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Biomedical subjects

J Resnick

Publications and source records attributed to J Resnick.

At least 19 recordsLinked to original sources
PubMed1996

The quality of cervical cancer screening: a primary care perspective.

The bulk of cervical cancer screening is performed by primary care providers; mostly nurses and physicians. The literature regarding the quality of this screening is largely described from three perspectives; clinical, laboratory, and public health. This article describes the primary care perspective regarding issues of quality in cervical cancer screening and suggests areas for improvement. The authors discuss how effectiveness of the test, sampling methods, interpretation by the laboratory, and reporting results impact on the quality of cervical cancer screening. Other factors which influence the quality of screening such as access to care, recall intervals, communication with the patient, costs of testing, and organizational issues are also reviewed.

Communication↗
PubMed1994

Aggression and fighting behavior among African-American adolescents: individual and family factors.

OBJECTIVES: This study examined the extent to which individual and family factors are associated with aggression and fighting behavior among African-American middle school adolescents. METHODS: Four hundred thirty-six African-American boys and girls from two middle schools in a predominantly low-income North Carolina school system were surveyed and their school records examined. Information was collected concerning students' aggression levels, school fighting behavior, school suspensions for fighting, attitudes toward violence, perceptions of their families' attitudes toward violence, weapon-carrying behavior, and sociodemographics. Multivariate analyses were employed to predict the students' aggression levels, fighting behavior, and school suspensions. RESULTS: Factors related to the individual adolescents, such as gender, age, weapon-carrying behavior, and attitudes toward violence, were associated with students' reports of aggression and fighting behavior. Factors related to family and school were associated with school suspension for fighting. CONCLUSIONS: This study suggests that violence prevention programs set in our elementary and middle schools may reduce aggression and fighting among our youth. School teachers and public health practitioners are encouraged to work together in understanding and preventing adolescent violence.

Adolescent↗
PubMed1994

Cervical smears.

Explore the source record for details and available documents.

Family Practice↗
PubMed1993

Urological aspects of sacrococcygeal teratoma in children.

Sacrococcygeal teratoma is the most common extragonadal germ cell tumor of infancy. Associated urological complications, most of which are reported in children with malignancy, include vesicoureteral reflux, ureteral and urethral obstruction, and neurogenic bladder. To evaluate the influence of tumor grade and type on adverse urological outcome we reviewed the charts of 29 children with sacrococcygeal teratoma and correlated urological problems to lesion type and grade. No correlation was noted between tumor grade and the incidence of urological complications. The most common urological complications were neurogenic bladder in 12% of the patients, ureteral obstruction in 10% and vesicoureteral reflux in 7%. The highest incidence of urological complications (81%) was seen in patients with type IV (presacral) disease. We recommend early radiographic and neurourodynamic evaluation in all children with sacrococcygeal teratoma.

Female↗
PubMed1993

Papanicolaou smear quality assurance: providing feedback to physicians.

BACKGROUND: The effective management of Papanicolaou (Pap) smears depends on the reliability and accuracy of obtaining and interpreting the specimen. Provider sampling error is one of the important factors contributing to inadequate specimens. Feedback on provider performance may be an effective way to improve the quality of Pap smears. METHODS: A pilot study in a university-based residency program involving resident and faculty physicians was initiated to assess the impact of feedback on performance of Pap smears. After establishing adequacy and inadequacy criteria and recording adequacy rates for 3 months, individual and group feedback was implemented. No formal educational intervention on Pap smear technique was undertaken. RESULTS: The quality of 836 Pap smears performed by 9 faculty and 13 resident physicians showed continued improvement in both sampling and slide preparation to 90% adequacy over a 9-month period. This improvement, though clinically useful, was not statistically significant owing to the relatively small numbers of smears performed by each physician. This form of feedback may be useful in both practice and educational settings. CONCLUSIONS: Feedback without any formal educational intervention led to a clinically useful trend of improvement in the quality of Pap smears, which has been sustained since the study began. This type of simple feedback may be useful in practice settings and particularly valuable in pinpointing areas for improvement for learners in residency programs.

Academic Medical Centers↗
PubMed1993

Development of a Pap smear quality-assurance system in family practice.

BACKGROUND AND OBJECTIVES: To improve the effectiveness of cervical cancer screening, quality assurance programs can be designed to ensure that normal Pap smear results are dealt with appropriately and that Pap smears yielding inadequate specimen material are brought to a physician's attention. The objective of this study was to use a new Pap Smear Quality Assurance (PAPQA) system to determine and monitor the performance of physicians in a family practice over a two-year period. METHODS: We developed a PAPQA system designed to gather data and report on: 1) Pap smear adequacy, 2) reporting of abnormal results to physicians, and 3) follow-up of patients who had abnormal Pap smear results. We followed these parameters for two years. RESULTS: Over a two-year period, 2,771 cervical Pap smears were performed, of which 64% were normal. The percentage of Pap smears that yielded adequate specimen material improved from 82% to 91%, an improvement we attributed to feedback the system provided to physicians. Overall, Pap smear results and follow-up appeared in the medical record of 94% of patients who had abnormal findings. However, during the second year, the quality assurance system detected a deterioration in documentation of results and follow-up plans that coincided with moving the practice to a new facility. The operating cost for this program was approximately $950 per year. CONCLUSIONS: Quality assurance programs can effectively monitor physicians' performance in dealing with abnormal Pap smears, can detect deteriorations in performance, and can improve some aspects of performance through feedback reporting to physicians.

Family Practice↗
PubMed1992

Characterization of activated and normal mouse Mos gene in murine 3T3 cells.

We have characterized the mouse Mos proto-oncogene product, pp39Mos, in murine fibroblasts. When expressed in NIH3T3 cells under the influence of the long terminal repeat regulatory element from Moloney murine sarcoma virus [NIH(pTS-1) cells], the Mos protein was present in low levels and had a half-life of about 30 min. In extracts from NIH(pTS-1) cells, we detected additional forms of Mos protein that apparently arose from internal initiation codons (p24Mos and p29Mos) or from upstream non-AUG initiation codons (p42Mos and p44Mos). The Mos protein was found to exist in these cells as a phosphoprotein, pp39Mos, and, when immunoprecipitated with an antiserum specific for the Mos N-terminus [anti-Mos(6-24)], had autophosphorylating kinase activity. We found that anti-Mos(6-24) also detected non-Mos protein kinase activity and non-Mos phosphoproteins in addition to p39Mos. We present evidence, on both the RNA and protein levels, that non-transformed mouse 3T3 cells do not express endogenous Mos.

3T3 Cells↗
PubMed1991

A critical review of labor and birth care. Obstetrical Interest Group of the North American Primary Care Research Group.

A critical review of the literature regarding important aspects of labor and delivery was conducted by members of the Obstetrical Interest Group of the North American Primary Care Research Group using computerized searches, personal communication, and literature exchange between group members. Each written topic summary was carefully reviewed by a second group member, and a consensus was reached regarding conclusions and recommendations by the group. The topics include family involvement, comfort measures, fetal heart rate monitoring, labor augmentation, birth positions, and episiotomies. Each topic summary is preceded by conclusions and recommendations given in the order of least invasive to most invasive of the woman in labor. The strength of these conclusions and recommendations is based on the amount and type of supportive data in the literature and is indicated by one to three stars preceding that statement. One-star conclusions are not well supported in the literature but reflect a family practice style and were reached through consensus from the group. Three-star conclusions are supported by data from clinical trials.

Delivery, Obstetric↗
PubMed1989

DNA binding by the herpes simplex virus type 1 ICP4 protein is necessary for efficient down regulation of the ICP0 promoter.

The herpes simplex virus type 1 ICP4 and ICP0 polypeptides are immediate-early proteins that positively and negatively regulate expression of other viral genes in trans. ICP4 has recently been shown to bind DNA bearing the consensus sequence 5'-ATCGTCNNNN(T/C)CG(A/G)C-3', present upstream of a number of viral genes. To test the hypothesis that this DNA-binding activity is involved in ICP4-mediated gene regulation, site-specific mutagenesis was employed to mutate the version of this sequence in the promoter of the ICP0 gene. The mutation eliminated detectable binding of ICP4 to the promoter as measured in vitro by a gel electrophoresis band shift assay. The ability of the mutated ICP0 promoter to direct synthesis of a reporter gene was also investigated in a transient transfection assay. Whereas ICP4 was found to transactivate the wild-type ICP0 promoter two- to threefold, the mutated promoter was transactivated seven- to ninefold. In assays containing the ICP0 transactivator gene, ICP4 down regulated the wild-type promoter far more efficiently than the mutated promoter. Finally, both the wild-type and mutated ICP0 promoters exhibited a similar response to ICP4 in transfections that included a vector expressing the viral transactivator protein VP16. These experiments suggest that the sequence-specific DNA-binding activity of ICP4 is an essential element of its role as a negative regulator of gene expression.

Animals↗
PubMed1989

Patterns of uterine contractions and prolonged uterine activity using three methods of breast stimulation for contraction stress tests.

The contraction patterns in 378 breast-stimulated contraction stress tests administered to 213 women are described. The subjects were assigned sequentially to one of four intervention groups: bilateral manual breast massage, unilateral pump stimulation, heating pad stimulation, and placebo. There was a marked increase in the proportion of tests with three to four contractions in 5-minute intervals after the interventions occurred. Twenty-five percent of all tests showed prolonged uterine activity, occurring most frequently in women with postdate gestations using manual massage or breast pump stimulation. The duration of prolonged contractions ranged from 1.5-8 minutes, with 19% lasting from 4.5-8 minutes. There was no difference in the incidence of fetal heart rate abnormalities between tests with and without prolonged uterine activity, and no late decelerations occurred in tests with tachysystole.

Adolescent↗
PubMed1987

Retention of court-referred adolescents and young adults in the therapeutic community.

Client retention for Abraxas, a therapeutic community (TC) whose clients are almost exclusively court referred, was compared with that for nine other TCs that primarily accept clients not referred by the courts. Retention was found to be dramatically higher for Abraxas than for all nine comparison TCs during the first month of treatment. After the first month of treatment, discharge rates for Abraxas were lower than those for an aggregate of seven of the TCs but were comparable to rates for two others. At the end of 10 months, more residents remained at Abraxas than at eight of the nine comparison programs. These differences between Abraxas and the nine comparison TCs are particularly notable in that Abraxas' population is primarily juvenile whereas the comparison program populations are primarily adult. Analysis of the Abraxas sample showed that client retention was significantly higher for court referrals, adults, and males, and did not significantly vary according to ethnicity. The author conclude that court pressure can strongly enhance retention in therapeutic communities, particularly during the initial stage of treatment.

Adolescent↗
PubMed1987

Uterine hyperstimulation. The need for standard terminology.

The incidence of uterine hyperstimulation during oxytocin augmentation in labor and in breast-stimulated and oxytocin contraction stress tests showed a wide variation in a number of reported studies. One major reason is the lack of a standard definition of uterine hyperstimulation.

Female↗
PubMed1986

Construction and characterization of CV-1P cell lines which constitutively express the simian virus 40 agnoprotein: alteration of plaquing phenotype of viral agnogene mutants.

The simian virus 40 (SV40) agnoprotein is a 61-amino-acid polypeptide encoded in the leader region of some late viral mRNAs. Its function is unclear, although previous investigations suggest that the agnoprotein may function in late transcriptional regulation and virus assembly. To define the specific role(s) of agnoprotein in the SV40 lytic cycle, CV-1P cell lines were constructed in which the agnogene was stably integrated and constitutively expressed under the control of a retroviral long terminal repeat. Two types of cell lines were isolated. One group, typified by the cell line Ag18, produced low levels of agnogene-specific mRNA and agnoprotein. The other type, represented by a single isolate named Ag8, produced high levels of agnogene-specific mRNA and correspondingly high levels of agnoprotein. By indirect immunofluorescence, the agnoprotein was located predominantly in the cytoplasmic and perinuclear region of both cell lines; this is its site of localization in wild-type (WT)-infected CV-1P cells. Viruses that were agnoprotein-minus formed small plaques on normal CV-1P cells, but produced nearly WT-sized plaques on Ag18 cells. Conversely, the plaques formed on Ag8 cells infected with agnoprotein-minus mutants of WT SV40 were markedly smaller than the plaques formed by these viruses when they were grown on control cells. Overall, our results suggest that the agnoprotein is a trans-effector of virus production. The opposite effects on plaquing that were observed with Ag8 and Ag18 cells correlated with the very different levels of agnogene expression in the two cell lines. This suggests that the nature of the effect of the agnoprotein on virus production may vary depending on its intracellular concentration.

Animals↗
PubMed1986

Simian virus 40 agnoprotein facilitates normal nuclear location of the major capsid polypeptide and cell-to-cell spread of virus.

The simian virus 40 agnoprotein is a 61-amino-acid, highly basic polypeptide that is coded within the 5' leader of late 16S mRNAs. To better understand agnoprotein function and to more effectively differentiate cis-from trans-acting effects of an agnogene mutation, we constructed a mutant virus that carries a single-base-pair substitution and fails to produce agnoprotein. pm 1493 contains a T/A to A/T transversion at sequence position 335. This mutation converts the agnoprotein initiation codon from ATG to TTG, preventing synthesis of the protein. The mutant displays only a modest growth defect in CV-1P and AGMK cells and no defect in BSC-1 cells. Early-gene expression, DNA replication, synthesis of late viral products, and the kinetics of virion assembly all appear normal in pm 1493-infected CV-1P cells. Immunofluorescent studies, however, indicate that localization of the major capsid polypeptide VP1 is different in mutant- than wild-type virus-infected cells. Furthermore, the lack of agnoprotein led to inefficient release of mature virus from the infected cell. Agnogene mutants could be severely compromised in their ability to propagate in monkeys given their reduced capacity for cell-to-cell spread.

Capsid↗
PubMed1986

Prepartum and intrapartum breast stimulation in obstetrics. A review.

The publication of studies that describe the use of breast stimulation to produce or augment contractions before and during labor has grown rapidly over the last three years. Until recently, this physiologic phenomenon appears to have been little recognized in the medical literature, though references to the technique do appear in the medical literature from Hippocrates to the present.

Breast↗
PubMed1986

Uterine responses to three techniques of breast stimulation.

Uterine contractions produced by three methods of breast stimulation and a placebo were compared in 202 high-risk women between 35 and 44 weeks' gestation during contraction stress tests. Manual stimulation produced significantly more successful responses of three or more contractions within ten minutes than did a heating pad or a placebo, but did not show significant differences when compared with a breast pump. The placebo group showed an increase in contractions over a resting state. Of the women with successful contraction stress tests, over 50% demonstrated exaggerated uterine activity (a hypertonic contraction of greater than 90 seconds, or five or more contractions in a ten-minute period).

Adolescent↗
PubMed1983

Interaction of single-strand binding protein and RecA protein at the single-stranded DNA site.

Escherichia coli single-strand binding protein (SSB), which participates in DNA replication, also plays a role in DNA repair and induction of SOS functions. We show that the formation of RecA-dATP-single-stranded DNA complexes is influenced by the presence of SSB. In equilibrium reactions with limiting bacteriophage fd DNA, the mutant SSB113 protein competes more effectively than SSB with RecA protein for sites on the DNA. This result can account for the inability of strain ssb113 to amplify RecA protein synthesis and induce lambda prophage. SSB fails to displace RecA protein completely, even at very high concentrations. Both proteins inhibit the dATPase activity of RecA protein in spite of a large proportion of RecA protein still complexed to single-stranded DNA. Analysis of the multiple RecA protein activities and how they respond to the presence of SSB suggests that they fall into two distinct classes. Those that are enhanced by SSB (proteolysis and strand assimilation) and those inhibited by SSB (NTPase, reannealing of complementary single-stranded DNA). We propose a two-state model of conformational change of RecA protein, affected by the number of available free bases in single-stranded DNA relative to the number of RecA monomers, that would explain the choice of mutually exclusive catalytic activities.

Bacterial Proteins↗