The effect of dietary cholesterol on cholesterol biosynthesis and other processes in mammalian liver.
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Biomedical subjects
Publications and source records attributed to R Booth.
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Transcutaneous fine-needle aspiration (FNA) biopsies were performed on 30 patients with space-occupying lesions in the pancreas. Patient selection for FNA was based on pancreatic lesions suspected of malignancy by clinical and/or radiologic imaging methods. Patients with obstructive jaundice were excluded because of the necessity of laparotomy to relieve biliary obstruction. Of these 30 cases, 15 cases were positive for malignant cells. Of these 15 positive cases, 11 were adenocarcinomas of duct cell origin, one cystadenocarcinoma, one islet cell tumor, one lymphoma, and one metastatic malignant melanoma. The remaining 15 cases, negative for malignant cells, were ultimately shown to have the following lesions: five adenocarcinomas of the pancreas, one metastatic carcinoma from the breast, and nine nonneoplastic disease. Overall diagnostic accuracy was 80%. The sensitivity, specificity, and predictivity for positive FNA biopsy of pancreatic malignancy were 79, 100, and 100%, respectively. Cytologic features with corresponding histologic types were presented. Immunocytochemical and electron microscopic studies were performed on some cases. Only one complication that was possibly related to FNA biopsy occurred. In conclusion, transcutaneous FNA biopsy of pancreatic malignancy is highly valuable in patient management.
In collaboration with the National Institute on Drug Abuse, the Health Resources and Services Administration is conducting a multisite, longitudinal study on issues of service needs, service utilization, and access to care for drug abusers with HIV. This article discusses access to drug abuse treatment and HIV secondary prevention for 116 women interviewed during the study's first year in five U.S. cities. Using interview data from 115 service providers in those same cities, it also discusses drug abuse treatment availability and barriers to service expansion for drug users with HIV. Study findings indicate that there are highly significant gaps between the drug abuse treatment services these women feel they need and those they have been able to receive; these were particularly pronounced for drug detoxification and residential and outpatient drug-free treatment. Women who used crack cocaine or injection drugs had particularly high levels of need for residential and outpatient drug abuse treatment, while women who use crack were found to have significantly less experience with the drug abuse treatment system than IDUs. HIV secondary prevention was also found to be a critical need for these women, many of whom were engaging in behaviors that place them at risk for reinfection, infection with other diseases, and transmission to others. Providers indicated that lack of funding was the major barrier to expanding services for this population; other barriers, such as lack of ancillary services and transportation, were also noted. Two positive findings were that many drug abuse treatment agencies in these cities provide a wide range of ancillary services and that many different kinds of agencies offer drug abuse treatment services.
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This paper presents first-year findings from a multi-site, longitudinal study being coordinated by the Health Resources and Services Administration (HRSA) in collaboration with the National Institute on Drug Abuse (NIDA) on access to care for drug abusers with HIV. The sample of 116 women and 187 men in five sites (Denver, Detroit, New Haven, New Orleans, and St. Louis) were interviewed regarding HIV testing history, HIV disease course, and use of health and social services. For both men and women, there were significant gaps between the medical services they reported needing and those they received. Significantly more women needed and received mental health services. Cost and waiting times emerged as the most important barriers to care. The study also found that significantly fewer women than men subjects received pre- and post-test counseling and were advised to get medical services after their first positive HIV test. Overall, first-year study results suggest that multiple barriers in access to service exist for drug-using women, the largest group of women affected by HIV in the United States.
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