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Biomedical subjects

J Dale

Publications and source records attributed to J Dale.

At least 19 recordsLinked to original sources
PubMed1992

Co-administration of progabide inhibits haloperidol-induced oral dyskinesias in rats.

Vacuous chewing movements in rats may be an animal analogue of the human motor disorder, tardive dyskinesia. The movements are phenomenologically and pharmacologically similar to tardive dyskinesia. The pathophysiology of these involuntary oral movements, and perhaps of tardive dyskinesia, are likely to include both dopamine receptor changes, and alterations in GABA (gamma-aminobutyric acid) system function. In an attempt to test the involvement of GABA system dysfunction in these movements, we treated rats chronically with water alone, haloperidol alone, the GABA agonist progabide alone, and haloperidol plus progabide. Sprague-Dawley rats received haloperidol (1.5 mg/kg per day) in their drinking water and progabide (100 mg/kg per day) in their food for 12 months. After 12 months of treatment, haloperidol had induced vacuous chewing movements when administered alone, but the prevalence of the movements was decreased by 40% with the coadministration of progabide. Moreover, the haloperidol-progabide-treated animals did not merely demonstrate movement suppression but actual inhibition of movement onset, as determined by an additional progabide-withdrawal experiment. These data would suggest that progabide and perhaps other GABAmimetic compounds can prevent the development of tardive dyskinesia in man.

Administration, Oral↗
PubMed1992

The nucleotide sequence of the coat protein gene and 3' untranslated region of papaya ringspot virus type W (Aust).

The nucleotide sequence of the 3' terminal region of the Australian isolate of papaya ringspot virus type W [PRSV-W (Aust)] was determined. An open reading frame (864 bp), encoding the putative coat protein gene, occurs upstream of the putative 3' untranslated region (206 bp) and poly(A) tail. A 23 amino acid sequence was obtained from N-terminal analysis of the coat protein from purified virions. This sequence has 100% homology with a region of the amino acid sequence inferred from the nucleic acid sequence of the coat protein gene. However, this region is 13 amino acids downstream from the N terminus predicted for two American isolates of PRSV. The coat protein gene of PRSV-W (Aust) was shown to have 96.8% and 96.4% nucleotide sequence similarity with American isolates of PRSV-W and PRSV-P, respectively.

Amino Acid Sequence↗
PubMed1992

Primary care in accident and emergency and general practice: a comparison.

This paper reviews the way in which literature describing 'inappropriate' attenders at Accident and Emergency (A & E) departments in Britain has suggested that they could be provided for in General Practice and that their attendance at A & E departments therefore implies a 'failure' of general practice in urban areas. One problem with much previous research is that 'inappropriate' attenders have been retrospectively identified. The comparative survey of attenders at a London A & E department and patients visiting their GP in the same district reported here prospectively identified A & E attenders with primary care problems and examined the differences between them and the GP attenders. Patients attending the hospital A & E department were similar to the GP attenders in terms of socio-economic indicators, but had problems which were not typical of the general practice workload and were in different circumstances. The results suggest that there will be a continuing demand for hospital-provided primary care in urban areas, and that attempts to deflect such care to the community will meet with limited success.

Adolescent↗
PubMed1992

Wound dressings on FP10 and GP10.

Although the full range of wound care products is not available in the community, new items are slowly being added to the list. Nurses have a responsibility to keep up-to-date with developments, particularly since nurse prescribing is imminent. Manufacturers' literature should be read frequently to keep up-to-date with additions and amendments.

Bandages↗
PubMed1991

Safety of high doses of low molecular weight heparin (Fragmin) in acute myocardial infarction. A dose-finding study.

We postulated that low molecular weight heparin (LMWH) in doses producing plasma levels in the range of 0.6-1.0 anti-Xa U/ml may reduce the incidence of left ventricular thrombi (LVT) secondary to acute anterior wall myocardial infarction (AAMI). In an open, dose-finding study, 72 patients with acute myocardial infarction (AMI) were treated with Fragmin (KABI) 240-360 anti-Xa U/kg/24h subcutaneously for 6-10 days. 300 anti-Xa U/kg/24h given as 2 or 3 injections resulted in a mean plasma concentration of about 0.8 anti-a U/ml. There were 3 minor haemorrhages, all in a subgroup of 22 patients also being treated with 0.3 g aspirin orally per day after 1.5 mill. U streptokinase intravenously on admission. In the 38 patients with AAMI receiving 300 anti-Xa U/kg/24h there were only 3 LVT during the period of treatment (8%). In conclusion, 300 anti-Xa U Fragmin/kg/24h s.c to patients with AMI appears safe, but minor haemorrhage may occur in patients receiving aspirin concomitantly. Although these data are limited, the low incidence of LVT in patients with AAMI suggests efficacy of this dose of Fragmin to prevent LVT.

Adult↗
PubMed1991

How do nurses working in hospital accident and emergency departments perceive local general practitioners? A study in six English hospitals.

One hundred and forty-three Accident and Emergency nurses working in six departments in contrasting districts of England completed questionnaires about their perception of local general practice. Much of general practice was perceived as being performed unsatisfactorily. Out-of-hours accessibility, caring for patients with 'difficult' or psychosocial problems, advising on health service usage, and minor surgery and first aid were all thought to be performed particularly badly. In addition, there was considerable inter-district variation with the views expressed in inner London being especially negative. To some extent these views may reflect real short-comings in general practice, but they are likely to be coloured by the disproportionate experience A&E departments inevitably have of patients who are dissatisfied in some way with their GP service. In addition, other factors such as departmental 'culture' and the separation that exists between hospital and community health professionals may have an important influence. The effect such negative perceptions have on the relationship between A&E departments and general practitioners, and the quality of care provided to patients attending A&W with primary care problems are discussed.

Attitude of Health Personnel↗
PubMed1991

Weight change in cardiac transplant patients.

The perception exists that excessive weight gain commonly occurs after cardiac transplantation. To examine this perception, 91 transplant patients from one to eight years post-transplant responded to a questionnaire eliciting data on premorbid and post-transplant weights, exercise frequency, and fat intake. Only 37% of subjects weighed more post-transplant than premorbidly. More than half of the subjects were over their ideal weights premorbidly and post-transplant. On t-test there was no significant difference (p less than .05) between weight gainers and weight losers in exercise frequency (t = .63; p = .53), or fat intake (t = -.80; p = .43). Findings of the study dispute the perception of excessive weight gain post-transplantation. This perception may be due to the comparison of cachectic pre-transplant weight with well weight post-transplant. Since more than half of the subjects were over their ideal weight post-transplantation, teaching regarding weight control remains important. Future research on effective methods of weight control is needed.

Adult↗
PubMed1990

Factors influencing general practitioners' management of psychosocial and physical problems: a study using case vignettes.

The reactions of a random sample of 72 Oxfordshire general practitioners to case vignettes illustrating psychosocial and physical presentations were assessed with a set of attitude rating scales. Two main underlying factors appeared to influence responses. The first reflected positive attitudes to both physical and psychosocial problems, and was associated with postgraduate experience in psychiatry and with older age. The second, reflecting measures of flexibility and responsibility for outcome, was associated with younger age and not having received vocational training. Other characteristics of the practitioners and their practices were not significantly related to these factors, and there was considerable unexplained variance. In addition, certain sex differences emerged: men general practitioners rated their ability to manage cases more highly than did their women colleagues, while women practitioners experienced more anxiety. These findings suggest that personal traits and qualities may remain a stronger determinant of general practitioners' reactions to patients' problems than formal training and qualifications.

Adult↗
PubMed1989

[Streptokinase treatment in acute myocardial infarction].

Myocardial necrosis develops gradually after coronary artery occlusion, and in man is completed after several hours. Most infarctions are precipitated by thrombi, and early fibrinolytic treatment should therefore be the rational therapy. Recanalization is achieved in three of four patients whether streptokinase is applied intracoronary or intravenously. Early treatment limits the size of the infarct, and he myocardial function is preserved better in patients treated with streptokinase than in others. Very early treatment, started within one hour from the onset of nitroglycerin-resistant chest pain, may prevent infarction in some patients. Streptokinase reduces mortality after infarction, in total by as much as 25 per cent, and even considerably more when infusion is started early. There is some risk of bleeding, but serious bleeding episodes are rare. Intracoronary application has no advantages as compared with intravenous infusion. Unless there are strong contra-indications, patients with nitroglycerin-resistant chest pain and abnormal ECG should receive streptokinase intravenously in a dose of 1.5 x 10(6) units. Most patients treated with streptokinase should be given acetylsalicylic acid.

Humans↗
PubMed1989

Psychiatric diagnoses in patients who have chronic fatigue syndrome.

Patients with persistent fatigue are often suspected of having psychiatric illnesses, particularly depression. The authors used the Diagnostic Interview Schedule to assess the lifetime prevalence of psychiatric disorders in 28 patients who met Centers for Disease Control case definition criteria for chronic fatigue syndrome. Compared with studies of the general population and studies of chronically medically ill patients who received the same structured interview, the rates of psychiatric illness in patients with the chronic fatigue syndrome appeared high. An examination of the medical histories of the 28 patients indicated that psychiatric disorders more often preceded the chronic fatigue than followed it.

Adult↗