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Biomedical subjects

R Tinsley

Publications and source records attributed to R Tinsley.

13 recordsLinked to original sources

Use of gene therapy in central nervous system repair.

Recent advances have increased our molecular understanding of the central nervous system (CNS), in both health and disease. In order to realize the clinical benefits of these findings, new molecular-based therapies need to be developed, such as CNS gene therapy. Although the field has suffered setbacks, it remains an attractive technology for providing new therapies in the post-genomic world. The development of new vectors, and their extensive application in animal models of CNS disease, provides evidence suggesting that gene therapy will eventually become an accepted clinical option. In fact, the first gene therapy clinical trial for Parkinson's disease has recently begun. This review discusses how gene therapy has been applied in animal models, and how it may be used to repair the damage caused by CNS diseases and trauma in human beings. Furthermore, it explores how such treatments may be combined with, and augment, more conventional therapeutic approaches.

Animals↗

A Paedomorphic parasite associated with a neotenic amphibian host: phylogenetic evidence suggests a revised systematic position for Sphyranuridae within anuran and turtle Polystomatoineans.

The phylogenetic relationships of the families Polystomatidae and Sphyranuridae (subclass Polystomatoinea) within tetrapod monogenean parasites were investigated using partial 18S rDNA sequences. About 600 nucleotides of 11 species were sequenced, including 7 species of the most common subfamilies of Polystomatidae found in anurans and turtles, 1 species of the family Sphyranuridae parasitizing exclusively urodelans, and 3 species of the subclass Oligonchoinea infesting teleostean fishes. The phylogenetic analyses were performed using three reconstruction methods: neighbor-joining, maximum-parsimony, and maximum-likelihood. Polystomatoineans but not polystomatids were shown to be monophyletic. Within the polystomatoineans there are two clades: one includes the amphibian monogeneans (anuran polystomatids and urodelan sphyranurids) and the other includes the turtle polystomatids. Polystomatoineans may have coevolved with amphibian hosts, and an ancestral "polystome" dispersed at least 200 million years ago, either from the basal stem of lissamphibians or from an anuran ancestral stock, to freshwater turtles. Furthermore, the urodelan genus Sphyranura, initially assigned to the family Sphyranuridae on the basis of morphological and ontogenetic evidence, is clearly nested within polystomatids, suggesting that its systematic status must be revised. This supports recent findings which argue that species of the family Sphyranuridae may be paedomorphic parasites exclusively infesting neotenic mudpuppies.

Animals↗

Merging medical practices: look before you leap.

Current changes in health care are forcing many physicians to merge their medical practices. Because any successful merger requires careful planning, there are many critical issues that should be reviewed, discussed, and decided by physicians considering merging their medical practices. This article explores some of these issues and provides a useful practice merger checklist.

Decision Making↗

Phase II trial of etoposide and cisplatin for refractory small cell lung cancer: a Cancer and Leukemia Group B Study.

A phase II trial of etoposide and cisplatin for patients with previously treated small cell lung cancer was carried out by CALGB from June 1983 to May 1984. Thirty-five evaluable patients who had failed one prior chemotherapy regimen were treated with etoposide 80 mg/m2 and cisplatin 20 mg/m2 days 1-5 every 3 weeks. Objective responses were seen in 7 patients (20%) with 1 complete response and 6 partial responses. The median duration of response was 5.1 months. Fifteen patients (43%) had stable disease. Overall survival was 49% at 6 months and 14% at 1 year. The median survival was 6 months. Toxicity was mainly hematologic with severe and life-threatening leukopenia and thrombocytopenia seen in 71% and 66% of patients, respectively. Two treatment-related deaths caused by infection were seen. This cooperative group study fails to confirm the high response rates previously reported in institutional pilot studies.

Adult↗

Unusual cause of increased intracranial pressure from metastatic germ cell cancer.

Metastatic lesions within the brain parenchyma are usually responsible for the development of increased intracranial pressure in patients with metastatic cancer. The lesions can usually be easily documented by computerized axial tomography (CT) of the head. Other causes must be sought in patients with metastatic cancer who present with signs of increased intracranial pressure and whose CT scan of the head fails to reveal any parenchymal lesions. Cranial metastases obstructing venous outflow from the brain may present in this manner.

Adult↗

The bottom line. What ailing hospitals should know.

Hospitals hire consultants to bail them out because they bring new perspective. But CEO's and department heads should prepare themselves for sweeping changes that will impact the bottom line.

Accounts Payable and Receivable↗

Negotiating or renegotiating managed care contracts.

When negotiating or renegotiating a managed care contract, medical groups need leverage. Medical groups have to offer the managed care company something it can't get anywhere else in order to get the most advantageous contract. Leverage can come by offering a large provider panel, geographic coverage or superior quality, among other things. In every case, physicians benefit by being proactive as they negotiate managed care contracts.

Contract Services↗

Messenger model IPAs need caution in managed care.

Messenger model independent practice associations (IPAs) are a popular choice for physicians coming to together to improve payer negotiations. However, it is easy for such models to run afoul of antitrust regulations, as did a messenger model IPA in Tampa, Fla. The following is a discussion of this case. You should be able to use it as a guide if and when you are ever involved in a messenger model IPA situation. This article also will provide tips and strategies for working in the messenger model IPA format.

Antitrust Laws↗