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Biomedical subjects

P Holden

Publications and source records attributed to P Holden.

At least 19 recordsLinked to original sources
PubMed2000

Intensive outpatient treatment of persons with mental retardation and psychiatric disorder: a preliminary study.

The impact of intensive outpatient mental health interventions (in a dual diagnosis clinic) on the hospitalization rate and length of stay was examined for 28 adults with mental retardation and severe psychiatric disorder. They were selected on the basis of frequent use of mental, medical, and social services. Charts were reviewed for the 12-month periods before and after referral to the program to compare service utilization. A single group pretest-posttest design with no control group was employed. Correlated t tests comparing the pre- and post-program number of hospitalizations and lengths of stay indicated significant decreases in both hospitalizations and lengths of stay after program entry, which may result in significant reductions in hospital costs.

Adolescent↗
PubMed1999

Identification of novel pro-alpha2(IX) collagen gene mutations in two families with distinctive oligo-epiphyseal forms of multiple epiphyseal dysplasia.

Multiple epiphyseal dysplasia (MED) is a genetically heterogeneous disorder with marked clinical and radiographic variability. Traditionally, the mild "Ribbing" and severe "Fairbank" types have been used to define a broad phenotypic spectrum. Mutations in the gene encoding cartilage oligomeric-matrix protein have been shown to result in several types of MED, whereas mutations in the gene encoding the alpha2 chain of type IX collagen (COL9A2) have so far been found only in two families with the Fairbank type of MED. Type IX collagen is a heterotrimer of pro-alpha chains derived from three distinct genes-COL9A1, COL9A2, and COL9A3. In this article, we describe two families with distinctive oligo-epiphyseal forms of MED, which are heterozygous for different mutations in the COL9A2 exon 3/intron 3 splice-donor site. Both of these mutations result in the skipping of exon 3 from COL9A2 mRNA, but the position of the mutation in the splice-donor site determines the stability of the mRNA produced from the mutant COL9A2 allele.

Adolescent↗
PubMed1998

Identification of a novel peroxisome proliferator responsive cDNA isolated from rat hepatocytes as the zinc-finger protein ZFP-37.

The implementation of a rat hepatocyte model system and differential display-polymerase chain reaction resulted in the isolation of ZFP-37 as a peroxisome proliferator-responsive gene. In addition to being responsive to peroxisome proliferators, rat ZFP-37 (rZFP-37) mRNA accumulates rapidly after treating cells with several other hepatic tumor promoters, serum, and cycloheximide, indicating that this gene belongs to the immediate-early growth responsive gene family. Although rZFP-37 and mouse ZFP-37 (mZFP-37) are both members of the Krüppel-associated box and C2H2 zinc finger superfamily of proteins, there are several features that distinguish the two proteins. The primary protein sequences of rat and mouse ZFP-37 are highly conserved, especially within the region encoding the 12 C2H2 zinc finger motifs; however, a region believed to be involved in DNA binding in mZFP-37 is divergent in rZFP-37. Mouse ZFP-37 mRNA is expressed almost exclusively in testes and brain, whereas rZFP-37 mRNA is expressed in testes, brain, kidney, spleen, thymus, lung, and at low levels in liver. A major difference between regulation of ZFP-37 in the two species exists as rZFP-37 is induced, while mZFP-37 is repressed, in liver by the administration of the potent peroxisome proliferator Wy 14,643. Despite the fact that mZFP-37 is believed to be important in cell growth and differentiation in testes and brain, the pronounced differences in regulation of this gene in two closely related species preclude an extrapolation to rZFP-37's biological role. Nonetheless, the effects of tumor promoters and mitogens on its expression and the inclusion of rZFP-37 into the immediate-early growth gene families raise the possibility that this gene plays a role in hepatocyte proliferation and/or differentiation.

Amino Acid Sequence↗
PubMed1995

Psychosocial factors affecting a child's capacity to cope with surgery and recovery.

Medical stressors associated with illness and surgery make extraordinary psychological demands on children. A child's coping abilities, both emotional and cognitive, are at the heart of adjustment to these demands. Social support is also an important element in the child's ability to recover psychologically. Finally, a child's previous medical experiences, psychiatric problems, and learning disabilities may affect the child's behavior.

Adaptation, Psychological↗
PubMed1989

Patients who leave the hospital against medical advice: the role of the psychiatric consultant.

Previous studies have identified characteristics of patients who threaten to leave non-psychiatric units against medical advice, but few have described the role of the psychiatric consultant in the patient's decision. This study compared the medical records of 31 patients who threatened to leave the hospital against medical advice (AMA) and who were seen in consultation with the records of AMA-discharged patients who were not seen by a psychiatric consultant. Most patients who received consultations remained hospitalized or were discharged in regular fashion. Those seen soon after admission were most likely to stay. Patients were more likely to remain hospitalized if the consultant's recommendations had a practical, rather than a psychological, orientation.

Adult↗
PubMed1989

Language barriers in pediatric care.

Language differences between pediatrician and parents can create a barrier in the doctor-patient relationship. Use of a translator to overcome that barrier introduces other potential problems such as a diminished sense of privacy, inadequate data collection, and misinterpretation of medical or family history due to translator distortions. Physicians should carefully choose the translator, avoiding persons who are linguistically incompetent, culturally insensitive, and medically unsophisticated. Physicians also should avoid assuming that parents who "speak English" are fluent. A determination of their language preference and their degree of English proficiency may lead the pediatrician to use a translator even with partially fluent families.

Child, Preschool↗
PubMed1988

Comparison of two methods for determining in vitro postantibiotic effects of three antibiotics on Escherichia coli.

The postantibiotic effect (PAE) for 10 isolates of Escherichia coli was measured by two methods after 1 h of exposure to ampicillin, ciprofloxacin, or tobramycin. The reference method involved serial colony counting to determine growth after antibiotic exposure in relation to control growth. A spectrophotometric procedure was developed with the Abbott MS-2 research system. This method measured the time to detection of growth after exposure and compared this with the time for growth detection in control chambers having the same initial colony count. A reference curve of time to growth versus log initial CFU per milliliter was used to standardize control growth. PAE was determined after exposure to antibiotic at two and six times the MIC and with inocula ranging from 10(3) to 10(9) CFU/ml. There was a statistically significant correlation between PAE measured by the spectrophotometric and the reference methods, and the residuals about the regression line were normally distributed. The mean PAE determined by both methods was statistically different for tobramycin-exposed, but not for ampicillin- or ciprofloxacin-exposed, organisms. There was a concentration-dependent PAE for ciprofloxacin and tobramycin. The PAEs for ciprofloxacin (151 min) and tobramycin (108 min) at concentrations six times the MIC were prolonged compared with those measured at two times the MIC (69 and 66 min, respectively). PAE was inversely related to the exposed inoculum for ciprofloxacin and tobramycin. The PAE for E. coli exposed to ampicillin was minimal and was not affected by either concentration or inoculum. The MS-2 method for determining PAE yields similar results, but is less laborious than the reference method.

Ampicillin↗
PubMed1979

Peer review of consultations in primary care: the use of audiovisual recordings.

A rating scale was designed to measure performance in interviewing techniques in primary care. Peer review of audiovisual recordings of their consultations showed that a group of experienced general practitioners achieved significantly higher scores on the rating scale compared with a group of similarly experienced general practitioners who did not observe their recordings. The higher scores were obtained at the expense of longer consultations. The traditional five-minute appointment system in general practice needs to be reconsidered if an improved interviewing technique results in a more favourable outcome.

Family Practice↗
PubMed1975

Pharmacodynamic distinctions between ouabain, digoxin and digitoxin.

Current pharmacologic texts recognize no significant pharmacodynamic differences between the various cardiac glycosides. To reconsider this concept, a special recording device was constructed so that electrocardiograms and phonocardiograms could be obtained in small mammals without anesthesia or premedication, and a spectrum of cardiac glycosides was studied. Utilizing guinea-pigs, cardiac rate reduction of 20% was sought and achieved with 0.07 mg/kg ouabain, 0.34 mg/kg digoxin and 1.12 mg/kg digitoxin. With comparable rate reduction, digitoxin produced significantly greater shortening of electro-mechanical systole than did ouabain or digoxin (P less than 0.05). Other authors have shown that cardiac glycosides produce slowing of cardiac rate prior to onset of positive inotropic effect. Therefore it is probable that for a given amount of vagal effect (sinoatrial slowing) digitoxin possesses greater positive inotropic effect (abbreviation of electromechanical systole) in guinea-pigs than do ouabain or digoxin. A review of the literature suggests that the same holds true for humans.

Animals↗