire to avoid surgery, but they did not predict hysterectomy rates. To decrease their chances of undergoing hysterectomy, patients should express their preferences and possibly seek the opinion of more recently trained gynecologists.

Adult↗
PubMed1994

Factors responsible for immunizations referrals to health departments in North Carolina.

BACKGROUND: Despite the existence of Medicaid and other programs designed to eliminate cost as a barrier to immunization in physicians' offices, referrals to local health departments for immunizations are common. Many children leave their physicians' offices without receiving needed immunizations. PURPOSE: To determine: 1) the frequency and determinants of immunization referrals to health departments in North Carolina, and 2) the factors associated with private physicians' decisions to immunize Medicaid children in their offices and participate in the state-funded vaccine replacement program. METHODS: The 2537 pediatricians and family physicians licensed in North Carolina were surveyed by mail using a 23-item, self-administered questionnaire. RESULTS: Seventy-two percent of physicians responded; 93% referred at least some children to local health departments for immunizations. Concern regarding parents' ability to pay for immunizations was the most important reason for referral for 93% of respondents. Forty percent referred all or some of their Medicaid patients; excessive paperwork, inadequate reimbursement, and parental preferences were the most common reasons. Only 33% of physicians had participated in the state's vaccine replacement program. Family physicians, and physicians in solo or two-physician practices in rural counties, and in practices caring for a small number of children on Medicaid were most likely to refer children covered by Medicaid and not participate in the state's existing vaccine replacement program. CONCLUSIONS: Medicaid and North Carolina's vaccine replacement program are not preventing large numbers of immunization referrals to health departments. Future programs designed to increase the proportion of children immunized in physicians' offices will not succeed if more effective incentives for physician participation are not developed.

Child↗
PubMed1993

Life-sustaining treatments during terminal illness: who wants what?

OBJECTIVE: To determine patient characteristics associated with the desire for life-sustaining treatments in the event of terminal illness. DESIGN: In-person survey from October 1986 to June 1988. SETTING: 13 internal medicine and family practices in North Carolina. PATIENTS: 2,536 patients (46% of those eligible) aged 65 years and older who were continuing care patients of participating practices, enrolled in Medicare. The patients were slightly older than the 65+ general population, 61% female, and 69% white, and most had one or more chronic illnesses. MEASUREMENTS AND MAIN RESULTS: The authors asked the patients whether they would want each of six different treatments (hospitalization, intensive care, cardiopulmonary resuscitation, surgery, artificial ventilation, or tube feeding) if they were to have a terminal illness. The authors combined responses into three categories ranging from the desire for more treatment to the desire for less treatment. After adjustment for other factors, 53% of women chose less treatment compared with 43% of men; 35% of blacks vs 15% of whites and 23% of the less well educated vs 15% of the better educated expressed the desire for more treatment. High depression scores also were associated with the desire for more treatment (26% for depressed vs 18% for others). CONCLUSION: Patients' choices for care in the event of terminal illness relate to an intricate set of demographic, educational, and cultural factors. These results should not be used as a shortcut to determine patient preferences for care, but may provide new insights into the basis for patients' preferences. In discussing choices for future life-sustaining care, physicians need to explore with each individual the basis for his or her choices.

Aged↗
PubMed1993

The independent effects of obesity and body fat distribution on blood pressure in black adults: the Pitt County study.

The relationship of obesity measures to blood pressure and hypertension prevalence was assessed in a community probability sample of 25-50-year-old black adults (1101 women and 655 men) who were examined in 1988 in Pitt County, North Carolina. Among black women, both body mass index and waist-to-hip ratio had independent relationships with systolic and diastolic blood pressures and hypertension prevalence after controlling for the effects of age, socio-economic status, physical activity, alcohol, and the other obesity measure (P < 0.05). Body mass index also had independent relationships with blood pressure levels and hypertension prevalence in black men (P < 0.05), while waist-to-hip ratio was associated with hypertension prevalence (P = 0.05) and diastolic blood pressure (P < 0.05), but not with systolic blood pressure. The relationships of waist-to-hip ratio with blood pressure and hypertension prevalence were considerably reduced in both sex groups after controlling for body mass index. This study presents new evidence that waist-to-hip ratio is related to hypertension and blood pressure level independent of body mass index, in young to middle-aged black adult women and men.

Abdomen↗
PubMed1992

Socioeconomic status, John Henryism, and blood pressure in black adults. The Pitt County Study.

The joint influence of socioeconomic status and John Henryism on blood pressure was examined in a probability sample of 1,784 black adults aged 25-50 years in Pitt County, North Carolina, in 1988. John Henryism was measured by means of the John Henryism Active Coping Scale. Socioeconomic status (low, medium, and high) was based on respondents' education and occupation. Prior research indicated that, for blacks, the inverse association between socioeconomic status and hypertension may be stronger for individuals who score high in John Henryism. In this more urban sample of blacks, the hypothesized interaction achieved modest statistical support (p less than 0.08) only for hypertension prevalence. For individuals with high levels of John Henryism, adjusted prevalences declined with increasing socioeconomic status (29.4%, 26.2%, and 20.5% for low, medium, and high socioeconomic status, respectively); for individuals with low levels of John Henryism, hypertension prevalence was similar in the low (22.6%) and medium (22.8%) socioeconomic categories but higher in the high socioeconomic category (25.9%). Elevated psychological stress in white-collar workers was probably responsible for the nonsignificant inverse gradients between socioeconomic status and mean blood pressures and for the weak interaction between socioeconomic status and John Henryism with regard to hypertension prevalence.

Adaptation, Psychological↗
PubMed1991

A prospective study of advance directives for life-sustaining care.

BACKGROUND: The use of advance directives is recommended so that people can determine the medical care they will receive when they are no longer competent, but the effectiveness of such directives is not clear. METHODS: In a prospective study conducted over a two-year period, 126 competent residents of a nursing home and 49 family members of incompetent patients were interviewed to determine their preferences with respect to hospitalization, intensive care, cardiopulmonary resuscitation, artificial ventilation, surgery, and tube feeding in the event of critical illness, terminal illness, or permanent unconsciousness. Advance directives, consisting of signed statements of treatment preferences, were placed in the medical record to assist in care in the nursing home and to be forwarded to the hospital if necessary. RESULTS: In an analysis of 96 outcome events (hospitalization or death in the nursing home), care was consistent with previously expressed wishes 75 percent of the time; however, the presence of the written advance directive in the medical record did not facilitate consistency. Among the 24 events in which inconsistencies occurred, care was provided more aggressively than had been requested in 6 cases, largely because of unanticipated surgery or artificial ventilation, and less aggressively than requested in 18, largely because hospitalization or cardiopulmonary resuscitation was withheld. Inconsistencies were more likely in the nursing home than in the hospital. CONCLUSIONS. The effectiveness of written advance directives is limited by inattention to them and by decisions to place priority on considerations other than the patient's autonomy. Since our study was performed in only one nursing home and one hospital, other studies are necessary to determine the generalizability of our findings.

Adult↗
PubMed1991

Mitochondrial protein import: isolation and characterization of the Saccharomyces cerevisiae MFT1 gene.

Mitochondrial targeting of an Atp2-LacZ fusion protein confers a respiration-defective phenotype on yeast cells. This effect has been utilized to select strains that grow on nonfermentable carbon sources, some of which have decreased levels of hybrid protein localized to the organelle. Many of the mutants obtained were also temperature-sensitive for growth on all media. The recessive mft (mitochondrial fusion targeting) mutants have been assigned to three complementation groups. MFT1 was cloned and sequenced: it encodes a 255 amino acid protein that is highly basic and has no predicted membrane-spanning domains or organelle-targeting sequences. The MFT1 gene is 91% identical to an open reading frame 3' of the SIR3 gene. Evidence is presented that these two closely related genes could represent a recent gene duplication.

Amino Acid Sequence↗
PubMed1991

Physical activity and hypertension in black adults: the Pitt County Study.

The relation of physical activity to hypertension was examined in 1751 Black adults in Pitt County, NC. More women (65%) than men (44%) were classified as sedentary. Sedentary behavior was not associated with the prevalence of hypertension in men, but was associated with a 31% increase in prevalence for women (sedentary-26.2%; active-20.0%; P less than .01). The association in women was independent of other risk factors for hypertension.

Adult↗
PubMed1991

Socioeconomic status and electrolyte intake in black adults: the Pitt County Study.

BACKGROUND: Although the inverse association between socioeconomic status (SES) and blood pressure has often been observed, little is known about the relationship between SES and dietary risk factors for elevated blood pressure. Therefore, this study described the distribution of dietary intakes of sodium, potassium, and calcium and examined the association between electrolyte intake and SES among 1784 Black men and women aged 25 to 50 residing in eastern North Carolina. METHODS: Household interviews were conducted in 1988 to obtain information on psychosocial and dietary correlates of blood pressure. Electrolyte intake (mg/day) was assessed using a food frequency questionnaire adapted to reflect regional and ethnic food preferences. SES was categorized into three levels defined by the participant's educational level and occupation. RESULTS: After adjustment for age and energy intake, potassium and calcium intake increased with increasing SES for both sexes. Sodium intake was high for all groups and did not vary markedly with SES, but sodium to potassium and sodium to calcium ratios decreased with increasing SES. In addition, high SES individuals were more likely to believe that diet affects risk for disease and to report less salt use at the table and less current sodium consumption than in the past. CONCLUSION: These data indicate that nutritional beliefs as well as the consumption of electrolytes are associated with SES in Black adults.

Adult↗
PubMed1989

Characterization of AAT1: a gene involved in the regulation of amino acid transport in Saccharomyces cerevisiae.

A new class of Saccharomyces cerevisiae mutants (aat1 - amino acid transport) has been identified. These mutants are unable to grow on rich medium or on minimal medium supplemented with certain amino acids (isoleucine, methionine, phenylalanine, tyrosine or valine). This phenotype is directly linked to the presence of the leu2 allele in these strains: aat1 LEU2 organisms grow normally on all media tested. Leucine uptake through the leucine-specific permease is inhibited to less than 35% of wild-type levels in aat1 cells preincubated in nonpermissive media, and the activity of the general amino acid permease is also low in these conditions. aat1 cells are therefore unable to grow on rich media because they cannot take up enough leucine to supplement their auxotrophic requirement.

Amino Acids↗
PubMed1988

Thermal denaturation and coagulation of whey proteins: effect of sugars.

The thermal coagulation of unfractionated whey proteins was inhibited by various sugars. The disaccharides, sucrose and lactose, were most effective, and the amino sugar, glucosamine, least effective in this respect. Ultraviolet absorption and light-scattering measurements on the thermal denaturation and coagulation of both unfractionated and individual whey proteins (alpha-lactalbumin, beta-lactoglobulin, and bovine serum albumin) showed that sucrose promotes the denaturation of these proteins but inhibits their subsequent coagulation. These results are interpreted in terms of the effect of sucrose on the hydrophobic interactions between solvent and protein.

Animals↗
PubMed1983

S gene product: identification and membrane localization of a lysis control protein.

The product of the bacteriophage S gene has been previously shown to be required for an essential step in triggering host cell lysis. By using two different protein labeling systems, maxicells and UV-irradiated infected cells, we identified the S gene product as an 8,500-molecular-weight polypeptide associated with the cell envelope. The apparent molecular weight is significantly less than the 11,500 predicted from the S gene sequence. We were unable to confirm two previous identifications of S gene products, an acidic 15,000-molecular-weight polypeptide found by two-dimensional gel electrophoresis of infected cells and a 5,500-molecular-weight polypeptide in purified phage particles.

Bacteriolysis↗
PubMed1982

Lethal action of bacteriophage lambda S gene.

The functions of the bacteriophage lambda lysis genes S, R, and Rz were investigated. Different combinations of wild-type and inactive alleles of all three lysis genes were cloned into the plasmid pBH20 and were expressed under the control of a lac operator-promoter. The involvement of the Rz gene in lysis was proposed in our previous work and was confirmed by the Mg2+-dependent lysis defect of clones in which part of the Rz gene is deleted. Membrane vesicles prepared from induced S+ cells were shown to have a severely reduced capacity for active transport of glucose; this defect was detectable at least 20 min before lysis. Cell viability was also shown to decrease very soon after induction, long before physiological death and lysis; this decrease in viability is absolutely dependent on S expression and independent of R and Rz. The nonviable fraction of cells at any time after induction was demonstrated to be equal to the fraction committed to eventual lysis. Induction of an Sts clone showed that the S gene product is stable and capable of inducing lysis long after the cessation of synthesis of S gene product. A model for S action is proposed.

Bacteriophage lambda↗