PubMed Health⌕ Search

Biomedical subjects

Patricia T Alpert

Publications and source records attributed to Patricia T Alpert.

8 recordsLinked to original sources

Promising new causal explanations for obesity and obesity-related diseases.

Current explanations for obesity center around a predisposition in genotype and phenotype, possibly triggered by an inflammatory process or event, and exacerbated by environmental and psychological factors. It is likely that a variety of physiologic factors may act in combination to produce clinical obesity. Leptin resistance may be an important neurochemical cause of obesity; elevated leptin levels have been correlated with weight gain over extended time periods. Genetic studies support the postulate that a gene originating with our cave-dwelling ancestors, critical to survival when food was scare, has evolved into a trigger for obesity and related diseases. A variety of biochemical markers are prevalent in obesity and obesity-linked disease states. C-reactive protein, interleukin-6, and others are elevated in obesity, supporting the hypothesis that inflammation plays a role in the condition. Tumor necrosis factor-alpha is overexpressed in obesity and diabetes, suggesting that it may be part of the link between the 2 conditions.

Appetite↗

Assessment and differential diagnosis of abdominal pain.

Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting. It is incumbent upon the primary care provider to have a thorough understanding of the many potential causes of abdominal pain, as well as a methodical, comprehensive, yet concise approach to its assessment.

Abdominal Pain↗

Pediatric systemic lupus erythematosus: management issues in primary practice.

PURPOSE: To provide nurse practitioners (NPs) with an update on pediatric systemic lupus erythematosus (SLE) with an emphasis on management considerations for primary care practitioners. DATA SOURCES: An extensive literature review was conducted using both Medline and CINAHL databases. Research articles reflecting the most compelling findings were included in this review. CONCLUSIONS: NPs who care for children with SLE may be able to prevent or delay the morbidities associated with this disease and its treatments, if they keep abreast of the new information evolving in this realm of rheumatologic diseases. IMPLICATIONS FOR PRACTICE: As more is learned about pediatric SLE, better treatments have evolved such that the survival rates have increased. The primary care of pediatric SLE patients that is focused on preventing or delaying SLE morbidities may help to restore, maintain, or improve the quality of life for these patients.

Calcium, Dietary↗

Practices of vitamin D recommendation in Las Vegas, Nevada.

Reports of vitamin D deficiency rickets, although rare in the United States, have increased over the past few years, including in children living in climates with abundant sunshine. The purpose of this study was to describe vitamin D recommendation practices among pediatric health care providers in Las Vegas, Nevada. Of the 155 providers surveyed, 52.3% did not recommend vitamin D for exclusively breastfed babies. Providers who were more likely to recommend supplementation were doctors of medicine, were female, specialized in pediatrics, were of Hispanic ethnicity, had previously practiced and trained in states less sunny than Nevada, had graduated from training 21 or more years previously, had taken histories of infants' sun exposure, and had clinical experience with cases of rickets. Providers demonstrated a knowledge deficitforquestions that dealt with preventive measures.

Clinical Competence↗

New and emerging theories of cardiovascular disease: infection and elevated iron.

Heart disease is the leading cause of death in both men and women in industrialized countries. Despite the tremendous gains made in decreasing the number of deaths due to cardiovascular disease, it still is health care's greatest challenge. Traditional risk factors account for only 50% of the incidence of cardiac disease. In fact, many individuals who develop heart disease have normal cholesterol and blood pressure levels. This suggests that other less well-studied risk factors may also play a role. The purpose of this report is to examine the role that recently suggested risk factors may play in the development of heart disease: coronary artery infection, specifically from Chlamydia pneumoniae, and elevated iron levels. Both initiate an inflammatory response, which might explain the elevated C-reactive protein levels frequently found in those who suffer from cardiac disease.

Anti-Bacterial Agents↗

Nurse practitioner: reflecting on the future.

The role of the nurse practitioner was first conceptualized in the late 1960s. Today, there are approximately 70,000 nurse practitioners in practice, they receive third-party insurance reimbursements, and they are in many specialty practices, as well as working in primary care practices promoting health and disease prevention. In the future, economics will shape our health care industry, placing a greater demand for nurse practitioners in this trillion-dollar marketplace. This article explores the evolving role of the nurse practitioner in education, practice, and research to meet the challenges of the health care needs into the 21st century.

Forecasting↗

The obese child: motivation as a tool for exercise.

The purpose of this article is to describe the importance of motivation in enhancing the participation of obese children in exercise activities. Recognizing the different influence that are important determinants of exercise behavior in children may help pediatric nurse practitioners play a significant role in advising parents and others of the need to offer positive, constructive, and immediate feedback without being evaluative, critical, or demanding. By addressing the problems of obesity and low fitness levels early in the child's life, a significant step can be taken toward reversing the negative trends of this unhealthy and potentially dangerous condition.

Adolescent↗