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Biomedical subjects

M Jamison

Publications and source records attributed to M Jamison.

8 recordsLinked to original sources
PubMed2004

Clinical and magnetic resonance imaging features of cricket bowler's side strain.

The clinical features of 10 cases of lateral trunk muscle injury in first class cricket pace bowlers are described. Typically the injury occurs during a single delivery, is associated with considerable pain, and prevents the bowler from continuing. The clinical picture is typical of a muscular or musculotendinous injury. The most consistent clinical tests were focal tenderness on palpation and pain with resisted side flexion towards the painful side. The magnetic resonance image in 70% of cases was consistent with an injury to the internal oblique, the external oblique, or the transversalis muscles at or near their attachments to one or more of the lowest four ribs. The injury occurs on the non-bowling arm side. Recovery can be prolonged. The injury was a recurrence in six of the 10 cases. The biomechanics of the injury are not yet understood.

Adrenal Cortex Hormones↗
PubMed2002

Comparative endocrinology of the insulin-like growth factor-binding protein.

Emerging early in chordate evolution, the IGF-regulatory axis diverged from an insulin-like predecessor into a vertebrate regulatory system specializing in cell growth activation and allied anabolic functions. Essential to the divergence of the IGF and insulin systems was an early presence of soluble IGF-binding proteins (IGFBPs), which bind IGF peptides at much higher affinity than that of the insulin receptor but at comparable affinities to that of the IGF receptor. IGFBPs have no homology with IGF receptors. Instead, IGFBPs are a derived group of proteins within a superfamily of cysteine-rich growth factors, whose members are found throughout the animal taxa. While blocking IGF actions through the insulin receptor is a fundamental role, IGFBPs evolved within the vertebrate line into centralized, 'integrators' of the endocrine growth-regulatory apparatus. IGFBPs have substantial influences on the distribution and bioavailability of IGF peptides in the cellular and physiological environments, but they have a variety of other properties. The six principal mammalian IGFBPs exhibit an array of specialized properties that appear to be derived from a complex evolutionary history (including cell membrane association, interaction with proteins that post-translationally modify them, direct IGF-independent effects on cells, and others) and they are regulated by a diversity of 'outside' factors (e.g. other hormones, metabolic status, stress). Thus, IGFBPs are multifunctional integrators having diverse physiological 'agendas'. Much less is known about IGFBPs and their properties in the other vertebrate taxa. Increasingly, however, it is being recognized that they play equally important endocrine roles, in both conserved and non-conserved ways, when compared with those currently defined in mammals. This review highlights selected 'comparative aspects' in current IGFBP research, in an attempt to view this essential group of endocrine regulators from a wider, biological perspective.

Animals↗
PubMed1991

Randomized study to evaluate the relation between oral isosorbide dinitrate dosing interval and the development of early tolerance to its effect on left ventricular filling pressure in patients with chronic heart failure.

BACKGROUND: Early development of nitrate tolerance has been shown in patients with chronic congestive heart failure (CHF) receiving continuous nitroglycerin therapy. The influence of dosing interval of oral isosorbide dinitrate (ISDN), the nitrate preparation most widely used for the treatment of CHF, has not been investigated. METHODS AND RESULTS: We performed a prospective, randomized study to evaluate the effect of various regimens of oral ISDN on the development of early tolerance to its effect on left ventricular filling pressure in patients with moderate to severe CHF. Forty-four responders (20% or greater reduction in mean pulmonary artery wedge pressure lasting 1 hour or longer) were divided into four groups of 11 patients each, and randomized to receive their effective ISDN dose (40-120 mg) Q 4 hours, Q 6 hours, Q 8 hours, or t.i.d. (drug given at 0, 6, 12, and 24 hours allowing 12 hours of ISDN washout interval between the third and fourth doses). All groups demonstrated a significant and comparable reduction in LV filling pressure following administration of the first ISDN dose. Early attenuation of hemodynamic response was demonstrated with frequent dosing (Q 4 hours and Q 6 hours) ISDN. Tolerance was with a Q 8-hour regimen as demonstrated by preserved hemodynamic response to each dose. The effect of each dose, however, was short-term, with return of pulmonary artery wedge pressure to baseline level at 2 to 4 hours, resulting in an intermittent effect totaling no longer than 12 hours of the 30-hour study period. The use of a t.i.d. regimen resulted in marked attenuation of response after the third dose with complete restoration of nitrate effect following a 12-hour washout period between the third and fourth doses. ISDN plasma concentration was measured in five patients in each of the Q 4- and Q 8-hour groups. In the Q 4-hour group, plasma levels were significantly higher after administration of the last dose than after the first dose (area under the curve, 242 +/- 216 versus 123 +/- 130 ng/ml, p less than 0.05), and trough levels before administration of the second and the fifth dose (15 +/- 17 and 27 +/- 27 ng/ml, respectively) were both markedly higher than the baseline value of 2 +/- 4 ng/ml. CONCLUSIONS: Our data demonstrate the development of tolerance and early attenuation of effect on left ventricular filling pressure with frequent oral dosing (Q 4 and Q 6 hours) with ISDN in patients with chronic CHF, which may be related to persistently elevated trough blood levels of ISDN. The development of tolerance can be reversed after a washout period of 12 hours and can be prevented with a Q 8-hour administration. These regimens, however, are limited by an inconsistent effect. Although long-term implications of these findings need further evaluation, the present study demonstrates the difficulty of maintaining a persistent ISDN-mediated reduction in left ventricular filling pressure in patients with chronic, moderate to severe CHF. These results suggest the need to use intermittent ISDN therapy allowing a daily nitrate washout interval and the rationale for combined vasodilator therapy in patients with CHF.

Drug Administration Schedule↗
PubMed1989

Central and renal hemodynamic effects of a new agonist at peripheral dopamine- and beta-2 adrenoreceptors (dopexamine) in patients with heart failure.

The effect of dopexamine, a new dopamine analogue, on central and renal hemodynamics was evaluated in nine patients with chronic, congestive heart failure caused by severe left ventricular (LV) systolic dysfunction. The administration of the maximally tolerated dose (7.2 +/- 4 micrograms/kg/min) resulted in a significant increase in cardiac index from 1.9 +/- 0.4 L/min/m2 to 2.6 +/- 0.9 L/min/m2 (p less than 0.05). This increase in cardiac index was largely a result of increase in heart rate (from 88 +/- 20 beats/min to 104 +/- 24 beats/min, p less than 0.05), because stroke volume index demonstrated only a small change (from 23 +/- 10 ml/m2 to 27 +/- 11 ml/m2, p not significant) in spite of a significant fall in systemic vascular resistance from 1992 +/- 717 dynes.sec.cm-5 to 1361 +/- 524 dynes.sec.cm-5 (p less than 0.05) and diastolic blood pressure (from 89 +/- 15 mm Hg to 80 +/- 17 mm Hg, p less than 0.05). No change was seen during dopexamine infusion in systolic blood pressure, right and left ventricular filling pressures, and LV stroke work index. Both renal blood flow and glomerular filtration rate were impaired at baseline in most patients. Dopexamine administration resulted in a significant increase (2x coefficient of variation) in renal blood flow in two patients only. Mean values of both renal blood flow and glomerular filtration rate did not show significant change (485 +/- 183 ml/min vs 563 +/- 221 ml/min and 89 +/- 39 ml/min vs 93 +/- 34 ml/min, respectively, p not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

Serum copper oxidase activity (coeruloplasmin) in chronic pancreatitis: inverse correlation with pancreatic exocrine function.

Serum copper oxidase activity (coeruloplasmin, ferroxidase, I, EC 1.16.3.1) and serum C-reactive protein (CRP) were estimated in 43 patients with chronic pancreatitis; total serum copper was also measured in 23 patients. Pancreatic exocrine function was assessed in all patients and compared with the respective copper oxidase activities. The following results emerged: (1) there was a strong positive linear relationship between total serum copper and serum copper oxidase activity; (2) in 34 patients CRP was undetectable Twenty-six patients were untreated and eight had received pancreatic extracts for variable periods of time. In the untreated patients there was an inverse correlation between serum copper oxidase activity and pancreatic exocrine function; (3) in the eight treated patients serum cooper oxidase activity was less than in untreated patients; (4) in three patients who were assessed before and six months after administration of pancreatic extracts serum copper oxidase activity showed a significant reduction with treatment; (5) nine patients with elevated CRP values also had raised serum copper oxidase activities but there was no correlation between these two serum constituents. The rise in serum copper which occurs in uncomplicated and untreated chronic pancreatitis does not represent an acute phase reaction. Our results provide further evidence that the pancreas assists in regulating copper metabolism in man.

Adult↗
PubMedDate not supplied

Implementation of the care coordinator role: a grounded theory approach.

The purpose of this study was to explore the process of implementing a new care coordinator role on a medical-surgical unit. Qualitative data were collected from employees and patients during a 3-month period; data analysis occurred concurrently. Using the constant comparative method, a grounded theory was developed to explain the initial process of implementation of the clinical nurse III (CNIII) role. The basic social psychological problem associated with implementation was role ambiguity. The basic social psychological process used to resolve this problem was "making the role of the CNIII". Making the role involves the following four strategies, which may occur simultaneously: communicating the vision, gaining new knowledge, accessing resources, and defining boundaries. Communicating the vision refers to efforts to articulate the role before and during the implementation process. Gaining new knowledge includes participating in educational workshops and acquiring new skills. Accessing resources refers to development of new relationships and acquisition of office space and equipment. Defining boundaries includes determining the scope of responsibilities and differentiating the role from other roles. This theory may be useful to researchers, educators, and administrators interested in role implementation.

Communication↗
PubMedDate not supplied

Chronic illness management in the year 2005.

Nurses must study the future of chronic illness management so they can anticipate change and influence the direction it takes. The driving forces of change include social, technological, economic, political, and environmental factors. Pressure to provide value will require providers, insurers, and purchasers to cooperate and coordinate health care services. The preferable future of chronic illness management involves nurses functioning in the role of care coordinators in disease management. To achieve the preferable future the nursing community must communicate the ability of nurses to coordinate care, be involved in developing clinical practice guidelines, produce more highly educated nurse executives capable of assuming positions of power within the community, develop new models of care and new programs to facilitate change, form single service networks that can sub-contract with health plans, and prepare future advanced practice nurses in both the art of nursing and the business of caring.

Case Management↗