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Biomedical subjects

W Simonson

Publications and source records attributed to W Simonson.

At least 19 recordsLinked to original sources
PubMed2000

Rel B is an early marker of autoimmune islet inflammation in the biobreeding (BB) rat.

Because the development of insulitis and diabetes is predictable in Lyp/Lyp congenic BB rats, we have characterized early islet inflammation in these rats to determine the cell subsets involved in the onset of autoimmune insulitis. Pancreas sections from prediabetic Lyp/Lyp, Lyp/+ and +/+ rats were analyzed by immunohistochemistry. We found W3/25+ cells in the exo- and endocrine tissue from all three genotypes, but intraislet insulitis was never found in Lyp/+ or +/+ rats. The onset of massive, intraislet B- and T-cell infiltration in Lyp/Lyp rats was preceded by Rel B+ cells in and around the islets, followed by ED1+ monocytes/macrophages. Rel B+ cells were more frequent in the parafollicular cortex of pancreatic lymph nodes from Lyp/Lyp than from Lyp/+ and +/+ rats. In the Lyp/Lyp thymus, we found significantly increased expression of IL-12p40 messenger RNA (mRNA; p<0.001), located in the Rel B-protein-rich corticomedullary junction. The NF-KB/Rel B complex specifically transactivates genes involved in antigen presentation in dendritic cells. Rel B+ cells in the islets may therefore mark the onset of autoimmune insulitis and antigen-specific activation of autoreactive T cells in the lymph nodes of diabetes prone Lyp/Lyp BB rats. In the thymus, Rel B+ cells may support the Lyp-dependent development of self-reactive thymocytes by activation of cytokine expression.

Age Factors↗
PubMed1998

Promising agents for treating Alzheimer's disease.

Key issues related to the pharmacotherapy of Alzheimer's disease (AD) are discussed, and current and investigational agents are described. There are three key issues in the pharmacotherapy of AD. First, there is a need to eliminate or minimize drug-related adverse reactions. Second, concurrent diseases that either resemble AD or complicate its treatment must be addressed. The third issue is the need for pharmacotherapy not only to improve cognitive performance but to treat related symptoms. Current strategies for treating AD usually rely on increasing cholinergic function. To date, cholinesterase inhibitors (ChEIs) are the only agents that have been well studied and that have shown efficacy by improving cognitive deficits and, in some cases, psychiatric and behavioral components of AD. Tacrine is rarely used today; the only other FDA-approved ChEI is donepezil. Many other approaches are under clinical investigation, including selective muscarinic agonists, antioxidants, anti-inflammatory drugs, and estrogen replacement therapy. New drug discovery efforts focus on molecular events believed to be important in the pathogenesis of AD. Future pharmacotherapy will probably involve increased use of ChEIs in combination with drugs that have other mechanisms of action. Current treatment of AD primarily involves ChEI therapy, but other therapeutic options, particularly combination therapies, hold promise.

Alzheimer Disease↗
PubMed1998

Medication use by community-dwelling elderly with urinary incontinence.

Medication consumption patterns among community-dwelling elderly persons with chronic urinary incontinence were examined. All health professionals, including nurses, should be knowledgeable of the potential for adverse drug reactions. Continuing education and establishment of routine monitoring systems could help to reduce the risk of potential for adverse drug reactions and prevent drug-induced UI in patients.

Aged↗
PubMed1996

Drug therapy implications on activity: a focus on the elderly patient.

Drug therapy is common in the elderly and may be very beneficial but it is associated with many potential complications. Adverse drug reactions are more likely to occur in the elderly patient, presenting with a wide spectrum of symptoms ranging from minor to severe. Adverse effects normally considered to be of little consequence in a younger adult may cause significant morbidity in an elderly individual and may have a negative impact on quality of life. A number of adverse drug effects can impact on an older person's ability to ambulate and participate in normal activities including: dizziness, mental status changes, weakness, decreased exercise tolerance, movement disorders and falls. Careful medication management may improve the patient's functional status and independence.

Accidental Falls↗
PubMed1983

Pharmacists' perceptions of geriatric pharmacy practice.

Four hundred thirty-two pharmacists from two separate pharmacy organizations associated with geriatric practice were surveyed to determine their perceptions of 51 content areas in terms of their importance for inclusion in pharmacy curricula. The population surveyed was also asked to respond to the question: What do you believe is the most difficult aspect of geriatric pharmacy practice? Demographic and descriptive information was collected for each respondent, for statistical purposes. The most important content areas for inclusion in pharmacy curricula were the pharmacist's responsibility in long-term care, patient compliance, drug interactions, adverse drug reactions, and psychotropic medication use. The most difficult aspects of geriatric pharmacy practice identified included inadequate geriatric knowledge, patient compliance, physician overprescribing, communication with the elderly, and lack of professional and/or financial recognition.

Attitude of Health Personnel↗
PubMed1978

Payment for nondistributive hospital pharmacy services--a regional survey.

Questionnaires were mailed to all (464) nongovernment, not-for-profit and investor owned for-profit hospital pharmacies in Washingon, Oregon and California. Responses were received from 350 institutions, a return rate of 75.4 percent. Pharmacists were asked to report data relating to the incidence of, the range of fees charged, and the extent of reimbursement received from third party carriers for the provision of nondistributive pharmacy services. The data received indicate that pharmacy consultation to physicians was provided by 77.9 percent of the respondents, drug therapy monitoring by 48.1 percent, generalized patient discharge consultation by 40.8 percent, CPR team participation by 27.2 percent, indepth patient discharge consultation by 17.5 percent and admitting medication history by 8.8 percent. Additionally, 12 institutions charged for providing 16 nondistributive pharmacy services. Directors of pharmacy from six hospitals indicated that they billed third party carriers for nondistributive pharmacy services as part of their total pharmacy charge via their usual billing procedure. All third party carriers billed in this manner paid for the nondistributive pharmacy service.

California↗
PubMed1978

Estimation of serum digoxin levels in geriatric patients.

The correlation in geriatric patients between estimated serum digoxin levels based on pharmacokinetic calculations and serum digoxin levels measured by radioimmunoassay was studied. Serum digoxin levels were estimated for 17 geriatric patients recieving digoxin using the "total body stores" concept. A statistically significant correlation between calculated and measured digoxin levels was shown (p less than 0.05, r = 0.51); however, 95% confidence limits were so large (+/- 1.75 ng/ml) that the results were clinically unacceptable. Until data describing specific causes of variance are available and calculations modified to account for specific variations, pharmacokinetic models should not be relied upon for accurate estimates of digoxin levels in geriatric patients.

Aged↗
PubMed1977

Pharmaceutical services in nongovernmental hospitals on the West Coast.

A survey of nongovernment, nonprofit and for-profit hospitals in Washington, Oregon and California was conducted to determine the incidence of selected hospital pharmacy services (1) directly related to drug distribution and (2) not directly related to drug distribution. Questionnaires were mailed to all qualifying hospitals in the three states; the return rate was 75.4%. Unit dose drug distribution was used in combination with other delivery systems by 58.3% of the respondents; 26.5% used unit dose exclusively. Over half of the respondents provided i.v. admixture programs, outpatient and inpatient discharge prescriptions, and inpatient medication profiles. Additionally, 77.9% provided pharmacy consultation to physicians. Nonprofit hospitals had significantly higher pharmacy staffing levels (both pharmacists and supportive personnel) than for-profit hospitals in the categories, "open seven days per week," "open nine to 16 hours per day," "open 17 to 24 hours per day, "101 to 200 beds" and "201 or more beds." Hospitals that provided the following services had significantly higher pharmacy staffing levels than those that did not provide the serices: unit dose drug distribution, i.v. admixture services, inpatient discharge prescriptions, inpatient medication profiles, drug therapy monitoring, and cardiopulmonary resuscitation team participation (difference of supportive staff only).

Hospitals, Proprietary↗