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Biomedical subjects

K R Smith

Publications and source records attributed to K R Smith.

At least 127 records · Page 7Linked to original sources
PubMed1987

Energy intake: its relationship to colon cancer risk.

A case-control study was conducted to assess the role of diet in the etiology of colon cancer. Diet was measured by means of a comprehensive quantifiable food frequency history instrument in 246 cases and 484 controls drawn from the general population of Utah. Each subject's diet was described by major nutrient groups and total energy based on the nutritional content of foods reported. Cases reported higher daily food intake 5 years preceding diagnosis than controls [men, rate ratio (RR) = 2.5; women, RR = 3.6], as measured by total energy content of the diet. Higher risk of colon cancer with increasing energy intake was independent of stage of disease at diagnosis and obesity, as measured by body mass. Fat, protein, and carbohydrate intake all had elevated RRs but could not be assessed as risk factors independent of energy intake because of their strong correlations with total calories. Due to the higher energy intake of the cases, odds ratios for the daily intake of dietary fiber and vitamins A and C were also greater than 1. However, adjusting for caloric intake removed this effect, and dietary fiber showed a weak protective effect. Total energy intake must be evaluated before attempting to assign a causal role to any food or nutrient that may be postulated to play a role in colon cancer.

Adult↗
PubMed1986

In vitro activity of piperacillin, ticarcillin, and mezlocillin alone and in combination with aminoglycosides against Pseudomonas aeruginosa.

A total of 103 isolates of Pseudomonas aeruginosa were studied to compare the in vitro effectiveness of three beta-lactam antibiotics (piperacillin, ticarcillin, and mezlocillin) when used alone and in combination with four aminoglycosides (tobramycin, gentamicin, amikacin, and netilmicin). All drugs were tested as single agents against a standard inoculum (5 X 10(5) CFU/ml). The three antipseudomonal penicillins were also tested against the isolates at a higher inoculum concentration (10(7) CFU/ml). Synergy testing was performed by the two-dimensional checkerboard method and was defined by a fractional bactericidal index of less than or equal to 0.5 and bacterial killing accomplished at antibiotic concentrations no greater than those achievable in serum. All combinations were assessed for synergy. The degree of synergy was further analyzed by dividing the isolates into groups based on their susceptibility and resistance to the individual agents in the combination. The overall effectiveness of the various aminoglycoside-antipseudomonal penicillin combinations was assessed regarding their ability to kill the isolates either as single agents or through synergy. Piperacillin was the most active antipseudomonal penicillin, and tobramycin and amikacin were the most active aminoglycosides when used as single agents. When tested against isolates at a higher inoculum concentration, ticarcillin was significantly more active than the other beta-lactams. The highest degree of overall synergy was noted with gentamicin-ticarcillin (78.2% of strains) and amikacin-piperacillin (77% of strains). When assessed for overall effectiveness, all combinations containing amikacin were the most active. The combination of amikacin-piperacillin was the most effective, with activity against 96% of all isolates.

Aminoglycosides↗
PubMed1986

Morale: a spectrum of attitudes among nurses.

Survey research among a sample of just over 900 nurses reveals that at any time there are some factors operating to enhance morale while other factors are constraints upon morale. It is suggested that a number of current problems relating to nursing morale can be solved only by that profession itself. Within the article several avenues for such ameliorative action are suggested or implied. Among many nurses there is evidence of considerable tenacity in their dedication.

Attitude of Health Personnel↗
PubMed1985

New trends in surgical stabilization of thoraco-lumbar spinal fractures with emphasis for sublaminar wiring.

Sixteen patients with unstable thoracic and lumbar spinal fractures and fracture-dislocations were treated surgically by contoured Harrington instrumentation and spinal fusion. Instrumentation was supplemented by sublaminar wires above and below the level of injury. Complications occurred in ten patients. All had solid fusion at follow-up. No loss of reduction occurred. Fourteen patients had a Fewett hyperextension brace post-operatively, and two had no immobilization.

Adult↗
PubMed1985

Biomass fuel combustion and health.

Biomass fuels (wood, agricultural waste, and dung) are used by about half the world's population as a major, often the only, source of domestic energy for cooking and heating. The smoke emissions from these fuels are an important source of indoor air pollution, especially in rural communities in developing countries. These emissions contain important pollutants that adversely affect health-such as suspended particulate matter and polycyclic organic matter which includes a number of known carcinogens, such as benzo[a]pyrene, as well as gaseous pollutants like carbon monoxide and formaldehyde.Exposure to large amounts of smoke may present a health risk that is of a similar order of magnitude to the risk from tobacco smoke. The effects on health arising from exposure to air pollution are reviewed, based on what has been reported in the literature so far. Further and more detailed information on exposures and on the epidemiological aspects is urgently required.The persons most frequently affected are women who do the cooking for households in rural villages; they suffer from impaired health due to prolonged and repeated contact with these harmful pollutants. When they are pregnant, the developing fetus may also be exposed and this leads to the risk of excess deaths. In the developing countries, exposure to biomass fuel emissions is probably one of the most important occupational health hazards for women. A conservatively estimated 300-400 million people worldwide, mostly in the rural areas of developing countries, are affected by these problems.

Air Pollutants↗
PubMed1984

A comparison of existing and alternative competitive bidding systems for indigent medical care.

Competitive bidding is gaining in popularity as a means of containing costs in indigent medical care programs. The economic implications of the bidding systems employed by Arizona and California are discussed in light of the existing literature. Two alternative bidding approaches are proposed for consideration by policymakers--the sealed bid 'Vickrey' auction and the 'ascending Dutch' auction. While the incentives it contains for providers are not optimal, the ascending Dutch auction has the greatest potential for effective implementation since it accommodates the realities of public sector budget constraints and political pressures for direct control over program expenditures.

Arizona↗
PubMed1983

Computerized tomographic and pathologic studies of the untreated, quiescent, and recurrent glioblastoma multiforme.

Pathological findings in 20 cases of glioblastoma multiforme were correlated with clinical histories and computerized tomographic (CT) scans. This was done to define the neoplasm in three stages: before treatment, during remission, and during recurrence. The untreated lesions were markedly cellular neoplasms composed predominantly of small anaplastic cells. The radiographic central region of low density was necrosis, the enhancing rim was a cellular zone of viable neoplasm, and the perilesional low-density area was edema with infiltrating tumor. In these 20 cases, all of the identifiable neoplasms lay within the zone of peritumoral edema or contrast enhancement, although small anaplastic cells may have been present in more distant regions. The lesions in remission were remarkable for their minimal mass effect, discrete nature, extensive necrosis, and content of large bizarre glia. The large cells were confined to the original tumor bed and were consistent with neoplastic cells inactivated and immobilized by radio- and chemotherapy. These lesions were accurately localized by CT scanning. The recurrent lesions were heterogeneous, but most were formed of widely disseminated small anaplastic cells. The highly cellular regions of such lesions could be localized by CT scanning, but CT could not detect less cellular foci in the cerebrum, cerebellum, or brain stem. In one patient, the contrast-enhancing lesions of "recurrence," were foci of radionecrosis, underscoring the difficulty in distinguishing this entity from recurrent neoplasm.

Adult↗
PubMed1983

Comparisons of carmustine, procarbazine, and high-dose methylprednisolone as additions to surgery and radiotherapy for the treatment of malignant glioma.

Within 3 weeks of definitive surgery, 609 patients with histologically demonstrated, supratentorial malignant glioma were randomized to receive, in addition to 6000 rads of radiotherapy, one of four treatment regimens: carmustine (BCNU), high-dose methylprednisolone, procarbazine, or BCNU plus high-dose methylprednisolone. We analyzed the data for the total randomized population and for the 527 patients (87% with glioblastoma multiforme) in whom the initial protocol specifications were met (the valid study group). Significantly longer survival was experienced by patients receiving procarbazine or BCNU alone compared to those receiving only high-dose methylprednisolone. No other pairwise comparisons demonstrated differences significant at the 0.05 level. However, the combination of BCNU plus high-dose methylprednisolone tended to be less effective than BCNU alone in patients with poor prognosis. This study indicates that BCNU and procarbazine are moderately useful agents in conjunction with radiotherapy for patients with malignant glioma. In addition, future protocols may allow use of corticosteroids in conventional dosages for treating cerebral edema and controlling symptoms; conclusions based on survival as the endpoint are unlikely to be affected by administering steroids at somewhat greater than the usual dose. More effective regimens for the treatment of malignant glioma should be sought.

Adolescent↗
PubMed1983

Schistosomiasis: proline production and release by ova.

The production and release of proline was measured in cleaned ova of Schistosoma mansoni. Proline was found to be released at approximately 76 mumoles/100 cc of ova water/hr. This high rate of proline production was found to correlate with extremely active proline synthetic enzymes in the ova. Ornithine-delta-transaminase, which converts ornithine to delta 1-pyrroline-5-carboxylic acid, was found to be twice that of adult schistosomes and over seven times that of rat liver. delta 1-pyrroline-5-carboxylic acid reductase, which converts delta 1-pyrroline-5-carboxylic acid to proline, is also more active than the adult isoenzyme and 35 times more active than the rat liver isoenzyme. These data suggest that proline emanating from the ova may play a role in stimulating fibrosis in the granulomata of schistosomiasis.

Animals↗
PubMed1982

Surgical decompression after cerebral hemispheric stroke: indications and patient selection.

Decompressive craniotomy has a place in acute hemispheric infarctions. Patient selection should be guided by CT to exclude those with huge dominant hemispheric lesions that make reasonable neurologic recovery unattainable. Intracranial pressure monitoring should reduce the severity of neurologic sequelae by providing earlier, more timely operative intervention.

Brain Edema↗
PubMed1982

Extradural lipomatosis simulating an acute herniated nucleus pulposus. Case report.

A 48-year-old laborer presented with a 1-year history of low-back pain radiating into the posterior aspects of both thighs. Two weeks before admission, acute exacerbation resulted in signs and symptoms of compressive radiculopathy at L-5. Myelography revealed concentric constriction of the lower thecal sac due to abundant fat, as shown by computerized tomography. Laminectomy produced immediate relief of pain. The significance of these findings and a review of the literature are presented.

Adolescent↗
PubMed1981

Traumatic occlusion in fibromuscular dysplasia of the carotid artery.

A patient with fibromuscular dysplasia involving the cervical carotid artery developed subtotal occlusion after a trivial head injury. An association between occlusion in fibromuscular dysplasia-diseased carotid arteries and trivial blunt head injuries is suggested and appropriate treatment options are discussed.

Arterial Occlusive Diseases↗