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Biomedical subjects

J P Lyons

Publications and source records attributed to J P Lyons.

At least 19 recordsLinked to original sources

Caregiving in virgin mice (Mus musculus): effects of biparental care and exposure to a second litter during preweaning development.

I examined the effects of early family unit conditions on later parenting behavior in laboratory mice (Mus musculus). I challenge previous studies that claim to show enhancing effects of biparental care on offspring parental responsiveness by raising mice with a male parent either present (MPP) or absent (MPA) during preweaning development. The results of those studies are confounded because MPP mice also have a second litter present (SLP) and MPA mice do not (SLA). Thus, the findings may have been due to the presence of second litter and not to the presence of the male parent. In this experiment I show that when offspring raised in different family units are tested as virgins with stimulus pups, more SLP mice are parental than SLA mice, and fewer SLP mice bite newborn pups than do SLA mice. Thus, results of previous studies are due to second litter exposure and not biparental care.

Animals↗

A study of Spanish sepiolite workers.

BACKGROUND: Sepiolite is an absorbent clay that is used as pet litter. It forms thin crystals, which are a transition between chain and layered silicates. Inhalation studies in animals have shown no evidence of pulmonary damage. This paper reports a cross sectional study of the total work force of the largest sepiolite production plant in the world. METHODS: Two hundred and eighteen workers (210 men and eight women) were studied. Height, age, and smoking history were recorded. Chest radiographs were read according to the International Labour Office (ILO) classification by two readers. Readings were used to construct a numerical score, which was then used in statistical analyses. Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were divided by the square of the height. Casella size selective personal samplers were used in randomly selected operatives to collect dust eight years before the rest of the study was carried out. These samples were evaluated gravimetrically. Total dust samples were examined by optical and electron microscopes. Results were analysed by bivariate linear regression, chi 2 tests, and analysis of variance. RESULTS: When allowance was made for smoking habit workers exposed to dry dust showed a significantly greater decline in FEV1 with age than workers with little exposure to dry dust. A similar pattern applied to FVC. Radiographic score showed deterioration with age but no clear differences from other variables. High concentrations of dust were found in the bagging department and also in the classifier shed. CONCLUSIONS: The major finding was that lung function deteriorated more rapidly in those who had had more exposure to dust, but there was no evidence of any accompanying radiographic change.

Adult↗

Health Care Plan's Nurse Advice System.

Staff model HMO's expend great effort in handling member phone calls. Health Care Plan, Inc. has developed a computer program to aid phone room nurses in their documentation and decision making processes. The Nurse Advice system has been successfully implemented in six of eight medical centers. By providing real-time access to patient clinical data, the quality of care and service is improved.

Decision Making, Computer-Assisted↗

Irregular coronary lesion morphology after thrombolysis predicts early clinical instability.

After successful thrombolytic treatment for acute myocardial infarction, recurrent ischemia and infarction may occur with little warning. Coronary lesion morphology was analyzed from angiograms performed in 72 consecutive patients at 1 to 8 days after streptokinase treatment for acute myocardial infarction and the data were evaluated in relation to the subsequent clinical course. All patients were clinically stable at the time of angiography and continued to receive heparin infusion for greater than or equal to 4 days after thrombolysis. The infarct-related artery was patent in 55 patients (76%). In the 10 days after angiography, 15 patients developed prolonged episodes of angina at rest; the condition of 4 stabilized with medical treatment, but 11 required urgent medical intervention (coronary angioplasty in 8 and bypass surgery in 3). There were no differences in age, gender, left ventricular function or extent of coronary artery disease between those patients who developed unstable angina and those who had a stable in-hospital course. However, the median plaque ulceration index of the infarct-related lesion was 6.7 (95% confidence limits 6.3, 10) in the 15 patients with an unstable course versus 3.3 (2, 4.4) in those with a stable course (p less than 0.001). There were no differences between the two patient groups in the severity of stenosis, length of diseased segment, symmetry/eccentricity, presence of a shoulder, location at branch point or bend, presence of globular or linear filling defects, contrast staining or collateral supply. These data show that after thrombolysis, the degree of irregularity of the infarct-related artery is a critical determinant of early clinical instability.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina, Unstable↗

Coronary lesion morphology in acute myocardial infarction: demonstration of early remodeling after streptokinase treatment.

Coronary lesion morphology was analyzed in 72 patients 1 to 8 days after streptokinase treatment for acute myocardial infarction and compared with lesion morphology in a control group of 24 patients with stable angina. In the streptokinase group the infarct-related artery was patent in 55 patients (76%). Compared with stenoses in the stable angina group, there were no differences in the stenosis length, severity, calcification or in the proportion located at an acute bend or at a branch point. However, lesions in the streptokinase group were more often irregular (p less than 0.005) and eccentric (p less than 0.01), had a shoulder (p less than 0.0001), globular filling defects (p less than 0.01), linear filling defects (p less than 0.00005) and contrast staining (p less than 0.05). Plaque ulceration index was higher in the streptokinase than in the stable angina group (6.2 +/- 7.9 versus 3.5 +/- 3.4, p less than 0.001). Of the 72 streptokinase-treated patients, 35 were maintained on heparin infusion until angioplasty 2 to 10 days later. At repeat angiography before angioplasty, globular lesion filling defects seen in eight patients had disappeared, whereas linear filling defects persisted in 7 of 14 cases. Fewer lesions were irregular (p less than 0.0001) and the ulceration index decreased from 7.4 +/- 10.4 to 3.0 +/- 1.6 (p less than 0.001). These data show that the lesion in the infarct-related artery after streptokinase treatment is irregular and often associated with filling defects, perhaps corresponding to plaque fissuring and intraluminal thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗

Fatigue, recovery, and low back pain in varsity rowers.

The purpose of this study was to determine whether surface electromyography (EMG) from the erector spinae muscles could correctly identify individuals with low back pain without a population of elite athletes. A similar technique had previously been successful in identifying low back pain patients within a non-athletic population. A Back Analysis System was used to compute the median frequency of the EMG power density spectrum to monitor metabolic changes in back muscles associated with muscle fatigue. Twenty-three members of a men's collegiate varsity crew team consisting of port (N = 13) and starboard (N = 10) rowers were tested in a laboratory during a fatigue-inducing isometric contraction sustained at a relatively high, constant force. Six of the rowers tested were further classified as having low back pain. A brief test contraction was repeated at a fixed interval following the fatiguing contraction to monitor recovery. A two-group discriminant analysis procedure correctly classified 100% of the rowers with low back pain and 93% of the rowers without back pain on the basis of the median frequency data. The median frequency parameters related to recovery were the best discriminators of back pain. A similar analysis correctly classified 100% of the port rowers and 100% of the starboard rowers on the basis of their spectral parameters. The best discriminating variables in this instance were the median frequency parameters relating to both fatigability and recovery. Results from this study demonstrate that low back pain and asymmetrical muscle function in rowers can be assessed on the basis of EMG spectral analysis.

Adult↗

Significance of "reciprocal" ST segment depression: left ventriculographic observations during left anterior descending coronary angioplasty.

To evaluate the significance of "reciprocal" ST segment depression resulting from coronary occlusion, 27 patients with single vessel coronary disease were studied with intravenous digital subtraction left ventriculography before and during angioplasty of the left anterior descending coronary artery. During balloon inflation, 13 patients developed inferior lead ST depression in addition to anterior lead ST elevation (Group 1), whereas the remaining 14 patients did not (Group 2). The degree of anterior lead ST elevation in Group 1 (5 mm) was greater than that in Group 2 (1.5 mm, p less than 0.001) as was the reduction in left ventricular ejection fraction (24% versus 13%, respectively; p less than 0.02). Anterior and apical regional shortening decreased in both groups similarly, but an additional decrease in anterobasal shortening was confined to Group 1 (from 38% to 21%; p less than 0.002). Despite the presence of inferior lead ST depression in Group 1, inferior regional shortening did not change and inferobasal contraction was enhanced (from 4% to 29%; p less than 0.01). Inferior lead ST segment depression during anterior descending coronary angioplasty reflects a greater degree of anterior wall ischemia. The concurrent preservation of inferior wall contraction and the augmentation of infero-basal shortening confirm that this electrocardiographic feature is a "reciprocal" phenomenon rather than a manifestation of remote ischemia.

Angioplasty, Balloon↗

Protective effect of collateral vessels during coronary angioplasty.

To assess the potential protective role of collateral vessels 27 patients undergoing angioplasty of the left anterior descending coronary artery were studied by intravenous digital subtraction left ventriculography. Fifteen patients had no collateral vessels (group 1) and 12 had some degree of collateral supply (group 2). During balloon inflation ST segment elevation in group 1 (4.9 mm) was significantly greater than that in group 2 (0.9 mm). Similarly the reduction in left ventricular ejection fraction was significantly greater in group 1 (24%) than in group 2 (12%). Both the size of ST segment elevation and the fall in ejection fraction correlated inversely with the extent of the collateral supply (r = -0.680 and r = -0.446 respectively). During balloon occlusion of the anterior descending coronary artery the percentage shortening of the anterior and apical segments fell in both groups but apical shortening fell to a lesser extent in group 2. An additional reduction in anterobasal contraction was confined to group 1. Electrocardiographic and ventriculographic manifestations of ischaemia produced by balloon inflation during angioplasty are less pronounced when collateral vessels are present. This suggests that the collateral circulation can protect myocardium at risk of ischaemia after coronary occlusion.

Angina Pectoris↗

Assessment of left ventricular performance during percutaneous transluminal coronary angioplasty: a study by intravenous digital subtraction ventriculography.

Left ventricular performance during percutaneous transluminal coronary angioplasty was assessed in 52 patients by intravenous digital subtraction ventriculography. After injection of contrast into the right atrium ventriculograms were obtained before and during balloon inflation. In 37 patients they were also obtained after the procedure. A 12 lead electrocardiogram was monitored throughout. During balloon inflation the left ventricular ejection fraction fell (from 73% to 57%) in all but one patient; the decreases in patients with single vessel or multivessel disease were similar. The fall in left ventricular ejection fraction during percutaneous transluminal coronary angioplasty of the left anterior descending artery (19%) was significantly greater than that during balloon inflation in the right coronary (10%) or circumflex (8%) coronary arteries. It also reduced anterobasal, anterior, and apical segmental shortening while right coronary percutaneous transluminal coronary angioplasty affected inferior and apical segments. In 33 (63%) patients the ST segment was altered during balloon inflation. The fall in left ventricular ejection fraction correlated significantly with the magnitude of both ST segment elevation (r = 0.637) and ST depression (r = 0.396). Left ventricular ejection fraction and regional wall motion returned to baseline values after the procedure. Balloon inflation during percutaneous transluminal coronary angioplasty produces considerable abnormalities of global and regional left ventricular performance and this indicates the presence of myocardial ischaemia, which may not be apparent on electrocardiographic monitoring. Intravenous digital subtraction ventriculography is useful for monitoring left ventricular performance during controlled episodes of coronary occlusion produced by balloon inflation.

Adult↗

Long term clinical outcome of coronary surgery and assessment of the benefit obtained with postoperative aspirin and dipyridamole.

Three hundred and twenty patients originally entered into a randomised study to assess the effect of aspirin and dipyridamole on the patency of coronary bypass grafts one year after operation were clinically reassessed a mean of 6.6 years (range 4.3-8.6) after operation. Patients were recruited between 1978 and 1982 after the present policy of total revascularisation had been adopted. During the follow up period there were 25 deaths of which 17 were due to cardiac causes (average annual cardiac mortality 0.8%). Of 280 patients available for contact, 250 (89.3%) attended an outpatient interview. Ninety four (37.6%) patients complained of recurrent angina but in only 23 (9.2%) was this severe. Two hundred and eleven (84.4%) of the 250 patients underwent exercise stress testing. There were 73 (34.6%) abnormal tests of which 52 were in the group of 94 patients with recurrent angina. Myocardial infarction occurred in nine of the 250 patients during the follow up period. Twenty six patients (10.4%) had reinvestigation for symptoms. This group had a graft occlusion rate of 52%. Half these patients have required reoperation and 20 of 22 occluded or severely stenosed grafts were replaced. In only two instances were vein grafts inserted into vessels with new disease. Half of the original group were given aspirin (330 mg three times a day) plus dipyridamole (75 mg three times a day). Of the 250 patients interviewed, 122 took aspirin and dipyridamole from the second postoperative day for a mean of 25 months, with warfarin for three months. The other 128 patients took placebo for a mean of 23 months together with warfarin for three months. This long term treatment with aspirin plus dipyridamole conferred no significant benefit for all clinical outcomes measured at a mean of 6.6 years.

Angina Pectoris↗

Thrombolysis for myocardial infarction.

Treating myocardial infarction by dissolving occlusive thrombi in coronary arteries is an attractive idea. Although some thrombolytic agents have been available for many years their use in this role has only recently been critically examined. The place of thrombolysis in the management of myocardial infarction has yet to be determined.

Fibrinolytic Agents↗

Prevalence and relation to underground exposure of radiological irregular opacities in South Wales coal workers with pneumoconiosis.

A total of 124 coal workers and ex-coal workers receiving disability benefit for coal worker's pneumoconiosis and routinely reattending the Cardiff Pneumoconiosis Medical Panel during a 10-week period were studied. Those with complicated pneumoconiosis were excluded. Their current chest radiographs and their chest radiographs at the time of certification were read in random order by three readers using the 1980 ILO Classification of Radiographs. An irregularity score was derived from the readings. The x-ray findings were examined for changes since certification and for relationships with age, smoking, and underground coal work exposure. One-fifth of the current radiographs showed mainly irregular opacities, whereas nearly all of those from the time of certification showed mainly irregular opacities, whereas nearly all of those from the time of certification showed mainly rounded opacities. Irregular opacities were related to age, smoking, and underground exposure. The exposure effect remained after excluding the older men. The findings suggest that radiological irregular opacities, and their associated pathology and lung function changes, commonly develop in coal workers with pneumoconiosis and should be considered part of the condition.

Adult↗