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Biomedical subjects

M Morgan

Publications and source records attributed to M Morgan.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

Ifosfamide and mitoxantrone (I-M) in relapsed and refractory high grade non-Hodgkin's lymphoma and Hodgkin's disease.

Fifty-five patients, initially diagnosed as having advanced high grade non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) refractory to first-line treatment or in relapse, were treated with ifosfamide 6 g/m2, infused over 48 h, followed by mitoxantrone 12 mg/m2. The regimen repeated at three-weekly intervals. Of 32 patients with NHL evaluable for response, 10 (31 per cent) achieved complete remission and five partial remission, giving an overall response rate of 47 per cent. Two patients subsequently went on to bone marrow transplant (BMT)--one allogeneic and the other autologous. Of 17 patients with HD evaluable for response, six (35 per cent) achieved complete remission and six partial remission, giving an overall response rate of 71 per cent. Two of this group also went on to BMT (both autografts). The principal toxicity was neutropenia, though central nervous system changes were observed in 10 patients. Given the need to offer alternative treatment of patients in these categories, this combination (I-M) is clearly of value in relapsed patients especially where therapeutic options are limited because of previous multi-drug treatment.

Adolescent↗
PubMedDate not supplied

Twin-track studies of ifosfamide and mitoxantrone (I-M) in recurrent high grade non-Hodgkin's lymphoma and Hodgkin's disease. Yorkshire Regional Lymphoma and Central Lymphoma Groups.

Fifty-seven patients, initially diagnosed as having advanced high grade non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) refractory to first-line treatment or in relapse, were treated with ifosfamide 6 g/m2, infused over 48 h, followed by mitoxantrone 12 mg/m2. The regimen repeated at three-weekly intervals. Of 33 patients with NHL evaluable for response, 10 (30 per cent) achieved complete remission and six partial remission, giving an overall response rate of 48 per cent. Two patients subsequently went on to bone marrow transplant (BMT)--one allogeneic and the other autologous. Of 18 patients with HD evaluable for response, seven (39 per cent) achieved complete remission and six partial remission, giving an overall response rate of 72 per cent. Two of this group also went on to BMT (both autografts). The principal toxicity was neutropenia, though central nervous system changes were observed in 10 patients. The possibility of increasing the safety of the regimen by increasing the time of infusion to 72 h is discussed. Given the need to offer alternative treatment to patients in these categories, this combination (I-M) is of value in relapsed patients, especially where options are limited because of previous multi-drug treatment. Remissions may not be prolonged but allow the effective application of additional intensive treatment including bone marrow transplantation.

Adolescent↗
PubMedDate not supplied

The development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers.

This paper describes the development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers (low dependence drinkers consuming more than recommended levels). This work, which forms part of a larger matching study of brief intervention, is based on the general proposition that outcome expectations of reduced consumption might be more important than previously thought for understanding and predicting behavior change. Twelve outcomes, derived from interviews with excessive drinkers, formed the basis of a questionnaire, the Excessive Drinker Outcome Expectations Scale (EDOES), which examined not only the valence of each outcome, but a comparison between expectations of reduced consumption versus drinking usual amounts. The questionnaire was administered to 235 hospitalized excessive drinkers. Principal components analysis produced two scales, reflecting the costs and benefits of change. The questionnaire proved to have acceptable levels of test-retest reliability and predictive validity. Analyses of construct validity revealed that outcome expectations of reduced consumption were increasingly positive across stages of change.

Adaptation, Psychological↗
PubMedDate not supplied

Use of a mobile health van by a vulnerable population: homeless sheltered women.

Little is known about the health status of homeless women. In this study, we examined the health problems of and services provided to sheltered, homeless, Midwestern women who used a mobile health van. Our objectives were to document these women's ages, self-reported past medical histories, self-reported histories of addictions and hospitalizations, presenting concerns, diagnoses, and visit patterns. To this end, we performed a retrospective review of the 689 records of 408 women who had sought care during a 3-year period. The data were divided into three groups, representing women ages 15-25 (n = 111), 26-40 (n = 211), and 41-70 (n = 86). In all three age groups, respiratory disorders were most frequently treated. Preventive health maintenance concerns were also major concerns of all age groups. Recommendations for improving the quality, continuity, and follow-up of care are offered.

Adolescent↗
PubMedDate not supplied

The temperture inside carbon dioxide absorbers.

The temperature changes which occur when soda lime is used to absorb carbon dioxide were measured simulated clinical conditions. The temperature reached in the circle absorption system was found to vary with the room temperature; with a room temperature of 24 degrees C, all brands of soda lime tested reached 40 degrees C in the centre of the circle system. The 'to and fro' absorber achieved a central temperature approximately 5 degrees C higher than in the circle absorber. Temperatures at the periphery were always lower than those measured at the centre of the system. It is still advisable to avoid the use of trichloroethylene in the presence of soda lime and the absence of a safety lock on new anaesthetic machines is regrettable.

Absorption↗
PubMedDate not supplied

Antidepressant pharmacotherapy: economic evaluation of fluoxetine, paroxetine and sertraline in a health maintenance organization.

The present study was designed to compare direct health service expenditures, for the treatment of depression, among patients enrolled in a health maintenance organization, and prescribed one of three selective serotonin reuptake inhibitors, fluoxetine, paroxetine or sertraline. Information regarding depression-related health service use was derived from the computer archive of a network-model health maintenance organization system serving 700,000 beneficiaries. A total of 744 health maintenance organization beneficiaries were found to satisfy the study selection criteria. Multivariate regression analysis was used to determine the incremental influence of selected demographic, clinical, financial and provider characteristics on health service expenditures related to the treatment of depression (ICD-9-CM, or DSM-IV code 296.2) 1 year after the start of antidepressant pharmacotherapy. Multivariate findings indicate that treatment with paroxetine increases average expenditures for physician visits ($31.93; P < or = 0.05), psychiatric visits ($19.33; NS), laboratory tests ($2.35; P < or = 0.05), hospitalizations ($85.33; P < or = 0.05), psychiatric hospitalizations ($82.01; P < or = 0.05), and antidepressant pharmacotherapy ($63.72; P < or = 0.05), for a total per capita increase in health service use of $284.68 (P < or = 0.05), compared with treatment with fluoxetine. Sertraline treatment increases average expenditures for physician visits ($21.74; P < or = 0.05), psychiatric visits ($56.79; P < or = 0.05), laboratory tests ($1.21; P < or = 0.05), hospitalizations ($70.59; P < or = 0.05), psychiatric hospitalizations ($95.75; P < or = 0.05), and antidepressant pharmacotherapy ($69.85; P < or = 0.05), for a total per capita increase in health service use of $315.96 (P < or = 0.05), compared with treatment with fluoxetine. Economic comparisons between paroxetine and sertraline did not demonstrate any significant differences in expenditures for the health services examined.

1-Naphthylamine↗
PubMedDate not supplied

Prenatal care of African American women in selected USA urban and rural cultural contexts.

The purpose of this ethnonursing research was to systematically discover, describe, and analyze the beliefs, practices, and values of African American women related to prenatal care. The domain of inquiry was prenatal care of African American women within their familiar cultural contexts. The study was conceptualized within Leininger's Theory of Culture Care Diversity and Universality which enabled the researcher to study professional and generic care as influenced by the worldview, social structural factors, cultural values and beliefs, ethnohistory, and environmental context. The goal of the study was to discover knowledge that could be used by health professionals to provide culturally congruent prenatal care that would increase the health and well being of the people. The rationale for the study was based on studies that showed the lack of prenatal care in the African American cultural group leads to low birth weights and high infant mortality rates. Four major themes that focused on the domain of inquiry were identified: 1) Cultural care meant protection, presence, and sharing; 2) social structural factors that greatly influenced the health and well being were spirituality, kinship, and economics; 3) professional prenatal care was seen by the women as necessary and essential but there was distrust of noncaring professionals, and barriers to such care; and 4) folk health beliefs, practices, and indigenous health care providers were widely used by women in the African American community.

Adolescent↗
PubMedDate not supplied

General anesthesia in the presence of Eisenmenger's syndrome.

The theoretical implications of anesthetizing patients with Eisenmenger's syndrome are discussed and the anesthetic management of 16 such patients is described. A variety of technics were chosen which caused minimal depression of the cardiovascular system. These patients tolerate general anesthesia well and do not present the risks that have been suggested on theoretical grounds.

Adolescent↗
PubMedDate not supplied

Loss of heterogeneous ribonucleoprotein A(2)/B(1) expression in thyroid neoplasms.

OBJECTIVE: To determine whether a difference exists in the immunohistochemical expression of heterogeneous ribonucleoprotein (hnRNP) A(2)/B(1) between benign and malignant thyroid lesions and to assess whether a gradient of expression could be found in normal thyroid, adenomas, and thyroid malignant tumors. METHODS: Formalin-fixed, paraffin-embedded archival tissues from 32 cases (8 nodular goiters, 8 follicular adenomas, 8 follicular carcinomas, and 8 papillary carcinomas) were immunostained with monoclonal antibody 703D4, directed against hnRNP A(2)/B(1), applied at a concentration of 10 microg/mL. The streptavidin-biotin peroxidase method was used to label bound monoclonal antibody. Positivity was independently scored by two pathologists, who used a three-tiered scale. RESULTS: The benign thyroid tissues, including the hyperplastic and adenomatous lesions, demonstrated 3+ granular cytoplasmic staining for hnRNP A(2)/B(1), except in two cases (one nodular goiter and one follicular adenoma) in which 2+ staining intensity was noted. In contrast, the papillary and follicular carcinomas failed to stain with the antibody, except in two cases that showed weak (1+) staining. CONCLUSION: hnRNP A(2)/B(1) immunostaining appears to distinguish benign from malignant thyroid lesions. Loss of hnRNP A(2)/B(1) expression seems to be a characteristic feature of thyroid malignant lesions.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

Nicotine metabolism in stumptailed macaques, Macaca arctoides.

Stumptailed macaques received a single i.v. dose of 14C-nicotine (5 microCi and 300 micrograms/kg) on several separate occasions to establish baselines. Then they were pretreated with phenobarbital (2.0 mg/kg/day im for 7 days) and 8 weeks later pretreated with cimetidine (8.5 mg/kg/day im for 4 days). Nicotine in the same dose as before was readministered after each pretreatment. The baseline pattern of nicotine metabolism observed in plasma and urine, highly reproducible within and between macaques, closely resembled that previously reported in humans using GC and HPLC analysis. In urine, nicotine and eight metabolites were identified, including high concentrations of metabolites A and G. Recently discovered in humans, metabolites A and G are of special interest for their long duration in the body. Phenobarbital pretreatment accelerated rates of production of all nicotine metabolites except nornicotine and nicotine-1'-N-oxide, whereas cimetidine retarded rates of production of five metabolites. Sex differences in nicotine metabolism resembled those reported in humans. Collectively, these results suggest that the stumptailed macaque may be a useful model for certain aspects of nicotine metabolism in humans.

Animals↗