PubMed Health⌕ Search

Biomedical subjects

S Hudson

Publications and source records attributed to S Hudson.

At least 19 recordsLinked to original sources
PubMed1998

Ethnicity and cancer outcomes: behavioral and psychosocial considerations.

Cancer has been the subject of thousands of behavioral and psychosocial studies. The literature has focused largely on non-Hispanic Whites, despite the fact that cancer outcomes vary by ethnicity. This article provides a review of those studies that do consider the relations between ethnicity and cancer-related adherence behaviors, survival, and quality of life. The authors propose a mediational framework that links ethnicity and cancer outcomes through socioeconomic status, knowledge and attitudes, and access to medical care. They use this framework to organize the literature and to develop recommendations for future research.

Ethnicity↗
PubMed1997

Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis.

BACKGROUND: Spasticity is a serious problem in multiple sclerosis (MS) and many patients do not achieve a satisfactory response to currently available oral antispasticity drugs. Tizanidine hydrochloride, an alpha 2-noradrenergic agonist, has been shown to have an antispasticity effect in single center trials of patients with MS. OBJECTIVE: To compare plasma concentrations of tizanidine with objective measures of muscle tone in patients with MS with moderate to severe spasticity. SETTING: Ten centers, all tertiary referral centers for the specialized treatment of patients with MS, in the United States and Canada. DESIGN: A randomized, double-blind, placebo-controlled, dose-response study of tizanidine hydrochloride (8 or 16 mg). PATIENTS: One hundred forty-two patients with spastic MS who were not taking any interfering medication, such as an antispasticity drug or other alpha-noradrenergic agonist, entered the trial. RESULTS: Tizanidine treatment reduced muscle tone significantly, as shown by improved Ashworth scores and increased knee swing amplitude recorded by the pendulum test, both of which correlated significantly with plasma concentration. Placebo had no significant effect on muscle tone. Dizziness, drowsiness, dry mouth, and fatigue were reported most often in the group treated with tizanidine at peak plasma concentration. CONCLUSIONS: Tizanidine reduces spasticity in MS, and both therapeutic effects and side effects are related to the plasma drug levels.

Adrenergic alpha-Agonists↗
PubMed1997

Are community health interventions evaluated appropriately? A review of six journals.

OBJECTIVES: To determine if Randomized Controlled Trial (RCT) methodology was used appropriately in community health, we: (1) determined the proportion of non-randomized studies that should have been RCTs, and (2) assessed the quality of the RCTs. METHODS: The 1992 issues of six community health journals were manually searched. Intervention studies were analyzed. Studies that did not use randomization were analyzed for feasibility and practicality of RCT methods; RCTs were analyzed for quality using a checklist. RCTs were compared with community health RCTs from The New England Journal of Medicine. The proportion of studies meeting each criterion was determined. RESULTS: Fourteen percent of 603 studies were interventions and 4% were RCTs. Of those not using randomization, 42% should have. Mean RCT scores were significantly lower for the community health journals than for The New England Journal of Medicine. Many criteria important to quality scored poorly. CONCLUSIONS: RCTs are underused and lack methodologic rigor in community health. Conclusions regarding the effectiveness of interventions are therefore suspect.

Community Medicine↗
PubMed1997

An evaluation of community pharmacy records in the development of pharmaceutical care in The Netherlands.

An electronic patient database linking prescribes with a Dutch community pharmacy consortium was evaluated in a subset of the population of Noordwijk (11,760 patients out of a total of 25,600). The pharmacy database (a file of 41 disease contra-indications representing a subset of the prescribers' medical diagnosis) was studied in order to assess its value for the accurate discrimination of target patient groups within the community and for support to the pharmaceutical care of individual patients. The aim was to examine the application of the pharmacy records to pharmaceutical care, tested by measuring the accuracy of the pharmacy database to predict the community public health profile; and, more specifically, the accuracy to identify three potential target groups for pharmaceutical care. The records of patients with angina, chronic respiratory disease and diabetes (n = 1116), representing 65% of the total pharmacy morbidity records, were studied in detail and verified by the files and texts of the prescriber's individual patient records. From samples of patients (n = 273) from the three patient groups, the extent and nature of co-morbidity, polypharmacy (drug entities prescribed annually) and drug therapy instability (prescription changes to dose or dose form annually) were characterised. Angina patients showed the most comorbidity, 46% having three or more additional diseases; chronic respiratory disease patients showed most drug therapy instability; and insulin-dependent diabetic patients received most polypharmacy per disease. The pharmacy database predicted the prevalence of 10 of 23 relevant disease categories (representing 51% of the total morbidity on the medical records). However, the prevalences of eight categories were underestimated and of five categories overestimated. Of the three patient groups, 73% of patients appeared on both the pharmacy and the medical database. Of the total co-morbidity recorded for these patients, 68% of records were common to both databases. The database discrepancies (32%) were due to morbidity omitted (12%) and morbidity unverified (10%) on the pharmacy database, together with morbidity omitted from the medical database (10%). The current pharmacy database provides a limited view of morbidity. A strategic approach to pharmaceutical care requires pharmacists and prescribers to verify and share patient information if patient groups and individuals within a group are to be usefully targeted.

Cardiovascular Diseases↗
PubMed1997

Scenario analysis of the future of clinical pharmacy.

The role of clinical pharmacy in the health care system is changing rapidly. This change is almost universal among different countries and is related to developments in medical technology, health economics, informatics, socio-economic status, and professional relations. Transitions to new systems of clinical pharmacy are difficult to anticipate. Even with well defined targets, it remains uncertain what the future of clinical pharmacy will bring us. The construction of plausible scenarios may help us better in preparing for the 'new world' ahead. At the annual congresses of ESCP in Prague 1995 (24th) and Lisbon 1996 (25th), a number of scenario analysis workshops with respect to the future of clinical pharmacy were organized. This paper gives a report of the results of these scenario sessions and reflects on the implications for future policy making. After we identified the driving forces behind the future of clinical pharmacy, various sets of assumptions were made and from them scenarios were constructed which are plausible: they 'could' happen. This analysis provided a logical framework in which we ultimately depicted three alternating stories of the future of clinical pharmacy, named 'CLERK', 'CONTROLLER' and 'CARE MANAGER'. These scenarios are intended to help clinical pharmacists to break free of familiar mental maps and to stimulate creative thinking on the future.

Education, Pharmacy↗
PubMed1997

A descriptive analysis of children's playground injuries in the United States 1990-4.

OBJECTIVES: To review playground injury statistics over a five year period in order to develop an awareness of how and where children in the United States are being injured. METHODS: All data are based on the United States Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) for playground related injuries during 1990-4. The surveillance data includes injuries recorded in more than 90 hospital emergency departments located throughout the United States. RESULTS: Each year there are roughly 211,000 preschool or elementary school-children in the United States who receive emergency department care for injuries associated with playground equipment. On average, 17 of these cases result in death. 70% of all injuries occur on public playgrounds, with nearly one third classified as severe. Swings, climbers, and slides are the pieces of playground equipment associated with 88% of all NEISS reported injuries. Falls to the surface are responsible for 70%. CONCLUSIONS: NEISS playground injury statistics contribute to our understanding of playground injuries. By identifying where and how children are injured, suggestions can be made in an attempt to make playgrounds safer.

Adolescent↗
PubMed1997

An association between the heat-humidity index and preterm labor and delivery: a preliminary analysis.

OBJECTIVES: The goal of this study was to determine whether a relationship exists between heat-humidity indexes and rates of preterm labor and preterm delivery. METHODS: Preterm labor and delivery rates were compared during the 2 summer and 2 winter weeks with the highest and lowest heat-humidity indexes for each season. RESULTS: The rate of preterm labor increased consistently from 1.23% to 3.00% as the heat-humidity index rose. When preterm births were examined, the trend was similar but not statistically significant. CONCLUSIONS: Given the public health import of preterm labor and the frequency with which pregnant women may be exposed to extremes of heat, studies designed to confirm or refuse our preliminary observations are warranted.

Delivery, Obstetric↗
PubMed1997

Strategies for weight control success in adults.

Recent evidence demonstrates that only about 5% of individuals embarking on a weight loss program show lasting weight reduction. While many weight loss strategies have demonstrated poor results, some combinations of approaches have been successful. Empirical evidence demonstrates that certain conceptual approaches can contribute to the development of strategies to facilitate weight loss. This manuscript addresses three conceptual approaches that direct intervention strategies. Cognitive-behavioral strategies are directed toward modification of eating behaviors, and the social-contextual approach is directed toward the social and partnership approach to intervention. Biophysical strategies that have demonstrated success in weight loss include the effect of dietary restriction and exercise on weight loss. Using this synthesis of empirical evidence for success in weight loss, practitioners can develop individually tailored intervention strategies for their clients.

Adult↗
PubMed1996

The intracellular signaling pathways involved in MCP-1-stimulated T cell migration across microvascular endothelium.

The adherence and transmigration of T cells through microvascular endothelium is an essential step for recruitment into inflammatory lesions, although the factors that stimulate the directional migration of T cells have not been fully characterized. In the present study we investigated the capacity of chemokines to induce migration of T cells across dermal microvascular endothelial cell monolayer. The results showed that recombinant MCP-1 significantly induced transendothelial migration of both resting and activated T cells. Maximal induction of migration was observed at a concentration of 10 ng/ml and a 3- to 4-hr incubation period. In contrast, the chemokines IL-8, RANTES, and MIP-1 alpha failed to stimulate T cell migration at doses as high as 100 ng/ml. In studies designed to investigate the intracellular signaling pathways mediating the MCP-1 effect, the results showed that MCP-1 at doses ranging from 10 to 100 ng/ml did not cause an increase in intracellular calcium ions in T cells, even though this chemokine induced rapid calcium mobilization in monocytes. Furthermore, pretreatment of T cells with either bisindolymaleimide HCl, a specific inhibitor of protein kinase C, or genistein, a protein tyrosine kinase inhibitor, significantly decreased the MCP-1-induced transmigration in a dose-dependent manner. In contrast, T cells pretreated with the protein kinase A-specific inhibitor H89 responded normally to MCP-1 stimulation. Finally, T cell transmigration was inhibited by antibodies against CD11a, thereby confirming the importance of beta 2-integrin in the transmigration process.

Calcium↗
PubMed1996

Does storage of sputum specimens adversely affect culture results?

It has been recommended that samples submitted for microbiological examination should be retained for 48 hours after issue of the final report. In order to ascertain whether reproducible results could be achieved following storage of sputum specimens, two laboratories each re-cultured 100 samples 48 hours after their report had been issued and a further laboratory re-cultured 100 samples 48 hours after receipt. Discordant results were obtained in only 5-25% of specimens, indicating that potential respiratory pathogens could survive storage.

Bacteriological Techniques↗
PubMed1996

Hemoglobin damages the cultured endothelial cell monolayer from bovine cerebral arteries.

We demonstrated that hemoglobin reaches the endothelial layers by an immunoelectron microscopic analysis in a rabbit subarachnoid hemorrhage model. Next, the effects of hemoglobin on cerebral artery endothelial cells were investigated both morphologically and histochemically using a cultured monolayer from a bovine endothelial cell system. The cultured monolayer was incubated with six different concentrations of hemoglobin ranging from 0 to 10(-5) M for 24 hrs on two-chambered glass slides. The denuded area of the glass slide increased dose dependently while the intensity of the actin fiber decreased. Superoxide dismutase did not modify this change. In a preliminary study, the endothelial cell membrane showed a hemoglobin binding molecule (94.5k dalton). This study thus suggests that the effects of hemoglobin on the endothelial monolayer were partly caused by the direct binding of hemoglobin to the membrane.

Animals↗
PubMed1994

Peripheral blood chimerism in renal allograft recipients transfused with donor bone marrow.

Experimental studies have shown that administration of antilymphocyte serum combined with donor bone marrow cells can induce tolerance to allograft tissue. We have initially reported application of these protocols in clinical studies of cadaveric renal allograft recipients who were treated with MALG and donor-specific bone marrow cells. To evaluate the effectiveness of the donor marrow cells in the production of chimerism, a detection method based on 32P-incorporated PCR was established. The 32P PCR was utilized with primers specific for the HLA class II, VNTR (D17S5 and D1S111), and/or Y-chromosome genes to detect the presence of allogeneic chimerism in the recipients. Immediately posttransplant, 26.4% of marrow recipients demonstrated the presence of allogeneic chimerism prior to the marrow transfusion as did 18% in the untransfused controls. In transfused patients, chimerism was detected most frequently during the 1-3-month interval after marrow transfusion (65%), and then diminished to 50-56% at 3-12 months posttransfusion. In the control group the frequency of allogeneic chimerism was gradually decreased and was undetectable in the majority of the patients beyond 3 months posttransplant while marrow-transfused recipients were more likely to have chimeric cells detected consistently beyond 3 months. Rejection episodes were significantly effected by the presence of chimerism in the recipients. Of the transfused patients, 91.3% who demonstrated allogeneic chimerism were rejection-free as compared with 8.7% who experienced at least one rejection episode (P = 0.01). While the presence of allogeneic chimerism in the control group was correlated with rejection-free graft survival, this difference did not reach statistical significance.

Base Sequence↗
PubMed1994

Persistence of microflora in biofilm within fluid pathways of contemporary haemodialysis monitors (Gambro AK-10).

Growth of bacteria within a biofilm, visible macroscopically as a yellow coating, was seen on the interior walls of semi-transparent plastic dialysis monitor fluid pipes. The level of bacterial growth along the water/dialysis fluid pathway, and the effect of in-line bacterial filters, on colony counts in reverse osmosis reject water and monitor effluent were examined. Little difference in colony counts was seen at either sampling point in monitors fitted with and without filters. Because of the increasing use of high-flux dialysis, and its potential for transmembrane transport of endotoxin and bacteria into patients, staff should be aware that dialysis fluid pathways may be colonized with viable bacteria, which are not readily killed by conventional heat and chemical cleaning processes.

Bacteria↗