PubMed Health⌕ Search

Biomedical subjects

C Bond

Publications and source records attributed to C Bond.

At least 37 records · Page 2Linked to original sources

Family with Pelizaeus-Merzbacher disease/X-linked spastic paraplegia and a nonsense mutation in exon 6 of the proteolipid protein gene.

We report on a C-to-T transition in exon 6 of the PLP gene in a male with Pelizaeus-Merzbacher disease/X-linked spastic paraplegia. The transition changes a glutamine at amino acid residue 233 to a termination codon. This premature stop codon probably results in a truncated protein that is not functional. Six other relatives were analyzed for the mutation and two female carriers were identified. Autopsy data on one male are presented.

Adult↗

Rheumatoid arthritis: are pets implicated in its etiology?

Rheumatoid arthritis (RA) is thought to be triggered by an environmental agent or agents in immunogenetically predisposed persons. To investigate if animals or animal products might be the disease reservoir for a putative environmental trigger for RA that acts in childhood, a case-control study was undertaken. Included were 122 cases of RA and 114 control subjects of similar age. A specifically trained assistant, blinded to the diagnosis, used a standard interview proforma to gather information on ages of exposure to agents before onset of symptoms. Univariate analysis showed that cases were significantly more likely to have had a close association with a cat in the prepubertal period (65%) than were controls (27%); odds ratio (OR), 4.9 (confidence interval [CI] 2.7 to 9.0). In addition, there was a dose-response relationship between extent of prior exposure to cats and RA. There was a weaker association between recalled prior exposure to birds, budgerigars (parakeets) in particular, and RA. These data suggest that certain pets may be the reservoirs for environmental agents that trigger RA after a period of latency.

Adolescent↗

Do physicians' perceptions of drug costs influence their prescribing?

This study examines general practitioner (GP) attitudes towards and knowledge of prescribing costs, and the influence of these 2 factors in the doctor's demand for drugs. The main emphasis of the study is on the influence of perceived cost of drugs on prescribing habits. A postal questionnaire was sent to all 273 GP principals in the Grampian region of Scotland. This questionnaire assessed GPs' attitudes and knowledge with respect to prescribing costs. Information was also collected on the prescribing habits of 176 of these GPs. This information was linked to look at the influence GPs' knowledge of drug costs has on their actual prescribing behaviour. Three drug groups were studied: ulcer-healing drugs, pain-killers and penicillins. The results showed that although most GPs agreed that costs should be borne in mind when prescribing medicines, their actual knowledge of the drug costs was often inaccurate. Furthermore, for certain therapeutic groups, prescribing habits are influenced by GPs' perceptions of drug costs. This implies that GPs are not as averse to considering costs as is often assumed, and that giving GPs better information about drug costs might promote more rational prescribing.

Attitude of Health Personnel↗

Characterization and variation of a human inwardly-rectifying-K-channel gene (KCNJ6): a putative ATP-sensitive K-channel subunit.

The ATP-sensitive K-channel plays a central role in insulin release from pancreatic beta-cells. We report here the cloning of the gene (KCNJ6) encoding a putative subunit of a human ATP-sensitive K-channel expressed in brain and beta-cells, and characterisation of its exon-intron structure. Screening of a somatic cell mapping panel and fluorescent in situ hybridization place the gene on chromosome 21 (21q22.1-22.2). Analysis of single-stranded conformational polymorphisms revealed the presence of two silent polymorphisms (Pro-149: CCG-CCA and Asp-328: GAC-GAT) with similar frequencies in normal and non-insulin-dependent diabetic patients.

Adenosine Triphosphate↗

Increasing the number of drugs available over the counter: arguments for and against.

Many drugs previously restricted to prescription only status are being reclassified as pharmacy only status and hence are becoming available over the counter to patients. A general practitioner should make enquiries about a patient's self-medication practices before deciding on treatment for the patient. Over-the-counter medicines are considered safe and their increased use indicates that patients are taking greater responsibility for their own health and possibly taking some of the financial burden of drug treatment from the National Health Service. The retention of their restriction to pharmacy only sale provides some additional protection for patients and promotes the role of pharmacists in the care of patients. However, having more drugs available for self-treatment may encourage patients to believe that there is a drug treatment for every ailment. Increasing the range of drugs available over the counter increases the risks of interactions and adverse reactions and of self-treatment being undertaken when medical aid should have been sought. For general practitioners to recommend positively use of over-the-counter preparations may involve some medicolegal risks, and the potential savings to the NHS may prove illusory. Education for patients and better communication between general practitioners and community pharmacists are required to allow easier availability of modern medicines to patients in order to bring the benefits anticipated.

Communication↗

A structural determinant of differential sensitivity of cloned inward rectifier K+ channels to intracellular spermine.

Large subtype-specific differences in the sensitivity of cloned inward-rectifier K+ channels of the IRK1, BIR10 and ROMK1 subtype to being blocked by intracellular spermine (SPM) are described. It is shown, by site-directed mutagenesis, that the four orders of magnitude larger SPM sensitivity of BIR10 channels compared to ROMK1 channels may be explained by a difference in a single amino acid in the putative transmembrane segment TMII. This residue, a negatively charged glutamate in BIR10, is homologous to the residue in IRK1 and ROMK1 which has previously been shown to change gating properties and Mg2+ sensitivity. Differential block by physiological SPM concentrations is suggested as a major functional difference between subtypes of inward-rectifier K+ channels.

Animals↗

Dispensing physicians and prescribing pharmacists: economic considerations for the UK.

Recent years have seen an increase in the number of dispensing physicians in the UK. There have also been suggestions that legislation restricting certain drugs to prescription-only availability should be relaxed and that pharmacists should take a more active role in the provision of drugs. General medical practitioners and pharmacists have common ancestry in the medieval spicers, who dispensed medicines and offered medical advice. Rural practitioners have been allowed to dispense drugs since 1911. Physician dispensing can benefit patients via savings in time and the monetary cost of visiting a pharmacist, but it restricts drug choice, can compromise safety, and encourages overprescribing except for physicians with drugs budgets. The effects of physician dispensing on government costs are not yet clear. Over-the-counter (OTC) purchase can save patients the cost of a physician visit and reduce drug costs to some patients, but it can also provide an incentive to pharmacists to profit twice from a drug, at government expense. Switching drugs from prescription-only to OTC reduces the government drug bill, but provides an incentive to pharmacists to overprescribe, and may not be as safe for patients. Liberalising prescribing by doctors would discourage community pharmacies which provide an advisory service to patients. Liberalising OTC switches would reduce opportunistic assessment of patients by doctors and could compromise patient safety. Separation of physician and pharmacist functions is probably safer for patients. It is concluded that the current situation in the UK, whereby most dispensing is done by pharmacists, is the preferred option other than for those patients who do not live within easy access of a pharmacy. A reassessment of the legal status of drugs and subsequent OTC switch of drugs used to treat minor self-limiting illnesses is also favoured.

Cost-Benefit Analysis↗

Changes in plasma cortisol and catecholamine concentrations in response to massage in preterm infants.

The biochemical and clinical response to massage in preterm infants was assessed. Eleven stable infants, of 29 weeks' median gestational age, median birth weight 980 g, and median postnatal age 20 days, were studied. Blood samples were obtained for the determination of adrenaline, noradrenaline, and cortisol 45 minutes before the start of massage and approximately one hour after completion of massage. Cortisol, but not catecholamine, concentrations decreased consistently after massage (median difference -35.8 nmol/l; 95% confidence interval -0.5 to -94.0, Wilcoxon matched pairs). There was a slight decrease in skin temperature (median difference -0.36 degrees C, 95% confidence interval -0.09 to -0.65) but there was no change in oxygenation or oxygen requirement. This study has shown that it is possible to detect an objective hormonal change following a supposedly 'non-therapeutic' intervention in preterm infants. The development of such methods of assessment are likely to be of particular relevance in the extremely immature or ill neonate in whom behavioural evaluation cannot play more than a limited part.

Birth Weight↗

Continuous cell movements rearrange anatomical structures in intact sponges.

Time-lapse cinemicrography was used to record the active movements of cells in living intact sponges. Each of the three main cell types (pinacocytes, mesohyl cells, and choanocytes) continuously moved and rearranged themselves so that the internal anatomy of the sponge was continuously remodeled. The shape and appearance of the sponges anatomical structures often changed substantially within a few hours. The most motile were the mesohyl cells, with many moving as fast as one cell-length per minute (15 microns/min). Mesohyl cell locomotion was often accompanied by displacements of spicules, canals, and choanocyte chambers; the patterns of these displacements suggested that the mesohyl cells were providing the motive forces for these rearrangements. The locomotion of the pinacocytes varied according to position: those along the outer sponge margins were most active, whereas those in other parts of the surface moved relatively little. Choanocytes were never observed to undergo independent locomotion but were always found grouped together in choanocyte chambers. These choanocyte chambers interacted with pinacocytes and mesohyl cells to form excurrent canals, which continuously moved, fused with, and branched from one another. These observations suggest that the experimental phenomenon of sponge cell-reaggregation and reconstitution, discovered by H. V. Wilson, represents an extreme version of morphogenetic processes that normally go on continuously within intact sponges. The results from the present study also suggest that these cellular rearrangements are controlled by active cell movements and behavioral responses that include but are not limited to selective cell adhesion.

Animals↗

Knowledge of drug costs: a comparison of general practitioners in Scotland and England.

The implementation of drug budgets will make it essential that general practitioners are aware of prescribing costs. A previous study of general practitioners in Scotland found that their knowledge of drug costs was often inaccurate. At the time of the Scottish study, doctors received very limited information on prescribing costs. By contrast, general practitioners in England have been receiving much more detailed information on their prescribing costs since the introduction of PACT (prescribing analyses and cost) in 1988/89. This study examines whether, as a result, doctors in England are more aware of drug costs. The results suggest that they are not; indeed, doctors in Scotland had marginally better knowledge of drug costs. There is a continuing need to improve the cost information available to general practitioners.

Awareness↗

Scottish general practitioners' attitudes and knowledge in respect of prescribing costs.

The government's proposal to introduce drug budgets will compel general practitioners to consider the financial consequences of prescribing. A survey was carried out of general practitioner principals in Grampian and a sample elsewhere in Scotland to examine their attitudes towards considering costs when prescribing and assess the accuracy of their knowledge of drug costs. Most general practitioners agreed that costs should be borne in mind when choosing medicines but their knowledge of drug costs was often inaccurate. Only one third of estimates were correct to within 25% of the actual cost, and there was a tendency to overstate the cost of cheap drugs and understate the cost of expensive ones. Some general practitioners were not aware of the relative prices of competing products or proprietary products and generic equivalents. The findings highlight the importance of providing general practitioners with readily accessible and up to date information on drug costs if prescribing budgets are to work.

Attitude of Health Personnel↗