Association between life stress and serious perinatal complications.

The association between stressful life changes, social supports, and serious complications of pregnancy was measured in 513 women obtaining prenatal care in four rural family practices. Those women whose life change score (LCS) increased from the second to the third trimester had a significantly higher rate of poor outcomes (neonatal death, transfer to a neonatal intensive care unit, birthweight less than 2500 g or 5-minute Apgar score less than 7) than those whose LCS did not increase (9.2% vs 3.

Do calcium antagonists protect the human hypertensive kidney?

The natural course of essential hypertension, and hypertension associated with advanced renal parenchymal disease, is characterized by a progressive deterioration of renal function. If calcium antagonists can control both systemic and glomerular hypertension, they may be able to attenuate this process. Short-term studies in our laboratory suggest that the calcium antagonists amlodipine, diltiazem, and nifedipine preserve and/or improve renal function; there were no adverse effects on glomerular filtration, effective renal plasma flow, and/or urinary protein excretion.

Gastroesophageal reflux disease. Medical aspects.

Symptomatic gastroesophageal reflux is one of the most common complaints encountered by clinicians. The pathogenesis of reflux remains unclear, but multiple factors are involved. Heartburn is the most common clinical manifestation.

Gastroesophageal reflux disease. Identification and management of the surgical patient.

Antireflux surgery remains the most reliable and expedient means of treating patients with a mechanically defective lower esophageal sphincter who are experiencing pathologic gastroesophageal reflux. Identifying these patients, who are known to have a poor response to medical therapy, permits control of the reflux process before serious complications develop. Well-planned and precisely performed antireflux surgery by an experienced medical team will enhance reflux control and reduce postoperative complications.

Dysphagia. Diagnostic pitfalls and how to avoid them.

Oropharyngeal and esophageal dysphagia involve different phases of swallowing, have different causes, and can usually be distinguished by a thorough patient history. Initial evaluation of patients with suspected oropharyngeal dysphagia includes patient history, physical and neurologic examination, and careful videofluoroscopic study of pharyngeal dynamics. Initial evaluation of patients with suspected esophageal dysphagia includes patient history and barium swallow with esophagography.

Financing graduate medical education in family medicine.

Family practice residency programs differ fiscally from residency programs in most other specialties because they have limited income-generating potential. The present review demonstrates that the typical family practice residency program has been fiscally solvent as a result of receiving approximately one-third of its income from state and federal appropriations. The level of such support plateaued in the 1980s and programs have not continued to expand despite an ongoing shortage of family physicians.

Fibromyalgia: a rehabilitation approach. A review.

Primary fibromyalgia syndrome, a myofascial disorder, is characterized by diffuse pain and tender points. Effective long term rehabilitation interventions for this disorder have not been demonstrated. The current rehabilitation interventions of fibromyalgia are evaluated and the psychologic consequences are summarized.

The murine MHC class I genes, H-2Dq and H-2Lq, are strikingly homologous to each other, H-2Ld, and two genes reported to encode tumor-specific antigens.

Two phenomena appear to distinguish the D region class I genes from those in the K region in the murine MHC: (a) haplotype disparity in the number of expressed D region class I molecules has been observed; and (b) clines of closely related D region class I molecules among and within mice of different H-2 haplotypes can be defined. Both of these observations have been based on serological and peptide mapping analyses of these molecules. Recent reports using molecular biological approaches have corroborated these findings.

Motor-evoked potentials of facial musculature in dogs.

Motor responses of limb musculature have been elicited by transcranial brain stimulation using electrical and magnetic stimulation. Recording from muscles innervated by cranial nerves has not previously been reported. A unilateral hemispheric craniotomy was performed in 24 dogs.

Motor-evoked potentials of tongue musculature in dogs.

Transcranial brain stimulation by either electrical or noninvasive magnetic stimulation has produced motor responses of limb musculature. However, recordings from muscles innervated by cranial nerves have not previously been reported. A right-sided craniotomy was performed in 18 dogs.

Alterations in regional catecholamine content and turnover in the male rat brain in response to in utero ethanol exposure.

Fetal ethanol exposure is known to produce CNS abnormalities. The molecular basis for these manifestations observed in animals exposed to ethanol in utero may be explained by changes in regional catecholamine content and turnover. This study was designed to determine changes in catecholamine content and turnover in the cerebral cortex, cerebellum, medial basal hypothalamus, diencephalon, and septal area of male rats exposed to ethanol pre- and postnatally.

Fluorescence intensity of immunostained cells as a diagnostic aid in lymphoid leukemias.

The standardized fluorescence intensity (FI) of immunostained normal and malignant B-cells was measured as a method of evaluating cellular heterogeneity between lymphoid malignancies. Mature B-cells from peripheral blood lymphocytes (PBL) of different individuals demonstrated characteristic peaks of FI when specific monoclonal antibodies (MoAbs) were employed in standard flow cytometric procedures. Malignant cells from patients with lymphoid leukemias demonstrated FI that differed from that of normal B-cells with various MoAbs and that differed among categories of leukemia.

The health belief model and attendance for prenatal care.

Adequate prenatal care as defined by timely initiation and completion of prenatal visits has been frequently associated with good perinatal outcomes. Health beliefs and other psychosocial and demographic variables were explored in a cohort of 255 rural recently delivered women to determine the important correlates with adequate prenatal care. Respondents' health beliefs relating to pregnancy and prenatal care were assessed with an instrument with acceptable construct validity and reliability.

Phase II trial of 4'-deoxydoxorubicin (DxDx) in non-small cell lung cancer: a Cancer and Leukemia Group B Trial.

Eighty-seven patients with histologically or cytologically proven non-small-cell carcinoma of the lung were treated with 4'-deoxydoxorubicin (DxDx) 30 mg/m2 every 3 weeks. Three responses (4%), all partial, were observed. All responses occurred in patients with large-cell anaplastic lung cancer and none in squamous or adenocarcinoma histologies (P less than 0.

Major depression in cardiology chest pain patients without coronary artery disease and with panic disorder.

104 patients in a cardiology clinic with atypical or non-anginal chest pain were studied through a structured clinical interview. 43 without coronary artery disease fit diagnostic criteria for panic disorder. 19 (44%) of this group reported a lifetime prevalence of major depression, nine (21%) current and ten (23%) past only.

Collecting cancer registry data with a Cancer Patient Questionnaire.

Tumor registries provide a valuable source of treatment, survival, and epidemiologic data but have been faulted for incomplete and insufficient collection of data. An eight page, 38-item Cancer Patient Questionnaire (CPQ) was developed to collect more extensive information for the tumor registry. The CPQ identified significantly more patients with a family history of cancer than had previously been detected by chart review by the tumor registrar.