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Biomedical subjects

L Green

Publications and source records attributed to L Green.

At least 109 records · Page 6Linked to original sources
PubMed1996

Discharge of elderly people from an accident and emergency department: evaluation of health visitor follow-up.

Elderly people discharged directly home from an accident and emergency department are known to be a vulnerable group. The value of health visitor follow-up in patients aged 75 years and over was assessed in a random controlled trail; 222 intervention patients were seen at home by a research health visitor shortly after discharge and screened for new dependency and support needs, appropriate community services then being offered. These patients, and 192 controls for whom no special arrangements were made, were followed up four weeks later by a research occupational therapist. New dependency, most commonly trauma-related, was found in approximately 50%, and in the majority proved transient. Advice and/or referral to a wide range of services was offered to 92% of the intervention group. Service refusal rates were high in both groups. Compared to controls, intervention patients received more services and were significantly more independent at four weeks. Health visitor assessment was seen as helpful. In order to identify elderly accident and emergency department patients at risk following discharge, study data were used to derive a short questionnaire. In follow-up visits to 48 patients the use of this questionnaire was piloted, and its validity demonstrated. A number of study limitations and areas for development of discharge planning are discussed.

Activities of Daily Living↗
PubMed1996

An unusual association of Felty syndrome and TCR gamma delta lymphocytosis.

Felty syndrome, comprised of neutropenia, rheumatoid arthritis and splenomegaly, occurs in approximately 1% of patients with rheumatoid arthritis. Up to one third of these patients have an increased number of large granular lymphocytes. The usual immunophenotype of these cells is CD3+, CD8+, CD57+, T cell receptor (TCR) alpha beta. A patient with Felty syndrome and large granular lymphocytosis, who had an unusual immunophenotype CD3+, CD4-, CD8-, TCR gamma delta, is described. Her neutropenia responded to treatment with granulocyte colony stimulating factor (G-CSF), which was given in order to raise her neutrophil count prior to bilateral knee replacement surgery. Thus, Felty syndrome with large granular lymphocytosis is a heterogeneous condition, one in which TCR gamma delta large granular lymphocytosis may be found, and also shows a response to treatment with G-CSF.

Adult↗
PubMed1996

Establishing outreach health services for homeless persons: an emerging role for nurse managers.

Nurse-managed clinics can be an effective strategy for addressing the health care needs of homeless and indigent populations. The role of the nurse manager in the establishment of a clinic involves community leadership--specifically, it involves addressing strategic planning, financial and manpower issues. The collaborative relationship of nurse managers, educators, and the community laid the groundwork for accessible and affordable health care for the homeless and indigent of one northwest Georgia community. Specific tools and strategies are presented.

Ambulatory Care Facilities↗
PubMed1996

Commitment using punishment.

Experimental parameters were adjusted so that pigeons' pairwise choices among three alternatives reflected the following order of preference: (a) a smaller-sooner reinforcer, (b) a larger-later reinforcer, and (c) the smaller-sooner reinforcer followed by a punishment (consisting of an extended blackout period). After this order of preference was established, the pigeons were exposed to a two-link, concurrent-chain-like choice procedure. One terminal link consisted of a choice between the smaller-sooner and the larger-later reinforcer; the other terminal link was identical to the first except that the smaller-sooner reinforcer was followed by blackout punishment. The pigeons' preference (in their initial-link choice) for the terminal link with the punished smaller-sooner alternative increased as the delay between the initial and terminal links increased. By choosing this terminal link, the pigeons are said to have "committed" themselves to obtaining the larger-later reinforcer. However, unlike prior studies of commitment (e.g., Rachlin & Green, 1972), it was still possible after making the commitment for the pigeons to choose the smaller-sooner reinforcer and undergo the punishment. The pigeons did in fact occasionally make this highly deleterious choice.

Animals↗
PubMed1996

Gastric emptying in early noninsulin-dependent diabetes mellitus.

UNLABELLED: The aims of this study were to determine in early noninsulin-dependent diabetes mellitus (NIDDM): (a) the prevalence of disordered gastric emptying of glucose; (b) the relationship between the blood glucose response to an oral glucose load and gastric emptying; and (c) the relationship between appetite and gastric emptying. METHODS: Sixteen patients (ages 39-79 yr) with recently diagnosed NIDDM consumed 350 ml water containing 75 g glucose and 99mTc-sulfur colloid while sitting in front of a gamma camera. Blood glucose concentrations were monitored immediately before and after the drink. Hunger and fullness were evaluated using visual analog scales. The results were compared to those obtained in 13 normal subjects of similar age and body mass index. All patients and control subjects were white and non-Hispanic. RESULTS: Gastric emptying was slightly slower in the NIDDM patients when compared to the control subjects (retention at 180 min 15.9 +/- 2.3% versus 3.8 +/- 1.0%, p < 0.001), but there was no significant difference in the 50% emptying time between the two groups. In the NIDDM patients, there was an inverse relationship between the magnitude of the increase in the blood glucose concentration and gastric emptying, e.g., between the area under the curve for blood glucose from 0-60 min and the intragastric retention of the drink at 60 min (r = -0.60, p < 0.05). In the NIDDM patients, fullness was greater (p < 0.005) both before and after the drink, and the score for hunger at 30 min was inversely related to the rate of gastric emptying (r = -0.52, p < 0.05). CONCLUSION: In patients with early NIDDM, gastric emptying of 75 g glucose is similar to that of normal subjects and is a significant determinant of the glycemic response.

Adult↗
PubMed1995

RNA ligands to human nerve growth factor.

High affinity RNA ligands to human nerve growth factor (NGF) were selected from pools of random RNA using SELEX [Tuerk, C. and Gold, L. (1990) Science, 249, 505-510]. Nerve growth factor, which is a protein required for the development of neurons, is not known to bind nucleic acids as part of its natural function. We describe two of the selected RNA molecules in detail. One of them is highly structured, folding into a pseudoknot with an additional hairpin-loop; this structure provides salt-resistant binding to NGF. The other is unstructured and elevated salt concentrations inhibit its binding. These molecules compete with each other for NGF binding. Our RNAs may furnish useful diagnostic tools for the study of an important neurotrophic protein; additionally, they illustrate another example of the potential for nucleic acids to take part in novel binding interactions.

Base Sequence↗
PubMed1995

Crystal structure of the T4 regA translational regulator protein at 1.9 A resolution.

The translational regulator protein regA is encoded by the T4 bacteriophage and binds to a region of messenger RNA (mRNA) that includes the initiator codon. RegA is unusual in that it represses the translation of about 35 early T4 mRNAs but does not affect nearly 200 other mRNAs. The crystal structure of regA was determined at 1.9 A resolution; the protein was shown to have an alpha-helical core and two regions with antiparallel beta sheets. One of these beta sheets has four antiparallel strands and has some sequence homology to RNP-1 and RNP-2, which are believed to be RNA-binding motifs and are found in a number of known RNA-binding proteins. Structurally guided mutants may help to uncover the basis for this variety of RNA interaction.

Amino Acid Sequence↗
PubMed1995

[Destructive tuberculous osteoarthritis of the shoulder in the elderly].

Osteoarthritis (OA) due to tuberculosis (TB) is rare. The usual sites are the spine and weight-bearing joints, while joints such as the shoulder are less often affected. In recent years there has been a resurgence of TB, the rate of increase of extrapulmonary surpassing that of pulmonary TB. The elderly, especially residents of nursing homes, are at increased risk for active TB. The course of the disease is characterized by insidious development, and systemic involvement is usually not noted. Months or even years may elapse before the correct diagnosis is made, sometimes only after irreversible damage. We present an 82-year-old woman with TB OA of the shoulder, illustrating the importance of this curable disease in the differential diagnosis of chronic monarthritis.

Aged↗
PubMed1995

Comprehensive chemical modification interference and nucleotide substitution analysis of an RNA pseudoknot inhibitor to HIV-1 reverse transcriptase.

We had previously used in vitro RNA selection techniques to describe a consensus RNA pseudoknot that binds and inhibits HIV-1 reverse transcriptase (HIV-RT). In this work we constructed variants of this consensus pseudoknot in order to evaluate the contributions of individual nucleotide identities and secondary structure to affinity for HIV-RT. We have also used chemical modification of ligand RNAs to corroborate the predicted structure of the pseudoknot, to discover which modifiable groups are protected from chemical attack when bound to HIV-RT, and to find which modifications interfere with binding to HIV-RT. A novel interference study is presented which involves selection of ligands from a pool created by mixed reagent oligonucleotide synthesis in order to rapidly determine allowed substitutions of 2'-OCH3 groups for the usual 2'-OH group in such RNA ligands.

Antiviral Agents↗
PubMed1995

Anaemia in lambs.

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Anemia, Iron-Deficiency↗
PubMed1995

Clinical and administrative consequences of a reduced census on a psychiatric intensive care unit.

The Psychiatric Intensive Care Unit at the FDR VA Hospital is a specialized ward designed to assess and treat suicidal and assaultive patients. Since its creation in 1983, over 1600 admissions have taken place. The authors have previously reported that patients referred for aggressive behavior had a statistically significant higher recidivism rate, as well as a statistically significant longer length of stay. The unit went through several changes in response to externally perceived needs and available resources. When the census cap was decreased, the referral pattern changed and the patients were even more likely to be aggressive. Length of stay decreased dramatically leading to a unit with a significantly higher turnover rate. Clinical and administrative concerns are also discussed.

Aggression↗
PubMed1995

Serious adverse events in Norplant users reported to the Food and Drug Administration's MedWatch Spontaneous Reporting System.

OBJECTIVE: To describe serious adverse events in Norplant users from reports submitted to the Food and Drug Administration's (FDA) MedWatch Spontaneous Reporting System. METHODS: Reports of certain serious adverse events in Norplant users in the United States from February 1991 to December 1993 were reviewed and analyzed. RESULTS: From the introduction of Norplant in the United States in February 1991 to December 1993, the FDA received reports of 24 women hospitalized for infections at the insertion site, 14 hospitalized or disabled because of difficulties removing the capsules, 14 hospitalized for stroke, three for thrombotic thrombocytopenia purpura, six for thrombocytopenia, and 39 for pseudotumor cerebri. The comparison of reported rates with expected rates and the relationship of some of these disorders with oral contraceptives raises the suspicion of a causal association with Norplant. CONCLUSIONS: The FDA has received reports of hospitalization or disability for infections, capsule removal difficulties, stroke, thrombotic thrombocytopenia purpura, thrombocytopenia, and pseudotumor cerebri in Norplant users. Health care professionals need to be trained in Norplant insertion and removal to ensure the proper technique. Studies are needed to determine if stroke, thrombocytopenia, and pseudotumor cerebri are causally related to Norplant use.

Adolescent↗