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Biomedical subjects

K Bailey

Publications and source records attributed to K Bailey.

At least 19 recordsLinked to original sources
PubMed1992

Fetal haemoglobin and early manifestations of homozygous sickle cell disease.

The relevance of fetal haemoglobin (HbF) concentration to the development of early clinical manifestations of homozygous sickle (SS) disease has been investigated by examining the time to first occurrence and the proportional hazard of these complications in three groups of the HbF distribution at age 5 years. HbF was significantly related to dactylitis, painful crises, acute chest syndrome, and acute splenic sequestration. The relationship suggested that a critically low HbF concentration increased the risk, little difference in risk occurring between the medium and high HbF groups. The abdominal painful crisis and hypersplenism were not related to HbF concentration suggesting that the degree of sickling may not be important in their genesis. Parental education on acute splenic sequestration should be focused on children with HbF concentrations in the lowest part of the HbF distribution for age.

Adolescent↗
PubMed1991

Emboli in infective endocarditis: the prognostic value of echocardiography.

OBJECTIVE: To determine whether vegetations visualized on two-dimensional echocardiography are an independent risk factor for the development of subsequent emboli in patients with infective endocarditis and to assess the timing of emboli relative to the initiation of antimicrobial therapy. DESIGN: Investigator-blinded, retrospective incidence cohort study. SETTING: Tertiary referral center. PATIENTS: Patients with left-sided native valve infective endocarditis who had two-dimensional echocardiography within 72 hours of beginning antimicrobial therapy. MEASUREMENTS AND MAIN RESULTS: The crude incidence rate of first embolic events in patients receiving antimicrobial therapy was 6.2 per 1000 patient-days (95% CI, 4.2 to 9.2). The rates in patients with and without vegetations were 7.1 and 4.9 per 1000 patient-days, respectively (incidence rate ratio, 1.4; 95% CI, 0.6 to 3.3). The relation between vegetations and risk for emboli was microorganism-dependent: Stratified incidence rate ratios were 6.9 (95% CI, 1.1 to 42.5; P less than 0.05) and 1.0 (95% CI, 0.2 to 3.9) for viridans streptococcal and Staphylococcus aureus endocarditis, respectively. The rate of first embolic events diminished over time (P less than 0.001), falling from 13 per 1000 patient-days during the first week of therapy to less than 1.2 per 1000 patient-days after completion of the second week of therapy. CONCLUSIONS: Overall, the presence of vegetations on echocardiography was not associated with a significantly higher risk for embolus in patients with left-sided native valve infective endocarditis. The relative risk for embolic events associated with echocardiographically visualized vegetations may be microorganism-dependent, with a significantly increased risk seen only in patients with viridans streptococcal infection. The rate of embolic events declines with time after initiation of antimicrobial treatment.

Adolescent↗
PubMed1991

The structure of expert diagnostic knowledge in occupational medicine.

Development of an artificial intelligence expert system for diagnosing occupational lung disease requires explicit specification of the structure of knowledge necessary in clinical occupational medicine independent of the process by which the knowledge is utilized. Furthermore, explicit recognition of sources of uncertainty is necessary. Seven categories of knowledge define the diagnostic knowledge base in occupational pulmonary medicine. These include four objects (jobs, industries, exposures, and diseases) and three relationships between pairs of objects. This analysis demonstrates some of the unique aspects of occupational medicine expertise.

Algorithms↗
PubMed1991

Trauma internship: a success story.

Internships, valuable mechanisms that bridge the gap between academic preparation and initial clinical experience, are attractive to new graduates who have had limited exposure to different aspects of nursing and want a chance to learn more about a particular specialty. Upon completion of an internship, nurses have a broader knowledge base than those who have had an indepth orientation to just one nursing unit. This article describes the development and implementation of a trauma internship in a 570-bed tertiary care, level I trauma center. Program components and evaluation are presented.

Curriculum↗
PubMed1990

Identification and characterization of a novel member of the nerve growth factor/brain-derived neurotrophic factor family.

The survival and functional maintenance of vertebrate neurons critically depends on the availability of specific neurotrophic factors. So far, only two such factors, nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) have been characterized and shown to have the typical features of secretory proteins. This characterization has been possible because of the extraordinarily large quantities of NGF in some adult tissues, and the virtually unlimited availability of brain tissue from which BDNF was isolated. Both NGF and BDNF promote the survival of distinct neuronal populations in vivo and are related in their primary structure, suggesting that they are members of a gene family. Although there is little doubt about the existence of other such proteins, their low abundance has rendered their identification and characterization difficult. Taking advantage of sequence identities between NGF and BDNF, we have now identified a third member of this family, which we name neurotrophin-3. Both the tissue distribution of the messenger RNA and the neuronal specificity of this secretory protein differ from those of NGF and BDNF. Alignment of the sequences of the three proteins reveals a remarkable number of amino acid identities, including all cysteine residues. This alignment also delineates four variable domains, each of 7-11 amino acids, indicating structural elements presumably involved in the neuronal specificity of these proteins.

Amino Acid Sequence↗
PubMed1989

The relation between resource limitations and optional conceptual processing by children and adults.

In some situations children fail to perform optional conceptual processing that they are able to perform. The purpose of the 4 experiments was to determine if the difficulty of word identification affects optional conceptual processing by second/third graders, fifth graders, and college students in a cued recall task. Conceptual processing was manipulated by presenting Hard (e.g., hawk eagle canary) or Easy (river lake canary) word triplets that varied in the contrastive processing necessary to identify the "odd" target word (canary). The orienting activity also varied: for the Oddity Choice activity, contrastive processing was obligatory because the subject had to identify the target; for the Read activity, contrastive processing was optional because the experimenter identified the target. A recall advantage for the Hard over the Easy triplets was the measure of contrastive processing. Finally, the difficulty of word identification varied in that the subjects read the stimuli or the experimenter read the stimuli, and all the words were degraded, only the nontarget words were degraded, or all the words were intact. The results established that contrastive processing facilitates recall, and that word identification difficulty may limit the extent of optional contrastive processing.

Adolescent↗
PubMed1987

Change in physician perspective on cholesterol and heart disease. Results from two national surveys.

The National Heart, Lung, and Blood Institute sponsored national telephone surveys of practicing physicians in 1983 (N = 1610) and 1986 (N = 1277) to assess attitudes and practices regarding elevated serum cholesterol levels. The 1983 survey was conducted just before the release of the results of the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease. In 1986, 64% of physicians thought that reducing high blood cholesterol levels would have a large effect on heart disease, up considerably from 39% in 1983. Whereas in 1983, physicians attributed considerably less preventive value to reducing the cholesterol level than to reducing blood pressure or smoking, this disparity was substantially smaller in 1986. The median range of blood cholesterol at which diet therapy was initiated was 6.21 to 6.70 mmol/L (240 to 259 mg/dL) in 1986, down from 6.72 to 7.21 mmol/L (260 to 279 mg/dL) in 1983; the median for drug therapy was 7.76 to 8.25 mmol/L. (300 to 319 mg/dL) in 1986 and 8.79 to 9.28 mmol/L (340 to 359 mg/dL) in 1983. In 1986, 87% of physicians surveyed felt that medical evidence warranted the recommended treatment levels set forth in the 1984 National Institutes of Health Consensus Conference on Lowering Blood Cholesterol. These changes indicate that by 1986, physicians were more convinced of the benefit of lowering high blood cholesterol levels and were treating patients accordingly. The data also suggest areas for continued educational initiatives.

Adult↗
PubMed1987

Change in public perspective on cholesterol and heart disease. Results from two national surveys.

The National Heart, Lung and Blood Institute, Bethesda, Md, and the Food and Drug Administration, Washington, DC, sponsored two national probability telephone surveys (N = 4000) of adults to assess attitudes and knowledge about heart disease risk from high blood cholesterol levels and the public's efforts to lower blood cholesterol levels. The first survey was conducted in 1983, before release of the results from the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease; the second survey was conducted in 1986. The percentage of adults who believed that reducing high blood cholesterol levels would have a large effect on heart disease increased from 64% in 1983 to 72% in 1986, so that the importance attached to reducing high blood cholesterol levels approached that attributed to reducing smoking and high blood pressure. In 1983, 35% of adults reported that they had their cholesterol level checked vs 46% in 1986. In both years, diet changes were most frequently chosen (greater than 60%) as ways to control the blood cholesterol level; reducing dietary fat was believed to be as important as reducing dietary cholesterol. By 1986, 23% of adults reported that they made dietary changes specifically to lower their blood cholesterol level, up from 14% in 1983. These comparative data show gains in public awareness and action relating to high blood cholesterol level risk. The data can be used to develop education programs.

Attitude to Health↗
PubMed1987

Synthesis and antilipolytic activities of quinolyl carbanilates and related analogues.

A series of quinolyl carbanilates was prepared and tested as antilipolytic agents. These compounds inhibited production of glycerol from rat adipocytes and inhibited liberation of free fatty acids from triolein by canine cardiac triglyceride lipases. An extensive structure-activity relationship study indicated that 8-quinolyl 4-methoxycarbanilate (1) contained features necessary for maximum potency in vitro. Substituting a benzofuranyl group for the quinolyl group of 1 provided the most interesting compound on the basis of both potency and structural novelty. 7-Benzofuranyl 4-methoxycarbanilate (44) has IC50's of 16 and 0.3 microM in the myocardial lipase and rat adipocyte assays, respectively. In vivo, compound 44 was orally active as an inhibitor (97% at 25 mg/kg) of lipolysis in the rat.

Adipose Tissue↗
PubMed1985

Synthesis and antiallergic activities of 1,3-oxazolo[4,5-h]quinolines.

A series of new 1,3-oxazolo[4,5-h]quinolines has been prepared. These compounds were tested as inhibitors of antigen-induced release of histamine (AIR) in vitro from rat peritoneal mast cells (RMC) and as inhibitors of IgE-mediated passive cutaneous anaphylaxis in the rat (PCA). After several modifications of the original lead, the most potent compound of the series was determined to be 5-chloro-1,3-oxazolo[4,5-h]quinoline-2-carboxylic acid methyl ester (4a). It has an IC50 of 0.3 microM in the RMC assay and an ED50 (intraperitoneal) of 0.1 mg/kg in the PCA test, which is 10 times and 60 times more potent than disodium cromoglycate (DSCG), respectively. Of greater importance, it is orally active (ED50 = 0.5 mg/kg) as an inhibitor of the PCA test.

Animals↗
PubMed1985

Functional aspects of T-lymphocyte subsets in pregnancy.

Several recent reports have suggested that a decrease in circulating T helper cells may contribute to the relative immunodeficiency of pregnancy. To investigate the significance of these findings, 90 pregnant women were evaluated. The results of this study indicate that although pregnant women have a decreased proportion of T helper cells, they do have adequate T helper cell function as determined by an in vitro immunoglobulin synthesis assay and a T-lymphocyte colony-forming assay. Based on these studies it is unlikely that decreased numbers of T helper cells are primarily responsible for the immunodeficiency of pregnancy.

Adult↗