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Biomedical subjects

D Pearson

Publications and source records attributed to D Pearson.

At least 73 records · Page 4Linked to original sources
PubMed1996

External radiation protection audit in National Health Service hospitals. Radiation protecgtion advisors (RPA) of the Nottingham City Hospital NHS Trust and the Oxford Radcliffe Hospital NHS Trust.

Radiation protection advisers are accustomed to carrying out internal audit in organizations for which they provide services but, traditionally, external audit has not been a part of the radiation protection adviser function. To provide an external audit function, two teams of radiation protection advisers undertook external radiation protection audits of their respective organizations, including the radiation protection adviser function itself. These audits were more representative of audits or inspections carried out by government agencies, for example the Health and Safety Executive and the former Inspectorate of Pollution, now the Environment Agency. Subsequently, reports, including recommendations for remedial action, were prepared for each management by the external auditors. The process of setting up and carrying out the external audits is described. Guidelines are suggested for those seeking to carry out an external audit.

England↗
PubMed1996

Kaposi's sarcoma-associated herpesvirus in Kaposi's sarcoma occurring in immunosuppressed renal transplant recipients.

Kaposi's sarcoma-associated herpesvirus (KSHV) has been implicated in the genesis of Kaposi's sarcoma and other tumors occurring in immunosuppressed individuals. Using amplification by the polymerase chain reaction and nucleotide sequencing of extracted DNA, we have detected the KS330(233) sequence of KSHV DNA in Kaposi's sarcoma tissue from 4 immunosuppressed renal transplant recipients. The sequences shared a greater than 98% homology with those described in KSHV DNA from Kaposi's sarcoma in patients with acquired immunodeficiency syndrome. In another 2 renal transplant recipients KSHV DNA could not be detected in scar tissue at the site of previous Kaposi's sarcoma that had resolved after immunosuppression was discontinued and haemodialysis recommenced. These findings support the hypothesis that KSHV may be the infectious agent concerned in the genesis of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Quantitative bone scintigraphy in the management of monostotic Paget's disease of bone.

OBJECTIVE: To assess the use of quantitative bone scanning (QBS) in the monitoring of patients with intravenous pamidronate-treated symptomatic monostotic Paget's disease of bone in whom biochemical markers of bone turnover are relatively normal. METHODS: QBS was performed in 9 patients and the results were expressed as a ratio, obtained by comparing isotope uptake at an affected and a control (unaffected) site. RESULTS: Serum alkaline phosphatase levels were normal in 7 of the 9 patients and changed minimally with treatment. The median QBS ratio was 2.72 (range 1.69-24.6) at baseline and 1.49 (range 0.63-4.18) posttreatment (P = 0.008). The median symptom score decreased with treatment, but QBS ratios provided the only objective measure of disease activity by which response to pamidronate therapy could be judged. CONCLUSION: QBS may be a useful technique for evaluating the effects of treatment in patients with Paget's disease of bone.

Adult↗
PubMed1995

Effect of corticosteroid on lymphocyte adhesion.

Pulse steroid therapy is utilised in the treatment of vasculitis and active rheumatoid arthritis. Decreased entry of lymphocytes to sites of cell-mediated immune reactions is well recognised, though the mechanism is not fully understood. It may involve adhesion to endothelium. We have therefore measured the effect of methylprednisolone on lymphocyte adhesion to porcine lamina propria endothelium. A marked decrease in adhesion was found after incubating cells at 4 degrees C or at room temperature, with a clear dose response effect, from 0.46mM to 6.3mM. We have previously demonstrated binding of rheumatoid synovial fluid mononuclear cells to lamina propria endothelium. It is suggested that the ameliorating effect of steroid pulsing may be mediated by down-regulating adhesin expression of a gut-seeking population of cells.

Animals↗
PubMed1995

A new immunohistochemical antibody for the assessment of estrogen receptor status on routine formalin-fixed tissue samples.

We describe a method for the immunocytochemical assessment of estrogen receptor (ER) status on routinely processed, formalin-fixed tissue using a recently developed commercially available monoclonal antibody (Dako 1D5) with a microwave antigen retrieval technique. A series of 90 cases of human breast carcinoma was analyzed and the staining was assessed using a semiquantitative microscopic scoring method and by assessment of the percentage of nuclei showing positive staining. The results were compared with assessment using another commercially available antibody (Abbott H222) and with clinical response to tamoxifen therapy. Direct comparison of the paired sets of H scores and the percentage of positively stained nuclei using the two different techniques showed a significant correlation. By assigning an arbitrary cut-off for positivity of H score = 50, assessment of ER status using DAKO 1D5 antibody was found to correlate with response to tamoxifen therapy with a sensitivity of 90% and a specificity of 51%, similar to values in previous studies using other methods. We conclude that assessment of ER status using this new antibody and technique gives accurate results on routinely processed, formalin-fixed tissue and may be used as an alternative to other methods.

Adult↗
PubMed1995

Pre-treatment serum levels of tumour markers in metastatic breast cancer: a prospective assessment of their role in predicting response to therapy and survival.

The value of pre-treatment serum tumour marker levels in 85 consecutive patients of newly diagnosed metastatic breast cancer was prospectively assessed for predicting response to therapy and survival. The markers studied were carcinoembryonic antigen (CEA), orosomucoid (ORO), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), ferritin (FERR), human milk fat globule membrane 1 and 2 (HMFG1 and 2), CA 15-3 and NCRC-11. There was no correlation between serum marker levels and response to therapy. Only serum concentrations of CRP (P = 0.02), FERR (P = 0.001), HMFG1 (P = 0.004) and HMFG2 (P = 0.04) were predictive for survival. The prognostic significance of HMFG1 was restricted to a minority of patients (7%) with extreme values of these serum markers.

Aged↗
PubMed1995

Results of the United Kingdom Children's Cancer Study Group first Wilms' Tumor Study.

PURPOSE: The first United Kingdom Children's Cancer Study Group (UKCCSG) Wilms' Tumor Trial (UKW1) applied treatment regimens stratified by stage and histology in accordance with National Wilms' Tumor Study (NWTS) criteria, seeking to reduce treatment of low-stage, favorable-histology (FH) tumors without impairing survival and to improve prognosis of stage III and IV (FH) and unfavorable-histology (UH) tumors with more intensive chemotherapy. PATIENTS AND METHODS: Three hundred eighty-four consecutively diagnosed patients with Wilms' tumor were recruited from the 20 UKCCSG centers and Oslo, Norway, between January 1980 and June 1986. The regimen for stage I patients was vincristine (Vcr) only, while stage II patients received Vcr and dactinomycin (Act-D). Stage III patients received three-drug therapy and stage IV and UH patients four-drug regimens. Act-D was given as pulsed doses of 1.5 mg/m2 every 3 or every 6 weeks. No lung irradiation was used in stage IV patients. No randomized comparisons were attempted. End points were survival and event-free survival (EFS). RESULTS: Survival at 6 years in FH patients was 96% for stage I, 93% for stage II, 83% for stage III, 65% for stage IV, and 50% for UH patients of all stages. CONCLUSION: Vcr alone is as effective for stage I FH tumors as the two-drug regimen used in the NWTS and International Society of Pediatric Oncology (SIOP) studies. Fractionation of Act-D is unnecessary. The poorer results for stage IV FH and UH patients compared with the NWTS may be due to treatment differences, such as the use of lung irradiation for stage IV FH patients in NWTS3, and/or to case selection bias.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Post-1945 international migration: New Zealand, Australia and Canada compared.

"New Zealand's immigration policies and trends since 1945 are compared with those of Canada and Australia. For most of this period, Australia has pursued the more expansive immigration policy while Canada and New Zealand have tended to link immigration intakes to fluctuations in labor demand. All three countries initially discriminated against non-European immigrants but gradually moved towards nondiscriminatory policies based on similar selection criteria and means of assessment. New Zealand has traditionally been more cautious than both Canada and Australia in terms of how many immigrants it accepted and from what sources, but it has recently followed the other two in raising immigration targets encouraging migration from nontraditional sources, particularly Asian countries. Historical, global and national factors are drawn upon to explain the degree of convergence between these three societies."

Americas↗
PubMed1995

Outcome of infants on chronic peritoneal dialysis.

To assess the outcome of infants on chronic peritoneal dialysis (PD), we retrospectively reviewed 21 patients who began PD prior to one year of age. Mean age at first dialysis was 56 +/- 56 days with mean weight of 3.6 +/- 1.6 kg. Seventeen infants were male and 17 were Caucasian. The most common primary renal diagnosis was renal hypoplasia/dysplasia, occurring in 7 infants. Mean time on PD was 10 +/- 10 months. Eleven infants had oliguria, and 10 infants had adequate urine output. All but 1 infant received tube feedings; mean caloric intake was 453 +/- 92 kJ/kg/day. Despite nutritional management, weight, height, and head circumference was at or above the fifth percentile in only 10, 4, and 5 infants, respectively. Nonrenal abnormalities were present in 12 of 21 infants with lung, heart, and central nervous system abnormalities occurring most often. Outcome included 7 receiving renal transplants, 1 who recovered renal function, 4 who continued on PD, and 9 who died. Seven infants with oliguria died, while only 2 infants with adequate urine output died. No infant with isolated renal disease died, while 9 of 12 patients with renal plus nonrenal abnormalities died. Thus mortality in infants less than one year of age on PD appears to be associated with the presence of oliguria and nonrenal abnormalities.

Female↗
PubMed1994

Clinical ecology.

Explore the source record for details and available documents.

Complementary Therapies↗
PubMed1994

Differences in sociodemographic, health status, and lifestyle characteristics among American Indians by telephone coverage.

BACKGROUND: Telephone interviews are often used to obtain population-based estimates of health-related behaviors but they have serious limitations if phone coverage is poor and people without telephones differ from those with telephones. In this article we examine differences in selected sociodemographic, health status, and lifestyle factors among a sample of American Indian adults with and without telephones. METHODS: In-person interviews were conducted with 410 adult residents of a Rocky Mountain state American Indian reservation. The interview included a question asking about telephone coverage. We compared respondents with and without telephones on demographics, health status, and lifestyle practices. The comparison was repeated for health status and lifestyle practices after adjusting for differences in demographic characteristics. RESULTS: Residents without phones generally were less educated, had lower income and were more likely to be unemployed. The prevalence of unhealthful lifestyle practices/factors was consistently higher for residents without telephones. Many of the differences were reduced by adjusting for demographic characteristics, but significant differences remained for alcohol and marijuana use. CONCLUSIONS: These results suggest that developing estimates of sociodemographic, health, and lifestyle characteristics on a Native American Indian reservation using a telephone survey method may result in significant noncoverage biases. Adjusting for demographic characteristics eliminated most of these differences. However, significant differences were still apparent with alcohol and marijuana use.

Adolescent↗
PubMed1994

Biological factors of prognostic significance in locally advanced breast cancer.

The biological features of tumour type, histological grade, vascular invasion, mitotic index, DNA index, and oestrogen receptor (ER) and progesterone receptor (PgR) status have been investigated as prognostic factors in primary operable breast cancer. We have studied these 7 factors in locally advanced primary breast cancer (LAPC): these patients have occult metastases at presentation. Of 60 consecutive patients presenting with locally advanced disease, 36 were treated initially with Tamoxifen and 24 by radiotherapy. Treatment failure was followed by cross-over to the other therapy. All patients were assessed for response in the primary tumour; external review of response was obtained. Survival was compared using the generalised Wilcoxon test. Response to therapy correlated significantly with histological grade (p = 0.02), ER (p = 0.02), PgR status (p = 0.02), mitotic index (p = 0.01), and tumour ploidy (p = 0.04). Survival from initial therapy correlated significantly with ER (p = 0.01) and PgR status (p = 0.04). Histological grade, mitotic index, tumour ploidy, and ER and PgR status of the primary tumour predict response and prognosis in patients with locally advanced (stage III) breast cancer.

Aged↗
PubMed1994

Length variation in the keratan sulfate domain of mammalian aggrecan.

The keratan sulfate domain of aggrecan consists of a series of tandemly repeating hexapeptides which have the consensus sequence Glu-Glu/Lys-Pro-Phe-Pro-Ser, where the serine side-chains presumably provide sites for the attachment of keratan sulfate (KS) chains. The number of hexapeptide repeats varies between species, ranging from four in rat (Doege et al., 1987) and mouse (Walcz et al., 1992) to 13 in human (Doege et al., 1991) and 23 in bovine aggrecan (Antonsson et al., 1989). Chicken aggrecan (Chandrasekaran and Tanzer, 1992) does not contain a KS domain with a recognizable hexapeptide motif. The extent of this variation among mammalian and avian species is not known, and there is currently no explanation to predict how differences in the size of the KS domain would affect aggrecan function. We used polymerase chain reaction (PCR) to amplify the portion of the human, canine and porcine aggrecan gene that codes for the KS domain. We sequenced the amplified products in each case. Human aggrecan, with 13 hexapeptide repeats (Doege et al., 1987), was used as reference and found to be essentially identical to published data. The canine and porcine KS domains consisted of six and ten hexapeptide repeats respectively. The same PCR protocol was used to amplify the KS domain from genomic DNA of eight other mammalian species. Comparison of the size of these amplified products, as determined by agarose gel electrophoresis, with those for which sequence data are available allowed us to estimate the number of repeats in the KS domain. In almost half the species examined, the KS domain consisted of 13 hexapeptide repeats.

Aggrecans↗
PubMed1993

Use of tumour marker immunoreactivity to identify primary site of metastatic cancer.

OBJECTIVES: To determine whether variations in the expression of tumour related antigens can predict the origin of tumours. DESIGN: Immunohistological study of tumour marker expression in primary adenocarcinomas and respective metastatic deposits. Antibodies to the following tumour markers were used: polymorphic epithelial mucin (NCRC-11 and SM3), carcinoembryonic antigen, carcinoembryonic antigen with non-specific antigen co-specificity, CA125, CA19.9, prostate specific antigens, and thyroglobulin. SETTING: Histopathology department of teaching hospital. SUBJECTS: 100 pathology sections of metastatic adenocarcinoma and their related primary tumours. MAIN OUTCOME MEASURES: Concordance of reactivity between primary and metastatic tumours. Reactivity profiles of tumour sites. RESULTS: The correct primary site of origin was predicted in 70% (33/47) of tumours in men and 54% (27/43) tumours in women with antibodies SM3, 288, CA19.9, CA125, and PSA (men only). Specificities ranged from 68% for breast tumour to 98% for prostate tumour. CONCLUSION: Use of tumour markers in patients presenting with metastatic adenocarcinoma of unknown origin can help localise the probable primary sites and reduce the need for extensive and expensive imaging techniques.

Adenocarcinoma↗
PubMed1993

Cortical tubers demonstrate reduced immunoreactivity for synapsin I.

To evaluate the effects of tuberous sclerosis (TS) on cortical synaptic organization, we analyzed synaptic densities within cortical tubers from the brains of two TS patients using a polyclonal antibody directed against synapsin I, a synaptic terminal-specific protein. The synaptic densities of the tubers and adjacent histologically normal cortex were obtained by determining optical densities using an IBAS (Zeiss) image analysis system. The tubers showed abnormally low levels of synapsin I compared with the normal cortex. The data suggest that cortical tubers do not contain a normal complement of synapses. This may reflect focal underdevelopment of normal cortical-cortical connections. Altered afferent cortical projections may also contribute to synaptic loss in cortical tubers.

Cerebral Cortex↗
PubMed1993

Pump-assisted hemofiltration in infants with acute renal failure.

Hemofiltration is accepted management for acute renal failure in critically ill patients. However, in infants, obtaining arterial access or adequate flow through the access is often difficult. We report our technique and experience with pump-assisted hemofiltration (PAHF) in ten infants with acute renal failure. In five patients, double-lumen venous catheters provided access, while two catheters at separate sites were used in the remaining patients. In all patients, hemofilters were used with standard intravenous tubing added to pre-filter tubing and placed through a standard volumetric infusion pump for regulation of blood flow. The infants, aged 5-575 days, weighed from 2.8 to 11.4 kg and had primary diagnoses of post-operative congenital heart disease in five, sepsis in four, and renal dysplasia in one. The duration of PAHF averaged 158 +/- 115 h (range 20-332 h). Complications included bleeding at a catheter or surgical site in one patient each and asymptomatic hyponatremia in five patients. Thus, with adequate nurse training, PAHF using a volumetric infusion pump for blood regulation can be acceptable therapy in acute renal failure in infants.

Acute Kidney Injury↗
PubMed1993

Activating communities for health promotion: a process evaluation method.

OBJECTIVES: To date, evaluations of community-based prevention programs have focused on assessing outcomes, not the process of organizing communities for health promotion. An approach was developed to analyze community organization efforts aimed at advancing community health objectives. These organizational processes are referred to as community activation. METHODS: Information was gathered from 762 informants through a key informant survey conducted in 28 western communities. The data collected included informant ratings of community activation and information about interorganizational activities analyzed through network analytic techniques. RESULTS: Activation levels, as measured by informant ratings, varied across communities. Program coordination, as measured by network analysis, occurred, on average, approximately 30% of the time. Higher income communities tended to be more activated than lower income communities. CONCLUSIONS: There is a widely recognized need for improved information about health-related community organization activities. It appears possible to gather such information through key informant surveys and to develop measures of community organization status that can be used in the evaluation of community health promotion programs.

Community Participation↗