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Biomedical subjects

M J Feldman

Publications and source records attributed to M J Feldman.

72 records · Page 4Linked to original sources
PubMedDate not supplied

Pair-feeding of sham-operated controls to rats with dorsomedial hypothalamic lesions: new evidence for an 'organismic' set point.

Weanling male Sprague-Dawley rats received electrolytic lesions in the dorsomedial hypothalamic nuclei (DMNL rats) and sham operations, respectively, and were maintained on lab chow ad libitum for 23 days (Expt. 1) and 55 days (Expt. 2). Following this period, one group of sham-operated controls was pair-fed to the DMNL rats, which were hypophagic compared to a second sham-operated group that was fed ad libitum. This period lasted 27 days (Expt. 1) and 24 days (Expt. 2). Although pair-fed controls were heavier than DMNL rats, they showed normal food utilization (EFU) in Expt. 1 and reduced EFU in Expt. 2. Pair-fed controls also had decreased carcass fat, hypoglycemia, hypoinsulinemia, hypotriglyceridemia and enhanced in vitro epididymal fat pad glucose oxidation when compared to DMNL rats. These data suggest that pair-fed controls cannot cope as efficiently with the reduced influx of substrate as do DMNL rats. Evidently, the reduced amount of food that DMNL rats spontaneously eat is adequate for their reduced body size, whereas this is not the case in the pair-fed controls. This is taken as evidence for a harmonious readjustment by DMN lesions of both body size and food intake and the underlying homeostatic processes and supports our concept of an 'organismic' set point that has been released by the DMN lesions.

Adipose Tissue↗
PubMedDate not supplied

Outcomes, clinical models and the redesign of behavioral healthcare.

Outcomes measurement and data-triggered improvements in treatment delivery are formidable challenges, in part because of their inherent interdependence. Outcomes systems need to provide reliable, valid and comparable data that can also guide transitions in care delivery. While there is much empirical support for the efficacy of psychiatric and behavioral healthcare interventions, it is incumbent upon those who know both the literature and clinical practice to participate in setting the future course of behavioral healthcare by stirring together the seemingly immiscible aims of good business and good care. This paper briefly reviews the importance of outcomes measurement systems and their use in redesigning treatment delivery in behavioral healthcare. It then describes a clinical care model now being implemented at Park Nicollet Medical Center, incorporating clinical and operational considerations, clinical outcomes measures and algorithms or decision trees into a framework for redesigning treatment and improving the delivery of appropriate clinical care.

Hospital Restructuring↗
PubMedDate not supplied

An evaluation of cytologic sampling techniques. A comparative study.

False negative cervical cytology is primarily due to errors in sampling. It has been demonstrated that combined ectocervical and endocervical sampling techniques will improve the yield. A prospective study was done to compare ectocervical and combined sampling with a selective technique in which the examiner determines the location of the squamocolumnar junction and chooses the appropriate method. The results demonstrate that combined ectocervical and endocervical sampling significantly increases the number of positive Papanicolaou smears. Selecting which cervices should be samples ectocervically and which need combined sampling does not significantly improve the yield over ectocervical sampling alone. It is the conclusion of this study that both ectocervical and endocervical sampling should routinely be used.

Diagnosis, Differential↗
PubMedDate not supplied

Uptake of myocardial imaging agents by rejected hearts.

Technetium 99 m pyrophosphate, Gallium 67 and Thallium 201 uptakes were measured in heterotopically transplanted rat hearts. Five days after transplantation, Technetium 99 m pyrophosphate, and Gallium 67 uptakes were significantly higher in allogeneic grafts than in syngeneic grafts. At an early stage of rejection (three days after transplantation), only Technetium 99 m pyrophosphate uptake in the left ventricle of allogeneic grafts showed a significant difference (p less than 0.04). At five days, Thallium 201 uptake was significantly lower in allo- than syngeneic grafts. There was a positive correlation between radionuclide uptake and histologic degree of rejection for Technetium 99 m pyrophosphate and Gallium 67 while Thallium 201 uptake correlated negatively. Analysis of variance revealed that hearts with no or minimal rejection had statistically different uptakes than hearts with mild to moderate rejection. These results suggest that uptake of imaging agents might be useful in the diagnosis of rejection of the transplanted heart.

Animals↗
PubMedDate not supplied

Allopurinol in prevention of reperfusion injury of hypoxically stored rat hearts.

We have studied the effect of the xanthine-oxidase inhibitor allopurinol on the performance of hypoxically stored rat hearts to evaluate the drugs' potential value in heart transplantation. Hearts were stored for 2 hours at 15 degrees C after potassium chloride cardioplegia. Hemodynamics were measured before hypoxia and after reperfusion. Hearts were treated with allopurinol in the cardioplegia, at the time of reperfusion, or with superoxide dismutase (SOD) and catalase (CAT) and compared with control hearts that received no treatment. Hemodynamic performance after hypoxia was significantly improved in the SOD/CAT group compared with the control group. Allopurinol-treated hearts were also significantly improved, especially when the drug was given in the reperfusion phase. Our results demonstrate the importance of free radicals during reperfusion of hypoxically stored hearts. Allopurinol and SOD/CAT may be of value in reducing such damage after heart transplantation.

Allopurinol↗
PubMedDate not supplied

Cost savings as an indicator of successful nursing intervention.

The purpose of this study was to provide cost-related data from an intervention study in the care of patients with peripheral vascular disease (PVD). In a previously reported study, the study group patients increased exercise more than control patients, but there were no differences on any other health promoting behaviors or clinical outcomes. However, analysis of the differences between the study (N = 44) and the control patients (N = 42) on costs for health care during the course of the study demonstrated substantial differences. A fixed per diem rate was used to determine inpatient and outpatient costs. Study patients required significantly fewer PVD-related hospitalization and health care costs than control patients but not on vascular-related and nonvascular-related illnesses. Since there were no differences between the study and control on non-PVD illnesses, it appears that the intervention targeted to influence PVD problems did so. Limitations to the study are identified and additional research in this area is warranted.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Effectiveness of health promotion interventions.

The purpose of the study was to determine whether patients who participated in an intervention program would improve exercise and foot-care habits, reduce smoking, and would, in turn, have fewer PVD-related illnesses than patients not exposed to the intervention. Eighty-six patients with ankle/brachial pressure indices of less than 1.0 on one or both legs were randomly assigned to a study (N = 42) or control (N = 44) group. All patients were assessed on a variety of health-related and activity behaviors prior to and again 26 weeks after enrollment in the study. Study patients who participated in the intervention worked with professionals on selecting programs designed to modify and improve their smoking, exercise, and/or foot-care habits. At the end of 26 weeks, chi-square analysis showed no significant differences between study and control groups on change in smoking and foot care, although the results were in the anticipated direction. Study patients who chose to increase their exercise showed greater increase than control patients in frequency (p = .001), distance (p = .007), and length (p = .002) of walks. Although behaviors were modified, especially in the area of exercise, it was felt that longer interventions on a larger sample size are needed.

Adult↗