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Biomedical subjects

K Gregory

Publications and source records attributed to K Gregory.

34 records · Page 2Linked to original sources

Medical students' expectations for encounters with minority and nonminority patients.

The authors examined the expectations of firstyear medical students (n = 139) at the University of California, Los Angeles, School of Medicine in regard to interacting with black, Latino, Asian, and white patients. Using slides and a questionnaire, the results indicated that students expected to be significantly less comfortable interviewing blacks than other patients and to view blacks and Latinos as less likely to comply with treatment than whites and Asians. Black and Hispanic students were significantly more likely than white and Asian students to expect black and Hispanic patients to comply with treatment.

Adolescent↗

Which first-year medical students expect to practice in an inner-city or ghetto setting.

The authors examined the expected practice location of first-year medical students at UCLA School of Medicine using self-administered questionnaires. The response rate was 94 percent. About 24 percent of students are from underserved minority groups. Compared with nonminority students, minority students are significantly older, of lower socioeconomic status, and more likely to have been raised in an inner-city or ghetto environment (each P<.05). While the average nonminority student expected to practice in a noninner-city, urban, or suburban environment, the average minority student expected to practice in an inner-city or ghetto environment (P<.0001). Differences in expected practice location due to ethnicity remained after controlling for sociodemographic factors. Students with previous medical experience and those from poorer sociodemographic backgrounds are also more likely to expect to practice in ghetto environments, regardless of ethnic background (each P<.05).

Adult↗

An analysis of the contact phase of blood coagulation: effects of shear rate and surface are intertwined.

This work analyzes, for the first time, the combined role of blood flow, protein transport and the reaction network of the contact phase up to the "common pathway" of the blood coagulation cascade. The model is comprised of a set of 20 dominant reactions with 11 components. Systems of ODEs reducible to 4 coupled equations describe rigorously the dynamic behavior, while systems of algebraic equations, reducible to a single polynomial equation, model the steady state concentrations of the coagulants. The analysis showed that there is never more than one stable steady state. This is in contrast to the analysis of common pathway that gives rise to multiple concentration states. It also revealed a general robustness of the system to changes in procoagulant concentrations, inhibition rates and most activation rate constants. The system is largely impervious to the level of activated Factor XII, given that a trace (non-zero) level is present. In contrast, the system displays a dual response to flow and surface activity: A change in either of these factors alone can promote, have no effect on, or (in the case of flow) impede the progress of coagulation, depending on the value of the other factor. Their effects must therefore be examined in unison. These results may help resolve contradictory findings attributed to one or the other factor alone.

Blood Coagulation↗

Effects of transmyocardial laser revascularization by using a prototype pulsed CO2 laser on contractility and perfusion of chronically ischemic myocardium in a porcine model.

The purpose of this study was to test a new prototype pulsed CO2 laser to be used for transmyocardial laser revascularization (TMR). We wanted to determine whether it can reduce thermal damage and mitigate induced ischemia with improvement in contractile reserve of the heart as evidenced by contrast echocardiography at rest and under dobutamine stress. TMR is an emerging surgical strategy for treatment of myocardial ischemia not amenable to conventional percutaneous or surgical revascularization. Eleven pigs underwent ameroid occluder placement at the origin of the circumflex coronary artery. Six weeks later, occlusion of the circumflex coronary artery was documented. TMR was then carried out on 10 pigs by using a prototype pulsed CO2 laser that delivered 8-12 joules in 1.5 ms with a spot size of 1 mm. Six weeks after TMR, the pigs were restudied. The animals developed significant ischemia after 6 weeks of ameroid occlusion, at rest (p = 0.01) and at peak stress (p = 0.004). Wall motion for the ischemic segments improved significantly 6 weeks after TMR at peak stress (p = 0.02). TMR results in an improvement in wall motion in our model of chronic ischemia and improves wall motion score index more during induced stress than at rest.

Animals↗

Returning to primary school after treatment for cancer.

Questionnaires were sent to the teachers of 14 children returning to school after treatment for childhood cancer and their 11 siblings. Forty-four control children from the same classes were also selected. Behavioral rating scores (Deasy-Spinetta) showed no differences between cases and siblings or control children in terms of learning disabilities, socialization, and emotional behavior. Teachers reported few problems on the case children's return to school, although many had been anticipated. Most children adapted well, and there were no major changes in behavior or performance. Siblings, too, coped well with the experience. The Royal Victoria Infirmary at Newcastle, where the children were treated, has two community liaison nurses and three social workers. The value of the support that they provide to both families and schools is clearly reflected in the ease with which children reintegrate into their school environment after what can be, for some, a prolonged absence.

Child↗