Do intracrine mechanisms regulate aromatase expression?
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Animals↗
Biomedical subjects
S Davis
Publications and source records attributed to S Davis.
Treatment of anemia in patients with HIV infection, Part 1: The need for adequate guidelines.
Anemia in HIV-infected individuals, still a common hematologic complication in the highly active antiretroviral therapy (HAART) era, is associated with shortened survival, increases in the rate of disease progression, and reduction in quality of life. Based on a thorough review of the literature, guidelines were developed for the assessment, diagnosis, monitoring, and treatment of anemia in patients with HIV/AIDS by a consensus committee consisting of nurses from academia and clinical practice. A major goal of this committee is to increase awareness within the nursing community of the prevalence of anemia in HIV-infected patients and its impact on their lives. Anemia developed in close to 90% of HIV-infected patients before the introduction of HAART, and it is still found in up to 46% of patients in the HAART era. Another goal is to encourage screening for anemia and the adaptation of a proposed classification system of anemia based on a graded decrease in hemoglobin levels.
Adolescent↗
Matrix metalloproteinase inhibition protects hepatic integrity in hemorrhagic shock.
Hemorrhagic shock increases cytokines, such as tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6), and compromises hepatic function and integrity. The production of TNF-alpha involves a cascade reaction regulated by the enzyme TNF-alpha convertase. The purpose of this study was to examine the effects of matrix metalloproteinase inhibitor (MMPI) (British Biotech 1101) in vivo on hepatic integrity in a rat model of hemorrhagic shock. Sprague-Dawley rats (n = 26) were divided as follows: hemorrhagic shock (group 1) and hemorrhagic shock plus MMPI (group 2). TNF-alpha, IL-6, and hepatic membrane potentials (Em) were obtained. The administration of MMPI significantly decreased TNF-alpha levels (P <0.001) and stabilized the membrane potential at -30 mV as compared to the depolarized membrane potential at -20 mV for hemorrhagic shock without MMPI. IL-6 levels were not affected by the MMPI. This study demonstrates that MMPI decreases TNF-alpha levels and protects hepatic integrity in hemorrhagic shock, as evidenced by the stabilization of the membrane potential, independent of the mean arterial pressure. The hepatic protection is closely related to the decrease in TNF-alpha levels seen in the portal circulation.
Animals↗
Electron microprobe analysis of particle deposited in lungs.
A technique that is based on the combined use of a conventional transmission electron microscope and a conventional electron probe x-ray microanalyzer permits an unambiguous identification of titanium dioxide (TiO2) particles in lung tissue and cells. Quite probably, many other inorganic particles can be identified with the use of this technique.
Aerosols↗
Quantitative estimates of soil ingestion in normal children between the ages of 2 and 7 years: population-based estimates using aluminum, silicon, and titanium as soil tracer elements.
This investigation was undertaken to provide quantitative estimates of soil ingestion in young children on a population basis, and to identify demographic and behavioral characteristics that influence the amount of soil ingested. A total of 104 children between the ages of 2 and 7 yr were selected randomly from the population of a three-city area in southeastern Washington State. Using aluminum, silicon, and titanium as tracer elements, a mass-balance approach was employed to assess daily soil ingestion. A duplicate of all food items consumed, all feces, and some urine excreted were collected on 4 consecutive d, along with soil and house dust samples from each child's home. Samples were analyzed by x-ray fluorescence spectrometry. After adjustment of the soil ingestion estimates to account for missing food, excreta samples, and nonfood items consumed, the average daily values based on the three tracer elements were: aluminum, 38.9 mg/d (median = 25.3 mg/d); silicon, 82.4 mg/d (median = 59.4 mg/d); and titanium, 245.5 mg/d (median = 81.3 mg/d). No consistent pattern emerged regarding a demographic or behavioral profile that was predictive of soil ingestion. This work demonstrates (a) the feasibility of conducting large-scale studies to determine soil intake levels in human populations, (b) provides estimates of soil ingestion in small children based on a random population sample, and (c) suggests several possibilities for additional research initiatives in this area.
Age Factors↗
Toxicologic lesions associated with two related inhibitors of oxidosqualene cyclase in the dog and mouse.
Two novel hypolipidaemic agents, both members of the aminopyrimidine series, with a mode of action of inhibition of oxidosqualene cyclase (OSC), were administered orally to dogs and mice for 14 and 28 days. Both compounds produced a similar spectrum of pathologic changes. In dogs, the agents produced equatorial single cell necrosis and cataract in the lens (also observed clinically); atrophy, ulceration, and inflammation of the cornea; hyperkeratosis, acanthosis, hair papillary atrophy, and inflammation of the skin; and epithelial degeneration and sperm granuloma in the epididymides. One female dog showed signs of liver toxicity. In mice, severe cataract formation was seen with both compounds, and liver toxicity was produced by one of the compounds. The severity and speed of onset of the cataract formation were very marked. The changes seen were dissimilar to those reported with the most commonly used class of hypolipidaemic agents in the clinic, the hydroxymethyl glutaryl coenzyme A (HMGCoA) reductase inhibitors but were reminiscent of those reported for the hypolipidaemic agent Triparanol. which was predictive of toxicity seen in man.
Administration, Oral↗
Infrequent elevation of plasma ACTH in patients with bronchogenic carcinoma.
Older methods for radioimmunoassay of ACTH in human plasma have detected a high frequency of plasma ACTH elevation in patients with lung cancer, even in the absence of Cushing's syndrome. It now appears evident that these assay systems measure biologically inactive forms and fragments of ACTH. Since ectopic Cushing's syndrome may be clinically atypical, a radioimmunoassay for ACTH that correlates with the clinical state would be of value. Accordingly, circulating plasma corticotropin (ACTH) levels were measured in 39 consecutive patients with biopsy-proven, untreated lung cancer, all without evidence of Cushing's syndrome. In only one instance was ACTH found to be elevated by the method of assay used. Two interpretations are justified: (1) elevated plasma ACTH levels are infrequent in patients with lung cancer, or (2) ACTH measurements vary according to the assay system used.
Adenocarcinoma↗
An effective approach to treating decubitus ulcers in home healthcare patients.
An innovative study conducted by the Visiting Nurse Association of Southern New Jersey resulted in a variety of benefits, including a more effective way for visiting nurses to help patients with pressure sores.
Aged↗
Alterations in the expression of specific glutamate receptor subunits following hippocampal LTP in vivo.
Quantitative in situ hybridization revealed that following the induction of hippocampal long-term potentiation (LTP) in the dentate gyrus of freely moving rats, specific increases in the expression of the NR2B subunit of the N-methyl-D-aspartate (NMDA) receptor and mGluR1c, a short splice variant of the metabotropic glutamate receptors that are linked intracellularly to phospholipase C (PLC) and protein kinase C (PKC), were seen in the postsynaptic dentate granule cells. There were no changes in the expression of NR2A; NR2C and NR2D NMDA receptor subunits; or mGluR1a, mGluR1b, mGluR5a, and mGluR5b PLC-associated metabotropic receptors. The elevations in NR2B and mGluR1c mRNA were delayed, occurring days after LTP induction. NR2B expression was enhanced significantly by 48 hr after LTP but was starting to decrease toward basal levels by 96 hr. The transient increase in the expression of NR2B mirrored the increase in the expression of PKC-sensitive isoforms of the NR1 subunits of the NMDA receptor we observed previously (Thomas et al. 1994a). The increase in mGluR1c expression was more persistent, showing a significant increase 96 hr after LTP. This study demonstrates that not only are there changes in the expression of individual glutamate receptor subunits but the increases in their expression occur days after the induction of LTP and may reflect so-called late-onset genes that may be important for the maintenance of LTP.
Animals↗
The clinical algorithm nosology: a method for comparing algorithmic guidelines.
Concern regarding the cost and quality of medical care has led to a proliferation of competing clinical practice guidelines. No technique has been described for determining objectively the degree of similarity between alternative guidelines for the same clinical problem. The authors describe the development of the Clinical Algorithm Nosology (CAN), a new method to compare one form of guideline: the clinical algorithm. The CAN measures overall design complexity independent of algorithm content, qualitatively describes the clinical differences between two alternative algorithms, and then scores the degree of similarity between them. CAN algorithm design-complexity scores correlated highly with clinicians' estimates of complexity on an ordinal scale (r = 0.86). Five pairs of clinical algorithms addressing three topics (gallstone lithotripsy, thyroid nodule, and sinusitis) were selected for interrater reliability testing of the CAN clinical-similarity scoring system. Raters categorized the similarity of algorithm pathways in alternative algorithms as "identical," "similar," or "different." Interrater agreement was achieved on 85/109 scores (80%), weighted kappa statistic, k = 0.73. It is concluded that the CAN is a valid method for determining the structural complexity of clinical algorithms, and a reliable method for describing differences and scoring the similarity between algorithms for the same clinical problem. In the future, the CAN may serve to evaluate the reliability of algorithm development programs, and to support providers and purchasers in choosing among alternative clinical guidelines.
Algorithms↗
Sodium valproate in the treatment of behavioral disturbance in dementia.
Management of the behavioral complications of dementia, including agitation and aggression, presents a tremendous challenge to families and caregivers of afflicted patients. Most previous pharmacotherapies have shown minimal efficacy and significant side effects. We report our initial, open-label experience using the anticonvulsant sodium valproate in four dementia patients with severe behavioral disturbance. The drug was well tolerated by all patients, with no side effects or laboratory abnormalities, during 1- to 3-month trials. Two patients showed significant improvement in behavior, and a third had a transient response. Valproate may be a useful agent in the treatment of behavioral disturbance in dementia; controlled trials are needed to document its efficacy.
Aged↗
The "new young chronic" psychiatric patient: a study in Vancouver.
A group of Vancouver B.C. schizophrenic patients were studied to see if the younger subjects possessed the characteristics of the "new young chronic" patient described in the literature. Information on a number of quantitative measures of community functioning was gathered from the clinical files of patients who were attending community mental health teams. The younger subjects possessed many of the same features of the "new young chronic" described by other workers. This was a group with a high level of instability, as reflected in high rehospitalization rates, a greater need for clinical services, an earlier initial contact with the psychiatric system, lower marriage rates, lower employment rates and greater mobility than the older subjects. Because age accounted for so much variability within the sample, the young patients may be regarded as a distinct sub-group. The limitations and implications of the study are discussed. There may be a "lack of fit" between patient needs and the services of the mental health delivery system.
Adult↗
Electron microscopic and immunohistochemical analysis of glomerular deposits in patients with bronchogenic carcinoma.
Kidneys of 27 consecutive autopsied patients with bronchogenic carcinoma without clinical renal disease were studied by electron microscopy and immunohistochemistry for the presence of glomerular deposits. Two patients had subepithelial electron-dense deposits compatible with immune complexes but failed to stain histochemically for immunoglobulin; most cases (19 of 27), including the two with complexes, demonstrated subendothelial deposition of fibrin. No tissue samples had histochemically detectable immunoglobulin. From this study it is suggested that renal immune complexes in lung cancer are rare.
Aged↗
Topical tobramycin and gentamicin sulfate in the treatment of ocular infections: multicenter study.
Tobramycin is an aminoglycoside antibiotic newly marketed for topical ophthalmic use. In a double-masked, multicenter study, tobramycin and gentamicin sulfate, the latter an established topical aminoglycoside, were evaluated in the treatment of patients with bacterial infections of the external eye. Efficacy was determined by resolution of signs and symptoms and the follow-up impression made by the physician. A quantitative, bacterial assay of the conjunctiva and skin-lash margin before and after treatment was used to determine the antimicrobial effectiveness of the two antibiotics. The results of the study, involving 511 patients, indicate that tobramycin is significantly more effective than gentamicin sulfate clinically, and the former exhibits a greater antibacterial efficacy, in the eye, against the combined conjunctival pathogens. On the conjunctiva, Staphylococcus aureus is significantly more susceptible to tobramycin than gentamicin sulfate. Although the solutions are equally safe, tobramycin ointment is associated with a significantly lower frequency of adverse reactions than gentamicin sulfate ointment. This may be due to the preservative used in gentamicin ophthalmic ointment, methyl and propyl paraben.
Anti-Bacterial Agents↗
Tracheal cartilaginous sleeve.
Tracheal cartilaginous sleeve (TCS) is a rare congenital malformation in which discrete cartilaginous rings are replaced by a grossly uninterrupted cartilaginous sleeve. Seven previous patients with TCS have been reported in the world literature; in each instance, TCS was associated with craniosynostosis (CS). We report details of five additional patients with TCS, of whom four had a dominantly inherited CS. Gross examination of the available tracheas and bronchi demonstrates a cartilaginous sleeve with posterior interruption but lacking a normal pars membranacea. The stained and cleared tracheas all demonstrate variable ring formation, usually limited to the posterolateral aspect. The functional significance of TCS, if any, is unknown. No data are available on the prevalence of TCS in CS syndromes. The formation of TCS implies a common mesenchymal defect in which normally discrete structures fuse and is probably analogous to other mesenchymal abnormalities seen in these patients.
Abnormalities, Multiple↗
Measuring the diffusion of innovative health promotion programs.
Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.
Adolescent↗