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Biomedical subjects

Sue Brown

Publications and source records attributed to Sue Brown.

14 recordsLinked to original sources
PubMed2005

Angiotension-converting enzyme gene I/D polymorphism in patients with angina and normal coronary arteriograms.

A polymorphism of the human angiotensin-converting enzyme (ACE) gene has been identified in which the insertion (I) rather than the deletion (D) variant is associated with lower circulating and tissue ACE activity. ACE I allele is associated with resistance and endurance performance. Skeletal muscle metabolic efficiency is reduced in patients with heart failure and is improved by ACE inhibition. Profound muscle fatigue is a predominant and debilitating symptom in a proportion or patients with angina and normal coronary arteriograms (ANCA), and we postulated that the gene D allele might be associated with the presence of fatigue in ANCA patients. We studied 33 consecutive patients with typical ANCA who completed a validated fatigue questionnaire, and found an excess of the D allele frequency in patients with the highest fatigue scores compared to those with the lowest (64% vs. 36%; p=0.027).

Alleles↗
PubMed2004

Patients' experiences of medication for anxiety and depression: effects on working life.

BACKGROUND: and objectives. The prevalence of depression and anxiety has increased in recent years, leading to extensive use of medication. This study used a qualitative, in-depth approach to investigate patients' experiences of taking medication prescribed for these conditions. Sampling from a range of occupational sectors, the research explored the impact of medication on working life. METHODS: The research involved nine focus groups with sufferers of anxiety and depression to investigate the personal experiences of mental ill-health and the impact of psychotropic drugs. A further three focus groups were conducted with staff in human resources, personnel, occupational health, and health and safety departments, to explore the organizational perspectives on psychotropic medication in the workplace. Focus groups were held at Loughborough University and at workplace settings throughout the UK. Results were presented to an expert panel (comprising practitioners and researchers in health care and occupational health) to consider implications for practice. RESULTS: Physical symptoms associated with anxiety and depression included: nausea, headaches, dizziness, trembling, insomnia and lack of energy. Psychological symptoms involved: poor concentration, emotional distress and lack of motivation. Non-compliance was widespread due to side effects, lack of improvement in symptoms or because medication made patients feel worse. Patients did not feel well informed about their medication. People took less than the prescribed amount or stopped taking the medication. Concerns about dependency caused patients to cease medication prematurely. CONCLUSION: Patients felt ill informed about their medication and would have welcomed more information. Drawing on the results, the authors outline areas for improvement in the care of patients with anxiety and depression.

Adolescent↗
PubMed2003

C-reactive protein, clinical presentation, and ischemic activity in patients with chest pain and normal coronary angiograms.

OBJECTIVES: We sought to investigate the relationship among C-reactive protein (hs-CRP), clinical characteristics, exercise stress test responses, and ST-segment changes during daily life in patients with typical chest pain and normal coronary angiograms (CPNCA). BACKGROUND: Patients with CPNCA have coronary microvascular endothelial dysfunction and myocardial ischemia. Elevated hs-CRP levels have been related to atherogenesis and endothelial dysfunction. The relationship between hs-CRP and disease activity has not been previously investigated in CPNCA patients. METHODS: We studied 137 consecutive CPNCA patients (mean age, 57 +/- 9; 33 men). All completed standardized angina questionnaires, underwent exercise stress testing, 24-h ambulatory electrocardiogram (ECG) monitoring (Holter), and hs-CRP measurements at study entry. RESULTS: C-reactive protein levels (mg/l) were higher in patients with frequent (2.9 +/- 3.3) and prolonged (3.9 +/- 4.1) chest pain episodes, and in those with ST-segment depression on exercise testing (2.6 +/- 2.8) and Holter monitoring (3.4 +/- 3.1) compared with patients with occasional (1.3 +/- 1.2; p = 0.002) or shorter chest pain (1.5 +/- 1.3; p < 0.001) episodes, negative exercise stress testing (1.1 +/- 1.1; p < 0.001), and no ST-segment shifts on Holter monitoring (0.9 +/- 0.7; p < 0.001). Moreover, we found a correlation between hs-CRP concentration and number of ischemic episodes during Holter monitoring (r = 0.65; p < 0.001) and with the magnitude of ST-segment depression on exercise testing (r = -0.43; p < 0.001). The hs-CRP was the only independent variable (multivariate logistic regression) capable of predicting positive findings on Holter monitoring (odds ratio [OR], 3.8; confidence interval [CI], 2.3 to 6.2) and exercise testing (OR, 1.7; CI, 1.2 to 2.2). CONCLUSIONS: The hs-CRP correlates with symptoms and ECG markers of myocardial ischemia in CPNCA patients. Whether hs-CRP is related to the pathogenesis of angina in these patients deserves further investigation.

Adult↗
PubMed2003

A novel form of recessive limb girdle muscular dystrophy with mental retardation and abnormal expression of alpha-dystroglycan.

The limb girdle muscular dystrophies are a heterogeneous group of conditions characterized by proximal muscle weakness and disease onset ranging from infancy to adulthood. We report here eight patients from seven unrelated families affected by a novel and relatively mild form of autosomal recessive limb girdle muscular dystrophy (LGMD2) with onset in the first decade of life and characterized by severe mental retardation but normal brain imaging. Immunocytochemical studies revealed a significant selective reduction of alpha-dystroglycan expression in the muscle biopsies. Linkage analysis excluded known loci for both limb girdle muscular dystrophy and congenital muscular dystrophies in the consanguineous families. We consider that this represents a novel form of muscular dystrophy with associated brain involvement. The biochemical studies suggest that it may belong to the growing number of muscular dystrophies with abnormal expression of alpha-dystroglycan.

Adolescent↗
PubMed2003

Skeletal muscle involvement in infantile systemic hyalinosis.

Infantile Systemic Hyalinosis is a rare autosomal recessive entity, characterised by deposition of hyaline material in skin and bone, often complicated by visceral involvement. The characteristic features are marked delay in motor milestones attributed to severe progressive flexion contractures of proximal and distal joints, and skin and mucosal hypertrophy and thickening, followed by failure to thrive. Pain secondary to osteolytic lesions is also a predominant feature. We report a patient with Infantile Systemic Hyalinosis, confirmed by the clinical findings, who also displayed clear evidence of proximal muscle weakness. Muscle biopsy revealed myopathic changes, which have not been reported previously. We suggest that skeletal muscle is involved in Infantile Systemic Hyalinosis and contributes to the characteristic poor outcome of these patients.

Alleles↗
PubMed2002

Comparison between ventricular gradient and a new descriptor of the wavefront direction of ventricular activation and recovery.

BACKGROUND: Total R T cosine (TCRT) is a new descriptor of repolarization heterogeneity that quantifies the deviation between the directions of ventricular depolarization and repolarization. It revives the old concept of ventricular gradient (VG). HYPOTHESIS: Our goal was to examine whether TCRT and VG contain nonredundant information by comparing their reaction to autonomic tests, namely, postural changes and Valsalva maneuver. METHODS: Digital 12-lead electrocardiograms were recorded in 16 patients with cardiovascular syndrome X (SX, chest pain, exercise-induced ST-depression, normal coronary arteries, 3 men, age 60 +/- 9 years) and 40 healthy volunteers (31 men, age 33 +/- 7 years) during postural changes and Valsalva maneuver. The angle (VGA) [degrees] and magnitude (VGM) [ms.mV] of VG in reconstructed XYZ leads and TCRT (average cosine of the angles between the QRS and T vectors in mathematically reconstructed three-dimensional space) were calculated. RESULTS: (mean +/- standard of the mean): In healthy subjects, VGM and TCRT decreased, whereas VGA increased in the sitting and standing compared with supine position (TCRT: 0.61 +/- 0.05,0.47 +/- 0.06,0.29 +/- 0.08, supine, sitting, and standing, p < 0.05) and during phase II Valsalva (TCRT: 0.47 +/- 0.06 vs. 0.61 +/- 0.05, p < 0.01 in supine, 0.24 +/- 0.08 vs. 0.37 +/- 0.07, p < 0.01 in standing). In patients with SX, VGM decreased in the standing position, VGA did not change significantly, while TCRT decreased only in patients without T-wave abnormalities (n = 9) (TCRT in standing and supine: 0.55 +/- 0.09 vs. 0.68 +/- 0.08, p < 0.05). VG(M) increased during Valsalva in patients with SX. Total R T cosine correlated strongly with VGA (r = -0.84, p < 0.00001) and, unlike VGM, did not correlate with heart rate. CONCLUSIONS: Ventricular gradient and TCRT contain nonredundant information. In healthy subjects, they react sensitively to autonomic provocation. In patients with SX, their reaction is attenuated, which suggests disturbance of the autonomic control of repolarization.

Adult↗
PubMed2002

Muscle development genes: their relevance in neuromuscular disorders.

Myogenesis is a complex cascade of events that involves the specification and differentiation of muscle precursor cells or myoblasts, their fusion to form primary and secondary myotubes and subsequent maturation into muscle fibres. In addition, the development of axial muscle requires the migration of muscle precursor cells. These events are under strict genetic control. The contribution of individual genes to this process has been highlighted both by the phenotype of mice with targeted inactivation of individual myogenic regulatory factors and by rare human disorders in which the involvement of these genes has been demonstrated. The inactivation of known myogenic regulatory genes is associated with abnormal regulation of skeletal muscle differentiation and has an effect on regeneration but does not cause progressive muscle weakness or wasting. This review summarises recent developments in this field and will be of particular relevance to those interested in neuromuscular disorders. We also examine the possibility that some rare human conditions associated with abnormal muscle formation may be due to genetic defects in one of the myogenic regulatory genes.

Animals↗
PubMed2002

Systematic review of nursing management of urinary tract infections in the cognitively impaired elderly client in residential care: is there a hole in holistic care?

A systematic review of the current literature available exposed the deficit in nursing research as a resource for planning strategies and procedures in the care of a urinary tract infection. The cognitively impaired older client living in residential care is at particular risk because of their inability to articulate their problems, the subtle presentation of symptoms and the overuse of antibiotic therapy that has led to an increase in resistant organisms. The fiscal responsibility now required by health authorities highlights the need for a more enlightened approach to this distressing condition from those registered nurses in the front line of care.

Aged↗
PubMed2002

Early postnatal death and motor disorders in mice congenitally deficient in calnexin expression.

Calnexin is a ubiquitously expressed type I membrane protein which is exclusively localized in the endoplasmic reticulum (ER). In mammalian cells, calnexin functions as a chaperone molecule and plays a key role in glycoprotein folding and quality control within the ER by interacting with folding intermediates via their monoglucosylated glycans. In order to gain more insight into the physiological roles of calnexin, we have generated calnexin gene-deficient mice. Despite its profound involvement in protein folding, calnexin is not essential for mammalian-cell viability in vivo: calnexin gene knockout mice were carried to full term, although 50% died within 48 h and the majority of the remaining mice had to be sacrificed within 4 weeks, with only a very few mice surviving to 3 months. Calnexin gene-deficient mice were smaller than their littermates and showed very obvious motor disorders, associated with a dramatic loss of large myelinated nerve fibers. Thus, the critical contribution of calnexin to mammalian physiology is tissue specific.

Alleles↗
PubMedDate not supplied

The use and benefits of compression stocking aids.

An exploratory study was undertaken to trial various stocking aids designed for use with compression and antiembolic hosiery. Their features were identified and assessed by professionals for ease of use. Factors affecting the choice of stocking aids were the style and grade of stockings and the physical ability of users.

Bandages↗