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Biomedical subjects

L Anderson

Publications and source records attributed to L Anderson.

368 records · Page 21Linked to original sources

Court-ordered foster family care reform: a case study.

The authors examine the implications of G. L. v. Zumwalt, a case that resulted in a far-reaching consent decree that mandates specific reforms in policy and practice to be implemented by a public social welfare agency in its delivery of services to foster children and their families.

Adolescent↗

The effects of protective equipment on styrene exposure in workers in the reinforced plastics industry.

This study was designed to determine whether styrene absorption through the skin results in measurable changes in biologic indicators of styrene exposure using a group of workers engaged in hand lay-up operations during which extensive styrene skin contact occurs. Serial measurements of expired breath and blood styrene and urinary excretion of mandelic and phenylglyoxylic acid were made in eight female workers during 4 consecutive days using different experimental conditions including either (1) gloves/protective clothing alone, (2) respirator alone, (3) both gloves/protective clothing and respirator, or (4) neither respirator nor gloves/protective clothing. A two-by-two factorial design imbedded in a Latin square design allowed estimation of the effects of the two types of protection (i.e., gloves/clothing and respiratory) and any interaction. Levels of styrene in venous blood and expired breath and urine mandelic and phenylglyoxylic acid excretion were no different when gloves/clothes were used as protection compared to no protection at all. Significant reduction in all biologic indices occurred when respiratory protection was used. The results of the study suggest that percutaneous absorption of styrene is not a significant exposure source and does not significantly contribute to the body burden of styrene of workers in the reinforced plastic industry engaged in hand lay-up operations. Respiratory protective devices were the most effective means for reducing styrene absorption. Even though skin absorption of styrene is limited, skin protection is necessary because of the risk of dermatitis.

Air Pollutants, Occupational↗

Luteal phase hyperprolactinemia.

OBJECTIVE: To determine the incidence of both isolated and repetitive prolactin elevations in the luteal phase of otherwise normoprolactinemic women. To see if sporadic luteal-phase hyperprolactinemia is associated with progesterone deficiency, and to explore a possible physiological basis for sporadic hyperprolactinemia by TRH challenge. SETTING: Hospital-based reproductive endocrinology/infertility service. DESIGN: Prospective measurement of luteal phase serum progesterone and prolactin in normoprolactinemic ovulatory women. TRH stimulation testing in volunteers with repetitive luteal phase hyperprolactinemia and normoprolactinemic controls. PATIENTS: 133 sequentially selected infertile, ovulatory women with normal prolactin levels in the proliferative phase of the cycle. INTERVENTIONS: Measurement of serum progesterone and prolactin during the luteal phase, based on the day of the LH surge. TRH testing in the midluteal phase of the cycle in patients with two or more luteal phase prolactin elevations, and in five normoprolactinemic volunteers in both the preovulatory and midluteal phase. RESULTS: Of 133 subjects, 85 (64%) had no prolactin level exceeding 20 ng/mL in the luteal phase. Thirty-three (25%) had two or more elevated levels, and were considered to have repetitive luteal phase hyperprolactinemia (LPH). TRH testing in control subjects resulted in a greater prolactin response in the preovulatory phase. The group with LPH demonstrated an initial elevation of prolactin greater than that of the normoprolactinemic controls, but a subsequent drop to levels lower than both preovulatory and midluteal normoprolactinemic controls by 45 minutes. CONCLUSIONS: Sporadic luteal-phase hyperprolactinemia is a relatively common event (36% of 133 subjects in the present series). Of these 48 women, 33 (69%) had repetitive elevations, suggesting the elevation in these subjects to be more than a random event. The physiological validity of this observation is further demonstrated by an abnormal response to TRH stimulation, but the normal levels of luteal phase progesterone leave questions as to its pathological importance.

Adult↗

Dornase alfa: a new option in the management of cystic fibrosis.

Recombinant human DNase I, or dornase alfa, is the first new therapy developed specifically for cystic fibrosis in almost 30 years. It selectively digests extracellular DNA and reduces the viscosity of purulent sputum. In clinical trials dornase alfa modestly improved pulmonary function, slightly decreasing the number of respiratory exacerbations requiring parenteral antibiotics compared with placebo. Phase III studies suggest that patients receiving dornase alfa also spend slightly fewer days in the hospital than those treated with placebo. The aerosolized preparation is safe and generally well tolerated. Voice alteration and sore throat are the most commonly reported adverse effects. Further research is necessary to determine the optimum time to initiate therapy and to evaluate the agent's pharmacoeconomic impact on the treatment of cystic fibrosis. Aerosolized dornase alfa should always be given in conjunction with standard cystic fibrosis therapies including antibiotics, chest physiotherapy, and pancreatic enzyme supplementation.

Administration, Inhalation↗