Using Riehl's model in midwifery.
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Consumer Behavior↗
Biomedical subjects
N Brown
Publications and source records attributed to N Brown.
Low intensity laser therapy for chronic venous leg ulcers.
Ulceration of the lower extremities is one of the most important medicosocial problems (Skobelkin et al 1990). In this article, two case studies show that it is the length of time that laser therapy is used that can have a significant impact on ulcer size.
Aged↗
Has managed care been a success so far? Where is the managed care IS industry headed?
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Consumer Behavior↗
Teleradiology service providers.
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Humans↗
Determination and confirmation of the amnesic shellfish poisoning toxin, domoic acid, in shellfish from Scotland by liquid chromatography and mass spectrometry.
During 1998 and early 1999, shellfish samples from sites in Scotland were found to contain the amnesic shellfish poisoning toxin, domoic acid (DA). Two different techniques, liquid chromatography (LC) with UV diode-array detection and LC with mass spectrometric (MS) detection, were used to detect and confirm DA in shellfish extracts. The LC/UV method was validated for routine monitoring by recovery experiments on spiked mussel and scallop tissues with a certified mussel tissue used as reference material. Crude extracts of selected samples as well as extracts cleaned with strong anion exchange (SAX) were analyzed by both LC/UV and LC/MS. Good correlation (linear regression r2 = 0.996, slope = 0.93) between the 2 methods was found for cleaned extracts. Analyses of crude extracts by LC/UV produced false-positive results in 2 crab samples, whereas LC/MS analyses gave accurate results. It was concluded that LC/UV is a valid approach for routine monitoring of DA in shellfish when cleanup is performed with a SAX cartridge to prevent false positives. A variety of shellfish species were surveyed for DA content, including Pecten maximus (king scallops), Chlamys opercularis (queen scallop), Mytilus edulis (blue mussels), Cancer pugaris (crab), and Ensis ensis (razor fish). The highest concentration of DA was 105 microg/g in Pecten maximus.
Amnesia↗
Clinical pharmacology of 1-beta-D-arabinofuranosyl-5-azacytosine (fazarabine) following 72-hour infusion.
The clinical pharmacology of fazarabine (1-beta-D-arabinofuranosyl-5-azacytosine), a structural analogue of 1-beta-D-arabinofuranosylcytosine (ara-C) and 5-azacytidine, was assessed in 14 patients with various malignancies during a phase I trial. Since the starting dose for the protocol was low (0.2 mg/m2/hr over a 72-hr continuous iv infusion), a radioimmunoassay (RIA) using commercially available ara-C antibody and [3H]ara-C was developed to measure the anticipated low plasma drug levels. The assay could be used to measure fazarabine accurately in plasma and urine with a sensitivity of 0.08 ng/ml. The RIA does not require extraction of samples. Using both RIA and HPLC, similar results were obtained in plasma samples from a patient receiving a high dose (180 mg/m2/hr) of fazarabine. The assay is simple, sensitive, reproducible, and specific. Following the infusion, plasma levels declined triphasically with a terminal half-life of 5.7 +/- 2.0 hr. The AUC was linearly related to dose. When the various doses were normalized to 1.75 mg/m2/hr (the maximum tolerated dose as determined from the phase I trial) the mean AUC value was 4232 +/- 987 (ng/ml)hr. Plasma steady-state drug levels (CPss) were achieved in 2-4 hr and were linearly dependent to dose. Also, when normalized, the mean CPss was 58 +/- 13 ng/ml, which is within the reported concentration range necessary for inhibiting malignant cell growth. Total clearance was rapid, 528 +/- 138 ml/(m2.min), and not dose-related.
Adult↗
Enzymatic conversion of 5-fluoro-2'-deoxyuridine to 5-fluorouracil or 5-fluoro-2'-deoxyuridine 5'-monophosphate in human tissues.
The relative activities and Km values of pyrimidine nucleoside phosphorylase (PNPase) and thymidine (TdR) kinase were compared in postsurgical human tissues. TdR kinase, which activates 5-fluoro-2'-deoxyuridine (FUdR), was higher in normal liver than in other tissues examined. PNPase, which cleaves FUdR, was higher in normal spleen and liver and lowest in kidney. In normal lung tissue, almost all of the FUdR was cleaved at a high concentration since PNPase activity was much higher than TdR kinase activity. The affinity of TdR kinase as indicated by Km was greater in normal than in cancerous lung tissue. At a low concentration, FUdR is relatively well activated in the normal tissue; thus it may not be suitable for chemotherapy of lung cancer. When comparing normal versus cancerous colon tissues, no difference was seen in either TdR kinase affinities or TdR kinase and PNPase activities. However, the PNPase affinity for FUdR was significantly higher in normal than in cancerous colon tissue. When FUdR is maintained at low concentrations, it might have a selective cytotoxicity for colon cancer tissue since it is well cleaved in normal colon.
Biotransformation↗
Polyethylene glycol-L-asparaginase and L-asparaginase studies in rabbits.
Injections of polyethylene glycol (PEG)-L-asparaginase or L-asparaginase were given to two rabbits each at doses of 40 units/kg. Ten min following injection of either enzyme preparation, the plasma enzyme concentration was approximately 1 unit/ml. This level decreased steadily in the rabbits given L-asparaginase, with a t1/2 of approximately 20 hr. In contrast, the enzyme level in rabbits given PEG-L-asparaginase decreased much more slowly, with a t1/2 of approximately 144 hr. The slower disappearance rate of PEG-L-asparaginase resulted in greater values for the area under the concentration versus time curve and smaller values for total clearance. Immediately following the enzyme injections, no L-asparagine could be detected in the plasma, and a transient elevation of L-aspartic acid levels was noted. By 4 hr, the L-aspartic acid level in all of the rabbits returned to near normal. The L-asparagine, however, was not measurable as long as plasma enzyme was detectable. Levels of L-asparagine returned to normal 4 days after L-asparaginase administration, and 27 days elapsed before L-asparagine was detected in rabbits given PEG-L-asparaginase.
Amino Acids↗
Carcinoma of the ileum 25 years after bypass for regional enteritis. A case report.
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Adenocarcinoma↗
The relationship between social support and self-care practices.
A two-study approach was used to investigate the relationship between individuals' perceived level of social support and their performance of specific, positive health practices. One sample consisted of 97 adults, age 55 and older, attending activities at a senior citizen's center. The second sample was comprised of adults attending a health fair. Subjects were surveyed using the Lifestyle Questionnaire and the Personal Resources Questionnaire. The primary study hypothesis--that a strong, positive association would be found between the social support and health practices variables--was upheld for both samples. A secondary hypothesis--that married participants would score significantly higher on both the social support and health practices instruments than would their nonmarried counterparts--was supported only among the senior center participants. An additional hypothesis generated for the senior center participants--that participants with a confidant would have significantly higher scores on both the social support and health practices instruments--was upheld.
Adolescent↗
Stiffness and strength of fracture callus. Relative rates of mechanical maturation as evaluated by a uniaxial tensile test.
Mechanical evaluation of healing fractures in rabbits suggests that tensile testing both minimizes artifacts and permits direct intrinsic determinations of tissue quality. In healing osteotomies in the rabbit fibula, there is a rapid return of stiffness at 16 days, correlating with callus maturation. The failure mode proved to be a "delamination" fracture. Values for the strength of bone (3.3 N/m2) and fibrocartilage (0.2 N/m2) correlate well with the results of other studies but are probably values of maximum tissue adhesion strength.
Animals↗
Effects of marijuana on human pregnancy, labor, and delivery.
We conducted a prospective study of the effects of marijuana use in 35 pregnancies. Thirty-six age- and parity-matched nonuser pregnancies were selected for comparison. (Users of other illicit drugs were excluded from study.) Users and nonusers were similar with respect to most potentially confounding prenatal risk factors, although users tended to come from lower income and educational background. Most adverse outcomes of pregnancy were too infrequent to allow reliable comparisons between the groups, but the infants born to users exhibited significantly more meconium staining (57%, versus 25% in nonusers). Significant differences in duration of labor were also observed. Possible reasons for these findings are discussed.
Adolescent↗
Development of tumorigenicity and rearrangement of chromosome 1 correlates with down-regulation of cell-surface glycoproteins in human mammary carcinoma cell line.
In the current study, attempts were made to identify any products of normal breast cell genes, that may become inactivated in the malignant counterparts. Using an immune-tolerization/immunization procedure of generating antibody, two different cell-surface glycoproteins termed luminal epithelial antigen, LEA.92 and LEA.135 were identified. LEA.92 and LEA.135 expressions on MEC in a culture model-system, that reflect various steps of neoplastic transformation were detected on normal or immortalized MEC lines that were non-tumorigenic in nude mice. Furthermore, no rearrangement of chromosome 1 was observed in those cells. In contrast, both glycoproteins were undetectable on oncogenically transformed or established lines of mammary carcinoma cells that were tumorigenic. LEA.92 or LEA.135 negative cell lines exhibited a partial deletion of their chromosome 1. In tissue sections, LEA.92 expression was detected on the apical plasma membrane of normal and hyperplastic but not on the malignant mammary or extramammary epithelial cells (MEC). However, unlike LEA.92, LEA.135 was detected on certain cases of primary breast carcinoma cells, irrespective of morphological differentiation, in tissue sections.
Antibodies, Monoclonal↗
GP-based memory aid group benefits clients and carers.
A memory aid group was run for people with memory difficulties and their carers in a local health centre. It aimed to develop coping strategies that carers and clients felt they could put into practice in their own homes. While the numbers in the initial study were small, the group outcome suggested that providing a more localised service, linking mental health specialists and local nursing practitioners had advantages.
Aged↗
Teaching tips for clinical faculty from the Zen tradition.
BACKGROUND AND OBJECTIVES: Teachers of family medicine may improve their skills by examining teachers from other disciplines and cultures. The teaching traditions of Zen might be adapted to medical education. Zen teachers work to eliminate restrictive preconceptions about themselves, their teaching roles, and their students. They strive to encounter their students with their minds and their perceptions clear and to remain ever open to moments of spontaneity and creativity. Examples of how these principles may be used in medical education are presented.
Buddhism↗
The use of heparin and normal saline flushes in neonatal intravenous catheters.
PURPOSE: To compare the effects of heparin versus normal saline flush solutions on the duration of patency of peripheral IV catheters in neonates. METHODS: A quasi experimental design compared the outcomes in 87 infants who were 32 weeks or greater gestation at birth. Thirty-three received heparin and 54 received normal saline. RESULTS: There were 159 starts among the subjects. No statistically significant difference in duration of patency between the groups was found. The duration was significantly longer for term than preterm infants and for insertion in scalp, arm, or hand than for leg or foot. CONCLUSIONS: Gestational age and site of insertion were the only predictor variables related to duration of patency for IV catheters.
Catheters, Indwelling↗