The effect of antispasmodic drugs on the endomural bronchial (or "squeeze") pressures in bronchitis and asthma.
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Aminophylline↗
Biomedical subjects
D Simpson
Publications and source records attributed to D Simpson.
Reversible and irreversible immobilization of enzymes on Graphite Fibrils.
Graphite Fibrils are hollow tubes (0.01 x 1-10 microns) consisting of concentric layers of graphite. Fibrils can be chemically modified to introduce surface functionalities such as carboxyl groups. Carboxylated fibrils were further functionalized to amino alkyl derivatives which were covalently linked to an enzyme, horseradish peroxidase (HRP). HRP fibrils showed substantial catalytic activity. Additionally, carboxyl fibrils were derivatized with specific inhibitors of the enzymes beta-galactosidase (beta-Gal) and alkaline phosphatase (AP). Enzyme inhibitor-modified fibrils were used to specifically purify both beta-Gal (using beta-Gal inhibitor fibrils) and AP (using AP inhibitor fibrils) from mixtures of these two enzymes. These studies demonstrate the feasibility of using Graphite Fibrils as supports in biocatalysis and biospecific affinity chromatography.
Alkaline Phosphatase↗
Management of acute iron poisoning.
Acute iron poisoning is most common in children below the age of 5 years. While there is no doubt that it may be fatal, recent surveys show that death occurs in only a very small percentage of cases and that iron salts are responsible for a small minority of fatalities due to overdosage with drugs. Similarly, the proportion of severe cases seems to have fallen over the last thirty years, possibly due to earlier and more aggressive treatment but more probably due to an increase in the number of minor exposures reported. Iron salts are directly toxic to the gastrointestinal tract causing vomiting, diarrhoea, abdominal pain and occasionally significant blood loss. They also cause metabolic acidosis by interfering with intermediary metabolism and producing shock and reduced tissue perfusion. The clinical course of acute iron poisoning is divided into 4 phases. Features of acute gastrointestinal irritation dominate the period up to 6 hours after ingestion and most patients do not develop other features or progress beyond this stage. Rarely, blood loss may be sufficient to cause hypotension. Severe poisoning is characterised by impairment of consciousness, convulsions and metabolic acidosis. The second phase, 6 to 12 hours after ingestion, is one of remission of features. Phase 3 comprises the period 12 to 48 hours from ingestion and is reached only by a small minority of patients. Recurrence or development of shock, and metabolic acidosis are usual and renal failure and features of extensive hepatocellular necrosis may develop. The last (fourth) phase, 2 to 6 weeks after ingestion, is only likely to develop in young children and is characterised by recurrence of vomiting due to gastric or duodenal stenosis caused by healing of iron-induced mucosal ulcers. Acute iron poisoning in humans has not been adequately studied and is unlikely to be so now because of the infrequent and sporadic occurrence of cases. The evidence for many conventional aspects of management is therefore unsatisfactory. Assessment of severity of poisoning is an essential prerequisite to optimum management but is difficult. The amount of elemental iron ingested is unacceptable since it is seldom known with accuracy and absorption is unpredictable because of vomiting and diarrhoea. The commonly encountered clinical features are also unreliable although it is generally accepted that coma, shock and metabolic acidosis indicate severe poisoning.(ABSTRACT TRUNCATED AT 400 WORDS)
Adult↗
HIV treatment adherence in women living with HIV/AIDS: research based on the Information-Motivation-Behavioral Skills model of health behavior.
Close and consistent adherence to anti-HIV medication regimens is necessary to achieve the maximum benefit of these potentially effective treatments. The authors examined cognitive and behavioral factors associated with HIV treatment adherence in a convenience sample of 112 women, 72 of whom were currently taking HIV treatments at the time of the study. Women completed confidential surveys and interviews to assess HIV-related health status, treatment regimens, and cognitive behavioral characteristics derived from the Information-Motivation-Behavioral Skills model of health promotion behaviors. Results showed that women who had missed at least one dose of their HIV medications in the past week reported lower intentions (motivation) to remain adherent and lower adherence self-efficacy (skills). Structural equation modeling showed that motivational and skills-building factors significantly predicted the number of medication doses missed. However, treatment-related information did not predict treatment adherence. In addition, women who had missed a dose of medication in the past week were more likely to have ever used devices and strategies to remind them of doses, but were no more likely to currently use such strategies. Interventions that enhance treatment adherence motivation and build adherence skills may help improve HIV treatment adherence in women receiving anti-HIV therapies.
Adult↗
Decreased homovanilic acid in cerebrospinal fluid correlates with impaired neuropsychologic function in HIV-1-infected patients.
To determine whether dopamine metabolism is abnormal in HIV infected patients and whether dopamine metabolism abnormalities are related to specific neuropsychologic characteristics in HIV-infected patients, we measured cerebrospinal fluid (CSF) levels of homovanilic acid (HVA), the primary dopamine metabolite, in 10 HIV-infected patients and compared it to HVA levels in CSF in a group of 13 healthy control subjects. HIV-infected patients were also assessed with a battery of neuropsychologic tests and HVA levels were then correlated with performance on specific neuropsychologic tests. The mean (+/-SD) HVA level in CSF was 100.9 +/- 29.3 nmol/L in the HIV-infected study group and 230.5 +/- 50.0 nmol/L in the non-HIV-infected control group (p < 0.0001). The decrease in concentrations of HVA in CSF correlated with impairment on performance on neuropsychologic testing (Spearman r = 0.67; p = 0.03). When the relationship between HVA levels and specific cognitive domains was evaluated, we observed trends for positive correlation between HVA levels and tests that measure motor speed (r = 0.59; p = 0.074) and those testing attention, concentration, and executive control (r = 0.54; p = 0.108). There was no relationship between performance on memory tests and CSF HVA levels (r = -0.0061; p = 0.987). These results further support the hypothesis that dopaminergic dysfunction plays an important role in the pathogenesis of AIDS dementia complex (ADC) and suggest that specific motor and cognitive abnormalities may be related to depressed dopaminergic activity. This may have important implications for the development of treatments or preventive strategies for ADC.
Adult↗
Use of the Hoffman 2 compact external fixator in the treatment of redisplaced unstable distal radial fractures.
The aim of this study was to examine the use of a new joint sparing external fixation device for unstable redisplaced fractures of the distal radius. Participants were twenty consecutive patients with unstable redisplaced fractures of the distal radius with sufficient space in the distal fragment to allow use of a nonbridging technique. The patients had to be capable of cooperating with functional outcome measures. All patients underwent closed nonbridging external fixation of the distal radius using the Hoffman 2 compact external fixator. The main outcome measures were radiological determinations of dorsal angle, radial shortening, and carpal alignment; measurements of mass grip strength and range of movement; and rate of complications. Volar tilt was successfully regained and maintained (mean 4 degrees) at final review. Radial shortening was a mean of one millimeter at final review. Nineteen of twenty patients regained normal carpal alignment. Grip strength returned to a mean of 74 percent of the opposite (normal) side in the whole group and 88 percent in those who completed review for the longest periods. Ranges of movement were restored to around 80 percent, except flexion (66 percent). The rate of major complications was 15 percent. We conclude that nonbridging external fixation using the Hoffman 2 compact device reliably restores and maintains volar tilt and radial length after re-reduction of unstable fractures of the distal radius. Functional outcome and complications are comparable with findings in previous reports.
Adolescent↗
Altered expression of tropomodulin in cardiomyocytes disrupts the sarcomeric structure of myofibrils.
Tropomodulin is a tropomyosin-binding protein that terminates "pointed-end" actin filament polymerization. To test the hypothesis that regulation of tropomodulin:actin filament stoichiometry is critical for maintenance of actin filament length, tropomodulin levels were altered in cells by infection with recombinant adenoviral expression vectors, which produce either sense or antisense tropomodulin mRNA. Neonatal rat cardiomyocytes were infected, and sarcomeric actin filament organization was examined. Confocal microscopy indicated that overexpression of tropomodulin protein shortened actin filaments and caused myofibril degeneration. In contrast, decreased tropomodulin content resulted in the formation of abnormally long actin filament bundles. Despite changes in myofibril structure caused by altered tropomodulin expression, total protein turnover of the cardiomyocytes was unaffected. Biochemical analyses of infected cardiomyocytes indicated that changes in actin distribution, rather than altered actin content, accounted for myofibril reorganization. Ultrastructural analysis showed thin-filament disarray and revealed the presence of leptomeres after tropomodulin overexpression. Tropomodulin-mediated effects constitute a novel mechanism to control actin filaments, and our findings demonstrate that regulated tropomodulin expression is necessary to maintain stabilized actin filament structures in cardiac muscle cells.
Actins↗
Fatal injuries of the head and spine: epidemiological studies in New South Wales and South Australia.
In 1977, 1402 people died in New South Wales and 325 in South Australia from injuries to the brain or spinal cord. Records indicate that neurological injury is the leading cause of death in these States in the age range 0-44 years, accounting for more than 20% of deaths. A high proportion (41%) of accidents causing neurological injury occurred in country areas. We considered factors contributing to preventable causes of death. We found evidence of excessive consumption of alcohol in one-third of those tested; however, this estimation was omitted in many cases in both States. In the SA series at least 6% of deaths showed features suggesting that the primary neurological injury was not lethal. Potentially lethal secondary complications, such as respiratory obstruction or intracranial bleeding, may be reduced by earlier and better first aid and by speedier neurosurgical consultation. There is a need for more complete coronial autopsy examinations in all cases of violent death, and for the application of standardised diagnostic criteria.
Accidents↗
Training program focuses on developing managers' skills.
The movement toward skill development and behavior modification in the training and staff development field is just beginning to affe(t management training in hospitals. The training model described in this article is adaptable to a variety of tasks involving the management of people.
Administrative Personnel↗
From educator to educator-consultant by 1990.
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Consultants↗
Progressive multifocal leukoencephalopathy in AIDS: are there any MR findings useful to patient management and predictive of patient survival? AIDS Clinical Trials Group, 243 Team.
BACKGROUND AND PURPOSE: While MR findings in progressive multifocal leukoencephalopathy (PML) have been described previously, usually in retrospective studies with limited sample size, what has not been well addressed is whether any are predictive of longer survival. Our participation in a large prospective clinical trial of AIDS patients with biopsy-proved PML and MR correlation allowed us to test our hypothesis that certain MR features could be found favorable to patient survival. METHODS: The patient cohort derived from a randomized multicenter clinical trial of cytosine arabinoside for PML. Pretreatment T1- and T2-weighted noncontrast images (n = 48) and T1-weighted contrast-enhanced images (n = 45) of 48 HIV-positive patients with a PML tissue diagnosis as well as the follow-up images in 15 patients were reviewed to determine signal abnormalities, lesion location and size, and the presence or absence of mass effect, contrast enhancement, and atrophy, and to ascertain the frequency of these findings. A statistical analysis was performed to determine if any MR abnormalities, either at baseline or at follow-up, were predictive of patient survival. RESULTS: No MR abnormalities either on univariate or multivariate analysis significantly correlated with patient survival, with the exception of mass effect, which was significantly associated with shorter survival. The mass effect, however, always minimal, was infrequent (five of 48). More severe degrees of cortical atrophy and ventricular dilatation, lesion location and size, and other MR variables were not predictive of outcome. CONCLUSION: Except for mass effect, we found no MR findings predictive of the risk of death in patients with PML. The mass effect, however, was so infrequent and minimal that it was not a useful MR prognostic sign.
AIDS Dementia Complex↗
Examining the episiotomy argument.
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Episiotomy↗
Factors contributing to bathroom accidents from carbon monoxide poisoning.
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Accidents, Home↗