Biomedical subjects
Publications and source records attributed to K Davis.
Clinical supervision is an important feature of the education of the group therapist. The authors describe the application of a summary written by trainee cotherapists in their supervision. They found that the summary, which is supplied to the patients as well as to the supervisor, serves several functions that contribute to improved quality of clinical supervision and training of group therapists.
Twelve healthy subjects were placed on aspirin in a dosage of 600 mg five times daily for 14 days. The capability of their lymphocytes in culture to incorporate 3H-thymidine in response to phytohemagglutinin and allogeneic lymphocytes (one-way mixed lymphocyte culture) was measured before and after the course of aspirin. The results were compared with those obtained simultaneously from non-aspirin-treated control subjects. Statistical analysis showed no significant differences between lymphocyte response in the pretreatment and posttreatment periods or between aspirin-treated and non-aspirin-treated subjects. In contrast to previous reports of lymphocyte suppression resulting from addition of aspirin directly to lymphocyte culture and from orally administered aspirin, we conclude that comparable dose ranges in vivo do not suppress lymphocyte responsiveness to either phytohemagglutinin or allogeneic lymphocytes, at least within a 2-week period of treatment.
We measured the levels of serum folate and vitamin B12 in newly discovered hypothyroid (n =56) and hyperthyroid (n =47) patients and in age- and sex-matched control subjects (n =103). Except for one patient with latent pernicious anemia, serum folate and vitamin B12 levels did not differ greatly in our patients and in our control subjects. Another patient was receiving monthly injections of cyanocobalamin for previously diagnosed pernicious anemia. We conclude that abnormalities of thyroid function per se did not alter serum folate or vitamin B12 levels in our patients.
A localized, transplantable testicular tumor of the Fischer rat regularly produces hypercalcemia and increased phosphorus clearance in host animals. Light and electron microscopic examinations of the tumor indicate that it is of Leydig origin. There is no evidence that the tumor secretes any biologically active sex steroids, judges by weights of target tissues, when the tumor is grown in castrated or spayed rats. No radioactive steroid hormone formation in vitro was detected using 1-14C-acetate as a precursor although 14C was incorporated into the "C27" sterol fraction. Mass (micrograms) amounts of sex steroids were not detected after purifying large amounts of tumor extracts. The phytosterols, beta-sitosterol, stigmasterol, campesterol, were tentatively identified in tumor extracts but were also found in other tissues and in tumors not associated with hypercalcemia. Administered in vivo, human chorionic gonadotropin caused an acute rise in serum calcium in 3 to 5 hours in tumor-bearing hypercalcemic rats. Only trophic hormones with luteinizing hormone activity were found to compete with 125I-human chorionic gonadotropin for binding to the tumor homogenate in vitro indicating the tumor possessed luteinizing hormone receptors. When the tumor was transplanted intrasplenically, hypercalcemia did not occur unless adhesions formed, suggesting that the tumor hormone was rapidly metabolized by the liver and was probably of small molecular weight. Secretory granules, usually thought to be associated with peptide hormone secretion, were not detected at the ultrastructure level. Cortisol, conjugated estrogen, and an inhibitor of sterol biosynthesis (AY-9944) were effective in lowering the elevated serum calcium. Definitive identification of the agent causing lethal hypercalcemia has not been accomplished. The available data suggest it is not parathyroid hormone or vitamin D. The Leydig cell origin of the tumor, its response to human chorionic gonadotropin in vivo, the lack of secretory granules at the ultrastructural level, and biologic characteristics, all lead to the speculation that the secretory product of the tumor is a new hormonal substance, possibly a steroid precursor or related substance not previously described or is a known substance of small molecular weight whose calcium-mobilizing properties have not been fully characterized. This transplantable tumor may represent a model for one form of neoplastic hypercalcemia occurring in man and may have important implications in the general area of calcium and phosphorus homeostasis.
This paper analyzes the distribution of Medicare benefits among elderly persons on the basis of income, race, and geographical location. It first presents available statistical evidence from Medicare on the distribution of benefits and the magnitude of differentials among these elderly. It then sorts out the contribution to differentials arising from differences in the availability of medical resources. prices of medical services, and other demographic factors. The importance of various Medicare program features on remaining differentials--such as the cost-sharing provisions of Medicare, reimbursement policies, and nondiscrimination enforcement procedures--are then investigated. The effect of health status on utilization of medical services by the elderly is also analyzed, and the distribution of Medicare benefits by income for elderly persons of similar health status is presented. The paper concludes with recommendations for reducing differentials in Medicare benefits and indicates those policy changes which would result in a distribution of benefits more closely related to health care needs of the elderly.
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