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Biomedical subjects

B Riley

Publications and source records attributed to B Riley.

At least 37 records · Page 2Linked to original sources
PubMed1992

Detection of an unstable fragment of DNA specific to individuals with myotonic dystrophy.

Myotonic dystrophy (DM) is the most common form of adult muscular dystrophy, with a prevalence of 2-14 per 100,000 individuals. The disease is characterized by progressive muscle weakness and sustained muscle contraction, often with a wide range of accompanying symptoms. The age at onset and severity of the disease show extreme variation, both within and between families. Despite its clinical variability, this dominant condition segregates as a single locus at chromosome 19q13.3 in every population studied. It is flanked by the tightly linked genetic markers ERCC1 proximally and D19S51 distally; these define the DM critical region. We report the isolation of an expressed sequence from this region which detects a DNA fragment that is larger in affected individuals than in normal siblings or unaffected controls. The size of this fragment varies between affected siblings, and increases in size through generations in parallel with increasing severity of the disease. We postulate that this unstable DNA sequence is the molecular feature that underlies DM.

Chromosomes, Human, Pair 19↗
PubMed1992

Colloid solutions in the critically ill. A randomised comparison of albumin and polygeline. 1. Outcome and duration of stay in the intensive care unit.

All patients admitted to an Intensive Care Unit were randomised to receive all volume replacement fluid as either human albumin solution or a synthetic colloid. A total of 475 patients were admitted during the study period. Patients' age, sex, APACHE score and calculated risk of death were assessed on admission. Outcome was assessed as length of Intensive Care stay and mortality. There was no difference between the groups. Subgroups of patients with APACHE score greater than 10, calculated risk of death greater than 50% and length of stay greater than 5 days were also evaluated but not significant differences were found between treatment groups. The use of albumin rather than 3.5% polygeline for volume replacement in the Intensive Care Unit has no influence on outcome.

Adolescent↗
PubMed1992

Colloid solutions in the critically ill. A randomised comparison of albumin and polygeline 2. Serum albumin concentration and incidences of pulmonary oedema and acute renal failure.

All patients admitted to an Intensive Care Unit were assigned randomly to one of two groups, A and B. Group A received colloid volume replacement as 4.5% albumin whilst group B received a synthetic colloid, polygeline. This study describes the changes in serum albumin concentration in survivors and nonsurvivors in the two groups during their stay in the Intensive Care Unit. The incidences of renal failure and pulmonary oedema were also assessed. Serum albumin concentration decreased in all nonsurvivors. In survivors the serum albumin concentration decreased to a greater extent in the synthetic colloid group than in the albumin group. Despite the differences in serum albumin concentration there were no significant differences between the groups in the incidences of pulmonary oedema or renal failure.

Acute Kidney Injury↗
PubMed1991

Quality assessment in support services: do practitioners concur with expert consensus?

The purpose of this study was to examine the degree of concordance between experts and practitioners as to the importance of quality assessment measures (elements and indicators) in therapeutic recreation (TR) services. Results from a survey of TR practitioners as to actual uses of these quality assessment measures within Veterans Affairs Recreation Services nationwide were compared to expert opinions used in a previous study that identified quality assessment measures for TR. Agreement between expert ratings of importance and frequency of use by practitioners were greatest for the experts' most important elements and indicators and least for the least important. Findings suggest that a select few "important" elements and indicators might be universally required of all quality assessment programs; others might be optional or can be modified to meet the needs of individual settings. Results also demonstrate the need for further study of optimal quality assessment approaches using both expert knowledge and practitioner experience.

Ancillary Services, Hospital↗
PubMed1990

Effects of molecular oxygen, oxidation-reduction potential, and antioxidants upon in vitro replication of Treponema pallidum subsp. pallidum.

The effects of various concentrations of dithiothreitol, molecular oxygen, and several antioxidants upon the in vitro replication of Treponema pallidum were studied. The optimal dithiothreitol concentration was between 0.65 and 1.62 mM, and the optimum oxygen concentration was 3.0% +/- 0.5% in both the presence and absence of additional antioxidants. It was discovered that the reduced sulfhydryl concentration and the oxidation-reduction potential of the medium were stabilized after 5 days. The water-soluble antioxidants cobalt chloride, cocarboxylase, mannitol, and histidine were individually tested for their ability to increase treponemal growth in vitro. The optimum concentrations for these antioxidants were 21 nM, 4.3 nM, 0.55 mM, and 0.23 mM, respectively. When combined at these concentrations, the mixture of antioxidants stimulated the in vitro replication of T. pallidum. The number of treponemes in cultures with the antioxidants averaged a 59-fold increase, compared with a 43-fold increase in cultures lacking the antioxidants. It was further demonstrated that histidine and mannitol were the most critical components of this mixture. Catalase and superoxide dismutase were investigated for their ability to promote the growth and maintain viability of T. pallidum in tissue culture. The optimum concentrations for these enzymes were 10,000 U/liter and 25,000 U/liter, respectively. When these enzymes and the above antioxidants were combined and added to a chemically reduced modified Eagle medium, the treponemes increased an average of 70-fold, compared with an average of 35-fold in cultures lacking them. Furthermore, this medium, T. pallidum culture medium, supported the replication of T. pallidum at oxygen concentrations from 5 to 7% with little loss in yield or viability. The lipid-soluble antioxidants vitamin A and vitamin E acetate were also shown to enhance the in vitro growth of T. pallidum in this medium.

Antioxidants↗
PubMed1988

Continuous arteriovenous haemodialysis in critically ill patients.

Continuous arteriovenous haemodialysis (CAVHD) is a new treatment for critically ill patients with renal failure that combines convective and diffusive solute removal. The clearance of urea (14.8-22.1 ml/min) is sufficient to achieve a steady-state urea concentration of 22 mmol/l, even in patients with a high catabolic rate and cardiovascular instability. The technique is simple and does not involve the use of blood pumps or specialised staff. Initial experience in 36 critically ill patients with renal failure indicates that it is safe and reliable, with less associated morbidity than other techniques.

Acute Kidney Injury↗
PubMed1983

Mechanical ventilation with air-oxygen mixtures during total intravenous anaesthesia. An evaluation of the Penlon Nuffield Series 400 ventilator.

Mechanical ventilation with air-oxygen mixtures during total intravenous anaesthesia is discussed with the associated problem of obtaining a medically suitable source of air in British rooms. Independently powered ventilators capable of entraining filtered room air were thought to be the best solution. The Penlon Nuffield Series 400 ventilator was modified and assessed for use in this mode. An entrainment adapter and circuit was devised which allowed the ventilator to entrain more than sufficient ambient air, premixed with added oxygen for patient ventilation even under adverse conditions. The entrainment system ensured good mixing of the entrained air and oxygen and allowed accurate determination of oxygen concentration in the patient system using a suitable nomogram and without an oxygen analyser. An assessment of one-way patient valves was also undertaken. The Laerdal valve was found to be the most suitable for use with the system described.

Air↗
PubMed1980

Bioavailability and pharmacokinetics of a new, slow-release potassium chloride capsule.

The bioavailability of a new, slow-release potassium chloride product consisting of coated beads in a hard gelatin capsule was compared with the bioavailability of two marketed products, an elixir and a slow-release tablet, by determining the urinary excretion of potassium. Twelve healthy male volunteers were dosed with a total of 80 mEq of potassium, in a single dose for the capsule and tablet and in three 26.6-mEq doses at 6-hr intervals for the elixir. Mean recoveries in 24-hr urine potassium levels from all three dosage forms after subtracting normal urine potassium excretion levels were 50.8% from the capsule, 53.9% from the elixir, and 63.1% from the tablet. Maximum excretion rates were reached at 2.0 hr for the elixir, 6.8 hr for the capsule, and 4.0 hr for the tablet. Fewer side effects were reported with the capsule than with the elixir and tablet.

Adult↗
PubMed1977

Papaverine hydrochloride: the evaluation of two new dosage forms.

The bioavailability of papaverine, administered as sustained release capsules, an elixir, and soft gelatin capsules, was studied with volunteers. Blood samples were assayed for papaverine, using a gas chromatographic method, following the administration of single 150 mg doses of papaverine HC1. The elixir and the soft gelatin capsule resulted in nearly identical papaverine blood levels, while peak levels, area under the blood level-time curve, and plasma levels 0.5, 1.0, 1.5, and 2.0 hours after dosing with the sustained release capsule were significantly (p less than 0.01) lower.

Administration, Oral↗
PubMedDate not supplied

Assessment of clinical decision-making ability of critical care nurses.

What are nurse administrators to do when their institution is in need of competent nurses to staff the ICU and the majority of applicants are either inexperienced or new graduates? Nurses from one institution grappled with this question. They decided that it was their job to teach novice nurses to make sound clinical judgments in life-threatening situations. As part of this process, they developed a Clinical Decision-Making Assessment (CDMA) tool. This article describes the CDMA and provides suggestions for classroom and clinical teaching.

Adult↗
PubMedDate not supplied

Intrapartum care of a woman with aortic aneurysms.

Advances in technology and complex care have enabled women with various health problems to become and remain pregnant. Consequently, health-care practitioners are seeing an increasing number of pregnant women who have aortic aneurysms. This case study describes the culturally sensitive intrapartum care of a Middle Eastern woman with ascending and descending aortic aneurysms.

Aorta, Abdominal↗
PubMedDate not supplied

[A questionnaire survey of intravenous drug addicts (Moscow, May 1997-January 1998)].

Questionnaires were distributed among users of intravenous drugs (UID) on the basis of Narcological Hospital No. 17 in Moscow and in the streets of the city (altogether, respondents filled in 298 questionnaires in the hospital and 126 questionnaires in the streets). The average age of the respondents was 21-22 years. The sufficiently wide spread of the joint use of injection instruments was noted (35-41%), the ensuing risk could be consciously evaluated by 38% of the respondents in the hospital and 20% in the streets. According to the observation diaries, HIV was not a priority for many UID. Their priorities included the problems of the treatment of hepatitis, abscesses, overdosage/poisoning, etc. Among the hospital respondents and selected street respondents the spread of hepatitis B and C was noted by 30% and 34% respectively. Under hospital conditions testing for HIV gave negative results in 58% and positive results in 5% of the respondents, while 37% of the respondents stated than they had never been tested. Among street respondents, 62% stated that they had negative results of testing and 39% stated that they had never been tested. The conclusion has been made that the realization of prophylactic programs may augment the level of knowledge concerning risks linked with the intravenous use of drugs, thus giving motivation to UID either to stop their use or to avoid contamination of the blood with HIV while using them.

Adolescent↗
PubMedDate not supplied

Restructuring public health in Ontario: implications for heart health promotion.

Community-based heart health promotion is viewed as an effective means of reducing cardiovascular disease risk. Although public health agencies have a central role in the implementation and dissemination of heart health programmes, their effectiveness is being challenged by major structural changes to Provincial public health systems across Canada, although the impacts of the changes have received relatively little attention in the research literature. As part of the Canadian Heart Health Initiative--Ontario Project (CHHIOP), this study used a qualitative approach to address the perceived implications of these changes to Ontario's public health system for heart health promotion. Interviews (n = 38) were conducted in eight public health units with staff most familiar with managing and/or delivering heart health activities. The results are mixed; that is, while many see the future of heart health promotion programming in Ontario as being at risk, others see recent changes as a step forward toward their institutionalization, particularly in light of recent funding decisions made by the Ministry of Health's Health Promotion Branch.

Female↗