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Biomedical subjects

B Foster

Publications and source records attributed to B Foster.

At least 55 records · Page 3Linked to original sources
PubMed1995

Malpractice coverage for health professionals with physical, mental, or substance-abuse impairments. How do insurance companies make their decisions?

How do insurance companies decide whether or not to provide malpractice insurance to health professionals? What information do they gather on applicants and renewing policyholders? Who has the responsibility to determine if health professionals are suffering from physical, mental, or substance-abuse impairments that make them unfit to care for patients? The authors conducted a survey to find the answers to these questions.

Data Collection↗
PubMed1995

Menstruation, menarche, and sexuality in the public school curriculum: school nurses' perceptions.

Nurses employed by schools and health departments have varying responsibilities for curricula related to menstruation, menarche, and sexuality. Nevertheless, the school nurse is usually a source of information on these subjects whether employed full-time in school health or also participating in other nursing roles in the community. This survey examines the involvement of school nurses in curricula related to human reproduction including contraception. Data about their involvement in these classroom topics provides a basis for evaluating their roles and making recommendations for subsequent continuing education programs for school health nurses.

Adolescent↗
PubMed1994

Retransplantation in hepatitis B--a multicenter experience.

Hepatitis B has become one of the most challenging diseases in liver transplantation. Infection of the allograft with subsequent graft failure is common and may prompt consideration of repeat liver transplantation. The aims of this study were to examine the experience in the United States with retransplantation in hepatitis B patients with recurrent disease as well as for other reasons. Questionnaires were mailed to adult liver transplant centers in the United States, requesting information on retransplantation in HBV patients. Responses were received from 71% of the centers. Thirty-eight patients were retransplanted, 20 for recurrent HBV and 18 for other reasons. The survival rate following retransplantation for HBV was poor. Nine patients (55%) died within 60 days. Eleven patients survived 60 days or longer, though eight died at a mean of 4.1 +/- 2 months, one required a third transplant for recurrent HBV infection at 4 months, and one died at 35 months. Only a single (5%) long-term survivor exists. Recurrent histologic disease occurred earlier in the second transplant at 2.8 +/- 2.9 months versus 6.1 +/- 5.2 months in the first allograft, though this difference did not reach statistical significance (P = .058). Patients transplanted for other reasons (primary non-function [9], hepatic artery thrombosis [6], persistent rejection [2], and a Pseudomonas graft infection [1]) had a better survival rate. Four patients survived less than 60 days. Of the 14 surviving longer than 60 days, 11 patients are alive at a mean of 21.2 +/- 14.8 months. Retransplantation for recurrent HBV appears to be contraindicated due to a high mortality. Retransplantation in HBV patients with graft failure due to other causes, however, should be considered, since over 60% of these patients appear to have good long-term survival. Additional studies examining risk factors for recurrent disease should be considered.

Adult↗
PubMed1994

Insulin regimens for the non-insulin dependent: impact on diurnal metabolic state and quality of life.

A randomized prospective study was conducted to determine whether the insulin regimen for NIDDM subjects poorly controlled on oral therapy should be designed primarily to control basal metabolism or to control mealtime hyperglycaemia. Grossly obese subjects were excluded. After a 2-month run-in phase involving intensive education, subjects were randomized to therapy with twice daily isophane or three times daily soluble insulin. Both Protaphane and Actrapid brought about similar improvement in HbA1 (9.5 +/- 0.5 and 9.7 +/- 0.4%) compared with baseline (11.7 +/- 0.5%; p < 0.001). Diurnal blood glucose profiles showed that despite the good post-prandial control achieved by pre-meal soluble insulin, loss of control occurred overnight, resulting in higher fasting blood glucose levels compared with Protaphane therapy (8.0 +/- 0.8 vs 10.6 +/- 0.8 mmol l-1; p < 0.05). The overall rate of hypoglycaemia was 0.44 patient-1 year-1. Thirty-two mild hypoglycaemic episodes occurred on Protaphane therapy and 79 on Actrapid therapy. Using formal psychometric tests it was shown that insulin therapy was associated with improved treatment satisfaction and that this was greater on Protaphane therapy (p < 0.05). Overall well-being increased similarly in the two groups. All subjects wished to continue with insulin therapy after the conclusion of the study. The insulin regimen for moderately or poorly controlled non-insulin-dependent diabetes should primarily be designed to correct the basal insulin deficiency rather than to mimic normal meal-induced insulin secretion.

Adult↗
PubMed1994

Delivering services to the rural elderly: a study of policy implementation.

This article presents an analysis of two demonstration projects designed to improve delivery of services to elderly residents of rural Nebraska. One project employs a statewide system of care management focused on individual clients. In the other, local agencies in four communities coordinate services by using the local senior center as a focal point. This article uses established theory of policy implementation to illustrate problems encountered in starting new social programs that require state-local cooperation. Four guidelines are suggested for policymakers: (a) if local agencies are responsible for implementation, local managers must be involved in all the planning activities for new programs; (b) clear guidelines are needed to be sure that there is consensus concerning the details of implementation; (c) all health care providers should be involved in implementation when health care services are being coordinated; and (d) community coordinating councils can be effective.

Aged↗
PubMed1993

The impact of a child death on marital adjustment.

One continuing concern in the sociological and psychological literature has been with the mental health consequences of stressful life events. Occasionally such stressful events have been linked to other outcomes such as a deterioration in the extent or quality of the relationship between a cohabiting (usually married) couple. This paper takes data from a longitudinal study of parents of an infant who has died (due to a Stillbirth, Neonatal Death or Sudden Infant Death), to determine whether the relationship between the parents is adversely affected. The follow-up data is available 2 months and 6-8 months after the infant death. The results indicate there is an increased marital break-up rate for parents whose infant has died. Further, shortly after the death there is evidence of a deterioration of the quality of the marital relationship between the partners whose relationship has remained intact. Both these consequences of an infant death are unlikely to be due to chance, but their magnitude is relatively modest. At the 6 month follow-up, there is evidence of a deterioration in the quality of the relationship for those partners whose infant survived, such that at 6 months there are no longer any marital adjustment differences between parents experiencing an infant death and parents whose infant survived.

Adaptation, Psychological↗
PubMed1993

Nursing administrators' responses to physically, mentally, and substance-impaired nurses.

Impaired nurses--whether the impairment is physical, mental, or substance use--can be a potential hazard in a healthcare setting, both to themselves and to patients. It is therefore imperative that nursing administrators identify such nurses in order to take the proper actions. But just how do administrators react toward nurses with impairments? The authors of this article present the results of a survey in an attempt to answer this question.

Decision Making, Organizational↗
PubMed1992

Intravenous nifedipine to treat hypertension after coronary artery revascularization surgery. A comparison with sodium nitroprusside.

We administered sodium nitroprusside (SNP) or nifedipine intravenously to patients who became hypertensive after elective coronary revascularization and compared their effects on hemodynamics and the electrocardiogram in a parallel, randomized, open-label study. Four of 21 patients treated with nifedipine required the addition of SNP to maintain mean arterial pressure less than 90 mm Hg, compared with 4 of 28 patients in the SNP group who required the addition of nifedipine. The success rates of nifedipine (81%) and SNP (86%) were not significantly different. There was no difference in the incidence of adverse ST-segment changes during drug infusion (4% versus 5%) or perioperative myocardial infarction (9.5% versus 10.7%) in the nifedipine versus SNP groups, respectively. The plasma nifedipine concentration (mean value +/- SD) at steady state for 21 patients receiving nifedipine was 119 +/- 42.5 ng/mL. The pharmacokinetic variables for nifedipine were as follows (mean values +/- SD): systemic clearance, 0.525 +/- 0.228 L.h-1.kg-1; apparent volume of distribution, 0.738 +/- 0.446 L/kg; and elimination half-life, 1.02 +/- 0.51 h. These values are similar to those reported previously in healthy volunteers. We conclude that intravenous nifedipine can be used safely to control hypertension after coronary revascularization but were unable to demonstrate an advantage of nifedipine compared with SNP in preventing postoperative ischemia or infarction in this group of patients who had good left ventricular function.

Blood Pressure↗
PubMed1991

Congenital ossifying fibroma (osteofibrous dysplasia) of the tibia--a case report.

Ossifying fibromas of the long bones of the leg are benign lesions occurring in the pediatric age group identical in histological appearance to the similarly named tumor of the jaw in adults. Most frequently presentation occurs after minor trauma with symptoms of a swelling of the tibia or fibula which may be painful. Pathological fracture or limp are also occasional presentations. Congenital cases are extremely rare. We describe an otherwise normal male neonate who presented at birth with a bowed right lower leg. The limb was 1 cm shorter than the other side, with tibia vara and a firm mass situated anteriorly. X-ray showed a mixed lytic and sclerotic lesion in the proximal metaphysis of the tibia. Biopsy showed collagenous stroma containing spindle cells and irregular trabeculae of woven bone rimmed by plump osteoblasts. As the appearances were typical of an ossifying fibroma (osteofibrous dysplasia) no surgical treatment was given. The patient was well with no growth of the tumor and with radiological evidence of healing at 1 year follow up. This case is presented to draw attention to the clinicopathological features of this unusual lesion which must be considered in the differential diagnosis of congenital lesions of the tibia.

Bone Neoplasms↗
PubMed1991

The application of a wedge perfusion technique to the in vivo-in vitro rat hepatocyte DNA-repair assay.

The in vivo-in vitro rat hepatocyte DNA-repair assay is regarded as labour-intensive and time-consuming to perform. This has tended to impose limitations on its use as a routine procedure for assessing the potential genotoxicity of chemicals. We have developed a simple wedge-perfusion technique which enables hepatocytes to be isolated from several different rats simultaneously. Hepatocyte yield and metabolic capacity are comparable to those isolated by conventional whole-liver perfusion. Hepatocyte viability was generally superior to that obtained when performing multiple in situ perfusions for the rat hepatocyte UDS assay. The median lobe is routinely used but no difference was observed in the UDS response to the positive control genotoxic agents, methyl methanesulphonate (MMS, CAS No. 66-27-3) and 2-acetylaminofluorene (AAF, CAS No. 53-96-3), in hepatocytes isolated from the median or either lateral lobe. The use of Williams medium E or Leibovitz L15 culture medium did not influence the response. This perfusion technique greatly reduces the time, equipment and personnel required and therefore the cost for hepatocyte isolation. It also facilitates the inclusion of concurrent control groups at each time point of assay.

2-Acetylaminofluorene↗
PubMed1989

Pervanadate [peroxide(s) of vanadate] mimics insulin action in rat adipocytes via activation of the insulin receptor tyrosine kinase.

Both vanadate and hydrogen peroxide (H2O2) are known to have insulin-mimetic effects. We previously reported that the mixture of vanadate plus H2O2 results in the generation of a peroxide(s) of vanadate, which strongly enhances IGF-II binding to rat adipocytes (Kadota et al., 1987b). We now report that pervanadate mimics insulin in isolated rat adipocytes to (1) stimulate lipogenesis, (2) inhibit epinephrine-stimulated lipolysis, and (3) stimulate protein synthesis. The efficacy of pervanadate is comparable to that of insulin. However, it is 10(2)-10(3) times more potent than vanadate alone. Exposure of intact rat adipocytes to pervanadate was found to activate the WGA-purified insulin receptor tyrosine kinase assayed with the exogenous substrate poly(Glu80/Tyr20) in a dose-dependent manner to a maximum of 1464% of control at 10(-3) M compared with a maximum insulin effect of 1046% at 10(-6) M. In contrast, in vitro assayed autophosphorylation of the WGA-purified extract was increased 3-fold after exposure of intact cells to insulin but not significantly increased after pervanadate. Furthermore, high concentrations of pervanadate (10(-5) M) inhibited subsequent in vitro added insulin-stimulated autophosphorylation. In vitro addition of pervanadate to WGA-purified receptors could not stimulate autophosphorylation or exogenous tyrosine kinase activity and did not inhibit insulin-stimulated autophosphorylation. Labeling of intact adipocytes with [32P]orthophosphate followed by exposure to 10(-4) M pervanadate increased insulin receptor beta-subunit phosphorylation (7.9 +/- 3.0)-fold, while 10(-7) M insulin and 10(-4) vanadate increased labeling (5.3 +/- 1.8)- and (1.1 +/- 0.2)-fold, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1989

Internalization and activation of the rat liver insulin receptor kinase in vivo.

The preparation of clearly delineated plasmalemma (PM) and endosomal subcellular fractions from rat liver has allowed us to compare insulin receptor (IR) kinase activity at the cell surface and in hepatic endosomes (ENs) as a function of dose and time after injected insulin. Tyrosine kinase activity in PM and ENs was measured, after solubilization and partial purification by wheat germ agglutinin chromatography (lectin-purified), using poly(Glu:Tyr) as substrate. Following the injection of a subsaturating dose of insulin (1.5 micrograms/100 g body weight), lectin-purified receptor showed peak activation at 30 s in PM and at 2 min in ENs. As observed previously (Khan, M. N., Savoie, S., Bergeron, J. J. M., and Posner, B. I. (1986) J. Biol. Chem. 261, 8462-8472) autophosphorylation activity was also augmented following insulin injection. In a pattern virtually identical to that of exogenous kinase activity, autophosphorylation attained peak activity at 30 s in PM and at 2 min in ENs. The time course of IR autophosphorylation in intact membranes was very similar to that observed for lectin purified receptors and was seen with an injected insulin dose as low as 150 ng/100 g body weight. Phosphatase treatment of the solubilized endosomal receptor abolished its enhanced activity. Hence, insulin treatment led to in vivo receptor phosphorylation which was reflected in the enhancement of both tyrosine kinase and autophosphorylation activities. Significant differences in the phosphorylation activities of PM and ENs were observed. Phosphoamino acid analyses revealed that the activated IR of intact PM was autophosphorylated in vitro, at both serine (55%) and tyrosine (45%) residues; whereas the activated IR of intact ENs was phosphorylated in vitro exclusively on tyrosine autophosphorylation specific activity for the activated IR of ENs was 3- to 4-fold that of the IR of PM. This was observed for the lectin purified IRs as well as for IRs of intact cell fractions. The reduced level of IR autophosphorylation in PM was not due to occlusion of tyrosine acceptor sites by prior in vivo phosphorylation. The rapidity with which activated IR accumulates in ENs as well as the sensitivity of endosomal IR kinase to activation by injected insulin are consistent with the endosomal apparatus serving a physiologically significant site for the regulation of transmembrane signaling.

Animals↗
PubMed1988

The YYRR box: a conserved dipyrimidine-dipurine sequence element in Drosophila and other eukaryotes.

We have discovered a novel DNA sequence element in Drosophila which is based upon a CTGA tandem repeat. This element has been named the YYRR box to emphasize its dipyrimidine-dipurine nature which is predicted to have unusual structural features. Southern hybridization analysis of genomic DNA indicates the presence of 25-30 copies of the YYRR box in each of three Drosophila species (melanogaster, pseudoobscura, and virilis) and conservation of genomic location within species. Similar analysis of human and rat DNA indicates the presence of YYRR related sequences in mammals as well. YYRR boxes have been localized to two genetic loci in Drosophila: Gld and a gene tentative identified as ted. These two genes exhibit correlated patterns of developmental expression and an identical mutant phenotype. Sequence analysis of the Gld YYRR box in three Drosophila species revealed a high degree of conservation despite its intronic location.

Animals↗