Biomedical subjects
J Fry
Publications and source records attributed to J Fry.
Evoked potentials in severe head injury--analysis and relation to outcome.
Somatosensory, visual and auditory cortical and brainstem evoked responses were obtained from 32 patients with severe head injury. A simple count of the number of waves present in the various responses provided the optimum method of analysing the data. The results of each cortical response, but not of the brainstem response, correlated with outcome, and a combined assessment gave the highest correlation. The data provided only slight improvement on predictions based upon clinical features.
Wider implications of health and disease.
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Comparison of family practice in the United States and the United Kingdom.
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Activation of concanavalin A by Cd2+.
Binding of Cd2+ to concanavalin A and the subsequent induction of saccharide-binding activity has been studied at pH 6.5. We found that Cd2+ bound to both metal sites, S1 and S2, and that Cd2+ alone would induce sugar binding in concanavalin A. Using the fluorescent sugar 4-methylumbelliferyl alpha-D-mannopyranoside we determined that full saccharide-binding activity was obtained only when the total bound Cd2+ stoichiometry reached 2 ions/concanavalin A subunit. We also report evidence suggesting that the binding of Cd2+ to S2 is the crucial step in activation and that Cd2+ binding to S1 induces a form of concanavalin A similar to that induced by Zn2+, Ni2+, or Co2+ and different from that induced by Mn2+.
Special features of general practice (primary care) and ethical implications.
In all systems of health care there are certain essential levels of care and service. These take the form of self-care within the family unit; primary professional care by general medical nursing or social practitioners within a local neighbourhood; general specialist care in a district and super-specialist care in a region. Each of these has its own special roles and responsibilities and each is considered in this paper.
Treatment for severe head injury.
Difficulties in establishing the value of certain treatments for head injury are reviewed. An analysis of 1000 severely head injured patients, managed by varying methods in three different countries, showed that certain treatments were more often used in the most severely injured patients. Even when the severity of injury was taken account of, it appeared that the use of steroids and tracheostomy did not affect outcome; but that patients undergoing mechanical ventilation had outcomes which were worse than expected. The value of treatments proposed for severe head injury needs rigorous scrutiny.
Infectious mononucleosis: some new observations from a 15-year study.
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New treatments for duodenal ulcer.
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Who does what best for the elderly?
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The effect of darkness on vitamin D in adults.
Circulating 25-hydroxy vitamin D measurements were made on Caucasians in the Antarctic. Following a period of 3 months' complete darkness there was a significant fall in 25-hydroxy vitamin D values. These results emphasize the importance of u.v. light on skin synthesis of cholecalciferol and support the view that the geriatric and immigrant population should be adequately exposed to sunlight to prevent vitamin D deficiency.
A rational policy for management of angina.
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Obstetrics and the family physician: changing situations.
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The primary care-hospital interface in England.
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The future of the General Medical Council as viewed by an elected member.
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The cure and care dilemma.
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Acute superior mesenteric artery occlusion: problems of pre-operative diagnosis.
I report five cases of occlusion of the superior mesenteric artery from one general practice; four of these occurred in one year.THE COMMON CLINICAL FEATURES WERE: acute diarrhoea and vomiting in elderly persons (all over 70) with abdominal pain and distension and shock. All had a previous history of auricular fibrillation and cardiac failure and past episodes of clinical arterial occlusive disorders had been experienced by four. Each diagnosis was confirmed at operation and all five patients died. It is important for general practitioners to recognize this syndrome.