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Biomedical subjects

T E James

Publications and source records attributed to T E James.

14 recordsLinked to original sources
PubMed2006

Outcomes and cost savings of free clinic care.

Healthcare costs and client health status were measured in a 10-month period before and after an index free clinic visit for 26 poor, working, uninsured patients. A significant number of patients reported overall improvement in their health. During the period of free clinic management, the equivalent of dollar 6500 of care was provided. Compared to utilization before the free clinic period, a savings of dollar 33,145 was realized, largely due to decreased emergency department care and hospitalization.

Adult↗
PubMed2001

Short-term mortality among middle-aged cataract surgery patients.

PURPOSE: To investigate the short-term mortality of middle-aged patients undergoing cataract surgery in the United Kingdom (UK), to compare this with the expected mortality for the UK population of similar age and to try to identify at-risk groups. METHODS: In a retrospective study, the 5-10 year mortality of all middle-aged patients undergoing cataract surgery between 1989 and 1993 was determined. Expected mortality was calculated from UK Interim Life Tables for 1991. Cox's regression analysis was performed using age, sex and self-assigned ethnic group as variables. RESULTS: From the 709 patients in the study group, there were 86 deaths. This is significantly greater than expected (p < 0.01). Ethnic minority status (hazard ratio = 1.72, confidence interval = 1.12-2.64) and male sex (HR = 1.68, CI = 1.08-2.63) were found to be significantly associated with early mortality (p < 0.05). CONCLUSIONS: This study suggests that, for some middle-aged patients, cataract is associated with a reduced life expectancy and may be a feature of premature ageing, reflecting systemic ill-health. Screening these and younger patients for systemic disease when they present with cataract provides the best opportunity to affect this increased mortality. The findings of this study are particularly relevant for patients from ethnic minority groups.

Adult↗
PubMed2001

Viral causes of the acute retinal necrosis syndrome.

Acute retinal necrosis has been described as a clinical entity for nearly 30 years. Acute retinal necrosis is a potentially visually devastating necrotizing vaso-occlusive retinitis affecting both healthy and immunocompromised patients. Acute retinal necrosis is caused by the herpes group of viruses, mainly varicella zoster, herpes simplex types 1 and 2, and, rarely, cytomegalovirus. Recently, polymerase chain reaction techniques have enabled detection of very small amounts of viral DNA from intra-ocular fluid samples. This can help in both the diagnosis of atypical cases of retinitis and uveitis and directing treatment in cases of acute retinal necrosis.

Antiviral Agents↗
PubMed1999

Behçet's disease: evaluation of a new instrument to measure clinical activity.

OBJECTIVE: Behçet's disease (BD) is a rare multisystem disorder characterized by vasculitis. At present, there are no laboratory markers that correlate well with the clinical activity in BD. This has led to the development of an instrument (BD Current Activity Form) to measure activity. Scoring is based on the history of new clinical features present over the preceding 4 weeks prior to assessment. Standardized questions were developed for all parts of the form. The face validity of the proforma was determined following worldwide collaboration with physicians and ophthalmologists managing patients with BD. The aim of this study was to evaluate the interobserver reliability of this form. METHODS: Nineteen patients fulfilling the International Study Group criteria for BD were randomly allocated, questioned and examined independently on the same day by five physicians experienced in BD. RESULTS: There was good agreement between the physicians' rating of oral [intraclass correlation coefficient (ICC) = 0.87] and genital (ICC = 0.95) ulceration, skin involvement (ICC = 0.62 for pustules and ICC = 0.66 for erythema nodosum), arthritis (ICC = 0.62), headache (ICC = 0.80), large vessel (kappa = 0.53), nervous system (kappa = 0.61) and eye involvement (kappa = 0.77). There was poor agreement for the question relating to the presence of bloody diarrhoea (ICC = 0.28). There was significant bias in the rating of fatigue by one of the physicians (F = 5.2, P = 0.001). CONCLUSION: Overall, this instrument has good interobserver reliability for assessing general disease activity. We therefore suggest that this proforma has a place in routine clinical monitoring of patients with BD, as well as assessing outcome in therapeutic trials.

Behcet Syndrome↗
PubMed1984

Genetic damage in CHO cells exposed to enzymically generated active oxygen species.

The genetic toxicity of active oxygen species produced during the enzymic oxidation of xanthine has been investigated using Chinese hamster ovary (CHO) cells. Incubation of cells with xanthine plus xanthine oxidase resulted in extensive chromosome breakage and sister-chromatid exchange and gave a small increase in frequency of thioguanine-resistant cells (HGPRT test). Inclusion of superoxide dismutase or catalase in the xanthine/xanthine oxidase system inhibited chromosome breakage, whereas only catalase prevented SCE and mutant induction. It is concluded that hydrogen peroxide is responsible for most of the genetic effects observed in CHO cells exposed to xanthine/xanthine oxidase but that superoxide plays a key role in chromosome breakage.

Animals↗
PubMed1977

Short term culture of human midterm and term placenta: parameters of hormonogenesis.

Monolayer cultures of human midterm and term placentae have been established following trypsin dispersion of placental minces. Maintenance of endocrine function was monitored by the concentrations of specific hormones in the culture media. At either gestational age the cultures 1) secret estradiol-17beta(1) and estrone (in a ratio of about 1:20) and aromatize 3H- or 14C-dehydroepiandrosterone sulfate and 14C-androstenedione, estrogen production being markedly enhanced by addition of dehydroepiandrosterone (10(-6)7) to the culture medium; 2) metabolize 3H-pregnenolone to progesterone and 14C-cortisol to cortisone; and 3) produce increasing amounts of chorionic gonadotropin and decreasing amounts of placental lactogen during the first week in culture. It is proposed that the model is highly suited to the study of factors affecting hormonogenesis by the human placenta whether they be of maternal or of fetal origin.

Chorionic Gonadotropin↗
PubMedDate not supplied

The effects of 4CMB, 4HMB and BC on SCE, chromosome aberration and point mutation in cultured Chinese hamster ovary cells.

Cultured Chinese hamster ovary cells (CHO-KI-BH4) were treated for 2 h with 4CMB, 4HMB and BC, in the absence of any exogenous metabolic activation system. The cells were subjected to tests for survival, sister-chromatid exchange, chromosome aberration and mutation to thioguanine resistance. 4HMB had no effect in any test at concentrations up to 100 microgram/ml. 4CMB was slightly more toxic than BC. Both 4CMB and BC induced SCE and chromosome aberrations, but the effects were more marked with BC. With 4CMB, SCE increased with dose only up to about 7 microgram/ml and then levelled off. A weak mutagenic effect was observed with both BC and 4CMB, but in each case, the response reached a peak and was not evident at higher doses.

Animals↗
PubMedDate not supplied

Genotoxicity studies of di(2-ethylhexyl)phthalate and its metabolites in CHO cells.

The widely used plasticizer di(2-ethylhexyl)phthalate (DEHP), its hydrolysis products mono(2-ethylhexyl)phthalate (MEHP) and 2-ethylhexanol, and also phthalic acid have been tested for clastogenic activity in cultured Chinese hamster ovary (CHO) cells. Only MEHP was found to cause chromosome damage. MEHP was without effect in the SCE and HGPRT mutation test in CHO cells. The clastogenicity of MEHP suggests a role for this compound in the observed carcinogenicity of DEHP and its positive effect in the dominant lethal assay.

Animals↗