PubMed HealthSearch

Biomedical subjects

B J Harrison

Publications and source records attributed to B J Harrison.

At least 19 recordsLinked to original sources

Plasma fatty acid profiles in benign breast disorders.

Breast pain (mastalgia) and macroscopic breast cysts present commonly. Mastalgia may be improved by dietary manipulation to reduce saturated fat or supplement essential fatty acid intake. Fatty acid profiles were measured in women with mastalgia and breast cysts, before and during treatment with evening primrose oil, a rich source of essential fatty acids. The fatty acid profiles of both groups of patients were abnormal, with increased proportions of saturated fatty acids and reduced proportions of essential fatty acids. Treatment with evening primrose oil improved the fatty acid profiles towards normal, but this was not necessarily associated with a clinical response.

Breast Diseases

Mesenteric venous thrombosis due to protein C deficiency.

Protein C deficiency is a known underlying risk factor for thromboembolic disease. Most commonly it presents as thrombophlebitis, deep venous thrombosis or pulmonary embolism. Less common presentations are becoming increasingly recognized now that assays for protein C are more widely available. We present two cases of mesenteric venous thrombosis who were found to have protein C deficiency.

Adult

Computerized clinic scheduling system at the University of Michigan Medical Center.

The University of Michigan Medical Center has a flexible computerized clinic scheduling system that handles approximately 750,000 visits per year at the main hospital and satellite locations. The system includes a wide variety of fully integrated functions, including appointment booking, multiple and series scheduling, wait and reschedule lists, routine reminder notices, routine requests for medical records and radiology reports, no-show follow-up, and managerial reporting at multiple levels of detail. The system is extremely flexible, and allows separate scheduling specifications for every physician and all other resources within the system. The system is available at any of the approximately 1,800 computer terminals throughout the Medical Center, and is regularly used at approximately 400 terminals.

Academic Medical Centers

A randomized trial of dietary intervention with essential fatty acids in patients with categorized cysts.

Two hundred women with breast cysts proven by aspiration were entered into a randomized double-blind trial of Efamol (evening primrose oil) at a dose of 6 capsules daily or equivalent placebo dose for a year. Cysts were categorized by initial electrolyte composition, and follow-up continued for 1 year posttherapy. Recurrent cyst formation in the first year was slightly (but not significantly) lower in the Efamol group compared with the placebo-treated group. The Efamol treatment was well tolerated as the dropout rate was only 7% and equal in both the active and placebo groups. The initial electrolyte composition did not predict for cyst recurrence.

Adult

A randomised controlled trial of medroxyprogesterone acetate in mastalgia.

A double-blind crossover study giving 20 mg/day of medroxyprogesterone acetate during the luteal phase was carried out in 26 women with cyclical mastalgia. Symptomatic response to this progestogen supplementation or placebo was assessed objectively by clinical examination and subjectively by linear analogue scales and breast pain charts. No significant relief of pain or tenderness was found on placebo or active treatment, irrespective of treatment order, and breast nodularity was similarly unaltered. No evidence of progesterone deficiency or prolactin abnormality was found. Side-effects were incurred in 11 patients (five on placebo, five on active treatment and one while on both) and were mostly vague premenstrual symptoms. We conclude that the therapeutic response of medroxyprogesterone acetate in cyclical mastalgia is no better than placebo and that progestogen supplementation can no longer be recommended for routine use in the management of breast pain.

Adult

Non-cyclical mastalgia: an improved classification and treatment.

A prospective study of 72 patients with non-cyclical breast pain was carried out. Non-cyclical breast pain was subdivided into true non-cyclical mastalgia (35 patients) and musculoskeletal pain (37 patients), the latter including Tietze's syndrome and other causes of chest wall pain. Mean age at presentation was significantly greater in the musculoskeletal group (39.3 versus 33.9 years) with a shorter mean duration of pain (14.7 versus 35.4 months) compared with the non-cyclical mastalgia group. True non-cyclical mastalgia was commonly bilateral and located within the upper outer quadrant of the breast, whereas musculoskeletal pain was almost always along the lateral chest wall or costochondral junctions and unilateral in 92 per cent of cases. Breast nodularity was present in 54 per cent of patients with non-cyclical mastalgia, but in only four cases (11 per cent) in the musculoskeletal group. Nine of 14 patients (64 per cent) with non-cyclical mastalgia obtained a good clinical response to drug therapy (over half responding to danazol alone); 19 underwent spontaneous remission, but there was a prolonged mean time to pain resolution of 27 months. In the musculoskeletal group 33 of 34 patients (97 per cent) had a good response to steroid and local anaesthetic injection; three resolved spontaneously without treatment, with a mean time to pain resolution of 17 months. This study indicates that differentiation of musculoskeletal pain from non-cyclical mastalgia may lead to more effective treatment with some prediction of the overall prognosis.

Adult

Low-dose danazol for mastalgia.

A low-dose danazol maintenance therapy (mean total dose 800 mg per month) was given during the luteal phase to 34 women with severe relapsing cyclical mastalgia. On conventional danazol dosage, all subjects had previously obtained a useful clinical response, but side effects occurred in 29 (85 per cent). Using this low-dose regimen, complete relief of symptoms was achieved in 15 women (44 per cent); the remainder obtained a substantial clinical improvement. Side effects were reduced to 12 per cent of women and were considered mild and tolerated by all patients. A low-dose regimen may be suitable for women with severe persistent cyclical mastalgia and minimises side effects that develop on conventional dosage.

Adult

Maintenance therapy of cyclical mastalgia using low-dose danazol.

In an open study, low-dose danazol (mean total dose 700 mg/month) was given during the luteal phase to 20 women with severe relapsing cyclical mastalgia. All subjects had previously obtained a useful clinical response on conventional dosage of danazol, but side effects occurred in 13 (65%). On the low-dose regimen, complete relief of symptoms was attained by 11 women (55%) and the remainder achieved a substantial clinical improvement; no side effects were reported. A low-dose regimen may be suitable for women with chronic relapsing cyclical mastalgia or those who develop side effects on conventional dosage.

Adult

Endocrine basis for the clinical presentation of hidradenitis suppurativa.

Clinical assessment of 134 patients with hidradenitis suppurativa revealed clinical evidence supporting an androgen-based endocrine disorder underlying the condition. Such features included postpubertal onset maximal during the third decade; female preponderance (13:5); premenstrual flare in 57 per cent of women; absence of this flare associated with irregular or anovulatory menstrual cycles; and an increased incidence of obesity and acne. Detailed hormone profiles in 36 female patients and 14 controls showed evidence of relative androgen excess and decreased progesterone levels in those patients without a premenstrual flare. Obesity and enhanced peripheral androgen conversion by apocrine tissue are possible explanations for normal serum androgen profiles in patients with a flare. Precise elucidation of the hormonal abnormality is a prerequisite for effective medical treatment of early disease.

Age Factors

Recurrence after surgical treatment of hidradenitis suppurativa.

From six to 89 months after surgery 82 patients who had been treated by radical surgery (118 excisions) for intractable hidradenitis suppurativa were reviewed. Local recurrence rates varied greatly with the disease site, being low after axillary (3%) and perianal surgery (0%) and high after inguinoperineal (37%) and submammary (50%) excision. Recurrence results from inadequate excision or an unusually wide distribution of apocrine glands, but physical factors such as obesity, local pressure, and skin maceration played a part in a few patients. Recurrence due to inadequate surgery tended to be the most troublesome. At follow up 75 (91%) of the patients were pleased with the results of their operation. A quarter of the patients developed disease at a new anatomical site after operation. Radical surgery gives good symptomatic control of severe hidradenitis suppurativa of the axilla, inguinoperineal, and perianal regions but is less satisfactory for submammary disease.

Adolescent

Hidradenitis suppurativa: evidence for an endocrine abnormality.

Women patients with premenstrual exacerbation of hidradenitis suppurativa have been studied to determine if an endocrine abnormality can be detected. A functional disorder of the hypothalamopituitary axis was found in 13 patients with hidradenitis when compared with 9 controls. In response to a combined thyrotrophin releasing hormone and gonadotrophin releasing hormone test, the prolactin and TSH responses were significantly greater in the hidradenitis patients than the controls. No significant differences were found in the mean basal levels of oestrogen, progesterone, testosterone, dehydroepiandrosterone sulphate, T3 and T4. These results may reflect a disturbance of feedback signals from peripheral hormones, rather than a primary dysfunction of the control of specific anterior pituitary cells.

Adult

Effects of dopamine and dobutamine on the distribution of pulmonary blood flow during lobar ventilation hypoxia and lobar collapse in dogs.

Hypoxic pulmonary vasoconstriction was induced in the left lower lobe of fifteen dogs by ventilating the lobe with 7% O2 or by absorption collapse, and the distribution of flow between the lobe and the remainder of the lung was measured with electromagnetic flow probes. The lobar to total blood flow ratio was reduced by lobar ventilation hypoxia and decreased further during lobar collapse. In seven dogs, an infusion of 20 micrograms kg-1 min-1 of dopamine produced an increase in total blood flow, an increase in pulmonary artery pressure (P less than 0.01), and an increase in lobar to total flow ratio (P less than 0.05) during both hypoxic states. There was a significant fall in arterial PO2 (P less than 0.01) during ventilation hypoxia. Similar changes in total and lobar to total flow ratio (P less than 0.01) were observed in eight dogs given 20 micrograms kg-1 min-1 of dobutamine, but there were no changes in pulmonary artery pressure. The greater increase in total flow (+ 111%) resulted in a marked increase in mixed venous PO2 and no significant changes in arterial PO2 in this group of dogs. It is concluded that both drugs produce an increase in lobar to total blood flow ratio and shunt fraction, but that the mechanisms causing the redistribution of flow may differ.

Animals

Comparative analysis of the development of wing-flapping and flight in the fowl.

The development of wing-flapping rate, lateral flight, wing area, and the ratio of wing area to body weight are described in the Japanese quail (Coturnix coturnix japonica) and three chickens (Gallus gallus) to determine common developmental phenomena and to assess the effects of domestication. The chickens were the White Leghorn (a commercial egg producer), the Cornish X Rock (a commercial meat producer), and the Red Jungle fowl (the probable ancestor of domestic chickens). All birds performed drop-evoked wing-flapping on the day of hatching, at least 1 week before lateral flight was possible. Flapping rate of chickens doubled between hatching (approximately 4-6 Hz) and 13 days (approximately 9-12 Hz), after which it leveled off. Japanese quail (JQ) maintained a high flapping rate (approximately 11-13 Hz) during the 21 days after hatching. The Jungle fowl (JF) and JQ flapped the fastest and the White Leghorn (WL) and Cornish X Rock (CR) chickens flapped the slowest. The JF, WL, and JQ developed lateral flight at 7-9 days. The CR first flew 1-2 weeks later but subsequently became flightless. The WL, JF, and JQ had similar ratios of wing area to body weight; the ratios increased to a peak at 11-15 days and later declined. The ratio of the very heavy, essentially flightless, CR was approximately one-half that of the flighted JQ, WL, and JF. The wing-flapping frequencies of the domestic WL and CR chickens approximated that of the JF, suggesting that domestication did not affect the motor pattern generator for flight. The artificial selection of the CR for high body weight drastically diminished its flight performance by producing an unfavorable ratio of wing area to body weight. The JF and the domestic WL both flew well and had similar ratios. Domestication affected flight performance but not the neural circuitry producing wing-flapping. The central nervous system is much more conservative in its response to selection than the peripheral effector structures that it drives.

Animals

The use of radiotelemetry techniques for the in vivo assessment of antacids.

The use of the pH radio pill for the assessment of antacid effect has been evaluated. The correlation between the pH pill and a conventional pH electrode system was high (r2 = 0.997). The records of in vivo pH against time allow unique measurements of antacid efficacy (defined as the integrated area under the pH against time curve) and duration of action to be obtained. Using a free pill, antacid assessments were performed in 13 subjects in the left lateral position. The effects of repeated antacid administrations were studied in five subjects using a pH pill which was prevented from leaving the stomach by tethering it to the teeth. These longer studies were performed in the sitting position. The efficacy (p less than 0.02) and duration of action (p less than 0.02) of sodium citrate 0.3 M were less in those subjects in whom the pill was tethered. The differences between the results of the studies using either a free or a tethered pill can be attributed to posture. The overall duration of action of sodium citrate 15 ml was short, the mean (SEM) value being 42.4 (4.5) minutes in the left lateral position and 21.2 (4.0) minutes in the upright position.

Aluminum Hydroxide

A study of persons aged 65 and over in the Leeds Metropolitan District.

A study of the elderly living in the community and in institutional care in the Leeds Metropolitan District is outlined. Four populations of persons aged 65 and over were examined: those living in their own homes; in sheltered housing; in social services aged persons' hostels (Part III accommodation); and in hospitals. Findings on one key concept--coping ability--are discussed. Those living in their own homes were most able to cope. Many living in institutions were well able to cope in the community according to the criteria of mobility and functional ability. The relationship between age, morbidity, and coping ability were examined. Women were more likely to report the presence of a long-term illness than men. Housebound respondents in the community were twice as likely to be suffering from non-traumatic locomotor disorders, eyesight disorders, and cerebrovascular disease than respondents in the community sample taken as a whole.

Activities of Daily Living