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Biomedical subjects

D Bird

Publications and source records attributed to D Bird.

At least 55 records · Page 3Linked to original sources
PubMed1984

Evaluation of test immunisation in the assessment of antibody deficiency syndromes.

Antibody responses after immunisation with pneumococcal polysaccharide did not correlate with the severity and frequency of infections in 22 patients with severe hypogammaglobulinaemia, when these were measured by a Farr radioimmunoassay. Five "healthy" patients with severe hypogammaglobulinaemia not only failed to make antipneumococcal polysaccharide antibody, when measured by radioimmunoassay, but also had very low or unrecordable antibody responses to Escherichia coli and failed to produce antibody when immunised with tetanus toxoid. Some of these subjects, however, did make small amounts of IgM antipneumococcal polysaccharide antibody when this was measured by an enzyme linked immunosorbent assay, while others retained some ability to produce IgM or IgA or both in their saliva. These findings show that the measurement of serum antibody responses after immunisation, with the possible exception of IgM antibodies to polysaccharides, is unlikely to be helpful in assessing the requirement for gammaglobulin replacement therapy in patients with hypogammaglobulinaemia.

Adult↗
PubMed1983

Increased serum concentration of T4-binding globulin in patients with hypogammaglobulinaemia.

Patients with hypogammaglobulinaemia have been regularly found to have abnormal conventional thyroid function test results. The abnormality is due to an increased plasma concentration of T4-binding globulin (TBG). As the prevalence of autoimmune thyroid disease is probably increased in hypogammaglobulinaemia this further abnormality in the plasma proteins may lead to diagnostic confusion. Administration of gammaglobulin by infusion causes a rapid but transient fall in plasma concentrations of TBG and T4 which is probably due to a temporary redistribution of the plasma proteins.

Agammaglobulinemia↗
PubMed1981

Behavioural changes during withdrawal from desmethylimipramine (DMI). II. Increased resistance to extinction.

Rats withdrawn from chronic treatment with the tricyclic antidepressant desmethylimipramine (DMI) showed increased resistance to extinction in a runway and in continuously reinforced lever pressing. Changes were not seen in animals maintained on DMI. In acquisition, in the runway, there were no significant differences between groups; in the Skinner box, animals maintained on DMI performed worse than controls, but withdrawn animals recovered to control levels of performance. It is suggested that the effect on extinction may be mediated by a decrease in the efficacy of the dorsal noradrenaline bundle, which develops during chronic DMI treatment, but is masked by the presence of DMI. The implications of the conclusion for the " revised catecholamine hypothesis of depression" are discussed.

Animals↗
PubMed1979

Spontaneous rupture of a liver cell adenoma after long term methyltestosterone: report of a case successfully treated by emergency right hepatic lobectomy.

A case of spontaneous rupture of a liver cell adenoma is reported in a female transexual treated with methyltestosterone 150 mg daily for 7 years. Emergency right hepatic lobectomy was performed successfully. Histology showed peliosis hepatis also. Emergency resection of a liver cell adenoma has been reported in a young woman taking oral contraceptives, and an elective resection in another female transexual treated with methyltestosterone. However, to the best of our knowledge this is the first case of emergency resection of a spontaneously ruptured liver cell adenoma in a transexual treated with long term methyltestosterone. Since there are numerous other patients similarly treated, it may be expected that this complication will be seen again.

Adult↗
PubMed1979

Interrelation of the pituitary-thyroid system at birth in man.

Samples of cord blood derived from 105 normal babies after uncomplicated deliveries were assayed for thyroxine (T4), tri-iodothyronine (T3), reverse tri-iodothyronine (rT3), thyroxine-binding globulin (TBG) and thyrotrophin (TSH). The values for T3, rT3 and TSH were log-normally distributed (geometric means 0.62 nmol/l, 3.28 nmol/l and 10.9 mu./l respectively) and those for T4 and TBG were normally distributed (means 126 nmol/l and 13.7 mg/l), The data were systematically analysed and no evidence was obtained to suggest that the concentration of TSH, which varied widely, was regulated by any of the thyroid hormones alone or in combination. There was a direct relation between the concentrations of T4 and T3 in the cord blood at birth but not between either of these and rT3. There is thus no evidence of a functional interdependence of the hypothalamic-pituitary-thyroid system in man at birth.

Fetal Blood↗
PubMed1978

Reverse triiodothyronine, thyroid hormone, and thyrotrophin concentrations in placental cord blood.

Reverse triiodothyronine (rT3), triiodothyronine (T3), thyroxine (T4), thyroxine binding globulin (TBG), and thyrotrophin (TSH) were measured in sera from placental cord blood in an unselected series of 272 deliveries. In this series the concentrations of rT3 (mean 3.33 nmol/l, 95% confidence limits 1.6--7.0 nmol/l), were log normally distributed and did not overlap the adult normal range (0.11--0.44 nmol/l). There were no correlations between the cord blood concentrations of rT3, T3, T4, and TSH. The cord serum rT3 concentration was not influenced by maturity, birth-weight, or neonatal risk factors, whereas these factors did affect the concentrations of T3, T4, AND TBG. There is no arteriovenous rT3 concentration difference across the placenta, therefore the cord rT3 reflects the systemic rT3 concentration in the baby at birth. As rT3 in the neonate largely, if not entirely, derives from thyroxine from the fetal thyroid, measurement of the cord rT3 concentration may be a good immediate screening test for neonatal hypothyroidism.

Fetal Blood↗
PubMed1978

Regulation of thyrotrophin secretion by negative feedback of tri-iodothyronine on the hypothalamus.

Bilateral injections of tri-iodothyronine (T3, 2 ng in 2 microliter artificial cerebrospinal fluid, CSF) were made into the hypothalami of 15 hypothyroid rhesus monkeys (Macaca mulatta) prepared with chronically implanted intrahypothalamic cannulae. In 29 out of 96 such injections, the concentration of thyrotrophin (TSH) in the plasma fell rapidly by more than 30% and returned to the basal value over the succeeding 48 h, in 13 experiments the fall was 20-30% and in the remaining 54 experiments the level of TSH was unaltered. With [125I]T3, the extent of diffusion of T3 through the hypothalamus in these experiments was shown to be very limited. The hypothalamic injection sites were subsequently identified histologically and it was found that in those experiments in which the level of TSH in the plasma had fallen, T3 had been injected into either the dorsomedial nucleus or the lateral hypothalamic area extending into the preoptic region. Injection of artificial CSF alone into these areas of the hypothalamus did not affect the concentration of TSH. Direct intrapituitary injections of T3 (4 ng) resulted in small and inconstant changes in the concentration of TSH in the plasma and injections of T3 (400 ng) into the third ventricle were without any effect. These experiments demonstrate that T3 can rapidly inhibit the secretion of TSH by a direct action upon defined parts of the hypothalamus.

Animals↗
PubMed1977

Non-clostridial gas gangrene in the diabetic lower limb.

Three cases of non-clostridial gas gangrene in diabetic lower limbs are reported. This rare condition occurs only in diabetes with peripheral neuropathy and is invariably fatal unless treated surgically. The clinical picture is deceptive with a slow, but insidiously progressive course, and the late appearance of skin necrosis. Antibacterial therapy is ineffective in preventing death. A serious delay may be fostered by inconclusive bacteriological investigations. Urgent radical amputation is required to save the patient's life.

Adult↗
PubMed1975

Obesity in a New Zealand community.

A retrospective analysis of the height, weight and certain biochemical data from the Rangiora Diabetic Survey is presented. In this survey 93 percent of the 2670 adult Europeans in Rangiora were studied. A high prevalence of obesity was found with 31 percent of the men and 46 percent of the women being greater than 20 percent above their ideal body weight. More than half the women aged 50 years and over were obese by the criteria used. The peak prevalence of obesity was in the seventh decade for women and in the eighth and ninth decades for men. There were significant increases in serum uric acid in obese men and women in each age decade. A surprise finding in the obese men was the increase in plasma protein levels but this did not occur in the obese women. Both men and women had a trend towards higher blood sugars when obese.

Adult↗
PubMedDate not supplied

Management of patients with depression by rural primary care practitioners.

OBJECTIVE: To investigate the extent to which variations in treatment and referral patterns for adult patients with diagnosed symptoms of depression seen in primary care practices are explained by practitioner characteristics, such as training, years in primary practice, sex, and knowledge about depression; practice characteristics, such as size, patient volume, and payer mix; and service area characteristics, such as availability of specialty mental health services and rural location. DESIGN: A 41-item telephone survey of primary care practitioners (PCPs) in Maine, including family and general practice doctors of medicine and doctors of osteopathy, general internists, nurse practitioners, and physician assistants (n = 267). MAIN OUTCOME MEASURE: The degree to which PCPs treat patients with depression themselves, rather than refer them to a mental health specialist. RESULTS: There is no significant (P = .10) urban-rural difference in the number of patients with depression seen as a percentage of total patient volume. Major barriers to referral to a mental health provider, as reported by the PCP, are long wait for an appointment, lack of available services, patients' unwillingness to use services, and reimbursement issues. Multivariate analyses indicate that PCP characteristics measuring knowledge and attitudes, as well as the lack of available services, are significantly related to treatment and referral patterns while practice characteristics and mental health provider supply are not. CONCLUSION: The treatment of rural patients with symptoms of depression is more likely to be improved by targeting PCPs' medical education than by efforts to increase the supply of specialty mental health providers in rural areas.

Community Mental Health Services↗
PubMedDate not supplied

Integrating risk management into working practice.

The aim of this article, the third in this series on the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004), is to explore how risk management can be integrated into the culture of a healthcare organisation and the working practices of clinicians, managers and their immediate teams.

Health Facility Administration↗
PubMedDate not supplied

Get glammed up.

Explore the source record for details and available documents.

Adaptation, Psychological↗