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Biomedical subjects

K E Smith

Publications and source records attributed to K E Smith.

At least 145 records · Page 8Linked to original sources
PubMed1989

Infection control barrier techniques. Used by physicians during routine examinations. Parental attitudes.

Parents of 316 children seen in the outpatient clinics of a large pediatric teaching hospital completed a questionnaire regarding their attitudes toward the use of infection control procedures by doctors during the routine examination and treatment of their children. Results revealed that the majority of parents held favorable attitudes toward the wearing of gloves and masks during patient care activities. Parents who agreed that gloves and masks should be worn also tended to believe that diseases could be spread through cross-infection, that protective wear would prevent such infection, and that their children generally would benefit from these precautions. Parents of preschool-aged children felt that such procedures might make their children more fearful. These data indicate that many parents are basically supportive of the use of infection control procedures with their children and that such techniques do not appear to be an obstacle to effective relationships between health-care professionals and their patients.

Attitude↗
PubMed1989

Helping the child with cancer: what school personnel want to know.

As more children with cancer survive, the importance of facilitating school reintegration as a part of maximizing the quality of life has become evident. Workshops have been presented to school personnel to acquaint them with the issues facing cancer patients and their families, but there are gaps in our knowledge of what school personnel really need or want to know. In this study, 18 teachers of children with cancer and 15 teachers with no prior contact with students with cancer completed a questionnaire designed to assess needs, beliefs, and priorities with regard to working with cancer patients in the classroom. Significant findings included: (a) a consensus that a certain core of information about medical/psychological issues would be useful, and presentation of such information by psychologists and medical personnel working with such families would be optimal; (b) teachers having cancer patients as students were less likely to see the adaptation of siblings as an important issue; (c) teachers associated working with a student with cancer with less stress and demands on their time than predictable from previous studies; and (d) cancer patients as a whole were rated as having fewer behavioral, emotional, and learning problems than randomly selected students without a major illness, suggesting a "halo effect" or contradiction of some literature. Preliminary findings are detailed and implications are discussed for those attempting to help teachers facilitate students' adjustment to school following diagnosis and treatment of cancer.

Child↗
PubMed1989

Children's strategies for coping with pain.

Children's typical modes of responding to stress influence their ability to manage painful events. Coping skills mediate a child's response to pain that is associated with illness, injuries, and medical procedures. A number of factors can influence children's use of coping skills and their adaptation responding to pain, including cognitive-developmental level, previous experiences with painful events and children's belief in their ability to tolerate pain, parental support, and the extent to which the pain is acute or chronic and perceived as controllable by the child. There has been recent progress in the assessment of children's coping with distressing and/or painful experiences. Research in this area is providing a foundation upon which interventions can be tailored to a particular child's specific needs to assist him or her in the management of pain.

Adaptation, Psychological↗
PubMed1989

In vivo susceptibility of Campylobacter pylori.

Campylobacter pylori infection has been associated with duodenal ulcer, gastric ulcer, and non-ulcer dyspepsia. Although in vitro studies have shown that C. pylori is susceptible to most commonly used antibiotics, predictions from in vitro sensitivity studies have not led to a safe and generally effective therapy; C. pylori has proved to be very difficult to eradicate in vivo. We used the urea breath test to assess the susceptibility of C. pylori in vivo to various drugs. C. pylori was susceptible to bismuth subsalicylate, bismuth subnitrate, and furazolidone. C. pylori was not susceptible (i.e., urease activity remained despite administration of the drug) to the following drugs: 1) antiulcer agents (cimetidine, ranitidine, famotidine, omeprazole, misoprostol, sucralfate, liquid antacids); 2) NSAIDs (aspirin, indomethacin, ibuprofen, naproxen, tolmetin); 3) antibiotics (oral penicillin V, trimethoprim-sulfamethoxazole, dicloxacillin); 4) salts (lithium, ferrous sulfate, gold); 5) miscellaneous (acetaminophen, phenytoin, hydrochlorothiazide, propranolol, metoprolol, metoclopramide, ursodeoxycholic acid). Oral antimicrobials can be administered directly onto the site of infection, so that a very low oral dose will provide many multiples of the in vitro minimal inhibitory concentration. Furazolidone suspension (7 mg) was administered seven times daily (daily dose 49 mg) to three individuals infected by C. pylori during suppression of gastric acid secretion with famotidine (40 mg bid). After 4 days, all subjects had significant reductions in urease activity (two to normal and one to a borderline value). This response suggested that very low-dose therapy may be useful either alone or combined with bismuth. Conclusive establishment of an etiologic (or major contributory) relationship of C. pylori to ulcer disease will require a safe and reliable method to eradicate the organism from the stomach and duodenum.

Anti-Bacterial Agents↗
PubMed1988

Studies of the phosphoenzyme intermediate of the yeast plasma membrane proton-translocating ATPase.

The yeast plasma membrane proton-pumping ATPase forms a phosphorylated intermediate during the hydrolysis of ATP. The fraction of enzyme phosphorylated during steady-state ATP hydrolysis was studied as a function of substrate concentration (MgATP), Mg2+ concentration, and pH. The dependence of the fraction of enzyme phosphorylated on the concentration of MgATP is sigmoidal, and the isotherms can be fit with parameters and mechanisms similar to those used to describe ATP hydrolysis. The isotherm is significantly more sigmoidal at pH 5.5 than at pH 6.0, with the limiting percentage (100.mol of phosphate/mol of enzyme) of enzyme phosphorylated being 70% and 6%, respectively, at the two pH values. The maxima in the steady-state rate of ATP hydrolysis occur at higher concentrations of Mg2+ and higher pH than the maxima in the fraction of enzyme phosphorylated. This suggests that the rate-determining step for ATP hydrolysis is different from that for enzyme phosphorylation and the hydrolysis of phosphoenzyme is enhanced by Mg2+ and high pH. The rate of phosphoenzyme formation was investigated with the quenched-flow method, but only a lower bound of 140 s-1 could be obtained for the rate constant at MgATP concentrations greater than 2.5 mM. Since the turnover number for ATP hydrolysis under similar conditions is 14 s-1, the rate-determining step in ATP hydrolysis occurs after enzyme phosphorylation.

Adenosine Triphosphate↗
PubMed1988

Microbial transformations of steroids--I. Rare transformations of progesterone by Apiocrea chrysosperma.

When Apiocrea chrysosperma is incubated with progesterone for 7 days in a peptone, yeast-extract medium, eight major metabolites are produced. Each compound has been purified and its structure determined by high-field 1D and 2D 1H nuclear magnetic resonance (NMR) spectroscopy. A clear synthetic pattern is recognisable. The products have been formed by multiple transformation reactions, usually double hydroxylations. Seven compounds are tertiary alcohols in which the hydroxyl group is located on the underside of the progesterone skeleton at either the axial 9 alpha- or the axial 14 alpha-site. One compound has hydroxyl groups at both these sites. Five metabolites are also secondary progesterone alcohols, the hydroxyl groups being at the 6 beta-, 15 alpha- or 15 beta-sites. Two compounds are monohydroxy metabolites; one is dehydrogenated in ring B and the other has lost the pregnane side-chain. The structures of the eight metabolites are 6 beta, 9 alpha-dihydroxyprogesterone; 6 beta, 14 alpha-dihydroxyprogesterone; 9 alpha, 14 alpha-dihydroxyprogesterone; 9 alpha, 15 beta-dihydroxyprogesterone, 14 alpha, 15 alpha-dihydroxyprogesterone; 14 alpha, 15 beta-dihydroxyprogesterone; 14 alpha-hydroxypregna-4,6-diene-3,20-dione and 15 alpha-hydroxyandrostene-3,17-dione. All compounds, except the last one, are biologically rare because they are not products of mammalian progesterone or androstenedione metabolism. They would be difficult to synthesise chemically. We believe that the compounds, 9 alpha, 15 beta-dihydroxyprogesterone; 14 alpha, 15 alpha-dihydroxyprogesterone and 14 alpha-hydroxypregn-4,6-diene-3,20-dione, have not been reported previously as microbial transformation products of progesterone.

Basidiomycota↗
PubMed1988

Non-neuronal cell-conditioned medium regulates muscarinic receptor expression in cultured sympathetic neurons.

Regulation of muscarinic receptor expression was examined in cultured sympathetic neurons of the neonatal rat superior cervical ganglion. Receptor concentration was determined by measuring binding of the muscarinic antagonist 1-quinuclidinyl[phenyl-4-3H] benzilate (3H-QNB). 3H-QNB bound to one apparent class of noninteracting sites on sympathetic neuron membranes with a Kd of 28.9 pM and a Bmax of 2.91 pmol/mg protein. Binding increased as a linear function of tissue protein and was saturable. The number of receptors per milligram protein increased approximately 6-fold during 16 d of culture, and receptor numbers were down-regulated by treatment with the agonist carbachol. These observations suggested that measurement of 3H-QNB binding would provide a reliable estimate of muscarinic receptor number on cultured sympathetic neurons. To determine whether nonneuronal cells produce soluble factors that influence muscarinic receptor expression, the effects of treatment with rat fibroblast-conditioned medium (RFCM) were examined. Exposure of sympathetic neurons to 50% RFCM resulted in a 57% decrease in muscarinic receptor numbers without a change in the apparent Kd. The decrease in 3H-QNB binding in response to RFCM was dose-related, with a minimum dose of 15% RFCM required to observe a significant effect. In contrast to the carbachol-induced down-regulation, the reduction in binding after RFCM treatment was not prevented by atropine, indicating that the effect was not mediated by acetylcholine stimulation of muscarinic receptors. Binding of 125I-alpha-bungarotoxin, which labels a nonfunctional membrane site distinct from nicotinic receptors, was not altered by treatment with RFCM, indicating the selectivity of the change in membrane muscarinic receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Adolescent mothers' successful participation in a well-baby care program.

Previous research suggests that adolescent mothers and their infants may benefit from participation in specialized well-baby care programs. Yet the literature has not addressed the issue of predictive factors related to continued program participation. In a retrospective study, stepwise multiple regression analyses were used to explore this issue in 61 mothers from one well-baby program. The results were partially cross-validated using 59 other mothers. Mothers ranged in age from 13 to 17 years. Most were Black, single, and receiving public assistance. Twenty-two percent of the variance in the number of routine clinic visits made and 34% of the variance in the number of visits made for specific health problems were accounted for by the predictive equations. Cross-validation supported these results, with the most significant predictive variable for both measures of program participation being inconsistent appointment keeping.

Adolescent↗
PubMed1987

Evaluation of efficacy of four commercial enzyme-based cleaners of ultrafiltration systems.

Use of UF and RO in the dairy industry is rapidly expanding. Because the dairy industry demands high levels of cleanliness, this new technology requires close evaluation to assure adherence to these standards. Efficacy of four commercial enzyme-based cleaners (pH 7.0 to 8.4) in UF systems was determined by microbiological evaluation and permeate flux restoration. The UF system containing two polysulfone UF membranes in parallel, was soiled by recycling 380 L of sweet whey (40 degrees C) for 2.0 h followed by concentrating whey for .5 h. The cleaning cycle consisted of acid cleaner (.5 h, 40 degrees C), followed by enzyme cleaner (10.0 h, 40 degrees C), and rinsing (2.0 h, 40 degrees C). A chlorine sanitizer was circulated (5 min, 40 degrees C) and the unit containing sanitizing solution left idle overnight. Flux was determined and swabs and rinse water samples were taken immediately after soiling, after cleaning, and the next morning to check sanitizing. The four enzyme-based cleaners were unsatisfactory when microbiological criteria were considered. Loss of sanitizer strength and problems with yeast and especially mold growth over time also indicated lack of effective cleaning. Flux, however, was restored easily and did not correlate with efficacy of cleaning based on numbers of microorganisms remaining.

Dairying↗
PubMed1986

Changes in plasma catecholamine levels after insula damage in experimental stroke.

The effect of permanent occlusion of the left middle cerebral artery (MCA) on plasma catecholamine levels was investigated in chloralose-anesthetized cats. Two-5 h after occlusion of the MCA the plasma levels of norepinephrine, epinephrine and dopamine were significantly elevated (33%, 44% and 28%, respectively) compared to preocclusion levels only in animals in which the cerebral infarction involved the insular cortex. No significant changes were observed in plasma catecholamine levels in animals in which either the infarction did not involve the insula or in sham-stroked animals. These data suggest that withdrawal of inhibitory inputs from the insula on central cardiovascular regulating centers after stroke results in an increase in the activity of the sympathoadrenal system.

Animals↗
PubMed1985

Characterization of mammalian neurofilament triplet proteins. Subunit stoichiometry and morphology of native and reconstituted filaments.

The three major proteins of mammalian neurofilaments of molecular weights 179,000 (NF1), 129,000 (NF2), and 66,500 (NF3) have been purified to homogeneity by multiple anion-exchange and hydroxylapatite absorption chromatography in 8 M urea. Silver staining of polyacrylamide gels of the purified proteins show single bands. In order to gain further insight into the molecular organization of the neurofilament triplet proteins, the molar stoichiometries and morphologies of native and reconstituted filaments and those isolated from developing brain were studied. Denaturing polyacrylamide gel electrophoresis followed by quantitative dye-binding analysis shows that the molar ratio of the three components in neurofilaments isolated from bovine spinal cord myelinated nerve is 4:2:1 (NF3:NF2:NF1). Comparison of the molar ratios of each component in neurofilaments isolated from rat, bovine, and human brain shows a variation in the ratio of each of these polypeptides and raises questions about the physiological uniqueness of the molar composition of the neurofilament triplet. Reconstitution of the three bovine polypeptides into 10-nm filaments was accomplished under conditions in which the NF3 protein was limiting. Reassembly of 10-nm filaments with varying amounts of NF2 and NF1 indicate that the NF3 homopolymer has a limiting capacity to bind NF2 and NF1 and is saturated at a molar ratio of 2:2:1 (NF3:NF2:NF1). Isolation of the neurofilament complex at various stages of rat brain maturation indicates that NF3 and NF2 are integrated into the neurofilament complex as early as embryonic day 17, while NF1 copurifies with these proteins at postnatal day 16, eventually reaching a molar stoichiometry of 2:2:1 in the adult rat. The molecular stoichiometry of the neurofilament proteins, the differential integration of these proteins during brain development, and the variation of the molar composition between mammalian species suggest accessory roles for the NF2 and NF1 proteins in the neurofilament complex.

Amino Acids↗
PubMed1985

Guanine nucleotides regulate [3H]substance P binding in rat small intestine.

The binding of [3H]substance P (SP) to membranes of the rat small intestine demonstrates specific binding to receptors having more than one affinity for SP. The values of the binding parameters for the high-affinity site obtained from a non-linear regression analysis are as follows: KD = 0.25 nM, Bmax = 149.5 fmol/mg protein. Inhibition curves of 3H-SP binding using various unlabeled tachykinins show that the high-affinity receptor is of the P-subtype, having the highest affinity for SP and lower affinities for eledoisin and kassinin. Guanine nucleotides and sodium independently reduce the binding of 3H-SP to the high-affinity receptor in a dose-related manner; GTP and GDP are more potent than GMP. The reduction of specific SP binding by GTP can be ascribed primarily to an increase in the off-rate. The effects of guanine nucleotides on 3H-SP binding to membranes of rat small intestine suggest that the high-affinity receptor is linked to an effector by a GTP-binding regulatory protein.

Animals↗
PubMed1984

Performance appraisal: a positive management tool.

Employees want to know and need to know where they stand. Managers are expected to improve performance and stimulate productivity. What more logical way to fulfill both of these requirements than employee performance appraisals? Informal appraisals are made by every medical group manager on a daily basis. When these appraisals are channeled into a more formal, systematic appraisal program, management, employees, and the organization can all benefit. The ingredients of a positive, effective employee performance appraisal system are identified here and critical areas are addressed, including program prerequisites, setting up a workable plan, completing the written appraisal, and conducting the evaluation interview.

Employee Performance Appraisal↗
PubMed1983

Suprofen. An overview of long-term safety.

Suprofen, a new oral peripherally acting analgesic agent, has been shown to be effective in the relief of acute and chronic pain. This paper reviews data relative to long-term safety from more than 800 patients who received suprofen. Some of these patients were followed up to 2 years. Suprofen was generally found to be at least as safe and as well tolerated as reference drugs of aspirin, propoxyphene and propoxyphene combination. The discontinuance rate because of side effects was 17.7% for patients receiving suprofen and 23.9% for patients receiving reference drugs. Gastrointestinal side effects were the most frequently reported reasons for all patient dropout in all treatment groups. Fewer patients receiving suprofen discontinued due to gastrointestinal side effects (10.9%) than with reference drugs (17.2%).

Adult↗
PubMed1982

Does mixing pancreatic enzyme microspheres (Pancrease) with food damage the enteric coating?

Supplemental pancreatic enzymes are required for the treatment of malabsorption associated with cystic fibrosis. It is a general practice for enzymes to be sprinkled on, or administered in, food given to infants or children who require pancreatic enzyme replacement. We tested the effect of in vitro incubation of enteric-coated pancreatic enzyme microspheres with infant foods on total recoverable enzyme activity and on the enteric coating. Incubation of enzyme beads with foods with pH greater than 5 (i.e., chicken pH 6.5, veal pH 6.3, and green beans pH 5.6) was without significant effect on either parameter. There was a statistically significant, albeit minor, reduction in maximum enzyme activity recovered following incubation with applesauce (pH 3.5). In addition, the thickness of the enteric coating was significantly reduced. Whether changes in the enzyme beads results in improved or diminished efficiency of therapy remains to be determined. Lipase, unprotected by enteric coating, was rapidly inactivated in applesauce, emphasizing the need to instruct parents about which foods to avoid when administering pancreatic enzymes without enteric coating.

Food↗