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Biomedical subjects

S Winn

Publications and source records attributed to S Winn.

At least 37 records · Page 2Linked to original sources
PubMed1998

Helicobacter pylori and plasma ammonia levels in cirrhotics: role of urease inhibition by acetohydroxamic acid.

BACKGROUND AND AIMS: The role of Helicobacter pylori as a cause of hyperammonaemia in cirrhotics has still not been fully clarified. This study was aimed at evaluating the effect of acute Helicobacter pylori urease inhibition by oral acetohydroxamic acid administration on blood ammonia levels in cirrhotic patients. METHODS: Twenty-nine cirrhotics (14 males, 15 females; mean age: 63 years; Child-Pugh class: 14 A, 9 B, and 6 C) undergoing upper gastrointestinal endoscopy were enrolled in the study. The presence of Helicobacter pylori infection was assessed by rapid urease test and histology. A semi-quantitative grading of bacterial density was also performed at histology. All patients received oral acetohydroxamic acid 750 mg, and blood samples for assessment of ammonia levels were taken before and at 15, 30, 60 and 90 minutes after administration. RESULTS: Helicobacter pylori infection was detected in 20 patients, while 9 patients were uninfected. Acetohydroxamic acid administration led to a significant reduction in blood ammonia levels at 15 and 30 minutes (mean +/- SD, 113 +/- 44 vs 101 +/- 43 and 93 +/- 38 micrograms/dl, respectively; p = 0.002) only in patients with Helicobacter pylori infection. Moreover, the reduction was statistically significant only in Child-Pugh B/C class patients and in those with moderate/marked Helicobacter pylori density in gastric mucosa. Basal ammonia levels did not differ between Helicobacter pylori positive and negative patients, nor in patients with mild and moderate/marked Helicobacter pylori density in gastric mucosa, while Child-Pugh class B/C cirrhotics had higher basal ammonia levels than class A cirrhotics, in both Helicobacter pylori positive and negative groups. CONCLUSIONS: Our data showed that Helicobacter pylori urease inhibition by acetohydroxamic acid administration significantly reduces blood ammonia levels in patients with more advanced liver cirrhosis and in those with a high bacterial density in gastric mucosa.

Aged↗
PubMed1994

Recent progress in immunoisolated cell therapy.

Biohybrid implants represent a new class of medical device in which living cells, supported in a hydrogel matrix, and surrounded by a semipermiable membrane, produce and deliver therapeutic reagents to specific sites within a host. First proposed in the mid-1970s for diabetes, this treatment modality has progressed rapidly in the past four years and is now being investigated not just for endocrine disorders but also for alleviation of chronic pain, treatment of neurodegenerative disorders, and delivery of neurotrophic factors to sites within the blood brain barrier, and as a practical alternative to conventional ex vivo.

Alzheimer Disease↗
PubMed1993

The effects of antidepressants on the thyroid axis in depression.

Thirty-nine patients with major depression were studied to determine the differential effects of desipramine (DMI) and fluoxetine (FLU) on thyroid hormones. Twenty-six percent showed some abnormality in baseline thyroid hormone levels. There were no demonstrable differences for any of the thyroid indices from baseline to the 3- or 6-week samples for the total group or for either drug by repeated measures analysis of variance. There was a significant group by time interaction for total thyroxine (TT4) between the drug treatment groups, which was caused by a small but significant increase in TT4 in the DMI sample. Correlations were performed between the change in hormones over the 6 week period and treatment response. There was a significant association between a decline in triiodothyronine (T3) levels and response to FLU but not DMI. The implications of these findings for the pathophysiology of depression and antidepressant drug mechanisms are discussed.

Ambulatory Care↗
PubMed1993

Somatostatin analogue phase I trials in neuroendocrine neoplasms.

To further investigate the antineoplastic efficacy and safety of somatostatin analogues, 2 trials were performed. Octreotide, SMS 201-995 (Sandostatin), was escalated in doses ranging from 1,500 micrograms to 6,000 micrograms daily in 14 patients with carcinoid. Somatuline, (BIM 23014C, Angiopeptin, Lanreotide) was given in doses ranging from 2,250 micrograms to 9,000 micrograms daily to 13 neuroendocrine patients (6 carcinoid, 2 atypical carcinoid, 3 pancreatic islet cell and 2 small cell lung cancer patients). All patients successfully completed dose escalations without significant adverse effects and were evaluable for toxicity. The dose limiting side-effect of octreotide was the injection volume. No dose limiting adverse effects have been observed with somatuline. Carcinoid syndrome symptoms were better controlled with higher octreotide doses. Thirteen patients were evaluable for octreotide's antitumor efficacy with a partial response observed in 4 (31%), stable disease in 2 and progressive disease in 7 patients. Radiographic changes of increased tumor necrosis occurred in 5 patients and was independent of response. Somatuline resulted in a partial response in 4 patients (2 carcinoids, 1 gastrinoma and 1 small cell lung cancer) (31%), stable disease in 1 atypical carcinoid, and progressive disease in 8 (4 carcinoid, 1 atypical carcinoid, 2 islet cell and 1 multi-drug resistant small cell lung cancer). Six of the 8 carcinoid patients had radiographic changes of increased necrosis. Dose escalation of somatostatin analogues is well tolerated and may be associated with antitumor activity in some neuroendocrine neoplasms.

Adult↗
PubMed1992

HIV in the U.K.: problems of prevalence, sociological response and health education.

It is argued that the prevalence of AIDS is substantially under-represented in existing national AIDS data. Thus although official statistics demonstrate significant recent shifts in transmission routes for HIV, health educators are faced with a problem because it is difficult to develop preventive strategies against a syndrome whose prevalence can only be estimated. Problems of the true extent of the prevalence of HIV are compounded when there is a lack of knowledge about the specifics of heterosexual behaviour. It is unwise to assume that the protective strategies developed by gay men in the face of HIV are routinely available for adoption by heterosexuals, who are characterised by social divisions of age, gender and relative amounts of social power. These concerns represent a problem for health educators. To date, sociological work may not have made the most effective contribution in its support of intervention strategies against HIV/AIDS. Examination of the empirical literature on lay concepts of health and illness reveals a pessimistic stance on the part of some researchers about the ability of individuals to modify behaviour. More positive readings of their own data are possible. The traditional concerns to emphasise the socio-economic determinants of health and behaviour, now also shared by some health educators, should not obscure a concern for the fate of individuals. The most effective contribution that health promotion may be able to make to the control of HIV in the heterosexual population is to assist in the development of strategies of empowerment and 'horizontal intervention'.

Adult↗
PubMed1991

What people want to know about health.

Brighton health authority and Brighton borough council are jointly planning a 'Healthy living centre' to provide a focal point for local health promotion activities. Sandra Winn and Martin Bradford report on a survey of community groups which not only provided information for the development of the centre but also gave useful insight into the community's concerns about health and people's needs for health information.

Adolescent↗
PubMed1988

The changing pattern of calls to an AIDS advice line.

An analysis of the number of and type of calls received by an AIDS advice line over a seven month period is presented. Variations in the number of calls received and differences in the types of questions asked by different sections of the population are examined. The results indicate that the number of calls received is strongly related to television publicity, and that different age and sex groups ask different questions about AIDS. There are also differences in the types of questions asked by homosexual and heterosexual callers. The results of the analysis have important implications for health education about AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Graded dose effects of angiotensin II on aldosterone production in man during various levels of potassium intake.

This study was performed to evaluate the hypothesis that adrenal aldosterone output is modulated by daily potassium intake in man. Eight normotensive subjects, aged 24-38 yr, were fed 3 separate 150 mEq sodium-containing diets. Potassium content ranged from 300 mEq daily during the first week, to 80 mEq daily and 10 mEq daily for the subsequent 2 wk. On days 4 and 5 of each diet each subject took oral dexamethasone 0.5 mg B.I.D. to prevent endogenous ACTH secretion. On day 6 an infusion of angiotension II (AII) was administered in doses of 0.1, 0.3, 1.0, 3.0 and 10.0 ng/kg/min, each lasting 30 min. Blood pressure, pulse, and plasma aldosterone and potassium were measured throughout the infusions. All at infusion rates of 3 and 10 ng/kg/min, produced significant increases in plasma aldosterone values during liberal potassium intake but not when potassium intake was 10 mEq/day. We conclude that dietary potassium in man modulates All-mediated aldosterone secretion.

Adult↗
PubMed1975

Assessment of cost related characteristics and conditions of long-term care patients.

The present federal policy that requires a cost differential to be imposed between intermediate and skilled care residents/patients is based on a number of unproven assumptions that need to be tested. Are there groupings of cost related characteristics and conditions that allow appropriate distinctions between intermediate and skilled nursing care? If so, is the difference in the cost of care greater than the cost of collecting the data? Do the intangible costs exceed the benefits, especially if forced transfer of residents/patients is involved? If groupings do exist, will facilities reimbursed for high-cost patients be encouraged to maintain them in a state of dependence? Further, can the decisions be made reliably, even in communities where a spectrum of alternative resources is not available? Are there political reasons why objective decisions would not be acceptable to state administrators trying to balance their budgets? At the least, it appears that further research is needed in all of these areas. Before the results are in, perhaps a careful, judicious interpretation of the law is needed in order to positively affect the quality of life available to the persons consuming nursing home services.

Costs and Cost Analysis↗