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Biomedical subjects

R West

Publications and source records attributed to R West.

At least 217 records · Page 12Linked to original sources
PubMed1989

Access and satisfaction in the Arizona Health Care Cost Containment System.

Results of a survey conducted in the summer of 1985 of beneficiaries of the Arizona Health Care Cost Containment System and a matched group of Medicaid beneficiaries concerning their access to and satisfaction with medical care services are described in this article. The Arizona Health Care Cost Containment System is an alternative to Medicaid's acute medical care coverage. The results of the study indicate few differences in access and satisfaction between the two groups of beneficiaries on access to care, reported use of services, or satisfaction with the care received.

Adolescent↗
PubMed1989

Will the increased military low-level flying activity in Labrador be detrimental to the hearing of humans in the region?

The Government of Canada has directed the Department of National Defence to encourage our NATO allies to increase use of their facilities at Goose Bay, Labrador. This has already resulted in a substantial increase in the amount of military flying in the area, and more is projected. Much of the flying is done at very low altitude. The aboriginal people in the region (the Innu and, to a lesser extent, the Inuit) are demanding a halt to low-level military flying, and their representatives claim that the noise from the low-flying jet aircraft can cause hearing loss and ear disease. A survey on the ground in the area measured noise levels up to 127.7 dBA with very brief exposure levels. A task force commission to look at the problem concluded that occasionally low-level subsonic overflights might produce noise levels that were potentially damaging to hearing, but that the probability of this happening is at present very low because of the low frequency of flights. This might change if the frequency of flights increases.

Aircraft↗
PubMed1988

Slowing the speedy.

Explore the source record for details and available documents.

Accidents, Traffic↗
PubMed1988

Loss of acute nicotine tolerance and severity of cigarette withdrawal.

Twenty-one smokers underwent 24-h abstinence from cigarettes. Both prior to, and after, the abstinence period cardiovascular and subjective effects of smoking a cigarette were measured. Withdrawal symptoms found during abstinence were: irritability, depression, hunger, difficulty concentrating, restlessness and urges to smoke. In addition, the subjects reported feeling physically less well. Withdrawal discomfort was positively correlated with the strength of the subjective effects (e.g. dizziness, nausea) of smoking the post-abstinence cigarette after taking account of estimated nicotine boost from that cigarette. A similar, though only marginally significant association was found between withdrawal severity and heart rate boost from the post-abstinence cigarette. Our results suggest that the severity of withdrawal may be related to loss of acute tolerance to nicotine. It is not clear whether this is due to more rapid nicotine clearance, constitutional differences in sensitivity to nicotine in the absence of acute tolerance, or other factors. There was no evidence to support the view that higher chronic tolerance to nicotine's heart-rate effects was associated with more severe withdrawal. If anything, the reverse appeared to be the case.

Adult↗
PubMed1988

Drop in heart rate following smoking cessation may be permanent.

Data are reported on the heart rates of nine smokers who underwent 5 weeks of abstinence. There was an initial fall of 9.1 beats per min from 79 to 69.9 beats per min on the 1st day, with no significant change thereafter. The average heart rates after 2, 3, 4 and 5 weeks were 69.1, 69.1, 71.7 and 69.9 beats per min, respectively. Heart rate after 5 weeks was still significantly below baseline. The results indicate that the drop in heart rate which occurs open smoking abstinence is either a permanent change, or if it is a temporary withdrawal effect lasts longer than 5 weeks. If it is a permanent change then it may not make sense to consider drop in heart rate as part of a withdrawal syndrome; it could merely reflect absence of nicotine's stimulant action.

Adult↗
PubMed1988

Fatal upper gastrointestinal hemorrhage or perforation among users and nonusers of nonsteroidal anti-inflammatory drugs in Saskatchewan, Canada 1983.

We report a cohort study of fatal upper GI hemorrhage and/or perforation in relation to use of nonsteroidal anti-inflammatory drugs (NSAIDs) among the one million residents of Saskatchewan Canada in 1983. All hospitalized cases of GI hemorrhage and/or perforation with a fatal outcome were identified using the records linkage system of the Saskatchewan Department of Health. Discharge summaries and autopsy records were reviewed to select the cases of upper GI hemorrhage or upper GI perforation and to exclude cases in which known risk factors were present. The 134,060 residents who filled one or more prescriptions for an NSAID in 1983 were identified and individually linked to their hospital records by patient identification number. The age- and gender-specific incidence of fatal upper GI hemorrhage and/or perforation in the absence of risk factors in users was compared to that in nonusers, controlling for recent history of upper GI disease. Fatal upper GI hemorrhage or perforation in temporal association with NSAIDs is extremely rare in persons younger than 75 years of age. No temporally-related cases occurred in male NSAID users age 75 and older, but NSAID usage in this group was limited. Among women age 75 and older, the rate in users was higher than in nonusers, with the highest rate being in female NSAID users age 75 and older with a recent history of upper GI disease. Total mortality among women age 75 and older was slightly lower among users than among nonusers. Physicians who prescribe NSAIDs to patients age 75 and older should be aware of the potential risks, particularly in those with predisposing factors such as a history of upper GI disease.

Adult↗
PubMed1988

Ethical aspects of genetic disease and genetic counselling.

With the reduction in diseases due to nutritional deficiencies and infection, disorders which are wholly or partly genetic are becoming relatively more important in all branches of modern medicine. Genetic counselling has developed in recent years from just explaining to an individual or a couple the risk of them producing a handicapped child, to the possibility in many cases of better diagnosis and active intervention to reduce the risks. At the same time antenatal screening programmes have been introduced to detect women who may be carrying a fetus with a severe handicapping anomaly. The ethical aspects of these advances are considered in this article. A practical approach to the resolution of any dilemmas is proposed which concentrates on the duties incumbent on doctors and other health care workers involved with patients who have or may carry genetic disorders.

Disclosure↗
PubMed1987

Subjective effects of cigarette smoking in adolescents.

Eighty-two per cent of a sample of 170 female adolescent smokers reported experiencing one or more of five specified subjective effects of smoking. Feeling calmer was the most frequently reported effect and daily smokers were more likely to report this than non-daily smokers (64% versus 38%, P less than 0.001). Self-reports of cigarette consumption and depth of inhalation and measures of smoke intake (salivary cotinine and expired-air carbon monoxide levels) were positively related to the report of feeling calmer when smoking and negatively related to feeling dizzy/light-headed and sick when smoking. The likelihood of experiencing at least one withdrawal effect when trying to quit was greater amongst those who reported feeling calmer when smoking (82% versus 40%, P less than 0.001). These results indicate that subjective effects of smoking are commonly reported by children and it is possible that pharmacological factors are implicated alongside psychosocial ones even at this early stage.

Adolescent↗
PubMed1987

Comparison of bolus and infusion methods for estimating hepatic blood flow in patients with liver disease using indocyanine green.

A non-invasive method of estimating liver blood flow by a two-compartment pharmacokinetic model of the plasma clearance of indocyanine green has been previously described in normal animals and patients without liver disease. This non-invasive technique has been compared with the conventional method of measuring liver blood flow by hepatic vein catheterisation in 25 patients with liver disease. There was good correlation between the values for indocyanine green clearance, with the infusion method tending to produce slightly higher results. However, there was poor agreement in the measurement of liver blood flow, as the non-invasive technique over-estimated the hepatic extraction ratio and thus underestimated liver blood flow. Therefore, in patients with liver disease the non-invasive method cannot be relied upon or replace hepatic vein catheterisation for the measurement of liver blood flow.

Humans↗