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Biomedical subjects

R West

Publications and source records attributed to R West.

17 recordsLinked to original sources

Thrombocytopenia associated with administration of trimethoprim/sulfadiazine in a dog.

A diagnosis of trimethoprim/sulfadiazine-induced, immune-mediated thrombocytopenia in a dog was made, using a novel in vitro assay for thrombolytic activity. The assay quantifies thrombolytic activity by measuring the amount of platelet fragments in normal canine platelets before and after incubation with plasma from the thrombocytopenic dog. This report confirms previous reports of the development of thrombocytopenia after administration of trimethoprim/sulfadiazine, and describes a new assay that, after further validation, may be useful in the diagnosis of immune-mediated thrombocytopenia when an adequate sample of platelets cannot be obtained for quantification of platelet-associated IgG.

Animals

Epidemiologic survey of juvenile-onset diabetes in Montreal.

Active search of hospital records was used to survey insulin-dependent juvenile-onset diabetics younger than 17 years resident in General Montreal at the time of onset of symptoms during a seven-year period (1971-1977). A mean annual incidence of 8.8/100,000 was found with variation from year to year (5.8 to 10.3). Eighty percent were five years of age or more at time of diagnosis, and the increase with advancing age was similar to that seen in other studies including the somewhat earlier increase in incidence among females. Seasonal peaks were noted in some but not all years and were more marked in years of high incidence and among males. More cases occurred in areas of high socioeconomic level as measured by average family income. The estimated incidence among siblings of diabetics is 15 times the incidence in the general population. Ten percent of diabetics have a first degree relative who is insulin dependent.

Adolescent

Predicting death from behavioral test performance.

This study described several brief behavioral measures which, with further validation, could be useful in predicting the deaths of older adults within a five-year period following testing. Such tests can be used in routine biomedical examinations, alerting the physician to possible problems in the future. The study was based on a battery of 18 tasks as well as 8 measures of health, social activity, and demographic characteristics administered to 380 healthy men and women aged 60 to 89 years. Five years later, the scores of those who had subsequently died (N = 83) were compared with a matched sample of those still living. Thirteen of the 18 task performances significantly distinguished between those still living and those who died. Discriminative analyses were carried out, and the discriminative score cut-offs correctly classified 66% of the subjects as to survival status.

Affective Symptoms

A new locus (leuK) affecting the regulation of branched-chain amino acid, histidine, and tryptophan biosynthetic enzymes.

A locus (leuK) affecting regulation of the leucine operon was selected by isolating a spontaneous Ara+ derivative of an Escherichia coli B/r strain carrying an ara-leu fusion in which the arabinose operon is under leucine control. Genetic analyses by P1 transduction demonstrated that the lesion is located to the right of the galactose operon. Regulation of the biosynthetic enzymes for leucine, isoleucine-valine, histidine, and tryptophan was altered in a strain carrying leuK16. High-level gene expression in the heterozygous merodiploid strain F' leuK+/leuK16) demonstrated the dominance of the mutant allele to the wild-type allele. No apparent effect was observed in the mutant on N-acetylornithinase, a biosynthetic enzyme in the arginine pathway, nor on any of the 18 aminoacyl-tRNA synthetases examined. However, compared with that of the parent strain, the extent of the charging of leucyl-, isoleucyl-, valyl-, histidyl-, and arginyl-tRNA was decreased in the mutant.

Chromosome Mapping

Bed usage and disease specific mortality within ICD chapters.

Using Hospital In-Patient Enquiry (HIPE) data (Department of Health and Social Security and Office of Population Censuses and Surveys, 1974), the relationship between mortality and bed usage was examined for a number of disease categories within 10 chapters of the International Classification of Diseases (ICD) (World Health Organisation, 1967). There was found to be significant correlation within six chapters for males and within six chapters for females. The use of standardised mortality ratios (SMRs) in the formula of the Resource Allocation Working Party (RAWP) (Department of Health and Social Security, 1976) for certain chapters where no correlation could be demonstrated is questioned. It is suggested that separate SMRs for urinary disease and genital disease should be used and that the SMRs for Chapter XVII (accidents, poisoning, and violence) should either be omitted from the formula or determined separately for subdivisions of the chapter.

Bed Occupancy

Grading criteria.

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Job Description

Early detection of breast cancer.

One thousand referred patients with breast symptoms, a history of breast disease, or a family history of breast carcinoma have been examined at a suburban breast clinic. This is a preliminary survey of the data and results so far obtained from the initial examination of these patients. The examination consisted of history-taking by means of a questionnaire, physical examination of the breasts, thermography and xeromammography. A report correlating the findings was forwarded to the referring doctor in each case and any necessary action was indicated in the report. Seventy-eight patients were thought to require biopsy of a suspicious lump or mammographic lesion (7.8% of the total number); 76 patients actually had biopsies, and 18 patients were found to have carcinoma of the breast (23.8% of the total number of patients who had biopsies). The overall incidence of carcinoma in the 1000 women attending the clinic was 1.8% at the initial visit. While general population screening for breast carcinoma may be hard to justify, from both the detection rate and an economic point of view, it would appear from our experience to date that screening of selected high-risk referred patients is justified and, in fact, desirable.

Adenocarcinoma

Small-scale trial of live-attenuated influenza vaccine (A/Hong Kong/68).

Seventy-one men who were given live-attenuated A/Hong Kong/68 (H3N2) influenza vaccine during November 1973, and 34 men given placebo were examined for changes in antibody level. Overall, 12 of the 71 men (17%) given the vaccine showed a fourfold rise in haemagglutination-inhibition (HI) antibody titre after 14 days. No such rises were seen in the 34 men given placebo. However, 10 of the men showing a fourfold rise were from 19 who had no detectable HI antibody to this virus before vaccination, representing a conversion rate of 53%. The other two had a HI titre of 1/10 before vaccination. The absence of antibody response, at 14 days, in those with an HI titre of 1/20 or greater may indicated that this represents a protective level against infection. However, the vaccine virus was probably overattenuated and may have constituted a weaker challenge than might occur with a wild strain. No influenza virus was isolated from either group in the week after vaccination and no evidence of transmission to the placebo group was seen. Mild symptoms, chills, muscle pain, and stiffness were more frequently seen in the 12 persons showing a fourfold rise in antibody than in the rest of the volunteers.

Administration, Intranasal

The protective effect of glucose-insulin-potassium on the response to atrial pacing.

The effects of glucose-insulin-potassium infusion (GIK) on atrial pacing-induced angina, ST depression, abnormal left ventricular end-diastolic pressure during pacing interruption (LVEDPi) and lactate metabolism (L), were studied in 18 patients: ten had angina during pacing = Ischemic group, and eight (5 normals and 3 with coronary artery disease) remained asymptomatic = Nonischemic group. The study consisted of 8-10 minute periods of control, pacing and recovery, before and after GIK. No untoward effects were observed. Comparison of the pacing responses (GIK vs pre-GIK states) showed that during GIK, angina occurred in only 4 patients, while significantly less severe changes were observed in ST depression (1.4 +/-0.5 vs 2.4 +/- 0.4 mm) and LVEDPi (16 +/- 3 vs 23 +/- 3 mm Hg). Lactate extraction was also higher (8.1 +/- 10.9 vs -5.2 +/- 11.1%), but not significantly so, although L became normal in 4 subjects and improved in another. These results indicate that GIK infusion was well tolerated and had a beneficial effect on pacing-induced myocardial ischemia.

Adult

Qualitative vocabulary test responses and age.

Vocabulary test responses, as traditionally scored were compared to these same responses when scored for finer nuances of understanding, as determined by the criterion of superior synonyms. It was hypothesized that the latter would be more related to age in a deficit pattern than the former. The results partly supported the hypothesis and partly not. In the context of the positive results, it is not clear whether the aged cannot, or simply do not, give synonym responses as readily as the young. It may be more of a cohort preference not to, rather than an age limitation of intellectual ability.

Adult