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Biomedical subjects

R Hughes

Publications and source records attributed to R Hughes.

At least 91 records · Page 5Linked to original sources
PubMed1997

Linking primary care centers and hospitals.

Primary care centers (PCCs) are increasingly entering into linkages with hospitals that go far beyond the traditional arrangements in which the hospitals serve as backups to the PCCs. The linkages can be for managed care purposes, for training of health professionals in primary care settings, or for other reasons. This article explores the advantages of such arrangements, the organizational forms that the linkages can take, the legal issues, and negotiating the deal.

Antitrust Laws↗
PubMed1997

Measuring treatment effectiveness. Part one: Newly emerging outcomes databases for organizations.

Provider organizations are under increased pressure from payors to produce outcomes data that demonstrate the effectiveness of their treatment services. More and more, providers are collaborating on joint outcomes projects that allow them to benchmark their results with similar organizations. Here are five brief descriptions of such projects. They span a wide spectrum of organizations and include hospitals and comprehensive healthcare systems, behavioral group practices, child welfare agencies, and psychosocial rehabilitation programs. Part one begins below, part two, on page 45.

Accreditation↗
PubMed1997

The five Cs of choice. Outcome measures for individuals with severe and persistent mental illness.

In a time when mental health service providers are cutting costs and services, stakeholders need adequate information in the form of outcome measures to evaluate services based on quality. Outcome measures are particularly important for high-risk populations, where severe and persistent mental illness results in serious functional impairment of daily life. A client-oriented method of gauging rehabilitation of real-world behavior over the long-term, as well as the short-term, and which allows for comparison with other programs, must be developed. Lack of agreement on the domains to be measured, however, has hindered the development of common standards, making it difficult to track accountability and service effectiveness. Four authors provide a framework to help organizations choose and develop appropriate outcome measures, as well as core data suggested to measure longitudinal changes in rehabilitation.

Chronic Disease↗
PubMed1996

Regulation of arachidonic acid metabolism, aromatase activity and growth in human breast cancer cells by interleukin-1beta and phorbol ester: dissociation of a mediatory role for prostaglandin E2 in the autocrine control of cell function.

Prostaglandin E2 (PGE2) levels are elevated in malignant human breast tissue. However, the cellular mechanisms regulating this arachidonate metabolism and the autocrine influence PGE2 production may have on breast cancer cell growth and function are unclear. In the present study, we have investigated the effects of 2 putative cyclo-oxygenase inducers, interleukin-1beta (IL-1beta) and the protein kinase C agonist 12-O-tetradecanoyl-phorbol-13-acetate (TPA), on PGE2 production, growth and aromatase activity in the MDA MB 231 breast cancer cell line. TPA stimulated a dose-dependent increase in PGE2 production, inhibited cell growth and stimulated aromatase activity. Although IL-1beta alone had no effect on any of these breast cancer cell functions, the cytokine greatly potentiated PGE2 production in the presence of TPA. Similarly, growth inhibition and aromatase stimulation in response to TPA were both further enhanced by IL-1beta treatment. Indomethacin and dexamethasone both prevented PGE2 production in response to IL-Ibeta and TPA but had no effect on the anti-proliferative action of the cytokine and phorbol ester. While indomethacin had no effect on induction of aromatase activity by IL-1beta and TPA, dexamethasone exhibited a temporally biphasic action. Dexamethasone alone stimulated aromatase activity and demonstrated a permissive action on aromatase stimulation by IL-1beta and TPA. However, pre-treatment of cells with dexamethasone prevented subsequent induction of aromatase activity by IL-1beta and TPA. Our study describes a novel synergistic interaction in response to protein kinase C activation and IL-1beta during the regulation of arachidonate metabolism, cell growth and aromatase activity in human breast cancer cells. We conclude that the cyclooxygenase pathway does not play a mediatory role during the inhibition of cell growth and the induction of aromatase activity by IL-1beta and TPA.

Arachidonic Acid↗
PubMed1996

Carcinoma and the peripheral nervous system.

An underlying carcinoma is an important differential diagnosis in peripheral neuropathy. While direct compression and infiltration of spinal roots or peripheral or cranial nerve trunks or branches can be identified easily when they occur in association with established malignancy, their diagnosis when they are presenting features may be difficult. In paraneoplastic sensory neuronopathy autoantibodies to neuronal antigens have become useful diagnostic markers for an underlying carcinoma, especially anti-Hu antibodies. Strong circumstantial evidence suggests that these antibodies form part of an autoimmune response which is responsible for the pathogenesis of some of these syndromes. Neuropathy appearing during the course of treatment of carcinoma may be due to radiation-induced damage or the neurotoxic effects of some chemotherapeutic agents. Neurotrophic factors are being investigated as a strategy for reducing the neurotoxic effects of these agents.

Combined Modality Therapy↗
PubMed1996

How can clinical supervision become a real vision for the future?

Clinical supervision is increasingly cited as being a necessary part of the work and development of all nurses. This paper discusses an educational programme offered to nurses in one particular Trust and outlines the course philosophy, content, organization and background to this development. Emphasis is placed on the importance of clinical supervision, the student-centred approach to course delivery, and the need to recognize the importance of adequate training and education of all nurses in this area.

Clinical Competence↗
PubMed1996

Nutrition education in rural Australia: why, who and how?

Improving nutrition knowledge through nutrition education had been a major strategy used by nutritionists and health educators to improve the dietary intake of Australians. This approach continues to be supported by contemporary practice, and nutrition and health policy documents at a national and state level. In Australia, the delivery of nutrition education services to rural and remote populations is limited by a scarcity of nutrition specialists such as dietitian/ nutritionists. This review highlights the importance of nutrition education in promoting the nutritional health of Australians in rural and remote areas, and describes a model for nutrition education service delivery based on generalists supported by specialists.

Allied Health Personnel↗
PubMed1996

Promoting breastfeeding in rural communities: breast is best and bottle is a last resort.

'Breast is best and bottle is a good second best' has been a common infant nutrition axiom in Australia in recent times. The impact of the widespread recognition of breastfeeding as the most appropriate form of infant nutrition for the first six months of life has been softened by this almost favourable premise about the suitability of artificial feeding. The promotion of breastfeeding becomes that much more difficult if bottle feeding is seen to be, and promoted as, a comparable alternative to breastfeeding by health professionals and the broader community. There is accumulating evidence to suggest that this is not the case, and that infant feeding with artificial formulas increases the risk of short- and long-term morbidity and mortality. This review of breastfeeding promotion challenges health professionals in rural Australia to adopt the more appropriate axiom that 'breast is best and bottle is a last resort'.

Adult↗
PubMed1996

Influence of nutrition on hepatic IGF-I mRNA levels and plasma concentrations of IGF-I and IGF-II in meat-type chickens.

We have examined the influence of nutrition on plasma IGF-I, IGF-II and IGF-binding protein (IGFBP) levels and on hepatic IGF-I gene expression in young meat-type chickens. Plasma IGF concentrations were measured by using RIA with recombinant chicken IGFs as standards. In chickens fed the control diet containing 200 g/kg dietary protein ad libitum for 7 days, plasma IGF-I concentrations increased significantly from those found in the initial control group. Food restriction for either 4 or 7 days decreased plasma IGF-I by 30% from the initial control. When chickens were refed ad libitum for 3 days after 4 days of restricted feeding, plasma IGF-I levels recovered to those of the control birds fed ad libitum. In chickens eating a low protein diet (100 g/kg protein), the plasma IGF-I tended to be lowered but the decrease was not significant. Although the intensity of IGF-I and beta-actin mRNA bands protected in the RNase protection assay was changed by nutrition, no statistical effect of nutrition on the ratio of IGF-I to beta-actin was observed. The nutritional treatments had no effect on plasma IGF-II concentrations. Western ligand blot and chromatographic analyses were used to investigate the influence of nutrition on IGFBP profiles. Both IGF-I and IGF-II ligands in the Western ligand blot revealed the most intense binding at 30 kDa for plasma obtained from chickens with restricted food intake. The 30 kDa band also appeared at a lower intensity in the group fed a low protein diet but not in any other groups. These observations were confirmed by neutral gel chromatography. The chicken IGF-II ligand revealed an intensely labelled band corresponding to 75 kDa and this was not affected by nutrition. IGF-I and IGFBP concentrations in the plasma of young broiler chickens were influenced by nutritional state but IGF-II concentrations were not. The lack of a response in circulating IGF-II levels may have been due to the presence of high concentrations of a 75 kDa specific binding protein which did not respond to nutrition in this experiment.

Animal Nutritional Physiological Phenomena↗
PubMed1995

3-amino-2-hydroxy-N-(4-nitrophenyl)-propanesulphonamide, a new class of GABAB receptor antagonist in central and peripheral preparations.

Racemic 3-amino-2-hydroxy-N-(4-nitrophenyl)-propanesulphonamide (AHPNS), a sulphonamide analog of GABA, reversibly and competitively antagonised the concentration-dependent depression of cholinergic twitch contractions by baclofen, in the electrically stimulated guinea-pig isolated ileum, with a pA2 of 4.0 +/- 0.2. In the rat neocortex, maintained in Mg(2+)-free medium, AHPNS (100-500 microM) also reversibly antagonised the baclofen (10 microM)-induced suppression of spontaneous discharges. AHPNS is a new class of GABAB receptor antagonist that has central and peripheral blocking actions.

Animals↗
PubMed1995

Cloning and chromosomal localization of a mouse cDNA with homology to the Saccharomyces cerevisiae gene zuotin.

The eukaryotic DnaJ homologs form a family of proteins with diverse functions. One member of the family, the Saccharomyces cerevisiae gene zuotin, was isolated for its ability to bind Z-DNA. Here, we have isolated a mouse cDNA called ZRF1 (for zuotin-related factor1) with significant homology to zuotin. The DnaJ domain and candidate phosphorylation sites of zuotin and ZRF1 are highly conserved. ZRF1 gene is localized on chromosome 5. The structural similarity of zuotin and ZRF1 suggests conservation of function of this DnaJ subfamily.

Amino Acid Sequence↗
PubMed1995

Selective indications for thoracic and lumbar radiography in blunt trauma.

STUDY OBJECTIVE: To determine indications for thoracolumbar radiography. DESIGN: Case series with prospective data collection. SETTING: Level I trauma center. PARTICIPANTS: Blunt-trauma victims more than 12 years old who underwent routine thoracic and lumbar radiography according to institutional protocol. Patients were classified as group 1, not able to be evaluated clinically (Glasgow Coma Scale score of less than 13, intoxication, intubation, or cervical neurologic deficit); and group 2, able to be evaluated clinically. RESULTS: Twenty-four of 319 patients sustained 25 thoracic or lumbar fractures. Seven of 136 group 1 patients and 17 of 183 group 2 patients had fractures. Eight of 17 patients with pain and 9 of 17 with tenderness had fractures (P = .001). No group 2 patients without pain, tenderness, thoracic or lumbar neuro-deficit, or major distracting injury, including cervical fracture, had fractures. The negative predictive value of pain and tenderness was 95%. Five of 46 patients with spinal fractures at any level had multiple fractures. CONCLUSION: Blunt-trauma victims who cannot be evaluated clinically should undergo thoracolumbar radiography. Routine radiography may be unnecessary in asymptomatic patients who can be evaluated clinically and who do not have neurologic deficits or distracting injuries. Spinal fracture at any level mandates complete spinal radiography.

Adolescent↗
PubMed1994

Differing actions of nitropropane analogs of GABA and baclofen in central and peripheral preparations.

In the guinea-pig isolated ileum, both baclofen (5-100 microM) and gamma-aminobutyric acid (GABA; 5-100 microM) induced a bicuculline-insensitive depression of cholinergic twitch contractions which was reversibly and competitively antagonised by 3-amino-1-nitropropane (50-250 microM). 3-Amino-1-nitropropane (pA2 = 5.0 +/- 0.1) was twice as potent as 2-hydroxysaclofen (pA2 = 4.5 +/- 0.1), but was equipotent with 3-aminopropyl(P-diethoxymethyl)phosphinic acid (CGP 35348) (pA2 = 4.9 +/- 0.2), and did not show any partial agonist activity at these peripheral GABAA or GABAB receptor sites. In rat neocortical slices, 3-amino-1-nitropropane did not activate GABAB receptor sites or affect baclofen-induced suppression of spontaneous discharges. In the cat spinal cord, however, under in vivo conditions, the corresponding nitro analog of baclofen 3-amino-2-(4-chloro)-nitropropane was an agonist at GABAB receptor sites, although more than 60 times weaker than baclofen in depressing monosynaptic excitatory field potentials, whereas 3-amino-1-nitropropane was an extremely weak agonist at bicuculline-sensitive GABAA sites. The differing actions of 3-amino-1-nitropropane at peripheral and central GABAB receptor sites suggest heterogeneity among these receptors.

Animals↗