Effect of atropine on humidification of respired gas.
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Atropine↗
Biomedical subjects
R Joshi
Publications and source records attributed to R Joshi.
Demonstration of choledochal cyst by computed tomography.
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Child↗
Effects of high-fat diet, angiotensinogen (agt) gene inactivation, and targeted expression to adipose tissue on lipid metabolism and renal gene expression.
To address the role of angiotensinogen (agt) in lipid metabolism and its potential endocrine effects in vivo, we studied the effects of high-fat diet (HFD) on adult, 28-week-old agt knockout (KO) mice compared to wild type (WT) mice. Recent studies (Massiera et al., 2001) have demonstrated that reexpression of agt in adipose tissue of KO mice normalized adiposity, blood pressure, and kidney abnormalities. We therefore used microarray analysis to investigate changes in gene expression profile in kidneys of KO vs. Tg-KO mice, where agt expression is restricted to adipose tissue. Body weight, adiposity and insulin levels were significantly decreased (p < 0.05) in KO mice on a chow diet (CD) compared to WT mice, while circulating leptin levels were similar. On a high-fat diet, KO mice exhibited significantly lower bodyweight (p < 0.05), adiposity (p < 0.05), leptin, and insulin levels (p < 0.05) compared to WT mice. In agreement with previously reported changes in kidney histology, agt KO mice displayed altered expressions of genes involved in blood pressure regulation and renal function, but these levels were corrected by reexpression of agt in adipose tissue. Collectively, these findings further document important endocrine roles of adipocyte agt, in part via regulation of lipid metabolism and kidney homeostasis.
Adipose Tissue↗
Humidification of respired gas by nasal mucosa.
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Adult↗
Self-adhesive drape (Opsite) for management of leaking abdominal wounds.
BACKGROUND: Leaking abdominal wounds (LAW) are associated with high patient morbidity. OBJECTIVES: To evaluate the efficacy of a self-adhesive drape (Opsite) with suction drains for the management of LAW. METHODS: Twenty patients with LAW (14 intestinal fistula, 4 biliary fistula, 2 ascites leak) were subjected to the use of a self-adhesive drape with a Romovac suction drain. Conventional wound management was used for the first 5 days, followed by the application of Opsite drape. The parameters evaluated were quantity of the effluent, skin integrity, ease of application, patient comfort and cost effectiveness. A discomfort score (based on four parameters: mobility, skin excoriation, wetness and unpleasant odor) was recorded on day 1 (pre conventional), day 5 (post conventional-pre Opsite), and day 5 after Opsite application. Opsite drape was changed whenever required. RESULTS: The discomfort score was not altered with conventional therapy but was lower following Opsite application: mobility (0 vs 2), skin excoriation (0 vs 2), wetness (0.5 vs 2) and odor (0 vs 1). Opsite drape allowed accurate measurement of the effluent in all patients. The drape required change after a median of 14 days (range 10 to 18). CONCLUSIONS: Opsite drape is easy to apply on LAW, is effective in containing the effluent, and is associated with low patient morbidity.
Adult↗
Long-term follow-up of implant-stabilised overdentures.
The aim of this retrospective study was to assess the long-term outcome of patients provided with implant-stabilised overdentures. Patients who had been entered into a previous trial were identified; the records were available for nineteen patients restored with conventional complete upper dentures and implant-stabilised lower overdentures. The mean follow-up period was 11.5 years (range 5.25-13.5 years). One implant was lost and all patients have successfully worn their prostheses, although most have experienced problems: loosening, loss and fracture of retaining clips, soft tissue complications and fractured bars. Nine patients subsequently had bars replaced with ball attachments. This conversion significantly reduced requirements for maintenance and professional care. Implant-stabilised lower overdentures supported on two implants provide a simple, predictable solution for patients with otherwise poorly retained and unstable lower dentures.
Adult↗
Accuracy of physical examination in the diagnosis of hypothyroidism: a cross-sectional, double-blind study.
BACKGROUND: Hypothyroidism is a common, potentially treatable endocrine disorder. Since hypothyroidism is not always associated with the signs and symptoms typically attributed to it, the diagnosis is often missed. Conversely, patients with typical signs and symptoms may not have the disease when laboratory tests are performed. AIMS: We aimed to determine the accuracy of physical examination in the diagnosis of hypothyroidism. SETTING AND DESIGN: Prospective, hospital-based, cross-sectional diagnostic study. MATERIAL AND METHODS: Consecutive outpatients from the medicine department were screened and an independent comparison of physical signs (coarse skin, puffy face, slow movements, bradycardia, pretibial oedema and ankle reflex) against thyroid hormone assay (TSH and FT4) was performed. STATISTICAL ANALYSIS: Diagnostic accuracy was measured as sensitivity, specificity, positive likelihood ratios, negative likelihood ratios and positive and negative predictive values. RESULTS: Of the 1450 patients screened, 130 patients (102 women and 28 men) underwent both clinical examination and thyroid function tests. Twenty-three patients (18%) were diagnosed to have hypothyroidism by thyroid hormone assays. No single sign could easily discriminate a euthyroid from a hypothyroid patient (range of positive likelihood ratio (LR+) 1.0 to 3.88; range of negative likelihood ratio (LR-): 0.42 to 1.0). No physical sign generated a likelihood ratio large enough to increase the post-test probability significantly. The combination of signs that had the highest likelihood ratios (coarse skin, bradycardia and delayed ankle reflex) was associated with modest accuracy (LR+ 3.75; LR- 0.48). CONCLUSION: Clinicians cannot rely exclusively on physical examination to confirm or rule out hypothyroidism. Patients with suspected hypothyroidism require a diagnostic workup that includes thyroid hormone assays.
Adolescent↗
Thermoplasticized gutta percha obturation techniques.
Gutta percha is the most widely used material in root canal obturation because of its relative inertness, lack of toxicity and biocompatibility. The most common method of obturation using gutta percha is lateral condensation, which has several disadvantages. The use of thermoplasticized gutta percha obviates many of the problems of this technique, but is still not commonly used. This article assesses the systems available for obturating root canals using thermoplasticized gutta percha.
Gutta-Percha↗
Anti-neoplastic properties of human corticotropin releasing factor: involvement of the nitric oxide pathway.
We report a series of the in vivo and in vitro studies that evaluate the anti-neoplastic potential of hCRF in W256 rat mammary carcinoma. Using magnetic resonance imaging (MRI) and direct measurements of tumor and peritumoral brain water content we found that hCRF treatment (100 micrograms/kg subcutaneously twice a day for 3 days) caused significant inhibition of growth and vascular permeability of the i.c. W256 tumors. hCRF also exhibited antiproliferative and differentiation-inducing effects in W256 cells in vitro. The calculated IC50 values were 70 nM and 100 nM of hCRF, as measured by digital videomicroscopic quantitation of tumor cell population growth rate and by [3H]-thymidine incorporation assay, respectively. The observed effects in W256 cells were CRF receptor mediated. This was shown in two ways: by the presence of relatively high levels of CRF1 receptor mRNA in W256 cells, and by the fact that the tumor growth inhibitory and differentiation inducing effects of hCRF in vitro were abolished by the CRF receptor antagonist a-helical CRF (9-41). Antiproliferative and differentiation inducing effects of hCRF in W256 cells involve activation of nitric oxide synthase (NOS) and L-arginine-NO pathway. This was shown by using the inhibitor of NOS, the L-nitro-arginine methyl esther (L-NAME), which prevented the antiproliferative and differentiation inducing effects of hCRF in vitro. The cytotoxicity of NO in W256 cells was assessed by the addition of sodium nitroprusside (SNP) to the media. SPN exhibited dose-dependent cytotoxicity in W256 cells with IC50 of 100 muM SNP as measured by [3H]-thymidine incorporation assay. We conclude, that hCRF has substantial anti-neoplastic effects which include inhibition of proliferation and induction of differentiation of the tumor cells in vitro, and a decrease in tumor vascular permeability (and possibly neo-angiogenesis) in vivo.
Animals↗