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Biomedical subjects

R Abramson

Publications and source records attributed to R Abramson.

11 recordsLinked to original sources

Expression of c-fos in human and murine multidrug-resistant cells.

In both mouse sarcoma 180 and human KB cells selected for the multiple drug resistance (MDR) phenotype, there is an elevation in the steady state mRNA level of c-fos. There is no detectable gene amplification for c-fos, nor is there any significant change in the rate of mRNA transcription or degradation, suggesting that other factors are responsible for the increased expression level in resistance. Cells selected for resistance to methotrexate, a drug not in the MDR group, do not have an increase in c-fos mRNA expression. When drug-sensitive cells are exposed for 30 min to an ED50 concentration of vinblastine, Adriamycin, colchicine, or VP-16, but not to methotrexate or cisplatin, there is a 3-6-fold induction in the level of c-fos message. Because the former drugs are members of the MDR class and the latter are not, the results are consistent with the hypothesis that induction of c-fos by low levels of cytotoxic drugs may be an early event in the acquisition of the MDR phenotype. If this were the case, then c-fos would be expected to act in concert with c-jun to control transcription by binding to a specific DNA regulatory site. Consistent with this explanation is the existence of an AP-1 sequence in the promotor region for the P-glycoprotein gene (mdr1), as well as the fact that c-jun is also overexpressed in MDR cells.

ATP Binding Cassette Transporter, Subfamily B, Mem

Cultural sensitivity in the promotion of breastfeeding.

Despite the efforts of health care providers, the problem of low and decreasing breastfeeding rates among low-income women and women of color persists. Failure to make progress in this crucial area makes it essential to develop new strategies and models for culturally appropriate promotion of breastfeeding. Sensitive cultural assessment helps to gather information regarding cultural characteristics that may affect clients' behaviors. Strategies for the promotion of breastfeeding should be based on an awareness of the sociocultural barriers to breastfeeding in a particular community. General approaches for assessing and overcoming cultural barriers are addressed.

Adult

Asthma in the vicinity of power stations: I. A prevalence study.

Respiratory symptoms, atopy, and bronchial reactivity were measured in primary school children living in Lake Munmorah (LM), a coastal town near two power stations, and in Nelson Bay (NB), a coastal town free from any possible major sources of outdoor air pollution. A prevalence survey and longitudinal follow-up study were performed 1 year apart. In both studies, the prevalence of ever wheezed, current wheezing, breathlessness, wheezing with exercise, diagnosed asthma, and use of drugs for asthma at LM were all approximately double the prevalence at NB (all P values less than 0.01). The prevalence of bronchial reactivity was significantly greater at LM than NB (P less than 0.01) at the first but not the second survey. By contrast, no significant differences were found between the two areas for skin test atopy or for parental history of allergic disease. Multivariate analysis supported the conclusion from the univariate analysis that there was more wheezing at LM compared to NB at both studies, when adjusted for atopy, smoking in the home, age, and sex. As expected, a positive skin test reaction to house dust mite was the predominant explanatory variable. Asthma was more common in the community near power stations (LM) than in the NB area. The absence of significant differences in skin test atopy and parental history of allergic disease argued against major genetic differences between the two groups. By contrast, the more common reporting of siblings' chest disease and asthma in Lake Munmorah supported an environmental cause.

Air Pollution

Asthma in the vicinity of power stations: II. Outdoor air quality and symptoms.

To assess longitudinally the effect of living in the vicinity of coal-fired power stations on children with asthma, 99 schoolchildren with a history of wheezing in the previous 12 months were studied for 1 year, using daily diaries and measurements of air quality. The children had been identified in a cross-sectional survey of two coastal areas: Lake Munmorah (LM), within 5 km of two power stations, and Nelson Bay (NB), free from major industry. Daily air quality [sulphur dioxide (SO2) and nitrogen oxides (NOx)], respiratory symptoms, and treatment for asthma were recorded throughout the year. Measurements of SO2 and NOx at LM were well within recommended guidelines although they were several times higher than at NB: maximum daily levels in SO2 (micrograms/m3) were 26 at LM, 11 at NB (standard, 365); yearly average SO2 was 2 at LM, 0.3 at NB (standard, 60); yearly average NOx (micrograms/m3) was 2 at LM, 0.4 at NB (standard, 94). Marked weekly fluctuations occurred in the prevalence of cough, wheezing, and breathlessness, without any substantial differences between LM and NB. Overall, the prevalence of symptoms was low (10% for wheezing, 20% for any symptom). Whether the daily SO2 and NOx levels affected the occurrence of respiratory symptoms was investigated in children at LM using a logistic regression (Korn and Whittemore technique). For these children as a group, air quality measurements were not associated with the occurrence of symptoms.

Air Pollution

Comparison of preservative-free and preservative-containing ipratropium bromide.

A double-blind crossover study was performed on 33 children with asthma to compare the effectiveness of nebulized solutions of preservative-containing and preservative-free ipratropium bromide. Both solutions produced bronchodilation. No significant differences were found between the two solutions at any time after nebulization in minimum and maximum changes from baseline value or in the areas under the lung function time curves. The presently formulated preservative-containing ipratropium bromide solution was not shown to be inferior to a preservative-free compound.

Administration, Intranasal

A case of developmental right hemisphere dysfunction: implications for psychiatric diagnosis and management.

The authors present the case of an adult woman who was treated in the mental health system for many years for a syndrome of mixed anxiety and depression unresponsive to psychopharmacologic or psychotherapeutic treatment. A computed tomography scan revealed asymmetrical enlargement of the right temporal horn. This finding, as well as findings of severe difficulties in spatial relations together with mildly abnormal posturing of the left hand when walking (especially when the gait was stressed), suggested that the patient had a developmental disability of the right cerebral hemisphere. The authors conclude that because such patients might appear to have primarily psychiatric rather than neurologic problems, the diagnosis of right hemisphere dysfunction should be considered when the clinical presentation is indicative of atypical anxiety and affective disorders.

Anxiety Disorders

Living dangerously--the effect of chronic pulmonary and renal failure on self-image.

Patients with severe chronic obstructive lung disease (COLD) are difficult to interview because of their inability to verbalize freely. The draw-a-person (DAP) and the draw-a-house (DAH) tests were given to COLD patients (n = 14), and to patients on chronic renal dialysis (n = 14). The COLD patients showed significantly more disorganization in the drawings (p less than 0.05 for DAP and p less than 0.001 for DAH) than the renal patients. There were certain other findings specific to the circumstances of each disorder. The DAP and DAH may be clinically useful in rapidly identifying the patients in need of greater psychosocial support.

Attitude to Health

A dying patient: the question of euthanasia.

Mrs. A. B., a 61-year-old woman who presented with carcinoma of the breast in 1964, was readmitted to the hospital in 1974 in respiratory distress ensuing from chronic lung disease and metastatic illness. An active member of Alcoholics Anonymous for the past sixteen years, she had a living pattern in which she felt in control of herself, and from which she derived an important sense of self-esteem. Although in the hospital she requested that no extraordinary measures be taken to prolong her life, when she went into respiratory failure the house staff on duty intubated her and placed her in the Intensive Care Unit. Even though her physical condition rapidly improved, the patient told her own physician that she wanted to be extubated and off Intensive Care, despite her knowledge of a probable short survival. When her request was agreed to, contrary to expectations, she continued to improve. A lawyer, interested in problems of dying and euthanasia, interviewed her, and subsequently Psychosocial Rounds were held. The general conclusions at the Rounds were that she would die an appropriate death, and that euthanasia would not be possible under current circumstances. The staff at the Conference decided to accept at face value her request that she be allowed to die without heroic measures and with dignity.

Attitude to Death

Early discharge with home follow-up: impacts on low-income mothers and infants.

Low-income mothers and infants discharged at 24 to 47 hours after birth were compared to two control groups: early discharge with infant separation and conventional discharge. No differences among the three groups in maternal or infant morbidity at seven to 15 days postdelivery were recorded. Simultaneous early discharge was associated with higher maternal attachment scores, fewer maternal concerns, and greater maternal satisfaction with discharge type than early discharge with infant separation. All three groups had substantial morbidity in the first two weeks of life. A shorter hospital stay and more health monitoring postdischarge may be a better use of health resources than a conventional hospital stay for low-income mothers and their infants.

Aftercare