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Biomedical subjects

K M Smith

Publications and source records attributed to K M Smith.

241 records · Page 14Linked to original sources
PubMedDate not supplied

Drugs used in acquaintance rape.

OBJECTIVE: To describe gamma-hydroxybutyrate (GHB), flunitrazepam, and ketamine and their purported uses to facilitate acquaintance rape. Patient presentation characteristics, treatment regimens, processes to detect the presence of the medications by toxicology screening, and methods to avoid exposure are discussed. DATA SOURCES: MEDLINE search from 1985 to 1998; additional references found within the articles; information obtained from the Internet. STUDY SELECTION: Clinical trials, reviews, and press releases concerning the use of GHB, flunitrazepam, and ketamine to facilitate acquaintance rape. Trials and reviews describing clinical effects, adverse effects, pharmacokinetics/pharmacodynamics, and usage trends were evaluated. Literature judged to be pertinent by the author was included in the discussion. DATA EXTRACTION/DATA SYNTHESIS: Reports of the use of GHB, flunitrazepam, and ketamine in acquaintance rape appear in the medical literature and lay press. Many health care professionals may not be familiar with these medications, and information about caring for patients under their influence is limited. Victims lose their ability to ward off attackers, develop amnesia, and are unreliable witnesses. Because symptoms caused by these agents mimic those of alcohol, not all victims are screened for their presence. Legislative efforts to further limit the use of or access to GHB, flunitrazepam, and ketamine have been initiated at the state and federal levels. Pharmacists should know the symptoms of exposure to the three agents; they should understand treatment regimens, methods to detect the presence of these and other drugs that may have been used in a sexual assault, and techniques individuals can use to avoid becoming victims of drug-assisted acquaintance rape. CONCLUSION: Because of their extensive drug knowledge and frequent access to patients, pharmacists are uniquely positioned to educate patients and other health care professionals about the dangers of acquaintance rape drugs and methods to reduce their risk of becoming victims.

Adjuvants, Anesthesia↗
PubMedDate not supplied

Reducing the transmission of HIV-1: needle bleaching as a means of disinfection.

OBJECTIVE: To review the efficacy, safety, and proper methods for use of bleach (sodium hypochlorite) as a means of needle disinfection. DATA SOURCES: Controlled studies cited in MEDLINE between 1966 and 1999 using indexing terms: needle, bleach, HIV/AIDS, and disinfection. STUDY SELECTION AND DATA EXTRACTION: Studies were categorized based on experimental conditions produced and specific testing procedures used. DATA SYNTHESIS: Used properly, undiluted bleach (sodium hypochlorite 5.25%) appears to be an effective disinfection solution for used needles. Proper needle disinfection with undiluted bleach may reduce the risk of HIV transmission among injection drug users from needle sharing. CONCLUSION: Pharmacists can play a role in reducing HIV transmission among injection drug users by advocating cessation of drug use, drug treatment programs, and avoidance of needle sharing. Pharmacists should be prepared to educate patients who are unwilling to cease illicit drug use or participate in drug treatment programs on the proper methods of bleach disinfection of used needles.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Recent molecular advances in studies of the concentrative Na+-dependent nucleoside transporter (CNT) family: identification and characterization of novel human and mouse proteins (hCNT3 and mCNT3) broadly selective for purine and pyrimidine nucleosides (system cib).

The human concentrative (Na+-linked) plasma membrane transport proteins hCNT1 and hCNT2, found primarily in specialized epithelia, are selective for pyrimidine nucleosides (system cit) and purine nucleosides (system cif), respectively. Both have orthologs in other mammalian species and belong to a gene family (CNT) that also includes members in lower vertebrates, insects, nematodes, pathogenic yeast and bacteria. The CNT transporter family also includes a newly identified human and mouse CNT3 transporter isoform. This paper reviews the studies of CNT transport proteins that led to the identification of hCNT3 and mCNT3, and gives an overview of the structural and functional properties of these latest CNT family members. hCNT3 and mCNT3 have primary structures that place them in a CNT subfamily separate from CNT1/2, transport a wide range of physiological pyrimidine and purine nucleosides and antineoplastic and antiviral nucleoside drugs (system cib), and exhibit a Na+:uridine coupling ratio of at least 2:1 (cf 1:1 for hCNT1/2). Cells and tissues containing hCNT3 transcripts include mammary gland, differentiated HL-60 cells, pancreas, bone marrow, trachea, liver, prostrate and regions of intestine, brain and heart. In HL-60 cells, hCNT3 is transcriptionally regulated by phorbol myristate (PMA). The hCNT3 gene, which contains an upstream PMA response element, mapped to 9q22.2 (cf chromosome 15 for hCNT1 and hCNT2).

Animals↗
PubMedDate not supplied

A nurse's story. The journey of a staff nurse.

This article describes the professional growth of a nurse who journeyed from being a staff nurse to becoming a coordinator of a national program. The critical turning points that fostered this nurse's development are detailed. The guidance and support of the nursing and hospital administration as well as the mentorship of fellow professionals were key in this developmental process. The communication of this story contributes to the varied tapes-try of professional nursing.

Anecdotes as Topic↗
PubMedDate not supplied

Changes in exercise capacity and lipids after clinic versus home-based aerobic training in coronary artery bypass graft surgery patients.

PURPOSE: Despite the documented benefits of participating in rehabilitation programs, access to cardiac rehabilitation is limited for a large number of people with coronary artery disease (CAD). There is potential to increase participation in exercise training if home-based exercise were a viable option. METHODS: We conducted a retrospective database review of 1,042 patients who took part in exercise rehabilitation following coronary artery bypass graft surgery (CABGS) between 1992 and 1998. Of these, 713 patients took part in supervised exercise, and 329 were in an unsupervised, home-based group. All exercise protocols were based upon American College of Sports Medicine guidelines, and patients in both groups received exercise prescriptions that were similar in intensity, frequency, and duration. RESULTS: There were no differences between groups at baseline. Following 6 months of exercise training, there were substantial improvements in peak VO2, peak workload, and peak MET levels in both the supervised and unsupervised groups (P < 0.0001). Patients in the supervised group had significant improvements in both LDL and HDL-cholesterol, whereas the home-based group showed improvement in HDL-cholesterol only. When analyzed by sex, men performed better than women for all measures of exercise capacity; however, women in both groups showed approximate 20% improvements (P < 0.05) in exercise capacity as well as improvements in HDL-cholesterol. CONCLUSION: Stable post CABGS patients who receive a detailed exercise prescription to follow at home do as well as those in supervised rehabilitation.

Aged↗
PubMedDate not supplied

Factors influencing postoperative urinary retention following orthopaedic surgical procedures.

This study was designed to identify factors contributing to postoperative urinary retention in patients undergoing hip and knee replacements and reconstructive surgeries. The clinical literature links post-operative urinary retention to various factors including a history of postoperative urinary problems, advanced age, the total amount of fluid replacement over a 24-hour postoperative period, type of anesthesia, pain management medications, and the route and length of medication administration.

Adolescent↗