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Biomedical subjects

S Perry

Publications and source records attributed to S Perry.

At least 55 records · Page 3Linked to original sources
PubMed1997

Determinants of pain expression in hospitalized burn patients.

This study examines the relationship between extent of injury, degree and type of psychological distress and self-report of pain in burn survivors. One hundred eighty burn patients were interviewed within 2 weeks of their burn trauma. Using a visual analogue scale to assess subjective pain and pain relief, and self-report measures of post-traumatic stress symptoms and general psychological distress, we assessed the relationship between PTSD symptoms, general distress and pain. Subjective pain was unrelated to sex, ethnicity, or total body surface area burned. The most important correlate of subjective pain was general psychological distress. Intrusive PTSD symptoms had no independent power to predict the variance in pain scores. However, among women, more severe avoidant symptoms were associated with greater subjective pain.

Adaptation, Psychological↗
PubMed1997

Medical and surgical supply costs. Case study of a costly low-cost technology.

There is a paucity of research regarding the contribution of "low-cost" technologies to the escalation of medical costs in the United States. We examined total charges for medical and surgical supplies (MSS) among all hospitalized Medicare beneficiaries in 1994; a total of US $16.8 billion was spent on MSS, or $1,397 per hospitalization. For selected surgical procedures, both the proportion of total hospital charges attributed to MSS and the mean charge per hospitalization were considerably higher. Concerns regarding excessive payments for MSS and the lack of accountability by the Medicare program are discussed. Itemization of MSS supplies may serve to eliminate wasteful use and lead to decreased costs.

Cross-Sectional Studies↗
PubMed1997

The status of health technology assessment worldwide. Results of an international survey.

Health technology assessment (HTA) has increasingly become a valuable tool to examine effectiveness, quality of care, patient outcomes, and cost-effectiveness of health care technologies. In 1994 and 1995, a survey was conducted to document the scope of worldwide HTA activities; 103 organizations from 24 countries responded. This paper summarizes the results of this international survey, including a description of each country's program, types of technologies assessed, methodologies used, and dissemination approaches. Results for Canada, the United States, and European and other countries are presented separately.

Canada↗
PubMed1997

A history of ISTAHC. A personal perspective on its first 10 years. International Society of Technology Assessment in Health Care.

This reflection on the history of the International Society of Technology Assessment in Health Care is an effort to describe the creation of the Society and its first 10 years of activity. Without analyzing the forces that spurred the growth of technology assessment internationally or linking events, policies, and changes in the various countries, this essay focuses on the persons and events that surrounded the birth and growth of the Society in the past decade.

Global Health↗
PubMed1997

A three- to six-year follow-up of former long-stay residents of mental handicap hospitals in Northern Ireland.

OBJECTIVES: Little is known about the first cohorts of long-stay hospital residents with learning disabilities who moved to the community. This study describes the pattern of residential reprovision for all former long-stay residents discharged from the three mental handicap hospitals in Northern Ireland between 1987 and 1990 (N = 283) as well as describing aspects of quality of life for a smaller sample of people. METHOD: The study employs a retrospective survey design and the method and findings are discussed within a quality of life framework. Information about destinational outcomes between 1987 and 1993 was collected for each former resident. Several instruments were also used to assess material, emotional and social well-being and development and activity for a 40 per cent sample of people (114/283) discharged from hospital during 1987-1990 and followed up in 1993. RESULTS: Approximately 70 per cent of residents were discharged to, and subsequently remained in, highly supported settings such as residential and nursing homes. Only 3 per cent were discharged to 'independent living' with their own families or foster families. Few of the sample had 'major' problems with daily living skills and serious behavioural problems were uncommon. Former patients were also more satisfied with their new homes and reported feeling happier, healthier and more independent since discharge. However, social networks were poor and there was no evidence to suggest that people were undertaking new or 'ordinary' daytime activities. CONCLUSION: Although the material needs of former hospital residents (many of whom may have been 'cream skimmed' from the long-stay population) appeared to be met and they were content with their new homes in the community, they had a limited choice of mainly private sector accommodation and few opportunities for personal and social development.

Activities of Daily Living↗
PubMed1997

Extracellular carbonic anhydrase and an acid-base disequilibrium in the blood of the dogfish Squalus acanthias

The electrometric [Delta]pH method and an in vitro radioisotopic HCO3- dehydration assay were used to demonstrate the presence of true extracellular carbonic anhydrase (CA) activity in the blood of the Pacific spiny dogfish Squalus acanthias. An extracorporeal circulation and stopflow technique were then used to characterise the acid­base disequilibrium in the arterial (postbranchial) blood. During the stopflow period, arterial pH (pHa) decreased by 0.028±0.003 units (mean ± s.e.m., N=27), in contrast to the increase in pHa of 0.029±0.006 units (mean ± s.e.m., N=6) observed in seawater-acclimated rainbow trout Oncorhynchus mykiss under similar conditions. The negative disequilibrium in dogfish blood was abolished by the addition of bovine CA to the circulation, while inhibition by benzolamide of extracellular and gill membrane-bound CA activities reversed the direction of the acid­base disequilibrium such that pHa increased by 0.059±0.016 units (mean ± s.e.m., N=6) during the stopflow period. When the CA activity of red blood cells (rbcs) was additionally inhibited using acetazolamide, the magnitude of the negative disequilibrium was increased significantly to -0.045±0.007 units (mean ± s.e.m., N=6). Blockage of the rbc Cl-/HCO3- exchanger using 4,4'-diisothiocyanostilbene-2,2'-disulphonic acid (DIDS) also increased the magnitude of the negative disequilibrium, in this case to -0.089±0.008 units (mean ± s.e.m., N=6). Exposure of dogfish to hypercapnia had no effect on the disequilibrium, whereas the disequilibrium was significantly larger under hypoxic conditions, at -0.049±0.008 units (mean ± s.e.m., N=6). The results are interpreted within a framework in which the absence of a positive CO2 excretion disequilibrium in the arterial blood of the spiny dogfish is attributed to the membrane-bound and extracellular CA activities. The negative disequilibrium may arise from the continuation of Cl-/HCO3- exchange in the postbranchial blood and/or the hydration of CO2 added to the plasma postbranchially. Two possible sources of this CO2 are discussed; rbc CO2 production or the admixture of blood having 'low' and 'high' CO2 tensions, i.e. the mixing of postbranchial blood with blood which has bypassed the respiratory exchange surface.

Journal Article↗
PubMed1997

Epidermal tumors of rainbow smelt with associated virus.

Epithelial tumors of the skin occurred in landlocked populations of rainbow smelt (Osmerus mordax) in several lakes in New Hampshire (USA) during the spawning runs. Histologically, these were noninvasive epithelial cell lesions. Herpesvirus-like particles could be seen in the nucleus and cytoplasm. The lesions occurred in both males and females. Prevalence which varied annually, was as high as 30%.

Animals↗
PubMed1996

An unusual cause of hiccups.

A case of persistent hiccup associated with cavitating pulmonary tuberculosis is reported. Though tuberculosis presenting with hiccup is rare, tuberculosis is again on the increase and clinicians should remain alert to the possibility of this diagnosis.

Antitubercular Agents↗
PubMed1996

Control of catecholamine and serotonin release from the chromaffin tissue of the Atlantic hagfish

An in situ saline-perfused systemic heart/posterior cardinal vein preparation of the Atlantic hagfish (Myxine glutinosa) was used to assess (1) the ability of the chromaffin tissue to release catecholamines in response to adrenocorticotropic hormone (ACTH; 7.5 i.u. kg-1), serotonin (250 nmol kg-1), carbachol (100 µmol kg-1), [Asn1-Val5]angiotensin II (Ang II; 100 nmol kg-1), histamine (0.3­300 µmol l-1) and a high-[K+] saline (60 mmol l-1), (2) whether serotonin is co-released with the catecholamines of the chromaffin tissues, and (3) the potential modulatory effects of NECA, an adenosine receptor agonist, and DPSPX, an adenosine receptor antagonist, on catecholamine release. Bolus injections of ACTH, serotonin or carbachol, or perfusion with high-[K+] saline, all elicited the release of both adrenaline and noradrenaline. Pre-treatment with the serotonergic receptor antagonist methysergide or the cholinergic receptor antagonist hexamethonium abolished the serotonin- and carbachol-mediated catecholamine releases, respectively. Neither receptor antagonist affected the ACTH-mediated catecholamine release. Bolus injections of Ang II or perfusion with a range of histamine concentrations, two potent secretagogues in other vertebrates, did not elicit catecholamine secretion in hagfish. While injections of Ang II or perfusion with the high-[K+] saline both elicited the release of serotonin, treatments with ACTH, carbachol or histamine did not. Hence, co-release of catecholamines and serotonin was elicited by non-specific cell membrane depolarization using K+, but not by the specific secretagogues assessed in this study. The adenosine receptor agonist NECA and antagonist DPSPX significantly modified the secretory responses elicited by ACTH, serotonin and carbachol. The results suggest that adenosine may inhibit catecholamine release induced by serotonin or carbachol, while stimulating ACTH-induced release. Although the contribution of the different secretagogues identified in this study has yet to be explored in vivo, our results suggest that the control of catecholamine and serotonin release from the aneural chromaffin tissue of the Atlantic hagfish can be achieved through hormonal and/or paracrine means.

Journal Article↗
PubMed1996

The effects of repeated physical stress on the b-adrenergic response of the rainbow trout red blood cell

The effects of a 7-day period of daily physical stress (chasing until exhaustion) on the beta-adrenergic response of the rainbow trout (Oncorhynchus mykiss) red blood cell (rbc) were examined in vitro. Physical stress was associated with pronounced increases in the circulating levels of the catecholamine hormones (adrenaline and noradrenaline) measured on days 1, 3 and 7 of the stress regime. After 7 days, the numbers of high-affinity cell surface beta-adrenoceptors were reduced in the physically stressed fish when measured in vitro under conditions of normoxia (20 % reduction) or hypoxia (30 % reduction). Under hypoxic conditions, the binding affinity of the rbc beta-adrenoceptor was significantly higher in the stressed fish. Although the stressed fish had fewer beta-adrenoceptors, rbc adrenergic responsiveness was enhanced after 7 days of physical stress as determined from dose-response curves relating noradrenaline concentration to water and Na+ accumulation (indices of rbc adrenergic Na+/H+ exchange activity). The EC50 values (concentrations yielding half-maximal responses) for noradrenaline were lowered significantly by 1.7- to 3.9-fold in the blood from physically stressed fish. The enhanced adrenergic responsiveness of the rbcs appeared to be unrelated to changes in the initial steps of the beta-adrenergic signal transduction pathway leading to cyclic AMP production because physical stress was without effect on the magnitude or the dose-dependency of rbc cyclic AMP accumulation. To determine whether post-cyclic-AMP events were affected by physical stress, water and Na+ accumulation were measured in rbcs that had been incubated with the permeable cyclic AMP analogue 8-bromo cyclic AMP. The EC50 values for 8-bromo cyclic AMP were lowered by 1.6- to 1.7-fold in the blood from stressed fish. These experiments demonstrate that repeated physical stress significantly enhances the adrenergic responsiveness of the rainbow trout rbc, presumably by modifying the sensitivity of the Na+/H+ exchanger (or the steps immediately preceding exchanger activation) to cyclic AMP. The results are discussed with respect to the interrelationships between chronic and acute stress responses in fish.

Journal Article↗
PubMed1996

Consequences of catecholamine release on ventilation and blood oxygen transport during hypoxia and hypercapnia in an elasmobranch Squalus acanthias and a teleost Oncorhynchus mykiss

The marine dogfish (Squalus acanthias) and the seawater-adapted rainbow trout (Oncorhynchus mykiss) were exposed to acute environmental hypercapnia or hypoxia to evaluate (i) the dynamics of catecholamine release into the circulation and (ii) the impact of catecholamine release on gill ventilation and blood oxygen transport. This comparison was undertaken to test the hypothesis that the pattern and consequences of catecholamine release differ in the two species according to the presence or absence of a Root effect and a red blood cell (rbc) ss-adrenergic response. Hypercapnia and hypoxia elicited marked increases in plasma catecholamine levels in the trout but not in the dogfish. In the trout, catecholamine release occurred abruptly during hypoxia when arterial PO2 (PaO2) decreased below 2.7 kPa. In the dogfish, plasma catecholamine levels remained stable during hypoxia even when PaO2 fell below 2.0 kPa. Trout and dogfish displayed pronounced hyperventilatory responses during both hypercapnia and hypoxia. In trout, the hyperventilatory response consisted of an increase in ventilation amplitude (estimated by opercular cavity pressure changes) with no change in ventilation frequency (fv), whereas in the dogfish, both amplitude (estimated by spiracular cavity pressure changes) and fv increased significantly. The use of an extracorporeal circulation and frequent blood sampling demonstrated that plasma catecholamine levels and ventilation amplitude were not correlated during hypoxia in either species. During hypercapnia in trout, the bolus injection of a catecholamine cocktail (final nominal circulating levels 200 nmol l-1 adrenaline, 50 nmol l-1 noradrenaline) caused a rapid (within 2 min) 33 % reduction in ventilation amplitude that persisted for 3 min; fv was unaffected. This hypoventilatory response occurred concurrently with activation of rbc Na+/H+ exchange and an increase in arterial blood O2 content (CaO2) and O2 specifically bound to haemoglobin (O2/Hb). During hypoxia in trout, a similar injection of catecholamines activated rbc Na+/H+ exchange and increased O2/Hb yet was without effect on ventilation amplitude or fv. In dogfish during hypercapnia or hypoxia, injection of a catecholamine cocktail (final nominal circulating levels 125 nmol l-1 adrenaline, 125 nmol l-1 noradrenaline) caused slight but significant reductions in fv (3-4 min-1) without affecting ventilation amplitude. Catecholamine injections did not affect blood oxygen transport in dogfish. The results demonstrate significant differences in the nature of catecholamine release in dogfish and trout that may reflect, in part, the absence of a Root effect and rbc adrenergic Na+/H+ exchange in the elasmobranch. The present data do not support the hypothesis that circulating catecholamines play a major role in controlling breathing during hypoxia or hypercapnia.

Journal Article↗
PubMed1996

A survey of injuries among Broadway performers.

To obtain more information about injuries of Broadway performers, 313 performers appearing in 23 Broadway companies were surveyed. The percentage of performers injured was 55.5%, with a mean of 1.08 injuries performer. Lower extremity injuries were the most common. Sixty-two percent of performers believed that their injuries were preventable. As this study reports factors that significantly increase the risk of injury for dancers and actors, it may help to heighten concern with reducing the incidence of injuries to professional performers, theatrical students, and nonprofessionals worldwide.

Accidents, Occupational↗
PubMed1995

Molecular cloning and expression of a cDNA for human kidney cysteine conjugate beta-lyase.

Kidney cysteine conjugate beta-lyase (glutamine transaminase K, kyneurenine aminotransferase, EC 2.6.1.64) metabolises the cysteine conjugates of certain halogenated alkenes and alkanes to form reactive metabolites which can produce nephrotoxicity and neurotoxicity in experimental animals and man. Using a combination of hybridisation screening and PCR techniques we have isolated a full-length cDNA for human kidney cysteine conjugate beta-lyase. Comparison of the deduced amino acid sequence with that of the rat enzyme indicated an 82% overall similarity, with 90% similarity around the pyridoxal phosphate binding site, many of the changes being conservative in nature. Expression of the cDNA in Cos-1 cells resulted in the production of a cytosolic enzyme which showed both cysteine conjugate beta-lyase and glutamine transminase K activity. Preliminary mapping of the gene for human cysteine conjugate beta-lyase by PCR analysis of genomic DNA from human-rodent hybrid cells indicated that it is located on human chromosome 9.

Amino Acid Sequence↗
PubMed1995

Does physical improvement reduce depressive symptoms in HIV-infected medical inpatients?

The Beck Depression Inventory, Karnofsky Scale of Physical Performance, and a visual-analogue scale to assess subjective distress were administered to 32 HIV-infected medical inpatients shortly after admission and prior to discharge. Twenty-eight percent of subjects had severe depressive symptoms on admission. Most of these subjects remained in the severe range of depressive symptoms at discharge, despite physical improvement comparable to subjects with lower levels of depressive symptoms. In contrast, subjects with moderate depressive symptoms on admission showed a significant decrease in depressive symptoms at discharge. The results suggest that the etiology and management of depressive symptoms in HIV-infected medical inpatients may differ depending on the initial severity of depressive symptoms.

Activities of Daily Living↗
PubMed1995

Inhaled nitric oxide and hemodynamic evaluation of patients with pulmonary hypertension before transplantation.

OBJECTIVES: We investigated the effect of inhaled nitric oxide and infused acetylcholine in patients with pulmonary hypertension undergoing cardiac catheterization before cardiopulmonary transplantation. BACKGROUND: The fate of patients under consideration for transplantation of the heart or lungs, or both, is influenced by the evaluation of their pulmonary vascular reactivity. METHODS: We evaluated 11 patients who were classified into two groups on the basis of mean left atrial pressure > 15 mm Hg (group I, n = 6) or < or = 15 mm Hg (group II, n = 5). All patients inhaled nitric oxide at 80 ppm. This was preceded by an infusion of 10(-6) mol/liter of acetylcholine in seven consecutive patients (n = 3 in group I, n = 4 in group II). RESULTS: In group I, inhaled nitric oxide decreased pulmonary artery pressure from (mean +/- SE) 71 +/- 13 to 59 +/- 10 mm Hg (p < 0.05), pulmonary vascular resistance from 14.9 +/- 3.8 to 7.6 +/- 1.7 Um2 (p < 0.05) and intrapulmonary shunt fraction from 17.8 +/- 3.6% to 12.7 +/- 2.1% (p < 0.05). Left atrial pressure tended to increase from 27 +/- 4 to 32 +/- 5 mm Hg (p = 0.07). In group II pulmonary vascular resistance decreased in response to nitric oxide from 36.4 +/- 9.0 to 31.1 +/- 7.9 Um2 (p < 0.05). Cardiac index, systemic pressure and resistance did not change in either group. Seven patients who received acetylcholine had no significant alteration in pulmonary hemodynamic variables. CONCLUSIONS: These preliminary observations suggest that nitric oxide is a potent pulmonary vasodilator with minimal systemic effects. It may be useful in discriminating patients needing combined heart and lung transplantation from those requiring exchange of the heart alone.

Acetylcholine↗
PubMed1995

Helicobacter pylori induced interleukin-8 expression in gastric epithelial cells is associated with CagA positive phenotype.

AIMS: To use a range of natural phenotypically variant strains of Helicobacter pylori with disparate CagA and VacA (vacuolating cytotoxin) expression to determine which bacterial factors are more closely associated with epithelial interleukin-8 (IL-8) induction. METHODS: Gastric epithelial cells (AGS and KATO-3) were co-cultured with five H pylori strains which were variously shown to express the cagA gene/CagA protein, VacA and/or to exhibit biological cytotoxicity. Secreted IL-8 was assayed by enzyme leaked immunosorbent assay (ELISA) and IL-8 messenger RNA (mRNA) was assayed using a reverse transcription polymerase chain reaction based technique (RT-PCR). RESULTS: Strains expressing CagA, including a variant strain (D931) which is non-cytotoxic and does not express the VacA protein, were found to upregulate epithelial IL-8 secretion and gene expression. In contrast, strains with no CagA expression, even in the presence of VacA and/or biological cytotoxicity, (G104, BA142), failed to induce IL-8 protein or mRNA above control values. CONCLUSIONS: These results strongly support a role for H pylori CagA or coexpressed factors other than the cytotoxin in upregulation of gastric epithelial IL-8. Increased epithelial IL-8 secretion and concomitant neutrophil chemotaxis and activation in addition to direct cytotoxicity may be an important factor in tissue damage and ulceration.

Animals↗