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Biomedical subjects

R Petty

Publications and source records attributed to R Petty.

At least 37 records · Page 2Linked to original sources
PubMed1991

Vascular endothelium: a potential role in HIV infection and the pathogenesis of Kaposi's sarcoma: observations and speculations.

Kaposi's sarcoma (KS) has become a source of interest in recent years primarily for its strong association with the acquired immune deficiency syndrome (AIDS). Endothelial cells (EC) are central to inflammation and can regulate coagulation and leucocyte emigration and may be central to the development of the disease. As they are also capable of being infected by HIV in vivo, this infection may contribute to the immunosuppressive effects of HIV seen in AIDS. Recent work has shed new light on the mechanisms involved in EC proliferation. The aim of this article is to review such evidence implicating EC in the development of KS. Additionally, hypotheses will be put forward to explain the mechanism of the vascular proliferation in KS and the possible role of EC in HIV infection. There is therefore enormous potential for the therapeutic targeting of endothelium to control these diseases.

Endothelium, Vascular↗
PubMed1991

Diabetologists' assessments of their outpatients' emotional state and health beliefs: accuracy and possible sources of bias.

The accuracy of physicians' perceptions of their patients' emotional state and health attitudes was examined in a diabetes outpatient clinic by comparing patients' ratings of anxiety, depression and health locus of control with physicians' ratings. In 234 patients, doctors' and patients' ratings correlated significantly for depression and anxiety. The physicians rated patients with a strong belief in control of health by others as most dependent on doctors. Men but not women with external locus of control were also rated as very dependent on doctors. Anxious or depressed patients were rated by their doctors as less able to cope with diabetes. The results indicate that non-psychiatric physicians are able to assess their patients' emotions and health attitudes with greater accuracy than is usually assumed.

Adaptation, Psychological↗
PubMed1991

Glycaemic control in adolescents with type I diabetes and parental expressed emotion.

The parents of 34 adolescents with type I diabetes were interviewed using the Camberwell Family Interview, a well validated and reliable standardised interview which measures aspects of family interaction previously reported as important in the families of diabetics. Contrary to predictions from previous research, poor glycaemic control was not associated with parental apathy, criticism of the child with diabetes, or marital discord. Greater emotional involvement by parents was associated with good glycaemic control. Overall, there was close agreement between parents in their responses although mothers showed more accurate appraisal of their child's diabetes than did fathers.

Adolescent↗
PubMed1991

The role of ultrasound in evaluation of Takayasu's arteritis.

Duplex ultrasound was used to assess the vascular status and predict the angiographic findings in 3 patients with Takayasu's arteritis. The most striking sonographic feature was the presence of concentric arterial wall thickening. Using pulsed Doppler, stenotic lesions were quantified, occlusive lesions were identified and collateral circulation was demonstrated. A high resistive flow pattern was demonstrated in diseased vessels compared with carotid wave-forms of control subjects. Subtle mural irregularity, minor stenotic lesions and areas of stenosis in branch vessels were missed by duplex evaluation. The thoracic aorta and occasionally major arterial branches in the abdomen were impossible to evaluate with ultrasound. Vascular magnetic resonance imaging was successful in delineating major aortic branches but was inferior to real-time ultrasound in resolving mural thickening. While angiography plays a major role as a baseline assessment of the entire vascular tree, duplex ultrasound can monitor disease progression and the effects of therapy. Serial duplex studies should greatly reduce the need for interval angiographic followup.

Adolescent↗
PubMed1991

Images of China.

Explore the source record for details and available documents.

Acupuncture Therapy↗
PubMed1990

Radiographic followup of joints injected with triamcinolone hexacetonide for the management of childhood arthritis.

Evidence of deleterious effects following intraarticular injection of triamcinolone hexacetonide was sought through a review of radiographs of 145 joints of 55 children with chronic arthritis. Possible deleterious effects were noted in 16 joints of 11 patients. These effects included: small patella (2 joints), patellar osteochondritis dissecans (1 joint), periarticular calcification (9 joints), intraarticular tibial bony spur (1 joint), avascular necrosis of the distal radial epiphysis (2 joints), and avascular necrosis of the proximal femoral epiphysis (1 joint). Only the latter possible complication was symptomatic. Serial radiographs of 76 joints of 30 children showed mild progressive changes compatible with the underlying disease, except in the hip joint, where changes were more severe. The intraarticular injection of triamcinolone hexacetonide is a procedure that appears to be associated with an acceptably low frequency of radiologic abnormalities for many joints in children with chronic arthritis, but its effects on the hip joint remain uncertain.

Anti-Inflammatory Agents↗
PubMed1990

Acute medical admissions: changes following a sudden reduction in bed numbers at Northwick Park Hospital.

The aim of this study was to gather information on the consequences of hospital bed closures on acute admission patterns. Each November during 1986-1988 we carried out a survey of requests and referrals for acute medical admission to Northwick Park Hospital (NPH). Between the first study in 1986 and the second study in 1987, 15 acute medical and 16 surgical beds were closed. In 1986 the hospital was 'full' and closed overnight to admissions from general practitioners (GPs) on 3/25 days. In 1987 this had increased to 16/27 days and in 1988 it was closed overnight on 20/31 days. Because GPs found it unreasonably difficult to admit patients to NPH, the number of patients referred by them fell from 55.8% of all admissions to 49.8% and 44.3%, while the number of self-referred patients rose from 27.1% to 34.5% and 39.1%. An increasing proportion of elderly patients had to be admitted to acute medical beds: those over 75 years of age represented 24.8% of admissions in 1986, 43.7% in 1987, and 43.8% in 1988. These changes have had important effects on our medical practice, and we suggest that audits of this type are necessary to quantify these changes. We make suggestions for improving such medical audits in the future.

Bed Occupancy↗
PubMed1989

Type A behaviour pattern and glycaemic control in type I diabetes.

People who exhibit the type A behaviour pattern have different approaches to problems compared with their non-type A counterparts. On the basis of published work on such differences, a number of predictions were tested in 85 outpatients with type I diabetes. Contrary to expectations, no differences were observed in glycaemic control between type A and non-type A diabetics of either sex. However, dividing type A diabetics according to their health locus of control beliefs yielded significantly different groups in terms of glycaemic control.

Adult↗
PubMed1986

A disease in the house of medicine.

For good reason the costs and casualties of medical malpractice have really earned the often overused sobriquet of "crisis." Invariably the debaters assert that the public's interest is best served by their program and their exchanges are not merely rhetorical, given the intense legislative activity on the "reforms" aggressively pushed in most of the nation's state capitals. The question of what is in the best interest of the public traverses a minefield of competing interests. The plaintiff's lawyer bias of Mr. Petty's article moved us to follow up with a brief commentary which raises some other criticisms. As a metaphor for many health policy issues, the tensions around malpractice will receive continuing attention in these pages.

Delivery of Health Care↗
PubMed1986

Stridor due to cricoarytenoid arthritis in pauciarticular onset juvenile rheumatoid arthritis.

A 2-year-old girl developed severe inspiratory and expiratory stridor 2 months after onset of pauciarticular juvenile rheumatoid arthritis (JRA). Direct laryngoscopy demonstrated that both vocal cords were immobile and approximated to each other in the midline secondary to arthritis of the cricoarytenoid joints. High dose corticosteroid therapy resulted in clinical and laryngoscopic improvement and tracheostomy was avoided. Cricoarytenoid arthritis can be a life threatening complication in JRA. Early institution of corticosteroids appears to be the treatment of choice.

Arthritis, Juvenile↗
PubMed1984

Erythrocyte choline concentrations and cluster headache.

Erythrocyte choline concentrations were measured in patients with cluster headache and age related control subjects. Concentrations were significantly reduced in the patients with headache both during a cluster period and between clusters, being 58% and 55% of the control value, respectively. After two weeks' treatment with lithium, choline concentrations in the patients with cluster headache increased to 78 times the control value (mean 369.2 mumol/l (3840 micrograms/100 ml) compared with 4.7 mumol/l (49 micrograms/100 ml]. The presence of depressed erythrocyte choline concentrations during and between cluster attacks indicates that this may be a predisposing condition which results in a cluster attack only when associated with a trigger factor.

Adult↗
PubMed1984

Low platelet monoamine oxidase activity in headache: no correlation with phenolsulphotransferase, succinate dehydrogenase, platelet preparation method or smoking.

Platelet monoamine oxidase activity in male migrainous and cluster headache patients was significantly lower than in male controls, confirming our previous study. The activity range showed a normal distribution and low mean values could not be attributed to a subgroup with particularly low activity. When Corash 's platelet preparation method was used, with its high platelet yield, specific enzyme activities of a similar order were obtained. Thus, the low values encountered were not due to abnormal recovery within the platelet population. Two other enzyme activities, phenolsulphotransferase M and succinate dehydrogenase, were also measured in the same platelet samples. Although low succinate dehydrogenase activity was identified in the headache groups, it appeared to represent a separate phenomenon and there was no significant correlation between activity of either enzyme and that of monoamine oxidase. This shows that the low activity of platelet monoamine oxidase in headache is not related to a generalised platelet enzyme deficit. It was also shown that the low monoamine oxidase activity in the headache patients could not be attributed to smoking.

Arylsulfotransferase↗