Biomedical subjects

B Castle

Publications and source records attributed to B Castle.

11 recordsLinked to original sources

PubMed1997

Gout is on the increase in New Zealand.

OBJECTIVE: To determine the current prevalence of hyperuricaemia and gout in New Zealand Maori and Europeans for comparison with previous studies. METHODS: 342 Maori and 315 European men and women aged 15 years and older were studied by personal interview and a musculoskeletal system examination. The 1977 ARA criteria for gout in a survey setting were used and serum uric acid was determined by a uricase method. The data were compared with those of previous New Zealand studies. RESULTS: Gout was significantly more common in Maori (6.4%) than Europeans (2.9%) (delta = 3.6%, 95% confidence interval 0.4 to 6.8) and in Maori men (13.9%) than in European men (5.8%) (delta = 8.1%, 95% CI 1.0 to 15.2). Hyperuricaemia was significantly more common in Maori men (27.1%) than in European men (9.4%) (delta = 17.7%, 95% CI 8.3 to 27.1) and in Maori women (26.6%) than in European women (10.5%) (delta = 16.1%, 95% CI 8.5 to 23.7). At least 14% of hyperuricaemic individuals were receiving diuretics, of whom 78% were women. Comparison with previous studies shows that the prevalence of gout has increased in both Maori and Europeans, particularly in men. In Maori men the prevalence of gout has risen from 4.5-10.4% previously to 13.9%, and in European men from 0.7%-2.0% previously to 5.8%. Clinical differences included a stronger family history, earlier age at onset, and a higher frequency of tophi and polyarticular gout in Maori than Europeans. Of those with gout, 62% of Maori and 63% of Europeans were hyperuricaemic on the day surveyed and six (19.4%) were on diuretics. Treatment of gout was inadequate in most cases. CONCLUSIONS: Hyperuricaemia and gout remain common among Maori. Of concern is that the prevalence of gout appears to be on the increase, not only in Maori but also in Europeans in New Zealand.

Adolescent↗

PubMed1996

Outcomes management: an interdisciplinary approach to improving patient outcomes.

Outcomes management provides a means for interdisciplinary collaboration in improving patient outcomes. The benefits of an outcomes management program are numerous, including decreasing healthcare costs, decreasing the length of stay, improving clinical outcomes, improving system processes, and fostering outcomes research. The outcomes manager is responsible for the development, implementation, and evaluation of an outcomes management program. One of the functions of an outcomes manager is developing collaborative practice teams to serve as vehicles of change through their analysis of outcomes data and the identification of best practice patterns. Interdisciplinary collaboration is a key component of an outcomes management program. Without an atmosphere os shared responsibility among disciplines for outcomes noted in a patient population, and recognition of individual expertise regarding care, efforts to produce change will move very slowly, if at all, and optimal improvements in care will be forfeited.

Costs and Cost Analysis↗

PubMed1990

Purification of a 130-kDa T cell glycoprotein that binds human interleukin 4 with high affinity.

The interleukin 4 (IL-4) receptor was purified from the gibbon T cell line MLA 144. These cells were found to express high numbers of human IL-4-binding proteins (5000-6000 sites/cell) with an affinity constant (Kd) similar to that measured in human cell lines (Kd = 40-70 pM). Affinity cross-linking of 125I-IL-4 to human cell lines and MLA 144 cells demonstrated the labeling of three proteins of approximately 130, 75, and 65 kDa. Human IL-4-binding sites were solubilized from MLA 144 cells using Triton X-100 and then purified by carboxymethyl chromatography, which removed 50% of the protein without loss of IL-4-binding activity. Then sequential affinity purification over wheat germ agglutinin and a single IL-4 Affi-Gel 10 column resulted in a final 8000-fold purification of the IL-4 receptor. When analyzed on a silver-stained sodium dodecyl sulfate-polyacrylamide gel, the purified receptor migrated as a single molecular species of 130 +/- 5 kDa. Identification of the 130-kDa protein as the IL-4 receptor was demonstrated by cross-linking experiments and specific binding of 125I-IL-4 to nitrocellulose membranes after electrophoretic transfer of the purified receptor on sodium dodecyl sulfate-polyacrylamide gel.

Animals↗

PubMed1989

Transfer of prostaglandins to the fetus after prostaglandin E2 vaginal pessary administration.

The kinetics of prostaglandins instilled vaginally has been studied in the maternal and fetal circulations, with observation of changes in the stable prostaglandin E2 metabolite 11-deoxy-13,14-dihydro-15-keto-11 beta,16-cyclo-prostaglandin E2. After the administration of prostaglandin E2, 10 mg in a wax-based pessary, concentrations of prostaglandin E2 metabolite in the maternal circulation increased; concentrations in the fetal circulation were higher than those in control subjects. There was a positive correlation between levels found in the fetal and maternal circulations. The implications of these preliminary findings are discussed in relation to the consequences of the use of vaginally administered prostaglandin E2 for cervical ripening and labor induction.

Abortion, Induced↗

PubMed1986

Prostaglandin binding by human fetal ductus arteriosus at midgestation.

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Dinoprostone↗

PubMed1986

The obstetric management of non-immunological hydrops.

During the past 8 years, non-Rhesus hydrops has been observed in 31 pregnancies extending beyond 28 weeks gestation. Only three of the babies survived. Antenatal diagnosis is possible by ultrasound examination and although 27 of our patients had at least one indication for this procedure, only 22 were so investigated and in 13, fetal hydrops was demonstrated. Twenty-three were delivered before 36 weeks gestation, 10 by caesarean section of whom none survived; 16 babies were stillborn. Fourteen infants had major cardiovascular anomalies and six had other major malformations. In five infants, infection was thought to be causally related to fetal hydrops and in only four could no cause for the hydrops be found. In five pregnancies the cause of hydrops was discovered antenatally; this influenced subsequent management and two of the five survived. The unexpected appearance of a very abnormal fetal heart rate pattern requires the exclusion of fetal anomaly and non-immunological hydrops. When a diagnosis of non-immune hydrops is made its underlying cause should be sought without delay so that specific treatment may be instituted in the few cases where this is appropriate. A high incidence of complications of the third stage of labour should be anticipated. Subsequent pregnancies are likely to be normal.

Adolescent↗

PubMed1975