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Biomedical subjects

A A Nelson

Publications and source records attributed to A A Nelson.

At least 19 recordsLinked to original sources
PubMed1986

Amine trapping: physical explanation for the inhibitory effect of gastric acidity on the postprandial release of gastrin. Studies on rats and dogs.

We investigated the relationship between the pH dependence of meal-stimulated gastrin release and the permeability of the antral mucosa to dietary amines. This study was undertaken after previous work from our laboratory had demonstrated that dietary amines are potent in vivo and in vitro stimulants of gastrin release and that it is well established that amines are trapped in acidic environments. Three contrasting experimental model systems were employed to investigate the association of these two pH-dependent properties. In the first in vivo study, it was demonstrated that ingestion of standard rat Chow resulted in an increase in circulating gastrin and ammonia levels, whereas the postprandial increases in both properties were abolished if the rats ingested Chow that was preacidified to a pH of 2.4. Second, the antral uptake of the fluorescent cyclic amine, quinacrine, from the gastric lumen of pylorus-ligated rats was monitored by fluorescent microscopy and spectrophotometry and was demonstrated to be inhibited in a step-wise fashion as the luminal pH was decreased. Lastly, our in vitro studies suggested that the transport of [14C]methylamine into canine antral mucosa mounted in Ussing chambers was pH-dependent, as was gastrin release into the incubation medium. Thus, all the data are consistent with the possibility that meal-stimulated gastrin release is inhibited at low pH, due (in part) to the protonation of dietary amines, preventing their diffusion into the G cell to activate hormone secretion.

Amines↗
PubMed1985

The differential impact of copayment on drug use in a Medicaid population.

In this study of the influence of copayment on drug utilization, we examined the prescription experience of 10 categories of drugs used by Medicaid beneficiaries in South Carolina over a four-year period. We observed an immediate and significant effect of copayment on the level of expenditures for all drug categories except analgesics and sedative/hypnotic drugs. The impact of copayment on the changes in the slopes of the series was not as dramatic. Only expenditures for cardiovascular, cholinergic, diuretic, and psychotherapeutic agents demonstrated a significant change in the long-term trend. We conclude that the imposition of a copayment for prescription services exerted a differential effect among therapeutic categories.

Deductibles and Coinsurance↗
PubMed1985

Validating the nursing diagnosis of impaired physical mobility.

The lack of research-based literature and of research models for validating nursing diagnoses results in some ambiguity in research efforts. Research must, however, move forward if there is to be progress in differentiating nursing and medical diagnostic models and use of nursing diagnoses to improve communication among nurses. Operational definitions of nursing diagnosis terminology are essential to continue work in validating nursing diagnoses, particularly in the clinical setting. The diagnosis impaired physical mobility was found to be an appropriate diagnosis for rehabilitation patients. Continued study and refinement of etiologies and defining characteristics is needed.

Activities of Daily Living↗
PubMed1978

Evaluation of the professional communications of a pharmacist in a 45-bed rural hospital with comprehensive pharmaceutical services.

The professional communications of a pharmacist providing comprehensive services were studied to determine the accuracy of the information provided, its usefulness to patient care and the level of expertise needed to respond appropriately. Data were collected by a diary technique for a four-month period. Patient charts were reviewed to collect clinical data needed to evaluate the appropriateness of the pharmacist's responses and to ascertain evidence that the information provided was implemented. The analysis classified the communications as either "clinical" or "pharmaceutical" in content. Practitioner panels of pharmacists and a physician assessed the communications for accuracy, relevance to the patient episode and level of pharmacy expertise necessary to communicate. Most communications with physicians were "pharmaceutical" in content. The most frequent information asked concerned dose or dosage schedule. Approximately one-third of the "pharmaceutical" communications could have been handled adequately by a technician. Only one communication should have required an extensive literature search for the pharmacist to respond. Less than half of the pharmacist's communications were pertinent to the patient episode and of clinical importance. Information from half of the communications was implemented in patient care within 48 hours. There did not appear to be any relationship between accuracy of response and implementation of information. It is not known whether the deficiencies identified apply to a large number of pharmacists. Hence, the bearing of the study on the cost-benefit of clinical pharmacy services is not clear.

Communication↗
PubMed1976

Cost of comprehensive pharmaceutical services in a 45-bed rural hospital.

The financial impact of a comprehensive pharmacy program on patient charges and hospital operating costs in a 45-bed community hospital was studied. Data were collected retrospectively for the fiscal year prior to initiating pharmacy services (FY73), the fiscal year during program development (FY74) and the fiscal year following full operations (FY75). The total cost of pharmacy services increased 75% from FY73 to FY75, with the largest dollar increase being in pharmacy salaries. Large increases among other cost items also were noted. The average total cost for pharmacy services increased from $3.28 per patient day in FY73 to $6.04 in FY75 (84%). Total hospital cost per patient day increased by approximately $35 from FY73 to FY75 (5%). The pharmaceutical services fee per dose of medication administered did not change from FY73 to FY75. Patient charges per day for medications and pharmaceutical services increased $0.55 (9.8%) from FY73 to FY75. There was a 55% reduction in the number of items carried in pharmacy inventory from FY73 to FY74 following the initiation of a formulary and a unit dose drug distribution system.

Costs and Cost Analysis↗
PubMed1975

A comparison of maintenance and nonmaintenance outpatient prescription directions, durations of coverage, and costs per day.

The purpose of this paper is to present the results of a study on maintenance and nonmaintenance drugs written for outpatients not covered by prescription insurance. The average cost to the patient for a day's supply of drugs, as well as the average dosage, frequency of administration, and length of duration for maintenance and nonmaintenance drugs were examined. The objective of the study was to present the economics and prescribing patterns for the two groups of drugs in order to provide data on the costs involved and the prescribing patterns of physicians. The results of comparing the various components of maintenance and nonmaintenance drugs revealed that significant differences exist in the dosage direction, frequency of administration, units prescribed per day, lengths of duration, costs per day, prescription prices, and quantities prescribed and dispensed. Maintenance drug prescriptions tend to have lower dosage directions, costs per day, and frequencies of administration and higher quantities prescribed and dispensed, prescription prices, and lengths of duration. Two variables, frequency of administration and quantity prescribed, were found to have the greatest influence on the cost per day and length of duration for maintenance drug prescriptions. It is the conclusion of this study that further examination into the factors which influence the physician when he specifies the frequency of administration and quantity to prescribe on maintenance drug prescriptions be conducted.

Analysis of Variance↗
PubMed1975

Drug default among schizophrenic patients.

This study attempted to isolate the relationship of two variables that operate to influence drug compliance among schizophrenic patients: the patient's attitude toward his disturbance, and the treatment milieu employed during hospitalization. Schizophrenic patients were administered the Rorschach test upon admission to the psychiatric service of a general hospital to determine their perception of their disturbance. Results of this psychological test were used to randomly select 48 patients who were then randomly assigned to two treatment milius: self-medication during hospitalization and as an outpatient, and traditional drug administration during hospitalization and self-medication as an outpatient. Phenothiazine drugs were used, and compliance was determined by urinalysis. Patients who were generally realistic in their perception of their disorder were significantly more compliant during hospitalization and subsequent outpatient treatment. The treatment milieu variable was not a significant influence. Further analysis via a linear regression model confirmed the relationship of several other compliance factors previously reported in the literature. The role of the patient's attitude toward his illness and the importance of personal relationships are considered in terms of the role of the pharmacist in influencing compliance.

Adult↗