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M Hickman

Publications and source records attributed to M Hickman.

52 records · Page 3Linked to original sources
PubMed1995

Regulation of glucose transport in cultured muscle cells by novel hypoglycemic agents.

The antidiabetic agent troglitazone (CS-045) and a metabolite designated M3 have potent blood glucose-lowering actions. The mechanism of the hypoglycemic effects of troglitazone and M3 was investigated in cultured L6 muscle cells. Short-term (2-hour) exposure of fully differentiated myotubes to troglitazone had no effect on glucose transport activity; M3 exposure caused a modest (50% to 60%) increase in basal and insulin-stimulated transport. Long-term (72-hour) treatment of myotubes with troglitazone resulted in a doubling of glucose transport in the absence of insulin, whereas M3 treatment resulted in a fivefold increase in basal glucose transport. Transport activity in M3-treated myotubes was greater than that seen after short-term insulin treatment. Insulin did not stimulate transport further in long-term M3-treated cells. A similar effect of prolonged exposure to M3 was observed in nondifferentiated myocytes. The agent had no influence on cell growth or the extent of differentiation. Augmentation of basal glucose transport by M3 was slow in onset, requiring 18 to 24 hours before significant effects were observed and 72 hours for full stimulation. M3 action on glucose transport was also dose-dependent, with half-maximal stimulation at 5 micrograms/mL of the agent and full effects at 10 to 20 micrograms/mL. Total membranes were prepared from control and M3-treated L6 myocytes and myotubes, and glucose transporter (GLUT1 and GLUT4) protein levels were measured by Western blotting. GLUT1 content was increased 2.9- +/- 1.3- and 2.8- +/- .2-fold by M3 treatment in myocytes and myotubes, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

A taxonomy of shared care for chronic disease.

BACKGROUND: Shared care is promoted as a way of integrating primary and secondary services and achieving one of the targets set for the NHS in the 1990s. We aimed to compose a taxonomy of shared care schemes for chronic disease in order to inform the development of develop shared care. METHODS: A two-phase postal questionnaire survey of Scotland and North West Thames Region, England. In the first phase we identified the number of shared care schemes for chronic disease, which were followed up in the second phase. RESULTS: Shared care schemes were classified into six groups, or models, according to their method of data transfer. These are: (I) community clinics, where the specialist undertakes a clinic in general practice; (II) basic, where communication comprises the regular exchange of letters or standardized record sheets; (III) liaison, where the hospital team and general practitioner (GP) meet to discuss and agree the management of patients under shared care; (IV) shared care record cards, where the exchange of information is made through a booklet or 'cooperation card', commonly carried by the patient; (V) computer-assisted shared care, where a circuit of information is established between GP and hospital specialist based on data collected at each patient visit and mediated through computer-generated summaries; (VI) electronic mail, where hospital specialist and GP both have access to the same data on patients shared between them. CONCLUSION: Despite substantial variation in the operation of shared care, schemes can be broadly classified and constructed in six different ways. In establishing this taxonomy, a choice is offered to health care workers wishing to develop shared care.

Chronic Disease↗
PubMed1994

Rural case management: a pilot study.

The long term goal of this research is to improve the quality, effectiveness and efficiency of home and community-based services for rural long term care clients. Case management has been espoused as one method to improve services. Long term care case management models have been tested in urban areas with good results, but it is not known to what extent these models are applicable to the special circumstances of rural home and community-based care. The purposes of this pilot study are: 1. To describe case management in long term home health care as practiced in rural Kentucky. 2. To analyze case management for factors that promote or impede effective and efficient delivery of long term home health care for older rural Kentuckians. 3. To propose a model appropriate to case management in long term home health care for older rural Americans.

Activities of Daily Living↗
PubMed1993

AIDS surveillance: a direct assessment of under-reporting.

OBJECTIVE: To assess directly the extent of under-reporting of AIDS cases to the National AIDS surveillance system. DESIGN: All AIDS cases diagnosed from 1 January 1982 to 1 August 1989 in Riverside Health Authority were identified from a local register of HIV infection and cross-checked against records of AIDS cases reported to the national AIDS surveillance system. SETTING: Riverside Health Authority, London, UK. MAIN OUTCOME MEASURES: An estimate of under-reporting was made by identifying both the number of AIDS cases that had not been reported and the number of AIDS cases reported after August 1989 (allowing for reporting delay). Changes in the timeliness, 1982-1989, of AIDS reporting by Riverside physicians were measured by comparing reporting delay (time between diagnosis and report) and the proportion of AIDS cases reported more than a year after diagnosis (non-reports). RESULTS: A total of 807 AIDS cases were identified. Under-reporting of AIDS cases was found to be 10%; less than 3% (20 cases) of the AIDS identified had not been reported by September 1991. The timeliness of AIDS reporting from Riverside improved significantly from 1987, when the median reporting delay fell from 7 to 4 months, and the proportion of non-reports fell from 36 to 17% (Mann-Whitney U test P < 0.001, chi 2 test P < 0.001, respectively). CONCLUSIONS: Our estimate of 10% AIDS under-reporting is half that used to adjust the previous forecasts of the AIDS epidemic in the UK, confirms current thinking that under-reporting lies between 5 and 15%, and supports the view that AIDS reporting is more complete than the reporting of most other infectious diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Impact of HIV infection on mortality in young men in a London health authority.

OBJECTIVE: To determine the number of deaths attributable to HIV infection among men aged 15-64 in a geographically defined population in the United Kingdom. DESIGN: Retrospective review of death certificates and linkage with local and national HIV and AIDS surveillance data. SETTING: Riverside District Health Authority, London. MAIN OUTCOME MEASURES: Numbers of deaths attributed to HIV infection in male residents of Riverside aged 15-64 and 15-44 over a six month period. Proportion of attributed deaths were (i) identified from death certificates by the Office of Population Censuses and Surveys as being due to HIV infection and (ii) reported as cases of AIDS or HIV related deaths to the Public Health Laboratory Service Communicable Disease Surveillance Centre. RESULTS: 34 of 213 (16%) deaths in men aged 15-64 and 27 of 69 (39%) deaths in men aged 15-44 were attributed to HIV infection. Six of 33 (18%) attributed deaths were identified by the Office of Population Censuses and Surveys and 32/34 (94%) were reported to the Communicable Disease Surveillance Centre. CONCLUSIONS: HIV infection was the leading cause of death in male residents of Riverside aged 15-44 and the third commonest cause of death in those aged 15-64. Most individuals dying of known HIV infection were reported to the Communicable Disease Surveillance Centre but identification of the true cause of death from the process of death certification was poor. Measures to improve the certification of HIV and AIDS or the use of AIDS surveillance information correctly to code the cause of death needs to be considered to ensure that the true impact of HIV infection is reflected in routine mortality statistics.

Adolescent↗
PubMed1992

Megestrol acetate in cancer anorexia and weight loss.

High-dose megestrol acetate has been associated with increased appetite and weight. To examine the effects of high-dose megestrol acetate in the treatment of anorexia and weight loss in patients with advanced hormone-insensitive malignant lesions, a randomized double-blind placebo-controlled trial was conducted. Patients receiving megestrol acetate for 1 month reported a significant improvement in appetite and adequacy of food intake compared with those receiving placebo. A three-item scale measuring appetite, adequacy of food intake, and concern about weight revealed a higher improvement with megestrol acetate than with placebo. Patients who worsened while receiving placebo had similar favorable changes after the cross over to megestrol acetate. These data indicate that megestrol acetate may improve appetite and food intake in patients with advanced cancer.

Adult↗
PubMed1991

Treatment of anorexia and weight loss with megestrol acetate in patients with cancer or acquired immunodeficiency syndrome.

Anorexia is a symptom of cancer and a cause of decreased caloric intake and weight loss. Successful treatment for anorexia can improve the patient's well-being and prevent or reverse the effects of anorexia on nutrition. Following reports of appetite enhancement and weight gain in uncontrolled studies of high-dose (320 to 1,600 mg/d) megestrol acetate in patients with cancer or AIDS (acquired immunodeficiency syndrome), several randomized, placebo-controlled trials have been completed. These trials demonstrate that megestrol acetate therapy improves appetite and food intake in patients with anorexia and advanced cancer, leading to weight gain in a subset of patients. The mechanisms of action of megestrol acetate (a progesterone derivative) probably include both behavioral and metabolic effects. Several carefully designed randomized trials are under way to establish the optimal dose and to determine the mechanism of weight gain. Patients with cancer or AIDS who complain of anorexia and whose nutritional status is compromised may benefit from megestrol acetate therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Treatment of cancer anorexia with megestrol acetate: impact on quality of life.

The quality of life of patients with advanced cancer depends to a large degree on the presence of disease or treatment-related symptoms. Anorexia is frequent in cancer patients, but has received less attention than other symptoms such as pain or nausea. Yet, anorexia is important because it reduces caloric intake and leads to malnutrition. Further, lack of appetite can disrupt basic activities of daily living, such as eating, and may also interfere with family and social interactions. To test the efficacy of drugs that reverse anorexia, we need accurate and reliable parameters to quantitate this symptom. The effects of anorexia and its reversal on the patients' clinical progress, food intake, nutritional status, and quality of life need to be evaluated. Our ongoing studies demonstrate that megestrol acetate can reverse cancer anorexia and that appetite changes strongly correlate with changes in weight, food intake, and quality of life scores.

Anorexia↗
PubMed1990

Appetite stimulation and weight gain with megestrol acetate.

The extreme anorexia and cachexia associated with cancer and other disease states often have important physical and psychologic impact on both patients and their families. Weight gain resulting from megestrol acetate therapy in breast cancer patients suggests that progestins may be useful for alleviation of disease-associated appetite and weight loss. Early breast cancer experience, as well as preliminary data from a randomized, placebo-controlled trial of high-dose megestrol acetate in cancer anorexia and wasting, is therefore reviewed. Although the precise mechanism by which megestrol acetate exerts its effect remains unclear, weight gain was observed in 75% of patients in the high-dose study and in nearly all of those who remained on therapy for 6 weeks. It was concluded that, although megestrol acetate cannot be expected to directly affect the prognosis of patients with hormone-insensitive tumors, it may increase host resistance by improving nutritional status and/or enhancing the quality of life.

Adult↗
PubMed1980

Increases in aggregation by and uptake of 5-hydroxytryptamine with platelets from rabbits treated with chlorpromazine.

1 Citrated platelet-rich plasma was prepared from New Zealand white rabbits before, during and after administration of chlorpromazine (2 mg/kg) intramuscularly once daily for 3 to 4 weeks. 2 In these plasmas, the velocity of platelet aggregation by 5-hydroxytryptamine (5-HT) added at 1, 3 and 10 microM increased greatly, beginning 3 to 4 days after the start of chlorpromazine injections and lasting for a similar period after they were terminated. The increase had two maxima, the first after 6 to 10 days and the second after 17 to 24 days. Chlorpromazine treatment did not affect aggregation by adenosine diphosphate (ADP). 3 The uptake of 5-HT by rabbit platelets was very fast and linear for less than 10 s. In platelets from untreated rabbits the uptake had a Km of 0.35 +/- 0.08 microM and a Vmax of 39.8 +/- 6.1 pmol 10(-8) platelets 10(-1) (n = 5). 4 In platelets from rabbits injected with chlorpromazine (see (2) above) both kinetic constants increased significantly, the Km to 0.88 +/- 0.08 microM and the Vmax to 67.8 +/- 5.5 pmol. 10(-8) platelets. 10(-1) s (n = 9).

Animals↗
PubMedDate not supplied

Orbital sinus histiocytosis: MR appearance.

This case report describes the appearance of orbital sinus histiocytosis by magnetic resonance (MR) imaging. Four years after the remission of unilateral cervical adenopathy due to sinus histiocytosis, a 6-year-old girl developed orbital sinus histiocytosis with extension into the middle cranial fossa. Computed tomography demonstrated a homogeneously enhancing lesion; on MR, this tumor was isointense to gray matter on T1-weighted, proton density, and T2-weighted images. Vascular embarrassment was clearly shown by MR.

Child↗