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Biomedical subjects

R Ellis

Publications and source records attributed to R Ellis.

At least 19 recordsLinked to original sources
PubMed1992

Apparent cleidocranial dysplasia associated with abnormalities of 8q22 in three individuals.

Cleidocranial dysplasia is an autosomal dominant, generalised skeletal disorder characterised by variable clavicular hypoplasia, frontal bossing, multiple Wormian bones, and delayed eruption of the teeth. The gene locus for this syndrome has not yet been assigned. Three individuals with manifestations of cleidocranial dysplasia associated with rearrangements of chromosome 8q22 are described. The evidence presented suggests that the gene for cleidocranial dysplasia may be located on chromosome 8q in humans in a region showing homology to mouse chromosome 3.

Adult↗
PubMed1992

Emergency department asthma treatment protocol.

OBJECTIVE: The purpose of this study was to determine if a brief educational intervention (INT) on the treatment of acute asthma improved prescribing patterns of internal medicine residents in an emergency department (ED). Additional objectives were to determine if optimal therapy reduced length of stay (LOS) in the ED and to determine if discharge prescribing patterns could be improved. DESIGN: Nonrandomized, single-blind INT study. SETTING: A large, urban, county-owned, university-affiliated ED. PATIENTS AND OTHER PARTICIPANTS: Eight internal medicine residents in each of three study periods; numbers of adult asthmatics for each period were: control group, 129 (Nov-Dec 1989); INT group A, 82 (Jan-Feb 1990); and INT group B, 139 (Nov-Dec 1990). INTERVENTIONS: INT consisted of a ten-minute verbal presentation, a three-page summary of the literature, and a posted protocol in the ED. Control data were collected prior to any INT. Prescribing patterns were covertly evaluated in each of the three study periods. Because discharge prescribing of long-term antiinflammatory therapy with inhaled corticosteroids was not improved in group A, emphasis on this point was added for group B. MAIN OUTCOME MEASURES: Percentage of patients who received desired acute and discharge therapies and LOS for each study period. RESULTS: Increased prescribing of desired acute therapy in the ED was seen in both INT groups. For discharge prescribing, the INT was partially successful. Reduced LOS was not found for the INT groups. CONCLUSIONS: A brief INT effectively improves prescribing of optimal acute therapy of asthma in the ED, yet does not appear to reduce LOS. Further strategies are needed to impact on therapy prescribed at discharge from the ED.

Adult↗
PubMed1991

Comparative safety and immunogenicity of yeast recombinant hepatitis B vaccines containing S and pre-S2 + S antigens.

One hundred and four healthy, hepatitis B virus (HBV) seronegative males were enrolled in a single blind, randomized pilot study to compare antibody and clinical responses to a yeast recombinant pre-S2 + S vaccine and a yeast recombinant S antigen vaccine (Recombivax HBR). Participants received either a 12, 24 or 48 micrograms dose of pre-S2 + S vaccine (with a 1:5 ratio by weight of pre-S2 and S antigens) or a 10 micrograms dose of Recombivax HBR by intramuscular injection at 0, 1 and 6 months; their serological and biochemical responses were measured at 0, 1, 2, 3, 6 and 7 months, while their clinical responses were monitored for 5 days after each injection. The proportion of vaccines with minor local or systemic complaints (mainly sore arm, malaise, myalgia, fatigue) and the proportion developing antibody to surface antigen (anti-HBs) were similar for all vaccine groups. Transient elevations in alanine aminotransferase occurred infrequently. By 7 months almost all vaccinees developed anti-HBs, but titres were generally higher among recipients of pre-S2 + S vaccine. Antibody to pre-S2 antigen developed in 70-75% by 2 months and in 91-96% by 7 months. These data imply that the recombinant yeast pre-S2 + S vaccine is as well tolerated and as immunogenic as Recombivax HBR. Further studies are being conducted to assess antibody responses in larger numbers of healthy adults as well as in special populations with sub-optimal responses to currently licensed hepatitis B vaccines.

Adult↗
PubMed1991

Asthma in the emergency department: impact of a protocol on optimizing therapy.

The objective of this study was to evaluate the impact of a simple educational intervention on the prescribing habits of internal medicine residents in the treatment of acute asthma in a busy emergency department (ED). Prescribing habits for 16 residents were documented for 4 months. The first 2 months served as a control period during which eight residents managed asthma patients without the benefit of any specific educational intervention beyond standard department protocols. A total of 129 patients treated by the residents during this initial phase were assessed. During the second 2-month period, a 10-minute verbal presentation and explicit written treatment protocol were provided to another eight residents, and their treatment of 83 patients was covertly evaluated. Increased prescribing of desired therapy was significantly improved in every area except that of prescribing an inhaled steroid metered dose inhaler for use as a discharge medication. The 10-minute verbal presentation given in conjunction with a three-page handout was found to be highly effective for eliciting improvement in treatment practices during short clinical rotations. The duration of this effect beyond each rotation is unknown. This educational intervention should be presented by the ED medical director, clinical pharmacist, or other appropriate clinician in virtually any ED as quality of patient care can be dramatically improved.

Acute Disease↗
PubMed1991

The efficacy and tolerability of enteric and non-enteric coated naproxen tablets: a double-blind study in patients with osteoarthritis.

A double-blind, crossover study was undertaken to compare the efficacy and tolerability of a novel enteric coated 500 mg naproxen tablet with normal release 500 mg naproxen in patients with osteoarthritis. Eighty-eight patients were randomly allocated to receive enteric coated naproxen as a single daily dose of 2 tablets at night or 1 normal release naproxen tablet twice daily for a period of 3 weeks, followed by the alternative treatment for a further period of 3 weeks. The results of patient and doctor assessments showed that both treatments were increasingly efficacious, with a significant period effect found in the measures for pain on passive movement and duration of morning stiffness. No significant treatment differences were seen in any of the measures of efficacy and tolerability, although there were more withdrawals on normal release than on enteric coated naproxen (p = 0.07). It was concluded that enteric coated naproxen given as a single 1 g dose at night and normal release 500 mg naproxen given twice daily are equally efficacious and well tolerated.

Adult↗
PubMed1991

The relationship between neuropsychological measures and self-care skills in patients with cerebrovascular lesions.

The present investigation examined the relationship between performance on the Michigan Neuropsychological Battery (MNB) and selected self-care skills in a group of patients with unilateral cerebrovascular lesions. Among MNB measures, left-sided somatosensory and motor functions were the best predictors of self-care skills, showing that in these stroke patients lower level cerebral functions mediated by the right hemisphere are more strongly related to the self-care skills examined than higher cerebral functions. Also, evidence that patients with cerebrovascular lesions in the left hemisphere performed better than patients with right hemisphere lesions in several self-care categories is further indication that right hemisphere processes have a special role to play in the mediation of these self-care activities. The research and clinical implications of these findings are noted.

Activities of Daily Living↗
PubMed1990

Plasma albumin and total protein in preterm babies from birth to eight weeks.

We have measured albumin and total protein concentrations over the first eight weeks of life in a group of preterm babies. The albumin concentration in newborn babies rose from about 20 g/l in 28 weeks gestation babies to about 30 g/l in term babies. The total protein concentration in newborn babies rose from about 40 g/l in 28 week gestation babies to about 60 g/l in term babies. In babies of postnatal age up to 8 weeks the albumin concentration continues to rise at the same rate as the in utero rise in concentration with increasing gestation, regardless of the clinical state of the baby. The total protein concentration, however, remains about the same as at birth. These results allow better clinical interpretation of albumin and total protein concentration in "older" preterm babies.

Blood Proteins↗
PubMed1990

Effect of prolonged intravenous infusion of gludopa in humans and a preliminary study of its oral bioavailability.

Intravenous infusion of gamma-glutamyl-L-dopa (25 micrograms/kg/min) for 10 h in normal humans caused a natriuresis of 46.5 mmol of sodium without an increase in plasma renin activity and was associated with small but significant falls in blood pressure. In a second study the oral bioavailability of gludopa was estimated in normal subjects and found to be low (less than 2%). The increase in urine dopamine excretion and the natriuretic effect of gludopa were much larger after intravenous infusion than oral dosing.

Absorption↗
PubMed1989

Varieties of object constancy.

Three experiments are described in which two pictures of isolated man-made objects were presented in succession. The subjects' task was to decide, as rapidly as possible, whether the two pictured objects had the same name. With a stimulus-onset asynchrony (SOA) of above 200 msec two types of facilitation were observed: (1) the response latency was reduced if the pictures showed the same object, even though seen from different viewpoints (object benefit); (2) decision time was reduced further if the pictures showed the same object from the same angle of view (viewpoint benefit). These facilitation effects were not affected by projecting the pictures to different retinal locations. Significant benefits of both types were also obtained when the projected images differed in size. However, in these circumstances there was a small but significant performance decrement in matching two similar views of a single object, but not if the views were different. Conversely, the object benefit, but not the viewpoint benefit, was reduced when the SOA was only 100 msec. The data suggest the existence of (at least) two different visual codes, one non-retinotopic but viewer-centred, the other object-centred.

Adolescent↗
PubMed1989

Severe thrombocytopenia in Epstein-Barr virus-induced mononucleosis.

Severe thrombocytopenia is a rare complication of Epstein-Barr virus-induced infectious mononucleosis. We evaluated the clinical and laboratory data from seven patients seen between 1976 and 1985 whose lowest platelet counts varied from 3 to 25 x 10(9) per liter. Five of the seven patients were initially thought to have either acute leukemia or idiopathic thrombocytopenic purpura; eventually, however, primary Epstein-Barr virus infections were confirmed in all patients. Two of six patients tested had antiplatelet antibodies during the acute phase of their illnesses. Eight additional patients with acute disease who had only mild thrombocytopenia (94 to 144 x 10(9) per liter) were also tested for platelet antibodies with negative results. Steroid therapy was administered to three patients and platelet transfusions to one. All seven patients recovered with no serious hemorrhagic sequelae.

Adolescent↗
PubMed1988

Nutritional status and phytate:zinc and phytate x calcium:zinc dietary molar ratios of lacto-ovo vegetarian Trappist monks: 10 years later.

A nutrition assessment of 16 members of a community of lacto-ovo vegetarian Trappist monks was conducted in 1977. Plasma zinc was found to be low-normal, which was attributed primarily to high intakes of phytate-containing foods. Individual and group counseling were instituted over a 10-year period in an attempt to emphasize the importance of wise food selection within the constraints of lacto-ovo vegetarianism. In 1987, a more comprehensive nutrition assessment of 21 members of the same community was performed. Food composites were analyzed, and 3-day instead of 24-hour dietary records were kept. Intakes of phytate-containing foods had decreased from 4,569 to 972 mg/day; intake of dietary zinc had increased from 7.4 to 9.7 mg/day; and the phytate:zinc molar ratio had decreased from 67 to 14 for the years 1977 and 1987, respectively. An analyzed phytate:zinc molar ratio of 9.8 and an analyzed phytate x calcium:zinc molar ratio of 0.3 were representative of the 1987 community. Both were within normal ranges. Plasma zinc had risen to upper-normal levels. The 1987 nutrition assessment showed that it is possible to be adequately nourished with a lacto-ovo vegetarian diet provided one has proper knowledge of the phytate-containing foods and the methods for compensating with foods of greater mineral density (primarily zinc).

Adult↗
PubMed1987

Bone marrow granulomas in mononucleosis.

Two patients with mononucleosis, one due to cytomegalovirus (CMV), and the other due to Epstein-Barr virus (EBV), presenting with high fever, malaise and hepatitis, had granulomas in the bone marrow but not in the liver. In patients who have unexplained fever, bone marrow granulomas may be a clue to CMV or EBV infection and need not initially raise the fear of prognostically more severe illness.

Adult↗