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Biomedical subjects

D Bailey

Publications and source records attributed to D Bailey.

At least 55 records · Page 3Linked to original sources
PubMed1997

The assessment of acute confusion as part of nursing care.

Older adults who become acutely confused when hospitalized present challenges to nurses because of their increased care needs and risk for injury. This study evaluated the feasibility of introducing the NEECHAM Confusion Scale as part of usual nursing care as a first step in improving nurses' ability to assess, prevent, and manage acute confusion in hospitalized older adults. By addressing several of the factors that influence adoption and continuation of a new practice, this study found that staff nurses could successfully use the NEECHAM Confusion Scale.

Acute Disease↗
PubMed1997

A guide to finding and evaluating best practices health care information on the Internet: the truth is out there?

BACKGROUND: The advent of virtually free Internet access has opened large vistas of health care information to those willing to invest a small amount of time and energy learning how to perform searches using browser software. Health care providers, organizations, and professional associations, among many others, publish "best practices" information for both administrative and clinical audiences, making these recommendations among the fastest-growing types of health care information appearing on the World Wide Web. The problem is how to find best practices among the wealth of resources on the Internet and then how to separate the proverbial wheat from the chaff. WHO IS SEEKING BEST PRACTICES ON THE INTERNET? Best practice describes a process or technique whose employment results in improved patient and/or organizational outcomes. Health care providers, managed care organizations, administrators, payers, and policy analysts are all interested in improving the quality of health care and are likely to be customers of best practices informational resources. HOW TO EVALUATE THE QUALITY OF BEST PRACTICES INFORMATION? Once the information is available on the Internet, the problem for the searcher shifts from one of quantity to quality. The best practices information seeker should stop and ask a number of questions about the quality of information, its sources, and the methods used to obtain it. CONCLUSION: The "truth" may be out there some-where in cyberspace, but locating best practices information and evaluating its quality require new skills and patience and time to practice and develop them to the point of efficiency.

Authorship↗
PubMed1997

Pre-bypass quality assessment of the long saphenous vein wall with ultrasound and histology.

OBJECTIVES: Pre-existing unsuspected wall changes in saphenous vein grafts have been implicated in the graft outcome. Pre-bypass assessment of the vein may identify grafts at high risk for failure. This study was conducted to evaluate preoperatively the quality of the long saphenous vein (LSV) wall with ultrasound and histology. DESIGN: Prospective clinical study. MATERIAL AND METHODS: Three particular LSV segments, ankle, knee and mid-thigh, were evaluated preoperatively by ultrasound in 40 limbs of 38 patients, candidates for coronary artery bypass grafting. The venous wall was characterised based on its thickness and echogenicity in three categories: normal, moderately and severely fibrotic. LSV specimens taken from the above sites were also grouped into the same three categories based on their fibrotic content found on histology. RESULTS: In total, 89 vein specimens were evaluated. On ultrasound, 81 specimens were detected as normal (91%), seven as moderately (8%) and one as severely fibrotic (1%). On histology, only eight specimens were found normal (9%), 75 with moderate (84%) and six with severe fibrosis (7%). Similar wall characterisation with both examinations was found in only 19% (17/89) of the specimens. Eighty-one specimens (91%) had some degree of fibrosis on histology. Different grades of fibrosis were found on histology in different sites of the same vein. CONCLUSIONS: Pre-existing wall changes are very common in vein grafts used for bypass surgery. However, the ultrasonic characterisation of the venous wall preoperatively cannot reliably identify these changes.

Aged↗
PubMed1997

The direct calculation of parametric images from dynamic PET data using maximum-likelihood iterative reconstruction.

The aim of this work is to calculate, directly from projection data, concise images characterizing the spatial and temporal distribution of labelled compounds from dynamic PET data. Conventionally, image reconstruction and the calculation of parametric images are performed sequentially. By combining the two processes, low-noise parametric images are obtained, using a computationally feasible parametric iterative reconstruction (PIR) algorithm. PIR is performed by restricting the pixel time-activity curves to a positive linear sum of predefined time characteristics. The weights in this sum are then calculated directly from the PET projection data, using an iterative algorithm based on a maximum-likelihood iterative algorithm commonly used for tomographic reconstruction. The ability of the algorithm to extract known kinetic components from the raw data is assessed, using data from both a phantom experiment and clinical studies. The calculated parametric images indicate differential kinetic behaviour and have been used to aid in the identification of tissues which exhibit differences in the handling of labelled compounds. These parametric images should be helpful in defining regions of interest with similar functional behaviour, and with FDG Patlak analysis.

Algorithms↗
PubMed1997

Comparative analysis of adult and fetal human small intestinal microvilli.

The aim was to study the development of human small intestinal microvillus membranes. We compared the protein patterns of human fetal and adult small intestinal microvillus membranes using the high-resolution technique of sodium dodecyl sulphate-polyacrylamide gel electrophoresis. We also examined the synthesis of brush border membrane proteins from the adult small intestine using small intestinal biopsy organ culture 35S-methionine uptake and subsequent gel electrophoresis. We observed that the fetal and colonic microvillus membranes were similar, but differed in certain respects from adult small intestinal microvillus membranes. The jejunal biopsy organ culture revealed that synthesised brush border membrane proteins could be recognized by gel electrophoresis.

Adult↗
PubMed1997

Castleman's disease in a 44-year-old male with neurofibromatosis and pheochromocytoma.

A case of Castleman's disease in a patient with type I neurofibromatosis and pheochromocytoma is reported. The association of pheochromocytoma and neurofibromatosis is well documented, but uncommon. Castleman's disease has not been previously documented in a patient with neurofibromatosis or pheochromocytoma and may represent a previously unrecognized association of this disease. Castleman's disease is an interleukin-6 (IL-6) mediated B-cell proliferation. We postulate a relationship between pheochromocytoma IL-6 secretion and Castleman's disease. The relevant literature relating to this unusual case is reviewed.

Adrenal Gland Neoplasms↗
PubMed1997

Learning together.

Explore the source record for details and available documents.

Community Health Nursing↗
PubMed1997

Phase IB clinical trial of the oligosaccharide processing inhibitor swainsonine in patients with advanced malignancies.

The indolizidine alkaloid swainsonine, a potent inhibitor of Golgi alpha-mannosidase II, has been shown to reduce tumor cell metastasis, enhance cellular immune responses, and reduce solid tumor growth in mice. In our previous Phase I study, swainsonine administered by 5-day continuous infusion inhibited L-phytohemagglutinin-reactive N-linked oligosaccharide expression on peripheral blood lymphocytes. Significant toxicities included edema and elevated serum aspartate aminotransferase (AST). One patient with head and neck cancer had objective (>50%) tumor remission. Two patients showed symptomatic improvement. The objectives of this Phase IB trial were to examine the pharmacokinetics, toxicities, and biochemical effects of bi-weekly oral swainsonine at escalating dose levels (50-600 microgram/kg) in 16 patients with advanced malignancies and 2 HIV-positive patients unsuitable for conventional therapy. Eastern Cooperative Oncology Group performance status was </=2. The maximum tolerated dose was defined as 300 microgram/kg/day due primarily to serum AST abnormalities and dyspnea. Other adverse events present in >20% of patients included increase in serum AST (all patients), fatigue (n = 9), anorexia (n = 6), dyspnea (n = 6), and abdominal pain (n = 4). Inhibition of Golgi alpha-mannosidase II occurred in a dose-dependent manner. Examination of immunological parameters revealed a transient decrease in CD25(+) peripheral blood lymphocytes and, in seven of eight patients, an increase in CD4(+):CD8(+) ratios at 2 weeks. Serum drug levels peaked 3-4 h following a single oral dose in most patients and were proportional to dose at levels >/=150 microgram/kg. We conclude that oral swainsonine is tolerated by chronic intermittent administration at doses up to 150 microgram/kg/day. Adverse events considered drug related were similar to those observed in the infusional study but with fatigue and neurological effects also noted. Investigations of alternative dosing schedules with low starting doses are suggested for further clinical testing.

Adult↗
PubMed1996

The assessment of discomfort in elderly confused patients: a preliminary study.

With the increasing numbers of older adults in our population, nurses are reexamining all aspects of nursing care in order to best meet the needs of these individuals. Normal age changes, the impact of decades of environmental challenges, successful adaptations, acute illnesses, trauma and chronic illnesses combine to create a challenge for accurate and effective assessment of elderly patients. The nurse finds her assessment skills challenged with increasing frequency by the elderly patient who is also acutely confused and experiencing discomfort. The purpose of this study was to explore the clinical utility, validity and reliability of four different approaches to nursing assessment of discomfort with this particularly vulnerable group of elders.

Aged↗
PubMed1996

Use of ionising radiation by professional football clubs to assess asymptomatic transfer candidates.

The financial considerations of transfer candidates in the football league is such that a detailed medical examination as well as other investigations are required prior to a successful transfer. With this in mind the concern is raised that professional footballers may be exposed to excessive ionising radiation by undergoing unnecessary radiological imaging. Our study was conducted in order to assess the use of plain films in the assessment of transfer candidates in the premier league

Arthrography↗
PubMed1996

Mucociliary clearance during and after isocapnic hyperventilation with dry air in the presence of frusemide.

We have previously shown that mucociliary clearance (MCC) decreased during and increased after isocapnic hyperventilation (ISH) with dry air, both in asthmatic and healthy subjects. Inhaled frusemide, an inhibitor of the Na+/K+/2Cl- and NaCl co-transporters on the basolateral membrane of the epithelial cell, prevents the airway narrowing provoked by ISH with dry air. The co-transport system controls epithelial cell volume and chloride secretion and, thus, frusemide has the potential to modify the rate of recovery of periciliary fluid volume during and after ISH with dry air, and hence affect MCC. Frusemide also blocks mediator release from mast cells, which may also modify the increase in MCC after ISH. Eleven asthmatic and 11 healthy subjects inhaled frusemide (35.7 +/- 0.44 mg) or its vehicle, from a Fisoneb ultrasonic nebulizer 30 min before ISH with dry air, on two separate occasions. MCC was measured using 99mTc-sulphur colloid and a gamma camera. Frusemide, compared to its vehicle, did not affect MCC during or 45 min after ISH. However, in the presence of frusemide, the onset of the increase of MCC after ISH was significantly delayed for approximately 10 min in the whole right lung (p < 0.002) and central region (p < 0.01) in the asthmatic but not in the healthy subjects. These findings could be explained by frusemide delaying the recovery of the periciliary fluid volume after ISH with dry air and/or interfering with the stimulus that causes the increase in MCC in the asthmatic subjects after ISH.

Adult↗
PubMed1996

Analysis of the glycosylation patterns of the extracellular domain of the epidermal growth factor receptor expressed in Chinese hamster ovary fibroblasts.

The extracellular domain (621 N-terminal amino acids) of the p170 epidermal growth factor (EGF) receptor has eleven consensus N-linked glycosylation sites. When expressed in Chinese hamster ovary cells this was glycosylated with a combination of high mannose and complex chains. The latter chains were shown by chromatographic separation and mass spectrometric analysis of tryptic digests to be clustered in the EGF-binding domain. Treatment with the endoglycosidase, peptide-N-glycosidase F (PNGase F), reduced the molecular weight from 110 kDa to 75 kDa. Released oligosaccharides were characterised at high sensitivity by high pH anion exchange chromatography with pulsed amperometric detection and gas-liquid chromatography/mass spectrometry. The data were consistent with the complex chains being trisialylated tetra-antennary oligosaccharides fucosylated on the reducing terminal GlcNAc. The large hydrodynamic mass of these oligosaccharides could influence ligand binding, an effect which is likely to vary with the difference in consensus glycosylation sites of proteins related to p170 i.e. p185erbB2/neu, p180erbB3 and p180erbB4.

Amidohydrolases↗
PubMed1995

Germline p16INK4A mutation and protein dysfunction in a family with inherited melanoma.

The gene encoding the cell cycle inhibitor p16INK4A (also known as p16, MTS1, CDKN2 and INK4) has been mapped to human chromosome band 9p21, a region that also contains a putative melanoma susceptibility gene. Although germline mutations in the coding region of the p16INK4A gene have been detected in some families with inherited melanoma, many other families show no evidence of such mutations and hence the role of p16INK4A in the development of this tumor is still unclear. In this report, we describe a family with inherited melanoma in which a novel mutation in exon 2 of the p16INK4A gene segregates with the disease. The mutant gene encodes a protein with an in-frame deletion of two amino acids (Asp96 and Leu97). We show that the mutant protein is functionally abnormal: it is unable to bind cdk4 in vitro and does not inhibit colony formation in tertiary passage rat embryo fibroblasts. Moreover, in a metastatic lesion from one patient the wild type p16INK4A allele was deleted and the mutant allele retained. We conclude that family members carrying this germline mutation in the p16INK4A gene are predisposed to melanoma. By extension, these findings implicate the p16INK4A gene in the development of some cases of familial melanoma.

Alleles↗
PubMed1995

Loss of heterozygosity of tumor suppressor genes in testis cancer.

Little is known of the molecular changes that occur in germ cell tumors (GCT) of the testis. We studied three GCT cell lines and 44 tumors for loss of heterozygosity (LOH) of the tumor suppressor genes APC, MCC, DCC, RB, TP53, and WT-1. We observed that LOH occurred in 55% (21 of 38) of informative cases at DCC, in 28% (10 of 36) of informative cases at APC, in 23% (6 of 26) at MCC, in 30% (13 of 43) at RB, and in 27% (6 of 22) at WT-1. The LOH level in these tumors using anonymous primers mapping to the short and long arms of chromosome 19, which is cytogenetically normal in GCT, revealed LOH of 11 and 5%, respectively. We also observed a LOH of 22% in the TP53 gene, despite the fact that mutations in TP53 do not occur in testis cancer. Since a high frequency of LOH at DCC (18q21.3) occurs equally at all histological subsets in GCT, we conclude that the loss of the function of this gene is an early event in testicular GCTs. However, the observed LOH levels at APC/MCC (5q21), RB (13q14), and WT-1 (11p13) could represent a functional loss of the corresponding tumor suppressor gene in some GCTs or reflect the loss of sequences in the same general chromosome region but involving a different tumor suppressor locus. Therefore, detailed mapping of these chromosomes is required to define the precise locations of maximal LOH in testis cancer.

Base Sequence↗
PubMed1995

Dynamics of follicular growth and atresia of large follicles during the ovarian cycle of the guinea pig: fate of the degenerating follicles, a quantitative study.

BACKGROUND: A quantitative integrated study of healthy ovarian follicles of different sizes and their mitotic activity and of clearly defined atretic stages of involuting large growing follicles at different stages of the guinea pig ovarian cycle is not available in the literature. We considered that such a study would reveal new aspects of ovarian tissue dynamics and provide new information in an organ with a continuous phenotypic transformation of its cellular components. METHODS: Ovaries from guinea pigs were removed on days 1 (opening of the vagina), 3, 6, 9, 13, and 16 of the cycle, and the following were measured in serial sections: (1) total number of healthy follicles falling into categories based on the volume occupied by granulosa cells, (2) total number of atretic follicles falling into clearly defined morphological stages of the degenerative and involutionary process affecting medium to large follicles, and (3) proportion of metaphase-arrested granulosa cells, after colcemid injection, in healthy follicles of different size categories. RESULTS: Dynamic patterns of follicular growth and degeneration were revealed that permitted the following main conclusions and observations: (1) small to middle-size follicles can reach the maximal category mass of granulosa mass within 6-7 days, and the number of granulosa cells can increase 6-7-fold during this interval, (2) the cohort that gives rise to 2-6 preovulatory follicles and to the large follicles that will undergo atresia during each cycle varied from 68 to 108 follicles, (3) cell death starts in the granulosa cell layers of large follicles even when neighbouring cells maintain a high mitotic activity and it spreads rapidly; dead granulosa cells are cleare by nucleolysis and cytolysis in the absence of blood leucocytes or neovascularization, (4) foci of atresia are observed also in a few preovulatory follicles, (5) antral cavities of follicles with dead granulosa cells in the process of being lysed shrink and are filled within 2-3 days with large fibroblast-like cells arising from phenotypic transformation of inner layers of theca interna, with no evidence of mitotic activity or angiogenesis; the outer layers of theca interna involute, and by progressive atrophy and a process of cell death, minute nodular structures arise with remnants of the ovum and zona pellucida, and (6) a transient wave of degeneration affects a proportion of small and middle-size follicles during the metestrous period. This process does not resemble the morphological phenomenology of follicular involution, which affects only large follicles. CONCLUSIONS: This study contributes to a fuller understanding of the dynamics and time relationships of follicular growth and loss in the guinea pig ovary and provides new morphogenetic information on the atretic process. It would be valuable for the design of experiments on endocrine and paracrine interactions involved in follicular growth and atresia.

Animals↗