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Biomedical subjects

A Franks

Publications and source records attributed to A Franks.

At least 19 recordsLinked to original sources
PubMed2001

How goes the night, watchman? An overview of the first annual clinical governance reports (1999/2000) from acute trusts in an English NHS region.

A review of 21 annual clinical governance reports for the period up to April 2000 reveals significant variation in presentation and content. There are certain common themes discernible, particularly concerns about audit and clinical incident reporting by doctors, and the frequent organisational separation of risk from other elements of clinical governance. Patient involvement and reference to a specific model for quality attainment were infrequent. It is concluded that while these reports can give insights into the perceived priorities of organisations and thus could stimulate others to consider their own approach, the value of these reports as a means of performance management or as a vehicle for informing users is uncertain.

Annual Reports as Topic↗
PubMed2000

Anthropometric and physiological predispositions for elite soccer.

This review is focused on anthropometric and physiological characteristics of soccer players with a view to establishing their roles within talent detection, identification and development programmes. Top-class soccer players have to adapt to the physical demands of the game, which are multifactorial. Players may not need to have an extraordinary capacity within any of the areas of physical performance but must possess a reasonably high level within all areas. This explains why there are marked individual differences in anthropometric and physiological characteristics among top players. Various measurements have been used to evaluate specific aspects of the physical performance of both youth and adult soccer players. The positional role of a player is related to his or her physiological capacity. Thus, midfield players and full-backs have the highest maximal oxygen intakes ( > 60 ml x kg(-1) x min(-1)) and perform best in intermittent exercise tests. On the other hand, midfield players tend to have the lowest muscle strength. Although these distinctions are evident in adult and elite youth players, their existence must be interpreted circumspectly in talent identification and development programmes. A range of relevant anthropometric and physiological factors can be considered which are subject to strong genetic influences (e.g. stature and maximal oxygen intake) or are largely environmentally determined and susceptible to training effects. Consequently, fitness profiling can generate a useful database against which talented groups may be compared. No single method allows for a representative assessment of a player's physical capabilities for soccer. We conclude that anthropometric and physiological criteria do have a role as part of a holistic monitoring of talented young players.

Adolescent↗
PubMed2000

A multidisciplinary approach to talent identification in soccer.

The requirements for soccer play are multifactorial and distinguishing characteristics of elite players can be investigated using multivariate analysis. The aim of the present study was to apply a comprehensive test battery to young players with a view to distinguishing between elite and sub-elite groups on the basis of performance on test items. Thirty-one (16 elite, 15 sub-elite) young players matched for chronological age (15-16 years) and body size were studied. Test items included anthropometric (n = 15), physiological (n = 8), psychological (n = 3) and soccer-specific skills (n = 2) tests. Variables were split into separate groups according to somatotype, body composition, body size, speed, endurance, performance measures, technical skill, anticipation, anxiety and task and ego orientation for purposes of univariate and multivariate analysis of variance and stepwise discriminant function analysis. The most discriminating of the measures were agility, sprint time, ego orientation and anticipation skill. The elite players were also significantly leaner, possessed more aerobic power (9.0 +/- 1.7 vs 55.5 +/- 3.8 ml x kg(-1) x min(-1)) and were more tolerant of fatigue (P < 0.05). They were also better at dribbling the ball, but not shooting. We conclude that the test battery used may be useful in establishing baseline reference data for young players being selected onto specialized development programmes.

Adolescent↗
PubMed1998

Pulmonary and hepatic gene expression following cecal ligation and puncture: monophosphoryl lipid A prophylaxis attenuates sepsis-induced cytokine and chemokine expression and neutrophil infiltration.

Polymicrobial sepsis induced by cecal ligation and puncture (CLP) reproduces many of the pathophysiologic features of septic shock. In this study, we demonstrate that mRNA for a broad range of pro- and anti-inflammatory cytokine and chemokine genes are temporally regulated after CLP in the lung and liver. We also assessed whether prophylactic administration of monophosphoryl lipid A (MPL), a nontoxic derivative of lipopolysaccharide (LPS) that induces endotoxin tolerance and attenuates the sepsis syndrome in mice after CLP, would alter tissue-specific gene expression post-CLP. Levels of pulmonary interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), granulocyte colony-stimulating factor (G-CSF), IL-1 receptor antagonist (IL-1ra), and IL-10 mRNA, as well as hepatic IL-1beta, IL-6, gamma interferon (IFN-gamma), G-CSF, inducible nitric oxide synthase, and IL-10 mRNA, were reduced in MPL-pretreated mice after CLP compared to control mice. Chemokine mRNA expression was also profoundly mitigated in MPL-pretreated mice after CLP. Specifically, levels of pulmonary and hepatic macrophage inflammatory protein 1alpha (MIP-1alpha), MIP-1beta, MIP-2, and monocyte chemoattractant protein-1 (MCP-1) mRNA, as well as hepatic IFN-gamma-inducible protein 10 and KC mRNA, were attenuated in MPL-pretreated mice after CLP. Attenuated levels of IL-6, TNF-alpha, MCP-1, MIP-1alpha, and MIP-2 in serum also were observed in MPL-pretreated mice after CLP. Diminished pulmonary chemokine mRNA production was associated with reduced neutrophil margination and pulmonary myeloperoxidase activity. These data suggest that prophylactic administration of MPL mitigates the sepsis syndrome by reducing chemokine production and the recruitment of inflammatory cells into tissues, thereby attenuating the production of proinflammatory cytokines.

Adjuvants, Immunologic↗
PubMed1997

Whipple's disease without malabsorption: new atypical features.

The diagnosis of Whipple's disease in the absence of intestinal involvement is difficult and often overlooked. We describe five patients aged 8-71 years with normal jejunal biopsies and disparate clinical features, previously unrecognized in Whipple's; all were investigated at a single institution over a period of 18 months. Routine histological examination for periodic acid-Schiff (PAS) positive macrophages and polymerase chain reaction (PCR) analysis for Tropheryma whippelii was performed on the small intestine in all patients. PCR analysis was also performed on various tissues including peripheral blood, lymph node, muscle, synovium and spleen in individual patients. Patients 1, 2, 4 and 5 had unusual presenting features not previously associated with Whipple's: intractable immune thrombocytopenic purpura (ITP), juvenile chronic arthritis, isolated muscle weakness and quadriparesis, respectively. Patient 3 presented with pyrexia of unknown origin. All patients had histologically normal small-bowel biopsies with no evidence of PAS positive macrophages. PCR for T. whippelii was positive in all patients in one or more tissues: peripheral blood, intestine, muscle, lymph node and synovium. PAS-positive macrophages were found in 4/5 patients in various sites: lymph node, muscle, spinal cord. Whipple's disease presents with protean clinical features and should be considered in granulomatous disorders of unknown aetiology even in the absence of gastrointestinal involvement.

Actinobacteria↗
PubMed1997

Medical student teaching in a hospice--what do the patients think about it?

Hospital inpatients are regularly involved in medical student teaching. The Leicestershire Hospice recently became more involved in such undergraduate activity by teaching second-year students basic clinical skills. As this was a new venture for the unit, it was thought important to seek the patients' feelings about taking part. This was done by questionnaire following each teaching session. Overall, the patients seemed enthusiastic, enjoyed the experience and had clear ideas on what hospice staff should particularly aim to pass on to the students.

Attitude to Health↗
PubMed1995

Improvements in trauma survival in Leeds.

One hundred and eighty-six cases of major trauma (Injury Severity Score > 15) admitted to the two Leeds hospitals in 1988/89 were compared with 198 cases admitted in 1992/93 to ascertain if a system of trauma care which had evolved in the hospitals during this time had affected outcome of these patients. Injury severity score, age, and sex distribution were similar for the two groups. There were significantly fewer deaths in 1992/93, particularly in those patients with a score less than 41. It would appear that the emphasis, since 1988, on timely and definitive management of patients with major trauma has led to improved survival of the seriously injured in Leeds.

Adolescent↗
PubMed1993

Unilateral localized idiopathic lipoatrophy.

An adult female is described in whom an area of lipoatrophy spontaneously appeared over the right side of the abdomen and chest. Idiopathic lipoatrophy affecting the trunk is rare and mainly described in Japanese children. We describe the condition occurring in an adult British female.

Abdominal Muscles↗
PubMed1989

Desquamative inflammatory vaginitis. A case report.

The differential diagnosis of noninfectious desquamative inflammatory vaginitis includes pemphigus vulgaris, erosive lichen planus and benign mucous membrane pemphigoid. A 32-year-old woman had persistent, noninfectious, erosive vaginitis and linear deposits of IgA in the vaginal epithelial basement membrane zone. The differential diagnosis should be expanded to include mucosal involvement by linear IgA disease, a cutaneous vesiculobullous disorder.

Adult↗
PubMed1988

Simple laboratory experiments to replicate some of the stresses on vertebro-basilar arterial walls. An investigation of possible mechanisms of traumatic subarachnoid haemorrhage.

The hypothesis that reversed blood flow in transiently occluded vertebral arteries may be responsible for some cases of massive traumatic subarachnoid haemorrhage has been investigated in vitro. Simple laboratory tests were performed on 25 vertebro-basilar arterial systems, and succeeded in producing either longitudinal tears in normally structured vertebral arteries, or tears at the origin of the posterior inferior cerebellar arteries. The results indicated that under such conditions, with systolic blood pressure in the physiological range, reversed blood flow had different characteristics and stressed the arterial wall to the point where it yielded.

Adult↗