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Biomedical subjects

R A Anwar

Publications and source records attributed to R A Anwar.

12 recordsLinked to original sources
PubMed1979

Orientation program for emergency medicine residents.

An orientation curriculum was developed for incoming residents in emergency medicine at the University of Cincinnati (UC) in July, 1976. The major objectives of the orientation were 1) to identify and delineate the subject matter of emergency medicine, and 2) to review the basic elements of emergency medicine. Results of a pre- and posttest using the residency program at the Medical College of Pennsylvania (MCP) as a control group are presented. The pretest scores of the study groups showed no significant difference at a .05 level. The posttest, however, resulted in a significant improvement of the UC scores (p less than 0.05), while little change occurred in the MCP scores. An inter-group evaluation shows the UC group to have out-performed the MCP group significantly (p less than 0.05). Results of a one-year posttest showed the UC residents scoring an overall average of six points higher on the test. However, the general difference between the two groups of residents was not significant at the 0.05 level.

Curriculum↗
PubMed1979

Purification of UDP-N-acetylenolpyruvoylglucosamine reductase from Escherichia coli by affinity chromatography, its subunit structure and the absence of flavin as the prosthetic group.

The enzyme UDP-N-acetylenolpyruvoylglucosamine reductase (EC 1.1.1.158) was purified to homogeneity from Escherichia coli by affinity chromatography on a NADP-agarose column. The evidence suggests that the enzyme (molecular weight 35,000) is composed of two nonidentical subunits of molecular weight 21,500 and 13,500, respectively. The absorption spectrum of the purified enzyme shows no absorption band around 450 nm and thus does not support the previous suggestions that the enzyme is a flavoprotein. However, the A280: A260 ratio gives a value of 0.86 which suggests the presence of tightly bound nucleotide. A quantitative transfer of tritium from 1,4-[4-3H]NADPH to UDP-N-acetylenolpyruvoylglucosamine to form UDP-N-E13H]acetylmuramic acid was also observed, which clearly shows that the enzyme is not a flavoprotein.

Alcohol Oxidoreductases↗
PubMed1978

Skills and procedures in emergency medicine: room for controversy.

To examine patterns of consensus and divergence of opinion about whether, and under what conditions, residency-trained emergency physicians use certain skills and perform procedures, directors of 35 emergency medicine, 28 surgery and 30 internal medicine residency programs were surveyed. The directors reacted to a list of 30 skills modified from the condition/skills list compiled by the Certification Task Force of the American College of Emergency Physicians representing a consensus on the core-knowledge for emergency medicine, as determined by both practicing and university-based emergency physicians. The responses indicate a wide variation of opinion about which skills are within the realm of residency-trained emergency physicians, and under what circumstances a procedure should be performed. The skills of greatest concern among emergency medicine directors include axillary and intravenous lidocaine blocks, bronchoscopy, burr holes, closed reduction of dislocated hips, Swan-Ganz catheterization, and cardiopulmonary by-pass. In contrast, slightly more than one third of the procedures on the modified list were clearly agreed upon by over 80% of the directors as procedures performed by trained emergency physicians.

Attitude of Health Personnel↗
PubMed1978

Extension of emergency medical care: continuing emergency care clinic.

An alternative follow-up system, a Continuing Emergency Care clinic (CEC) was developed at The Medical College of Pennsylvania in an attempt to increase emergency department patient compliance for follow-up. One year after the CEC was in operation, in an attempt to determine variables influencing the effectiveness of the clinic, a total of 375 emergency department patients given follow-up appointments to the CEC were studied. Results showed that a change in the structure of the clinic appointment and a shift in the line of responsibility for follow-up care directly to the emergency physician are two major variables positively affecting patient compliance.

Adolescent↗
PubMed1977

The continuing emergency care clinic: improving patient compliance with follow-up care.

Traditionally, emergency patients have been noted for high rates of noncompliance with appointments in outpatient clinics for follow-up care. S study of cases referred for follow-up care at the outpatient clinic of The Medical College of Pennsylvania showed that less than 20% of the patients kept their appointments. To cope with this problem, a Continuing Emergency Care (CEC) clinic was established on the assumption that a change in structural environment could change noncompliance behavior patterns. The clinic is a small unit near the emergency department, separate from the larger hospital outpatient clinic area. Patient compliance data were collected on each case referred to the CEC clinic during a three-month period. Findings showed a threefold increase in appointment compliance over the previous study in which referrals were made to the hospital clinics.

Appointments and Schedules↗
PubMed1977

The research component in the development of emergency medicine as a specialty.

The development of emergency medicine as a separate medical specialty involves several major processes, including professional identification, delineation of the dimensions of the specialty, development of a body of knowledge, and creative investigative activities. Residents in emergency medicine offer a potential source of expertise that could be utilized in the development of such research activities. However, for a variety of reasons routine research has not been part of current resident education. One example of a methodology for programmatic research development in emergency medicine is identified in this paper through the establishment of a nonclinical health services research position. The effect of having staff to assist in the development and analysis of research projects has contributed to building a body of knowledge specific to emergency medicine and creating a sense of professional identity among graduate trainees.

Emergency Medicine↗
PubMed1975

Mechanism of pyruvate-uridine diphospho-N-acetylglucosamine transferase. Evidence for an enzyme-enolpyruvate intermediate.

The enzyme, phosphoenolpyruvate:uridine-5-diphospho-N-acetyl-2-amino-2-deoxyglucose-3-enolpyruvyltransferase, which catalyzes the transfer of enolpyruvate from phosphoenolpyruvate to uridine diphospho-N-acetylglucosamine with the liberation of Pi, was found to form a covalent intermediate with the enolpyruvate moiety. Radioactivity from [1-14-C]phosphoenolpyruvate in the forward reaction and from UDP-GlNAc-[1-14-C]enolpyruvate in the reverse reaction was incorporated into the enzyme and remained bound to the protein after precipitation with ammonium sulfate or treatment with sodium dodecyl sulfate and heat. This incorporation from UDP-GlcNAc-[1-14-C]enolpyruvate took place in the absence of Pi. When [32-P,1-14C]phosphoenolpyruvate was used, only 14-C appeared to be incorporated. In the forward reaction, the incorporation was contingent on the removal of UDP-GlcNAc from the transferase. Consistent with the formation of an enzyme-enolpyruvate intermediate, exchange of UDP-[6-3-H]GlcNAc with UDP-GlcNAc-enolpyruvate was observed in the absence of Pi. Nonstoichiometric incorporation of 3H from 3H2O into the product, UDP-GlcNAc-enolpyruvate, was observed and was shown to be due to a product isotope effect. Based on these observations, a mechanism of action for this enzyme is proposed which involves synchronous addition-elimination followed by a second addition-elimination step.

Butyrates↗
PubMed1975

Pyruvate-uridine diphospho-N-acetylglucosamine transferase. Purification to homogeneity and feedback inhibition.

Phosphoenolpyruvate:uridine-5'-diphospho-N-acetyl-2-amino-2-deoxyglucose-3-enolpyruvyltranferase catalyzes the transfer of enolpyruvate from phosphoenolpyruvate to uridine diphospho-N-acetylglucosamine with the liberation of inorganic orthophosphate. It was purified to homogeneity from Enterobacter cloacae with the use of UDP-N-acetylmuramyl-L-Ala-D-Glu-meso-Dap, a feedback inihibitor, as a ligand covalenty bound to Sepharose 4B. The evidence suggests that the enzyme is a single polypeptide with a molecular weight of 41,000. The enzyme catalyzes the first committed step in the biosynthesis of bacterial cell wall peptidoglycan. The cytoplasmic end product of this pathway is UDP-N-acetylmuramyl-L-Ala-D-Glu-meso-Dap-D-Ala-D-Ala (see article). UDP-MurNAc-pentapeptide and its precursor, UDP-MurNAc-tripeptide, were found to be effective inhibitiors of the enzyme. The kinetic data suggest a binding site for these inhibitors distinct from the active site. This is consistent with the proposed role for UDP-MurNAc-tripeptide and pentapeptide as negative modulators of the enzyme.

Amino Acid Sequence↗
PubMed1975

Comparative studies of the cross-linked regions of elastin from bovine ligamentum nuchae and bovine, porcine and human aorta.

1. The preparative Edman degradation of desmosine-containing peptides permitted the isolation of peptides C-terminal to the desmosine cross-links in bovine, porcine and human aortic elastin as well as bovine ligamentum nuchae elastin. This identifies the lysines in the tropoelastin which give rise to the desmosine cross-links. 2. The sequences from bovine aortic elastin were identical with those obtained from bovine ligamentum nuchae elastin but differed from those obtained from the other species. The most striking difference involves the occurrence of phenylalanine in bovine elastin and tyrosine in porcine and human elastin C-terminal to the desmosine cross-links. 3. The sequences of the C-terminal peptides were found to fall into two distinct classes, one starting with hydrophobic residues, the other starting with alanine. It is proposed that thehydrophobic residue prevents the enzymic oxidative deamination of the adjacent lysine e-amino group and this then contributes the nitrogen to the pyridinium ring of the cross-links.

Amino Acid Sequence↗