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Biomedical subjects

L Lewis

Publications and source records attributed to L Lewis.

At least 19 recordsLinked to original sources
PubMed1995

Daily gastrointestinal symptoms in women with and without a diagnosis of IBS.

This study compared daily gastrointestinal symptoms and stool characteristics across two menstrual cycles, and recalled bowel symptoms and psychological distress in women with irritable bowel syndrome (IBS, N = 22), IBS nonpatients (IBS-NP, N = 22), and controls (N = 25). Daily reports of abdominal pain, bloating, intestinal gas, constipation, and diarrhea did not differ significantly between the IBS and IBS-NP groups but both groups reported significantly higher symptoms than the control group. Stool consistencies was significantly looser in the IBS group relative to the control group. Menstrual cycle effects on symptoms were noted in all the groups. There were no significant differences in psychological distress between women with IBS and IBS-NP, but both groups reported significantly higher global distress than the control group. The lack of difference between the IBS and IBS-NP groups in contrast to the results of others, can be understood in terms of differences in recruitment strategies.

Abdominal Pain↗
PubMed1995

The use of continuous quality improvement to achieve proper isolation of patients with suspected tuberculosis.

The infection control staff worked on their first project that used the methods of continuous quality improvement from January through July 1993. The purpose of this initial project was to achieve proper isolation of patients with suspected tuberculosis. Flowcharting revealed that appropriate clinical performance by the charge nurses was crucial, and cause and effect diagraming demonstrated the importance of good policies and procedures. The team hypothesized that the charge nurses' current knowledge of tuberculosis and isolation procedures was low and that fewer exposures would occur if a concerted effort were made to educate this particular group. A self-administered examination to test their knowledge base was completed by 87% of approximately 75 charge nurses. The average score was 48 of a possible score of 100. Eight education programs were given to the charge nurses; these included information about tuberculosis and revised policies and procedures. After the intervention, the test was readministered to a group of 20 charge nurses. Scores of this group improved by 49%. Mistakes were made and lessons were learned in this first continuous quality improvement endeavor. Despite the flaws in this project, its ultimate goal of reducing exposures to tuberculosis was achieved.

Algorithms↗
PubMed1995

Short- and long-term repeatability of fatty acid composition of human plasma phospholipids and cholesterol esters. The Atherosclerosis Risk in Communities (ARIC) Study Investigators.

We examined short-term and long-term repeatability (reliability) of the fatty acid (FA) composition of plasma phospholipids and cholesterol esters (CEs). For short-term reliability, fasting blood samples of 34 subjects were collected three times, 2 wk apart, and in 24 subjects duplicate samples were collected during each visit. For long-term reliability, two fasting samples were collected in 50 subjects approximately 3 y apart. In both phospholipids and CEs, short-term and long-term reliability coefficients were > 0.65 for the major plasma FAs (16:0, 18:0, 18:2n-6, and 20:4n-6), with the exception of 18:1n-9, but were generally lower for FAs that compose < 1% of total FAs. Reliability tended to be better for CEs than for phospholipids. Method variability was small (< 5% of total variability for most FAs), indicating that biological and dietary variability contribute most to total variability. Plasma FA measurement warrants consideration as a biochemical marker of diet in epidemiologic studies.

Cholesterol Esters↗
PubMed1995

Role of bradykinin B2 receptors in the developmental changes of renal hemodynamics in the neonatal rat.

The present study was performed to evaluate the role of bradykinin, acting via B2 receptors, in the developmental rise in renal blood flow (RBF) and glomerular filtration rate (GFR) in the rat. Newborn rats were chronically treated from birth with the kinin B2 receptor antagonist HOE-140 (600 micrograms/kg sc, every 12 h, n = 9) or 0.9% saline (n = 7). Weanling rats (mean age 23 days) were anesthetized with pentobarbital sodium (50 mg/kg ip) for measurements of mean arterial pressure (MAP), GFR, and renal plasma flow estimated from p-aminohippurate (PAH) clearance (ERPF). Outer cortical RBF (OCBF) was measured by laser-Doppler flowmetry. Baseline MAP was similar in HOE-140- and saline-treated rats (96 +/- 4 vs. 97 +/- 4 mmHg). Also, baseline GFR (0.65 +/- 0.05 vs. 0.52 +/- 0.08 ml.min-1.g-1) and ERPF (1.6 +/- 0.2 vs. 1.3 +/- 0.1 ml.min-1.g-1) were not different in HOE-140- and saline-treated rats, respectively. Intravenous infusion of 200 ng bradykinin did not change MAP or OCBF in HOE-140 rats but decreased MAP (-29 +/- 3%, P < 0.05) and OCBF (-20 +/- 2%, P < 0.05) in controls. Intravenous infusion of 25 ng angiotensin II increased MAP equally in both groups (-32 +/- 4%) and caused a similar reduction in OCBF (-37 +/- 14 vs. -46 +/- 5%). The angiotensin type 1 (AT1) receptor antagonist losartan (10 mg/kg iv) decreased MAP equally in both groups (-22 +/- 2%). However, AT1 blockade increased ERPF to 3.1 +/- 0.8 ml.min-1.g-1 (P < 0.05 vs. baseline) in saline but not in HOE-140 rats (1.9 +/- 0.4 ml.min-1.g-1). Kidney renin mRNA and angiotensin II contents were not different in HOE-140 vs. saline groups. The present findings indicate that bradykinin is not a primary mediator of the maturational rise in RBF or GFR in the rat. However, the data suggest that under control conditions, angiotensin II, acting via AT1 receptors, counteracts the renal vasodilatory effects of endogenous bradykinin in the developing kidney.

Angiotensin II↗
PubMed1995

Serotonin syndrome.

We describe a patient treated with trazodone, isocarboxazid, and methylphenidate hydrochloride who developed confusion, agitation, poor concentration, rigidity, myoclonus, involuntary movements, orthostatic hypotension, and hyperreflexia. CK was normal, and the syndrome resolved spontaneously over 12 hours. The serotonin syndrome occurs following the use of serotomimetic agents (serotonin reuptake inhibitors, tricyclic and tetracyclic antidepressants, tryptophan, 3,4-methylenedioxy-methamphetamine, dextromethorphan, meperidine, S-adenosylmethionine) alone or in combination with monoamine oxidase inhibitors. It is characterized by various combinations of myoclonus, rigidity, hyperreflexia, shivering, confusion, agitation, restlessness, coma, autonomic instability, low-grade fever, nausea, diarrhea, diaphoresis, flushing, and rarely, rhabdomyolysis and death.

Depressive Disorder↗
PubMed1995

Caring for the carers.

The author reports a small-scale study of stress in the labour ward. 25 labour ward staff were asked about stress at work. 80% felt stressed at work, citing overwork as the main cause, and talking to others as the main way of coping. Existing counselling facilities were found to be underused Stress did not appear to spread over into private lives. Only half of those questioned felt adequately supported at work. Participants were offered a 20-minute massage, and all felt this helped reduce stress. The average pulse rate of participants dropped by 12 beats per minute during massage.

Burnout, Professional↗
PubMed1994

Symbolization in psychotherapy with patients who are disabled.

Symbols created during the process of psychotherapy serve psychological functions of giving form and substance to previously murky experiences, making what is private something shared, and forging meaningful linkages among thoughts, emotions, and perceptions. Symbols can also enable therapist and patient together to gain insight into transference themes, transformations in identity, and feelings about life changes, as well as serve as guides to articulating treatment goals. Clinical vignettes are used to illustrate the process.

Adult↗
PubMed1994

Tubular fluid concentrations and kidney contents of angiotensins I and II in anesthetized rats.

Previous micropuncture studies have reported nanomolar concentrations of angiotensin II in proximal tubular fluid and have indicated that angiotensin II or a precursor may be secreted into the tubular lumen. Further experiments were performed to determine if proximal tubular fluid angiotensin I concentrations are also greater than plasma and kidney levels and to estimate the degree of intrarenal compartmentalization of the angiotensin peptides. Free-flow proximal tubular fluid samples were collected in micropipets and were pooled for each animal. At the end of each experiment, a blood sample was collected and the micropunctured left kidney was harvested and homogenized in methanol. The angiotensin I concentration in proximal tubular fluid samples averaged 6.1 +/- 1.2 pmol/mL, whereas the angiotensin II concentration averaged 8.1 +/- 1.6 pmol/mL (N = 13). HPLC analysis of a separate sample pooled from collections in five rats indicated that the immunoreactive angiotensin I and angiotensin II primarily represented authentic angiotensin I and II. Plasma concentrations of angiotensin I and angiotensin II averaged 0.39 +/- 0.09 and 0.15 +/- 0.03 pmol/mL, respectively. The kidney contents of angiotensin I and angiotensin II were 1.28 +/- 0.24 and 0.97 +/- 0.17 pmol/g of kidney, respectively. These findings indicate that proximal tubular fluid contains nanomolar concentrations of angiotensin I as well as angiotensin II. These high tubular fluid concentrations, which greatly exceed the plasma and kidney levels, likely reflect net secretion of the angiotensin peptides by proximal tubule cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin I↗
PubMed1993

Behavioral Intensive Care Unit (BICU): a new concept in the management of acute agitated behavior in elderly demented patients.

Intensive care units were developed in response to the perceived need for increased monitoring in critically ill medical patients. The same principle applies to elderly patients with severe agitated behaviors. These patients can be served by the Geriatric Behavioral Intensive Care Unit (BICU). The uniqueness of the program results from the application of a behavioral and environmental approach to the treatment of agitated behavior. The underlying strategy in the treatment process is to enhance the patient's ability to adapt to his or her home environment. Preliminary results have been encouraging, showing positive outcomes in diverse areas such as low level of institutional placement, patient quality of life, and caregiver symptoms of burden and depression.

Aged↗
PubMed1993

Antibodies to platelet glycoprotein V in polytransfused patients with haematological disease.

Polytransfused patients often develop platelet-reactive antibodies (PRAb). These give positive reactions in the platelet immunofluorescence test (PIFT) and may be either lymphocytotoxic (LCTAb) or platelet-specific antibodies (PSAb). The latter may be detected in the PIFT using chloroquine-treated platelets (Chl-PIFT) or by immunoblotting. Serial samples from 106 multiply transfused patients with bone marrow failure were screened by PIFT using a microplate method and flow-cytometric analysis. PSAb activity was confirmed by Chl-PIFT. In 45 (42%) of the patients studied PSAb were detected; 37 (35%) formed LCTAb and 19 (51%) had co-existent PSAb. Sera from 25 of 27 patients with a positive Chl-PIFT, retested by immunoblotting, recognised determinants of Mr 82-160 kD on whole platelets. A large group became sensitised to a component of Mr 105-115 kD reduced (99 kD non-reduced) with similar electrophoretic mobility to GPIIIa using a monoclonal anti-GPIIIa and two human polyclonal anti-HPA-1a sera; some also produced anti-GPIIb. The largest group recognised a determinant of Mr 80-83 kD, probably glycoprotein V (GPV). Three sera were immunoblotted against thrombin-treated platelets and the results confirmed GPV specificity.

Adolescent↗
PubMed1993

Evaluation of a supplementary retention program for black allied health sciences students.

The Medical College of Georgia's (MCG's) Minority Academic Advising Program (MAAP), which began in 1984, is a supplementary retention program for Black students. This paper describes an evaluation study of the effectiveness of MAAP within the MCG School of Allied Health Sciences (SAHS). The study sample consisted of 89 Black students who enrolled in the SAHS from fall 1978 to fall 1982 (preMAAP period) plus 129 Black students who entered the SAHS from fall 1984 through fall 1988 (MAAP period). The comparison group consisted of all other students who entered the SAHS (n = 1,884) within those same time periods. Using an evaluation design produced by merging a quasi-experimental and a time-series design, the authors found that the MAAP succeeded in increasing both the Black student retention-to-graduation rate and the time-persisted-in-program, to the extent that Black students achieved parity with other SAHS students.

Black or African American↗
PubMed1992

Anti-sulfatide antibodies in neurological disease: binding to rat dorsal root ganglia neurons.

Increased titers of anti-sulfatide antibodies were detected by ELISA in 5 of 200 patients and control subjects. All 5 patients had sensory impairment; 4 had neuropathy, and one had multiple sclerosis. Of the patients with neuropathy, 2 had a clinical syndrome of small fiber sensory neuropathy with normal electrophysiological or nerve biopsy studies, 1 had a sensorimotor axonal neuropathy associated with IgM monoclonal gammopathy, and 1 had sensorimotor neuropathy with multifocal motor conduction block and anti-GM1 antibodies. The anti-sulfatide antibodies bound to the surface of unfixed rat dorsal root ganglia neurons and human neuroblastoma cells, and to fixed sections of central and peripheral myelin. No binding was detected following intraneural injection into rat sciatic nerves. Pre-absorption with sulfatide but not with galactocerebroside eliminated the tissue binding activity. These findings indicate that increased titers of anti-sulfatide antibodies are found in patients with sensory impairment but are not restricted to a particular neurological syndrome or type of neuropathy. The significance of anti-sulfatide antibodies is uncertain although sulfatide on dorsal root ganglia neurons may be a target antigen.

Aged↗
PubMed1992

Evaluation of a summer prematriculation program for black and other nontraditional students.

This study evaluated the effectiveness of the Medical College of Georgia School of Medicine's Summer Prematriculation Program in facilitating participants' first-year achievement and retention from 1980 to 1989. The four-week curriculum included biochemistry, anatomy, immunology, learning skills, medical or anatomy terminology, and clinical forums. Of 101 black and 96 other nontraditional, at-risk students who had been invited to attend the program, the 115 attendees were compared with the 82 nonattendees on a variety of demographic and academic measures. For all measures examined, no statistically significant difference was found between the two groups. Several factors may have obscured the results. However, there were indications that the program had a favorable effect, including the evaluation by over 90% of the attendees that the program had contributed positively to their adjustment to medical school.

Black or African American↗
PubMed1992

Prematriculation program grades as predictors of black and other nontraditional students' first-year academic performances.

This study explored the relative strengths of select background variables, including grades in a summer prematriculation program (SPP), as predictors of students' first-year academic performances. During the years 1980-1989, 115 black and other nontraditional prematriculants at the Medical College of Georgia School of Medicine attended a four-week SPP featuring courses in biochemistry, anatomy, and immunology. Canonical correlation analysis revealed that the combination of undergraduate grade-point average (GPA) and SPP grades in biochemistry and anatomy was the best predictor of the students' academic performances based upon their first-year grades in biochemistry, anatomy, and microbiology, and upon their GPAs for all first-year basic science courses. The authors conclude that SPP grades can be used to identify the specific academic weaknesses of nontraditional students at highest risk of falling into academic jeopardy.

Black or African American↗