PubMed Health⌕ Search

Biomedical subjects

R Chambers

Publications and source records attributed to R Chambers.

At least 55 records · Page 3Linked to original sources
PubMed1993

Irrigation of the abdominal cavity in the treatment of experimentally induced microbial peritonitis: efficacy of ozonated saline.

Ozone is an oxidizing agent possessing potent in vitro microbicidal capacity. This study was designed to address the extent to which irrigation of the contaminated abdominal cavity using a saline solution primed with ozone is effective in reducing morbidity and mortality. Gelatin capsules containing different quantities of a premixed slurry of filtered human fecal material were implanted in the peritoneal cavities of a preliminary series of rats. Three inocula concentrations were selected for later experiments, based upon their ability to produce morbid consequences: (1) high (100% 1-day mortality), (2) medium (70% 3-day mortality, 100% abscess rate in survivors), and (3) low (100% 10-day survival, 100% abscess rate). Fecal and abscess bacteriology were similar in all rats. The peritoneal cavities of 240 rats then underwent fecal-capsule implantation (three groups of 80 rats/inoculum concentration). At celiotomy 4 hours later, equal numbers of rats from each group were randomly assigned to one of four protocols: (1) no irrigation, (2) normal saline irrigation, (3) saline-cephalothin irrigation, and (4) ozonated saline irrigation. Each treatment lasted 5 minutes, using 100 ml of irrigation fluid. Mortality was significantly reduced when, in lieu of no irrigation, any of the irrigation solutions were used. Additionally, ozonated saline statistically proved the most effective irrigating solution for reducing abscess formation in survivors.

Abscess↗
PubMed1992

Decreased mesenteric blood flow in experimental multiple organ failure.

Disorders of mucosal blood flow may contribute to gut barrier dysfunction in multiple organ failure (MOF). We evaluated alterations of mesenteric microcirculation in a rat model of MOF. Male Wistar rats received 1 mg/g body weight of zymosan A in 4 ml of mineral oil by intraperitoneal injection and were studied on Days 1, 3, and 5 following injection. A control group received no zymosan. The experimental group also received a fluid resuscitation regimen of 0.9 N saline subcutaneously equal to 0.1 ml/g body weight on the day of zymosan injection and 0.05 ml/g body weight daily thereafter. Day 1 animals tended toward a statistically significantly lower mean arterial pressure versus controls (86.6 +/- 8 mm Hg versus 106 +/- 5 mm Hg, F = 0.09 by ANOVA). Significant arteriolar vasoconstriction occurred on Days 1 and 3 versus control (70 +/- 4 microns and 57 +/- 8 microns versus 96 +/- 3 microns, F = 0.0002). Laser doppler velocity, indicating red blood cell velocity, expressed as a percentage of control paralleled this vasoconstriction (70 +/- 9 and 72 +/- 7%, respectively). We conclude that mesenteric arteriolar vasoconstriction occurs accompanied by decreased red blood velocity. We believe that this is indicative of decreased mesenteric perfusion in this zymosan model of MOF and that survival to Day 5 is associated with a reversal of these microcirculatory changes.

Animals↗
PubMed1992

The effectiveness of lifestyle-related health screening: a 2 year follow-up study of doctors and teachers.

The effects of screening a group of 98 general practitioners and teachers for fitness, body mass index, serum cholesterol and lifestyle measures--smoking, alcohol consumption, diet and exercise habits were assessed 6 and 24 months later by postal questionnaire (response rate 98%). There was no significant difference for any screened measure between zero months and 6 or 24 months except that subjects found to have a raised cholesterol at 0 months were subsequently more likely to reduce the proportion of fat in their diet. There were no significant differences between screened subjects compared with a control group of non-screened doctors and teachers at 24 months. The number of subjects with abnormal measurements found at the screening session who altered to measurements within the normal range was equal to the number of subjects who changed from normal to abnormal measurements over the 2 year period of study.

Alcohol Drinking↗
PubMed1992

Health and lifestyle of general practitioners and teachers.

General practitioners (408) and secondary teachers (385) responded to a questionnaire about their health and lifestyle with a response rate of 48 and 45 per cent respectively. Their answers were corroborated by a separate questionnaire completed by their spouse or domestic partner. A sub-group of 50 general practitioners and 50 teachers were examined to assess their physical fitness and mental health. Half of each group was below average fitness compared to the general population. General practitioners were more likely than teachers to practise disease prevention. Ten per cent of general practitioners and 13 per cent of teachers were smokers; 8 per cent of general practitioners and 14 per cent of teachers reported an alcohol consumption that exceeded recommended limits. General practitioners took remarkably little sickness absence compared to teachers. Symptoms of anxiety and depression were more common in teachers: a need for alcohol, binge eating and sleep difficulties were frequently experienced in both groups. Medication taken by the two groups was similar and self-medication was common amongst the general practitioners. Less than half the general practitioners thought they would use an occupational health service if it were established.

Absenteeism↗
PubMed1992

Advantages of achiral h.p.l.c. as a preparative step for chiral analysis in biological samples and its use in toxicokinetic studies.

1. Achiral reverse-phase h.p.l.c. with semi-automated post-column fraction collection and solid-phase sample reconcentration, has been applied as the purification procedure during the enantiomeric quantification of two widely differing experimental drugs; an HMG-CoA reductase inhibitor (I) and an alpha 2-adrenoceptor antagonist (II). 2. The robust and specific achiral methodologies were available prior to the need for chiral analyses and recovery of drug from the fractions provided clean samples from a variety of biological matrices, without the need to develop compatible achiral/chiral mobile phases. 3. Compared with direct chiral chromatography of plasma extracts, this approach decreased the potential for metabolites and endogenous components to interfere or impair the performance of the chiral stationary phase. 4. The availability of quantitative data from achiral analysis of samples negated the need for internal standardization of the chiral analyses, helped confirm assay specificity and provided potential to determine enantiomeric ratios where only one isomer could be accurately measured. 5. Routine enantiomeric analyses were successfully carried out on samples taken from animals dosed orally with the racemic drugs, providing important data on the possible levels of exposure to individual enantiomers during toxicity testing.

Animals↗
PubMed1992

Mesenteric microcirculatory changes in nonlethal hemorrhagic shock: the role of resuscitation with balanced electrolyte or hypertonic saline/dextran.

Class I and II hemorrhage has been routinely treated clinically with 2-2.5 times the volume of shed blood as balanced electrolyte solution. Although this regimen has been shown to adequately restore arterial pressure in trauma patients, it is not clear that it uniformly restores regional perfusion. Since it is becoming apparent that the gut plays a major role in the development of the posttraumatic septic state, we studied the effects of graded doses of balanced electrolyte resuscitation on the mesenteric microcirculation. Regimens consisting of one (1 x LR), two (2 x LR), or three (3 x LR) times the volume of shed blood as lactated Ringer's (LR) solution or 7.5% hypertonic saline and 6% dextran (HSD) equal to one seventh the volume of shed blood were given to groups of anesthetized (urethane-chloralose) male Sprague-Dawley rats after 30 minutes of hemorrhage to 50% of baseline mean arterial blood pressure. The microcirculation of the distal ileum was observed using an in vivo video microscope. Mean arterial pressure and ileal A1 diameters returned to baseline values with HSD within 20 minutes following this moderate hemorrhage. Additionally, A1 diameters returned to baseline in the 2 x LR and 3 x LR groups. A1 vessels remained significantly constricted in the 1 x LR group. Mean arterial pressure remained significantly lower than the baseline value in all of the LR groups. We conclude that in this model, HSD is superior to LR for restoration of blood pressure. In restoring A1 diameters, LR is equivalent to HSD only when volumes of balanced electrolyte two and three times shed blood volume are given.

Animals↗
PubMed1992

Self-reported health care over the past 10 years: a survey of general practitioners.

To investigate how and where doctors receive their health care, 275 general practitioners were given a questionnaire about their health care in the previous 10 years; responses were received from 247 doctors (90%). Thirty nine per cent of the subjects were registered with a general practitioner who was independent of them. All but one of the remainder were registered with a practice partner, close friend or relative. Whatever the relationship of the subjects with their own general practitioner, personal health problems were managed to a great extent by themselves. Most (84%) of the medication taken in the previous five years had been self-prescribed and one third of medical investigations had been self-initiated. Over half of the general practitioners studied had seen a specialist about their health in the preceding 10 years; 51% had referred themselves. A 'jury' of seven general practitioners compared the subjects' referrals to a specialist with the care that would be expected for a non-general practitioner patient. Where the jury reached agreement, 68% of referrals were thought to have been appropriate; self-referrals were significantly more likely to be thought inappropriate (P less than 0.05); and self-treatment prior to self-referral to a specialist was considered inappropriate in 78% of cases. The amount of self-prescribed medication and frequency of consultation was the same, whatever relationship the subject held with the general practitioner. This study shows that most general practitioners manage their own health care. The question of whether this is always appropriate is raised and the provision of an occupational health service for general practitioners is discussed.

Humans↗
PubMed1990

MRI and diabetic foot infections.

The role of magnetic resonance imaging and plain radiographs in evaluating osteomyelitis in the diabetic foot was studied. Fifty patients were prospectively examined by magnetic resonance imaging and plain radiographs to determine the extent of infection. Thirty-seven patients had positive MRI for osteomyelitis and 19 were positive with conventional radiography. Thirteen patients had negative MRI healed with short course of antibiotics. Five patients with positive MRI received four weeks' course of intravenous antibiotics with two still having persistent infection in the six weeks follow-up. Thirty-two patients underwent surgery with favorable results. Sixty-two bone specimens were obtained for histologic evaluation of osteomyelitis. In cases with histologic proof of diagnosis, magnetic resonance sensitivity was 99%, specificity was 81%, and accuracy was 94%. Thus magnetic resonance imaging was shown to have a high sensitivity, specificity, and accuracy in detecting osteomyelitis.

Adult↗
PubMed1988

Non-cardiac pulmonary edema following intravenous contrast injection.

Acute non-cardiogenic pulmonary edema (NCPE) following intravenous administration of contrast media is a rare but life-threatening complication of radiologic contrast material. We recently observed this complication as an idiosyncratic reaction following a coelio-mesenteric arteriography.

Angiography↗
PubMed1988

Neuroblastoma-like epidural localization in non-Hodgkin's lymphoma.

We report a case of non-Hodgkin's lymphoma with CNS involvement confined to the epidural space causing cranial suture diastasis. Cerebrospinal fluid and bone marrow were normal. Two cases only of cranial epidural lymphoma have been reported in the literature; in both cases, the leptomeninges were also involved but without suture diastasis.

Adolescent↗
PubMed1986

Relationship of abnormal Tamm-Horsfall glycoprotein localization to renal morphology and function.

Tamm-Horsfall glycoprotein (TH) distribution was studied using a biotin-avidin immunoperoxidase technique in renal biopsies from 166 consecutive patients and 8 normal kidneys. Tubulointerstitial damage was independently assessed and graded. In 109 patients TH antibodies were measured by ELISA and in 30 of these urinary TH and beta 2-microglobulin excretions were measured by radioimmunoassay. In 124 biopsies only distal tubular epithelium and casts were stained. Glomerular space (8) or interstitial (34) deposits were seen in 42 biopsies; 16/68 with glomerulonephritis, 4/14 with systemic vasculitis, 12/33 with chronic interstitial nephritis, 1/8 with acute interstitial nephritis, 9/43 with other nephropathies. There was no correlation between TH distribution and the degree of tubulointerstitial damage (p greater than 0.5), urinary TH excretion (p greater than 0.05), urinary beta 2-microglobulin excretion (p greater than 0.05), glomerular filtration rate, urinary concentrating ability, or the incidence of pyuria. TH antibodies did not correlate with TH distribution (p greater than 0.5) or the degree of tubulointerstitial damage. Abnormal TH distribution showed no statistical relationship to the degree of tubulointerstitial damage, changes in renal function or levels of TH antibodies.

Animals↗
PubMed1986

C3 nephritic factor in an individual with recurrent viral infection and lipodystrophy.

A patient with nephritic factor in the serum following an attack of disseminated herpes is described. In the majority of cases, the factor is associated with mesangio-capillary glomerulonephritis, with or without partial lipodystrophy. It has, however, been described in cases of partial lipodystrophy alone, in one patient with recurrent pyogenic infections, and in one healthy individual. It has not previously been described in an individual with disseminated viral infection.

Adult↗
PubMed1985

The acute phase response in acute anterior uveitis.

The acute phase response is part of the body's systemic response to inflammation. It consists of the synthesis and release of proteins participating in the inflammatory process. The acute phase protein serum amyloid A (SAA) was studied by serial measurement of its concentration in 57 patients with acute anterior uveitis. Patients were divided into two big groups on the basis of their SAA concentrations. Thirty-eight patients showed a transient elevation of SAA and were designated responders. In 19 patients SAA levels remained normal throughout the study and these patients were designated non-responders. Responders and non-responders were of similar age and sex distributions. The severity of the uveitis was equal in the two groups, and did not correlate with the SAA concentrations at presentation. Responders tended to have had fewer previous attacks of uveitis than non-responders. HLA typing showed that HLA B27 was more frequent in patients with recurrent disease than in those suffering their first attack. The majority of HLA B27 positive patients were responders. SAA concentration does not predict the severity of an attack of uveitis, but absence of an acute phase response may be associated with a greater tendency to recurrence.

Acute Disease↗