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Biomedical subjects

L Bauman

Publications and source records attributed to L Bauman.

11 recordsLinked to original sources
PubMed1997

Psychosocial characteristics of inner-city children with asthma: a description of the NCICAS psychosocial protocol. National Cooperative Inner-City Asthma Study.

Previous research has demonstrated a significant reciprocal relationship between psychosocial factors and asthma morbidity in children. The National Cooperative Inner-City Asthma Study investigated both asthma-specific and non-specific psychosocial variables, including asthma knowledge beliefs and management behavior, caregiver and child adjustment, life stress, and social support. This article presents these psychosocial characteristics in 1,528 4-9-year-old asthmatic urban children and their caretakers. Caretakers demonstrated considerable asthma knowledge, averaging 84% correct responses on the Asthma Information Quiz. However, respondents provided less than one helpful response for each hypothetical problem situation involving asthma care, and most respondents had more than one undesirable response, indicating a potentially dangerous or maladaptive action. Both adults and children reported multiple caretakers responsible for asthma management (adult report: average 3.4, including the child); in addition, children rated their responsibility for self-care significantly higher than did adults. Scores on the Child Behavior Checklist indicated increased problems compared to normative samples (57.3 vs. 50, respectively), and 35% of children met the criteria for problems of clinical severity. On the Brief Symptom Inventory, adults reported elevated levels of psychological distress (56.02 vs norm of 50); 50% of caretakers had symptoms of clinical severity. Caretakers also experienced an average of 8.13 undesirable life events in the 12 months preceding the baseline interview. These findings suggest that limited asthma problem-solving skills, multiple asthma managers, child and adult adjustment problems, and high levels of life stress are significant concerns for this group and may place the inner-city children in this study population at increased risk for problems related to adherence to asthma management regimens and for asthma morbidity.

Adult↗
PubMed1996

Phase I trial of the thymidylate synthase inhibitor AG331 as a 5-day continuous infusion.

AG331 (N6-[4-(morpholinosulfonyl)benzyl]-N6-methyl-2, 6-diaminobenz-[c,d]-indole glucuronate) is a lipophilic thymidylate synthase inhibitor with activity in solid tumor models. On the basis of preclinical data supporting regimens of frequent drug administration, we performed a Phase I trial of AG331 as a 5-day continuous infusion repeated every 3 weeks. Twenty-nine patients were entered at doses ranging from 25 to 1000 mg/m2/day. The major side effects were mild to moderate fatigue, nausea, vomiting, diarrhea, and fever. At doses >/=400 mg/m2, acute reversible elevation of bilirubin, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltranspeptidase was observed. All patients who received >/=600 mg/m2/day experienced elevated alanine aminotransferase. Elevated liver function tests were evident by day 3 of the infusion and had resolved by day 8 in the majority. This toxicity was dose limiting at 1000 mg/m2/day, at which dose two of two patients developed grade 4 reversible hyperbilirubinemia in addition to the enzyme elevations. Serum and urine samples were analyzed by a novel high-pressure liquid chromatography method for the determination of the pharmacokinetics of AG331. Over the 50-1000 mg/m2/day dose range, mean total clearance ranged from 11.6 to 30.0 liters/h/m2, and volume of distribution at steady state ranged from 279.5 to 758.7 liters/m2. These parameters were dose independent over the dose range tested. The harmonic mean terminal half-life of AG331 was 20.2 h. Less than 5% of an AG331 dose is eliminated unchanged in the urine. Both the administered dose and exposure to the drug were related to the changes in bilirubin and aminotransferase blood levels. Evidence for inhibition of thymidylate synthase was obtained at doses ranging from 100 to 1000 mg/m2 in seven patients; plasma deoxyuridine concentrations at end-infusion were 1.8-3.8-fold higher than pretreatment values. Because of the nature of toxicity on this schedule, more extensive Phase II evaluation is not recommended, although an AG331 dose of 800 mg/m2/day for 5 days is tolerable. Exploration of less frequent dose administration is under way.

Adult↗
PubMed1988

Demystifying the patient dropout: a study of 122 brief-stay day-treatment center admissions.

Past studies examining the dropout from treatment phenomenon have failed to identify comparable populations or a standardized definition of the term "patient dropout." Although the phenomenon is widespread, few investigators have studied the problem within day-treatment programs serving subacutely disturbed clients in need of socialization or prevocational services. The primary purpose of the present study was to determine the reasons for brief Day Treatment Center (DTC) stays of 10 sessions or fewer and to ascertain implications of these findings for admission screening processes. Analysis of demographic information revealed that the average brief-stay patient was in his mid-thirties, was single (65%), was schizophrenic (39%) or suffering a mood disorder (27%), and had attended up to 4 days (63%) before leaving treatment. A retrospective review of 122 brief stay records revealed six categories of reasons for leaving the DTC: (1) a desire to return to work, (2) exacerbation of psychiatric symptoms, (3) resistance to treatment recommendations, (4) negative reaction to the treatment milieu, (5) a desire for less intense treatment, and (6) a belief that problems were resolved during the brief stay. The authors concluded that admission screening interviewers would benefit from complete past school and work records. Strategies for reducing dropout rates should include (1) longer transition periods for newly referred patients, (2) obligatory meetings with the patient and his family and therapist before inpatient discharge, and (3) improved orientation to the DTC program.

Day Care, Medical↗
PubMed1980

Nutritional composition of milk produced by mothers delivering preterm.

The nutritional composition of milk obtained during the first month postpartum from 33 mothers delivering preterm and 18 mothers delivering at term was determined. Milk produced by mothers delivering preterm contained significantly higher concentrations of protein, sodium, and chloride, and significantly lower concentrations of lactose than milk produced by mothers delivering at term. The caloric concentration of milk produced by the two groups of mothers was similar, as were the concentrations of potassium, calcium, phosphorus, and magnesium. PT milk appears to approximate more closely the nutritional needs of the preterm infant than does other breast milk.

Calcium↗
PubMed1965

Malignant melanoma arising from an intradermal nevus.

A case of malignant melanoma apparently arising from the lower portion of a preexisting intradermal hairy nevus is presented. This case is an exception to the general rule that if malignant melanomas arise from nevi they originate in nevi with a junctional component.

Female↗
PubMed1965

Granuloma faciale with lesions on the face and hand.

A patient with granuloma faciale had multiple lesions on the face and one lesion on the dorsal surface of one hand. This case adds a clinical parallel to the recognized histological parallel between granuloma faciale and erythema elevatum diutinum.

Facial Dermatoses↗
PubMedDate not supplied

Spectral sensitivity of a novel photoreceptive system mediating entrainment of mammalian circadian rhythms.

Environmental light cycles are the dominant synchronizers of circadian rhythms in the field, and artificial light cycles and pulses are the major tools used in the laboratory to analyse properties of circadian systems. It is therefore surprising that few studies have analysed the physical parameters of light stimuli that affect circadian rhythms. There have previously been no spectral sensitivity measurements for phase shifting the circadian rhythms of mammals and only two preliminary reports on the wavelength dependence of this response exist. Using the magnitude of phase shift caused by a single 15-min pulse of monochromatic light given 6 h after activity onset, we have now characterized the spectral sensitivity of the photoreceptors responsible for phase shifting the locomotor rhythm of the hamster (Mesocricetus auratus). The sensitivity curve for this response has a maximum near 500 nm and is similar to the absorption spectrum for rhodopsin. Although the spectral sensitivity is consistent with a rhodopsin-based photopigment, two features of the photoreceptive system that mediates entrainment are unusual: the threshold of the response is high, especially for a predominantly rod retina like that of the hamster, and the reciprocal relationship between intensity and duration holds for extremely long durations (up to 45 min). These results suggest that the photoreceptive system mediating entrainment is markedly different from that involved in visual image formation.

Animals↗
PubMedDate not supplied

Assessing managed care for children with chronic conditions.

This paper reviews opportunities to monitor managed care for children and adolescents with chronic conditions and considers how well the Health Plan Employer Data and Information Set, version 3.0 (HEDIS 3.0), assesses care for these children. We propose four steps to strengthen the applicability of HEDIS to children with chronic conditions: (1) develop methods of identifying and monitoring groups of children with chronic conditions; (2) report HEDIS indicators for these children separately from those for other children; (3) develop and implement consumer and provider surveys that elicit information specific to these populations; and (4) develop specific structure, process, and outcomes indicators for children with chronic conditions.

Adolescent↗