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Biomedical subjects

R Hatch

Publications and source records attributed to R Hatch.

17 recordsLinked to original sources
PubMed2000

Remedial education: can this doctor be saved?

In the first two years of the program 30 physicians have completed the program. A list of the distribution of specialties/practice areas [table: see text] served is provided in Table 1. The data reveal that the distribution of practice areas corresponds approximately to the distribution of physicians practicing in the state. The UF C.A.R.E.S Program provides a great benefit to physicians and their patients. It provides an atmosphere of professional collaboration and encouragement to address specific educational needs and underscores a commitment to providing continuing medical education, meaningful doctor-to-doctor collaboration, better patient care, and reflects a medical model of diagnosis and treatment of specific problems.

Adult↗
PubMed1998

H. pylori stimulates gastrin release from canine antral cells in primary culture.

Patients chronically infected with Helicobacter pylori are known to have hypergastrinemia. Previous studies have demonstrated the stimulation of gastrin from isolated G cells by monocytes and cytokines. The aim of this study was to determine if H. pylori can directly stimulate gastrin secretion. The secretion of gastrin from canine G cells in 48-h primary cultures was investigated using either live H. pylori bacteria or various bacterial extracts from three well-characterized strains. Whole bacterial sonic extracts and water-extracted surface proteins, but not PBS extracts, from strains 43579 (CagA+/VacA+), 60190 (CagA+/VacA+), and 60190:v1 (CagA+/VacA-) significantly stimulated gastrin release. Controls demonstrated that gastrin stimulation by the sonic extracts was not due to a direct toxic effect on G cells. We conclude that H. pylori produces a soluble factor(s), which can directly stimulate gastrin release in enriched canine G cell cultures. This stimulatory effect may play an important role in the H. pylori-associated hypergastrinemia and subsequent development of peptic ulcer disease.

Animals↗
PubMed1993

Carisoprodol as a drug of abuse.

Carisoprodol (available as Soma and in other commercial forms) is a commonly prescribed muscle relaxant. A small group of patients was recently discovered colluding to obtain the drug under false pretenses for the purposes of substance abuse. Animal and human studies have previously shown limited potential for tolerance or abuse, while the evidence for therapeutic efficacy is inadequate. There are two previous case reports of human carisoprodol abuse or dependence, one in which a patient showed signs of a true withdrawal syndrome. A third case involved a fatality linked to carisoprodol abuse. Data from the National Institute on Drug Abuse reveal that overdose and abuse of carisoprodol may be more common than previously suspected. Carisoprodol use should be limited to short-term treatment of acute musculoskeletal conditions involving significant muscle spasm. Suspicions of abuse should be raised by patients requesting the drug by name, "losing" prescriptions, using carisoprodol chronically, or denying the efficacy of less mind-altering alternatives.

Behavior, Addictive↗
PubMed1993

Pediatric human immunodeficiency virus infection in a low seroprevalence area.

Although increasing information is available regarding human immunodeficiency virus (HIV) infections of children in high seroprevalence areas, few data are available describing trends in low seroprevalence populations. In San Diego County approximately 1 in 1450 live births are to women infected with HIV as identified by nonlinked heel stick testing. Seventy-seven HIV-infected children were identified and followed in our clinics during the period 1983 to 1991, of whom 32 (42%) were infected perinatally, 32 (42%) were hemophiliacs and 13 (17%) were infected by blood transfusions. During the last 4 years of the study period (1988 to 1991), most (28 of 37, 76%), newly identified HIV-infected children less than 13 years old were perinatally infected. Of the 32 perinatally infected children 50% were Hispanic, 34% were Caucasian and 16% were African-American. The prospective vertical transmission rate was 16%. Twenty-nine (38%) of the HIV-infected children have a diagnosis of acquired immunodeficiency syndrome and 17 (22%) have died. Comparatively few of the HIV-infected hemophiliac patients (4 (12%)) have progressed to an acquired immunodeficiency syndrome diagnosis. The number of acquired immunodeficiency syndrome diagnoses declined in the last 2 years of the study as a result of fewer cases of Pneumocystis carinii pneumonia; 11 cases of P. carinii pneumonia were diagnosed in 1988 to 1989 compared with 4 cases in 1990 to 1991. Survival analysis for the perinatally infected group yielded a median survival of 9.2 years. The apparent trend in our data toward improved outcomes of children infected with HIV suggests the beneficial effects of early identification, antiretroviral treatment, and P. carinii pneumonia prophylaxis.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Intensive surveillance for infections in a three-year study of nursing home patients.

The authors report the results of a 3-year (August 1984-May 1987) prospective study of intensive surveillance for nursing home-associated infections in 666 patients in a 300-bed nursing home in San Diego, California. Ninety-three percent (666 of 714) of the eligible subjects enrolled; 75% were women. The mean age of the subjects was 81.6 years. Lengths of stay ranged from 1 day to 1,025 days, with a mean of 166 days; the cumulative length of stay for all subjects was 110,746 days (303 years). Operational definitions that were heavily dependent on evaluation of clinical signs and symptoms were used by nurse practitioners in weekly or biweekly assessments of all patients to identify infections. The overall incidence of nursing home-associated infection was 7.1 infections/1,000 patient-days. Many of the infections would not have been recognized by persons less skilled than nurse practitioners. Among the 788 nursing home-associated infections identified, 362 (47%) were in the respiratory tract (286 lower respiratory and 76 upper respiratory); 200 (25%) were associated with skin and subcutaneous and mucous membranes; 140 (18%) were symptomatic urinary tract infections; 13 (2%) were bacteremia; and 73 (9%) were other infections.

Adult↗
PubMed1985

Protein O-carboxylmethylation in relation to male gamete production and function.

Protein O-carboxylmethyltransferase (PCM) activity of differentiating male germ cells in the testis and of spermatozoa is strikingly high. PCM catalyzes the methylesterification by S-adenosylmethionine of dicarboxylic amino acid residues in proteins. PCM appears to be the only type of protein methyltransferase present in mature spermatozoa. Mammalian sperms contain considerable amounts of S-adenosylmethionine and can apparently synthesize this nucleoside from L-methionine and ATP. Spermatozoa are rich in S-adenosylhomocysteine hydrolase. The characteristics of this enzyme in testicular germ cells and in sperms are very similar to those in other mammalian tissues; the very sub-stoichiometric extent of methylation of various pure protein substrates, and the rapid spontaneous hydrolysis of the protein methyl ester products at physiological and especially higher pH values, are particularly remarkable. From studies on processes related to protein O-carboxylmethylation in rat spermatozoa from different regions of the epididymis, and in ejaculated spermatozoa from normal and infertile men, unequivocal evidence could not be obtained for hypotheses of other investigators that PCM-catalyzed reactions are of regulatory importance for the acquisition of a potentiality for motility in sperms during their transit and maturation in the epididymis, or for the locomotion of ejaculated sperms. The findings are discussed in the light of the recent hypothesis of S. Clarke that PCM catalyzes methylesterification of D-aspartyl residues that accumulate in certain proteins as a result of slow spontaneous racemization of L-aspartyl residues, and that the methyl esterification of D-aspartyl residues may be related to disposal or repair of proteins damaged in this fashion.

Animals↗
PubMed1985

Protein O-carboxylmethyltransferase in spermatozoa from normal and infertile men.

In confirmation of several reports, suspensions of normal washed human spermatozoa exposed to a nonionic detergent exhibited considerable activity of the enzyme protein O-carboxylmethyltransferase (PCM), which catalyzes the methyl esterification of carboxyl groups of dicarboxylic amino acid residues in proteins. Various methods for assay of human spermatozoal PCM levels were evaluated, and some properties of the enzyme were studied. Normal human spermatozoa appear to be devoid of other types of protein methyltransferases that catalyze N-methylations of arginyl or lysyl residues in proteins. Spermatozoal PCM levels in infertile patients with motile sperm cells tended to be somewhat higher than those of normal control subjects, especially in those instances where the spermatozoal populations contained abnormally high proportions of immature forms of spermatozoa. Although totally immotile spermatozoa obtained from certain patients exhibited very low PCM activities (as recently reported by other investigators), in this study no invariant relationship between zero motility indexes and spermatozoal PCM was observed. These results are discussed in light of various current hypotheses regarding the functions of PCM in animal cells.

Cell Separation↗
PubMed1981

Hirsutism: implications, etiology, and management.

Hirsutism usually results from a subtle excess of androgens. As such, it is a clue to possible endocrine disturbance in addition to presenting cosmetic problems. We use the term hirsutism to mean male-pattern hirsutism--excessive growth of hair in areas where female subjects normally have considerably less than male subjects. An elevation of the plasma free (unbound) testosterone level is the single most consistent endocrinologic finding in hirsutism. The plasma free testosterone level is sometimes elevated when the total level of plasma testosterone is normal because testosterone-estradiol--binding globulin (TEBG) levels are often depressed in hirsute women. Frequent blood sampling is sometimes necessary to demonstrate subtle hyperandrogenic states since androgen levels in the blood are pulsatile and seemingly reflect episodic ovarian and adrenal secretion. The source of hyperandrogenemia can usually be determined from dexamethasone suppression testing. Those patients whose plasma free androgen levels do not suppress normally usually have functional ovarian hyperandrogenism (polycystic ovary syndrome variants). Very high plasma androgen levels or evidence of hypercortisolism, which is not normally suppressible by dexamethasone, should lead to the search for a tumor or Cushing's syndrome. Those patients in whom hyperandrogenemia is suppressed normally by dexamethasone have a form of the adrenogenital syndrome, a prolactinoma, obesity, or idiopathic hyperandrogenemia. In such patients, glucocorticoid therapy may reduce hirsutism and acne and normalize menses. The treatment of hirsutism resulting from functional ovarian hyperandrogenism is not as satisfactory; estrogen-progestin treatment is the most useful adjunct to cosmetic approaches to hirsutism in this country. However, other manifestations of polycystic ovary syndrome, such as infertility, may take precedence over hirsutism when an optimal therapeutic program is designed for many patients.

Adrenal Glands↗
PubMed1979

A reciprocal translocation (X;11) in a female with gonadal dysgenesis.

A 24-year-old female patient was referred for evaluation of primary amenorrhea. Endocrine studies showed elevated gonadotropins, consistent with gonadal failure. At laparoscopy, a normal nulligravid uterus, normal fallopian tubes, and bilateral streak gonads were observed. Histologic studies showed that the left gonad consisted entirely of fibrous tissue, confirming the presence of streak gonads. Chromosome banding studies of peripheral blood and cultures of tissue from the left gonad demonstrated a 46,X,rcp(X;11)(q22;q13) karyotype. A review of reports of X-autosome reciprocal translocations indicated that abnormal gonadal development is associated with break-points in the mid-region of the long arm of the X chromosome.

Adult↗