PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Obstacles”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1992

Preoperative evaluation. Medical obstacles to surgery.

The primary curative therapy for colorectal cancer is surgical resection. In addition, surgery is the mainstay for palliative therapy in most patients with more advanced colorectal cancer. Medical problems may have an impact on the decisions of when to operate and what procedure to do. Postoperative morbidity and mortality are affected by preoperative medical conditions. These medical problems may be secondary to the carcinoma, such as obstruction, perforation with sepsis, or malnutrition, or may be a result of underlying disorders, especially cardiopulmonary diseases. Adequate evaluation and indicated therapeutic intervention before surgical procedures will improve the patient's outcome.

Adult↗
PubMed1992

Clinicians and research: recurring obstacles and some possible solutions.

We surveyed clinicians in residential treatment centers (RTCs) to explore their perceptions of barriers to and resources for accomplishing research and scholarly pursuits. A nationwide sampling of RTCs generated a sample of 273 respondents, which consisted of 95 psychologists, 27 psychiatrists, and 151 social workers. Our sample of clinicians expressed very favorable attitudes toward research and the scientist-practitioner model. However, the great majority are not combining the roles of clinician and researcher/scholar. The most frequently cited barriers to scholarly activity were insufficient time, research not part of the job description, and lack of funding. Recommendations are offered.

Attitude of Health Personnel↗
PubMed1989

Obstacles to organ donation.

Attitudes towards transplantation were investigated in national surveys of the general public (n = 1471), the medical profession (n = 590) and key clinical staff in units referring potential organ donors (n = 380). A clear majority of doctors would like to see more transplants. Only 16 per cent of doctors opposed them on cost grounds, and a 50 per cent 5-year survival rate is seen as more than adequate clinical justification. However, doctors are less supportive of liver and heart grafts than of kidney and cornea grafts. Few lay people would refuse donation of specific organs, but 30 per cent worry that doctors might be pressured into removal of organs when they are not sure the patient is dead. Religious or moral objection is rare. Intensive care unit staff felt the most important factor restricting organ harvest in their own units was dislike of adding to relatives' distress, followed by lack of training in approaching relatives and adverse media publicity. Only 11 per cent thought reservations on brain stem death a likely or possible influence. Enhanced public awareness of the need for transplants was seen as the most important means of increasing organ harvest. Required request would be controversial and perhaps impossible to implement. We conclude that the time, effort and expense involved in potential organ donation do not play a substantial part in limiting referral. Neither do reservations about brain stem death. Increased training of staff (both in communication skills and in the professional responsibility to encourage donation) and greater public awareness are seen as the twin foundations of a realistic approach to enhancing referral.

Adult↗
PubMed2002

Obstacles to human hematopoietic stem cell transduction by recombinant adeno-associated virus 2 vectors.

Recombinant adeno-associated virus 2 (AAV) vectors have proven to be a potentially useful alternative to the more commonly used retroviral and adenoviral vectors for gene therapy in humans. Their safety and efficacy in Phase I clinical trials for gene therapy of cystic fibrosis and hemophilia B have been well documented, and their remarkable versatility and efficacy in a wide variety of pre-clinical models of human diseases have catapulted these vectors to the forefront. AAV vectors have been shown to be particularly well suited for transduction of brain and muscle cells. However, controversies exist with regard to their utility as a vector for gene transfer into human hematopoietic stem cells. On the one hand, some investigators have concluded that AAV vectors do not transduce hematopoietic stem cells at all, and others have reported that stem cell transduction requires enormously high vector-to-cell ratios. On the other hand, some investigators have reported high-efficiency transduction of human hematopoietic stem cells at low vector-to cell ratios. This article will provide a historical perspective as well as attempt to elaborate the reasons behind these controversies which have become clearer by studies focused on understanding, at the molecular level, the fundamental aspects of the life cycle of recombinant AAV vectors.

Animals↗
PubMed1994

Overcoming obstacles to metastasis--defenses against host defenses: osteopontin (OPN) as a shield against attack by cytotoxic host cells.

Osteopontin (OPN) serves both a cell attachment function and a cell signalling function via the alpha v beta 3 integrin. In its cell attachment capacity it can promote attachment of both osteoclasts to bone hydroxyapatite and various other cell types to basement membrane/extracellular matrix. In its cell signalling capacity it initiates a signal transduction cascade that includes changes in the intracellular calcium ion levels and the tyrosine phosphorylation status of several proteins including paxillin. Effects on gene expression include suppression of the induction of nitric oxide synthase by inflammatory mediators. OPN can also reduce cell oxidant levels and inhibit the killing of tumor cells by activated macrophages and endothelial cells. We hypothesize that those cancer cells that produce OPN at elevated levels can suppress the oxidative burst, inhibit NO production, and thus protect themselves from killing by specific host cell types.

Amino Acid Oxidoreductases↗
PubMed1989

Impact of blood glucose monitoring on diabetic control: obstacles and interventions.

Despite frequent use in the management of diabetes mellitus, self-monitoring of blood glucose (SMBG) is not achieving its potential therapeutic impact. Among the behavioral factors which may interfere with the improvement of diabetic control through SMBG are noncompliance and inadequate utilization of obtained blood glucose data. This paper reviews the research concerning these issues, including estimates of the prevalence and clinical significance of each of these limiting factors and an evaluation of assessment and intervention strategies which have been investigated. The methodological problems encountered in attempts to demonstrate that SMBG behaviors affect diabetic control are discussed. Although the existing research literature provides very weak evidence linking SMBG behaviors and diabetic control, the author asserts that it is premature to conclude that such relationships cannot be established and maintained.

Blood Glucose Self-Monitoring↗
PubMed1980

The public's current beliefs about mental illness: serious obstacle to effective community psychology.

A demythologizing, educational approach to the community is outlined and recent empirical studies are summarized which demonstrate that beliefs in favor of the mental illness concept can be significantly changed. Such conceptual change, reflecting an acceptance of a psychosocial paradigm of psychological problems, apparently induces a seminar participants a number of desirable effects from a community psychology perspective: an increased positive image of the mental patient, increased positive self-attributions, decreased fear ratings of mental patients, and a decreased fear of becoming insane. The importance of these findings for community psychology is discussed.

Adult↗