PubMed Health⌕ Search

Biomedical subjects

L Russell

Publications and source records attributed to L Russell.

At least 37 records · Page 2Linked to original sources
PubMed2000

Osteoporosis.

Osteoporosis is a disorder of decreased bone mass, microarchitectural deterioration, and fragility fractures. Osteoporosis is widespread and can affect people of all ethnic backgrounds and many older women and men. An essential element in preventing osteoporosis is the achievement of normal peak bone mass. Adequate nutrition, appropriate calcium and vitamin D intake, regular menstrual cycles and a well balanced exercise program of exercise are essential elements in achieving peak bone mass. At menopause women undergo accelerated bone loss. Thereafter, women and men gradually lose bone mass. A loss of one standard deviation give rise to an enhanced twofold risk of spine fractures or a 2.5 risk of hip fracture. Bone mass is determined by dual energy x-ray absorptiometry, quantitative computed tomography scan, and a peripheral ultrasound. Dual energy x-ray absorptiometry has outstanding precision (within 1% to 2%), and has the ability to show the efficacy of drug intervention. Peripheral measurements may identify osteoporosis but only have a 70% correlation with hip and spine bone mass. Dual energy x-ray absorptiometry determines bone mass in a patient but the bone collagen breakdown products (N-telopeptide crosslinks) establish the current rate of bone loss. Major risk factors leading to fragility fracture include low body weight, history of fracture, family history of osteoporosis, and smoking. All individuals should ingest adequate calcium and vitamin D, exercise, and prevent falls. Women with low bone mass, high urinary bone collagen breakdown products, and/or major risk factors should consider hormone replacement therapy or a selective estrogen receptor modulator (Evista), calcitonin and bisphosphonates (alendronate). These agents successfully increase bone mass and limit fracture risk. Men at risk for fragility fractures respond similarly as women to alendronate and calcitonin. Although vertebral compression fractures can occur spontaneously, hip fractures are attributable to low bone mass coupled with a fall. Hence, fall prevention programs in addition to medical treatment are critical in the prevention of fragility fractures.

Female↗
PubMed2000

Fever and pneumonia in a steroid treated patient with systemic lupus erythematosus.

Systemic lupus erythematosus is reported to affect the lungs in almost half of patients, but pleuritis is most commonly encountered. Acute pneumonitis is an uncommon but recognized manifestation of SLE. Infection and drug reactions are more frequently diagnosed. The case discussed below permits consideration of the dilemmas typical of the SLE patient who presents with an acute pulmonary process.

Female↗
PubMed2000

The Arabidopsis COMATOSE locus regulates germination potential.

Mutation of the COMATOSE locus in Arabidopsis results in a marked reduction in germination potential. Whilst the morphology of comatose (cts) embryos is not altered, physiological analysis reveals that mature cts seeds do not respond to gibberellin. Prolonged chilling of imbibed seeds only partially restores germination potential, and seeds do not after ripen. Genetic analysis shows that the cts phenotype is expressed in the embryo and phenotypic differences between wild-type and mutant plants were not observed during other stages of plant growth and development. Therefore cts represents a new class of mutant, with a specific lesion that results in severely impaired germination potential. Genetic interactions were analysed between cts and loci that regulate embryo maturation, and abscisic acid biosynthesis and perception. Results from these studies showed that the cts mutant phenotype required the wild-type action of these loci, and suggested that CTS exerts a repressive function on these loci. A model is presented postulating that CTS promotes increased germination potential, and represses embryo dormancy. These functions of CTS may result in the removal of embryo dormancy as a prerequisite to germination.

Arabidopsis↗
PubMed2000

Down-regulated RPS3a/nbl expression during retinoid-induced differentiation of HL-60 cells: a close association with diminished susceptibility to actinomycin D-stimulated apoptosis.

The efficacy of anticancer agents significantly depends on the differential susceptibility of undifferentiated cancer cells and differentiated normal cells to undergo apoptosis. We previously found that enhanced expression of RPS3a/nbl, which apparently encodes a ribosomal protein, seems to prime cells for apoptosis, while suppressing such enhanced expression triggers cell death. The present study found that HL-60 cells induced to differentiate by all-trans retinoic acid did not undergo apoptosis following treatment with actinomycin D whereas undifferentiated HL-60 cells were highly apoptosis-susceptible, confirming earlier suggestions that differentiated cells have diminished apoptosis-susceptibility. Undifferentiated HL-60 cells highly expressed RPS3a/nbl whereas all-trans retinoic acid -induced differentiated cells exhibited markedly reduced levels, suggesting that apoptosis-resistance of differentiated cells could be due to low RPS3a/nbl expression. Down-regulation of enhanced RPS3a/nbl expression was also observed in cells induced to differentiate with the retinoid 4-[(E)-2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-napthalenyl)-1- propenyl]benzoic acid without any significant induction of cell death. While down-regulation of RPS3a/nbl expression during differentiation did not apparently induce apoptosis, RPS3a/nbl antisense oligomers triggered death of undifferentiated HL-60 cells, but not of retinoid-induced differentiated cells. It therefore seems that while down-regulation of enhanced RPS3a/nbl expression can induce apoptosis in undifferentiated cells, down-regulation of enhanced RPS3a/nbl expression during differentiation occurs independently of apoptosis, and could be regarded as reverting the primed condition to the unprimed (low RPS3a/nbl) state.

Antigens, Differentiation↗
PubMed2000

Randomised controlled trial of two pressure-relieving systems.

The primary objective of this randomised controlled trial was to determine whether there were significant differences between two pressure-relieving systems. A secondary aim was to investigate whether the availability of extra pressure-relieving equipment would reduce the incidence of ulcers in an acute hospital setting. A total of 141 patients in a care-of-the-elderly unit, who were assessed to have a high risk of developing pressure ulcers using the Waterlow score, were recruited; 70 were nursed using Huntleigh Nimbus 3 in conjunction with the Aura cushion (Group A), and 71 using the Pegasus Cairwave Therapy System in conjunction with the Proactive 2 Seating cushion (Group B). The main outcome measure was visual assessment, supported by a photographic record. There were three main findings: for non-heel ulcers and overall improvement, there was no statistically significant difference between the two products tested; for heel ulcers there was a significant difference (P = 0.019) with more patients healing in Group A than in Group B. The average length of stay of patients who completed the trial was 21.6 days (Group A) and 21.7 days (Group B) for patients completing a live (range 1-121 days) and for patients who died 29.7 days (Group A) and 24.3 days (Group B). Routine monitoring showed that, before the trial, the incidence of hospital-acquired pressure ulcers (Torrance grade 2+) was 0.2%; during the trial, this dropped to 0.13%. The study showed differences in the efficacy of different mattress products; with a sufficiently large study, it is possible to demonstrate statistically significant results. Provision of extra pressure-relieving equipment can reduce the incidence of pressure ulcers but may not influence length of stay.

Aged↗
PubMed1999

A comparison of two methods of dietary assessment in peritoneal dialysis patients.

OBJECTIVE: To conduct a comparison of two methods of dietary assessment in patients on peritoneal dialysis. DESIGN: Comparative, cross-sectional study of two methods of dietary assessment (3-day diet diary and 24-hour recall). Data was collected simultaneously by a single experienced dietitian. Each assessment was coded and analyzed blind. SETTING: Regional speciality peritoneal dialysis training unit. PATIENTS: In this study, 30 peritoneal dialysis patients recruited prospectively and consecutively as they attended for out-patient assessment of dialysis adequacy. Age range was 22 to 77 years. Patients were excluded if unwell, younger than 18 years, or had peritonitis. OUTCOME MEASURES: Total energy and protein intakes from both methods were compared. Protein intakes from both methods were compared with the protein catabolic rate generated from urea kinetics. Data obtained from both methods were compared using paired t tests, linear regression, and Bland and Altman techniques. RESULTS: There were no significant differences in the mean daily protein (72.4 g v 76.6 g) and total energy (1757 kcals (7.35 MJ) v. 1897 kcals (7.94 MJ)) intakes determined by the two methods. Positive correlations were seen between the measurements for protein intake (r =.58, P =.0026) energy intake (r =.78, P <.00001), with mean differences of.066 g/kg/d (SD.38) 2.04 kcal/kg/day (SD 6.67), respectively. For both methods there was a similar positive correlation between dietary protein intake and protein catabolic rate. A 24-hour recall was more likely to result in successful collection of data (29 of 30) than 3-day diet diaries (25 of 30) and was less time consuming. CONCLUSION: These two methods of determining dietary protein and energy intake do not differ significantly in the information they provide. The relative success in obtaining completed records of intake, the shorter time taken and the opportunity for patient education and assessment of other nutrition related factors has led to the adoption of the 24-hour recall method in our institution.

Adult↗
PubMed1999

Congenital orbital teratoma.

A case of congenital orbital teratoma is described in which there was no organized eye only microscopic evidence of ocular tissues within the disorganized teratoma. A baby boy presented at birth with a 10-x-8-cm mass extruding from the left orbit. Magnetic resonance imaging (MRI) showed a mixed cystic-solid orbital mass containing areas of calcification and deforming the bony orbit around its margins. There was no organized eye and no intracranial extension. The eye was removed with reconstruction of the eyelids. Histopathology showed representation from all three germ cell layers consistent with a teratoma. There was no organized eye, but some disorganized ocular structures within the teratoma. Follow-up has been uneventful. Neonatologists and pediatricians should be aware of the possible diagnoses in a newborn presenting with an orbital mass, so that early definitive surgery can be performed with preservation of the globe where possible.

Anophthalmos↗
PubMed1999

Assessing the generalizability of OSCE measures across content domains.

PURPOSE: To assess the degree to which OSCE measures generalize across multiple administrations to the same students. METHODS: Students' scores from three OSCEs at one institution were correlated to determine the generalizability of the scoring systems across course domains. RESULTS: Analysis revealed that while checklist scores showed quite low correlations across examinations from different domains (ranging from 0.14 to 0.25), global process scores showed quite reasonable correlations (ranging from 0.30 to 0.44), with the correlations for global scores being significantly higher than those for checklist scores in all three comparisons. CONCLUSION: These data would seem to confirm the intuitions about each of these measures: the checklist scores are highly content-specific, while the global scores are evaluating a more broadly based set of skills. Implications for the use of these scales are discussed.

Clinical Clerkship↗
PubMed1999

Crisis management to controlled recovery: the emergency planning response to the bombing of Manchester City Centre.

Fuelled by terrorist attacks on urban areas, emergency planning responses to manmade disasters is a growing area of critical debate within the field of urban management. The response of a major British city--Manchester--to the 1996 bombing of its commercial core, is examined in this paper. It focuses on the transformation of the emergency planning response from dealing with the immediate crisis during the first week, to a stage of controlled recovery that still continues. The response to the devastation caused by the bomb was co-ordinated by the city council, which developed a range of short- and long-term initiatives, but the re-opening of the city centre could not have happened so quickly had the council not worked in collaboration with other key organisations and agencies. Working partnerships were crucial to the immediate response and subsequent recovery, with such capacity for organisational learning built upon existing co-operative arrangements within the city, which had developed over the previous decade.

Crisis Intervention↗
PubMed1999

Effect of supplemental sodium chloride and hydrochloric acid added to initial starter diets containing spray-dried blood plasma and lactose on resulting performance and nitrogen digestibility of 3-week-old weaned pigs.

Four experiments evaluated the efficacy of Na or Cl or their combination added to weanling pig diets that contained plasma protein and lactose on pig performance and N digestibility. The four experiments used a total of 563 crossbred pigs weaned at 22+/-1 d of age averaging 6.4 kg body weight. The basal diet in each experiment contained 5.8% plasma protein and 20% lactose and analyzed .20% Na and .23% Cl. In Exp. 1, NaCl was added to treatment diets at 0, .20, .40, or .60%. The trial was conducted for a 21 d period in a randomized complete block (RCB) design in seven replicates. Improved growth rates (P < .01) and gain:feed ratios (P < .01) occurred up to a dietary salt level of .40%. In Exp. 2, we evaluated the interaction of Na and Cl on pig performance. The experiment was a 2 x 2 factorial arrangement in a RCB design conducted in seven replicates. Total dietary Na was .20 or .36%, and Cl was included at .25 or .45%. Although there was a numerical increase in pig gains with added Na, the response was not significant (P > .15), but both gains (P < .01) and gain:feed ratios (P < .01) increased at the higher dietary Cl level. In Exp. 3, we evaluated the effect of five dietary levels of Cl added at .06% increments to a basal diet that analyzed .34% Na and .20% Cl on postweaning pig performance. The experiment was a RCB design conducted in eight replicates. A growth response (P < .01) to the .38% Cl level occurred during the initial 14-d postweaning period and to the .32% Cl level from 14 to 21 d. Gain:feed ratio increased each week with added Cl, but it was significant only for the period from d 0 to 7 d (P < .01). A N digestibility trial, using the diets of Exp. 3, constituted Exp. 4, and groups of three pigs per stainless steel metabolism crate were pair-fed to pigs fed the basal diet. The experiment was a RCB design conducted in three replicates over a 3-wk period. The results demonstrated a weekly decrease in fecal N (P < .01), no effect on urinary N (P < .15), improved N retention (P < .01), and an improved apparent N digestibility (P < .01) to the .38% dietary Cl concentration during the initial 2 wk postweaning. These experiments suggest that although plasma protein contributed Na and Cl to the initial diets of weaned pigs, additional Na and Cl, but particularly Cl, improved pig growth, N retention, and N digestibility. The results suggest a dietary minimum of .38% total Cl level during the initial 2 wk postweaning.

Animal Feed↗
PubMed1999

Severe hemolytic reaction due to anti-JK3.

A 35-year-old gravida 3, para 3 Filipino woman with a negative antibody screen, no prior history of transfusion, and no hemolytic disease of the newborn in her children suffered a massive postpartum hemorrhage requiring transfusion. A severe hemolytic transfusion reaction occurred 5 days after delivery. Subsequently, a panagglutinin on a routine antibody identification panel was identified as anti-Jk3. The patient's red blood cell phenotype was Jk(a-b-) and all of her children were Jk(a-b+), yet the antibody that formed reacted with equal strength against all Jk(a)- or Jk(b)-positive cells. The rare Jk(a-b-) phenotype is more common in Polynesians. Anti-Jk3, like other Kidd system antibodies, is difficult to detect because in vivo production may be absent between provocative episodes and because these antibodies often show weak in vitro reactions. The increasing numbers of Pacific Islanders in the United States could result in more frequent encounters with this rare phenotype. Increased awareness of ethnic variability in blood phenotypes and of the capricious nature of Kidd antibodies can help pathologists and technologists deal more effectively with these cases.

Adult↗
PubMed1998

Increased cell surface exposure of fucose residues is a late event in apoptosis.

Apoptosis is a well defined physiological process characterised by many specific features including DNA fragmentation and protease activation. Cell membrane-associated changes such as the altered exposure of phosphatidylserine and glycosylation patterns have also been described. We investigate here the change in exposure of surface alpha-L-fucose residues during thymocyte and P815 cell apoptosis. We show that apoptosis in these cells induced by dexamethasone, gliotoxin or thapsigargin was associated with an increase in the exposure of terminal fucose residues. Furthermore, this increase in fucose exposure occurred late in the apoptotic process. The observation of increased fucose exposure in two different cell types by three different apoptosis-inducing agents suggests it may be part of the normal apoptotic process.

Animals↗
PubMed1998

Development and validation of the Burton Score: a tool for nutritional assessment.

This paper describes the development and validation of the Burton Score, a nutritional assessment tool based on the Waterlow score, with the rationale that since nurses already collect data for one score, it would only lead to unnecessary duplication of effort if a totally different scoring scheme were to be used for nutritional assessment. Initial cut offs were determined by a pilot study of 26 patients on an elderly care ward and validated by comparing the nutritional status of 263 patients estimated by the Burton score with a dietitian's assessment of nutrition. The validation study showed that although there was significant correlation between the Burton and Waterlow scores the Burton score correlated more closely with the dietitian's assessments. The King's Fund report of 1992 stated that all patients should have assessment of nutritional status on admission to hospital: we believe the Burton score could provide a simple tool to achieve this goal.

Energy Intake↗
PubMed1998

Expression and processing of G0/G1 switch gene 24 (G0S24/TIS11/TTP/NUP475) RNA in cultured human blood mononuclear cells.

The human G0/G1 switch (G0S) gene, G0S24, and its rodent immediate-early homolog (TIS11, TTP, NUP475) are part of a mammalian gene family whose members encode CCCH zinc finger domains and domains similar to part of the large subunit of RNA polymerase II and to the Mei2 regulator of G1 arrest in fission yeast. We compared the RNA expression of G0S24 with that of other G0S genes in cultured blood mononuclear cells and examined the levels of various RNA processing intermediates. Freshly isolated cells contained high levels of several G0S RNAs, which declined by 24 h, suggesting transient spontaneous stimulation during cell purification (Heximer et al., 1996). However, in cells preincubated for 24 h, G0S24 RNA levels remained much higher than those of other G0S genes (107+/-42 x 10(6) molecules/microg of RNA); stimulation with lectin (Con-A) further increased G0S24 RNA, much of which remained nuclear. Like those of FOS/G0S7, EGR1/G0S30 and of the gene encoding the regulator of G protein signalling 1 (RGS1), G0S24 RNA levels increased more in response to a protein kinase C activator than to a calcium ionophore, whereas the opposite held for FOSB/G0S3 and RGS2/G0S8. With appropriate PCR primer pairs, we showed a G0S24 RNA processing intermediate, which crossed the exon-1/intron boundary, and nonpolyadenylated nuclear RNA extending into the 3' flank, where there is a second CpG island. The concentration of the latter intermediate (1.2+/-0.2 x 10(6) molecules/microg of RNA), which increased transiently on cell stimulation, did not account for all G0S24 nuclear RNA. The levels of G0S24 RNA and both intermediates were increased by the protein synthesis inhibitor cycloheximide, consistent with regulation by a labile repressor.

Base Sequence↗
PubMed1998

The normal copy of the G0S19-3-associated, CpG island-containing, upstream sequence is downstream of G0S19-2/MIP1alpha in association with a TRE17 oncogene.

The G0S19-1/MIP1alpha and G0S19-2/MIP1alpha genes locate to human chromosomes 17q and encode similar copies of the beta-chemokine G0S19/MIP1alpha. The G0S19-3 gene, present in 1 in 4 humans, is a 5' truncated version of G0S19-2; a CpG island-containing upstream sequence (CpG-US), rich in potential transcriptional activation motifs, replaces much of the first intron and the first exon. Sequences hybridizing with the CpG-US sequence, normally exist in all human genomes. Thus, it appears that there has been recombination between a duplicated G0S19 gene and a duplicated CpG-US-like sequence. We have isolated sequences hybridizing with the CpG-US sequence from a human genomic library in bacteriophage lambda. Restriction mapping and sequencing shows a CpG-US-like sequence approximately 8 kb downstream of G0S19-2 (hence, named CpG-DS sequence). The sequence is contiguous with a TRE17 oncogene-associated sequence (GenBank locus HSTRE175). Members of the TRE17 family are known to locate to chromosome 17q (Onno et al., 1993b), and have sequence characteristics suggestive of positive Darwinian selection. Linkage with a TRE17 oncogene may have arisen by recombination and imply no functional relationship. However, it is possible that the CpG-DS may normally regulate TRE17 expression. PCR and sequencing studies indicate the close proximity of other chemokine-related sequences in the 17q11.2 region.

Amino Acid Sequence↗
PubMed1998

Longitudinal lipid profiles on CAPD: their relationship to weight gain, comorbidity, and dialysis factors.

The dyslipidemia of chronic renal failure may worsen after the commencement of continuous ambulatory peritoneal dialysis (CAPD). The purpose of this study was to relate baseline and longitudinal changes in the lipid profile to anthropometrics (weight, mid-arm circumference), aspects of treatment (albumin, total protein losses, peritoneal solute transport [dialysate:plasma ratio of creatinine], dialysate caloric load), total calorie intake (cal/kg), preexisting cardiovascular comorbidity, and survival. Lipid profiles (triglycerides [TG], total cholesterol [TC], and HDL) were measured, along with the above factors, every 6 mo in an unselected prospective cohort of 124 patients who were not treated with lipid-lowering drugs, commencing CAPD between 1990 and 1993, until 1995. On univariate analysis, age, plasma albumin, cardiovascular disease, baseline TG, and TC:HDL ratio predicted survival. Simultaneous multiple Cox regression including all of the significant predictors demonstrated that either high TG or TC: HDL still predicted death, both in patients with and without clinically overt cardiovascular disease. Between 6 and 36 mo of treatment, TC, TG, and TC:HDL were elevated when compared with the baseline, more so in patients with preexisting cardiovascular disease (P < 0.05). Throughout this period, weight and mid-arm circumference correlated positively with TG and negatively with HDL. There were positive correlations between TC and albumin levels for 12 mo after commencement of treatment, but otherwise there were no significant or consistent relationships between lipid profiles and total protein losses, dialysate calorie load, or total cal/kg or solute transport. The worsening dyslipidemia associated with CAPD was not associated with aspects of treatment such as glucose load or protein losses. The strongest predictors of worsening lipid profiles were weight gain and preexisting cardiovascular comorbidity.

Adult↗