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Biomedical subjects

D Moir

Publications and source records attributed to D Moir.

At least 19 recordsLinked to original sources
PubMed2001

Supporting Partners of People with Aphasia in Relationships and Cconversation (SPPARC).

This paper reviews new theoretical and practical developments in working with partners of people with aphasia and describes the development of a clinician's resource entitled 'SPPARC: Supporting Partners of People with Aphasia in Relationships and Conversation'. It focuses particularly on one part of that resource: the SPPARC Conversation Training Programme, which adapts conversation analysis for clinical use. The paper describes the stages involved in assessing and working on conversation in everyday life.

Aphasia↗
PubMed2001

Structure-activity relationship study on the bioreduction of azo dyes by Clostridium paraputrificum.

Seven commercially available, structurally related azo dyes have been bioreduced by the anaerobic bacterium Clostridium paraputrificum. The rates of reduction of these dyes were found to vary between 24 and 74 nmoles reduced/mg protein/h. Acid red 1 and desmethyl acid red 106 were found to be the most readily reduced, while chromotrope 2R and cibacron brilliant red 3B-A were reduced at the slowest rates. The differences in reduction rates can be rationalized on the basis of structural differences and are consistent with the possible intermediacy of low molecular-weight electron carriers as the mediators of reduction. The incorporation of electron-withdrawing groups into the dyes, even if remotely placed, was found to increase the rate of reduction of dyes under controlled conditions, supporting the inversely proportional relationship between the electron density of the azo bond and the ease of bioreduction.

Azo Compounds↗
PubMed2001

First steps in developing a managed clinical network for vascular services in Lanarkshire.

AIM: To survey key personnel involved in setting up a Managed Clinical Network (MCN) for vascular services in Lanarkshire to assess their views, knowledge and understanding about networking, with a view to facilitating the implementation of the MCN. DESIGN: A questionnaire was designed covering current networking practice, use of protocols, audit and training. It was piloted with the MCN core group and extended to the wider steering group. Semi-structured interviews were completed with core group members focusing on the structure and management of the network. SETTING: Lanarkshire Health Board, Lanarkshire Acute Hospital Trust and Lanarkshire Primary Care Trust. SUBJECTS: The core group and steering group for the development of a Managed Clinical Network for Vascular Surgical Services. RESULTS: Clinicians tend to have more contacts with clinicians and managers with managers. There was close and frequent networking among clinicians of equal status. Respondents shared increased expectations for participation in audit, working to protocols, training and development and improved means of obtaining patients' views and providing information. All respondents recognised the necessity for network leadership although, in this study, it was not possible to define the style of leadership. CONCLUSION: This study identified a degree of existing, informal networking among members of the core group and steering group and it will be important to build on that foundation as the MCN develops. Further research is required to determine the most appropriate form of leadership for the network, and to identify, more clearly, what is understood by a managed network and what accountability there should be.

Attitude of Health Personnel↗
PubMed2000

Needs assessment in primary care: general practitioners' perceptions and implications for the future.

BACKGROUND: Health needs assessment can guide the appropriate shift to primary care by identifying the most effective and efficient resource allocation to meet the needs of populations. Assessing health care needs will be a continuing challenge for primary care trusts in Scotland (or equivalent groups in other parts of the United Kingdom); however, lessons must be learned from the experience of needs assessment that followed the 'internal market' reforms of the 1990s. AIM: To examine general practitioners' (GPs') awareness and experience of needs assessment, to identify barriers to needs assessment in primary care, and to ascertain how better progress might be made in the future. METHOD: A postal questionnaire survey of 1777 Scottish GPs (a one-in-two sample) was combined with a semistructured interview survey of 'lead' GPs from a random sample of 64 mainland Scottish practices between May and August 1996. RESULTS: Sixty-five per cent (1154) of GPs responded to the questionnaire, of which 54% (965) were completed. Over 73% (47) of interviews were completed. Most GPs were unfamiliar with the concept of needs assessment and there was no evidence that needs assessment had influenced commissioning decisions. Most GPs argued that it was not a 'core' activity and that they lacked training in the relevant skills. While the attitude of the majority was indifferent, cynical, and sometimes hostile, a minority, comprising mostly younger fundholders, was more enthusiastic about needs assessment. CONCLUSION: The motivation and attitude of the majority of GPs present a barrier to needs assessment in primary care. GPs will require more resources and training if they are to undertake this responsibility. Most GPs believe than incentives (financial or organisational) will be necessary. Primary care trusts and equivalent structures should be aware of these attitudes as they seek to establish plans based on estimates of population needs in defined locations.

Adult↗
PubMed1998

Pharmacokinetics of benzo[a]pyrene in the rat.

Groups of 4 male Wistar rats were dosed intravenously with 14C-labeled benzo[a]pyrene dissolved in an Emulphor/water vehicle at 3 different dose levels and killed at 1 of 15 specific time intervals from 5 min to 32 h after dosing. 14C-Radiolabel concentration-time data were obtained for blood, brain, adipose, heart, kidney, liver, lung, spleen, and testes. Benzo[a]pyrene concentration-time data were obtained for blood, adipose, kidney, liver, and lung. Appropriate mathematical models were fitted to these data and to the data for metabolites derived as the residuals from 14C-radiolabel minus benzo[a]pyrene difference, where applicable. Nonlinear kinetics were found for 14C-radiolabel in liver, while the data from lung for both 14C-radiolabel and for benzo[a]pyrene per se supported the binding of benzo[a]pyrene in that tissue.

Adipose Tissue↗
PubMed1998

A study to determine how needs assessment is being used to improve health.

OBJECTIVE: To determine how needs assessment is being used in Health Authorities and General Practice. DESIGN: A postal survey of a one in two sample of Scottish GPs, semistructured interviews with selected health authority executives and a random sample of GPs. SUBJECTS: Nine hundred and sixty-five GPs (54% of those sent the postal questionnaire), 47 randomly selected GP practices and 36 selected health authority (called health boards in Scotland) executives. RESULTS: In health authorities, a view of commissioning/planning emerged with three components: (1) planning (including needs assessment); (2) leadership; and (3) strong relationships with stakeholders. Health authority executives believed that GP involvement is one of several vital components but doubted the commitment of all but a few GPs to the planning process. GPs welcomed enhanced influence but feared increases in workload and admitted to a lack of training in the skills required for needs assessment. Health authority executives aspired to place needs assessment at the centre of planning but admitted that, at present, cost and volume issues predominate. Most GPs were not involved in needs assessment and argued that it is not part of a GPs core activity. National needs assessment documents were well received by health authorities but made little or no impact on GPs. CONCLUSIONS: Needs assessment will have little involvement from primary care until there are changes in the attitudes and skills of the majority of GPs. Fundamental changes are required in health authority priorities and practice if their rhetoric about needs assessment is to be turned into reality. The role of needs assessment could be enhanced but this will only happen if it can be shown to lead to improved health outcomes while addressing the financial pressures that currently dominate the agenda.

Attitude of Health Personnel↗
PubMed1997

The subchronic toxicity of acridine in the rat.

The subchronic toxicity of acridine was investigated in rats following dietary exposure at 0, 1, 10, 100 and 500 ppm for 13 weeks. The growth rate and food consumption were not affected by treatment and no clinical signs of toxicity were observed. There was a slight but significant decrease in spleen weight, both in absolute terms and as a percent of body weight, in the 500 ppm males and a slight increase in absolute thymus weight in the females of the same dose group. Both hepatic ethoxyresorufin O-deethylase (EROD) and pentoxyresorufin O-dealkylase (PROD) activities were slightly, but significantly, elevated in females in the 500 ppm dose group. No haematological or other biochemical changes were observed. Females also displayed dose-related increases in inorganic phosphate and uric acid levels. Treatment-related histopathological changes were seen in the thyroid, liver and kidney and included hepatic anisokaryosis and vesiculation of nuclei and glomerular adhesions, reticulin sclerosis and nuclear pyknosis in the kidney. Residue data showed a dose-dependent accumulation of acridine in liver, kidney and adipose with the highest concentration being found in the fat of the 500 ppm dose group. Based on these data, the no observable adverse effect level of acridine was judged to be 100 ppm or 12 mg/kg bw/day.

Acridines↗
PubMed1996

Structure of the human receptor tyrosine phosphatase gamma gene (PTPRG) and relation to the familial RCC t(3;8) chromosome translocation.

The receptor protein tyrosine phosphatase gamma gene, PTP gamma (locus name PTPRG), was previously mapped to chromosome region 3p14.2, within a 2- to 4-Mb region centromeric to the 3p14.2 breakpoint of the t(3;8) familial renal cell carcinoma (RCC)-associated constitutional chromosome translocation. Because of its chromosomal position, its enzymatic properties as a receptor phosphatase, which might oppose a growth activating kinase activity, its homozygous deletion in murine L cells, and its transcriptional activity in numerous normal tissues, including kidney, the PTP gamma gene was an attractive tumor suppressor gene candidate for renal cell carcinoma. To determine whether the PTP gamma gene was a target of loss of heterozygosity or mutation in RCCs and to determine its map position relative to the t(3;8) break at 3p14.2, we have isolated YAC and lambda genomic clones for the PTP gamma gene and other 3p14.2 markers and determined the relative positions of the t(3;8) break, a 3p14.2 de novo break possibly in a fragile site, and the 5' end of the PTP gamma gene. Additionally, the genomic structure, position of the proximal promotor, and intron-exon border sequences of the 30-exon 780-kb PTP gamma gene have been determined, which will facilitate analysis of the PTP gamma gene in tumors.

Base Sequence↗
PubMed1995

Experience of an implantable central venous access system in a district general hospital.

Reliable access to a central vein is increasingly important in the treatment of major acute and chronic disease. The use of an implantable central venous access device in a district general hospital is reviewed. Fifty-four PortaCaths (Kabi Pharmacia, Milton Keynes, UK) were inserted in 51 patients over a 7-year period. Most patients had haematological disease, often with neutropenia and thrombocytopenia. There were a total of 22,515 catheter days experience. Twelve catheters were removed for complications with an overall complication rate of 0.93/1000 catheter days. There were four line infections and four episodes of periport sepsis. Occasional catheter thrombosis was usually cleared with urokinase. Neutropenic and immunocompromised patients had an increased complication rate. PortaCaths were well tolerated by patients and required minimum maintenance. An implantable central venous access device proved safe and reliable for use in a district general hospital.

Adolescent↗
PubMed1993

Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial.

High-dose chemotherapy and radiotherapy with autologous bone-marrow transplantation (ABMT) are increasingly used for the treatment of relapsed and resistant Hodgkin's disease, although there has been no randomised trial of this treatment. The British National Lymphoma Investigation therefore undertook a randomised comparison of high-dose chemotherapy (BEAM = carmustine, etoposide, cytarabine, and melphalan) plus ABMT with the same drugs at lower doses not requiring bone-marrow rescue (mini-BEAM) in patients with active Hodgkin's disease, for whom conventional therapy had failed. 20 patients were assigned treatment with BEAM plus ABMT and 20 mini-BEAM. All have been followed up for at least 12 months (median 34 months). 5 BEAM recipients have died (2 from causes related to ABMT and 3 from disease progression) compared with 9 mini-BEAM recipients (all disease progression). This difference was not significant (p = 0.318). However, both event-free survival and progression-free survival showed significant differences in favour of BEAM plus ABMT (p = 0.025 and p = 0.005, respectively). Recruitment to the trial became increasingly difficult because patients refused randomisation and requested ABMT. It was therefore closed early (40 patients rather than 66 intended). Nevertheless, we found a dose-response effect in these patients with relapsed and resistant Hodgkin's disease. High doses facilitated by ABMT can lead to better disease-free survival.

Adolescent↗
PubMed1992

Comparative metabolism of phenanthrene in the rat and guinea pig.

In the present study the biotransformation of phenanthrene in the rat and guinea pig was investigated. 14C-labelled phenanthrene was administered by gavage in corn oil to Sprague-Dawley rats (10 mg/kg b.w./day) and guinea pigs (10 mg/kg b.w./day). Urine and feces were separately collected for the determination of the radioactivity content, and pooled urine was used for the analysis of metabolites. Phenanthrene was metabolized by the rat and guinea pig to free hydroxylated phenanthrenes and their conjugates. The percentages of conjugates, expressed as the total urinary radioactivity, were 39% glucuronides, 24% sulfates and 18% cysteinylglycine for rats; and 39% glucuronides, 23% sulfates and 28% cysteinylglycine for guinea pigs. Enzymatic hydrolysis of glucuronides and sulfates resulted in the formation of free 1,2-, 3,4- and 9,10-dihydrodiols of phenanthrene and 1-, 2-, 3-, and 4-hydroxyphenanthrene in both species.

Administration, Oral↗
PubMed1992

Mini-BEAM followed by BEAM and ABMT for very poor risk Hodgkin's disease.

High dose chemotherapy and autologous bone marrow transplantation (ABMT) is an effective form of salvage therapy in patients with relapsed or resistant Hodgkin's disease. Patients with large tumour masses at the time of ABMT have a poorer prognosis and we have therefore administered intermediate dose BCNU, etoposide, cytarabine and melphalan (mini-BEAM) prior to high dose therapy with the same agents (BEAM) and ABMT in such patients. In addition we have used the same strategy in patients with bone marrow infiltration at the time of relapse in an attempt to clear the bone marrow for transplant. A total of 23 patients received mini-BEAM and 21 proceeded to BEAM and ABMT. Platelet engraftment was delayed compared to BEAM recipients who had not received mini-BEAM (P = 0.008) but there was only one procedure related death. Responses to BEAM and ABMT were not predicted by the response to mini-BEAM indicating a dose response effect at the upper end of the dose intensity spectrum. At 2 years, the overall survival and progression free survival are 61% and 46% respectively for this group of Hodgkin's patients with extremely poor prognosis.

Adult↗
PubMed1989

Dynamics and orientation of glycolipid headgroups by 2H-NMR: gentiobiose.

Deuterium nuclear magnetic resonance has been used to investigate the dynamics and determine the orientation of the headgroup of the glycolipid 1,2-di-O-tetradecyl-3-O-(6-O-beta-D-glucopyranosyl-beta-D-glucopyranosyl )-sn- glycerol (beta-DTDGL), in aqueous multilamellar dispersions. In addition, its anomeric analog, having an alpha glucose-glycerol linkage, was prepared and examined. The lipids were labelled with deuterium at specific positions in the disaccharide moiety. Analysis of the deuterium quadrupolar splittings for the first glucose ring (glycerol-linked) gave segmental order parameters of 0.43 and 0.35 for the beta and alpha isomers, respectively. Both isomers had similar orientations of the sugar ring relative to the bilayer surface, as determined for lipid in the liquid-crystalline phase. 2H-NMR results for the lipid labelled at C-6' are consistent with a single conformation about the C-5'-C-6' bond of the first glucose residue, with a dihedral angle (O-5'-C-5'-C-6'-O-6') of -17 degrees. The results obtained for the second sugar ring suggest that two conformers may be present, which are in slow exchange on the 2H-NMR timescale. Measurements of longitudinal relaxation times, T1z, gave similar values for both sugar moieties in the headgroup, suggesting that the disaccharide does not exhibit the flexibility expected about the 1----6 linkage. Since T1z for 2H in these compounds decreases with increasing temperature and increases with magnetic field strength, the motion(s) dominating relaxation is in the long-correlation-time regime [omega 0 tau c)2 greater than 1). Thus, the gentiobiosyl headgroup undergoes the slowest motion of the glycolipid headgroups studied to date.

Calorimetry, Differential Scanning↗
PubMed1989

Afferent arteriolar C3 disease--a distinct pathological entity.

Afferent arteriolar C3 deposition was the sole histological abnormality in 79 and the major histological abnormality in an additional 39 of 959 renal biopsies performed over a 10-year period. Of these 79 patients, hematuria was the presenting symptom in 90%, with coincident loin pain in 49%. Urine microscopy of asymptomatic first-degree relatives revealed hematuria in 44% of children and siblings and 54% of parents, suggesting autosomal dominant inheritance. Arteriolar C3 deposition was confirmed by biopsy in four asymptomatic relatives with hematuria. Generalized thinning of glomerular basement membrane (less than 200 nm) was observed in five patients and focal thinning was observed in six patients with coincident afferent arteriolar C3 deposition. Seven other patients were identified as having generalized thinning of glomerular basement membrane in the absence of afferent arteriolar C3 deposition. Renal function was stable and similar in all groups studied over 37.9 +/- 23.7 months. No difference in clinical presentation or urinary abnormalities was evident between the groups. No arteriolar C3 deposition was evident in eight autopsy specimens with no known renal disease. It was concluded that afferent arteriolar C3 deposition is a marker of a distinct hereditary pathological entity, with differentiation from thin basement membrane disease not possible on clinical grounds. The medium- and long-term prognoses with respect to renal function are excellent.

Adolescent↗
PubMed1989

Preservation of high-energy phosphates in human myocardium. A phosphorus 31-nuclear magnetic resonance study of the effect of temperature on atrial appendages.

After prolonged exposure to low temperatures (1 degree and 4 degrees C), human atrial trabeculae show poor recovery of contraction. At somewhat higher temperatures (12 degrees and 20 degrees C), recovery is much better (Keon and associates. Ann Thorac Surg 1988;46:337-41). Although better preservation of adenosine triphosphate and therefore improved contractile recovery might be expected after exposure to lower temperatures, it remained possible that, below a certain temperature, adenosine triphosphate-generating mechanisms could be slowed more than adenosine triphosphate utilization. To investigate this phenomenon further, we followed the time course of metabolic changes in human atrial appendages, harvested during cardiac bypass operations, at 1 degree, 4 degrees, 12 degrees, and 20 degrees C using high-resolution 31P and 1H nuclear magnetic resonance spectroscopy. The results are quantitated by correlation with data obtained from biochemical assays on quick-frozen tissues. Initial adenosine triphosphate levels in myocytes of human atrial appendages are 3.3 to 4.3 mumol.gm-1 tissue wet weight. At 20 degrees C, adenosine triphosphate disappears after 6 hours; at 12 degrees C, about half the initial adenosine triphosphate is still observable at this time; at 4 degrees C or 1 degree C, the decline is still slower. Only a small contribution toward adenosine triphosphate maintenance comes from creatine phosphate, since creatine phosphate, inorganic phosphate, and total creatine levels in the appendage are low (less than 2 mumol.gm-1 tissue wet weight). Glycolysis is active at all temperatures; the rate of glycolysis correlates positively with increasing temperature. Adenosine triphosphate generated by glycolysis falls just short of demand at all temperatures, but the difference is small at 1 degree and 4 degrees C. These studies lead us to conclude that the relatively poor recovery of contractile response of human atrial trabeculae, together with contracture reported previously at lower temperatures (1 degree and 4 degrees C), is not due to a failure to maintain adenosine triphosphate levels.

Adenosine Triphosphate↗