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Biomedical subjects

M Hyland

Publications and source records attributed to M Hyland.

At least 19 recordsLinked to original sources

Swelling and delamination of multi-electrode sensor arrays studied by variable-pressure scanning electron microscopy.

Multi-electrode sensor arrays are made of soft and wet materials not easily examined by most microscopic techniques. In this paper, we have demonstrated that low-vacuum scanning electron microscopy (LVSEM) and energy-dispersive X-ray analysis (EDX) are adequate for studying the hydration, swelling, and possible delamination of multi-electrode sensor arrays. We found that the LVSEM environment had no detectable effect on the morphology of Na(+), K(+), and Ca(++) sensors, and EDX analysis indicated that all three membranes have similar compositions. However, once hydrated, the sensors exhibited different behaviors. The K(+) and Ca(++) sensors swelled more than the Na(+) sensor did. This swelling is due principally to water sorption in the membrane. We believe that the larger thickness of the K(+) and Ca(++) membrane is partly responsible for the observed swelling effect. A simple Griffith analysis of the interface rupture confirms the experimental evidence that these thicker membranes also are more prone to delamination failure.

Biocompatible Materials↗

The design of a prospective study of Pravastatin in the Elderly at Risk (PROSPER). PROSPER Study Group. PROspective Study of Pravastatin in the Elderly at Risk.

The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) is a randomized, double-blind, placebo-controlled trial designed to test the hypothesis that treatment with pravastatin will diminish risk of subsequent major vascular events in a cohort of men and women (70 to 82 years old) with preexisting vascular disease or significant risk of developing this condition. Five thousand eight hundred four men and women in addition to receiving advice on diet and smoking, have been randomized equally to treatment with 40 mg pravastatin/day or matching placebo in 3 centers (Cork, Ireland, Glasgow, Scotland, and Leiden, The Netherlands). Following an average 3.5-year intervention period, a primary assessment will be made of the influence of this therapy on major vascular events (a combination of coronary heart disease, death, nonfatal myocardial infarction, and fatal and nonfatal stroke). A number of additional analyses will also be conducted on the individual components of the primary end point, on men, on women, and on subjects with and without previous evidence of vascular disease. Finally, an assessment will be made of the effects of treatment on cognitive function, disability, hospitalization or institutionalization, vascular mortality, and all-cause mortality.

Aged↗

Associations between an asthma morbidity index and ideas of fright and bother in a community population.

There is a need for simple asthma outcome measures for primary care which are not only valid in terms of their relationship with lung function but also in terms of pragmatic psychological constructs. This study assesses the usefulness of adding items on the degree of 'bother' and 'fright' caused by the condition to a previously validated simple asthma morbidity index. A postal questionnaire survey comprising a simple asthma morbidity index and questions on 'fright' and 'bother' was conducted in one general practice in the north-east of England. Responses were obtained from 570 individuals. Of these, 184 (32%) reported low, 133 (23%) medium and 253 (44%) high morbidity. Twenty-nine per cent of respondents had felt frightened by their asthma in the previous 4 weeks. Both the 'fright' and 'bother' items were significantly associated with the morbidity index. The addition of 'bother' and/or 'fright' questions may improve both the content, construct and predictive validity of the morbidity index, but this needs to be established prospectively.

Anxiety↗

Predictive value of a simple asthma morbidity index in a general practice population.

BACKGROUND: There is a need in primary care for simple asthma outcome measures that are valid in terms of their relationship with lung function and capable of predicting those patients for whom additional management is indicated. AIM: To assess the predictive validity of a revised asthma morbidity index in United Kingdom (UK) general practice. METHOD: Morbidity index and peak flow rate data were gathered from nine general practices over a three-month period. Two postal questionnaire surveys, one year apart, were conducted in one Tyneside general practice. Morbidity index data from 570 asthmatic patients were gathered in the first survey and used to predict morbidity over the next year. RESULTS: For 120 responders with low morbidity, mean peak flow as a percentage of the predicted value was 91% (SD = 21%); for 91 responders with medium morbidity, the percentage was 77% (SD = 21%); and for 90 responders with high morbidity, it was 63% (SD = 29%). Fifty-seven per cent of the morbidity index categories remained unchanged after 12 months. The relative risks of high morbidity for having any acute asthma attacks, more than four attacks, and needing oral steroids during a one year period were 2.88 (CI = 1.87 to 4.43), 2.52 (CI = 1.84 to 3.44) and 2.38 (CI = 1.70 to 3.33) respectively. CONCLUSION: The revised morbidity index is a simple and valid tool for the opportunistic surveillance of asthma in primary care.

Asthma↗

Acute inflammation, acute phase serum amyloid A and cholesterol metabolism in the mouse.

Acute inflammation results in a profound change in the apolipoprotein composition of high density lipoprotein (HDL). Several isoforms of the serum amyloid A (SAA) family, SAA1 and SAA2, become major components of HDL. This structural relationship has suggested that acute phase SAA plays some as yet unidentified role in HDL function, possibly related to cholesterol transport, during the course of acute inflammation. Using subcutaneous AgNO3 to induce a sterile abscess changes in plasma cholesterol and SAA were monitored over the subsequent 144 h. Total plasma cholesterol began to increase within 12 h of the induction of inflammation and reached a peak in 24 h. Thereafter its plasma levels fell returning to normal values by 96-120 h. The bulk of the increase in plasma cholesterol was found in the free cholesterol fraction of HDL. This pattern of cholesterol increase corresponds to the established temporal changes for acute phase SAA (AP-SAA). AP-SAA levels increased within 8 h of the induction of inflammation and reached a peak at 24 h. They began to decrease by 48 h with small quantites still present 120 h later. In concert, but inversely, with the changes in AP-SAA the apoA-I, apoA-II, and apo-E, content of HDL decreased during the AP-SAA increases and increased as AP-SAA levels fell. The plasma appearance of cholesterol from the periphery, and central parts of the inflammatory site was assessed by the use of radiolabelled cholesterol. The peripherally placed cholesterol rapidly reached a peak plasma concentration within 24 h of injection. Cholesterol placed in the central part of the sterile abscess, a site relatively inaccessible to the vasculature required 48 h to reach its peak and was 5-times lower than that placed peripherally. The influence of AP-SAA on neutral cholesterol ester hydrolase (nCEH) activity in mouse liver homogenates, mouse peritoneal macrophage homogenates, and a purified porcine pancreatic enzyme with nCEH activity was also assessed. Following optimization with regard to pH, bile salt concentration, protein concentration and incubation time, mouse peritoneal macrophages had a significantly higher nCEH specific activity than that found in liver (7-8 fold). Purified AP-SAA, assessed over a concentration range of 0-10 microg/ml, enhanced nCEH activity at concentrations above 2 microg/ml. The nCEH activity, regardless of its source, increased by 3-7 fold in the presence of AP-SAA. Equivalent concentrations of apolipoprotein A-I (apo A-I) and bovine serum albumin (BSA) failed to alter the activity of nCEH. The effect of AP-SAA on a purified form of nCEH suggests that AP-SAA may have a direct effect on the activity of this enzyme. The temporal correlation of circulating AP-SAA and plasma cholesterol and the significant stimulation of nCEH by AP-SAA (but not apoA-I or BSA) provides further evidence that AP-SAA plays a role in cholesterol metabolism during the course of acute inflammation.

Animals↗

Do elderly patients mind how doctors address them?

A survey was carried out in the Geriatric Unit at Cork Regional Hospital to determine how elderly patients would like to be addressed by their doctor. Two hundred patients over the age of 65 were given a Questionnaire asking them to state their preference. Only a minority (4.5%) expressed a definite preference for the formal mode of address. The remainder either did not mind (38%) or preferred to be addressed by their first name (57.5%). We concluded that most elderly patients do have a preference and this should be established on admission.

Aged↗

Diseases associated with aging.

Friese has recently presented a graph of the demographics of aging, indicating that the number of people over 65 in 1990 will approach 21 million, or 15% of the population. The life expectancy of men will soon approach that of women (74 to 75 years). As cancer, heart disease, and stroke are conquered, longevity will increase by less than 12 years. The older population will have increasingly diminished physical and mental capacity, not necessarily associated with specific disease processes, but rather resulting from a generalized cellular and extracellular deterioration, particularly affecting the homeostatic control mechanisms of the central nervous, neuroendocrine, and immune systems. They will require increased protection from the environmental insults with which they could cope more easily at an earlier age. Their treatment will have to be individually adjusted depending on the combination of lesions they display. The patient's socioeconomic status, family support structure, and general psychological profile play significant roles in their longevity and terminal illness.

Adolescent↗