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Biomedical subjects

R Duffy

Publications and source records attributed to R Duffy.

14 recordsLinked to original sources

Eating soya improves human memory.

RATIONALE: Soya foods are rich in isoflavone phytoestrogens with weak agonist activity at oestrogen receptors. Oestrogen treatment has been found to improve memory in men awaiting gender reassignment and in post-menopausal women. OBJECTIVE: To examine the effects of supervised high versus low soya diets on attention, memory and frontal lobe function in young healthy adults of both sexes. METHODS: Student volunteers were randomly allocated to receive, under supervision, a high soya (100 mg total isoflavones/day) or a low soya (0.5 mg total isoflavones/day) diet for 10 weeks. They received a battery of cognitive tests at baseline and then after 10 weeks of diet. RESULTS: Those receiving the high soya diet showed significant improvements in short-term (immediate recall of prose and 4-s delayed matching to sample of patterns) and long-term memory (picture recall after 20 min) and in mental flexibility (rule shifting and reversal). These improvements were found in males and females. In a letter fluency test and in a test of planning (Stockings of Cambridge), the high soya diet improved performance only in females. There was no effect of diet on tests of attention or in a category generation task. Those on the high soya diet rated themselves as more restrained and, after the tests of memory and attention, they became less tense than did those on the control diet. CONCLUSIONS: Significant cognitive improvements can arise from a relatively brief dietary intervention, and the improvements from a high soya diet are not restricted to women or to verbal tasks.

Adult↗

Muscarinic agonists and antagonists in the treatment of Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disease characterized by cognitive impairment and personality changes. The development of drugs for the treatment of the cognitive deficits of AD has focused on agents which counteract loss in cholinergic activity. Although symptoms of AD have been successfully treated with acetylcholinesterase inhibitors (tacrine, donepezil. rivastigmine, galanthamine), limited success has been achieved with direct M1 agonists, probably due to their lack of selectivity versus other muscarinic receptor subtypes. Muscarinic M2 antagonists have been reported to increase synaptic levels of acetylcholine after oral administration to rats (e.g. BIBN-99, SCH-57790), but their selectivity versus other muscarinic receptor subtypes is modest. Exploration of a series of piperidinylpiperidines has yielded the potent and selective M2 antagonist SCH-217443. This antagonist has excellent bioavailability in rats and dogs and shows activity in a rat model of cognition.

Alzheimer Disease↗

New advances in the understanding of the role of steroids and steroid receptors in disease.

Steroids and related compounds are important in disease development and prevention, via steroid receptor-mediated and receptor-independent mechanisms. Interaction of endogenous oestrogens with the oestrogen receptor has unfortunate mitogenic effects in breast cancer. However, dietary consumption of non-steroidal weak oestrogens, such as the soy isoflavone phytoestrogens genistein and diadzein, is associated with a decreased breast cancer risk. This may arise in part from the suboptimal configuration induced in the transactivation helix of oestrogen receptor-beta.

Animals↗

Multistate outbreak of hemolysis in hemodialysis patients traced to faulty blood tubing sets.

BACKGROUND: Hemolysis associated with hemodialysis is rare. The most frequent causes of hemodialysis-associated hemolysis are chemical contamination, heat, or mechanical injury of erythrocytes from occluded or kinked hemodialysis blood lines. When patients in three states developed hemolysis while undergoing hemodialysis between May 13 and 23, 1998, an investigation was initiated. METHODS: A case-patient was defined as any patient at healthcare facilities A (Nebraska), B (Maryland), or C (Massachusetts) during May 13 through 23, 1998 (epidemic period), who had hemolysis diagnosed > or =48 hours after undergoing hemodialysis. To identify case-patients and to determine background rates, the medical records of patients from facilities A, B, and C who were undergoing hemodialysis during the epidemic and pre-epidemic (that is, May 5 through 19, 1998) periods were reviewed. Experiments simulating hemodialysis with the same lot numbers of hemodialysis blood tubing cartridge sets used on case- and control-patients were conducted. RESULTS: The rates of hemolysis among patients at facilities A, B, and C were significantly higher during the epidemic than the pre-epidemic period (13 out of 118 vs. 0 out of 118, P < 0.001; 12 out of 298 vs. 0 out of 298, P = 0.001; and 5 out of 62 vs. 0/65, P = 0.03, respectively). All case-patients had hemolysis. Twenty (66%) had hypertension. Eighteen (60%) had abdominal pain, and 10 (36%) were admitted to an intensive care unit. There were two deaths. The only commonality among the three outbreaks was the use of the same lot of disposable hemodialysis blood tubing from one manufacturer. Examination of the implicated hemodialysis blood tubing cartridge sets revealed narrowing of an aperture through which blood was pumped before entering the dialyzers. In vitro experiments with the hemodialysis blood tubing revealed that hemolysis was caused by increased pressure on erythrocytes as they passed through the partially occluded hemodialysis blood tubing. CONCLUSIONS: Our investigation traced the multiple hemolysis outbreaks to partially occluded hemodialysis blood tubing produced by a single manufacturer. On May 25, 1998, the manufacturer issued a voluntary nationwide recall of the implicated lots of hemodialysis blood tubing cartridge sets.

Adult↗

A military-civilian resource-sharing agreement.

A first-of-its-kind resource-sharing agreement between the US Department of Defense and a civilian hospital was undertaken with resounding success. This article discusses how Sacred Heart Medical Center, Spokane, Wash, and the 92nd Medical Group at Fairchild Air Force Base, Spokane, Wash, developed the project and accomplished the integration, which continues to benefit each organization.

Hospital Planning↗

Obstacles to addressing professional misconduct.

The Ethical Principles exhort psychologists "to encourage ethical behavior by students, supervisees, employees, and colleagues, as appropriate" (American Psychological Association, 1992, p. 1599). In spite of a clear directive to attempt resolution of unethical conduct by colleagues, research indicates that satisfactory resolution or actual reporting of misconduct is infrequent. This paper will address some of the forces that discourage psychologists from dealing responsibly and appropriately with professional misconduct by colleagues. The goals of this paper are to promote understanding of factors that interfere with the effective resolution of ethical misconduct, to identify possible signs of reluctance to address misconduct, and to propose strategies to combat those forces that keep us in silent collusion with colleagues who engage in unethical practices. A flowchart of steps for addressing possible misconduct by a colleague is provided, and educational, organizational, and professional considerations are discussed.

Awareness↗

Residency training in dental public health: assessment of status, needs, and issues.

The opportunities for public health training have declined over the years while the need for public health skills is likely to increase. This paper reports the results of a project, sponsored by the Health Resources and Services Administration, which answers the question of "how best to invest in the dental public health education system so as to fulfill the profession's responsibilities to protect and improve the oral health of individuals and society." An information base on dental public health education, practice, and specialization was developed from an extensive review of the literature and a survey of dentists concerning employment and practice requirements for public health dentists. An advisory group considered this information, met to discuss the issues involved in dental public health training, and provided advice to the project staff. Based on the information gathered as part of the project, recommendations were made to: (1) develop a grant program to support advanced education in dental public health; (2) increase the competencies of dentists who are working in public health positions and not eligible for board certification via off-site residencies; (3) develop model programs in areas of great need, such as general public health, management, policy, prevention, environmental health and research, that in conjunction with a basic public health core, could satisfy the eligibility requirements of the American Board of Dental Public Health; (4) develop student loan forgiveness programs for dentists and dental hygienists working in public health; and (5) develop additional credential recognition programs for dental public health workers.

Certification↗

Dental public health for the 21st century: implications for specialty education and practice.

A panel of public health practitioners sponsored by the Health Resources and Services Administration met December 6-8, 1994, to examine current roles and responsibilities for dental public health workers and to recommend changes in education and training to meet challenges posed by an evolving health care system. Overall, at least the same number, if not more, dental public health personnel will be needed in the future. While some new roles were identified, the panel felt that only small numbers of personnel will be needed to fill these new roles. Not all of these roles necessarily require a dental degree. The panel felt that a need exists for more academicians for dental schools, schools of public health, dental public health residencies, and dental hygiene programs; oral epidemiologists and health services researchers; health educators; and specialists in utilization review/outcomes assessment, dental informatics, nutrition, program evaluation, and prevention. To meet these personnel needs: (1) dental public health residency programs should be structured to meet the educational needs of working public health dentists with MPH degrees through on-the-job residency programs; (2) the standards for advanced specialty education programs in dental public health should be made sufficiently flexible to include dentists who have advanced education and the requisite core public health courses; (3) flexible MPH degree programs must be available because of the rising debt of dental students and the decreased numbers of graduating dentists; (4) loan repayment should be available for dentists who have pursued public health training and are working in state or local health departments; and (5) standards for advanced education in dental public health should be developed for dental hygienists.

Certification↗

Sch 50971, an orally active histamine H3 receptor agonist, inhibits central neurogenic vascular inflammation and produces sedation in the guinea pig.

We studied the actions of Sch 50971, a novel histamine H3 receptor agonist, in an experimental neurogenic model of migraine and characterized its sedative and respiratory actions. Sch 50971 (i.v. and p.o) inhibited plasma protein extravasation in the dura mater of guinea pigs after electrical stimulation of the trigeminal ganglia. The minimum effective doses of Sch 50971 were 3.0 mg/kg i.v. and 10 mg/kg p.o., which produced a 40% and 42% decrease in plasma protein extravasation, respectively. The effects of Sch 50971 (3.0 mg/kg i.v. ) were blocked by the histamine H3 antagonist thioperamide (3.0 mg/kg i.v.). The 5-HT1D agonist, sumatriptan (0.3 mg/kg i.v.), and the histamine H3 agonist, (R)-alpha-methylhistamine (0.3 mg/kg), also inhibited plasma extravasation by 40 and 46%. In sedation studies, Sch 50971 (1-100 mg/kg p.o.) potentiated pentobarbital-induced sleep. The ED40 min for Sch 50971, the benzodiazepines triazolam and diazepam, the histamine H1 antagonist diphenhydramine and the H3 receptor agonist (R)-alpha-methylhistamine were 7.0, 0.5, 2.3, 14.1 and 23.4 mg/kg p. o., respectively. The sedative effects of oral Sch 50971 was blocked by thioperamide (10 microgram i.c.v.). The sedative activity of Sch 50971 was also examined using EEG activity, locomotor activity and sleep. In conscious guinea pigs, Sch 50971 (10 mg/kg p.o.) depressed locomotor activity, increased total sleep time and produced EEG patterns consistent with physiological sleep. Sch 50971 decreased beta wave activity but had no effects on delta wave activity, theta activity or alpha wave activity. In contrast, triazolam (1.0 mg/kg p. o.) depressed delta and theta wave activity and produced large increases in alpha and beta wave activity. In conclusion, Sch 50971 is an orally active, potent and selective agonist of histamine H3 receptors that may act to ameliorate the sequelae of migraine headaches, where activation of histamine H3 receptors may be beneficial. Sch 50971 also decreases motor activity and promotes EEG activity consistent with physiological sleep.

Administration, Oral↗

Advancing discourse on health promotion: beyond mainstream thinking.

Attention must be redirected toward health promotion as nursing evaluates the goal of health for all. Confusion regarding health promotion behavior is illustrated by terms with diverse meanings and uses. In a process of critical analysis, five multidisciplinary experts in health promotion responded to a survey targeting the distinction of health promotion, health promotion behavior, health protection behavior, disease prevention behavior, preventive health behavior, health behavior, and healthy lifestyle. Descriptors of health promotion were derived from a multidimensional conception of well-being. Disagreement existed concerning health protection and health behavior. Nursing interventions are linked to reflective discourse regarding health promotion behavior.

Health Behavior↗

General dentistry grant program: 1976-1996.

The federal general dentistry grant program supports the development of new programs and first-year positions in postdoctoral general dentistry (PGD) education. One hundred and fifteen institutions have participated in the grant program since awards were first made in 1978. The grant program assisted in establishing 59 new PGD programs and 560 new positions. Eighty-eight percent of the new programs are still in operation; 69 percent of the positions are still being filled. These retained programs and positions represent 72 percent and 77 percent of the net growth in PGD programs and positions, respectively, that has occurred since 1977.

Education, Dental, Graduate↗

Reproductive hazards of fire fighting. I. Non-chemical hazards.

Fire fighters are regularly exposed to chemical and non-chemical agents that have known or suspected adverse effects on reproductive health. Although chemical agents have received some attention, non-chemical hazards such as heat, noise, and physical exertion have only recently been examined for their reproductive effects. There is evidence that heat, noise, and physical exertion may affect various endpoints of reproductive health, including fertility, fetal loss, and growth parameters of the offspring. In particular, hyperthermia, a major fire fighting hazard, has been shown to impair male fertility and may also be teratogenic. Further study of the potential reproductive effects of this and other common non-chemical agents in the fire environment is needed to ensure the reproductive health of male and female fire fighters.

Animals↗

Reproductive hazards of fire fighting. II. Chemical hazards.

Studies of the health of fire fighters have historically focused on non-malignant respiratory disease and cancer. More recently, concerns have surfaced about reproductive health effects in many areas of the workforce, including fire fighting. These concerns prompted this review of chemical exposures that may contribute to adverse reproductive health outcomes in male as well as female fire fighters. A review of the industrial hygiene literature was undertaken to identify agents commonly found in fire smoke. These agents were then examined for evidence of reproductive toxicity or mutagenicity/carcinogenicity. This profile of chemical agents and their reproductive toxicities permits a qualitative determination that fire fighters are exposed to potential reproductive toxicants as a part of their normal fire fighting duties. Considerations for mitigating these risks are also discussed.

Air Pollutants, Occupational↗