P1: health and illness. Part (iii): Professionals and consumers.
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Biomedical subjects
Publications and source records attributed to M Davis.
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Three novel metabolites of the benzazepine SK&F 86466 (6-chloro-2,3,4,5-tetrahydro-3-methyl-1H-3-benzazepine) have been isolated from dog urine and characterized by tandem mass spectrometry, using fast atom bombardment and thermospray ionization, and 1H and 13C NMR spectroscopy. The parent drug undergoes oxidation to yield an N-oxide or N-demethylation to yield the primary metabolite SK&F 101055 (6-chloro-2,3,4,5-tetrahydro-1H-3-benzazepine). This desmethyl metabolite then undergoes N-sulfoconjugation to yield 6-chloro-2,3,4,5-tetrahydro-1H-3-benzazepine-3-N-sulfonate. Two glucuronide conjugates derived from the desmethyl metabolite were also isolated and characterized. One glucuronide is formed from an intermediate carbamic acid, formally derived from the addition of CO2 to the desmethyl benzazepine. A second glucuronide is derived from an intermediate hydroxylamine metabolite. Methodology for characterizing the carbamyl glucuronide was developed, using an ethanolysis reaction to give a stable ethyl carbamate derivative that can then be characterized by GC-MS. This methodology should prove useful in establishing whether such carbamylation reactions occur with other amines.
Excessive breast cancer mortality and limited use of mammography among black women point to a need for breast cancer education and increased use of breast self-examination (BSE) and other screening procedures. The Illinois Cancer Council (ICC), a consortial comprehensive cancer center, and the Chicago Chapter of the National Black Nurses' Association (CCNBNA) developed and piloted an educational project to increase black women's knowledge about breast cancer and their use of BSE and other screening methods. This paper describes the steps leading up to this collaborative effort, the procedures necessary to implement it, the difficulties encountered, and the impact of the educational program on the CCNBNA nurses and the high risk, hard-to-reach, underserved women who participated. This program is offered as a model for a collaborative effort between a cancer center or other healthcare facility and a professional organization to address unmet community health needs.
Gastric adenomas are uncommon, and multiple gastric adenomas are rare. We report an instance of three gastric adenomas found in an elderly man. Of the two polyps that contained histologic changes of malignancy, one measured 8 cm in length. The radiographic and pathologic findings are presented with a pertinent review of the literature.
Duplication of the inferior vena cava (IVC) is not an uncommon vascular anomaly. We describe here the appearance of double IVC by radionuclide angiography, computed tomography (CT) scan, and digital angiography. It is important to confirm the presence of duplicated IVC, which is usually first seen on CT scan, because patients undergoing certain surgical procedures would be at greater risk for injury to the IVC as well as other complications.
Peritoneal spread of non-Hodgkin lymphoma is rare: fewer than three percent of persons afflicted with this disease develop peritoneal spread. Pericardial involvement by non-Hodgkin lymphoma is equally rare. We report an instance of peritoneal and pericardial spread in a patient with non-Hodgkin lymphoma that was detected only by CT scan. The peritoneal lesions were not visible by ultrasound examination. A pertinent review of the literature is presented.
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Data from a street survey conducted among 717 women aged 17-35 in two inner-city Baltimore communities in 1991-1992 indicate that 17% of the entire sample, 38% of women using the pill and 11% of users of methods other than the pill used a condom in addition to another method the last time they had intercourse. Although adolescents reported the highest rate of combined condom and pill use (22% of 17-19-year-olds), condom use was significantly associated with pill use among adult women (odds ratio of 1.57) but not among adolescents (odds ratio of 1.03). Condom use was negatively associated with use of methods such as the diaphragm, the IUD, the implant and the sponge (odds ratio of 0.21) among both adolescents and adults. Logistic regression analyses show that positive attitudes toward safer sex, ever having refused sex without a condom and believing in condom efficacy all significantly predicted use of the condom with another method. Having ever been tested for HIV was negatively related to combined use, while behavioral risk factors showed no association.
Thirteen years into a devastating epidemic that is having a serious impact on women of color, we are only a few steps closer to genuine participation by women in AIDS clinical trials. Those who depend most heavily on research settings not only for the promise of an accessible cure, but also for life-prolonging therapies and state-of-the-art medical care are hurt most by exclusionary policies. Restrictive and contradictory federal policies, pharmaceutical company reluctance to complete animal toxicology and reproductive studies, inadequate informed consent, and unfounded industry fear of liability all play a part in keeping women with AIDS from participating in clinical research.
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