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Biomedical subjects

G F Fairclough

Publications and source records attributed to G F Fairclough.

11 recordsLinked to original sources
PubMed1993

Mental health services for medical students: perceptions of students, student affairs deans, and mental health providers.

PURPOSE: To examine (1) whether there is any consistency among medical schools in mental health services provided and (2) how these services are perceived by student affairs deans, mental health service providers, and the students themselves. METHOD: Questionnaires were sent in October 1991 to the student affairs dean (or director), the individual responsible for student mental health services, and a student representative in each of the 126 U.S. and Canadian medical schools. Data were sought regarding personnel, individuals served, location, hours, administration, funding, confidentiality, administrative referrals, and respondents' suggestions for improvement. Possible differences among the three groups of respondents were tested by chi-square. RESULTS: Responses were received from 75 student affairs deans, 53 mental health providers, and 30 students. There was much diversity among schools in services provided, especially in the areas of administration and funding. Although perceptions of the three respondent groups were often the same, they differed significantly in a number of areas. Suggestions for improvement of services involved funding, personnel, hours, confidentiality and privacy, specialty services, preventive and support programs, and visibility. The suggestion most frequently made by the students was for increased information and visibility. CONCLUSION: The differences among schools coupled with the differing perceptions within schools indicate a need for a comprehensive consideration of what kinds of mental health services are needed and how they can best be made accessible to a diverse body of students experiencing a variety of academic and personal challenges.

Canada↗
PubMed1989

The post-operative electrocardiogram and creatine kinase: implications for diagnosis of myocardial infarction after non-cardiac surgery.

The objective of this study was to evaluate different approaches to the diagnosis of post-operative myocardial infarction. A total of 232 patients, mostly hypertensive and/or diabetic patients, who were undergoing elective non-cardiac surgery were evaluated pre-operatively. They were followed serially from the day of operation to discharge or the sixth post-operative day with daily clinical evaluations, electrocardiograms, creatine kinase and creatine kinase isoenzymes. In total 22% (51/232) of the patients had post-operative ECG changes in two or more leads. Only 1% developed new Q waves; most of the changes involved changes in the T or ST segments. Seventy percent of patients who had changes in their electrocardiogram were completely asymptomatic. The highest risk of ECG changes or symptoms occurred on the day of operation and the first post-operative day; evidence of post-operative infarction was infrequent after the second post-operative day. Creatine kinase levels rose an average of 250-300 IU on the first and second post-operative day (also the peak time for post-operative ECG changes), reducing its utility as an adjunct to the diagnosis of post-operative infarctions. Importantly, 52% (12/23) of the patients who had greater than or equal to 5% MB isoenzyme had neither ECG changes nor symptoms; the diagnosis of a myocardial infarction should not be made in these patients. In summary, most patients who experience ischemia or infarction post-operatively are asymptomatic. Symptoms should not be required for the diagnosis of post-operative infarction. Seemingly minor differences in criteria can produce major discrepancies in post-operative myocardial infarction rates (from 1 to 9%). The development of a final set of criteria will require further study but the diagnosis of post-operative infarction should probably be based on ECG changes, their duration and consistency, and the association of a positive MB fraction.

Aged↗
PubMed1981

Isolation and characterization of lamellar body material from rat lung homogenates by continuous linear sucrose gradients.

A technique is described for isolating lamellar body material from rat lung. Membranes with relative densities ranging between 1.050 and 1.074 g/ml were isolated by centrifugation of crude lung homogenates upward through continuous linear sucrose gradients at 40,000 rpm (199,000 g) for 3 hr. Their protein and lipid content was characteristic of that of lamellar bodies. They were free of contaminating microsomal and mitochondrial marker enzymes but contained enzyme activities associated with lysosomes and Golgi complex. Longer or repeated centrifugation resulted in a reduced yield and an apparent transformation of some of the material to lower densities. Electron microscopy revealed that most of the images represent disrupted rather than intact lamellar bodies. Other methods for preparation of lamellar bodies entail either sedimentation or pelleting at interfaces between sucrose solutions. Such preparations are often contaminated with endoplasmic reticulum membranes and have apparently lost the more fragile bodies. The present technique reveals the heterogeneous nature of lamellar body material and should be useful in a search for lamellar body precursors and in the investigation of the mechanisms by which surfactant is synthesized or assembled.

Animals↗
PubMed1980

A comparison of plasma phenytoin level determinations by EMIT and gas-liquid chromatography in patients with renal insufficiency.

Monitoring the blood levels of antiepileptic drugs (AED) has proven to be of value in the clinical management of epileptic patients. We have compared the plasma concentrations of AED determined by enzyme multiplied immunoassays (EMIT) and gas-liquid chromatography (GLC) assays and identified a group of patients (n = 22) in whom the EMIT values for phenytoin were up to three times higher than those obtained by GLC. All these patients were oliguric with various degrees of azotemia, most of them undergoing weekly hemodialysis. The ratio of EMIT over GLC was 2.0 in 14 patients, 2.5 in 5 patients, and near 3.0 in 3 patients. These ratios remained relatively constant during repeated determinations over several months. The magnitude of difference between EMIT and GLC values (microgram/ml) was not related to the degree of azotemia. The discrepancy remained unchanged when various modifications of EMIT and GLC techniques were used. When phenytoin was added in vitro to plasma from nonepileptic oliguric azotemic patients, the measured phenytoin values were close to and not higher than the target values by either methodology. We feel that, when monitoring phenytoin blood levels in epileptic patients with renal insufficiency, one should be aware of a discrepancy between phenytoin values assayed by GLC and EMIT.

Chromatography, Gas↗
PubMed1978

Oxygen-mediated heterogeneity of apo-low-density lipoprotein.

Mild oxidation of human serum low-density lipoprotein (LDL) converts the apoprotein from a nearly homogeneous component of high apparent molecular weight to a mixture of apparently lower molecular weight polypeptide components, as characterized by sodium dodecyl sulfate/polyacrylamide gel electrophoresis. This protein alteration, which correlates temporally with increases in the formation of lipid oxidation products and in the fluorescence of the apoprotein, is markedly reduced when oxygen is excluded or when EDTA or the free-radical-scavenging antioxidants, butylated hydroxytoluene or propyl gallate, are added. The conversion thus appears to be due to a reaction between the protein moiety and auto-oxidizing lipid. The presence of the antibacterial agent sodium azide markedly accelerates the oxidation, suggesting that it should only be used with caution in lipid-containing solutions.

Apolipoproteins↗
PubMed1978

Correlation of the "EMIT" with a gas-liquid chromatographic method for determination of antiepileptic drugs in plasma.

We report a study of the comparison of antiepileptic drugs (phenobarbital, phenytoin, primidone, and carbamazepine) by the Enzyme Multiplied Immunoassay Technique "EMIT" and the gas chromatography (GLC) method. Overall, reasonable correlations were observed for all of the above-mentioned assays by both methods in the majority of samples included in this study. Our observations for statistical and clinical differences at various levels of phenobarbital and phenytoin are discussed. A suggestion is provided in order to avoid a major discrepancy (approximately 30% higher values by EMIT vs GLC) in results observed from the "Bottom of the Bottle Effect" for EMIT reagent.

Anticonvulsants↗