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Biomedical subjects

L Linn

Publications and source records attributed to L Linn.

At least 19 recordsLinked to original sources
PubMed2004

Safety and pharmacokinetics of inhaled morphine delivered using the AERx system in patients with moderate-to-severe asthma.

OBJECTIVE: The safety and pharmacokinetics of inhaled morphine in asthmatic subjects were investigated using the AERx System, a novel aerosol system. METHODS: Twenty subjects with asthma received inhaled placebo and inhaled morphine sulfate, 2.2 mg, 4.4 mg and 8.8 mg, on separate days in a single-blind crossover study. Six of the subjects received an additional open-label dose of 17.6 mg on a separate day. Plasma morphine concentrations and safety evaluations including pulmonary function testing were performed. RESULTS: Mean tmax values were similar following all dose groups at approximately 1-2 minutes. Mean AUC(0-->1) values showed dose proportionality for the first 3 dose groups (6.3, 12.3 and 24.3 ng x h x ml(-1)), the mean AUC(0-->1) for the 17.6 mg dose group was 1.6x that of the 8.8 mg dose group. No statistically significant differences in forced expiratory volume in 1 sec (FEV1) were found for the 2.2 mg, 4.4 mg, or 8.8 mg dose groups; at 17.6 mg, a statistically significant but not clinically meaningful reduction in mean FEV1 (-8.18%) from baseline occurred at 10 minutes compared to placebo, spontaneously returning to baseline by 60 min. Four subjects experienced significant but reversible decreases in FEV1 of > or = 20% compared to baseline and across all dose levels including after placebo, but with no associated increase in dyspnea, wheezing or other adverse events. CONCLUSIONS: Inhaled morphine using the AERx System was absorbed rapidly and demonstrated dose-dependent plasma concentrations. It was well-tolerated and did not cause clinically significant bronchoconstriction in most subjects with moderate-to-severe asthma.

Administration, Inhalation↗
PubMed1995

The role of L-carnitine in pediatric cardiomyopathy.

Metabolic and genetic factors underlie some forms of cardiomyopathy in childhood. A variety of inborn errors of metabolism can impair mitochondrial energy production, or beta-oxidation, in the heart and lead to myocardial dysfunction. L-Carnitine, an essential element of beta-oxidation, transports fatty acids across the mitochondrial membrane for energy production. L-Carnitine deficiency syndromes are now well described as secondary to a variety of inborn errors of metabolism and often include cardiomyopathy in the clinical picture. Despite traditional therapies for cardiomyopathy, mortality for this disorder remains at well over 50%. Review of reports of L-Carnitine supplementation studies and results from our own trial underscore the importance of its role in cardiac function and demonstrates that there is likely a subpopulation of patients with cardiomyopathy responsive to L-carnitine treatment.

Cardiomyopathies↗
PubMed1993

AIDS-related risk behavior, knowledge, and beliefs among women and their Mexican-American sexual partners who used intravenous drugs.

OBJECTIVE: To assess the risk behaviors, knowledge, and beliefs regarding human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among women and their sexual partners who were Mexican-American men who used intravenous drugs. DESIGN: Survey of male methadone users and their female sexual partners. PARTICIPANTS AND SETTING: Mexican-American male clients at a methadone clinic in Los Angeles, Calif, were consecutively recruited for the study. A method similar to partner contact tracing was used to identify female subjects. One hundred subjects, representing 50 male-female pairs of sexual partners, answered identical questionnaires. The responses from females were compared with those from their male partners. RESULTS: Seventy-four percent of the females disclosed that they used intravenous drugs, and 88% knew that their male partners were intravenous drug users. Of subjects who used intravenous drugs, 73% (27/37) of females and 88% (44/50) of males currently injected themselves and shared uncleaned needles. Seventy-six percent of females and 84% of males never used a condom during the previous year, and about 20% of both sexes had more than one sexual partner. Even though most of the females understood how HIV was transmitted and recognized themselves as at risk for AIDS, they continued to share needles unsafely and place themselves at risk for acquiring HIV infection through sex. CONCLUSION: This group of females and their male sexual partners engaged in multiple behaviors that may contribute to the further propagation of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Conditions that justify strikes as perceived by housestaff at a public hospital.

Although physicians' strikes provoke considerable controversy and are increasing in incidence, little information is available regarding house officers' attitudes towards the ethics of striking. To determine house officers' views of whether and when it is justified to strike, and to understand the factors affecting their judgments, in 1988 the authors surveyed 432 residents (including interns and fellows) at a large public hospital shortly following a four-day housestaff work action; 255 (59%) responded. In responding to 12 hypothetical scenarios, 218 residents (85%) thought striking was justified if vital equipment were in short supply and the strike was unlikely to cause lethal harm, but only 10 (4%) thought striking justified if the issue was low salaries and the risk to patients was high. Twenty-two residents (9%) thought striking unacceptable in all 12 cases. Training in obstetrics-gynecology or psychiatry, liberal politics, and low levels of job satisfaction were independent predictors of residents' believing that strikes were more often justified. Although the residents' responses to the hypothetical scenarios were related to their prior work action behaviors, the association was weakened by adjustment for contextual factors such as specialty and social norms. Implications for education in medical ethics are discussed.

Attitude of Health Personnel↗
PubMed1990

To strike or not to strike? House-staff attitudes and behaviors during a hospital work action.

Work actions by house staff are an infrequent response to sometimes difficult working conditions, but they can have a notable effect on institutional cohesiveness and represent a challenge to traditional notions of medical ethics. To determine the extent of participation in a hospital-wide doctors' strike and factors associated with participation, we surveyed 432 house officers at a university-affiliated public hospital where a contract dispute had recently led to a 4-day work action. Of 257 respondents, 69% approved of the strike and 50% participated in it. Both strikers and nonstrikers agreed that quality of care and specific contract issues were important precipitants of the event. By logistic regression, factors independently associated with strike participation (P less than .05) included being unmarried, training in internal medicine or psychiatry, being in earlier stages of training, being assigned to an outpatient service at the time of the strike, holding a favorable view of physician activism, and perceiving nurses, faculty, peers, and the public to have favored the strike. These associations may provide a basis for understanding the individual and social determinants of house-staff strike activity.

Adult↗
PubMed1985

Career orientations of medical and pediatric residents.

Educators have expressed concern about the declining percentage of graduating residents who choose an academic career. This study identifies characteristics of postgraduate physicians that are associated with intentions to pursue an academic career or a full-time private practice. Data were obtained from 299 residents in pediatrics and internal medicine at five academic medical centers in Southern California, using self-report questionnaires. Preference for an academic career was strongest among residents who were most satisfied with their work, were frequently sponsored by faculty, had published, or who either lived alone or were married to another professional. The likelihood of full-time private practice was strongest among residents who were less frequently sponsored by faculty, had not published, lived with others, were from certain medical schools, or were females. Training programs may wish to consider some of these factors in the selection of residents and in program development.

Academic Medical Centers↗
PubMed1980

Prescribing psychotropic drugs: whose responsibility?

Through the use of a questionnaire it has been ascertained that a significant number of second-year graduate school social work students at the Columbia University School of Social Work are called upon to monitor and dispense psychotrophic drugs in various placements where they receive their practical clinical training. In some instances they may even fill out prescription blanks that are signed by psychiatrists who do not have the time to see the patients personally. This situation not only represents the abdication of medical responsibility, frequently leaving non-medical personnel with functions beyond their training and professional competence, but also raises important ethical and legal problems. Non-medical professionals in mental health settings should receive appropriate instruction in the essentials of psychopharmacology. Such training should not be left to chance as apparently is the case now. Non-medically trained members of the mental health team, if properly instructed, could cooperate more effectively with the psychiatrists who must in any event retain primary responsibility for pharmacotherapy.

Clinical Competence↗
PubMed1979

An evaluation of traditional and alternative mental health facilities.

Traditional mental health facilities were compared with alternative mental health facilities on their response to a crisis situation. Over one-third of the total sample of facilities (n = 50) did not respond with any help. Alternative facilities gave more direct counseling than did traditional facilities, indicating the particular suitability of alternative facilities for crisis intervention.

California↗
PubMed1978

Reactions of schizophrenics to life-threatening disease.

This contribution reports a study of chronic schizophrenics hospitalized in state hospitals who suffer from serious and life-threatening medical and surgical illnesses. Four primary findings are described and discussed: lack of verbalization of pain and discomfort; bodily self-mutilation; toleration and exhibition of loathsome lesions; and inability or unwillingness to tolerate medical care. Some examples of exceptions to these four findings are also presented. Possible explanations for the findings are discussed in terms of their biological, social, and psychological components, recognizing that no single factor can explain the findings in this complex and varied population. It is concluded that treatment staffs in the hospital or community must be alert to changes in patient state, must utilize compromise methods of care and must anticipate or deduce a patient's needs while the patient is physically ill.

Adult↗