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PubMed1990

Effects of dexamethasone on the availability of L-tryptophan and on the insulin and FFA concentrations in unipolar depressed patients.

Several authors have shown that the availability of L-tryptophan (L-TRP) in the serum is lower in patients with major depression than in controls. It has recently been reported that the administration of a dose of dexamethasone sufficient to cause cortisol suppression also caused significant decrements in the availability of L-TRP. In order to elucidate the putative pathophysiological mechanisms underlying this decreased L-TRP disposition, the authors examined 37 depressed women categorized according to the DSM-III. L-TRP, the sum of five competing amino acids (CAA), the L-TRP/CAA ratio, and insulin and free fatty acid (FFA) levels were determined both before and after oral administration of 1 mg dexamethasone. The availability of L-TRP was significantly lower in depressed women with melancholia compared with simple major and minor depressives. The baseline disposal of L-TRP was related neither to insulin nor to FFA concentrations Dexamethasone administration significantly reduced the L-TRP and L-TRP/CAA values and increased FFA and insulin levels. Postdexamethasone L-TRP and FFA levels were significantly and positively correlated.

Adjustment Disorders↗

PubMed1988

Control of bovine placental progesterone synthesis: roles of cholesterol availability and calcium-activated systems.

It was previously reported that dispersed bovine placentome secretes progesterone and that the steroidogenic activity of these cells is stimulated by a calcium-mediated, cyclic nucleotide independent mechanism. In the present study, the influence of substrate availability was explored and the roles of calmodulin and protein kinase C in progestin production examined. Incubation of dispersed fetal cotyledon cells with 25-hydroxycholesterol (25-OH-C), a soluble sterol which readily enters cells and is metabolized to steroid hormones, increased progesterone secretion in a dose-dependent manner. The response to 25-OH-C was dependent on the extracellular calcium concentration. Methyl isobutyl xanthine (MIX) alone also increased pregnenolone as well as progesterone secretion, and the combination of 25-OH-C and MIX stimulated progesterone secretion was inhibited by trifluoperazine. The phorbol ester, 12-O-tetradecanoyl-phorbol-13-acetate (TPA), caused no major effects on steroidogenesis but the stimulatory effects of MIX or the ionophore A23187 were enhanced in its presence. These findings suggest that (1) basal progesterone secretion by fetal cotyledon cells is limited by cholesterol availability; (2) MIX increases steroidogenesis in part by increasing the synthesis of pregnenolone, but its actions are expressed independently of cholesterol availability; (3) both calmodulin and protein kinase C may participate in the modulation of bovine placental steroidogenesis.

1-Methyl-3-isobutylxanthine↗

PubMed1995

Assessment of two-dose vaccination schedules: availability for vaccination and catch-up strategies.

An age-specific transmission model is used to discuss aspects of two-dose vaccination schedules. Motivated by measles, the model allows for a period of maternally acquired immunity and assumes that infection leads to permanent immunity. The model expresses the coverage at the second dose in terms of the availability of individuals for vaccination, where availability depends on whether the individual received the first vaccination and the time between the first and second doses. It is emphasized by illustration that medium-term performance is a more appropriate assessment of vaccination schedules than eventual outcome, particularly since elimination of measles does not seem possible at this time. Failure to take account of individuals' availability for vaccination when designing vaccination schedules can lead to a poor control strategy and to unjustified optimism. When disease transmission is in equilibrium, an instantaneous change to a vaccination schedule with high coverage often results in a period of low incidence followed by a series of substantial epidemics occurring over a long period of time. A gradual increase to the same level of vaccination can dampen these epidemic waves significantly and gives similar numbers of cases in the medium and long terms. It is found that a strategy based on doses offered at ages 1 and 11 years is far from optimal, but the inclusion of a catch-up vaccination at school entry, offered only to previously unvaccinated individuals, can improve this two-dose strategy dramatically.

Age Factors↗

PubMed1996

Traumatic childhood events, perceived availability of emotional support, and the development of dissociative tendencies.

Past research has documented a link between childhood traumatic experiences and dissociative tendencies in adulthood. This study was undertaken to investigate the possibility that the previously reported link is purely an artifact of the level of emotional support available during childhood. A nonclinical sample of Australian adults was surveyed for the incidence of traumatic childhood events, the perceived availability of emotional support from intrafamilial and extrafamilial figures, and the presence of a dissociative coping style. Hierarchical regression analysis revealed that perceived availability of emotional support in childhood was a predictor of current dissociative tendencies, but account of the support factor did not eliminate the relationship between childhood trauma and dissociation. The data are consistent with the view that lack of emotional support is an important mediator, but not a primary cause, of the development of dissociative tendencies.

Adolescent↗

PubMed1986

An NMR study on the effect of glucose availability on carbohydrate metabolism in Dipetalonema viteae and Brugia pahangi.

Adult Brugia pahangi and Dipetalonema viteae utilise a percentage of absorbed glucose (ca. 15%) in the formation of the disaccharide trehalose [8]. This paper reports an investigation, employing 13C-NMR techniques, of the utilisation of trehalose by these nematodes and also the effect of glucose availability on metabolic product composition. The metabolism of [1-13C]trehalose in D. viteae differed dramatically from that of [1-13C]glucose under normal experimental conditions. A succinate/lactate ratio of 0.73 was obtained from the metabolism of [1-13C]trehalose compared with 0.05 from [1-13C]glucose at an initial concentration of ca. 5 mM. Similar, but less consistent, results were obtained from B. pahangi adults. Macrofilariae of D. viteae were fed variable, low levels of glucose at hourly intervals for 8 h, and a significant relationship (P less than 0.001) between the glucose addition rate and the ratio of succinate to lactate production was obtained. The lower the amount of glucose added each hour, the higher was the observed succinate to lactate ratio. The percentage yield of succinate increased greatly as the amount of added glucose was diminished. Parallel experiments performed on B. pahangi macrofilariae indicated that B. pahangi did not increase their succinate output so greatly with reduced glucose availability. It is clear that in the absence of available external glucose, B. pahangi and D. viteae draw on their internal trehalose reserves as a source of carbohydrate for energy generation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1989

Students performance vs. hospital performance in the labor market for medical interns and residents. Do hospitals perform better due to asymmetry in information available to them relative to students?

This paper concerns the labor market for medical interns and residents in the U.S., and in particular, the question of whether the current matching mechanism between graduating medical students and hospitals is 'informationally inefficient'. It was found that overall students performed better than hospital programs in contrast to the common claim that hospitals are more likely to perform better due to seeming superiority in analyzing publicly available information or through access to non-publicly available information. We also conducted a similar analysis for the different specialty programs. In six specialty programs the students' performance was better than hospitals, in two specialty programs the hospitals performance was better than the students and in 14 specialty programs the difference in performance was not statistically different from zero. Thus, only in two cases the hypothesis that the specialty market is informationally inefficient cannot be rejected using the data available. It should be noted that this market is atypical (compared with other labor markets) in that we can test whether it is informationally inefficient by using a practical definition adopted from the field of finance.

Algorithms↗

PubMed1995

The changing availability of residential aged care in Australia.

Australian aged care services have undergone a series of substantial reforms in recent years under the rubric of the Aged Care Reform Strategy. Overall, there has been a progressive refinement of the targeting of available services on those most in need, defined in terms of both disability levels and financial resources. A key component of this process has been a deliberate reduction in the relative emphasis accorded to nursing home care within the aged care system. This has been accompanied by increases in the resources directed toward less intensive forms of residential care (hostels) and community based services. This paper explores the actual consequences of these intentional policy changes in terms of the availability of nursing home and hostel care, and the changing characteristics of nursing home residents. The results suggest that a more substantial reduction has occurred in the availability of nursing home care than has hitherto been suggested, with consequent decreases in the proportion of aged persons in nursing homes. The effect has been particularly marked amongst women and the very old. These findings raise policy questions about the appropriateness of current and planned future levels of provision.

Aged↗

PubMed1994

Morphological and biochemical characterization of influenza vaccines commercially available in the United Kingdom.

Four vaccines are available in the United Kingdom against influenza virus. All are subunit vaccines, defined as either split-virion or purified surface antigen vaccine; there are two of each distinct type available. Both vaccine types are less reactogenic than whole inactivated virus, with antigenicity induced by viral surface glycoproteins. Here, each of the four vaccines has been characterized by electron microscopy and SDS-PAGE analysis, giving a unique vaccine profile. Three vaccines contain internal viral nucleoprotein which, in the presence of residual haemagglutinin, may induce an influenza A virus cross-reactive cytotoxic T-cell response and thus be of value to vaccine efficacy. Residual lipid was present in three vaccines and recent evidence suggests that pyrogenicity is correlated with the presence of viral lipid with clusters of surface glycoproteins. By a combination of electron microscopic evidence and biochemical characterization, it has been possible to resolve compositional differences, not only between vaccine type, but also between each individual currently available vaccine. Hence, there is the possibility that the morphological differences characterized here may be contributory to potential reactogenic effects subsequent to vaccination.

Blotting, Western↗

PubMed1996

Measurement of biologically available organic material in intertidal sediments subject to inputs of sea coal or colliery wastes.

A method for the measurement of biologically available organic matter in intertidal or subtidal marine sediments subject to an input of sea coal or colliery wastes is described. The method involves boiling sediment in hydrogen peroxide (H2O2) for 4 h at 160 degrees C to dissolve non-colliery waste organic matter which is then recorded as weight lost after rinsing and drying. Samples are then ashed at 495 degrees C to determine the weight of coal or colliery wastes present. Although H2O2 shows a slight reaction with colliery wastes (overall mean of 0.86% weight loss), it is appropriate to use this technique for the determination of organic matter available to sediment-dwelling biota. We show that shore organic content should not be determined merely by ashing sediment, even on shores which do not appear to contain wastes, since even visibly 'clean' shores in north-east England generally contain some coal fragments in their sediment. Our method is suitable anywhere where biologically available organic matter needs to be measured independently of waste content, e.g. in terrestrial systems close to centres of mining activity.

Journal Article↗

PubMed1985

Acid modification of thermal damage and its relationship to nutrient availability.

The purpose of this present investigation was to determine if the presence of exogenous nutrients constitutes a prerequisite for acid modification of thermal damage and to determine if thermal cytotoxicity is affected by nutrient availability under acid conditions. To this end, Chinese hamster ovary cells (CHO) were heated (42 degrees or 43 degrees C) and/or irradiated in either McCoy's medium containing 10% fetal bovine serum or glucose free Hanks Balanced Salt Solution (HBSS). Both thermal sensitivity and thermal radiosensitization were increased when CHO cells were treated under acid conditions (e.g., pH 6.8) compared to alkaline conditions (e.g., pH 7.2), independent of the media used. Furthermore, decreasing nutrient availability increased thermal cytotoxicity, but the increase was greatest at pH 7.2 compared to pH 6.8. This study indicates that thermal sensitivity is more dependent upon pH than upon nutrient availability.

Animals↗

PubMedDate not supplied

Periodic availability: factors affecting alcohol selection in rats.

The joint influence of alcohol availability conditions and alcohol concentration on the acquisition and maintenance of alcohol selection was examined in non-alcohol preferring Sprague-Dawley rats. Relative alcohol selection increased gradually in rats given periodic access to 10% alcohol but was immediately apparent in rats given periodic access to 5% alcohol. Rats given continuous access to alcohol (either forced or choice) did not show similar increases in alcohol selection until switched to the periodic schedule. The increases were not sustained in any group when alcohol became continuously available. Comparable increases in alcohol selection were evident in rats given periodic access to alcohol on various fixed schedules or on a random schedule. Several factors appear to influence the degree of alcohol selection under conditions of periodic availability: alcohol concentration, nature of prior experience with alcohol, the frequency of access to alcohol, the regularity of the periodic access to alcohol, and differences in individual responsivity to the schedule variable.

Alcohol Drinking↗

PubMedDate not supplied

Impact of changes in distilled spirits availability on alcohol distribution.

An important change in the distribution and availability of distilled spirits in North Carolina has resulted from a move to liquor-by-the-drink. Previously drinkers had to plan to bring distilled spirits with them to eating establishments and purchase mixers and ice; LBD eliminates the need for such planning and makes liquor more easily available. The shift from more restrictive to less restrictive availability does not occur immediately after a local election but is gradual over a two-year period following a local election.

Alcoholic Beverages↗

PubMed2005

The beer campaign in Stockholm--Attempting to restrict the availability of alcohol to young people.

A number of Swedish studies have indicated that it is easy for underaged youths to purchase medium strength beer in grocery shops. The aim of this study was to follow the effects of a community action-based intervention involving information/training of parents, police, and shopkeepers, media advocacy, and monitoring of the sales of beer to underaged youths. Eighteen-year-old students, looking younger, attempted to purchase a six-pack of medium strength beer in grocery shops without showing ID. A questionnaire about perceived availability was distributed among ninth-grade students. Surveys of parental awareness and shopkeepers' attitudes were also conducted. A significant decrease in sales was observed in both the intervention area (from 73% of all purchase attempts to 44%) and in the comparison area (from 60% to 44%). No significant difference was found between the intervention and the comparison areas, in part due to a contamination effect in the comparison area, where similar activities were conducted by the local community. Perceived availability by teenagers did not change. Following the intervention, availability to medium strength beer for young people in the intervention area decreased, but remained high. It is possible that this moderate reduction was due to the intervention but the same is not certain, given the developments in the comparison area. The intervention was primarily based on information and training, whereas a policy of surveillance and sanctions in the comparison area appears to have achieved the same result, with lesser resources. The study also illustrates the feasibility of engaging parents in community action for prevention purposes.

Adolescent↗

PubMed2006

The availability and cost of healthier food alternatives.

BACKGROUND: Many people, especially low-income consumers, do not successfully follow dietary recommendations to eat more whole grains and less fat and added sugar. The food environment may have a significant impact on the choice by low-income consumers to eat healthier foods, as both the availability and price of healthier food items may limit their ability to eat a healthier diet. We investigated the cost and availability of a standard market basket of foods, and a healthier basket that included low-fat meat and dairy and whole grain products. METHODS: Market-basket surveys were conducted in 25 stores in Los Angeles and Sacramento. Stores were selected from neighborhoods that were varied by income and surveyed three times from September 2003 to June 2004. The average cost of a standard market basket (based on the U.S. Department of Agriculture's Thrifty Food Plan [TFP]) and a healthier market basket was calculated from these prices and compared using a standard t-test to determine if they were significantly different from each other. The analysis was conducted in 2005. RESULTS: In neighborhoods served by smaller grocery stores, access to whole-grain products, low-fat cheeses, and ground meat with <10% fat is limited. Among all items that were unavailable, 64% were in small grocery stores. For the 2-week shopping list, the average TFP market-basket cost was $194, and the healthier market-basket cost was $230. The average cost of the healthier market basket was more expensive by $36 due to higher costs of whole grains, lean ground beef, and skinless poultry. The higher cost of the healthier basket is equal to about 35% to 40% of low-income consumers' food budgets of $2410 a year. CONCLUSIONS: The lack of availability in small grocery stores located in low-income neighborhoods, and the higher cost of the healthier market basket may be a deterrent to eating healthier among very low-income consumers. Public policies should take the food environment into account in order to develop successful strategies to encourage the consumption of healthier foods.

California↗

PubMed2004

Consumer behavior in the setting of over-the-counter statin availability: lessons from the consumer use study of OTC Mevacor.

Despite the proven benefits of statins, large numbers of patients meeting guideline criteria for therapy are not receiving these drugs. It has been suggested that over-the-counter (OTC) availability of statins would allow more consumers to use statins and achieve cardiovascular risk reduction. However, concerns have been raised as to the consumers' ability to self-manage hyperlipidemia and use statins safely. The Consumer Use Study of OTC Mevacor (CUSTOM) was designed to define consumer behaviors in the setting of OTC statin availability. The study was conducted in a simulated OTC setting and allowed consumers to purchase once-daily lovastatin 20 mg. The CUSTOM dataset includes >3,300 consumers who evaluated OTC lovastatin for potential purchase at study sites and follow-up information on purchasers for up to 6 months of self-managed therapy. These data have been analyzed to address consumers' knowledge of their cholesterol concentrations as well as their ability to make OTC use decisions based on their cardiovascular risk, avoid drug-drug interactions, self-manage their cholesterol treatment after deciding to use the OTC product, and maintain interactions with physicians while using lovastatin OTC. The results showed that most study participants appropriately self-selected OTC statin therapy and managed their treatment. Use of OTC statins by consumers needing more intensive statin therapy or facing the risk of potential drug-drug interactions remains an area of concern but occurred infrequently in CUSTOM. These data are important for making an informed risk-benefit decision concerning OTC statin availability.

Anticholesteremic Agents↗

PubMed2004

Closure of long surgical incisions with a new formulation of 2-octylcyanoacrylate tissue adhesive versus commercially available methods.

BACKGROUND: Topical 2-octylcyanoacrylate tissue adhesive is an alternative to traditional devices for closing short surgical incisions. METHODS: An open-label, randomized study compared a new high-viscosity formulation of 2-octylcyanoacrylate with commercially available devices, including low-viscosity 2-octylcyanoacrylate, for epidermal closure of incisions > or = 4 cm requiring subcutaneous and/or deep-dermal suturing. RESULTS: Of patients with 1 to 3 wounds, 106 were treated with high-viscosity 2-octylcyanoacrylate and 103 with commercially available devices. The day-10 rates of healing by wound were 96% and 97% for study versus control treatment and 97% and 95% for new and old 2-octylcyanoacrylate formulations versus other controls, respectively. Day-10 infection rates by wound were 4 of 145 versus 7 of 131 for study versus control treatment and 6 of 207 and 5 of 69 for new and old 2-octylcyanoacrylate versus other controls, respectively. CONCLUSIONS: The new tissue adhesive formulation provides epidermal wound closure equivalent to commercially available devices with a trend to decreased incidence of wound infection.

Administration, Topical↗

PubMed2006

Availability, stability, and sterility of pralidoxime for mass casualty use.

STUDY OBJECTIVE: Pralidoxime is indicated to treat patients poisoned with nerve agents. It is available in intravenous formulation for more seriously ill hospitalized patients and intramuscular formulation for field treatment and less seriously ill patients. Our study describes a method to convert the intramuscular formulation for intravenous use and determines the stability and sterility of the resulting formulation over time and under various environmental conditions. METHODS: An inventory was taken of all intravenous (Protopam) and intramuscular (Mark I Autoinjector kits) pralidoxime available in Franklin County, Ohio hospitals, and out-of-hospital stockpiles. A method was devised to safely convert the intramuscular pralidoxime to an intravenous formulation, which was then tested for stability and sterility under a variety of environmental temperatures over time. RESULTS: In Franklin County, Ohio (population 1.1 million), the 10 acute care hospitals and out-of-hospital community have 36 g of intravenous pralidoxime and 4,398 g (7,270 Mark I kits) of intramuscular pralidoxime. The reformulated pralidoxime retained greater than 90% stability and remained sterile at all environmental temperatures through day 28. CONCLUSION: Available pralidoxime in Franklin County is predominantly in the intramuscular preparation. Conversion of intramuscular to intravenous pralidoxime results in a stable and sterile solution for up to 28 days under a variety of environmental conditions and should be considered in a mass casualty situation in which additional intravenous supplies are needed.

Antidotes↗

PubMed2006

Survey of California emergency departments about practices for management of suicidal patients and resources available for their care.

STUDY OBJECTIVE: To determine the resources available and current practices for the treatment of patients with suicidal ideation or attempts in California emergency departments (EDs). METHODS: We conducted a mail and e-mail survey of the directors of all 346 EDs in the state of California. Data collected included identification of hospital and respondent, type of hospital, presence of separate psychiatric ED, total number of ED patients and number of ED patients with suicidal ideation or attempts who were treated per week, mental health personnel on call to evaluate suicidal patients, criteria for patient disposition, available disposition options, delays in patient care, changes desired in the ED treatment of suicidal patients, and adequacy of community resources for suicidal patients. RESULTS: Two hundred twenty-three of 346 (64.5%) ED directors responded to the survey. Overall, the mean estimate of the proportion of ED visits by suicidal patients was 1.7%. Though evaluation of patients with suicidal ideation by a mental health professional was the usual practice, 51 respondents (23%) reported that they occasionally send patients with suicidal ideation home without such an evaluation, and 8.5% reported this was done more than 10% of the time. No single type of mental health professional, including psychiatrist, social worker, county or private psychiatric evaluation team, psychiatric nurse, or psychologist, was available for evaluation of suicidal patients in more than 50% of respondent EDs. In the majority of EDs, psychiatric evaluations were performed by either mobile county or private psychiatric evaluation teams or social workers on call to the ED. Psychiatrists were reported to evaluate the majority of suicidal patients in only 10% of EDs. Only 27% of respondents had the ability to admit patients to a psychiatric service at their hospital. When patients needed to be transferred, the estimated mean wait for these transfers was 7 hours. Seventy-one percent of respondents reported needing improved access to mental health personnel for evaluation of suicidal patients; 61% reported needing improved access to mental health personnel for patient disposition. CONCLUSION: In California EDs, there are limited mental health services for suicidal patients. Regional solutions to emergency and nonemergency mental health problems are needed, including improved access to mental health personnel for ED evaluation, disposition, and follow-up of suicidal patients and community mental health resources for patient referrals.

Adolescent↗