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Biomedical subjects

P E Bundred

Publications and source records attributed to P E Bundred.

10 recordsLinked to original sources
PubMed2002

The ratio of 2nd to 4th digit length: a proxy for transactivation activity of the androgen receptor gene?

The androgen receptor gene (AR) contains a domain which includes a variable number of CAG sequences and alleles with low numbers of CAG repeats show high transactivation activity when complexed with testosterone. The ratio of 2nd and 4th digit length (2D:4D) is negatively correlated with phenotypic effects of testosterone. Low numbers of CAG repeats and low 2D:4D are both associated with high sperm numbers and protection against breast cancer. This suggests that CAG number and 2D:4D are correlated i.e. low CAG number and low 2D:4D indicate high activation of androgen-responsive genes. Findings from AR studies predict that low 2D:4D will be associated with prostate and hepatocellular cancer, urolithiasis, ADHD, ankylosing spondylitis, spontaneous abortion, and polycystic ovaries, while high 2D:4D will be associated with motor neuron diseases and endometrial cancer. Findings from 2D:4D studies predict that short CAG length will be common in autism and Asperger's syndrome, while high numbers of CAG repeats will be found in men who are prone to early myocardial infarction.

Breast Neoplasms↗
PubMed2001

Users' views on hospital and home care for acute illness in childhood.

This mainly qualitative study compared 40 families' experience of hospital and home care. This is one aspect of a randomised, controlled trial, which aimed to evaluate the clinical and cost effectiveness of a paediatric hospital at home service (HAH) for acute illness in children. This paper builds upon previous work that has aimed to examine parents' and children's views as service users. Forty families from a larger sample population took part in structured interviews. Eleven children aged 5 to 12 years took part in semistructured interviews. A drawing technique was the chosen method of augmentation in the children's interviews. Research findings showed that HAH is an acceptable alternative to hospital care where there are essentially nursing needs. Thirty-six (90%) parents and seven children stated a clear preference for HAH. The parents' preference was based on a perception that their child's illness wasn't serious or life threatening and therefore could be managed at home with appropriate support from health professionals. The social and financial costs of hospital care compared with HAH were the other main drivers, rather than a comparison of the quality of nursing care of their child.

Acute Disease↗
PubMed2001

The ratio of 2nd to 4th digit length: a proxy for testosterone, and susceptibility to HIV and AIDS?

The incidence of HIV and AIDS is high in sub-Saharan Africa and in male homosexuals. It is suggested that testosterone-mediated immune dysfunction may account for this pattern. The ratio of the length of the 2nd and 4th digit (2D:4D) is negatively related to prenatal and adult testosterone concentrations. There is evidence that black South Africans have lower 2D:4D ratios than most other populations and male homosexuals have lower 2D:4D ratios than male heterosexuals. Men with low 2D:4D ratios may also be more sexually active and/or more fertile than men with high ratio. We suggest that men and women with low 2D:4D are susceptible to HIV infection and AIDS and babies with low 2D:4D ratio susceptible to vertical transmission. Infection rates may therefore be reduced by education and condom supply directed towards low 2D:4D adults.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Are occupational stress levels predictive of ambulatory blood pressure in British GPs? An exploratory study.

BACKGROUND: Occupational stress has been implicated as an independent risk factor in the aetiology of coronary heart disease and increased hypertensive risk in a number of occupations. Despite the large number of studies into GP stress, none have employed an objective physiological stress correlate. OBJECTIVES: We conducted an exploratory study to investigate whether self-reported occupational stress levels as measured by the General Practitioner Stress Index (GPSI) were predictive of ambulatory blood pressure (ABP) using a Spacelabs 90207 in a sample of British GPs. METHOD: Twenty-seven GPs (17 males, 10 females) participated in the study. Each GP wore an ABP monitor on a normal workday and non-workday. All GPs completed the GPSI before returning the ABP monitors. Demographic data were also collected. RESULTS: Stress associated with 'interpersonal and organizational change' emerged from the stepwise multiple regression analysis as the only significant predictor of ABP, explaining 21% of the variance in workday systolic blood pressure, 26% during the workday evening and 19% during the non-workday. For diastolic blood pressure, the same variable explained 29% of the variability during the workday and 17% during the non-workday. No significant gender differences were found on any of the ABP measures. CONCLUSIONS: For the first time in GP stress research, our findings established that higher levels of self-reported occupational stress are predictive of greater ABP in British GPs. More detailed psychophysiological research and stress management interventions are required to isolate the effects of occupational stress in British GPs.

Adult↗
PubMed2000

The ratio of 2nd to 4th digit length: a new predictor of disease predisposition?

The ratio between the length of the 2nd and 4th digits is: (a) fixed in utero; (b) lower in men than in women; (c) negatively related to testosterone and sperm counts; and (d) positively related to oestrogen concentrations. Prenatal levels of testosterone and oestrogen have been implicated in infertility, autism, dyslexia, migraine, stammering, immune dysfunction, myocardial infarction and breast cancer. We suggest that 2D:4D ratio is predictive of these diseases and may be used in diagnosis, prognosis and in early life-style interventions which may delay the onset of disease or facilitate its early detection.

Disease↗
PubMed1999

Clinical pathways.

Explore the source record for details and available documents.

Critical Pathways↗
PubMed1996

Prevalence, aetiology and management of heart failure in general practice.

BACKGROUND: There is a high level of morbidity and mortality among patients with heart failure. Management of the condition has changed substantially in recent years. However, there is little information on the management of heart failure in general practice. AIM: A study was carried out in 1994 to assess the prevalence, aetiology and management of heart failure in a general practice setting. METHOD: A retrospective review was undertaken of the manual and computerized medical records of patients in two group practices in Liverpool (combined patient population of 17 400). RESULTS: A total of 266 patients with heart failure were identified (a prevalence of 15 per 1000). The two practices had 2747 patients who were aged 65 years and over and 221 of these had heart failure (prevalence of 80 per 1000). The principal aetiological factor considered responsible for heart failure was: coronary heart disease in 45% of patients, hypertension 18%, valve disease 9%, cor pulmonale 7%, cardiomyopathy 2% and a metabolic problem 2% (aetiology unknown in 17% of cases). Urea and electrolytes had been checked in the last year in 59% of patients. Chest x-ray and electrocardiography had been performed in 89% and 80% of patients, respectively, and echocardiography in 30%. Angiotensin converting enzyme (ACE) inhibitors were being prescribed to 33% of patients. CONCLUSION: The study found a high prevalence of heart failure among patients aged 65 years and over. Coronary heart disease was considered to be the main aetiological factor. Patients were being investigated mainly by means of chest x-ray and electrocardiography. Most patients with heart failure were not receiving treatment with ACE inhibitors. Evaluation of heart failure by clinical criteria alone is now deemed insufficient. Echocardiography should be used routinely to assess cardiac dysfunction. Patients with confirmed left ventricular dysfunction will benefit from treatment with ACE inhibitors unless contraindications exist. The study suggests that there is a need to explore ways of optimizing the management of patients with heart failure.

Adult↗
PubMed1991

Advanced training in general practice in the UK for overseas postgraduates.

The strengths of general practice in the UK as a training environment for overseas doctors intending to implement the World Health Organization strategy 'Health for All by the Year 2000' in primary care are identified. A course of advanced training for teachers and administrators of primary care is described and evaluated in terms of participants' academic achievements and wider issues, including influence upon the development of primary care in their countries of origin.

Education, Medical, Graduate↗