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Biomedical subjects

S Howard

Publications and source records attributed to S Howard.

At least 91 records · Page 5Linked to original sources
PubMed1983

Oral route as method for immunizing against mucosal pathogens.

In the past three decades significant strides have been made in attempts at nonparenteral immunization. Appreciation of the importance of secretory immunity led to attempts to stimulate antibody production locally. The vaccines developed against respiratory pathogens as a result of this new knowledge have many practical limitations, such as the need for highly trained personnel, expensive equipment, very cooperative recipients for intranasal or aerosol administration, and a vaccine that is both adequately attenuated, immunogenic, and stable during storage. With recognition of the presence of a common mucosal defense system, new approaches to vaccine development have become possible. Oral immunization, by stimulating GALT, presents a promising approach for protecting many secretory surfaces against a variety of infectious agents. Recently, emphasis has been placed on developing an oral vaccine against S. mutans. McGhee et al. have demonstrated antibody to S. mutans in saliva and tears following oral ingestion of that antigen, without a rise in serum antibody, in both humans and rats. The rats were afforded protection from caries after rechallenge with both the original and cross-reacting serotypes of S. mutans. Similar results have recently been seen with viral antigens. Mice have been shown to have significant protection against influenza infection following oral immunization. And in a pilot study with human volunteers, the secretory antibody response in nasal washes was similar following either oral or parenteral vaccination. Oral immunization may prove to be far superior to parenteral vaccination against a variety of pathogens, because of fewer side effects and greater ease in vaccine preparation and administration.

Administration, Oral↗
PubMed1976

Model systems for dissolution of finely divided (multisized) drug powders.

Several reports have dealt with model systems for the dissolution of log-normally distributed powders. A numerical solution is presented for the previously published Higuchi-Hiestand equations for a log-normal particle-size distribution. This solution was realized via an application of the System 360 Continuous System Modeling Program (CSMP). The resulting computer-aided calculations were utilized in the comparisons between the Higuchi-Hiestand model and other existing models. These comparisons provided a basis for the development of an adaptation of the Nielsen moving sphere model for log-normally distributed powders. The adaptation of the Nielsen equation for multisized particle systems is suggested as being potentially useful for treating experimental data where hydrodynamic effects must be considered.

Chemical Phenomena↗
PubMed1976

Oedipus of Thebes: the myth and its other meanings.

Sigmund Freud used the Oedipus myth to represent a crucial part of sexual development. Careful attention to the details of the myth as related by Sophokles points the way to entirely different and fruitful understandings. Myth is seen as an external representation of man's inner life; omens and the gods are viewed in this context. We can then see Oedipus' suffering as inseparable from loss and growth. In his struggle and ambivalence, Oedipus represents that suffering and transcendence for all of us. The myth tells us of the responsibilty, the pain, and the courage which are necessary ingredients in all human growth.

Blindness↗
PubMed1976

The Vietnam warrior: his experience, and implications for psychotherapy.

The psychodynamic experience of the Vietnam trooper is described and emotionally evoked by the author, who is both a psychiatrist and a combat veteran of that war. It is shown how that experience continues to affect the lives of these men. The special implications of that experience for psychotherapy are then discussed.

Attitude of Health Personnel↗
PubMed1975

Use of carboxyhaemoglobin levels to predict the development of diseases associated with cigarette smoking.

Carboxyhaemoglobin (COHb) levels in tobacco smokers vary throughout the day since they are affected by the pattern of tobacco consumption and the rate at which COHb is eliminated. A method is described whereby a single COHb measurement together with a recent smoking history may be used to estimate the average COHb "boost" produced by each cigarette, the total daily carbon monoxide (CO) uptake from smoking, and the mean COHb level throughout the day. These three indices of tobacco smoke absorption were estimated in nine healthy cigarette smokers on different days, each set of three estimations being derived from separate COHb determinations. The indices were reasonably reproducible within the same person, and the differences between people were statistically highly significant (P less than 0-001). For example, the estimates of mean daily COHb level resulting from smoking ranged from 0-7% to 9-3% in smokers who smoked 15 to 40 cigarettes a day. These differences are sufficiently large to distinguish possible differences in the risk of developing diseases such as ischaemic heart disease which may result from the inhalation and absorption of tobacco smoke. The suggested indices also depend less on the time of the blood test and on the daily pattern of smoking than a COHb level alone. The ratio of the COHb boost to the CO yield of a cigarrette may reflect depth of inhalation more accurately than a smoker's self-assessment. Moreover there was little correlation between these two measures of inhalation in the nine subjects studied.

Carbon Monoxide↗
PubMed1973

Association between atherosclerotic diseases and carboxyhaemoglobin levels in tobacco smokers.

In a cross-sectional study carboxyhaemoglobin (COHb) levels in tobacco smokers were found to provide a better indication of a person's risk of having developed certain atherosclerotic diseases, including ischaemic heart disease, than the smoking history. In the age group 30-69 years a person with a COHb level of 5% or more was found to be 21 times (lower 95% confidence limit 3.3 times) as likely to be affected by these diseases as another person of the same age and sex with similar smoking history and current smoking habits but with a COHb level of less than 3%.

Age Factors↗
PubMedDate not supplied

Costing neonatal care alongside the Collaborative ECMO trial: how much primary research is required?

Researchers working on economic evaluations alongside trials have to balance minimising data collection with maximising the ability to measure differences in costs. Using existing data sources may keep the costs of research down, but these data may not be entirely appropriate to the evaluation question. When evaluating technologies in intensive care it is particularly important to be able to classify patients correctly by their resource requirements especially when those requirements vary considerably from day to day. This paper describes and justifies methods for costing the care provided for babies in (one arm of) an on-going multi-centre trial, the Collaborative ECMO trial. This trial is evaluating alternative policies of life support for mature (full term) newborn babies with severe respiratory failure. The most reliable cost information on neonatal intensive care is available from a study, conducted independently from the trial, which has used simple cost apportionment on a large sample of units. By drawing on clinical opinion and carrying out a case note exercise we assessed whether this available information was appropriate to estimate 'baseline' costs for the control group during their initial 'acute' phase of illness. We concluded that the available cost estimates would need to be weighted to reflect the additional costs of drugs and investigations for this group of babies during the acute phase. Multidisciplinary collaboration on trials can help economists and other researchers to balance the requirement for simple cost measurements with more detailed primary research.

Cost-Benefit Analysis↗
PubMedDate not supplied

A randomized study of oral metoclopramide in small bowel biopsy of infants and children.

As an intravenous injection is not used in our premedication of infants and children for small bowel biopsy, we investigated what effects oral metoclopramide might have on small bowel biopsy procedure time and fluoroscopy time. Eighteen infants and children were randomized to receive 0.2 mg/kg metoclopramide or placebo orally, 40-45 min before starting the procedure, and the procedure was monitored for the time required for the biopsy capsule to reach the pylorus, to cross into the proximal duodenum, and to reach the biopsy site. Corresponding fluoroscopy times were recorded as well. Mean total procedure time was less for those treated with metoclopramide, 43.7 +/- 11 min, than for controls, 86.5 +/- 15.5 min (p less than 0.005). Mean total fluoroscopy time was also less in treated patients (40.9 +/- 11.5 s versus control 84.4 +/- 17 s) (p less than 0.005). The effect of metoclopramide occurred in the interval for the biopsy capsule to cross the pylorus (15.1 +/- 2.7 min versus control 60.8 +/- 16.6 min) (p less than 0.005) and in fluoroscopy time required (15.1 +/- 1.9 s versus control 46 +/- 17 s) (p less than 0.005). Oral metoclopramide is effective in reducing procedure time for small bowel biopsy, and its predictable action facilitates reduction in fluoroscopy exposure.

Administration, Oral↗
PubMedDate not supplied

An immunohistochemical study of the germinal layer in the late gestation human fetal brain.

In the cerebral lateral ventricle of the human fetus, the embryonic ventricular and subventricular zones (VZ and SVZ) persist into the latter half of gestation, particularly in the lateral wall. The SVZ is usually referred to as the germinal layer at this stage. The VZ is gradually replaced by ependyma, a single epithelial layer composed of tanycytes and ciliated columnar cells. In the prematurely born infant, the germinal layer is frequently the site of haemorrhage, the incidence of which diminishes with increasing maturity. There are many contributory pathogenetic factors but the structure of the germinal layer itself is considered important. It contains numerous, thin walled vessels in a cellular matrix which demonstrates little fibrillary background. Immunohistochemical evidence of glial differentiation in the germinal layer was sought in 21 preterm brains, using antibody to glial fibrillary acidic protein (GFAP). Early immunoreactivity was due to GFAP positive tanycyte fibres. Subsequently, associated with astrocyte differentiation, there was progressive development of a glial fibre network. It is suggested that the increase in glial fibres may be a significant factor in capillary stabilization, and in the inverse relationship between gestation of the infant and the risk of intracerebral haemorrhage. The possible structural significance of the tanycyte is also highlighted.

Astrocytes↗