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B Lewis

Publications and source records attributed to B Lewis.

At least 73 records · Page 4Linked to original sources
PubMed1996

An overview of the oral health component of the 1988-1991 National Health and Nutrition Examination Survey (NHANES III-Phase 1).

As part of a Federal consortium, the National Institute of Dental Research's (NIDR) Division of Epidemiology and Oral Disease Prevention (DEODP) staff and consultants collaborated with the National Center for Health Statistics (NCHS) to conduct a national oral health examination as a component of the 1988-94 National Health and Nutrition Examination Survey (NHANES III). The Phase 1 took place between October 18, 1988, and October 24, 1991, at 44 survey locations; Phase 2, between September 20, 1991, and October 15, 1994, at 45 sites. This article provides general background information on the NHANES III and its oral health examination component which pertains to all six years of the full survey. It also focuses on particular aspects of the first three years of the survey (NHANES III-Phase 1)--the database for the articles in this peer-reviewed Special Issue--and provides the essential context for the substantively oriented analyses of the Phase 1 database which are presented in the articles which follow this overview.

Adolescent↗
PubMed1996

Coronary heart disease prevention and the infarctogenic plaque.

The characteristics of a subset of atherosclerotic plaques that is responsible for myocardial infarction (infarctogenic plaques) are increasingly well defined. They include moderate size, a thin fibrous cap, and a large lipid pool. Fissuring of the cap leads to thrombotic occlusion and often to an acute coronary event. Physical stresses on, and proteolytic weakening of, the cap--both related to effects of hyperlipidemia on the plaque--increase the risk of fissuring. Treatment of hyperlipidemia leads to regression of experimental atherosclerosis, promotes regression and reduces progression of human coronary artery disease. The arterial changes in humans are predictive of reduced incidence of coronary events. This sequence of events may reflect gradual depletion of plaque lipids, and also a more rapid depletion of chronic inflammatory cells in the plaque cap that are the source of collagenase and other proteases. The primary objective of lipid-lowering therapy appears to be the induction of these changes in infarctogenic plaques, and vigorous treatment should be targeted on patients likely to harbor such plaques.

Animals↗
PubMed1996

AANA Journal course: update for nurse anesthetists--do psychotropes affect anesthetic medications?

Psychotropic medications modify the psychic function behavior or experiences of persons using them. They can be divided into the following classes: antipsychotic, antidepressant, antianxiety, and mood stabilizing. There are significant implications for the anesthetist caring for patients on these medications. These issues are reviewed in this installment of the AANA Journal course.

Anesthetics↗
PubMed1995

Frequent measurement of chronic pain: an electronic diary and empirical findings.

The PIPER (Prompting Intensity of Pain Electronic Recorder) is a compact data-logging device, easily worn by a subject. It emits audible beeps at pre-programmed times, prompting the subject to enter a pain rating by button press. Ratings are stored, for later down-loading. We report two studies suggesting that PIPER pain ratings have good reliability, and good validity assessed against the VAS. In a third study, the PIPER was found practical for use by elderly subjects, and for periods of more than 2 months. In addition, PIPER pain ratings taken 4 times per day were found to have different properties than 4 other measures of chronic pain, suggesting that very frequent measures should be taken if a full understanding of chronic pain is to be obtained.

Aged↗
PubMed1995

Quantitative coronary cineangiography for the study of atherosclerosis.

Angiography is the definitive procedure for characterising the extent and course of coronary artery disease. We describe the methodology required to measure, with optimal resolving power, angiographic changes in coronary artery disease. We utilised recent technological developments in image digitization, storage and analysis. The measures of change quantified both diffuse and focal atherosclerosis. Frames from angiographic cine films were digitized at high resolution (1024 x 1024 pixels, 8 bit grey scale) and archived on optical disk. Four radiographic projections were stored to ensure good visualization of as many as possible of a set of ten major arterial segments. Edges of segments and catheter were automatically delineated by computer using a dynamic programming algorithm involving a cost function which contained terms based on edge strength and on continuity. For every digitized radiographic projection, delineation was repeated in three adjacent frames, to improve precision. Edge points for each coronary segment were stored on disk. From these we computed the mean width along the segment (pixels). Scaling to obtain the Mean Absolute Width of the Segment (MAWS, mm) was achieved using catheter dimensions known from micrometry, systematic error due to imaging system line-spread function being corrected using data from computer simulations and phantom studies. Correction for geometric image intensifier distortion was also applied. We used the methodology in a randomized, controlled trial of the effect of lipid-lowering therapy, the St Thomas' Atherosclerosis Regression Study. The fundamental measure of change of disease in each segment was the change in MAWS (delta MAWS). Using in-vitro and in-vivo studies we established that the overall resolving power for one segment delta MAWS was 0.10 mm at 2 mm width and 0.14 mm at 4 mm width. Subsidiary end-points were the change (delta) in minimum absolute width of segment (MinAWS), edge irregularity index (EII) and percent diameter stenosis (%DS). Delta%DS (the conventional angiographic measure of coronary disease) was significantly correlated with change in all indices, closest correlation being seen with delta EII (r = 0.94, p < 0.001).

Arteriosclerosis↗
PubMed1995

Electrogenic sodium absorption and chloride secretion by an inner medullary collecting duct cell line (mIMCD-K2).

The initial segment of the inner medullary collecting duct (IMCDi) absorbs Na+ by an electrogenic mechanism and plays an important role in regulating the composition and volume of the urine. The purpose of the present study was to establish a permanent cell line derived from the IMCDi, which has the ion transport properties of the IMCDi in vivo. To this end, we isolated IMCD cells from the IMCDi of a mouse, Tg(SV40E) Bri 7, transgenic for the early region of SV40 (large T antigen) and established a permanent cell line, mIMCD-K2, by clonal dilution. mIMCD-K2 cells retain many differentiated characteristics of the IMCDi, including amiloride-sensitive electrogenic Na+ absorption stimulated by nanomolar concentrations of aldosterone. Aldosterone (1.5 x 10(-6) M) increased Na+ absorption from 0.2 +/- 0.1 to 4.6 +/- 1.7 microA/cm2. In addition, the cells secrete Cl- by an electrogenic mechanism at a rate of 0.5 +/- 0.1 microA/cm2. We propose that IMCDi cells either absorb or secrete NaCl depending on NaCl homeostasis. The mIMCD-K2 cell line should be useful for studying the cellular mechanisms responsible for electrogenic Na+ and Cl- transport in the IMCDi.

Absorption↗
PubMed1995

Vasopressin and cAMP stimulate electrogenic chloride secretion in an IMCD cell line.

Previously, we demonstrated that the mIMCD-K2 cell line, derived from the inner medullary collecting duct (IMCD) of a transgenic mouse, secretes Cl- by an electrogenic mechanism [N. L. Kizer, B. Lewis, and B. A. Stanton, Am. J. Physiol. 268 (Renal Fluid Electrolyte Physiol. 37): F347-F355, 1995]. The objective of the present study was to characterize the cellular mechanisms of electrogenic Cl- secretion (IscCl) and to determine whether arginine vasopressin (AVP) and adenosine 3',5'-cyclic monophosphate (cAMP) stimulate IscCl. To this end, we measured IscCl across monolayers of mIMCD-K2 cells mounted in Ussing-type chambers. AVP increased IscCl with a Michaelis constant (Km) of 2.1 +/- 0.7 x 10(-12) M. 1-Desamino-8-D-AVP, a specific V2 receptor agonist, increased IscCl from 3.3 +/- 0.4 to 17.4 +/- 1.3 microA/cm2, 8-(4-Chlorophenylthio)-cAMP, a cell-permanent analogue of cAMP, a second messenger of AVP, increased IscCl from 1.4 +/- 0.3 to 15.2 +/- 1.2 microA/cm2. Furosemide and bumetanide, inhibitors of Na(+)-2Cl(-)-K+ cotransport, and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS), an inhibitor of Cl-/HCO3- exchange, reduced IscCl when added to the basolateral solution. Our data suggest that AVP, via V2 receptors, and the second messenger cAMP stimulate IscCl and that Cl- secretion by mIMCD-K2 cells involves uptake of Cl- across the basolateral membrane by Na(+)-2Cl(-)-K+ cotransport and Cl-/HCO3- exchange and diffusion out of the cells across the apical membrane by cystic fibrosis transmembrane conductance regulator Cl- channels.

Absorption↗
PubMed1995

Selective retention of VLDL, IDL, and LDL in the arterial intima of genetically hyperlipidemic rabbits in vivo. Molecular size as a determinant of fractional loss from the intima-inner media.

To explore possible mechanisms whereby the triglyceride-rich lipoproteins IDL and VLDL may promote atherosclerosis, fractional loss of these lipoproteins from the intima-inner media was measured in vivo in genetically hyperlipidemic rabbits of the St Thomas's Hospital strain and compared with the fractional loss of LDL, HDL, and albumin. These rabbits exhibit elevated plasma levels of VLDL, IDL, and LDL. In each rabbit, two aliquots of the same macromolecule, one iodinated with 125I and the other with 131I, respectively, were injected intravenously on average 24 and 3 hours, respectively, before removal of the aortic intima-inner media. The fractional loss from the intima-inner media of newly entered macromolecules was then calculated. The average fractional losses for VLDL, IDL, LDL, HDL, and albumin in lesioned aortic arches were 0.1%/h (n = 4), -0.2%/h (n = 3), 1.8%/h (n = 4), 11.4%/h (n = 3), and 26.3%/h (n = 1), respectively; in nonlesioned aortic arches fractional losses for IDL, LDL, HDL, and albumin were 1.7%/h (n = 1), 0.6%/h (n = 2), 14.6%/h (n = 3), and 25.9%/h (n = 3). In both lesioned and nonlesioned aortic arches, the logarithms of these fractional loss values were inversely and linearly dependent on the diameter of the macromolecules (R2 = .57, P = .001 and R2 = .84, P < .001), as determined from electron photomicrographs of negatively stained lipoproteins. These results suggest that after uptake into the arterial intima, VLDL and IDL as well as LDL are selectively retained in comparison with HDL and albumin.

Albumins↗
PubMed1995

Family accommodation in obsessive-compulsive disorder.

OBJECTIVE: Family accommodation of patients with obsessive-compulsive disorder, i.e., participation in symptoms and modification of personal and family routines, was assessed in relation to family stress, functioning, and attitudes toward the patient. METHOD: Primary caretakers for 34 patients with obsessive-compulsive disorder were interviewed to assess the nature and frequency of accommodating behaviors. The caretakers also completed several measures of family functioning. RESULTS: Of the 34 spouses or parents, 30 (88.2%) reported accommodating the patient. Family accommodation correlated with poor family functioning, rejecting attitudes toward the patient, and several types of family stress. CONCLUSIONS: Family accommodation of patients with obsessive-compulsive disorder was associated with global family dysfunction and stress. This study suggests that families' efforts to accommodate patients may be intended to reduce patient anxiety or anger directed at relatives.

Adult↗
PubMed1995

Psychotherapeutic discourse analysis.

Psychotherapeutic discourse analysis is a significant, largely unexplored, tool for psychotherapist and an ideal data sight for linguists. Increased multidisciplinary research in this area would be particularly fruitful. Conversations, including therapeutic conversations, are far from transparent conduits of information from one person to another. Complicating surface communication is "metacommunication," which takes the form of unconscious conversational styles--culturally influenced rules, norms, and expectations of how a conversation should proceed. If the therapist and the patient are working with different conversational styles, then blocks in communication and understanding are inevitable. Through discourse analysis conversational styles can become more available to awareness for use in the service of therapeutic goals. This paper is an example of a discourse analysis of an individual therapy session. I attempt to bridge the gap between broad psychodynamic treatment strategies and minute micro-conversational strategies that can be used to enhance the therapeutic process.

Adult↗
PubMed1995

The effectiveness of alternative planned durations of residential drug abuse treatment.

Randomized controlled trials were conducted at two residential drug abuse treatment facilities to compare programs that differed in planned duration. One trial compared a 6-month and a 12-month therapeutic community program (n = 184), and the second compared a 3-month and a 6-month relapse prevention program (n = 444). Retention rates over comparable time periods differed minimally by planned treatment duration, and the longer programs had lower completion rates. There was no effect in either trial of planned treatment duration on changes in psychosocial variables between admission and exit or on rates or patterns of drug use at follow-up between 2 and 6 months after exit.

Follow-Up Studies↗
PubMed1995

Dynamic muscle strength as a predictor of bone mineral density in elderly women.

Although muscle strength has been shown to predict bone mineral density (BMD) in older adults, the variance explained by isometric and isokinetic testing has been generally low (< 20%) and limited to only a few exercises and muscle groups. To elucidate the relationship of muscle strength to BMD at multiple sites, and to ascertain the most robust predictor of BMD using isotonic strength testing apparatus, we examined dynamic muscle strength and BMD in 40 healthy elderly women aged 65-82 years. BMD of the spine (L2-4), proximal femur (neck, trochanter, Ward's triangle), forearm (midradius), and whole body were measured by dual-energy X-ray absorptiometry. Dynamic strength (1-RM), utilizing isotonic weight-lifting equipment, was assessed for 10 standard upper and lower body exercises. In stepwise multiple regressions, leg press was the only independent predictor of spine (R2 = 0.11), neck and trochanter (R2 = 0.21 and 0.18), forearm (R2 = 0.21), and whole body BMD (R2 = 0.19), while bench press was an independent predictor of Ward's BMD (R2 = 0.12). The most robust predictor of regional and whole body BMD using isotonic equipment was the leg press, which may reflect overall skeletal health in this population. The portion of variance explained by dynamic muscle strength (11-21%) is similar to that reported when strength is assessed by isometric and isokinetic testing. The relationship of dynamic strength to BMD was not generally site-specific.

Absorptiometry, Photon↗