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Biomedical subjects

S Brown

Publications and source records attributed to S Brown.

At least 523 records · Page 29Linked to original sources
PubMed1990

Rheumatology algorithms for primary care physicians.

Primary care physicians were trained on three rheumatology topics to assess the effectiveness of an educational strategy for continuing medical education. Algorithm training was shown to be at least as effective as that based on standard prose monographs. Both training groups improved their knowledge of patient management skills but there were no statistically significant differences between groups in the amount learned. When algorithms were used to design text materials, the designed texts required less study time than did the annotated clinical algorithms alone. That difference was significant for the shoulder pain materials (P less than 0.05) but not for the osteoporosis materials. The ratio of knowledge gained to study time was significantly higher for the algorithm group on the low back pain topic (P less than 0.05) but not for the other topics. Taped interview problems tests were studied as a method for assessing patient management skills related to problem-specific indicator conditions and were found to produce interrater reliability greater than 0.80 on five of the six tests.

Clinical Protocols↗
PubMed1990

Perspective of the patient with rheumatoid arthritis on issues related to missed medication.

In order to better understand issues surrounding missed medication doses, 140 patients with rheumatoid arthritis in a tertiary care clinic were interviewed about their medication-taking behavior and beliefs. Findings from work in memory and attention and concepts from Ajzen and Fishbein's theory of reasoned action were used to guide the development of questions. Key findings included: (a) some ignorance about their regimen, (b) a tendency to rely just on their memories rather than environmental cues to remember doses, (c) variation in responses to a missed dose, and (d) the use of an inferential process for judging a medication's efficaciousness. These findings suggest several areas that physicians and allied health professionals can investigate with patients to help minimize missed doses.

Arthritis, Rheumatoid↗
PubMed1989

Shared idiotypes expressed by human B-cell lymphomas.

Each B-cell lymphoma expresses a surface immunoglobulin that contains unique antigenic determinants (idiotypes). We have produced 199 murine monoclonal antibodies reactive with the idiotypes isolated from 67 patients with follicular small-cleaved-cell lymphoma. These antiidiotype antibodies were analyzed for their ability to react with lymphoma cells from patients other than the one against which each antibody was made. Twenty of the 199 antiidiotype antibodies were reactive with lymphoma cells from more than one patient. Depending on the antibody, the frequency of idiotype sharing ranged from 0.6 to 6.2 percent of B-cell lymphoma tumors evaluated. Tumors could be grouped into distinct families on the basis of their reactivity with these antibodies. In the aggregate, the 20 antibodies reacted with a total of 49 of 150 B-cell lymphomas (33 percent), including 30 of 110 follicular small-cleaved-cell lymphomas (27 percent). Many of these shared idiotypes were expressed by more than one histopathological subtype of lymphoma. We conclude that a panel of antibodies reactive with shared idiotypes can be produced for patients with B-cell lymphoma, obviating the need to produce an antiidiotype antibody for each patient.

Antibodies, Anti-Idiotypic↗
PubMed1989

Time of action of 4.5 S RNA in Escherichia coli translation.

A new class of suppressor mutants helps to define the role of 4.5 S RNA in translation. The suppressors reduce the requirement for 4.5 S RNA by increasing the intracellular concentration of uncharged tRNA. Suppression probably occurs by prolonging the period in which translating ribosomes have translocated but not yet released the uncharged tRNA, indicating that this is the point at which 4.5 S RNA enters translation. The release of 4.5 S RNA from polysomes is affected by antibiotics that inhibit protein synthesis. The antibiotic-sensitivity of this release indicates that 4.5 S RNA exits the ribosome following translocation and prior to release of protein synthesis elongation factor G. These results indicate that 4.5 S RNA acts immediately after ribosomal translocation. A model is proposed in which 4.5 S RNA stabilizes the post-translocation state by replacing 23 S ribosomal RNA as a binding site for elongation factor G. The 4.5 S RNA-requirement of mutants altered in 23 S ribosomal RNA support this model.

Anti-Bacterial Agents↗
PubMed1989

Missed medication doses in rheumatic arthritis patients: intentional and unintentional reasons.

A survey of 200 rheumatoid arthritis (RA) patients was conducted to identify the kinds and frequencies of intentional and unintentional reasons for missed medication dose. Planned and unplanned changes in usual activity routines accounted for most of the unintentionally missed doses, while side effects attributed to the medication accounted for most of the intentionally missed doses. Patients who did not miss medication doses were different from those who did by tending to have more financial resources and social support available to them.

Anti-Inflammatory Agents↗
PubMed1989

A study of inter-reviewer reliability of attacks recorded on ambulatory EEG.

Eleven ambulatory EEG (A/EEG) cassette tapes were sent to 5 reviewers from different EEG laboratories in the U.K. Each tape included one attack recorded from a different patient. Attacks were chosen to include various possible EEG changes that can occur during attacks on A/EEG. Reviewers were asked to give details of EEG changes seen during attacks and to state whether they thought attacks were epileptic. Total agreement about the presence of abnormality was found on 2 tapes. Four out of 5 reviewers agreed on 4 tapes and on the remaining 5 tapes only 2 or 3 reviewers were in agreement. It was concluded that the amount of agreement amongst reviewers was poor but reasonable in view of the degree of difficulty of the tapes which were not a random sample. Compared to the final clinical opinion of referring consultants, these findings would have resulted in 16% false negatives, 7% false positives and 13% of cases in which no decision was made.

Ambulatory Care↗
PubMed1989

Open versus endoscopic surgery in the treatment of vesicoureteral reflux.

Surgical reimplantation of the ureters was compared to subureteral injection of polytetrafluoroethylene (Polytef) in the treatment of primary vesicoureteral reflux. Reflux was eliminated successfully in 98 per cent of the 76 ureters treated by reimplantation and in 70 per cent of the 40 ureters treated endoscopically. Although the surgical morbidity of endoscopic surgery appears to be less than that of open surgery, the patients undergoing endoscopic surgery required more hospital admissions, more anesthetics and more micturating cystourethrograms than did those in the reimplantation group. It is concluded that subureteral polytetrafluoroethylene injection does not represent a satisfactory substitute for reimplantation.

Child↗
PubMed1989

A combined 2D-NMR and molecular dynamics analysis of the structure of the actinomycin D: d(ATGCAT)2 complex.

We present a comparative analysis of an NMR experiment and molecular and harmonic dynamics simulations of an actinomycin D: d(ATGCAT)2 complex. A comparison of NOE measurements and 1/R6 weighted proton-proton distances confirm the general correctness of the Actinomycin D-DNA model proposed by Sobell. There are, however, some substantial differences between the proton-proton distances inferred from the NOE results and the molecular and harmonic dynamics simulations. The remaining discrepancies could either come from contributions of other conformations to the average properties of the complex or from uncertainties in the NMR distance analysis. An analysis of the molecular dynamics helix properties, sugar puckers, hydrogen bonding, rms fluctuations and torsional properties are qualitatively consistent with those from previous simulations, but the presence of an intercalated drug leads to some new structural and dynamical features.

Chemical Phenomena↗
PubMed1989

Construction of clinical algorithms for educational programs.

Clinical algorithms have been used successfully in a variety of health care settings to assist health care professionals in the diagnosis and management of medical problems. In addition to their clinical applications, algorithms also serve as an instructional resource by themselves and when used in conjunction with other educational methodologies. A recommended algorithm development process is described for cancer educators who wish to take advantage of the unique contribution clinical algorithms can offer for their educational programs. Algorithm design conventions are reviewed and specific writing suggestions are offered for the guidance of educators who want to design their own clinical algorithms. Objections to clinical algorithms can often be attributed to a misunderstanding of their proper role, which is to facilitate, not dictate, the decision process and guide the application of management logic. Clinical algorithms are a valuable instructional resource that can be used in a wide range of educational settings from self-instruction units to the design of lecture presentations.

Algorithms↗
PubMed1989

Academic performance of reapplicants to a medical school.

This study examined the academic performance of 399 reapplicants who had entered the University of Alabama School of Medicine between 1978 and 1984. Compared with the first-time applicants, the reapplicants had lower preadmission measures and a higher rate of academic difficulty during medical school. However, applicant status (that is, first-time or reapplicant) added nothing to the prediction of academic difficulty over what could be predicted by preadmission measures alone: the students with lower preadmission measures were more likely to experience academic difficulty, regardless of their applicant status. Based on these results, reapplicants should not be viewed negatively simply because they are reapplicants.

Achievement↗
PubMed1989

Provision of a panel of anti-toxoplasma-negative blood donors.

Toxoplasma gondii has been reported to cause complications only in immunosuppressed patients receiving leucocyte transfusion, when severe acute toxoplasmosis has been reported with associated mortality. At the North London Blood Transfusion Centre (NLBTC) we have screened 392 plasmapheresis donors (using toxoreagent latex agglutination test manufactured by Eiken) to provide a panel of blood donors negative for antibody to toxoplasma for seronegative recipients. A toxoplasma-negative panel of donors would only be required for those rare instances when granulocyte concentrates are indicated for transfusion of seronegative recipients. The toxoreagent test classified the 392 blood donors as 36% positive, 23% weakly reactive and 41% negative; these negative sera were retested with toxoreagent and 17% of them reacted weakly but none were positive. The toxoreagent 'weakly-reactive' sera (all of which were Sabin-Feldman dye test negative) can probably best be accounted for by the exacting screening conditions under which we operated to ensure seronegativity in our special donor panel. 40% of the antibody-positive donors were female and 34% male. Seropositivity increased with age.

Adult↗
PubMed1989

Graded neuropsychological impairment and elevated gamma-glutamyl transferase in chronic alcoholic men.

This study hypothesizes that distinct biochemical and metabolic disturbances associated with liver injury may be related to specific cognitive changes in alcoholics. In 132 alcoholic men admitted to an alcohol treatment program, increases in gamma-glutamyl transferase (GGT) values were correlated with impairment in several measures of visuoperceptual and visuoconceptual functioning. The association between plasma levels of GGT and neuropsychological performance was independent of the relative contribution of other laboratory measures of liver injury and of alcohol consumption histories. These observations support the hypothesis that elevated levels of GGT are distinctly associated with neuropsychological deficits and suggest that possible mechanisms beyond severe hepatic dysfunction and alcohol consumption underlie cognitive deficits in alcoholics.

Adult↗
PubMed1989

Genetic selection and DNA sequences of 4.5S RNA homologs.

A general strategy for cloning the functional homologs of an Escherichia coli gene was used to clone homologs of 4.5S RNA from other bacteria. The genes encoding these homologs were selected by their ability to complement a deletion of the gene for 4.5S RNA. DNA sequences of the regions encoding the homologs were determined. Since this approach does not require that the homologous genes hybridize with probes generated from the E. coli sequence, the sequences of the homologs were not all similar to the sequence of the E. coli gene. Despite the dissimilarity of the primary sequences of some of the homologs, all could be folded to obtain a similar structure.

Bacillus subtilis↗
PubMed1989

Effect of bile acid on anorectal function in man.

The effects of rectal infusions (500 ml) of deoxycholic acid (1 mmol/l, 3 mmol/l) or normal saline on basal anorectal motility and responses to rectal distension were studied in 11 normal volunteers. Deoxycholic acid (1 mmol/l) did not alter anorectal motor patterns under basal conditions but reduced the rectal volumes required to induce a desire to defecate (deoxycholic acid 76 (12) ml v saline 123 (12) ml; mean (SEM) p less than 0.01), and to produce anal relaxation (deoxycholic acid 83 (14) ml v saline 152 (24) ml; p less than 0.05) and perception of the rectal balloon (deoxycholic acid 56 (10) ml v saline 104 (17) ml; p less than 0.01) that were sustained for the period of distension (1 min). Seven of 10 subjects could not tolerate an infusion of 3 mmol/l deoxycholic acid. Between two and 30 minutes after the start of the infusion they experienced an extreme urge to defecate which was associated with large amplitude pressure waves in the rectal channels (amplitude 30 (5) mmHg, duration 0.7 (0.1) min, frequency 1.7 (0.4)/min). Such contractions were never seen during saline infusion. Thus, rectal infusion of deoxycholic acid at physiological concentrations increases the sensitivity of the rectum to distension, and promotes an urgent desire to defecate in normal subjects.

Adolescent↗