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Biomedical subjects

M Lawrence

Publications and source records attributed to M Lawrence.

At least 37 records · Page 2Linked to original sources
PubMed1992

Body composition of rural Beninese women in different seasons assessed by skinfold thickness and bioelectrical-impedance measurements and by a deuterium oxide dilution technique.

Body composition of 24 rural Beninese women was assessed in a pre- and a postharvest season by using skinfold-thickness measurements, bioelectrical-impedance analysis (BIA), and deuterium oxide (D2O) dilution. Fat mass assessed by D2O dilution was 12.3 +/- 3.3 kg; by skinfold-thickness measurements, 13.8 +/- 3.3 kg; and by BIA, 14.1 +/- 2.9 kg. Fat mass assessed by D2O was significantly lower (P less than 0.05) than fat mass assessed by the other two methods. Body weight in the postharvest season was 0.8 +/- 1.6 kg higher (P less than 0.05) than during the preharvest season. All three methods demonstrated that there were no significant changes in fat mass but that fat-free mass increased significantly (P less than 0.05) from pre- to postharvest season.

Adult↗
PubMed1992

Patient compliance with colorectal cancer screening in general practice.

A randomized controlled trial to test patient compliance with screening for colorectal cancer in association with general practice health checks was carried out in six practices (three urban and three rural). A total of 1588 patients aged 45-64 years were randomized to one of four intervention groups. In the first group patients were posted a Haemoccult test (Kline Beckman) kit. This group was not invited for a health check. In the second group patients were posted the Haemoccult test kit, together with an invitation to attend for a health check. In the third group patients were posted an invitation for a health check, which explained that the patient would be offered the Haemoccult test kit by the nurse at the health check. In the fourth group patients were just invited for a health check. It was found that combining faecal occult blood testing with the health check did not reduce attendance at the health check--43.5% of patients attended when the Haemoccult test kit was offered by the nurse at the health check, 43.6% attended when a test kit was included with the invitation to attend the health check and 42.9% attended when the health check invitation was posted on its own. Overall, compliance with Haemoccult testing was not significantly increased by associating it with a health check (26.2% versus 25.5%) but compliance was higher when the faecal occult blood testing kit was enclosed with the health check invitation than when it was offered at the health check (31.7% versus 20.6%, P less than 0.001). It is easier and cheaper to combine various screening procedures. Although the overall use of the Haemoccult test in the study population was low, there is no reason why the relatively higher compliance rate obtained on posting the test kit with a health check invitation cannot be achieved in previously unscreened populations with higher expected compliance rates. However, faecal occult blood screening for colorectal cancer should not be undertaken on a population basis until its effectiveness in reducing mortality has been proven by randomized trial.

Colonic Neoplasms↗
PubMed1991

Auditing audits: the method of Oxfordshire Medical Audit Advisory Group.

OBJECTIVES: To develop a systematic method for both summative and formative audit of practice audits, and to use the method to review Oxfordshire practice audits and to plan improvement. DESIGN: Development of a coding system for the audit cycle subsequently used prospectively to assess audits reported to medical audit advisory group coordinators on practice visits. SETTING: All 85 general practices in Oxfordshire, of which 80 were visited by Oxfordshire Medical Audit Advisory Group coordinators. MAIN OUTCOME MEASURES: Satisfaction of criteria for different levels of audit (full, partial, potential, planning or no audit) according to coding scores for practice audits. RESULTS: 46 (58%) practices were classified as doing audit, the remainder doing no audit or only collecting data for family health services authority returns. Of audits being undertaken, 55/102 (54%) included planning care or the setting of targets. CONCLUSIONS: The coding system offers the prospect of formative assessment for practices to help them improve their audits, and summative assessment for the family health services authority to satisfy the needs for professional accountability. Its use in Oxfordshire disclosed considerable deficiencies in the process of practice audit. IMPLICATIONS AND ACTION: Practices in Oxfordshire should improve their audits. The advisory groups target to March 1992 is for 50% of practices to be doing full or partial and 25% potential audit and half of the remainder planning audit. Practices are encouraged to include in their audit implementing change, planning care, and agreeing criteria for further assessment.

England↗
PubMed1991

Multiple integrins share the ability to induce elevation of intracellular pH.

Previous work has shown that adhesion of anchorage-dependent cells to fibronectin via integrin alpha 5 beta 1 leads to activation of the Na-H antiporter and a rise in intracellular pH (pHi). We now show that adhesion of bovine capillary endothelial cells (BCE) to fibrinogen; collagens type III, IV, and V; laminin; and vitronectin; ligands that bind other members of the integrin family, resulted in significant elevations in pHi. Other ligands (basic fibroblast growth factor, concanavalin A, and thrombin), which bind cells when immobilized on plastic, but that do not bind integrins and do not support cell growth, do not elevate pHi. Adhesion to an antibody against integrin alpha v beta 3 also elevates pHi. Adhesion of peripheral human T lymphocytes to an antibody against the integrin LFA-1 induced a rise in pHi. Antibodies to CD2 or ICAM-2 had only slight effects on pHi, whereas an antibody to the T cell receptor complex that strongly activates T cells induced a large increase in pHi. We conclude that elevation of pHi by integrins is specific and is a property shared by many members of the integrin family.

Animals↗
PubMed1991

Preparation of monoclonal antibodies to the beta A subunit of ovarian inhibin using a synthetic peptide immunogen.

Seven different synthetic peptides were prepared corresponding to regions of the beta A subunit of 32 KDa human ovarian inhibin predicted to contain possible continuous B cell epitopes. These were coupled to tuberculin as a carrier and used to immunize mice previously given a priming dose of human tuberculosis vaccine. Only one of these peptides, corresponding to sequence 82-114, consistently gave good titres of antibodies reactive with intact 32 KDa bovine inhibin by ELISA. From one of the mice immunized with this peptide, six stable hybridomas were prepared. Five of these secreted an IgM and the sixth (clone E4) secreted an IgG2b antibody. Immunoblotting experiments on follicular fluid concentrates, after treatment with sodium dodecyl sulphate and mercaptoethanol, showed strong reactivity of the antibody from clone E4 only with bands of about 13 kDa and 58 kDa corresponding to forms of the beta A subunit previously described. This monoclonal antibody, and an antibody to the alpha subunit previously made in this laboratory using synthetic peptides, should prove useful reagents for further study of inhibins and activins.

Amino Acid Sequence↗
PubMed1991

Early gastric cancer. Twenty-eight-year experience.

A retrospective study of early gastric cancer (60 patients) was performed to evaluate its diagnosis and treatment. Ninety-five per cent of patients presented with nonspecific gastrointestinal symptoms and 53.3% had been treated for presumed benign disease for up to 48 months before diagnosis. Fiberoptic endoscopy detected these lesions more accurately than radiologic examination. The disease-free 5-year survival rate after resection was 76.4%. Survival showed no significant correlation with sex, tumor site, macroscopic appearance, extent of gastric resection, or histopathologic type. Tumors larger than 1.5 cm in diameter, invasion of submucosa, or lymph node metastasis resulted in significantly lower survival rates. Three of eight patients with nodal metastasis survived 5 or more years, including one who had second-echelon deposits. A high index of suspicion may permit more frequent detection. Extended lymphadenectomy (R2) is recommended to achieve the highest possible cure rate.

Adenocarcinoma↗
PubMed1991

Women who gain more fat during pregnancy may not have bigger babies: implications for recommended weight gain during pregnancy.

The correlation between infant birthweight and the amount of fat gained during pregnancy (estimated as the change in maternal weight between 10 weeks gestation and 2-3 weeks postpartum) was studied in 115 healthy, parous, urban Scottish housewives. There was very little correlation between these variables (r = 0.13, falling to r = 0.07 after birthweight was adjusted for initial maternal weight and length of gestation), i.e., women who gained more fat during their pregnancies did not give birth to heavier babies. This suggests that for most women one of the principal effects of increasing food intake during pregnancy may be to increase maternal fat gain rather than promote fetal growth, and that efforts to increase birthweight by encouraging greater weight gain during pregnancy may be unsuccessful.

Adult↗
PubMed1991

A comparison of physical activity in Gambian and UK children aged 6-18 months.

The activity patterns of 81 Gambian and 53 UK children aged six, 12 or 18 months were compared by means of an activity diary technique. Major differences between communities were observed in the duration of play (2-3 times longer in UK compared to Gambian children) and in the duration of vigorous activities such as crawling, walking and running (2-4 times longer duration in the UK compared to the The Gambia). To investigate whether the lower activity of Gambian children could be explained by differences in nutritional or health status, subgroups of Gambian children were compared. Only small differences in activity pattern were found between Gambian children above and below 80% weight for age and between Gambian children who were or were not diagnosed ill within 10 days of study, suggesting that other factors (e.g. socio-cultural differences or the absence of conventional toys) may explain the lower activity of Gambian compared to UK children.

Analysis of Variance↗
PubMed1991

Prevention of adult heart disease beginning in childhood: intervention programs.

Multiple strategies are available to affect children's cardiovascular health. From clinic-based high-risk counseling to broad-based school or community programs, intervention strategies are being developed and tested to find the most effective means of changing the risk factors of youth to assure a healthier future for our children. Since adoption of new behaviors is improved by consistent messages from multiple sources, a concerted effort is needed. The involvement of health professionals, educators, community organizations, industry, and government together will be important to support the adoption of healthy lifestyles for succeeding generations. Intervention through cardiovascular health promotion for school children may well be the future direction for preventive cardiology.

Adolescent↗
PubMed1990

A total audit of preventive procedures in 45 practices caring for 430,000 patients.

OBJECTIVE: To develop and report the results of a system of audit of computer records in general practice. DESIGN: A retrospective audit of records in practices using the same computer system. Information about recorded preventive procedures was collected by sending the same audit program to each practice on floppy disk. Other characteristics of the practices were determined by postal questionnaire. SETTING: Forty five general practices, widely distributed in England and Wales. SUBJECTS: All 430,901 patients registered with the practices. MAIN OUTCOME MEASURES: Within each practice the percentage of patients in specified age groups for whom certain preventive procedures were recorded as having been carried out. These measures were analysed in relation to practice characteristics. RESULTS: Practice characteristics and recording rates for preventive procedures varied over a wide range. Recording rates were higher in practices with computer terminals on every doctor's desk. Only one practice achieved the new contract target of 90% coverage for recorded primary immunisations, and fewer than two thirds recorded 80% coverage for cervical cytology in the past five years. Practices holding clinics did no better than those without. Smaller partnerships and smaller doctors' list sizes were associated with better performance. CONCLUSIONS: Centrally programmed audit of computerised records is a feasible method of providing data on a regular basis for epidemiological purposes and for performance review. The fact that practices with smaller list sizes had higher levels of recorded preventive care suggests that the trend towards larger lists promoted by the new contract might militate against the intended effect of better preventive care.

Adolescent↗
PubMed1990

Monoclonal and polyclonal antibodies reactive with the 1-32 amino terminal sequence of the alpha subunit of human 32K inhibin.

A monoclonal antibody was made after immunization of mice with the 1-32 amino terminal peptide of the alpha subunit of 32K human ovarian inhibin. The IgG2a mouse antibody reacted 6 times better with bovine 1-32 peptide than it did with 32K bovine inhibin. By contrast sheep polyclonal antibodies made by a similar method had a 29 fold bias in reactivity towards the immunizing peptide. Relative to homologous 1-32 peptide standards, the monoclonal antibody measured apparently higher amounts of immunoreactive material(s) in human (13.5 fold) and bovine (27 fold) follicular fluids than did the polyclonal anti 1-32 peptide antibodies. Immunochemical studies revealed that the epitope recognized by the monoclonal antibody was different from the major epitope recognized by the polyclonal antibodies. The monoclonal antibody reacted much better with human inhibin 1-32 sequences than with bovine (73 fold) or porcine (23 fold). Although the 32K form of human inhibin has not yet been purified, it can be inferred that the monoclonal antibody would be able to detect as little as 2 ng/ml of 32K human inhibin in competitive radioimmunoassays. The antibody must also react with some of the multiple molecular forms of inhibin found in human follicular fluids, and it was shown to function well in the quantitative immunoaffinity extraction of inhibin-like immunoreactivity from follicular fluid. It seems likely that this monoclonal antibody will prove a useful tool for research on human inhibin.

Amino Acid Sequence↗
PubMed1990

Serum creatinine and its relation to cardiovascular disease risk variables in children and young adults from a biracial community. The Bogalusa Heart Study.

The distributions of serum creatinine levels and their relationship with selected anthropometric and cardiovascular risk variables have been described in 3983 children and young adults, aged 5 to 26 years, obtained from a biracial population, Bogalusa, Louisiana. For both blacks and whites serum creatinine levels increased slowly with age, until 11 years of age when a steeper increase occurred to around 19 years of age. Before this age there was a significant age by sex interaction (p less than 0.0001) in the distributions of serum creatinine. After the age of 19 years mean serum creatinine levels were significantly higher in black men than in white men (1.16 mg/dl vs 1.09 mg/dl, p less than 0.0005) and in black women than in white women (0.87 mg/dl vs 0.84 mg/dl, p less than 0.08). Creatinine levels were also significantly higher in men than in women (1.11 mg/dl vs 0.85 mg/dl, p less than 0.0001). Creatinine clearance, estimated from an equation using serum creatine, age, and weight, showed a steady increase until 13 years of age when a maximum range of 120 to 140 ml/min was reached. By the age of 19 years the clearance had declined to a relatively constant range of 100 to 120 ml/min. Black men had the highest correlation of serum creatinine concentration with height, weight, and lean body mass after adjusting for age. White men had the highest correlation of serum creatinine concentration with uric acid. Diastolic blood pressure becomes an important determinant of creatinine levels by the age of 11 years. The race-sex differences in serum creatinine levels in children and young adults are likely related to body mass.

Adolescent↗
PubMed1988

Predicting energy requirements: is energy expenditure proportional to the BMR or to body weight? An analysis of data collected in rural Gambian women.

It has been suggested that energy requirements are either proportional to the BMR (FAO/WHO/UNU, 1985) or to body weight (WHO, 1973). The present analysis sought to distinguish between these two possibilities by determining whether, in rural Gambian women, energy expenditure was more nearly proportional to the BMR or to body weight. For nine of eleven common daily activities energy expenditure expressed per kg body weight was significantly lower in heavier compared to lighter individuals, indicating that energy expenditure was not proportional to weight. Since, in a preliminary analysis, it was found that in Gambian women BMR was roughly proportional to weight raised to the power 0.5, energy expenditure was also compared per kg. For ten of the eleven activities there were no significant differences between different weight groups in the energy costs expressed per kg, and it follows from this that in Gambian women the energy cost of common daily activities was more nearly proportional to the BMR than it was to body weight. Possible reasons for and implications of these results are discussed.

Basal Metabolism↗