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Biomedical subjects

C Edwards

Publications and source records attributed to C Edwards.

At least 109 records · Page 6Linked to original sources
PubMed1997

Neutralizing IGF-1 monoclonal antibody with cross-species reactivity.

We report the generation of a murine IGF-1 monoclonal antibody designated 35I17, which exhibits unique cross-species reactivity. The antibody recognizes recombinant human and rat IGF-1 in ELISA, Western blots, and in an 125I-recombinant human IGF-1 Scintillation Proximity Assay. In addition, 35I17 blocks cell proliferation induced by recombinant human and rat IGF-1, and inhibits cell proliferation induced by sera from human, rat, calf, dog, goat, or mouse. The antibody inhibits rat IGF-1 binding to IGF-1 receptors, and prevents IGF-1-stimulated receptor and IRS-1 phosphorylation in LISN C4 cells, an IGF-1 receptor-transfected cell line. The cross-species and neutralizing properties of 35I17 may be useful in in vitro and in vivo animal studies for elucidating the role of IGF-1 in cancer, rheumatoid arthritis, and other diseases.

3T3 Cells↗
PubMed1997

The coagulation/fibrinolysis balance in systemic sclerosis: evidence for a haematological stress syndrome.

Systemic sclerosis (SSc) is a disease characterized by progressive microvascular occlusion and fibrosis resulting in irreversible organ damage, the pathogenesis of which is felt to be of vascular origin. To gain a comprehensive view of the coagulation/fibrinolytic balance in SSc, a number of haemostatic and fibrinolytic variables were measured in 26 SSc patients (11 limited, 15 diffuse) and in 22 control subjects. Of the coagulation activation markers, the mean plasma level of prothrombin fragment 1 + 2 (F1 + 2), but not of thrombin-antithrombin complexes (TAT), was higher in SSc patients than in controls (P < 0.001). Plasma levels of fibrin split product D-dimer (DD), fibrinogen (FNG) and von Willebrand factor (vWF) were higher amongst patients than controls (P < 0.001). vWF and FNG levels were positively correlated (P < 0.001). Mean levels of DD and vWF were more elevated in patients with diffuse than limited disease (P = 0.001 and P = 0.04, respectively). On the fibrinolytic side, defective tissue plasminogen activator (tPA) release (venous occlusion test, stimulated level < basal level) was noted in 46% (12/26) of SSc patients, but only in 4% (1/22) of controls. Patients had higher mean levels of tPA inhibitor (PAI) than controls (P < 0.001), levels being more elevated amongst patients with diffuse than limited disease (P = 0.01). An abnormally high lipoprotein (a) [Lp(a)] level was found in 9% (2/20) of control subjects, but in 30% (8/26) of SSc patients (P = 0.04) where it clustered with fibrinolytic defects. Altogether, these data suggest that patients with SSc are in a hypercoagulable state characterized by elevated plasma levels of FNG and vWF, by a dual hypofibrinolytic pattern (defective tPA release and elevated PAI), and by increased thrombin generation with enhanced fibrin formation. Higher levels of vWF, DD and PAI in patients with diffuse disease are consistent with more extensive (micro)vascular involvement, although no causal relationship can be inferred. The lack of a parallel increase of TAT with F1 + 2, in the presence of normal levels of antithrombin III (ATIII), indirectly suggests an impairment of the heparan sulphate-ATIII system which would favour thrombin generation. Since thrombin may act as a mitogen for fibroblasts, may upregulate vWF, PAI and endothelin production by endothelial cells, and may promote fibrin deposition on the vessel wall leading to worsening of microvascular occlusions, limitation of thrombin generation, besides fibrinolytic enhancement, could represent a possible coadjuvant interventional strategy.

Adult↗
PubMed1997

Early medical career choices and eventual careers.

The revised structure of hospital specialist training being introduced in the United Kingdom means that a doctor wanting a career in a hospital specialty will need to be confident that his or her early career choice, made within 3 years of qualification, is realistic. Using data from a longitudinal study of the 1983 cohort of UK medical graduates, the early career choices made by over 2000 doctors were compared with their employment 11 years after qualification. At year 11 65% of the doctors were working within the first choice they had expressed towards the end of their pre-registration year, and 79% were employed in their year 3 first choice. There was, however, important variation within this general picture: lower predictive value was associated with choices made by women; choices for hospital mainstreams rather than for general practice; and choices that were less than definite. The recent drop in popularity of general practice as a career choice of new graduates in the UK, and the steady increase in the proportion of women graduates, mean that the predictive value of the career choices of recent graduates may prove to be lower than that of the 1983 cohort.

Career Choice↗
PubMed1997

Administration of medicines by emergency nurse practitioners according to protocols in an accident and emergency department.

OBJECTIVE: To present the legal and professional issues related to nurse administration of drugs according to protocols, and describe the implementation and initial audit findings of such a scheme. SETTING: Accident and emergency (A&E) department of a district general hospital. METHODS: Analysis of legal and professional opinion. Protocols acceptable to the medical, nursing, and pharmacy professions were developed across a wide range of drugs appropriate for administration by accident and emergency nurse practitioners (ENPs). The first six months of the scheme were audited. Audit initially addressed general compliance with protocols and later the specific areas of tetanus immunisation and emergency contraception. RESULTS: ENPs assessed 2925 patients in six months (10.9% of all new patients); 455 patients (15.5% of the ENP patients) were given drugs according to protocols. There were no breaches of the protocols. Subsequent audit of tetanus immunisation showed 94-100% compliance with protocol standards and 71-100% compliance for emergency contraception. CONCLUSIONS: There are no legal or professional obstacles to the development of protocols for the administration of drugs to patients by nurses without reference to a doctor, providing the protocols meet all the requirements of the UKCC and have the support of consultant medical staff. Such a system must be subject to regular audit to promote a dynamic approach to protocols and training. The system safely enhanced the quality of care of patients treated by ENPs in A&E.

Clinical Protocols↗
PubMed1997

Non-invasive in vivo techniques to differentiate photodamage and ageing in human skin.

It is important to differentiate skin changes due to the intrinsic ageing process from those due to chronic photodamage in the development of therapies to assist the latter condition, and in this study we have used instrumental techniques to differentiate between changes in a range of properties of skin due to ageing and those due to photodamage, especially with regard to elasticity. We measured three sites of differing sun exposure in a group of younger and in a group of older subjects. A pulsed A-scan ultrasound system was used to measure skin thickness, and a uniaxial extensometer was employed to assess elastic properties. Skin surface roughness measurements were made using silicone rubber impressions and a stylus profilometer. We demonstrated significant differences in skin roughness between young and old subjects at every site and differences between sun-exposed and sun-protected sites only in the older group. Parameters of the elastic properties of skin differed between the groups, and also between sites of most different sun exposure. The uniaxial extensometer can demonstrate a loss of the skin's elasticity predominantly by photodamage, and the roughness of the skin surface can be shown to increase mostly by chronological ageing but to decrease modestly by photodamage. This demonstrates that differences between the two processes can be quantified, and indeed they should be.

Adult↗
PubMed1997

A dynamic test of lower extremity function following anterior cruciate ligament reconstruction and rehabilitation.

It is essential to assess the functional status of patients with surgically reconstructed and rehabilitated anterior cruciate ligaments prior to discharge. This study established a testing paradigm for functional force production and absorption. Data were obtained from 100 healthy subjects for maximal hops, controlled leaps, and hopping and leaping symmetry. Only 10% of symptomatic patients met maximal hopping criteria, while 15% achieved controlled leaping norms. Ninety-five percent of these patients failed to reach both hopping and leaping symmetry norms. Asymptomatic patients were 63% successful in meeting hopping criteria, and 57% were successful in meeting leaping criteria. Hop symmetry and leap symmetry were achieved at rates of 70% and 60%, respectively. The performance of both groups fell significantly below that of normal subjects (p < .05). Data suggest that this protocol does accurately assess functional and dysfunctional knees, and that force absorption may be more critical than force production in the determination of functional capacity.

Adult↗
PubMed1997

Purification and characterization of the protease enzymes of Streptomyces thermovulgaris grown in rapemeal-derived media.

When grown in a particulate-free, protein-rich medium derived from rapemeal (termed medium B), Streptomyces thermovulgaris produced multiple protease enzymes. The main protease activity was attributed to two types of serine protease, denoted as SV1 and SV2. A metallo protease component (SV3) and an azocaseinase component (SV4) were also present. Protease SV1 had a molecular weight of 30 kDa and a pI of 5.8. Protease SV2 was characterized by a high thermostability in the presence of calcium ions and had a pI of 8.4. This enzyme had a molecular weight of 60 kDa, but we suggest that this is the dimeric form, with 30 kDa being the monomer unit. The method chosen for initial downstream processing influenced both the yield and type of protease purified. When cell-free supernatant fluid was concentrated using ultrafiltration, rather than acetone precipitation, a higher percentage and a greater range of proteases were recovered. The medium used for the growth of Strep. thermovulgaris also appeared to affect the type of protease produced. A more diverse range of proteases were produced on rapemeal-derived medium when compared to yeast extract medium.

Chromatography, Ion Exchange↗
PubMed1997

The Tripler Army Medical Center LEAN Program: a healthy lifestyle model for the treatment of obesity.

This paper provides an overview of the Tripler Army Medical Center LEAN Program for the treatment of obesity, hypercholesterolemia, and essential hypertension. The LEAN Program, a multi-disciplinary prevention program, emphasizes healthy Lifestyles, Exercise and Emotions, Attitudes, and Nutrition for active duty service members. The treatment model offers a medically healthy, emotionally safe, and reasonable, low-intensity exercise program to facilitate weight loss. We will discuss the philosophy behind the LEAN Program and the major components. Thereafter, we will briefly discuss the preliminary results.

Counseling↗
PubMed1997

Fosinopril national survey: a post-marketing surveillance study of fosinopril (Staril) in general practice in the UK.

This open, non-comparative, PMS study of fosinopril (Staril) involved 12,067 hypertensive patients assessed at baseline and after two and six months of treatment; 10,791 patients provided evaluable data with 5.2 months average treatment totalling 4667 patient-years. Adverse events were reported in 24% of patients, the most common being mild-to-moderate cough (6.05%). Events considered possibly related to fosinopril were reported in 15% of patients, the frequency being lower in younger patients, males and those receiving fosinopril monotherapy. Patient well-being improved during the study. At the end of the study, most patients were taking fosinopril 10 mg once daily. Mean reductions in systolic and diastolic blood pressures were -11.0% and -11.7%, respectively; 71.3% of patients were 'responders'. No important differences were observed between subgroups. This study found fosinopril to be effective, well tolerated in a broad range of hypertensive patients, and with no previously unrecognised adverse events reported.

Adult↗
PubMed1996

A gene map of the human genome.

The human genome is thought to harbor 50,000 to 100,000 genes, of which about half have been sampled to date in the form of expressed sequence tags. An international consortium was organized to develop and map gene-based sequence tagged site markers on a set of two radiation hybrid panels and a yeast artificial chromosome library. More than 16,000 human genes have been mapped relative to a framework map that contains about 1000 polymorphic genetic markers. The gene map unifies the existing genetic and physical maps with the nucleotide and protein sequence databases in a fashion that should speed the discovery of genes underlying inherited human disease. The integrated resource is available through a site on the World Wide Web at http://www.ncbi.nlm.nih.gov/SCIENCE96/.

Amino Acid Sequence↗
PubMed1996

Career preferences of doctors who qualified in the United Kingdom in 1993 compared with those of doctors qualifying in 1974, 1977, 1980, and 1983.

OBJECTIVE: To report the career preferences of doctors who qualified in the United Kingdom in 1993 and to compare their choices with those of earlier cohorts of qualifiers. DESIGN: Postal questionnaires with structured questions, including questions about choice of future long term career, were sent to doctors a year after qualification. SETTING: United Kingdom. SUBJECTS: All medical qualifiers of 1993, comparing their replies with those from earlier studies of the qualifiers of 1974, 1977, 1980, and 1983. MAIN OUTCOME MEASURES: Choice of future long term career and certainty of choice expressed at the end of the first year after qualification. RESULTS: Questionnaires were sent to 3657 doctors. 2621 (71.7%) replied. Of the 2621 respondents, 70.5% (1849) stated that their first preference was for a career in hospital practice, 25.8% (677) specified general practice, 1.0% (25) specified public health medicine or community health, 1.4% (36) specified careers outside medicine, and 1.3% (34) did not state a choice. By contrast, 44.7% (1416/3168) of the doctors in the 1983 cohort had specified that their first preference was general practice. Among the 1993 qualifiers, general practice was the first career choice of 17.5% of men (227/1297) and 34.0% of women (450/1324). Only 7.4% of men (96/1297) stated that they definitely wanted to enter general practice. Only 7.8% (103/1324) of women qualifiers in 1993 expressed a career preference for surgical specialties. Within hospital practice, comparing 1993 with 1983, choices for the medical specialties and for accident and emergency medicine rose and those for pathology fell. Women were less definite than men about their choice of future long term career. CONCLUSIONS: If the 1993 cohort is typical of the current generation of young doctors, there has been a substantial shift away from general practice as a career choice expressed at the end of the preregistration year. General practice was much more popular among women than men. Few women opted for surgery. The sex imbalance in the percentage of doctors who choose different mainstreams of medical practice seems set to continue.

Adult↗
PubMed1996

Bumph busters.

Explore the source record for details and available documents.

Efficiency, Organizational↗
PubMed1996

Laboratory-scale purification of microcystins using flash chromatography and reversed-phase high-performance liquid chromatography.

Microcystins were extracted from 7 l (equivalent to 313 g dry weight) of cyanobacterial scum collected from Rutland Water in Leicestershire, UK in 1989. The resulting aqueous extract was rapidly concentrated on a C18 flash chromatography cartridge and microcystins were eluted using a step gradient. Fractions were collected manually and monitored by UV spectrophotometer and analytical HPLC. Fractions containing microcystins of similar polarity were pooled to give three fractions. Simple isocratic methods for separating each fraction were developed on an analytical column and scaled up to a 15 x 7.5 cm I.D. column. Closed-loop recycling was used to maximise yield and purity of two hydrophobic microcystins.

Amino Acid Sequence↗
PubMed1996

Career destinations in 1994 of United Kingdom medical graduates of 1983: results of a questionnaire survey.

Cohort studies of doctors' career choices and career progression since the mid-1970s have shown important changes in the medical workforce, in specialist training, and in employment. Examples of these changes are the increasing proportion of women doctors and of doctors who wish to work part time, the emigration patterns of doctors, and the development of vocational training for general practice. Studies enable the effects of longer term changes to be assessed, and sometimes they inform current debate.

Career Choice↗
PubMed1996

Fluorescent probes and flow cytometry: new insights into environmental bacteriology.

Recent trends in flow cytometry have established new techniques in bacteriology. Advances in fluorescent dye technology complement these improvements, offering probes for a variety of cellular functions. Bacterial ecology requires the application of new techniques to help answer questions unanswerable by traditional methods alone. Here we review some aspects of how coupling the two technologies has enabled researchers to directly study individual bacterial cells, and revealed the complexity and heterogeneity present in both laboratory cultures and in environmental samples. Results are discussed with respect to viability analysis, stress induced changes, specific cell detection and cell sorting.

Bacteriological Techniques↗
PubMed1996

Patterns of expression of tumor necrosis factor alpha, tumor necrosis factor beta, and their receptors in synovia of patients with juvenile rheumatoid arthritis and juvenile spondylarthropathy.

OBJECTIVE: To assess the expression of tumor necrosis factor alpha (TNF alpha), TNF beta, and their receptors in synovia of patients with juvenile rheumatoid arthritis (JRA) and juvenile spondylarthropathy (JSpA), and to determine similarities with and differences from adult RA. METHODS: Twenty-eight synovial tissue samples from patients with JRA, 6 from patients with JSpA, and 6 from patients with RA, selected for the presence of inflammatory infiltrates, were analyzed for the expression of TNF alpha, TNF beta, and their receptors (p55 and p75 TNFR), utilizing the dual approach of reverse transcriptase-polymerase chain reaction and immunohistochemistry analysis. RESULTS: The presence of both TNF alpha and TNF beta expression was demonstrated in most JRA and JSpA tissues, although samples from patients with pauciarticular JRA had somewhat lesser amounts of these cytokines. TNF beta expression correlated significantly with the occurrence of lymphocytic aggregates in tissues. Staining with monoclonal antibodies specific for the p55 and p75 receptors revealed that a diverse range of cell types expressed the receptors, with the most intense p55 staining on vascular endothelial cells. In the vast majority of synovial tissues, far greater numbers of cells expressed the p55 form of the receptor than the p75 form. CONCLUSION: JRA and JSpA synovia are characterized by the presence of TNF alpha, TNF beta, and cells expressing TNFR. These findings provide further evidence that TNF, through autocrine/paracrine mechanisms, may amplify local inflammation, leading to joint destruction. The prominence of TNF beta in the synovium in particular subgroups of JRA patients and in JSpA patients may be a distinguishing feature of these diseases.

Adult↗