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Biomedical subjects

F Hughes

Publications and source records attributed to F Hughes.

At least 19 recordsLinked to original sources
PubMed2006

Nurses at the forefront of innovation.

BACKGROUND: This paper is based on a presentation given by the author at the 23rd Quadrennial ICN Congress and 7th International Regulation Congress in Taipei in May 2005. AIM: Nurses worldwide are engaged in innovative practice on a daily basis. In most health systems across the world, nurses provide up to 80% of primary health care and are therefore well positioned to provide critically needed innovative solutions to many global health challenges. The aim of this paper is to increase awareness of the importance and value of innovations in nursing; provide an improved understanding of the contribution nurses make to innovation in health care; and increase understanding of the importance of creating environments that inspire innovation and help shape practice in new and improved ways. DESIGN: This paper explores the concept of innovation, the inherent set of characteristics that need to be present in order for innovations to succeed, and the barriers that impede innovation from occurring. CONCLUSION: There are numerous examples of successful innovations worldwide that are developed and implemented by nurses, some of which are described in this paper. The paper concludes that organizations need to have a support climate that encourages creativity and innovation to occur.

Creativity↗
PubMed2002

Anorectal sepsis.

Anorectal sepsis is a common cause of hospital admission, presenting with abscess or fistula formation. This article discusses the aetiology of acute anorectal sepsis and its management.

Abscess↗
PubMed2001

A heterocycle-forming double michael reaction. [5 + 1] annulation route to highly substituted and functionalized piperidines.

[reaction: see text]. Nitrogen-containing tethered diacids, easily prepared by reductive alkylation of diethyl aminomalonate or ethyl cyanoglycinate, undergo double Michael reactions with 3-butyn-2-one to give highly functionalized and substituted piperidines (pipecolic acid derivatives) with surprisingly high stereoselectivity. The heterocyclic double Michael adducts can be induced to undergo further cyclizations to give a variety of azabicyclic and diazabicyclic compounds.

Alkylation↗
PubMed1999

Retroviral transduction of human periodontal cells with a temperature-sensitive SV40 large T antigen.

The periodontal ligament (PDL) is considered to contain subpopulations of cells responsible for the development, repair and regeneration of the periodontium. Cell cultures have been used as model systems in order to understand the complex cellular and biochemical events underlying these processes. In order to obtain long-term cultures of these cells that can be cloned and characterized, primary cultures of PDL and gingival cells were infected with an amphotropic retroviral construct encoding a temperature-sensitive SV40 large T antigen (tsT). After selection for drug resistance, the cells expressed the T antigen and proliferated at 34 degrees C for more than 40 passages. However, when the T antigen was inactivated by incubation at 39 degrees C, the cultures became growth-arrested and the granularity of the cells increased, possibly as a result of differentiation. Reverse transcribed-polymerase chain reaction and flow cytometry showed that the tsT-transduced cells expressed a number of soft and hard connective-tissue antigens, including osteocalcin, osteonectin, osteopontin, collagen type I and alkaline phosphatase. Moreover, incubation of the transduced PDL cells at 39 degrees C was found to upregulate the expression of osteocalcin, osteopontin and collagen type I, but downregulate osteonectin. At this temperature, the presence of the dexamethasone downregulated type I collagen, while vitamin D3 had no effect on the expression of any of the antigens examined. Under all culture conditions, antigen expression was far higher in the transduced PDL cells than the gingival cells. The findings thus show that growth of the tsT-transduced PDL and gingival cells is temperature-dependent and that the presence of the T antigen increases their lifespan but does not ablate the expression of certain of their characteristic phenotypic and functional features.

Alkaline Phosphatase↗
PubMed1997

The relationship between life-events and periodontitis. A case-control study.

This case-control study (n = 100 dental patients, matched for age and sex) investigated the role of life-events in periodontitis. Data collected included life events, tobacco use, oral health behaviours and socio-demographics. The results of conditional simple logistic regression analysis showed that periodontitis was associated with the negative impact of life-events (p < 0.01), the number of negative life-events (p < 0.05), high levels of dental plaque (p < 0.01), tobacco smoking (p < 0.01) and being unemployed (p < 0.05). These associations remained statistically significant after adjusting for oral health behaviour and socio-demographic variables, but not tobacco smoking (p > 0.05). Marital status became statistically significant after adjusting for the other variables (p < 0.05). A model is suggested to explain the pathways through which life events may affect periodontal health. It was concluded that psychosocial factors and oral health risk behaviours cluster together as important determinants of periodontitis.

Adolescent↗
PubMed1994

Mental attitude.

Explore the source record for details and available documents.

Community Mental Health Services↗
PubMed1993

A comparative study of cefepime and ceftazidime in the treatment of community-acquired lower respiratory tract infections.

Antibiotic treatment for community-acquired pneumonia must target Gram-positive pathogens, especially frequently isolated organisms such as Streptococcus pneumoniae. The severity of community-acquired pneumonia is often related to underlying factors. Occasionally it may be complicated by staphylococcal or Gram-negative bacillary infection. We have compared the safety and efficacy of cefepime 1 g bd with ceftazidime 1 g tds as empirical treatment in adults with community-acquired lower respiratory tract infections (LRTIs). One hundred and thirty-one patients with moderate to severe LRTIs were randomized to two treatment groups: 87 received cefepime and 44 received ceftazidime. The treatment groups were comparable with regard to sex, age and treatment duration. Of the 116 pathogens isolated, 57 were Gram-positive (46 strains of S. pneumoniae) and 59 were Gram-negative (33 strains of Haemophilus influenzae). Of the 111 patients evaluated, clinical cure rates were 87% (65/75) in the cefepime group and 86% (31/36) in the ceftazidime group. Pathogen eradication rates were 95% (74/78 and 36/37, respectively) in both groups. Both drugs were well tolerated and the incidence of adverse events in each group was comparable. Cefepime 2 g per day (1 g bd) was as safe and effective as ceftazidime 3 g per day (1 g tds) in the treatment of community-acquired LRTIs.

Adult↗
PubMed1991

Osteogenic progenitor cells in rat bone marrow stromal populations exhibit self-renewal in culture.

Marrow stromal cells are a heterogeneous population, comprising a variety of lineages including osteogenic cells. In the presence of ascorbic acid, sodium beta-glycerophosphate, and dexamethasone, rat bone marrow stromal cells form discrete nodules of mineralized, bonelike tissue. We used nodule formation by rat bone marrow stromal cells to assay for the self-renewal capacity of osteogenic progenitor cell populations. Cultures were subcultured every 5 days up to six times. Osteogenesis was assayed from second to sixth subcultures by counting the number and measuring the areas of mineralized nodules formed in cultures grown with 10(-8) mol/L dexamethasone. Nodule number and area decreased progressively between second and sixth subcultures. Alkaline phosphatase activity associated with individual cells and measured videodensitometrically decreased exponentially between the second and sixth subculture. The number of cells with alkaline phosphatase activity also decreased with progressive subculturing. The proportions of 3H-thymidine-labeled cells after continuous labeling from the beginning of the culture period showed 90% labeling for cells with alkaline phosphatase activity and fibroblastlike cells. Cultures labeled for only the first 3 days exhibited higher labeling of alkaline phosphatase-positive cells than fibroblastlike cells (P less than .05). Cultures that were flash-labeled at the end of the culture period demonstrated low labeling indices for cells with alkaline phosphatase activity and up to 10-fold higher labeling indices for fibroblastlike cells. Separate cultures treated with a cytocidal dose of high specific activity 3H-thymidine did not form nodules. These results indicate that osteogenic progenitor cells or another cell type required for nodules to develop must divide early in culture if nodule formation is to occur, and that osteoprogenitor cells express a limited capacity for self-renewal.

Alkaline Phosphatase↗
PubMed1986

Primary lymphoma of the thyroid: clinical features, prognostic factors, and results of treatment.

This study analyzes the results of 46 cases of biopsy-proven primary lymphoma of the thyroid, localized at diagnosis and treated at the Royal Marsden Hospital between 1948-1980. In all cases, disease was limited to the thyroid and cervical lymph nodes. There were 43 females and 3 males, with a mean age of 64.4 years (median 66 years; range 17-86). A short history (less than 3 months) of a neck mass and local compressive symptoms was the typical presentation. The majority of patients (91%) had adverse histologies, with diffuse histiocytic lymphomas being most common (78%). The overall crude 5-year survival rate was 40%, with 30% of patients surviving beyond 10 years. Disease-free and overall survival were virtually identical, indicating the ineffectiveness of salvage therapy. The important prognostic factors were: size of tumor, fixation, extra-capsular extension, and retrosternal involvement. Survival was not correlated with age, sex, histology, thyroid status, or stage of disease, as defined by the Ann Arbor classification. Patients who had total macroscopic removal of tumor had the highest rate of local control and long survival (p less than 0.005). No significant difference was seen between lobectomy, subtotal or total thyroidectomy, but 7 of 9 long-term survivors (58-129 months) have had total thyroidectomy. A radiotherapy dose to the tumor, of at least 40 Gy, was required to produce consistent local control in patients with unresected disease. The majority of patients who died had generalized disease. Only 52% of these patients were free of local recurrence. In view of the frequency of occult disseminated disease, adjuvant chemotherapy is one recommendation for patients with poor prognostic factors. For optimal local control, complete surgical eradication is recommended followed by high-dose local radiotherapy. The use of aggressive cytoreductive chemotherapy prior to radiotherapy is a possible alternative option which needs to be explored.

Adolescent↗
PubMed1983

An assessment of the value of epithelial membrane antigen and other epithelial markers in solving diagnostic problems in tumour histopathology.

Using standard immunohistological techniques on formalin-fixed paraffin-embedded sections, we have evaluated the role of epithelial membrane antigen in the histopathological diagnosis of tumours. Of the 70 samples examined, 22 were taken for staging purposes from patients known to have carcinoma and, in half these cases, malignant cells were seen which could not be identified with confidence by conventional means. Forty-eight tumours were stained in order to determine their histogenesis. Twenty-two of these were positive and 20 subsequently proved to be epithelial on follow-up studies, including six in which a diagnosis of non-epithelial malignancy had been made on conventional preparations. The distinction of anaplastic carcinoma from malignant lymphoma and of spindle-cell carcinoma from sarcoma were the most useful applications. One of the positive tumours was of germ cell origin and in one the histogenesis is still not clear. Comparison with carcinoembryonic antigen and pre-keratin showed that epithelial membrane antigen was the most sensitive marker of epithelial differentiation in formalin-fixed tissue. A combination of all three reagents, though, increases diagnostic accuracy and allows tentative suggestions to be made about the possible site of origin of a metastatic carcinoma.

Antigens, Surface↗