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Biomedical subjects

J Root

Publications and source records attributed to J Root.

11 recordsLinked to original sources

Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review.

Osteoarthritis (O.A.) is the most common type of articular disease. This is an idiopathic joint disease characterized by an imbalance between synthesis and degradation of articular cartilage and subchondral bone accompanied by capsular fibrosis, osteophyte formation and variable grade of inflammation of synovial membrane. Joint lubrication is naturally provided by Hyaluronic acid in syovial fluid. Hyaluronan is present in abundance in normal young and healthy joints. In degenerative O.A. Hyaluronan is smaller in size, molecular weight and diminished in concentration. This decrease in joint lubrication and shock absorbing mechanism in O.A. can be remedied by intraarticular viscosupplementation. Alternatively the pain and secondary inflammation in O.A. can be relieved by intraarticular injection of steroids and long acting local anesthetics. Promt and effective reduction in local inflammation occurs after intra-articular injection of corticosteriod. This article reviews the cartilage metabolism in O.A., discusses the pros and cons of these treatments and provides a literature review of the studies which compare benefits and adverse reactions of viscosupplementation vs. intraarticular steroids with placebo treatment.

Adrenal Cortex Hormones↗

Effects of a chewable sodium bicarbonate oral composition on plaque and gingivitis.

The purpose of this pilot study was to evaluate the effects of an effervescent sodium bicarbonate based oral composition on plaque and gingivitis. Subjects selected for this study presented at screening with moderate plaque and American Academy of Periodontology (AAP) Type I/II periodontal status. At baseline, subjects were allocated to one of two groups by simple randomization; placebo (n=16) and active (n=16). During the study two subjects withdrew due to non-compliance and one because of a death in the family. Data were collected at baseline, day 14, and day 28. The Plaque Index (PI) of Silness and Loe was used to quantify the amount of supragingival plaque surrounding six selected teeth (3,14,8,19,24,30), and the Gingival Index (GI) of Loe and Silness was used to assess bleeding tendencies and visual appearance on the same six teeth. A soft tissue oral assessment was completed at each visit. Subjects were asked to perform study treatment three times a day, after meals, and continue with normal oral hygiene procedures. Subjects were requested to complete a 28-day diary to assess compliance. Data were analyzed using repeated measures analysis of variance. There were no statistically significant differences between the placebo and the active product groups and no statistical significant interaction between product and location within the mouth or visit for either the plaque or gingival scores. Results reveal the product was safe to oral tissues and was well accepted by subjects.

Adolescent↗

The human homolog of Escherichia coli Orn degrades small single-stranded RNA and DNA oligomers.

We report here the identification of human homologues to the essential Escherichia coli Orn protein and the related yeast mitochondrial DNA-escape pathway regulatory factor Ynt20. The human proteins appear to arise from alternatively spliced transcripts, and are thus identical, except the human Ynt20 equivalent contains an NH(2)-terminal extension that possesses a predicted mitochondrial protease cleavage signal. In vitro analysis revealed that the smaller human protein exhibits a 3' to 5' exonuclease activity for small (primarily </=5 nucleotides in length) single-stranded RNA and DNA oligomers. We have named this human protein Sfn for small fragment nuclease to reflect its broad substrate range, and have termed the longer protein hSfnalpha. Sfn prefers Mn(2+) as a metal cofactor and displays a temperature-resistant (to 50 degrees C) nuclease activity. Kinetic analysis indicates that Sfn exhibits a similar affinity for small RNAs and DNAs (K(m) of approximately 1.5 micrometer), but degrades small RNAs approximately 4-fold more efficiently than DNA. Mutation of a conserved aspartate (Asp(136)) to alanine abolishes both nuclease activities of Sfn. Northern blot analysis revealed that a 1-kilobase transcript corresponding to SFN and/or SFNalpha (these mRNAs differ by only two nucleotides) is expressed at varying levels in all fetal and adult human tissues examined. Expressed tag sequence clone analysis found that the two splice variants, SFN to SFNalpha, are present at a ratio of roughly 4 to 1, respectively. The results presented within suggest a role for human Sfn in cellular nucleotide recycling.

14-3-3 Proteins↗

Easy-to-read consumer communications: a missing link in Medicaid managed care.

Effective consumer communication is key to successfully moving Medicaid recipients into managed care systems and realizing the promised cost savings from the upheaval. Yet, little attention has been paid to educating these consumers with easy-to-read materials. The Maine Area Health Education Center (AHEC) Health Literacy Center, with the support of the Center for Health Care Strategies, Inc., addressed the problem by offering three national skills training workshops called Writing for the Medicaid Market. The training was marketed to public and private organizations providing Medicaid managed care services, including state Medicaid officials, health benefit counselor staff (enrollment brokers), managed care plan (HMO) staff, and consumer advocates. The training addressed the core issue in health literacy: the mismatch between the low literacy skills of the target population and the high reading level of most health and managed care materials. Posttraining survey data revealed that training was successful in skill building, but also that it addressed only the tip of the iceberg. Faulty and/or nonexistent communication planning limits the success not only of Medicaid, but of other large health and social programs as well. The authors outline the broad scope of the national health literacy problem, share their posttraining survey data, discuss lessons extrapolated from both their data and their experience, and propose a national agenda to address a vast and generally ignored public problem.

Adult↗

The challenges and opportunities of laboratory regionalization.

These are some of the major historical trends and rationale for the sea change in laboratory medicine today. The creation of cooperative regional networks and consolidated regional laboratories potentially can: 1) Pool the technologic strengths of individual laboratories across a region; 2) Create economies of scale by combining capacities for certain procedures; 3) Lower unit costs by increasing volumes of business from nonpatients; 4) Span all of the traditional testing venues along the new expanding continuum of care. The authors in this monograph will take the saga forward in time, outlining critical organizational, technologic, and strategic aspects of the newly evolving laboratory of the 21st century.

Automation↗

High-dose intravenous lorazepam for the treatment of refractory status epilepticus.

We treated nine refractory status epilepticus cases with high-dose intravenous lorazepam. We monitored the EEGs continuously, and lorazepam dosing was titrated to stop clinical and electrographic seizures. Lorazepam doses needed to terminate status epilepticus ranged from 0.3 to 9 mg/hr. Lorazepam did not cause hypotension. All patients survived. Outcome was complete recovery in two cases, moderate disability in four, and severe disability in three. These findings suggest high-dose intravenous lorazepam may be an effective alternative to pentobarbital for the treatment of severe status epilepticus.

Adult↗

Famotidine (20 mg) b.d. relieves gastrooesophageal reflux symptoms in patients without erosive oesophagitis. Famotidine/GERD Investigation Group.

Previous clinical trials have evaluated a large number of symptomatic individuals with heartburn. Most studies have documented the need for multiple daily dosing with H2-antagonists to achieve clinical and statistical efficacy for symptom relief. The purpose of this study was to compare the safety profile and efficacy of famotidine oral dosing regimens, 40 mg nocte and 20 mg b.d. with placebo in the relief of symptoms in patients suffering from frequent heartburn found to have endoscopically normal oesophageal mucosa or mild non-erosive oesophagitis. Famotidine (20 mg) b.d. reduced and eventually completely relieved gastro-oesophageal reflux disease symptoms in most patients during the 6-week trial. Global assessment of improvement at 2 and 6 weeks indicated significantly greater improvement with a b.d. treatment regimen than with either a 40 mg nocte or placebo treatment. No statistically significant differences between famotidine and placebo in the number of patients who experienced clinical adverse experiences were noted and no serious adverse events attributable to famotidine occurred. Based upon these findings, patients with gastro-oesophageal reflux symptoms experience good relief of their complaints with twice daily famotidine in standard doses.

Administration, Oral↗

The Wenckebach phenomenon.

The Wenckebach phenomenon, or type I AV block, refers to a progressive lengthening of impulse conduction time, followed by a nonconducted impulse, or dropped beat. It can occur in a variety of pathologic settings, especially inferior myocardial infarction. Although a temporary pacemaker may be required, full spontaneous recovery is the rule.

Diagnosis, Differential↗

The interrelationships of thyroid and growth hormones: effect of growth hormone releasing hormone in hypo- and hyperthyroid male rats.

Growth hormone (GH) and the thyroid hormones interact in the hypothalamus, pituitary and peripheral tissues. Thyroid hormone exerts a permissive effect upon the anabolic and metabolic effects of GH, and increases pituitary synthesis of this protein hormone. GH depresses the secretion of thyrotropin and the thyroid hormones and increases the peripheral conversion of thyroxine to triiodothyronine. In the adult male rat experimental hypothyroidism produced by ingestion of propylthiouracil depresses the GH secretory response to GH-releasing hormone in vivo and in vitro, reflecting the lowered pituitary stores of GH in the hypothyroid state. Short term administration of large amounts of thyroxine with induction of the hyperthyroid state does not affect the in vivo GH secretory response to GH-releasing hormone in this animal.

Animals↗

Materials and strategies that work in low literacy health communication.

In a Maine Area Health Education Center program some solutions were developed to the well-documented problem of health information material that cannot be read or comprehended by low literacy adults. Professionals in health education and adult education were trained to produce easy-to-read health materials and created dozens of low-cost pamphlets on the nation's year 2000 health objectives. The pamphlets are easily reproducible on a copy machine. Concurrently, a model for teaching oral communication skills to health care providers who deal with low-literacy adults was developed in partnership with Maine's largest rural health center delivery system. The train-the-trainers model reached more than 500 direct health care service providers. Participants in the two programs gained skills useful in all aspects of public communication that are replicable in other cities, States, and regions.

Communication Barriers↗