Therapeutic renal transplantation in dogs is currently being investigated as a treatment for endstage renal disease. This pilot study examines the effect of donor bone marrow (DBM) infusion and antithymocyte serum (ATS) in combination with immunosuppressive drug therapy in prolonging renal allograft survival in dogs. Seven normal outbred mongrel dogs received an unmatched renal allograft. All dogs received rabbit anti-dog thymocyte serum (RADTS), prednisone (Pr), cyclosporine-A (CsA) and azathioprine (Aza). In addition, three dogs (group 1 test) received DBM and four dogs (group 2 control) did not receive DBM. Serum CsA levels were measured throughout the study. Immunosuppressive therapy was gradually reduced with Pr, CsA, and Aza withdrawn at 200, 450, and 680 days, respectively. Allograft rejection was treated with prednisolone sodium succinate. One dog in group 1 and one in group 2 died as a result of infectious canine rhinotracheitis and rejection early in the study. Renal allograft torsion occurred in one group 1 dog. The remaining four dogs survived the 2 years of the study. The dogs in group 2 (three dogs) all rejected the renal allograft after total drug withdrawal, the surviving dog in group 1 did not. This study demonstrates that RADTS, Pr, CsA, and Aza in combination can prolong renal allograft survival in mongrel dogs, whereas DBM may enhance the unresponsive state.

Animals↗

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Patient advocates or patient adversaries? Using fiduciary law to compel disclosure of managed care financial incentives.

Explore the source record for details and available documents.

Adult↗

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Interactive multimedia sexual risk assessment: using a video doctor to screen patients.

Sexual risk assessment is a vital component of early detection of HIV infection and other sexually transmitted diseases (STDs). We developed the Interactive Multimedia Sexual Risk Assessment, which uses a "video doctor" to question patients about risk-associated sexual behavior, and administered it to a convenience sample of 393 people. Their acceptance of the technology was evaluated, and their risk of contracting an STD was identified according to both liberal and conservative criteria. Most respondents (99%) reported that they had answered the questions truthfully, 74% reported that they had felt comfortable answering the questions, and 79% stated that they would return to the physician portrayed in the video. Fifty-nine percent were at risk for an STD according to the liberal definition, compared with 8% according to the conservative definition.

Adolescent↗

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HIV risk assessment: a video doctor seeks patient disclosure.

We assessed the influence of a "video doctor's" affective communication style (warm vs. neutral) and of a preamble to questions about sexual activity on patients' disclosure of risky sexual behavior and injectable drug use. To isolate the effects of the independent variables, we created an interactive multimedia program for HIV risk assessment using a video doctor portrayed by an actor. Participants were assigned to one of four conditions: no preamble and a neutral physician, no preamble and a warm physician, a preamble and a neutral physician, or a preamble and a warm physician. Almost 60% of a convenience sample of 393 subjects reported engaging in two or more risky behaviors. Disclosure of risky behaviors was not significantly affected by the preamble. A warm communication style elicited more disclosure than a neutral style, suggesting that physicians' communication style is important in determining how much sensitive information patients are willing to reveal.

Adult↗