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Biomedical subjects

S G Taylor

Publications and source records attributed to S G Taylor.

At least 19 recordsLinked to original sources
PubMed1992

Effect of Rb+ on cromakalim-induced relaxation and ion fluxes in guinea pig trachea.

The effects of cromakalim, verapamil and salbutamol have been examined in guinea pig trachealis smooth muscle in both Krebs physiological salt solution and Krebs solution where K+ has been replaced by Rb+. Cromakalim-induced relaxation in the presence of Rb+ was reduced in extent and became transient, whilst the relaxation response to verapamil was enhanced and that to salbutamol unaffected. The transient relaxation occurring in Rb+ was blocked by quinidine and glibenclamide. The presence of extracellular Rb+ also prevented cromakalim-stimulated efflux of both 86Rb+ and 42/43K+. There was, however, no effect on cromakalim-stimulated 86Rb+ uptake. It is proposed that cromakalim is opening two populations of potassium channel in guinea pig tracheal smooth muscle, one of which is susceptible to blockade by Rb+ and one of which is not. The latter channel appears to play the dominant role in cromakalim-stimulated uptake, and is responsible for the transient relaxation response in the presence of rubidium, whilst the former is responsible for the maintained relaxation.

Albuterol↗
PubMed1992

Combined modality therapy for stage III non-small cell lung carcinoma: results of treatment and patterns of failure.

Patients with Stage III non-small cell lung carcinoma continue to pose a therapeutic problem with dismal cure rates. In an effort to improve on these results, 129 patients with biopsy-proven clinical Stage III non-small cell lung carcinoma from November 1982 through November 1987, were entered into two consecutive Phase II studies at Rush-Presbyterian-St. Luke's Medical Center. Treatment in the first study consisted of Cisplatin and 5-Fluorouracil infusion with concomitant split course radiation; in the second Etoposide was added. Radiation and chemotherapy were given simultaneously on days one through five of each cycle in a preoperative fashion for four cycles in patients considered eligible for surgery and in a definitive fashion for six cycles in patients considered ineligible for surgery. Radiation was given in 2 Gy fractions for a planned preoperative dose of 40 Gy and a definitive dose of 60 Gy. Surgical resection was attempted four to five weeks later in patients treated preoperatively. Thus, 83 patients were treated preoperatively and 46 definitively. Eighty-three patients (64%) had IIIA disease and IIIB disease was found in the remainder of the patients. Sixty-two patients (75%) in the eligible for surgery group had a thoracotomy after the combined treatment with a resectability rate of 97% and an operative mortality rate of 5%. There were 17 patients (27%) with no evidence of residual cancer in the resected specimen. Three-year survival for the eligible for surgery group at 40% was significantly better than 19% observed in the ineligible for surgery group (p = 0.003). Seventy-six percent of the patients with no residual cancer in the resected specimen are recurrence-free at three years compared to 34% of the patients with gross residual. A total of 81 patients have failed after their treatment; 49 (59%) in the eligible for surgery group and 32 (70%) in the ineligible for surgery group. Of all the patients who failed, local failure alone and as a component occurred in 21 (26%) and 36 (44%) patients, respectively. Failure in distant sites alone was noted in 56% of the overall failures. Severe toxicity was unusual. There were three treatment related deaths (2%). Radiation esophagitis and pneumonitis were only mild to moderate seen in less than 10% of the patients. Survival rates and patterns of failure according to the stage of the disease, histology, treatment group and pathologic response will be presented in detail.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Nursing theory as a base for a computerized nursing information system.

This article illustrates how nursing theory can be used in a computerized nursing information system (CNIS). Before development of such a system can begin, data relationships must be specified so that: (a) the relationships are specific enough to support a computerized relational base and (b) the resultant information can support nursing science. Both goals were achieved through three interrelated processes: (a) validation of a practice model based on Orem's self-care deficit nursing theory, (b) classification of clinical data into theory-related categories, and (c) establishment of data relationships to yield meaningful information.

Databases, Factual↗
PubMed1992

Medication management by recently hospitalized older adults.

Community-dwelling older adults often manage numerous prescriptive medications. The purpose of this study was to describe prescriptive medication management by older adults recently discharged from hospitals. The sample (N = 179) included adults, 65 to 101 years old, who managed a total of 950 prescriptive medications. Overall, subjects reported high confidence in their ability to manage medications. The lowest confidence levels were reported for recognizing unwanted side effects of medications. Although "forgetting" was the most commonly given reason for missed doses, one fourth of the reasons for missed doses indicated deliberate omission. Almost half of the subjects received assistance from others with their medications; most of the assistance served to counteract the tendency to forget medication doses. The results of this study provide a research-based foundation for community health nursing efforts to strengthen the effectiveness of older adults' medication self-care behaviors.

Aged↗
PubMed1992

Head and neck cancer.

Explore the source record for details and available documents.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

The inhibitory effects of cromakalim and its active enantiomer BRL 38227 against various agonists in guinea pig and human airways: comparison with pinacidil and verapamil.

The effects of the potassium channel activators, cromakalim, BRL 38227 and pinacidil, and the calcium antagonist, verapamil, have been compared against various spasmogens on airway responses in vitro and in vivo in the guinea pig and also in human isolated bronchi. In guinea pig tracheal spirals, potassium channel activators generally had a greater inhibitory effect than verapamil against tone induced by a wide range of spasmogens (spontaneous, 5-hydroxytryptamine, leukotriene D4, prostaglandin E2). The potassium channel activators had very little effect against potassium chloride- and carbachol-induced tone in guinea pig tracheal spirals [e.g., cromakalim (20 microM) induced relaxations of 0.21 +/- 0.03 (relative to an isoprenaline maximum = 1.0, mean +/- S.E.M.) against carbachol, compared to 0.77 +/- 0.03 against histamine]. In vivo, the potassium channel activators prevented histamine and 5-hydroxytryptamine-induced bronchoconstrictions, but had little inhibitory effect against acetylcholine. In contrast, in human bronchi, cromakalim was capable of inducing powerful concentration-dependent relaxations against carbachol-induced tone [cromakalim (20 microM) induced relaxations of 0.77 +/- 0.09 (relative to isoprenaline = 1.0, mean +/- S.E.M.) against carbachol, compared to 0.95 +/- 0.04 against histamine]. In human bronchi, all the inhibitory agents were more potent and more effective, except that verapamil did not have an increased maximum response. We conclude that potassium channel activators should be effective at relaxing contractions induced by a wide range of spasmogens in man.

Animals↗
PubMed1991

Pre-treatment prognostic factors in stage III non-small cell lung cancer patients receiving combined modality treatment.

Approximately one-third of non-small cell lung cancer (NSCLC) patients present with locally advanced disease. Increasing numbers of clinical trials are being conducted in this group of patients and recently a new international staging system has been introduced, resulting in the sub-division of Stage III into IIIa (potentially operable disease) and IIIb (inoperable disease). Kaplan-Meier survival analyses and Cox regression analyses were used to analyze data from 129 Stage III NSCLC patients who had been treated on two consecutive Phase II trials testing combined modality treatment. The pretreatment characteristics of these patients were: median age--59 years, males/females--87/42, caucasian/non-caucasian--111/18, squamous cell or adenocarcinoma/large cell carcinoma--57/72, previous weight loss less than or equal to 5%/greater than 5%-76/46, previous history of cardiorespiratory disease--no/yes--91/36, performance status (PS) 0-1/2-3--102/27, Stage III, 2 groups--IIIa/IIIb--83/46, Stage III, 3 groups--IIIa T3 N0/IIIa N2/IIIb--41/41/47, surgical eligibility--eligible/ineligible--83/46. Kaplan-Meier statistics revealed significantly longer survival for PS 0-1 versus 2-3 (p = .001), for eligible versus ineligible for surgery (p = .003), for Stage-IIIa versus IIIb (p = .004), and for Stage-IIIa T3N0 versus IIIa N2 versus IIIb (p = .004). The best model developed from Cox regression analyses included stage (IIIa T3 N0 vs IIIa N2 vs IIIb), PS, and sex. These observations appear to have implications for clinical research in Stage III NSCLC.

Adenocarcinoma↗
PubMed1991

Synthesis and smooth muscle relaxant activity of a new series of potassium channel activators: 3-amido-1,1-dimethylindan-2-ols.

The synthesis of a novel series of smooth muscle relaxants which have been shown to act via the opening or activation of potassium channels is described. Compounds have been evaluated for their ability to inhibit spontaneous tone in guinea pig isolated trachealis and structure-activity relationships are discussed. One compound in particular, 1,1-dimethyl-5-nitro-3-(2-pyridon-1-yl)indan-2-ol, (16) was identified as a potent relaxant of airways smooth muscle in vitro with IC50 = 0.15 microM and was found to significantly inhibit histamine-induced dyspnoea in conscious guinea pigs when given orally 30-45 min prior to challenge.

Amides↗
PubMed1991

Relaxant activity of 6-cyano-2,2-dimethyl-2H-1-benzopyran-4-carboxamides and -thiocarboxamides and their analogues in guinea pig trachealis.

Structural modifications of the potassium channel activator cromakalim (1) are described in which the amide moiety at C-4 has been replaced by carboxamide and thiocarboxamide functions. Analogues in which the hydroxyl group at C-3 has been oxidized or removed are also disclosed. Such analogues display an interesting profile of smooth muscle relaxant activity in the guinea pig isolated trachea, not all of which appears to result from the opening of potassium channels, but few compounds retain useful in vivo activity. However, one compound in particular, 6-cyano-2,2-dimethyl-N-methyl-2H-1-benzopyran-4-thiocarboxamide (13) was shown to be a potent potassium channel activator in vitro and to provide prolonged protection to guinea pigs from the respiratory effects of inhaled histamine.

Animals↗
PubMed1991

Myocardial infarction survivors: age and gender differences in physical health, psychosocial state and regimen adherence.

Little is known about women's and older adults' experiences after myocardial infarction (MI). The purpose of this study was to determine if gender and age differences exist in psychosocial condition, health state and therapeutic regimen adherence among MI survivors. Adults aged 40 to 88 years (n = 197) were interviewed 1 to 2 years after their first MI. The Profile of Mood States was used to measure anxiety and depression, the Personal Resources Questionnaire was used to measure social support, the Rosenberg Self-Esteem scale was used to measure self-esteem, the Perceived Quality of Life scale was used to measure quality of life, and the Health Behaviour Scale was used to assess therapeutic regimen adherence. Cardiac rehabilitation participation was recorded from rehabilitation centre records. Subjective health appraisals were assessed using investigator-developed questions. Increased age was associated with higher depression scores, lower quality of life, less social support, less participation in formal cardiac rehabilitation, less therapeutic exercise and poorer general health. Women reported poorer health than men. Findings indicated older males may be at risk for lower social support and continued smoking after infarction. These findings suggest that the often-reported experience of middle-aged males post-MI cannot be generalized to all adults experiencing infarction.

Adult↗
PubMed1991

Medication regimen complexity and adherence among older adults.

Two studies were conducted to examine the relationship between medication regimen complexity and adherence among older adults recently discharged from hospitals (N = 178) and those not recently hospitalized (N = 98). Medication regimen complexity was measured by the Medication Complexity Index (Kelley, 1988), which measures the number, frequency, and types of actions required to enact a medication regimen. Adherence to the regimen was measured by pill count and verbal self-report. The negative correlations between regimen complexity and adherence were in the predicted direction but did not achieve statistical significance. Medication regimen complexity may have a larger impact on aspects of medication management other than adherence to the prescriptive regimen.

Aged↗
PubMed1991

The structure of nursing diagnosis from Orem's theory.

Nursing diagnosis is generally accepted as a legitimate part of the nursing process; however, there is no consensus on the form, structure, or meaning of diagnosis within the discipline. Some nursing theories and models provide the basis for deriving a structural model for nursing diagnoses. A general structural model for a classification schema for the perspective of Orem's general theory, the self-care deficit theory of nursing has been developed and described. Sample diagnostic statements for various levels within the schema are presented. The language of nursing diagnosis which is appropriate to the theoretical perspective is also described and examples are provided. Diagnostic statement models are identified. This work is the beginning of a formal classification system for nursing diagnosis from one nursing theoretical perspective.

Classification↗
PubMed1991

Orem's general theory of nursing and community nursing.

The purpose of this article is to examine the way in which theoretical concepts of community articulate with Orem's theory. Philosophical and theoretical perspectives of community are presented as the basis for developing a model for community nursing. The development of nursing theory and science related to the concept of community proceeds from an understanding of community and its articulations with nursing. Three basic models of community are identified and described: (a) atomistic/contractarian, (b) organic/functional, and (c) mutual/personal. Orem's theory can be legitimately viewed as having meaning for nursing when the community is viewed from any of the three models. It is not limited to the use of "aggregate" models. The distinction comes in the view of community consistent with the underlying philosophical view of the nature of person expressed or inherent in the nursing theory. A general model for the community as a unit of service, congruent with Orem's theory, is presented.

Community Health Nursing↗
PubMed1991

Concomitant chemotherapy and split-course radiation for cure and preservation of speech and swallowing in head and neck cancer.

To assess the ability of simultaneous cisplatin, 5-Fluorouracil, and radiation to substitute for surgery and radiation in advanced head and neck cancer, we have retrospectively selected from our phase II study a subgroup of 29 patients having primary disease requiring either more than a hemiglossectomy or a laryngectomy for control. Patients included 22 with stage IV and 7 with stage III disease, 12 tongue, 10 hypopharynx, and 7 larynx primaries. The treatment consisted of concurrent cisplatin, 5-Fluorouracil, and split-course radiation every other week for a total of 7 cycles within 13 weeks. With a median follow-up of 5 years, 86% of patients had preservation of speech and/or swallowing function. Median survival was 45 months, with 14 (48%) patients currently alive and disease free, 11 (38%) dead from their cancer, and 4 (14%) dead of other causes. The overall failure rate was 38%. Advanced-stage presence of N3 nodal disease and fewer than 7 cycles of chemotherapy received were significantly associated with increasing failure rates. This program of concomitant cisplatin, 5-Fluorouracil, and radiation produced control rates quite competitive with surgery and radiation and is appropriate for definitive testing in a randomized trial.

Adult↗
PubMed1991

Controversies in the multimodality management of head and neck cancer.

A number of prospective controlled trials currently exist, with consistent results that help define the current role of chemotherapy in patients with advanced-stage head and neck cancer, and they may offer directions for future research. Neoadjuvant combination chemotherapy appears to offer no survival advantage but does appear to select a subgroup of patients who do not require surgical intervention, thereby resulting in organ preservation. Patients who have received neoadjuvant chemotherapy and obtain a prompt complete response are more likely to realize a significant local control advantage following regional therapy. Randomized studies using simultaneous chemotherapy and radiotherapy have resulted in higher clinical local control and overall survival rates. These studies have used only single agents, however. Phase II trials with drug combinations have been even more encouraging as compared with historical data. By comparing different treatment schemes, such as alternating and sequential, to simultaneous schedules, it is hoped that differences in toxicity, the role of dose-intensity, and regional control rates can be further defined. The information now exists for the formulation of well-designed, prospective randomized clinical trials comparing different schemes of concomitant chemotherapy with standard regional treatment regimens.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Retrospective analysis of hyperthermia for use in the palliative treatment of cancer: a multi-modality evaluation.

Forty-two patients with local or superficial metastatic or recurrent malignant tumors were treated in a non-randomized Phase I/II study to assess the tumoricidal effects of heat combined with radiation and/or chemotherapy. Radiation doses administered averaged 3130 +/- 350 cGy; chemotherapeutic agents employed included bleomycin, mitomycin-C, adriamycin, and cis-platin, heat was induced by radiative or interstitial microwave applicators operating at frequencies ranging from 95 to 900 MHz. Forty-one of the forty-two patients were evaluated for initial therapeutic effects yielding the following response distributions: local hyperthermia with radiation--42% complete response (CR), 44% partial response (PR), and 15% no response (NR); local hyperthermia with chemotherapy--0% CR, 50% PR and 50% NR. Long-term response duration was evaluated for local hyperthermia with radiation, yielding mean time to recurrence of 9.4 months for CR's and mean time to progression of 3.4 months for PR's. In retrospective analysis, we examined the correlations of previously established response-predictor variables of tumor volume and minimum thermal dose with both initial and long-term response rates. Initial complete response rates were correlated directly with non-site-specific minimum thermal dose, varied inversely with tumor volume and exhibited a positive correlation for a limited histologic type/treatment site combination. Surprisingly, long-term response did not correlate either with tumor volume or thermal dose. The frequency of thermally induced complications, which did not correlate with any measured thermal parameters, was found to be 42%, expressed on a per-patient basis.

Adult↗