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Biomedical subjects

D Kyle

Publications and source records attributed to D Kyle.

32 records · Page 2Linked to original sources
PubMed1992

Mental illness and help-seeking behavior among Mariel Cuban and Haitian refugees in south Florida.

Differences in psychopathology and use of the mental health system by recent refugee groups are explored in light of competing hypotheses stemming from theories of immigrant adaptation and minority mental health. Results show that would-be Haitian refugees arriving in South Florida during the early 1980s had relatively small needs for mental health care, but whatever needs they had were largely unattended by the health services system. Mariel Cubans had far greater needs that were mostly met satisfactorily by virtue of their familiarity with service facilities prior to departure and their incorporation into a favorable social environment. These contextual factors are added and compared with the individual-level predictor variables suggested by Andersen and others. The results' implications for theories of immigrant mental health and help-seeking and for the implementation of effective delivery programs are discussed.

Adolescent↗
PubMed1990

Ethnic differences in incidence of sudden infant death syndrome in Birmingham.

Among the 45,204 live births in Birmingham in the three calendar years 1981-3, there were 218 postneonatal deaths, giving a postneonatal mortality rate of 4.82 per 1000 live births. Postneonatal mortality rates were 4.22 for whites, 5.91 for Asians (relative risk 1.26, 95% confidence interval (CI) 1.04 to 1.53) and 8.20 for Afro-Caribbeans (relative risk 1.78, 95% CI 1.25 to 2.55). Among Asians malformations were common (3.36) and sudden infant death syndrome rare (1.18), in contrast to Afro-Caribbeans among whom the rates were 0.66 and 5.25, respectively. Logistic regression analysis demonstrated a significantly lower risk of sudden infant death syndrome (SIDS) in Asians and significantly raised risks of SIDS in very low birthweight babies and those with unemployed parent(s). Ethnic differences persisted after controlling for maternal age, social class, and birth weight. Studies of sociocultural differences in child rearing practices are needed and may uncover important aetiological factors of sudden infant death syndrome.

Birth Rate↗
PubMed1988

Factors affecting the uptake of screening for neural tube defect.

A questionnaire concerning pregnant women's knowledge of, and attitudes to, serum alpha fetoprotein (AFP) screening for spina bifida was sent to all pregnant women receiving a health education leaflet on AFP screening who booked at the Birmingham Maternity Hospital in the first quarter of 1984. The majority said that they would accept the test, and subsequently did so. This suggests that low uptake of the test is not a result of patients' resistance, and the results indicated that the provision of early information about the test is likely to improve uptake and decrease anxiety. With the increasing clinical usefulness of the AFP test, routine screening of pregnant women with an 'opt-out' system is becoming clinically desirable, and the survey suggests that it would be acceptable to the patients.

Attitude to Health↗
PubMed1979

The anion-transport protein of the human erythrocyte membrane. Studies on fragments produced by pepsin digestion.

We have studied the fragmentation by pepsin in 1 M-acetic acid of the erythrocyte anion-transport protein in erythrocyte membranes. The location of the fragments obtained was determined by radioiodinating the protein with the use of lactoperoxidase, and identifying the labelled peptides obtained in peptide "maps" of thermolysin digests of the fragments. Three of the fragments were found to be related overlapping products, and shared a common C-terminus. The major site of pepsin cleavage leading to the C-termini of these fragments was shown to be close to the major site of extracellular cleavage of the protein by proteinases active at a neutral pH. Another two fragments were isolated and shown to be derived from the C-terminal portion of the protein. No well-defined large radioactive fragments of the protein were solubilized from the membrane by pepsin in 1 M-acetic acid, the bulk of the radioactivity attributable to the anion transport protein being recovered in very small fragments that could not be resolved by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. Our results suggest that the polypeptide chain of the anion-transport protein emerges at the extracellular face of the membrane 8000-13000 daltons on the N-terminal side of the major site of extracellular cleavage of the protein by proteinases that are active at a neutral pH.

Amino Acid Sequence↗
PubMed1975

The anticipation of death by violence: a psychological profile.

College students (n = 172) completed Cattell's personality factor questionnaire, Rotter's locus of control scale, Speilberger's trait anxiety measure, and Sabatini and Kastenbaum's self-completed death certificate. Comparison of profiles for subjects anticipating sudden violent death (SVD, n = 59) with those anticipating natural death (ND, n = 113) disclosed that the SVD group was characteristically more anxious and socially isolated. A sex-by-type of death interaction occurred for locus of control, with SVD females being the most external, suggesting that this group was more likely to "give up" in response to stress. The data support Shneidman's concept of subintentioned death in disclosing that several personality factors may be associated with violent death.

Accidents↗
PubMed1971

Contribution of a general-practitioner hospital.

A properly functioning general-practitioner hospital with good facilities including visiting consultants can greatly lighten the work load of the district general hospital. A general-practitioner hospital is described, run entirely by general practitioners, which cares for over 70% of the inpatients of a group practice. It deals with 98% of all who attend casualty, and carries out almost all of its x-ray work. Its facilities reduce the estimated demand for outpatient appointments at the district general hospital by almost half.The social advantages of a general-practitioner hospital are obvious, and there may be economic advantages as well. Moreover, such a hospital increases the attractiveness of general practice and improves its quality. It is suggested that the general-practitioner hospital is good for the patient, the community, and the doctor-and even the Treasury. There is room for many more.

Economics, Hospital↗
PubMed1971

Terminal care.

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

Pharmacokinetics of oral artesunate in children with moderately severe Plasmodium falciparum malaria.

The pharmacokinetic properties of oral artesunate (3 mg/kg) were determined in 10 Vietnamese children, aged from 6 to 15 years, with acute falciparum malaria of moderate severity. Plasma concentrations were measured using a bioassay and expressed in terms of antimalarial activity equivalent to dihydroartemisinin, the principal biologically active metabolite. Oral artesunate was absorbed rapidly with a mean time to peak plasma bioactivity of 1.7 h (95% confidence interval [95% CI] 0.8-2.6). There was wide variation in peak plasma concentrations with a mean value equivalent to 664 ng of dihydroartemisinin/mL (95% CI 387-9410, range 179-1395) and a four-fold variation in the area under the plasma concentration-time curves. Elimination from plasma was rapid with a mean (95% CI) half-life of 1.0 h (95% CI 0.8-1.4). Plasma antimalarial levels were below the limit of detection in all cases by 12 h, despite the relatively high dose of artesunate used. Oral artesunate is rapidly absorbed and rapidly eliminated in children with moderately severe malaria but there is considerable variation between individuals.

Administration, Oral↗
PubMedDate not supplied

Pharmacokinetics of quinine and 3-hydroxyquinine in severe falciparum malaria with acute renal failure.

The plasma concentrations of quinine and its main metabolite, 3-hydroxyquinine (3OHQn), were measured in 5 adult Thai patients with severe Plasmodium falciparum malaria and acute renal failure. Two patients required peritoneal dialysis but all survived. During acute renal failure plasma concentrations of 3OHQn rose to reach up to 45% of the levels of the parent compound. The estimated median (range) quinine clearance was 0.83 mL/kg/min (0.58-1.16), and 3OHQn clearance/fraction of quinine converted was 3.40 mL/kg/min (2.58-4.47). The estimated 3OHQn terminal elimination half-life was 21 h (16.5-32.5). These data suggest that 3OHQn contributes about 12% of the antimalarial activity of the parent compound in patients with falciparum malaria and acute renal failure. It is also likely that 3OHQn contributes to adverse effects, although this metabolite is not quantitated routinely by current high-performance liquid chromatography quinine assays.

Acute Kidney Injury↗
PubMedDate not supplied

Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase of isolates from the Amazon region of Brazil.

Since the late 1970s pyrimethamine-sulfadoxine (PS; FansidarTM Hoffman-LaRoche, Basel) has been used as first line therapy for uncomplicated malaria in the Amazon basin. Unfortunately, resistance has developed over the last ten years in many regions of the Amazon and PS is no longer recommended for use in Brazil. In vitro resistance to pyrimethamine and cycloguanil (the active metabolite of proguanil) is caused by specific point mutations in Plasmodium falciparum dihydrofolate reductase (DHFR), and in vitro resistance to sulfadoxine has been associated with mutations in dihydropteroate synthase (DHPS). In association with a proguanil-sulfamethoxazole clinical trial in Brazil, we performed a nested mutation-specific polymerase chain reaction to measure the prevalence of DHFR mutations at codons 50, 51, 59, 108 and 164 and DHPS mutations at codons 436, 437, 540, 581 and 613 at three sites in the Brazilian Amazon. Samples from two isolated towns showed a high degree of homogeneity, with the DHFR Arg-50/Ile-51/Asn-108 and DHPS Gly-437/Glu-540/Gly-581 mutant genotype accounting for all infections in Peixoto de Azevedo (n = 15) and 60% of infections in Apiacás (n = 10), State of Mato Grosso. The remaining infections in Apiacás differed from this predominant genotype only by the addition of the Bolivia repeat at codon 30 and the Leu-164 mutation in DHFR. By contrast, 17 samples from Porto Velho, capital city of the State of Rondônia, with much in- and out-migration, showed a wide variety of DHFR and DHPS genotypes.

Adult↗