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Biomedical subjects

P R Beck

Publications and source records attributed to P R Beck.

At least 19 recordsLinked to original sources
PubMed1999

Human parvovirus B19 infection in acute fulminant liver failure.

We previously reported detection of human parvovirus B19 DNA in livers from patients requiring transplantation for acute fulminant liver failure. In this study, we used immune adherence PCR (IA-PCR) to bind B19 virions in recipient native liver onto solid phase with specific monoclonal antibodies followed by PCR amplification of virion DNA. IA-PCR had sensitivity and specificity similar to conventional PCR. We examined liver tissue from 16 patients with non-A, non-B, non-C, non-E (NA-E) acute fulminant liver failure (AFLF) (6 of unknown etiology associated with aplastic anemia (AA), 4 of unknown etiology without AA; and 6 patients with AFLF of known etiology). IA-PCR detected B19 virions in 5 of 6 (83%) of livers from patients with idiopathic NA-E AFLF associated with AA and in 2 of 3 (75%) without AA, compared to 1 of 6 (17%) of livers from patients with AFLF of known etiology and to 6 of 34 (18%) of 34 control patients with chronic or neoplastic liver disease. Viral mRNA encoding the structural protein was detected in the liver tissue from three B19 IA-PCR positive patients with AFLF. Detection of B19 virions and mRNA for capsid proteins provided strong evidence for B19 infection during the course of NA-E AFLF and argues for involvement of B19 virus in liver injury.

DNA Replication↗
PubMed1991

Exaggerated and prolonged thyrotrophin releasing hormone (TRH) test responses in tertiary hypothyroidism.

A 60 year old man with panhypopituitarism due to a large meningioma and prolonged and exaggerated thyroid stimulating hormone (TSH) responses is described. Initial investigations showed a subnormal urinary free cortisol concentration, a low serum cortisol taken at 0900 hours, and a low free T4 concentration. The TSH was towards the upper end of the normal range. Subsequently pituitary function tests showed subnormal production of luteinising hormone in response to luteinising hormone releasing hormone (LHRH) and a short synacthen test with a low 30 minute cortisol value. Long synacthen testing showed a normal response at four days, confirming that the abnormalities were due to a pituitary or hypothalamic cause. A computed tomogram showed a large meningioma compressing the hypothalamus, pituitary, and temporal lobe. TRH testing showed a prolonged and exaggerated response, consistent with tertiary hypothyroidism.

Humans↗
PubMed1990

Pharmacokinetic study of controlled-release choline theophyllinate in elderly patients.

Controlled-released choline theophyllinate tablets (Sabidal SR 270, Zyma) were administered to 17 elderly patients aged between 68 and 86 years (mean 76 +/- 7 years) until steady state was obtained. The dosage form was one tablet every 12 hours for four days. Plasma theophylline concentrations were measured by high-performance liquid chromatography after the first dose and during the fourth day for a 12-hour period. The tablets showed evidence of controlled-release properties: the maximum plasma concentration (10.8 +/- 2.5 mg/l) was obtained after 3.4 +/- 1.6 hours. The mean trough level was 6.6 +/- 1.5 mg/l and the difference between the peak and trough levels was 4.1 +/- 1.2 mg/l. The mean steady-state plasma theophylline concentration was 8.5 +/- 2.2 mg/l. The mean elimination half-life was 14 +/- 7 hours. The mean volume of distribution was 0.8 +/- 0.4 l/kg. The mean total body clearance was 0.05 +/- 1/h/kg. All values, the half-life excepted, were found to be within the ranges for the patients reported in the literature. The values show the usual interindividual variation.

Aged↗
PubMed1988

Therapists' perceptions of difficult psychiatric patients.

Psychotherapists often describe patients who present management problems as "difficult patients." This article describes a 5-factor scale to measure how therapists perceive difficult psychiatric patients. Reliability and validity evidence is presented for scales labeled Demanding, Help Rejecting, Unreachable, Dangerous, and Poor Fit. Fifty-four psychiatric outpatients identified as difficult to treat by two or more therapists were compared with 54 control psychiatric outpatients matched on age, sex, marital status, and diagnosis. Therapists rated difficult patients higher on each scale. Patients rated higher on the Demanding, Help Rejecting, and Poor Fit scales were heavier and more varied users of the treatment system than were those rated lower on these scales. The scale helps identify causes of staff dissatisfaction and inappropriate organization of services and suggests how to meet the special needs of difficult patients. Problem patients can be seen as denying the competence and authority of the mental health professional but also as central to the unique mandate of psychiatry. The reward system should more adequately support those therapists who care for the patients often avoided by others.

Ambulatory Care↗
PubMed1982

Serum gamma-glutamyltransferase and alkaline phosphatase in rheumatoid arthritis.

Serum gamma-glutamyltransferase (GGT) and alkaline phosphatase (AP) were assayed in 98 consecutive patients with rheumatoid arthritis. Twenty-three patients had increased GGT activities and 45 an increased AP activity. Twelve patients showed an increase in both enzyme activities and AP isoenzyme studies were performed on seven of this group. In three subjects an increase in the bone isoenzyme was observed and in three others the increase in activity was attributed to the liver isoenzyme. The remaining patient, who probably suffered from coexistent primary biliary cirrhosis, showed an increase in both bone and liver isoenzymes. The liver involvement, suggested by the alkaline phosphatase isoenzyme results, was largely confirmed by the butanol extraction of GGT. The changes in these enzymes in this small series could not be related definitely to drug therapy. It is concluded that though increases in GGT and AP are common in rheumatoid arthritis, this does not necessarily indicate hepatic involvement. Further isoenzyme studies are needed to define the extent to which organs other than the liver bring about increases in these serum enzymes in rheumatoid disease.

Adult↗
PubMed1979

Serum enzymes in colorectal cancer.

A study of the value of serum enzymes in 184 patients with colorectal cancer has been performed. The enzymes studied were gamma glutamyltransferase (gammaGT), alkaline phosphatase (AP), lactate dehydrogenase (LDH), 5'-nucleotidase (5'-NT), glutathione reductase (GR), alanine and aspartate transaminases. In patients without liver metastases, elevated enzyme levels were found in 11-55% preoperatively. 5'-NT showed the least number of elevated activities, while gammaGT activities were increased in 29% and LDH in 55%. The percentage of elevated enzyme levels rose significantly in the early postoperative period. Patients with liver metastases showed increased enzyme activities in 40-60% preoperatively: gammaGT was the most sensitive indicator. Increased enzyme activity was related to the degree of liver involvement with secondary tumor. With extensive liver metastases, gammaGT levels were increased in 82%. It is concluded that serum enzymes are of limited value in the preoperative detection of liver metastases, and particularly when tumor involvement of the liver is small.

Alanine Transaminase↗