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Biomedical subjects

S Myers

Publications and source records attributed to S Myers.

At least 73 records · Page 4Linked to original sources
PubMed1991

The home care practice and attitudes of Minnesota family physicians.

OBJECTIVE: Assess home care practice and attitudes of Minnesota family physicians (FPs). DESIGN: Mailed survey. SETTING: State of Minnesota. PARTICIPANTS: Members of the Minnesota Academy of Family Physicians, 80% of the FPs practicing in the state. INTERVENTION: A 55-item mailed, self-complete questionnaire regarding general practice and personal physician characteristics (18 questions), specific questions regarding geriatric and home care practice and related attitudes (37 questions); up to four reminder or follow-up surveys were sent. MAIN OUTCOME MEASURES: Descriptive summary of FP home care practice and attitudes. RESULTS: Eighty percent of surveys were completed, 76% of responding physicians made at least one home visit in the previous year, and 92% of home visits were to geriatric patients. Discriminant function analysis identified six significant (P less than 0.001) variables that explained 52% of the variance (r2 = 0.52, Wilks Lambda = 0.48) in home visiting behavior between frequent home visiting FPs (greater than 24 visits/year) and non-visiting FPs. FPs most likely to do home visiting were older and tended to have small group or solo practices in rural settings. CONCLUSION: The survey documented continued decline (from previously published surveys) of physician home visiting behavior and widespread dissatisfaction with reimbursement. However, attitudes regarding home care provided by other professionals were highly positive.

Attitude of Health Personnel↗
PubMed1991

Randomized, controlled, crossover trial of oat bran in hypercholesterolemic subjects.

BACKGROUND: Despite animal and metabolic ward studies that support the benefit of oat bran as a useful dietary supplement for the lowering of cholesterol, there have been few controlled studies on free-living subjects that have convincingly demonstrated this benefit. METHODS: This is a report of a randomized, controlled, blinded clinical trial with a crossover design using oat bran (28 g [1 oz] twice daily) vs wheat cereal as a supplement to a fat-modified diet for the reduction of total cholesterol and low-density lipoprotein (LDL) cholesterol. The study included male and female subjects aged 20 to 70 years, with baseline LDL cholesterol in the 50th to 95th percentile. All subjects were instructed in the American Heart Association Step I (AHA-I) diet, and eating behavior was monitored using 4-day food records during each study period. RESULTS: Eighty-two percent (n = 145) of the total number of subjects who were randomized to treatment groups completed the study. Blood lipid studies demonstrated significantly greater reductions in total cholesterol (average -2.2%) and LDL cholesterol (average -3.9%) in the oat-bran groups than in the wheat-cereal groups (average total cholesterol +3.3%, average LDL cholesterol +4.0%) or in the diet alone group (total cholesterol +6.0%; LDL cholesterol +6.4%). All groups did comparably well at adhering to the AHA-I diet; however, dietary factors alone, when analyzed by the Keys equations, could not explain the group differences in lipid change. CONCLUSIONS: The addition of oat bran (28 g [1 oz] twice daily) to the AHA-I diet provided significant added benefit in lowering total cholesterol and LDL cholesterol in most hypercholesterolemic subjects. Analysis for factors that predict LDL cholesterol response to oat bran revealed a significant age-by-sex interaction (P less than .001). Women under the age of 50 years, as a group, showed essentially no increased benefit from the addition of oat bran to their diet. Cholesterol levels in older women appear to be significantly more responsive to a modified diet containing oat bran than those of younger women.

Adult↗
PubMed1990

A refined linkage map for DNA markers around the pericentromeric region of chromosome 10.

A refined genetic linkage map for the pericentromeric region of human chromosome 10 has been constructed from data on 12 distinct polymorphic DNA loci as well as the locus for multiple endocrine neoplasia type 2A (MEN 2A), a dominantly inherited cancer syndrome. The map extends from D10S24 (at 10p13-p12.2) to D10S3 (at 10q21-q23) and is about 70 cM long. Overall, higher female than male recombination frequencies were observed for this region, with the most remarkable female excess in the immediate vicinity of the centromere, as previously reported. Most of the DNA markers in this map are highly informative for linkage and the majority of the interlocus intervals are no more than 6 cM apart. Thus this map should provide a fine framework for future efforts in more detailed mapping studies around the centromeric area. A set of ordered cross-overs identified in this work is a valuable resource for rapidly and accurately localizing new DNA clones isolated from the pericentromeric region.

Chromosome Mapping↗
PubMed1990

Seclusion: a last resort measure.

The practice of secluding patients after violent incidents has long been a treatment used by mental health nurses. While seclusion keeps the patient from further self-inflicted pain and restores normalcy to the unit, the practice often sets up an unending cycle of negative behavior. Other methods of dealing with the violent patient are explored in this article, including early intervention by nurses, ignoring the outburst, separating the disruptive person for a shorter time, and speaking gently with the client. The conclusion reached is that nurses must keep in mind the goal: to help the patient reintegrate into the group as safely and quickly as possible.

Ethics, Nursing↗
PubMed1990

The genetic defect in multiple endocrine neoplasia type 2A maps next to the centromere of chromosome 10.

Multiple endocrine neoplasia type 2A (MEN2A) is a rare cancer syndrome that is inherited in an apparently autosomal dominant fashion. Previous linkage studies had assigned the MEN2A locus to chromosome 10 in the pericentromeric region. We recently have described several new easily scorable RFLPs for the chromosome 10-specific alpha satellite DNA (the D10Z1) locus that is known, on the basis of previous in situ hybridization experiments, to lie at the centromere. We report here tight linkage between MEN2A and D10Z1, as demonstrated by a maximum lod score of 12.02 at the recombination frequency of zero (1-lod-unit support interval 0-4 cM), indicating that the genetic defect in MEN2A lies in the immediate vicinity of the centromere. By means of a set of ordered polymorphic DNA markers from the pericentromeric region, multipoint as well as pairwise linkage analyses place the MEN2A locus at the middle of a small region (approximately 11 cM) bracketing the centromere with FNRB (at 10p11.2) and RBP3 (at 10q11.2) on either side, providing further support for the centromeric location of the MEN2A locus. Marked sex difference in recombination frequencies exists in this pericentromeric region: significantly (P less than .01) more female than male crossovers were observed across all of the adjacent intervals D10S24-FNRB, FNRB-D10Z1, and D10Z1-RBP3. However, a sex difference was not seen in the 7-cM interval from RBP3 to D10S5, suggesting that large variation in the sex difference in recombination can occur over small chromosomal regions.(ABSTRACT TRUNCATED AT 250 WORDS)

Centromere↗
PubMed1990

A new DNA marker (D10S94) very tightly linked to the multiple endocrine neoplasia type 2A (MEN2A) locus.

Combined somatic cell hybrid and linkage studies between D10S94 and five pericentromeric loci (FNRB, D10Z1, MEN2A, RBP3, and D10S15) have localized the new DNA sequence pcl1/A1S-6-c23 at D10S94 to 10q11.2. No recombinants were observed between D10S94 and D10Z1 or MEN2A. D10S94 maps in proximal 10q11.2 very near to MEN2A. There are three possible orders for the six loci that we investigated from the centromeric region of chromosome 10. At present the genetic data do not allow us to order MEN2A with respect to D10Z1 and D10S94. The three possible orders are FNRB-D10Z1-D10S94-MEN2A-RBP3-D10S15, FNRB-D10Z1-MEN2A-D10S94-RBP3-D10S15, and FNRB-MEN2A-D10Z1-D10S94-RBP3-D10S15. In view of the fact that no recombinants between D10S94 and MEN2A or between D10S94 and D10Z1 were observed, the combined haplotypes formed from RFLPs and D10Z1 and D10S94 will increase the informativeness and accuracy of genotype prediction for at-risk members of the families having the MEN 2A syndrome, particularly when the affected parent is female. The localization of D10S94 with respect to MEN2A will prove valuable in experiments directed toward cloning the MEN2A locus.

Adrenal Gland Neoplasms↗
PubMed1989

The beta subunit locus of the human fibronectin receptor: DNA restriction fragment length polymorphism and linkage mapping studies.

The beta subunit of the human fibronectin receptor (FNRB) is a transmembrane protein belonging to the VLA (very late antigens of activation) family. Using pGEM-32, a 2.5-kb partial cDNA clone corresponding to the 3' portion of the human FNRB locus, multiple restriction fragment length polymorphisms (RFLPs) were revealed on DNAs from unrelated Caucasians. RFLPs detected by five enzymes, BanII, HinfI, KpnI, BglII, and SacI, are of the simple two-allele form, and pairwise linkage analyses of these RFLPs with numerous known DNA markers from the chromosome-10 pericentromeric region not only confirmed the chromosome-10 assignment of the functional FNRB gene but also supported its localization at p11.2 suggested by in situ hybridization. An infrequent MspI RFLP was detected by pB/R2, a 4.6-kb genomic clone from the FNRB locus. Another type of DNA polymorphism was also revealed by the cDNA clone and it was visualized on the Southern blot analyses as the presence or absence of an extra band (or a set of extra bands). It seems to stem from a stretch of DNA sequence present in some individuals at one single locus but absent in others, and is of non-chromosome-10 origin based on linkage analyses with known chromosome 10 markers. This "presence/absence" type of polymorphism could be revealed by all of the 25 restriction enzymes tested and is similar in nature to that previously reported with one of the human dihydrofolate reductase pseudogenes, DHFRP1. Dissection of the pGEM-32 clone demonstrated that the region revealing the non-chromosome-10 sequences is within a fragment about 1.7 kb in length extending from about 600 nucleotides preceding the stop codon down to the end of the cloned FNRB 3' untranslated region. Due to its high polymorphism information content (PIC) value (0.71 for haplotypes of BanII, HinfI, and KpnI RFLPs) and proximity to the centromere. FNRB will prove to be a highly useful marker for genetic linkage studies of multiple endocrine neoplasia type 2A (MEN2A) as well as for chromosome-10 linkage studies in general.

Chromosome Mapping↗
PubMed1989

Neurofibromatosis type 1 (Recklinghausen's disease). Neurologic and cognitive assessment with sibling controls.

Neurologic and cognitive function in neurofibromatosis type 1 (NF1) were assessed in a controlled pilot study of 13 pairs of siblings aged 6 to 27 years. One subject in each pair was affected with NF1, and the other, the control subject, was unaffected. Subjects with evidence of focal central nervous system disease were excluded. The 13 subjects with NF1 had no excess of mental retardation, attention-deficit disorder, or specific learning disorders (using Wilcoxon's Signed Rank Test and McNemar's Test for Symmetry). These subjects, however, had significantly higher scores for subtle neurologic abnormalities (21 vs 6) and significantly lower full-scale IQ scores (94 vs 105) than their unaffected siblings. The IQ scores of the affected subjects were not clustered at the lower end of the scale but showed a slight downward shift in distribution compared with those of their siblings. In addition, a visual-spatial orientation deficit was present in eight of nine affected subjects so evaluated. The findings suggest that subjects with NF1 have a widespread alteration of the brain during development that manifests as one or more specific types of neuropsychologic deficits.

Adolescent↗
PubMed1988

A linkage group of five DNA markers on human chromosome 10.

Five chromosome 10 DNA markers (D10S1, D10S3, D10S4, D10S5, and RBP3) were typed in five large pedigrees with multiple endocrine neoplasia type 2A (MEN-2A) and in five non-MEN-2A pedigrees. Linkage analyses showed that these loci and the locus for MEN-2A (MEN2A) are in one linkage group spanning at least 70 cM. The order of the marker loci is RBP3-D10S5-D10S3-D10S1-D10S4, with interlocus recombination frequencies of 7, 13-19, 19, and 19%, respectively, all on the same side of MEN2A. Analyses of sex-specific recombination frequencies indicated no significant differences between males and females for any of the map intervals studied. Previous localization of D10S5 and RBP3 to the proximal region of the long arm and the pericentric region, respectively, comparison of results with other studies, and our preliminary results with other chromosome 10 markers suggest that the D10S4 end of the map extends into the long arm. Our linkage map has been constructed using only two- and three-locus analyses. It will be possible to combine our results with those of other groups to construct a more detailed and accurate genetic map of chromosome 10.

Alleles↗
PubMed1988

The effects of progressive muscular relaxation on subjectively reported disturbance due to hospital noise.

Hospital noise has repeatedly been demonstrated to exceed levels recommended by the Environmental Protection Agency. Hospital noise from staff and machinery has been implicated in the etiologies of many behavioral disorders such as sleep deprivation, sensory overload, and altered comfort levels. Relaxation techniques have been shown to be effective in decreasing the aversiveness of many situations. This study tested the effects of progressive muscular relaxation (PMR) on subjectively reported disturbance due to hospital noise. In addition, noise sensitivity as a personality attribute was correlated with disturbance due to hospital noise and efficacy of PMR. A sample of 100 acutely ill hospitalized patients were randomly assigned to an experimental group or control group. The experimental group was instructed in the Bernstein-Borkovec technique of PMR; the control group received a short visit. Results revealed that the experimental groups had a significantly lower amount of disturbance due to hospital noise after being instructed in the use of PMR than prior to the intervention. Control group subjects demonstrated no such change. Noise sensitivity was found to be unrelated to either disturbance due to hospital noise or efficacy of PMR in decreasing disturbance due to hospital noise.

Affective Symptoms↗
PubMed1988

Increased pacing threshold after an automatic defibrillator shock in dogs: effects of class I and class II antiarrhythmic drugs.

A high energy shock delivered by an automatic defibrillator may interfere with pacemaker function. To provide insight into the changes that occur in the threshold for ventricular pacing after the shock from an automatic defibrillator, we measured the time to capture during asynchronous ventricular pacing in dogs from endocardial or epicardial sites, after a 30 joule shock was delivered via conventional automatic defibrillator (AICD) patch electrodes. After a 30 joule shock, there was a transient loss of ventricular capture. The duration of capture loss was related to current strength. During endocardial pacing at threshold current, the time to capture was 4.9 +/- 1.2 s, whereas at current values twice threshold the time to capture from endocardial pacing was 2.2 +/- 0.9 s. No difference was found between endocardial and epicardial pacing sites in the time to capture. To ascertain the mechanism of capture loss we: (1) examined the effects of converting the pacing catheter to a current sink (transiently shunting to ground); (2) altered excitability by an infusion of flecainide; (3) blocked sympathetic input (propranolol). No change in time to capture was noted by shunting the pacer to ground. After an infusion of flecainide the time to capture from endocardial pacing was significantly prolonged to 14.9 +/- 2.2 s at the threshold value (P less than .01) and 5.6 +/- 2.1 s at twice threshold (P less than .05). Conversely, intravenous propranolol had no effect on the time to capture after shock from endocardial pacing. These data indicate that there is a transient increase in pacing threshold after the shock from an automatic defibrillator.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

The hemodynamic response of the conscious pregnant guinea pig to nicotine.

The hemodynamic response to continuous intravenous infusion of nicotine, at 4.5 and 18 micrograms/min, was measured using radiolabeled microspheres in nine chronically catheterized pregnant guinea pigs. These gave serum nicotine levels of 72.3 +/- 6.6 ng/ml and 315 +/- 32 ng/ml (mean +/- SEM), respectively. During low-dose nicotine infusion there was no significant change in cardiac output, its distribution, or uteroplacental blood flow. During high-dose nicotine infusion, cardiac output fell from 257.8 +/- 30.9 ml/min to 212.7 +/- 19.3 ml/min (p less than 0.05) and uteroplacental blood flow fell from 31.2 +/- 3.1 ml/min to 22.3 +/- 2.4 ml/min (p less than 0.05). During control, low-dose, and high-dose periods, serum epinephrine levels rose from control value of 60.2 +/- 2.6 to 98.9 +/- 35 and 1200 +/- 295 pg/ml (p less than 0.05 low dose versus high dose) and serum norepinephrine levels did not change significantly during nicotine infusion. Hence at nicotine levels 20 times but not at two to five times those seen in smokers, modest reductions in cardiac output and uteroplacental blood flow were observed.

Animals↗