Search PubMed⌕ Search

Biomedical subjects

R Adams

Publications and source records attributed to R Adams.

At least 127 records · Page 7Linked to original sources

The impact of physicians' brief smoking cessation counseling: a MIRNET study.

Although many family physicians may discuss smoking cessation with their patients, few do so consistently. A common belief among many physicians is that such efforts will not deter their patients from smoking. Others believe the time commitment required for a successful intervention is excessive. The present study addressed the above issues by examining the effect of a 3- to 5-minute unstructured physician discussion encouraging smoking cessation with family practice patients. Cigarette-smoking patients of two busy family practices in southeast Michigan were randomly assigned to either a control group receiving routine care or an intervention group receiving, in addition to routine care, smoking cessation counseling from their physician. A third comparison group was drawn from smokers in practices not involved in delivering the intervention. Two hundred thirty-eight patients from the intervention group, 178 from the control group, and 47 from the comparison group were followed up with a telephone interview at 6 months. Intervention group patients made significantly more quit attempts than did those in the control group (P less than .001), which was similar to the comparison group. At the 6-month follow-up, 8% of intervention group members, and 4% of both the comparison and control groups reportedly were abstinent from smoking. Among those contacted at the 1-year follow-up, the respective percentages abstinent were 8%, 3%, and 4%. Although these differences in quit rates were not statistically significant, the findings suggest that physicians can positively affect patient smoking cessation. This intervention was feasible in busy family practices, highlighting its generalizability and applicability to other family practice settings in the United States.

Adult↗

Malignant lymphoma in three horses with ulcerative pharyngitis.

Three horses were examined for ulcerative pharyngitis, which had been unresponsive to treatment. Biopsy specimens of the pharyngeal lesions were characterized histologically by a mixed population of lymphocytes and histiocytes, suggesting chronic inflammation. Only when biopsy specimens of regional lymph nodes revealed this cell population disrupting the lymph node architecture was the diagnosis of malignant lymphoma made.

Animals↗

Inhibition of methyltransferase reduces the turnover of acetylcholine receptors.

Because of the putative rule of phospholipid methyltransferase reactions in many important membrane and receptor translocation processes, we studied the effect of methyltransferase inhibitors on acetylcholine receptor (AcChoR) turnover in cultured rat skeletal muscle. Inhibition of methyltransferase significantly reduced the normal rate of degradation of AcChoRs, a process that involves endocytosis. Further, under conditions that greatly accelerate the rate of degradation of AcChoRs--i.e., by addition of anti-AcChoR antibody--methyltransferase inhibitors again significantly reduced receptor turnover. AcChoR synthesis was unaffected. Thus, the net effect of this treatment was slowing of the antibody-induced loss of surface AcChoRs. That this drug effect was mediated specifically by inhibition of methylation reactions was suggested by certain additional pharmacologic features: partial reversibility of the effect by methionine, enhancement by homocysteine, and correspondence with marked inhibition of phospholipid methylation. The substrate specificity of the methyltransferase inhibitors capable of reducing AcChoR degradation suggests that phospholipid methylation reactions may be most relevant. Methyltransferase inhibitor drugs may provide a therapeutic strategy in receptor disorders such as myasthenia gravis, in which accelerated receptor endocytosis plays a major role.

Adenine↗

Exploratory celiotomy for gastrointestinal disease in neonatal foals: a review of 20 cases.

The medical records of 20 neonatal foals in which exploratory celiotomies were performed for gastrointestinal disease were reviewed. In all 20 foals, persistent pain and/or progressive abdominal distension were the primary clinical findings influencing the decision to operate. However, ancilliary laboratory data were important to the proper medical management of these foals during anaesthesia and following surgery. Surgical diagnoses of the 20 foals included ileus (nine foals; 45 per cent), small colon obstruction (five foals; 25 per cent), large colon displacement (three foals; 15 per cent), small intestinal displacement (two foals; 10 per cent), and perforated gastric ulcer (one foal; 5 per cent). Seventeen foals were recovered from anaesthesia, 13 of these were discharged from the hospital, seven were alive six months or more following discharge. Sepsis was the cause of death in six of the 10 foals that died following recovery.

Animals↗

Exploratory celiotomy for suspected urinary tract disruption in neonatal foals: a review of 18 cases.

The medical records of 18 neonatal foals, in which exploratory celiotomies were performed for suspected urinary tract lesions, were reviewed. Despite clinical signs and laboratory values indicative of disruption of the urinary tract, three foals did not have a site of urinary tract leakage at surgery. Eight foals had ruptured bladders and seven foals had urachal lesions. Ultrasonography was used as a pre-operative diagnostic procedure in eight foals to evaluate the presence of free peritoneal fluid and urinary tract integrity. Nine foals were alive six months after discharge. Seven of the nine non-surviving foals died or were destroyed because of fungal or bacterial infections.

Animals↗

Activated charcoal in tricyclic antidepressant poisoning.

Tricyclic antidepressants (TCA) bind to activated charcoal both in vitro and in vivo in healthy volunteers after a therapeutic dose of TCA. These findings provide a basis for the routine use of activated charcoal in TCA poisoning. The object of this study was to examine the effect of a single dose of 20 g of activated charcoal in overdose patients. Ninety-one patients from four centres with suspected TCA overdose were entered into a randomized study. Gastric lavage was performed on all patients. Thirty-four received 20 g of activated charcoal and 43 served as controls. Fourteen patients were excluded. Plasma drug concentrations were taken on admission and at 1, 2, 4, 8 and 24 h. The incidence of toxic symptoms was registered during 24 h. There was no significant difference in the area under the plasma drug concentration versus time curve, the peak plasma concentrations or plasma half-lives between the two groups. Toxic symptoms were more frequent in the non-treated groups although this difference was not statistically significant. In patients with TCA overdose initially treated with gastric lavage, a single dose of 20 g of activated charcoal had no effect on the systemic absorption or elimination of TCA.

Antidepressive Agents, Tricyclic↗

The impact of utilization review on nursing.

At first glance, nursing's role in UR appears to be of strategic significance to the profession. But there are several issues that nurse executives need to consider. First, since UR departments are seldom part of the nursing department, UR nurses are practicing outside the realm of nursing. What responsibility, if any, does the nursing department have to nurses practicing in the hospital, yet not in the nursing department? What can the nursing department do to help UR nurses maintain their identification with the profession and appreciate the strategic importance of their role, with its legal and financial ramifications? Second, UR is changing the established role of the primary care nurse. In your institution UR may already have taken the staff nurses' discharge planning function. It appears that several factors are contributing to this role change. Patient acuity has increased the time needed to administer physical care. The nursing shortage means more patients are assigned to each professional nurse and paraprofessionals are doing more patient care. There is less and less time left for the primary nurse to practice the professional attributes of nursing, primarily discharge planning. This function is shifting to the UR Department. Is discharge planning a function nurse executives wish to relinquish? Finally, we are entering another period of severe nurse shortages, where recruitment and retention of staff are paramount. Actively competing for our staff are the UR departments. Forty professional nurses work in three regional centers of the American Health Network, American Group Insurance Company (Dallas, Texas). In one hospital of 450 beds, nine nurses are employed by the UR department.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

The role of osmotic effects in haloadaptation of Vibrio costicola.

Growth rates of Vibrio costicola showed a broad optimum between 0.8 and 1.5 M-NaCl, and there was no growth above 3.3 M-NaCl in a peptone-based medium. The minimum requirement of 0.5 M-NaCl for growth in NaCl alone was reduced to 0.3 M-NaCl when the total solute concentration was raised to 0.5 to 1.0 M equivalent with sucrose or glycerol. Compared with equivalent NaCl concentrations, higher concentrations of sucrose were more inhibitory to growth, whereas glycerol had less effect. Increasing the medium NaCl concentration suddenly by 2- or 3-fold with either a constant starting, or final, salt concentration showed that, after the shift-up, the lag in growth, the rate of growth, and the inhibition of phospholipid synthesis depended both on the final NaCl concentration and the magnitude of the shift in salinity. The time-courses of phospholipid synthesis following a 2- or 3-fold shift-up in NaCl or sucrose media were very similar and exhibited a relative increase in phosphatidylglycerol synthesis over that of phosphatidylethanolamine. This 'switch-over' was not seen following shift-up in glycerol media when there was also a stimulation, rather than inhibition, of phospholipid synthesis. It is concluded that during phenotypic haloadaptation of V. costicola, osmotic effects play a significant part in the sensing of and response to raised external salinity.

Glycerol↗

Contribution of whole blood L-lactate, pyruvate, D-lactate, acetoacetate, and 3-hydroxybutyrate concentrations to the plasma anion gap in horses with intestinal disorders.

Increased anion gap (AG) was due, in part, to L-lactic acidosis in 14 of 14 horses with intestinal disorders. In a few horses, increased whole blood concentrations of D-lactate made a minor contribution to the AG. However, the increase in AG was often greater than the sum of the increases in these 2 acid anions. This unexplained increase was not a result of increases in whole blood pyruvate, 3-hydroxybutyrate, or acetoacetate concentrations or serum albumin or phosphate concentrations. Identification of other anions causing increased AG could lead to better understanding, diagnosis, and treatment of metabolic imbalances in critically ill horses.

3-Hydroxybutyric Acid↗

Acuity and staffing under prospective payment.

Nursing administrators are debating the desirable mix of professional (RN) and paraprofessional (LPN) nursing staff under the prospective payment system (DRGs). The staffing mix reflects the cost and quality of nursing care provided by an acute care hospital. Based on a reliable and valid acuity/care plan system, standards of care and nursing diagnoses, several DRGs were analyzed on an eight-bed medical/surgical intensive care unit with regard to intensity of care and staffing mix. This study showed nursing administrators that the staffing mix on an intensive care unit varies according to the acuity/care plan rather than DRGs or nursing diagnoses.

Diagnosis-Related Groups↗

Neurologic diseases.

The responses of apparently healthy newborn foals to neurologic testing differ significantly from those of adult horses. These responses and the diagnostic techniques pertinent to neurologic problems are reviewed as a basis for evaluation of the compromised neonatal foal. The more frequently encountered neurologic diseases are discussed in a problem-oriented format. These clinical problems include behavioral abnormalities, convulsions, changes in consciousness, blindness, ataxia without loss of strength, ataxia with weakness and paralysis, and the floppy foal.

Animals↗

Evaluation of a technique for measurement of gamma-glutamyltranspeptidase in equine urine.

gamma-Glutamyltranspeptidase (GGT) activity in equine urine was measured, using an assay developed for use with serum and was found to be reproducible. The GGT activity was measured in samples prepared by serial dilution of exogenous GGT with equine urine, and the activity was determined to be linear between 21 IU/L and 407 IU/L. The behavior of exogenously added GGT was compared in equine serum and urine. The enzyme behaved similarly in both fluids. The GGT activity was measured in serum and urine samples after storage at -20, 4, and 25 C for 24 and/or 72 hours. Enzyme activity decreased after storage at all temperatures and times, but the decrease was greatest and most variable at -20 C. The urine GGT: urine creatinine ratio was calculated on serial urine samples collected over 24 hours. Although the urine GGT activity and creatinine concentration had significant variation, the ratio remained constant. The urine GGT: urine creatinine ratio was calculated from random urine samples collected from 27 clinically healthy adult horses and was found to be 10.52 +/- 4.78 (mean +/- SD).

Animals↗