PubMed Health⌕ Search

Biomedical subjects

S L Baker

Publications and source records attributed to S L Baker.

At least 37 records · Page 2Linked to original sources
PubMed1993

Incentives for physicians to treat HIV-seropositive patients: results of a statewide survey.

We asked primary care physicians in South Carolina about their knowledge, attitudes, and beliefs regarding patients with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) and the services they provide for these patients. In support of an effort to develop more effective state policies regarding HIV/AIDS, the survey focused on conditions under which physicians would provide additional services for such patients; 597 of 900 physicians (66%) responded. Among responding physicians, 40% had not seen a patient with HIV infection/AIDS during the past year and 50% had seen only one to nine. Respondents identified lack of specialty backup support, insufficient clinical knowledge, and lack of available community services as the major barriers to providing care for these patients. Gaps in their knowledge included state and federal policies, available community resources, and clinical issues. Respondents said they would provide additional services if they had specialty backup (54%), better community and social support services (50%), additional training (46%), and limited liability (44%). We concluded that policy changes in these areas could expand access to care for HIV/AIDS patients in South Carolina.

Acquired Immunodeficiency Syndrome↗
PubMed1992

High risk channeling to improve Medicaid maternal and infant care.

To improve the medical care access of the poorest women and newborns, South Carolina began a High Risk Channeling Project since April 1986. The Project directs physicians to screen all Medicaid-eligible pregnant women and newborns for specified clinical high risk factors. High risk patients are channeled to designated clinics for prenatal and newborn care. Channeled pregnant women are directed to deliver their babies at regional referral hospitals. For the first two years of the Project, about two-thirds of pregnancies and 60% of newborns were actually screened. Channeled women were much more likely than the non-channeled to deliver at higher level hospitals. In counties where relatively few women were channeled, the rate of prematurity among Medicaid newborns was significantly higher than in other counties.

Delivery, Obstetric↗
PubMed1991

Cognitive mediators of pain perception and tolerance.

A social learning model of pain perception and tolerance was evaluated. Responses to cold-pressor pain were examined in 4 groups of 20 Ss each. One group was given instruction in cognitive coping strategies, the 2nd was given a monetary incentive contingent on tolerance time, the 3rd was given both cognitive training and monetary reinforcement, and a no-treatment control group was given neither. Incentive and coping instructions significantly increased tolerance but did not alter pain perception. A path analysis indicated that pain tolerance was affected by self-efficacy, which in turn was predicted by pain expectancy and the provision of incentives. Incentive also had an impact on tolerance that was independent of self-efficacy. Pain perception was strongly affected by pain expectancy, but was unrelated to self-efficacy.

Adaptation, Psychological↗
PubMed1990

Is indicated or spontaneous preterm delivery more advantageous for the fetus?

We performed a case-control study to determine whether fetuses delivered prematurely because of pregnancy complications (primarily pregnancy-associated hypertensive disease) had a different neonatal course than that of those born after either spontaneous preterm labor or after premature rupture of the membranes. Two case-control populations were matched by gestational age at delivery, fetal sex, and race. There was no perinatal survival advantage in babies delivered from "stressed" pregnancies. Selected neonatal morbidities were generally similar, but there was an increased incidence of necrotizing enterocolitis in babies born after preterm labor and a higher incidence of both necrotizing enterocolitis and neonatal sepsis after premature rupture of the membranes. We conclude that a "stressed" pregnancy confers a negligible survival advantage to the fetus.

Adult↗
PubMed1990

A second tumor necrosis factor receptor gene product can shed a naturally occurring tumor necrosis factor inhibitor.

An inhibitor of tumor necrosis factor (TNF) has been isolated from the human histiocytic lymphoma cell line U-937 that is capable of inhibiting both TNF-alpha and TNF-beta. Protein sequencing has verified that it is distinct from a previously described TNF inhibitor that is a soluble fragment of a TNF receptor molecule (TNFrI). The cDNA sequence of this second TNF inhibitor clone suggests that it is also a soluble fragment of a TNF receptor. Expression of this cDNA sequence in COS-7 cells verified that it encodes a receptor for TNF-alpha (TNFrII) that can give rise to a soluble inhibitor of TNF-alpha, presumably through proteolytic cleavage. The extracellular domain of TNFrII has significant homology with that of TNFrI and these two receptors share a striking conservation of cysteine residue alignment with the extracellular domain of the nerve growth factor receptor. These three receptor molecules are therefore members of a family of polypeptide hormone receptors.

Amino Acid Sequence↗
PubMed1990

Medicaid prospective payment: case-mix increase.

South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced.

Abstracting and Indexing↗
PubMed1989

Human eosinophil cytotoxicity-enhancing factor. Purification, physical characteristics, and partial amino acid sequence of an active polypeptide.

Medium conditioned by PMA/LPS-stimulated U937 cells was processed for the purification of an eosinophil cytotoxicity-enhancing factor (ECEF) by the following sequence: 1) phenyl-Sepharose chromatography; 2) DEAE-cartridge chromatography; 3) preparative SDS-gel electrophoresis; and 4) reversed-phase HPLC. This resulted in the isolation of a 10 kDa polypeptide with ECEF activity. Purified material from 21 different preparations enhanced eosinophil killing of antibody-coated Schistosoma mansoni schistosomula by a mean of 206% (increase from 13.2 +/- 7.9% to 40.4 +/- 20.2% of targets killed, p less than 0.0001). Activity was maximal at a concentration of 20 ng ECEF polypeptide/ml and half-maximal between 0.8 and 4 ng/ml. Antibody specific for the 10 kDa polypeptide precipitated ECEF activity from a crude preparation and, by Western blot analysis, reacted only with a 10 kDa species in that preparation. The following N-terminal amino acid sequence was determined for the purified polypeptide: Val-Lys-Gln-Ile-Glu-Ser-Lys-Thr-Ala-Phe-Gln-Lys-Ala-Leu- -Ala- Gly- -Lys-Leu.... Computer search showed that this sequence is unrelated to other known protein sequences. Thus, the ECEF polypeptide is a newly defined monokine, with the ability to enhance eosinophil cytotoxic function in vitro. This monokine may be an important regulator of eosinophil function in inflammation in vivo.

Amino Acid Sequence↗
PubMed1989

An appraisal of organizational response to fiscally constraining regulation: the case of hospitals and DRGs.

Results from analysis of 227,771 discharge abstracts from 68 short-term, acute-care hospitals and from interviews with a stratified random selection of 24 of the 68 chief executives of these hospitals demonstrate that institutions perceive implementation of DRGs as fiscally constraining, especially in light of other resource-constraining conditions (an increase in unemployment resulting in fewer people with hospitalization insurance, in addition to severe cuts in Medicaid rolls and budget). Hospitals responded to DRGs by decreasing the use of affected resources or services available to the hospitalized Medicare patient. In order to survive a more economically stringent marketplace, hospitals no longer protected the traditional core within the Medicare inpatient market. They opted instead to change practices and products at the unregulated margins of the DRG system.

Aged↗
PubMed1988

A study of the use of captopril in elderly hypertensive patients.

Captopril (12.5-25 mg b.d.) was compared with placebo in a double-blind, cross-over study in elderly, hypertensive subjects. Sixteen patients, aged between 65 and 80 years, were studied. The mean baseline blood pressure off treatment was 204.7 +/- 24.5/111.8 +/- 11.1 mmHg. In the 14 patients who completed the study, captopril significantly reduced the systolic and diastolic pressures compared with baseline (P less than 0.001) and compared with placebo (P less than 0.01). The fall in blood pressures was significantly greater at 4 weeks than at 2 weeks (P less than 0.001). No significant change in blood pressure was noted from baseline whilst on placebo. No significant serious side-effects were encountered during the study. We conclude that captopril would appear to be an effective antihypertensive agent which can be safely used in the elderly.

Aged↗
PubMed1987

Preparation and characterization of monoclonal antibodies against the fifth component of rabbit complement (C5).

By immunizing mice genetically deficient in C5 we were able to obtain a group of monoclonal antibodies to rabbit C5 that cross-react with C5 from a wide variety of mammalian sera, including mouse. The specificity of the monoclonal antibodies was against native C5 and C5b but not C5a. The antibodies strongly inhibit the expression of C5 hemolytic activity. We suggest that these monoclonal antibodies will be useful for studying C5 as well as providing a way to selectively deplete C5 from plasma in vitro or in vivo.

Animals↗
PubMed1987

The pharmacokinetics of enoxacin in elderly patients.

Twenty-three patients of greater than 70 years of age, with proven urinary tract infections were treated with 200 mg of enoxacin twice daily. Serial blood samples were taken on day 1 and peak and trough levels on days 3 and 5. Enoxacin and oxo-enoxacin plasma levels were measured. The mean plasma half-lives of enoxacin and the oxo-metabolite were 6.1 h and 6.7 h respectively. The 2 h plasma level of enoxacin increased from a mean of 1.5 mg/l on day 1 to 2.65 mg/l on day 3 and 2.80 mg/l on day 5. No significant accumulation of the oxo-metabolite (as judged by the 2 h level) occurred. No alteration in enoxacin dosing in the elderly compared with that in younger patients is suggested. Eighty-five per cent of the patients were cured of their infection and no significant adverse advents were noted.

Aged↗
PubMed1987

Complement activity in normal rabbit bronchoalveolar fluid. Description of an inhibitor of C3 activation.

Hemolytically active C4, C3, C5, and C6, and trace amounts of C1, were present in bronchoalveolar lavage fluid from healthy adult rabbits. Both the alternative and classical pathways were functionally intact through C5. Complement depletion by intravascularly administered cobra venom factor caused a parallel decrease in lavageable C5 from the rabbit's lungs. Whereas BALF C5 had specific activity comparable to serum C5, that of BALF C3 was lower than predicted. This was found to be due to the action of a substance that selectively blocked C3 activation. The inhibitor did not cause irreversible inactivation of C3, and it had no effect on C5 activity. It blocked the formation of EAC423 from EAC42 + C3, but not the lysis of preformed EAC423 + C5-9 or EAC423 rosetting with rabbit neutrophils. Hydrophobic chromatography of BALF separated the activity of the inhibitor from that of C3. Further chromatography showed that it had a net negative charge at physiologic pH, and molecular weight between 14 and 30 kilodaltons. The presence of an inhibitor of C3 activation in the airways would provide control of complement activation in an environment that is constantly exposed to bacteria, dust, and other potential inflammatory stimuli.

Animals↗
PubMed1984

Analysis of an outbreak of staphylococcal scalded skin syndrome: strategies for typing 'non-typable' strains.

Thirteen newborn babies were studied during an outbreak of scalded skin syndrome. Staphylococci isolated from seven babies were non-typable using the international set of typing phages; the remainder were of phage group II. In only one instance was there transmission of phage group II strains other than within families. However, 'heat treatment' and plasmid profiles of the non-typable strains showed that five of the seven babies were infected by strains which were indistinguishable. These five strains were more closely related to phage III staphylococci than to phage group II. The identity of the epidermolytic toxin has not been established.

Bacteriophage Typing↗