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Biomedical subjects

R Elton

Publications and source records attributed to R Elton.

At least 37 records · Page 2Linked to original sources
PubMed1995

Acute-phase protein response and survival duration of patients with pancreatic cancer.

BACKGROUND: Current methods to predict survival duration of patients with pancreatic cancer are limited. The aim of this study was to determine whether certain nutritional indices and the acute-phase protein response are prognostic factors independent of disease stage for patients with unresectable pancreatic cancer. METHODS: Variables at the time of diagnosis of 102 patients with unresectable pancreatic cancer were entered into a Cox's proportional hazards model. Included in the analysis were the serum concentration of C-reactive protein (CRP) and albumin, the extent of weight loss, age, sex, and disease stage (International Union Against Cancer criteria). RESULTS: A multivariate analysis in which each factor was adjusted for the influence of the other factors revealed the patient age, disease stage, serum albumin, and serum CRP to be independent predictors of survival. The presence of an acute-phase protein response was the most significant independent predictors of survival duration. The median survival of those with an acute-phase protein response (CRP > 10 mg/L, n = 45) was 66 days compared with 222 days for those with no acute-phase protein response (n = 57, P = 0.001, Mann-Whitney U test). CONCLUSION: The acute-phase protein response is a useful prognostic indicator for patients with unresectable pancreatic cancer. Moreover, the metabolic disturbances associated with an acute-phase protein response of patients with pancreatic cancer may be a worthwhile therapeutic target.

Acute-Phase Proteins↗
PubMed1995

Influence of clinical resources on the treatment of intermittent claudication.

Management of intermittent claudication varies between surgeons, even after adjustment for case-mix, and could be related to the availability of clinical resources. The aim of this study was to ascertain whether vascular surgeons perceived deficiencies in the resources available to them for the management of claudication and to determine whether an association existed between reported deficits and patient management. Over a six month period, 28 vascular surgeons in Scotland completed recording forms on their treatment intentions for 1,180 claudicants. Subsequently, the surgeons were interviewed about resources available for vascular surgery. The majority of surgeons reported deficiencies in resources, predominantly insufficient operating lists (71%) and staff shortages (71%). Although considered less important than clinical factors or patient wishes, resources were independently associated with treatment. Surgeons reporting insufficient operating lists were less likely to opt for surgical treatment (p < 0.05), and those working with reluctant or inexperienced radiologists were less likely to consider percutaneous transluminal angioplasty (p < 0.05) and more likely to offer surgery (p < 0.001). However, case-mix and resources explained only some of the variations in treatment. The residual variation was likely to reflect an underlying lack of agreement among surgeons on the most appropriate management of claudication. Randomised controlled trials to address this issue would be welcomed by the majority of surgeons questioned.

Angioplasty, Balloon↗
PubMed1994

An evaluation of the repeatability and reproducibility of a surface test for the activity of disinfectants.

A collaborative study was carried out to determine the precision of a disinfectant surface test method which is currently under consideration for development as a harmonized European standard surface test. Results indicate that significant variation in microbicidal effect occurs both within and between test laboratories despite careful standardization of test conditions, but that the variability may be less than that associated with suspension tests. Indications are that much of this variability derives from random variations in the resistance of the test strains from day to day and, most particularly, from test period to test period both within as well as between laboratories. It is concluded that although the test may be sufficiently reliable to be used as a standard method, adequate replication must be specified to distinguish borderline pass from borderline fail concentrations.

Bacteria↗
PubMed1994

Parental smoking and carriage of Neisseria meningitidis among Greek schoolchildren.

In December 1990 and January 1991, primary (320) and secondary (697) pupils in 2 areas of Athens were screened to determine the rate of carriage of Neisseria meningitidis and to determine if the genetic and environmental factors associated with carriage of meningococci in Greece were similar to those observed for northern European populations. In 1 area, socioeconomic indicators were significantly lower than in the other (p < 0.0005), but the isolation rates from pupils in the areas were similar, 5.3% and 6.3%. In contrast to studies in northwest Europe, carriage was not associated with lower socioeconomic conditions, sex, numbers of individuals per household, upper respiratory tract infection, or secretor status. By univariate analysis, carriage was associated with age (15-18 years) (p < 0.05) and mother's or other carer's smoking habits (p < 0.05)--but not father's smoking. Although the proportion of fathers who smoked was greater in the area where socioeconomic indicators were lower (61%) vs. (47%) (p < 0.0005), the proportions of women smokers were similar (33% vs. 38%). By multiple regression analysis, the only significant factors were age (p < 0.01) and carer's smoking (p < 0.05).

Carrier State↗
PubMed1992

Pneumonia and pneumonitis in childhood malignancy.

We conducted a survey over a 21-year period of the incidence and risk of occurrence of episodes of pneumonia and pneumonitis in children treated for solid tumours and leukaemia. One hundred episodes occurred amongst 219 patients, seven of which were associated with death. Focal opacification on the chest radiograph was more common than diffuse opacification. Patients with leukaemia had a significantly higher rate of occurrence of pneumonia and pneumonitis during the periods of induction and maintenance compared with the off-treatment period, and during the relapse period compared with the period of maintenance. Patients with solid tumours had a significantly higher rate of occurrence during treatment compared to the off-treatment period. The rate of occurrence on treatment was the same in patients with solid tumours and acute leukaemia. Children with malignancy have a high incidence of pneumonia and pneumonitis and death is rare if the patient does not have terminal malignant disease.

Acute Disease↗
PubMed1991

What do young people think about screening for cystic fibrosis?

We investigated the knowledge of cystic fibrosis and the views about neonatal and carrier screening in 216 school students aged 14 to 16 years. This work was completed before the published identification of the cystic fibrosis gene in September 1989. Although initial knowledge of cystic fibrosis was low (only 17% of the students knew that the disease affected the lungs), there was good recall of basic information about cystic fibrosis and of recessive inheritance after a brief lecture. A total of 86% considered that carrier detection should be offered routinely and 88% felt that an offer of prenatal diagnosis for cystic fibrosis should be made if both prospective parents were known to be carriers. We believe that pilot studies of cystic fibrosis carrier screening in schools should be undertaken.

Adolescent↗
PubMed1990

A project in diabetes education for children.

Forty-eight families with children less than 13 years old attending a paediatric diabetic clinic volunteered for a 2-year randomized crossover trial to determine whether an informal education programme (diabetic club) could improve diabetic control. Group A attended the diabetic club for 10 afternoons of informal education in the first year, while Group B continued at the routine clinic (5 visits per year). For the second year Group A returned to the clinic, Group B attended the club. Glycosylated haemoglobin (HbA1) remained stable while attending the club but rose significantly (p less than 0.01) while attending the clinic in both groups (HbA1 at baseline, 1 year, and 2 years: Group A, 9.6 (SD 1.2), 9.6(1.4), 10.7(2.1)%; Group B 8.9(1.3), 10.4(1.4), 10.5(1.4)% (normal reference range 4.7-7.9%)). Other indices of control were unchanged. Diabetic problem-solving scores of parents improved (p less than 0.01) but their knowledge of diabetes did not correlate with their child's HbA1. Dietary intake showed a reduction in percentage of energy taken as fat (40% vs 37.7%, p less than 0.05) during club attendance. The percentage of parents reporting helpful social contact between families increased during their club year (Group A 50 to 78%, Group B 32 to 57%, p less than 0.001). Psychological measurements remained unchanged. An education programme for diabetic children may stabilize diabetic control in the short term but this effect is not sustained. The main benefit was the support provided by increased social contact with families of other diabetic children within the informal framework of the diabetic club.

Child↗
PubMed1990

The diets of men in four areas of the UK: the Caerphilly, Northern Ireland, Edinburgh and Speedwell studies.

Nutrient intakes in four areas of the UK were compared, 7-d weighed intake data were obtained for representative community samples of middle-aged men in Caerphilly (South Wales), Northern Ireland, Edinburgh and Bristol (Speedwell). Intakes of energy were higher in Edinburgh than in the other three areas, but following allowance for this, differences in nutrient intakes were very small. The exceptions were P/S ratio and alcohol consumption. The P/S ratio for Northern Ireland (0.38) was considerably higher than that for the other areas (0.30 to 0.32). The proportion of heavy drinkers was higher in Edinburgh (15 per cent) than in other areas (5-9 per cent) and the proportion of abstainers was highest in Northern Ireland (38 per cent). Differences in nutrient intakes did not parallel the differences in ischaemic heart disease (IHD) mortality rates between the areas.

Alcohol Drinking↗
PubMed1989

Adipose fatty acid composition and the risk of serious ventricular arrhythmias in acute myocardial infarction.

The relation between subcutaneous adipose tissue fatty acid composition and serious ventricular arrhythmias during acute myocardial infarction was studied in 2 groups of patients. In group 1 (n = 42), studied retrospectively, patients with ventricular fibrillation or tachycardia had a higher concentration of long-chain saturated fatty acids than those without (32.5 +/- 0.8% vs 29.7 +/- 0.4% [mean +/- standard error of the mean], p less than 0.01). In a prospective study, patients with arrhythmias (n = 106) had higher levels of long-chain saturated fatty acids (32.1 +/- 0.5% vs 30.7 +/- 0.4%, p less than 0.05) and of stearic acid (4.9 +/- 0.2% vs 4.4 +/- 0.1%, p less than 0.02) and a lower concentration of palmitoleic acid (7.3 +/- 0.3% vs 8.1 +/- 0.2%, p less than 0.005). When peak plasma creatine kinase concentrations were included with the individual fatty acid levels in a multiple logistic regression, only creatine kinase correlated significantly with ventricular arrhythmias (p less than 0.01). Thus, saturated fatty acids in cardiac membranes may lead to greater vulnerability to ventricular arrhythmias, although infarct size is the only statistically significant predictor after multiple regression analysis.

Adipose Tissue↗
PubMed1989

Low plasma vitamins E and C. Increased risk of angina in Scottish men.

Cross-cultural studies suggest that low plasma antioxidant levels contribute to the high incidence of coronary heart disease (CHD) in Scotland. One hundred twenty-five cases of angina without reported history were identified by a postal WHO chest pain questionnaire from a systemic population sample of 6000 Edinburgh men (35-54 years). Classical CHD risk factors (lipids, blood pressure, smoking, and relative weight), plasma vitamins, and a new independent CHD risk factor, adipose tissue linoleate, were measured in angina (n = 125) and healthy controls (n = 430). Cigarette smoking was common in angina (46% vs. 29%, p less than 0.01), and adipose tissue linoleate was lower (8.77 +/- 0.18% vs. 9.81 +/- 0.14% (p less than 0.01). Classical CHD risk factors were not different. Vitamin E/cholesterol molar ratio (micron/mM) was lower in angina than in controls: 1.58 +/- 0.03 vs. 1.66 +/- 0.02 (p less than 0.01). Plasma vitamin C was also lower in angina than in controls: 23.6 +/- 1.7 vs. 30.5 +/- 1.1 microM (p less than 0.001). The relative risk of angina for those in the lowest versus those in the highest quintile of the vitamin E/cholesterol ratio distribution was 2.2:1, irrespective of other risk factors (p less than 0.009). Adipose tissue linoleate removed the association between vitamin E and angina. The relative risk of angina for those in the lowest versus those in the highest quintile of plasma vitamin C was 2.6:1 (p less than 0.01), and the increased risk was also independent of classical risk factors, but closely related to a smoking habit. Low plasma vitamin E or adipose linoleate predisposes to angina, and smoking may increase the risk of angina by lowering plasma vitamin C levels in Scottish men.

Adult↗
PubMed1989

Ontogeny of pulsatile gonadotrophin secretion and pituitary responsiveness in male puberty in man: a mixed longitudinal and cross-sectional study.

The onset of puberty is characterized by a sleep-associated increase in pulsatile LH secretion which is not observed in adults. The ontogeny of gonadotrophin secretion during pubertal maturation may reflect changes in endogenous LHRH secretion, pituitary sensitivity to LHRH and/or alterations in gonadal steroid feedback. To understand the interplay between these mechanisms, we have examined the pulsatile pattern of plasma LH, FSH, testosterone, oestradiol and prolactin between 20.00 and 09.00 h and the pituitary response to repeated exogenous LHRH stimulation in 16 boys with delayed puberty (age 16.3 +/- 2.7 (S.E.M.) years) on one to four occasions in a mixed longitudinal/cross-sectional analysis. Physical maturity was determined by Tanner G staging (1-5) and clinical progress followed for a mean duration of 22.4 +/- 8.5 months during which 33 hormone profiles were obtained. Nocturnal (23.00-09.00 h) LH pulse frequency increased to a peak of 0.54 +/- 0.03/h at stage 2 which was followed by a gradual decline to 0.42 +/- 0.04/h at stage 5. The appearance of LH pulses in the evening (20.00-23.00 h), probably representative of the rest of the day, was delayed until mid-puberty from which point frequency increased to a peak of 0.53 +/- 0.08/h at stage 5. LH pulse amplitude showed a linear increase from stages 1 to 5, with nocturnal pulse amplitudes being higher than evening pulses throughout. FSH did not show a clear pulsatile pattern. The LH:FSH ratio reversed from less than 1 to greater than 1 at stage 2. The LH response to exogenous LHRH increased in parallel with LH pulse amplitude. There was no difference in the pattern of LH response to repeated LHRH stimulation as puberty advanced; the first stimulus always elicited a greater response than subsequent doses. In contrast, the FSH response to LHRH was maximal at stage 1 and became attenuated thereafter. The estimated mean nocturnal LHRH concentration or amplitude did not show any increase during pubertal maturation from 20.42 +/- 11.57 at stage 1 to 35.96 +/- 20.83 ng/l at stage 5. In conclusion, the sequential changes in this study suggest that the sleep-entrained increase in LHRH pulse frequency plays a key role at the onset of puberty. By enhancing pituitary responsiveness and setting in motion a cascade of events, this peripubertal augmentation of LHRH pulse frequency can account for most of the subsequent changes in LH, FSH and testosterone secretion during pubertal development in the male without any apparent alteration in LHRH pulse amplitude.

Adolescent↗
PubMed1987

Immunocompetent cells in human testis in health and disease.

The authors have investigated lymphocyte subpopulations and macrophages in normal human testes and the testes of patients under investigation and treatment for subfertility. Specific monoclonal antibodies were used in an indirect immunoperoxidase technique. In normal tissues, T lymphocytes (Leu 4-positive cells) were present in the rete testis with a preponderance of cells of the suppressor/cytotoxic phenotype. In contrast, no lymphocytes were detected within the peripheral portions of the testis. Cells reacting with the anti-Leu M3 monoclonal antibody, which defines monocytes/macrophages, were detected in appreciable numbers in peripheral testis with a specific location around the seminiferous tubules. HLA-DR-positive cells (human leukocyte antigens--class II [DR] determinants of the major histocompatibility complex) also were identified and showed a similar pattern of distribution to that of the Leu-M3 positive cells. While no lymphocytes were seen in the normal peripheral testis, T lymphocytes were detected in testicular biopsies from subfertile patients. Suppressor/cytotoxic T cells (Leu 2a-positive) predominated in patients with oligozoospermia and obstructive azoospermia while T cells of the helper/inducer phenotype predominated in patients with unilateral testicular obstruction and in postvasectomy patients. Sperm antibody measurements correlated with these findings.

Adult↗
PubMed1987

Adipose tissue fatty acids and blood pressure in middle-aged men from southern Italy.

Adipose tissue (AT) biopsies were performed in a random population sample of 74 clinically healthy middle-aged men (40-49 years) from southern Italy. The percentage of saturated fatty acids (FA) in AT was directly correlated with systolic (SBP) and diastolic (DBP) blood pressure (p less than 0.01). This relationship was independent of smoking habit and body weight. AT of men in the upper DBP quintile (range 90-102 mmHg) was significantly richer in palmitic acid (p less than 0.01) compared to that of men in the lowest DBP quintile. Dietary history demonstrated that the overall intake of saturated fat (% energy) was similar in the two extreme DBP quintiles. There was a relatively higher consumption of fish by those in the lowest DBP quintile (p less than 0.05). The amount of monounsaturated fat consumed (% energy) was also higher (p less than 0.05) in men with low blood pressure. Men in the upper quintile of DBP consumed more eggs (p less than 0.05).

Adipose Tissue↗
PubMed1984

Adipose tissue and platelet fatty acids and coronary heart disease in Scottish men.

The relation between coronary heart disease (CHD) and fatty acid composition of adipose tissue and platelets was examined in a random sample of 448 middle-aged Scottish men. The linoleic acid (18:2n6) content in adipose tissue of 28 men with previously unidentified CHD was significantly lower than that in the rest of the group. Platelet linoleic and other fatty acids were not significantly different in men with new CHD. Fatty acid content of adipose tissue reflects long-term dietary intake, and a 7-day weighed dietary record in a random sub-sample of 164 men confirmed that intake of linoleic acid in 10 of the 28 new CHD cases was significantly lower than in the healthy men. In a multiple logistic analysis adipose tissue linoleic acid, age, high density lipoprotein cholesterol, and weight/height index each made an independent contribution to the explanation of new CHD. When all fatty acids were included in a second regression analysis, low concentrations of dihomo-gamma-linolenic (20:3n6) acid in adipose tissue showed a more significant relation with new CHD than did linoleic acid.

Adipose Tissue↗
PubMed1982

Short-term prophylaxis with cefotaxime for prostatic surgery.

A randomised controlled trial of a new cephalosporin, cefotaxime, was carried out in men undergoing transurethral resection of the prostate. The purpose of the trial was to determine whether 48-hour prophylaxis with this new broad-spectrum, non-nephrotoxic cephalosporin would reduce postoperative bacteriuria and postoperative complications. The treated patients fared significantly better than the non-treated patients in having fewer febrile episodes, fewer episodes of tachycardia, a lower incidence of appreciable bacteriuria postoperatively, and fewer complications, and spending on average one day less in hospital. There was no difference in postoperative urea and creatinine concentrations between the groups, and no other side effects of cefotaxime occurred in this elderly population. Prophylaxis with cefotaxime would appear to make prostatic surgery safer.

Bacteriuria↗
PubMed1982

Randomised trial of clomiphene citrate treatment and vitamin C for male infertility.

A prospective randomised trial was carried out to assess the effect of 6 months' treatment with either clomiphene citrate or vitamin C in 179 men complaining of infertile marriage. There was no significant difference in the wife's pregnancy rates between the 2 treatment groups. In order to detect a subgroup that might respond to clomiphene the results were analysed according to pre-treatment FSH and sperm density, with allowance being made for the result of the wife's tests, but still there was no significant difference in treatment response Vitamin C would seem a preferable and cheaper alternative treatment for male infertility.

Ascorbic Acid↗
PubMed1980

The significance of serum sperm-agglutinating antibodies in men with infertile marriages.

Three hundred consecutive male partners of infertile marriages had serum samples tested for sperm agglutinating and sperm immobilising antibodies, using a micro-technique: 30.3% were found to be positive. Out of a control group of 100 fertile men 10 had antibodies detected (10%) and these at low titre; this difference was significant. The results of these serum tests were found to correlate with the results of seminal plasma tests, the mixed antiglobulin reaction for IgG and sperm cervical mucus contact testing, although all of these tests were less discriminatory with regard to fertility. The serum micro-immobilisation test showed a statistical association with fertility when analysed in those couples where both husband's and wife's tests showed no other bar to fertility.

Antibodies↗