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Biomedical subjects

L Lambert

Publications and source records attributed to L Lambert.

At least 37 records · Page 2Linked to original sources
PubMed1998

Length of stay for uncomplicated vaginal birth: a perinatal continuous quality improvement project.

Health care changes continue to challenge providers to reconsider how care is delivered. Shorter lengths of stay for mothers and newborns in California sparked the creation of a continuous quality improvement (CQI) project to reengineer care for women undergoing an uncomplicated vaginal birth. The perinatal service at the tertiary center discussed in the article has a birthrate of approximately 140 per month, about 43% of which are uncomplicated vaginal births. As a result of the CQI project, the length of stay decreased from 1.8 days to 1.4 days with no change in patient satisfaction and quality. The article illustrates the interdisciplinary process of CQI in the perinatal setting.

California↗
PubMed1996

Silicosis presenting as bilateral hilar lymphadenopathy.

Classical radiographic features of patients presenting with silicosis are diffuse interstitial shadowing with subsequent enlargement of hilar nodes, sometimes with "eggshell" calcification. Five case histories are described of workers who were exposed to silica and presented initially with bilateral hilar lymphadenopathy without radiographic evidence of interstitial lung disease. One case progressed to show features of silicosis.

Adult↗
PubMed1995

Identification and characterization of SNQ2, a new multidrug ATP binding cassette transporter of the yeast plasma membrane.

The SNQ2 gene of Saccharomyces cerevisiae, which encodes an ATP binding cassette protein responsible for resistance to the mutagen 4-nitroquinoline oxide, is regulated by the DNA-binding proteins PDR1 and PDR3. In a plasma membrane-enriched fraction from a pdr1 mutant, the SNQ2 protein is found in the 160-kDa over-expressed band, together with PDR5. The SNQ2 protein was solubilized with n-dodecyl beta-D-maltoside from the plasma membranes of a PDR5-deleted strain and separated from the PMA1 H(+/-)ATPase by sucrose gradient centrifugation. The enzyme shows a nucleoside triphosphatase activity that differs biochemically from that of PDR5 (Decottignies, A., Kolaczkowski, M., Balzi, E., and Goffeau, A. (1994) J. Biol. Chem. 269, 12797-12803) and is sensitive to vanadate, erythrosine B, and Triton X-100 but not to oligomycin, which inhibits the PDR5 activity only. Disruption of both PDR5 and SNQ2 in a pdr1 mutant decreases the cell growth rate and reveals the presence of at least two other ATP binding cassette proteins in the 160-kDa overexpressed band that have been identified by amino-terminal microsequencing.

ATP-Binding Cassette Transporters↗
PubMed1995

Imagery rehearsal treatment for chronic nightmares.

Fifty-eight chronic nightmare sufferers were randomly assigned to two groups: treatment (n = 39) and wait-list control (n = 19). Treated Ss were taught a cognitive-behavioral technique called imagery rehearsal in which they learned in a waking state to change a nightmare and then to visualize the new set of images. Subjects were assessed pre-treatment and 3 months followup for nightmare frequency, self-rated distress and subjective sleep quality. Compared to controls, the treatment group showed significant and clinically meaningful decreases in nightmares. Treated Ss decreased nightmares as measured in nights/week (mean = -2.0, SD = 1.7, P = 0.0001) and actual number of nightmares (mean = -4.2, SD = 4.5, P = 0.0001). Significant improvement in self-rated sleep quality occurred in those treated compared with controls (P = 0.004); and, reduction in nightmares was a significant predictor of improvement in sleep (r = 0.55, P = 0.0001). These preliminary results lend support to the theory that, for some chronic sufferers, nightmares may be conceptualized as a primary sleep disorder which can be effectively and inexpensively treated with cognitive-behavioral therapy.

Anxiety↗
PubMed1995

Baseline and mitomycin C (MMC)-induced sister-chromatid exchanges in XX and XY cells of Callithrix jacchus chimeric twins.

Lymphocytes from chimeric individuals of the species Callithrix jacchus (Primates) were examined to evaluate differences in the frequency of sister chromatid exchanges (SCE) between XX and XY cells. The aim was to discover whether SCE differ according to genetic sex and whether XX and XY cells show a different sensitivity to SCE inducing agents. This experimental model has enabled us to eliminate the possible differences caused by environmental factors. The results obtained do not reveal significant differences between male and female cells, in either the baseline SCE frequency or that induced by mitomycin C at concentrations of 0.01 and 0.03 microgram/ml. No significant differences were observed in the distribution of high SCE frequency cells (HFC), even if it is possible to observe a higher level of exchanges in XX cells in each trial. With regard to the phenotypic sex, there appears to be a trend towards slightly higher SCE rates in females, even if results are not statistically significant.

Animals↗
PubMed1995

Impact of environmental patient education on preventive medicine practices.

BACKGROUND: Studies show that provider-oriented reminders alone are less effective at increasing physician compliance with prevention guidelines than are combinations of patient- and provider-oriented physician reminders. The effectiveness of environmental patient education (ie, office-based videos, pamphlets, and posters) without individual staff or educator involvement has not been well established. The objective of this study was to evaluate the effectiveness of environmental patient education in increasing the amount of preventive services patients receive. METHODS: A nonrandomized controlled trial using historical controls was conducted in a model family practice clinic at the University of New Mexico School of Medicine in Albuquerque. The study group (n = 389) included adult women who had been seen at the clinic at a time when educational materials were present in the waiting area. The control group (n = 381) were similarly selected patients seen during the same period of the previous year, when no such materials were available. During the intervention, patients in the waiting area were exposed to educational materials that encouraged them to ask their physicians about cholesterol testing, Papanicolaou (Pap) smears, tetanus boosters, and mammograms. For both the control and study groups, physician orders for preventive services were monitored over a 4-month follow-up period by reviewing medical records. RESULTS: There were no statistically significant changes in the number of cholesterol tests, Pap smears, tetanus boosters, or mammograms ordered after the environmental patient education intervention, despite adequate statistical power. CONCLUSIONS: Environmental patient education materials were not effective in increasing the amount of preventive services performed by physicians in this study. Although such interventions are inexpensive, easily comprehended, and well intended, they may be ineffective in increasing the performance of patient preventive services.

Adult↗
PubMed1995

Risk factors for homelessness: a study of families of origin.

OBJECTIVE: This study's objective was to test the hypothesis that there are health issues and other factors in families of origin that have an association with, and may be risk factors for, homelessness. METHODS: This case control study identified risk factors in a group of homeless patients at a health clinic for the homeless. Two comparison groups from an academic family practice center were included. One comparison group was county indigent patients, and the other was patients who had health insurance. RESULTS: Significant differences in families of origin among these three groups were identified. On univariate analysis, homeless persons were found to have an increased prevalence of alcoholism in the family of origin, earlier departure from the home, minority status, a self-described negative childhood, experiences of abuse as a child, high birth order in large families, less parental education, less-skilled parental occupations, less feeling of love in the childhood family, less likelihood of the father being in the home, more risk of the father having been in jail, and less identification with a religious group. Multivariate analysis revealed that compared to the study groups, the following family of origin factors were associated with homelessness: ethnic group, alcoholism, feeling loved as a child, and having one's father in jail. CONCLUSIONS: Homelessness is a multifactorial issue, but risk factors can be identified that may distinguish individuals at increased risk. Root causes may begin in childhood and be related to the family of origin.

Adult↗
PubMed1994

Topical 0.050% betamethasone dipropionate. Pharmacokinetic and pharmacodynamic dose-response studies in humans.

BACKGROUND AND DESIGN: Effective topical drug therapy requires drug delivery into the skin to produce the desired pharmacodynamic response. For topical corticosteroids, the visual skin-blanching assay has been used to rank the potency of the corticosteroids and their overall efficacy. While vehicles have been shown to influence the resulting blanching response, the dose of drug applied has not always produced proportional differences in the blanching assay. The mechanism of the nonproportional pharmacodynamic response to the corticosteroid dose is unclear. We describe four methods for assessing the dose-response relationship of topical betamethasone dipropionate on the ventral forearm of six human subjects: duration, concentration, film thickness, and surface area. Drug uptake analysis in human stratum corneum and the resulting pharmacodynamic response, measured visually and with a chromameter, were performed with each method to quantify the dose-response relationship. RESULTS: Only the concentration and duration methods demonstrated an increase in mean drug uptake with increasing dose. The maximal mean pharmacodynamic response reflected the mean drug uptake with all four methods. Application conditions for maximal pharmacodynamic activity of topical betamethasone dipropionate in the skin include short duration of treatment (< or = 2 hours), a lower concentration than commercially marketed, and thin film thicknesses (1 to 5 microns). CONCLUSION: A dose response can be produced by increasing the drug concentration or the duration of application time. Achievement of steady-state betamethasone dipropionate uptake into the stratum corneum was not commensurate with the maximal pharmacodynamic response. Very small amounts of this potent corticosteroid within the skin appear to maximize the receptor response to drug.

Administration, Topical↗
PubMed1994

Histamine H2-receptor antagonists in peptic ulcer disease. Evidence for a prophylactic use.

The H2-receptor antagonists have undoubtably been successful in healing primary gastric and duodenal ulcers so there is a tendency to assume that they will be equally successful when used as prophylactic agents. When used to prevent gastroduodenal ulceration induced by nonsteroidal anti-inflammatory agents, they are unsuccessful in protecting against gastric damage, but reduce the incidence of duodenal ulceration. However, their effect on the incidence of serious complications remains unknown. In the prevention of stress ulceration and bleeding in intensive care units there is evidence of a beneficial effect of H2-receptor antagonists, but other agents are also equally effective. In patients who present with haematemesis and melaena, there is little evidence to show that H2-receptor antagonists reduce rates of transfusion or surgical intervention, or decrease mortality.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

Imagery rehearsal treatment of chronic nightmares: with a thirty month follow-up.

Nightmare frequency and self-rated distress were assessed retrospectively in two groups of chronic nightmare sufferers 30 months after treatment. In the initial phase, the image group (N = 9) learned a cognitive-behavioral technique (imagery rehearsal) for the treatment of nightmares. They were taught in one group session to: (1) record a nightmare; (2) change it (usually to something positive); and (3) rehearse the new images daily. The record group (N = 10) recorded nightmares during the first month only and learned imagery rehearsal subsequent to 3-month follow-up measurements. At 3 months and at 30 months, both groups had significantly fewer nightmares, but only the rehearsal group had less total distress. The results support the theory that nightmares are a primary sleep disorder rather than a symptom of an underlying psychiatric problem.

Analysis of Variance↗
PubMed1993

[Study of a group of diabetic patients enrolled in the INAMI convention "Self-monitoring of blood glucose"].

We have studied the clinical characteristics of 126 insulin-treated diabetic patients, mainly type I subjects, who regularly performed during 18 months home glucose monitoring. The numbers of strips used each month was of 60 +/- 33 (mean +/- lSD). During the study period, HbA1C levels decreased from 8.6 +/- 2.1 to 7.0 +/- 1.3% (p < 0.001). A significant decrease of HbA1C was also observed in a subgroup of 30 patients, in whom insulin therapy scheme (number of injections a day) was similar before and during home glucose monitoring. Our results confirm the benefits of regularly performed home glucose monitoring.

Adolescent↗
PubMed1993

Change is brewing.

Explore the source record for details and available documents.

Attitude to Health↗
PubMed1992

Portal vein thrombosis after acute pancreatitis: diagnostic confirmation with computed tomography during arterial portography.

Portal vein thrombosis is a rare complication of pancreatic inflammatory disease. Usually, the radiologic diagnosis is made either by ultrasonography, contrast-enhanced CT or angiography. Moreover, MRI seems a very promising method. CT during arterial portography (CTAP) focused on portal system proved to have a place in the evaluation of portal vein thrombosis in a particular case.

Acute Disease↗
PubMed1991

Effects of interparental violence on the psychological adjustment and competencies of young children.

Preschool children (N = 107) were divided into 4 groups on the basis of maternal report; home and shelter groups exposed to verbal and physical conflict, a home group exposed to verbal conflict only, and a home control group. Parental ratings of behavior problems and competencies and children's self-report data were collected. Results show that verbal conflict only was associated with a moderate level of conduct problems: verbal plus physical conflict was associated with clinical levels of conduct problems and moderate levels of emotional problems; and verbal plus physical conflict plus shelter residence was associated with clinical levels of conduct problems, higher level of emotional problems, and lower levels of social functioning and perceived maternal acceptance. Findings suggests a direct relationship between the nature of the conflict and residence and type and extent of adjustment problems.

Adaptation, Psychological↗
PubMed1989

Enhanced immunogenicity of a T cell immunogenic peptide by modifications of its N and C termini.

The modification of the terminal ionizable charges of an immunogenic peptide, HEL (46-61), was found to greatly increase the immunogenicity of the peptide. The modified peptide had 100- to 1000-fold enhanced activity in both in vitro and in vivo T cell assays. The mechanism of the enhancement was investigated by determining the binding affinities to I-Ak as well as circular dichroism (CD) studies. The native and enhanced peptides had indistinguishable binding affinities, as well as similar kinetics. The CD studies revealed that in aqueous solution, neither peptide had any detectable helicity; however, the addition of trifluoroethanol did result in significant helicity; with the two peptides being indistinguishable. These same modifications were also shown to enhance other immunogenic peptides if they contained a basic carboxy-terminal amino acid residue. Thus, by modifying the termini of T cell epitopes, their immunogenicity can be dramatically increased, but the molecular basis for this enhancement is still unclear.

Amino Acid Sequence↗