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Biomedical subjects

E Berry

Publications and source records attributed to E Berry.

At least 91 records · Page 5Linked to original sources

Breast feeding: differences in prevalence between caucasian and negroid women resident in Paddington and North Kensington, London, England.

Three hundred and thirty-seven caucasian women and 150 negroid women who were resident in an inner London health district, who gave birth in the district's maternity unit and who were transferred home before 6 days after delivery were studied in respect of their intentions and practices for feeding their babies. Differences in the numbers breast feeding within and between various sub-groups of the two racial groups were compared and inferences drawn in respect of to which group effort in promoting breast feeding should be directed.

Adult↗

Motivational deficit in childhood depression and hyperactivity.

A recent theory states that the immediate cause of adult depression is low motivation, where motivation is the multiplicative product of a person's expectation for a reward times his value for that reward. The present experiment supported the extension of this theory to childhood depression. The expectations, values, and motivations of three groups of children (Ns = 18; mean ages = 10) were measured: A depressed group and a hyperactive control group were selected from a population of clinically disturbed children, while normal controls were selected from regular classrooms. As predicted, the depressed children exhibited reduced motivation, primarily because their expectations were pessimistic. Unexpected findings were that the depressives' expectations were not abnormally irrational; and that hyperactives exhibited optimistic expectations, inflated values, and, hence, inflated motivation--especially for tangible rewards. Cognitive therapy techniques that focus upon expectations were recommended for the treatment of both depressed and hyperactive children.

Attention Deficit Disorder with Hyperactivity↗

Vitamin D uptake by the perfused rat liver is determined by its transport protein.

Radiolabelled vitamin D3 and 25(OH)vitamin D3 (25(OH)D) were added to an isolated perfused rat liver, bound either to lipoproteins or lipoprotein-free plasma. The disappearance of vitamin D and 25(OH)D from the perfusate was determined. When vitamin D or 25(OH)D were added to the perfusate on lipoproteins there was a rapid decline in the amount present in the perfusate, as compared to when they were added bound to lipoprotein-free plasma. The uptake of vitamin D and 25(OH)D by the liver from lipoproteins was associated with a transfer of radioactivity from the lipoprotein portion to the lipoprotein-free portion of the perfusate. These results demonstrate the importance of the vitamin D transport protein to its uptake by the liver.

Animals↗

Acute rheumatic fever in adults over the age of 45 years: an analysis of 23 patients together with a review of the literature.

The natural history of acute rheumatic fever (ARF) in adults has been studied from an analysis of 23 patients together with a review of a further 466 published cases. In contrast to the picture in juvenile ARF, in our patients (average age 55 yr), only arthritis (83%) and carditis (35%) were major criteria for the diagnosis. All patients had at least 3 minor criteria. To summarize, 39% of the patients, average age 56 yr were seen in their initial attack of ARF. In those patients with a previous history of rheumatic fever, the mean interval between the index attack and the first illness was 20.5 yr. Contact with young children appeared to be an important predisposing factor. None had an ESR of less than 50 mm in the first hour, even in the presence of cardiac failure. Findings in the acute illness included anemia (70%), hyperglobulinemia (70%), urinary sediment (66%), and hypercalcemia in 7 out of 12 cases. The response to treatment was good and only 1 patient of 13 followed-up developed a new valvular lesion. A survey of the literature shows that attacks of ARF may occur at any age; death in the acute episode is rare and occurs only in patients with severe preexisting valvular disease with congestive failure. The problem of diagnosing active carditis in the presence of rheumatic heart disease (RHD) is discussed. While juvenile ARF may be overdiagnosed, the diagnosis may be missed in the adult rheumatic patient whose cardiac state inexplicably deteriorates. In such patients evidence for a preceding streptococcal infection should be sought. Patients with a high risk of developing ARF include those with carditis in previous attacks, with preexistent RHD, and with several children in the family. These factors should be considered when advising on the duration of antibiotic prophylaxis.

Acute Disease↗

Absorption of orally administered digoxin after massive resection of the small bowel.

Digoxin absorption was studied in a patient after massive small bowel resection (with only 15 cm. of jejunum left) after mesenteric thrombosis. Oral administration of 0.25 mg. digoxin tablets resulted in therapeutic blood levels between 0.7 and 2.2 ng./ml. Measurement of the urinary excretion of the drug in steady state revealed more than 80% of the maintenance dose. Renal digoxin clearance was 125 ml./min. This resulted in slowing of the heart rate from 120 to 80/min. with no side-effects. It is thus concluded that total absorption of digoxin might be normal in a patient with only 15 cm. of jejunum and that usual dogs of digoxin were sufficient for a therapeutic effect and "therapeutic" blood levels

Aged↗

Infectious hepatitis and glucose-6-phosphate dehydrogenase deficiency.

The occurrence of infectious hepatitis in patients with coexistent glucose-6-phosphate dehydrogenase (G6PD) deficiency may present a clinical picture similar to that of fulminant hepatitis. To determine the factors which enable a rapid diagnosis of this disease combination, the clinical and biochemical findings in 14 patients were compared with those in 50 patients with uncomplicated hepatitis and those in 14 patients with fulminant hepatitis. Similarities with the latter group included persistence of fever, tachycardia, leukocytosis and hyperbilirubinemia of greater than 340 mumol/liter (20 mg/dl). A rise in bilirubin values of more than 50 mumol/liter (3 mg/dl) per day in patients with viral hepatitis strongly suggested the presence of G6PD deficiency. Despite the severity of the illness, prothrombin activity was well maintained in G6PD-deficienct patients.

Adolescent↗

Pyorrhoea as cause of pyrexia.

Three patients with fever and malaise, one of whom also had joint pains, were extensively investigated before their condition was attributed to dental sepsis. Each patient recovered fully after appropriate dental treatment. Dental sepsis should be added to the list of possible causes of pyrexia of undetermined origin, and a routine dental examination should be carried out in each case.

Adult↗

Benign hemoglobinuria following transfusion of accidentally frozen blood.

A patient was transfused with a unit of red blood cells that had been frozen accidentally prior to transfusion. Although he had received approximately 60 gm of free hemoglobin intravenously, the patient's only clinical reaction was massive hemoglobinuria. The benign clinical response, in the presence of massive hemoglobinuria, is attributed to the absence of immunologic imcompatibility and, thus, failure to activate vasoactive mediators and disseminated intravascular coagulation. The case illustrates revised concepts of the pathophysiology of acute renal failure associated with hemolytic blood transfusion reactions.

Accidents↗

Simulation of two-dimensional tagged MRI.

MR tagging is a recent imaging development that, in cardiac applications, makes possible the tracking of points in the myocardium during the cardiac cycle. Researchers have developed semiautomated, computer-based methods for analyzing tagged images, but the images are complex and present a challenge to automated tracking systems. Simulation can provide an inexhaustible supply of images for testing and validation of tag tracking software and preview the effect of parameter changes in acquisition. SIMTAG is an interactive computer program that simulates two-dimensional tagged-MR experiments. The mathematic model used in the simulation and algorithms for simulating image noise and object deformation are described. Examples of the use of simulated images in SPAMM parameter selection, a comparison of tag contrast in signal-averaged SPAMM and CSPAMM, and simulated images as test sets for tag-tracking software are presented.

Computer Simulation↗

Frequency-domain simulation of MR tagging.

Simulation of MR images is a useful tool for offline sequence development and as an aid to understanding image formation. One particular application of simulation is MR tagging, which is used for tracking myocardial motion. Simple spatial-domain methods cannot adequately represent effects common in these images, such as motion artifact and signal wrap. An existing frequency-domain model is shown to be inappropriate for tagged images, and an extension based on the Bloch equations and Fourier shift theorem is described to correct this. Software incorporating the new model is used to generate ideal tag intensity profiles and to accurately simulate tagged images. The shifted k-space patterns associated with tagged images, and their dependence on the order of the binomial tagging sequence, are explained. An application of the Fourier shift theorem is suggested that allows more rapid simulation of static tagged images.

Computer Simulation↗

Systematic assessment of World Wide Web materials for medical education: online, cooperative peer review.

OBJECTIVE: : To develop a generic methodology for the online assessment of medical education materials available on the World Wide Web and to implement it for pilot subject areas. DESIGN: An online questionnaire was developed, based on an existing scheme for computer-based learning material. It was extended to involve five stages, covering general suitability, local suitability, the user interface, educational style, and a general review. It is available on the Web, so expert reviewers may be recruited from outside the home institution. The methodology was piloted in three subjects areas--clinical chemistry, radiology, and medical physics--concentrating initially on undergraduate teaching. MEASUREMENTS: The contents of completed questionnaires were stored in an offline database. Selected fields, likely to be of use to students and educators searching for material, were input into an online database. RESULTS: The online assessment was used successfully in clinical chemistry and medical physics but less well in radiology. Fewer resources were found to fit local needs than expected. CONCLUSION: The methodology was found to work well for topics where teaching is highly structured and formal and is potentially applicable in other such disciplines. The approach produces more structured and applicable lists of resources than can be obtained from search engines.

Computer Communication Networks↗

Antitumor necrosis factor antibodies reduce hepatic steatosis during total parenteral nutrition and bowel rest in the rat.

BACKGROUND: In previous studies, we demonstrated the overgrowth of gram-negative bacteria in the gut and an enhanced release of tumor necrosis factor (TNF) by peritoneal macrophages, suggesting that endotoxin, TNF, or both, may act as hepatotoxins to produce hepatic steatosis during total parenteral nutrition (TPN) and bowel rest. The present study attempts to better define the role of each of these two mediators. The first part examines the LD50 for various doses of endotoxin in TPN-treated rats compared with free-feeding and free-feeding saline-infused rats. In the second part we repeatedly administered anti-TNF monoclonal antibodies to rats subjected to TPN and bowel rest. METHODS: In the first set of experiments, 87 male Sabra rats were randomized into three groups: free-feeding, infused with normal saline, and infused with TPN. On day 7 of the experiment, all rats received an IV injection of endotoxin at various doses (1.5, 2.5, 5.0, 7.5, and 10 mg/kg). The LD50 in the three groups and at the various doses of lipopolysaccharide tested was determined at 24 hours postinjection. In the second set of experiments, 38 male Sabra rats were randomized into three groups: infused with normal saline and fed rat food ad libitum, infused with TPN, and infused with TPN but also receiving monoclonal antibodies against TNF. RESULTS: Lower endotoxin doses were required to achieve LD50 in the two IV-infused groups (2.5 to 5.0 mg/kg) compared with the free-feeding group (7.5 mg/kg) (p < .03). These findings suggest a moderate increase in susceptibility to the lethal effect of endotoxin in IV-treated rats. The total hepatic fat and triglyceride levels, which were markedly increased in TPN rats, were significantly reduced by using anti-TNF antibodies. Enhanced TNF production by peritoneal macrophages during TPN was completely eliminated by anti-TNF antibodies, probably the result of suppressed TNF production. CONCLUSIONS: The continuous translocation of endotoxin from gram-negative bacterial overgrowth in the gut during TPN and bowel rest results in enhanced release of TNF by macrophages. TNF causes hepatic dysfunction, portrayed in the present experimental model as hepatic steatosis. TPN-induced hepatic steatosis was significantly reduced by the administration of monoclonal antibodies against TNF-alpha.

Animals↗