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Biomedical subjects

D Goodman

Publications and source records attributed to D Goodman.

100 records · Page 6Linked to original sources
PubMedDate not supplied

Early-invasive or early-conservative management of patients with unstable angina or non-Q-wave myocardial infarction.

The optimal therapy for non-ST-segment-elevation acute coronary syndromes is the subject of considerable debate: is early catheterization and revascularization (early-invasive strategy) or continued medical therapy unless symptoms are refractory (early-conservative strategy) best? Although several clinical trials have sought to answer this question, the methodologies they employed have been widely criticized, and no consensus has been reached. The new antiplatelet therapies have proved beneficial for primary medical management and as adjuncts to percutaneous interventions. It is not yet clear, however, whether use of these therapies will preferentially benefit one of the treatment strategies.

Algorithms↗
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Early- versus late-onset dythymic disorder: comparison in out-patients with superimposed major depressive episodes.

BACKGROUND: This study examined the validity of the early-late onset subtyping distinction in dysthymic disorder. METHODS: Participants were 340 out-patients meeting DSM-III-R criteria for dysthymia and a concurrent major depressive episode (MDE). The sample was drawn from a 12-site double-blind randomized parallel group trial comparing the efficacy of sertraline and imipramine in the treatment of chronic depression. All patients received comprehensive evaluations using semi-structured interviews and rating scales. RESULTS: 73% of the sample met criteria for the early-onset, and 27% for the late-onset, subtype. The early-onset patients had a significantly longer index MDE, significantly higher rates of personality disorders and lifetime substance use disorders, and a significantly greater proportion had a family history of mood disorder. The subgroups did not differ in symptom severity or functional impairment at baseline, nor in response to a 12-week trial of antidepressants. LIMITATIONS: Further work is needed to extend these findings to dysthymic disorder without superimposed MDEs. CONCLUSIONS: These results support the distinction between early-onset and late-onset dysthymic disorder.

Adult↗
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Application of the critical pathway and integrated case teaching method to nursing orientation.

BACKGROUND: Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice. METHOD: The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill. RESULTS: The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful. CONCLUSION: Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.

Adult↗
PubMedDate not supplied

Over-expression of DT-diaphorase in transfected NIH 3T3 cells does not lead to increased anticancer quinone drug sensitivity: a questionable role for the enzyme as a target for bioreductively activated anticancer drugs.

Murine NIH 3T3 cells were stably transfected with human NQO1 (DT-diaphorase) cDNA and clonal cell lines with up to 15-fold elevated DT-diaphorase activity were obtained. These cell lines showed no significant increase in cell growth inhibition by the quinone anticancer drugs mitomycin C, diaziquone and menadione, when compared to vector alone transfected control cells. There was a small increase in sensitivity to doxorubicin. The relative increase in DT-diaphorase activity in the transfected cells compared to the control cell lines is similar to the increase of DT-diaphorase activity found in some human tumors compared to their paired normal tissue. The results of this study, and other evidence, suggests that DT-diaphorase may not, as suggested by others, be a clinically useful target for the bioreductive activation of anticancer drugs.

3T3 Cells↗
PubMedDate not supplied

Dietary fatty acid modulates actions of nucleotides on humoral immune responses.

Polynucleotides enhance T cell-dependent antibody production in culture. Impaired antibody production in mice fed a nucleotide-free diet can be easily restored by in vivo supplementation of both a mononucleotide-nucleoside mixture (OG-VI) and polynucleotides. Polynucleotides appear to act partly by modulating antigen presentation processes mediated by cell surface molecules. We examined whether dietary fatty acid manipulation alters nucleotides' actions on humoral immunity. Antibody production was studied in C57B1/6 mice fed I) a nucleotide-free diet high in saturated fatty acid (SFA diet), 2) a nucleotide-free diet high in polyunsaturated fatty acid (PUFA diet), and 3) a regular nucleotide-free diet (control). In vivo and in vitro T cell-dependent antibody production decreased in all groups, but mice fed the SFA diet produced more antibody in vivo than did mice in the other diet groups. Spleen cells from mice fed the SFA diet also produced more interferon-alpha when stimulated with mitogens than did those from mice fed the control diet. In contrast, polynucleotides enhanced in vitro antibody production much less efficiently in mice fed the SFA diet than in the other mice and in vivo supplementation of OG-VI was also less effective in restoring impaired antibody production in these mice. A diet with a high content of SFA may alter nucleotides' action on humoral immune responses, in addition to its direct effects on immune functions.

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