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Biomedical subjects

R E Johnson

Publications and source records attributed to R E Johnson.

At least 289 records · Page 16Linked to original sources
PubMed1979

Examining the annual drug utilization of a cohort of low income health plan members.

Changes in the annual drug utilization of a cohort of 828 low income Kaiser Foundation Health Plan members in the Oregon region over a four-year period are examined. The study also attempts to identify relationships between consistency in the levels of annual drug utilization and characteristics of the cohort, prescriptions received and doctor office visits (DOVs). The results show no change in the: 1) annual prescription rate; 2) types of drugs received each year; 3) annual DOV rates; and 4) annual prescribing rate by physician specialties. There was consistency in the annual drug and DOV utilization rate among the cohort through time. Consistency in the level of drug utilization was not always directly related to consistency in the level of DOV utilization. Consistent high users of drugs, while few in number (4.6 per cent), received a large proportion (37.3 per cent) of all prescriptions. A substantial proportion (15.8 per cent) of the cohort were consistent nonusers of drugs. Consistency in the level of drug use was related to: sex and age, purpose (disease classification) of the DOVs, the types (new or refill) of prescriptions received, the therapeutic classes of drug received, the number of prescribing physicians and the number of pharmacies patronized.

Adolescent↗
PubMed1979

Comparing the medical utilization and expenditures of low income health plan enrollees with Medicaid recipients and with low income enrollees having Medicaid eligibility.

The study examines the medical care (hospital, physician, drug, diagnostic) utilization and expenditures of low income persons enrolled in a prepaid health plan with a matched group of Medicaid recipients. The study also examines the medical care utilization of low income persons enrolled in a prepaid health plan with a similar group of low income persons enrolled in the health plan but also eligible for Medicaid benefits. Utilization and population-at-risk data were obtained from the Kaiser-Permanente Medical Care Program of Portland, Oregon and from the State of Oregon Welfare Division. A hypothesis of lower hospital utilization by low income enrollees compared with Medicaid recipients was accepted. A hypothesis of higher ambulatory care utilization was accepted for diagnostic procedures and prescription use, but rejected for office visit utilization. An analysis of the findings appeared to implicate the Medicaid program for differences observed. The hypotheses of no significant differences in inpatient and ambulatory medical care utilization of low income health plan enrollees with and without Medicaid eligibility were generally rejected. Low income enrollees with concurrent Medicaid had consistently higher utilization rates for all services resulting in substantially higher medical care expenditures per person. The findings appear to contribute some useful information to planning or establishing policy for Medicaid Prepayment programs or other programs enrolling low income persons in prepaid health plans or HMOs.

Adolescent↗
PubMed1978

Gallium scans for staging small cell lung cancer.

The high incidence of gallium 67 accumulation in lung cencer has made radioistope scanning with this agent useful in identifying the extent of cancer locally. However, we investigated the usefulness of whole-body gallium 67 scanning, compared with physical examination, bone, liver and brain scans, and bone marrow aspirate and biopsy, in detecting metastases outside the chest in 47 patients with small cell lung cancer. In each case whole-body scanning with gallium 67 was inferior to the other methods used to detect extrathoracic tumor deposits.

Bone and Bones↗
PubMed1978

Thermodynamics of protein cross-links.

The thermal transitions of native lysozyme and a well-characterized cross-linked derivative of lysozyme [Imoto, T., and Rupley, J. A. (1973), J. Mol. Biol. 80, 657] have been studied in 1.94 M guanidine hydrochloride at pH 2. The observed increase in the melting temperature from 32.4 degrees C for native lysozyme to 61.8 degrees C for the cross-linked derivative corresponds to a calculated 5.2 kcal/mol increase in the free energy of denaturation. This free-energy change is attributed to the decreased entropy of the unfolded polypeptide chain following introduction of a cross-link and is shown to compare well with theoretical predictions. The possibility that an introduction of a cross-link could also affect the enthalpy of an unfolded protein was investigated. The heats of reduction of bovine serum albumin and lysozyme by dithioerythritol in 6 M guanidine hydrochloride were determined and compared to that for the model peptide, oxidized glutathione. The near identity of the observed heats was taken as evidence that the introduction of cross-links into a random-coil protein does not, in general, introduce strain.

Chemical Phenomena↗
PubMed1978

Sequential nonsurgical and surgical staging of non-Hodgkin's lymphoma.

The results of clinical and surgical staging in a series of 170 patients with non-Hodgkin's lymphoma are reviewed. Advanced disease (Stage IV) was established without laparotomy in 95 patients (56%), primarily through bone marrow biopsy, closed liver biopsy, and peritoneoscopy. Laparotomy revealed a high incidence of liver involvement and involvement of lymph nodes outside of conventional abdominal irradiation portals only in patients with nodular types of pathology and in patients with positive lymphangiograms. The limitations and indications for staging laparotomy are discussed in the context of these findings.

Biopsy↗
PubMed1978

Side-to-side portacaval shunt versus nonsurgical treatment of Budd-Chiari syndrome.

Although a side-to-side portacaval shunt will relieve some patients with Budd-Chiari syndrome, distinction between relief as a result of operation and spontaneous recovery may be inexact. A nonshunting operation relieved one of two patients as much as a side-to-side portacaval shunt did. In these two patients and one additional patient, streptokinase therapy may have been beneficial.

Adult↗
PubMed1978

"Total" therapy for small cell carcinoma of the lung.

Seventy-one consecutive patients with small cell carcinoma of the lung were treated with an integrated approach between November, 1974, and May, 1977. The regimen included radiotherapy to the primary site, relatively brief (6 to 12 weeks) although intensive chemotherapy, and prophylactic cranial irradiation. Complete responses were achieved in 75% and 40% of patients with limited and extensive disease, respectively. Modest prolongation of survival (median, 10 months) was realized by patients with extensive disease, but prolonged relapse-free survival was not observed. In contrast, one-half of the patients with limited disease who achieved a complete response have remained clinically free of disease without further treatment for a mean of 18 months (range, 6 to 33 months). Since all relapses to date have been noted within the first year following cessation of treatment, this experience suggests there may be a potential for cure in those survivors who are now relapse free for intervals exceeding two years.

Antineoplastic Agents↗
PubMed1978

Antiviral activity of some beta-diketones. 4. Benzyl diketones. In vitro activity against both RNA and DNA viruses.

The synthesis and in vitro antiviral evaluation of a series of substituted benzyl beta-diketones are described. The introduction of a styryl group onto the phenyl ring enhanced activity against herpesvirus type 2. The 4-methoxystyryl homologue 8 was evaluated extensively in vitro and was found to be effective against both RNA and DNA viruses. Compound 8 was evaluated in the mouse vagina against herpes simplex type 1 and produced a significant increase in survival rate as well as in survival time.

Animals↗
PubMed1978

Examining physicians' drug order recording behavior.

The study reports the impact of a computer-based drug profile upon physicians' drug order recording behaviors. The drug profile system, including information about both drugs ordered and prescriptions received, was implemented for a randomly selected group of Kaiser Foundation Health Plan members during 1973. The monthly updated profile was made readily accessible to physicians. Drug order notations entered by physicians on outpatient medical records were examined to determine if the availability of the profile influenced the completeness of drug-related data being recorded by physicians. Using an experimental design, the results indicated the availability of the profile did not influence the completeness of drug-related data recorded. Also, observation of the data generated for analysis suggests caution in assuming drug notations or prescriptions reflect complete and reliable drug use data.

Drug Information Services↗
PubMed1978

Chemotherapy (cyclophosphamide, vincristine, and prednisone) versus radiotherapy (total body irradiation) for stage III-IV poorly differentiated lymphocytic lymphoma.

Seventy-two patients with stage III-IV malignant lymphoma of the poorly differentiated lymphocytic (PDL) type were randomly assigned to initial chemotherapy with cyclophosphamide, vincristine, and prednisone (CVP) or to radiotherapy with total body irradiation (TBI). The response and survival rates were similar for CVP and TBI in patients with nodular PDL, with 66% and 67%, respectively, surviving at 7 years. Induction treatment with TBI yielded better response and early survival than CVP for patients with diffuse PDL but a survival advantage did not exist at 5 years, the survival rate being 28% and 25%, respectively. TBI was more easily tolerated than CVP as initial therapy, 19 (51%) of the 37 CVP patients had a complication which required hospitalization during the first six cycles as contrasted to only one of 35 patients receiving TBI who required hospitalization. Most chemotherapy complications were infectious in nature, secondary to relatively severe granulocytopenia, and one patient died from Candida sepsis following the first cycle of CVP. Late complications consisted of two TBI patients who developed a myeloproliferative disorder and two CVP patients who experienced persistent disabling neurotoxic reactions. Durable remissions were not achieved with significant frequency using either form of treatment, indicating a need to evaluate new therapeutic approaches for the management of PDL lymphoma.

Cyclophosphamide↗
PubMed1977

Role of radiation therapy in management of adult leukemia.

There are both defined and evolving roles for radiation therapy in the management of adult leukemias. For the acute leukemias, emphasis presently is on adjuvant irradiation of local manifestations including CNS "prophylaxis" for subclinical meningeal involvement. In chronic myelocytic leukemia, local palliative radiotherapy is complemented by the use of splenic irradiation for its systemic effect. Recently, total body irradiation has been shown to influence the natural history of chronic lymphocytic leukemia. For the first time, it has been possible to achieve remissions that prolong survival as well as improve the quality of life. Future exploitation or radiotherapy in adults with leukemia will be dependent upon improved communication and cooperation between the various medical specialists concerned with patient care in these diseases.

Adult↗