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Biomedical subjects

W Bailey

Publications and source records attributed to W Bailey.

At least 37 records · Page 2Linked to original sources

Monozygotic twins discordant for the Russell-Silver syndrome.

Russell-Silver syndrome (RSS) is a pattern of malformation characterized by intrauterine and postnatal growth retardation, limb asymmetry, triangular face, and hypospadias. We report on a patient, from a triplet pregnancy, who was one of identical male twins discordant for RSS. R.B. was a 710-g male born at 33 weeks of gestation, with hypospadias, chordee, and undescended testes. He had a normal 46,XY karyotype and no renal abnormalities. Female triplet A weighed 1,843 g, and male triplet B weighed 1,920 g. Both had normal physical findings and neonatal period. R.B. was first seen by us at age 6 7/12 years with short stature, triangular and asymmetric face, lower limb length discrepancy, and surgically repaired genital anomalies. Growth hormone testing results were normal. At age 8 7/12 years the brothers appeared physically identical except for size, with a height differential of 114.25 vs. 121.5 cm. Testing to establish biological zygosity was performed using VNTR (variable number tandem repeat) DNA probes YNH24 (D2S44), CMM101 (D14S13), EFD52 (D17S26), TBQ7 (D10S28), and 3'HVR (D16S85), PCR loci MCT118 (D1S80), and HLA-DQ alpha. These data indicate a > 99.99% probability of triplets B and C being monozygotic twins. While most occurrences of RSS are sporadic, familial cases suggesting autosomal dominance have been reported. Three other cases of probable monozygotic twins with RSS have been described. The significance of this confirmation of discordance in determining the cause of RSS is discussed.

Abnormalities, Multiple↗

Rapid molecular cytogenetic analysis of X-chromosomal microdeletions: fluorescence in situ hybridization (FISH) for complex glycerol kinase deficiency.

Diagnosis of X-chromosomal microdeletions has relied upon the traditional methods of Southern blotting and DNA amplification, with carrier identification requiring time-consuming and unreliable dosage calculations. In this report, we describe rapid molecular cytogenetic identification of deleted DNA in affected males with the Xp21 contiguous gene syndrome (complex glycerol kinase deficiency, CGKD) and female carriers for this disorder. CGKD deletions involve the genes for glycerol kinase, Duchenne muscular dystrophy, and/or adrenal hypoplasia congenita. We report an improved method for diagnosis of deletions in individuals with CGKD and for identification of female carriers within their families, using fluorescence in situ hybridization (FISH) with a cosmid marker (cosmid 35) within the glycerol kinase gene. When used in combination with an Xq control probe, affected males demonstrate a single signal from the control probe, while female carriers demonstrate a normal chromosome with two signals, as well as a deleted chromosome with a single signal from the control probe. FISH analysis for CGKD provides the advantages of speed and accuracy for evaluation of submicroscopic X-chromosomal deletions, particularly in identification of female carriers. In addition to improving carrier evaluation, FISH will make prenatal diagnosis of CGKD more readily available.

Chromosome Mapping↗

Quality of care among Jamaican private physicians offering family planning services.

The National Family Planning Board is the agency of Government empowered to prepare, carry out and promote family planning programs in Jamaica. The Board has prioritized the expansion and sustainability of family planning services in large part through encouraging the participation of the private sector. To enhance the availability, acceptability and effectiveness of private physician family planning services, information was collected on the service practices of 90% of physicians, through face to face interviews. Bruce's framework was used to evaluate the findings of the study. The study indicated that: A wide variety of contraceptives are available - Basic equipment and adequate supplies are in place for the provision of services - Provider bias, inappropriate contraindicators and process and scheduling hurdles exist. The major recommendations relate to the: Revision of norms and guidelines for all contraceptives - Continuation of contraceptive technology updates for private physicians - Revision of legal/regulatory barriers which restrict access to some contraceptives for certain target groups.

Adolescent↗

The effect of user fees on the utilization of family planning services. A clinical study.

A new fee structure was introduced to the Advanced Training and Research in Fertility Management Unit in 1992. The study looked at the effect of the new fees on attendance and the choice of contraceptive methods through an examination of clinical records and a questionnaire survey. There was a decline in attendance of roughly 28 per cent between 1992 and 1993. The decline affected mainly new clients and those who accepted injectables. A reduction in the price of injectables is suggested since the fee for this short-term method is more in line with those charged for long-term and permanent methods.

Family Planning Services↗

Show, no show and sterilization.

The study investigates the factors involved in the decision of a sample of women to break appointments for sterilizations at the Fertility Management Unit of the University of the West Indies. A case control study involved 50 women who did not show up (no-shows) and an equal number who did show up (shows) over the same period. The no-shows had spent a shorter time in their current union than the shows, and some had no children for their partners at the time the appointments were made. Marriage was the single most important event that would encourage the no-shows to consider sterilization in the future. As long as poor women see child bearing as a precondition for financial assistance from spouses, they will hesitate to give up this capability.

Adult↗

Techniques to enhance extramyocardial collateral blood flow after a cardiomyoplasty.

OBJECTIVE: Chronic stimulation of a cardiomyoplasty was combined with low-dose infusion of heparin into the arterial supply of the cardiomyoplasty in order to determine if latissimus-derived collateral blood flow could be further enhanced. SUMMARY BACKGROUND DATA: Acute and chronic stimulation of a latissimus dorsi cardiomyoplasty increased extramyocardial collateral blood flow to 35 +/- 9% and 27 +/- 5%, respectively, of normal myocardial blood flow. METHODS: A model of coronary artery disease was created with an ameroid constrictor in goats, and a cardiomyoplasty was performed. Heparin (15 to 50 U/h) was delivered into the left subclavian artery for a period of 4 weeks. Simultaneously, the latissimus dorsi was chronically stimulated at 2 Hz. RESULTS: Chronic ischemic myocardium received a collateral flow per gram from the skeletal muscle equivalent to 11.8 +/- 5.2% of the blood flow to normal myocardium. The extramyocardial collateral flow correlated with the latissimus muscle flow (r = 0.72). CONCLUSIONS: Enhancement of extramyocardial collateral flow was not found with heparin treatment. In view of the correlation of extra-coronary collateral flow with latissimus muscle flow, the lack of a heparin effect may have been due to low latissimus blood flow. These results suggest that extramyocardial collateral blood flow to the myocardium is highest if the blood flow to the latissimus dorsi muscle is maintained.

Animals↗

Improving ambulatory oncology nursing practice. An innovative educational approach.

To meet the educational needs of ambulatory oncology nurses, an innovative and flexible program was created at a major cancer institute in Canada. Utilizing adult learning principles, standards of nursing practice, and departmental goals, the Clinical Nurse Specialists and Clinical Teachers creatively approached the need for extensive education. Five site specific educational workshops were provided to the nursing staff utilizing a self-directed learning style to capture the varied experiences, educational background, and motivations of the staff. This paper highlights the necessary program elements, implementation of, and evaluation of the educational program.

Ambulatory Care↗

Race, integration and family planning in Trinidad and Tobago.

"The study considered the effect of the integration of the health services on family planning in Trinidad and Tobago. A drop-out study was based on a sample of six clinics, three representing integrated and three clinics that were non-integrated or vertical. Efforts were also made to solicit the views of a sample of drop outs, current acceptors and health-care providers. The study found that there were characteristics of the population from which acceptors were drawn that were more important in explaining utilization than the question of integration or non-integration of the clinics. Many of the problems were organizational and could, with adequate financing, be met by an even higher level of integration."

Americas↗

Spotlight on free beds.

What happens in today's hospitals when keeping the faith with donors clashes with fiscal politics? An enterprising assistant attorney general asked that question and turned up some disquieting answers.

Charities↗

Prenatal diagnosis of a craniopharyngioma using ultrasonography and magnetic resonance imaging.

We report an infant with a craniopharyngioma which was detected in utero. Maternal uterine ultrasonography, done at 27 weeks because of polyhydramnios, revealed a 4 cm midline mass near the base of the fetal skull. At 31 weeks, magnetic resonance imaging of the maternal abdomen confirmed the presence of a mass in the region of the third ventricle and revealed hydrocephalus. Two days post-partum a computed tomography (CT)-guided needle biopsy of the mass was performed and recovered tissue which was histologically consistent with a craniopharyngioma. The infant's postnatal period was complicated by seizures, which were treated with phenobarbital, and by progressive hydrocephalus, necessitating placement of a ventriculo-peritoneal shunt. He also received therapy for central hypothyroidism and diabetes insipidus. The infant's parents refused permission for attempted resection of the tumour and he died at 8 weeks of age. This represents the second reported case of an antenatally detected craniopharyngioma. Four other cases of different intracranial tumours have been detected in utero using ultrasound, with no reported survivors past 3 days of age. There is a uniformly poor prognosis of such infants, but earlier diagnosis and intervention may change this result.

Craniopharyngioma↗

Primate evolution at the DNA level and a classification of hominoids.

The genetic distances among primate lineages estimated from orthologous noncoding nucleotide sequences of beta-type globin loci and their flanking and intergenic DNA agree closely with the distances (delta T50H values) estimated by cross hybridization of total genomic single-copy DNAs. These DNA distances and the maximum parsimony tree constructed for the nucleotide sequence orthologues depict a branching pattern of primate lineages that is essentially congruent with the picture from phylogenetic analyses of morphological characters. The molecular evidence, however, resolves ambiguities in the morphological picture and provides an objective view of the cladistic position of humans among the primates. The molecular data group humans with chimpanzees in subtribe Hominina, with gorillas in tribe Hominini, orangutans in subfamily Homininae, gibbons in family Hominidae, Old World monkeys in infraorder Catarrhini, New World monkeys in semisuborder Anthropoidea, tarsiers in suborder Haplorhini, and strepsirhines (lemuriforms and lorisiforms) in order Primates. A seeming incongruency between organismal and molecular levels of evolution, namely that morphological evolution appears to have speeded up in higher primates, especially in the lineage to humans, while molecular evolution has slowed down, may have the trivial explanation that relatively small genetic changes may sometimes result in marked phenotypic changes.

Animals↗

Spatial patterns of use of health services in the Kingston metropolitan area, Jamaica.

This study focuses on the influence of distance, transport and accessibility on the use of health services in Kingston, Jamaica. It reviews various factors affecting the use of health care with particular reference to Third World cities and presents results from a case study of utilization in the Kingston Metropolitan Area. Three pairs of sites of contrasting social status were selected and 50 respondents questioned in each about spatial patterns of primary health care (PHC) attendance. Types of facility attended, mode of transport, travel times, distance and frequency of utilization were discussed. Some distinctive differences appeared between low and high status site respondents with regard to distances to facilities and travel times, which were almost always higher for the low status respondents. Most respondents were not using their nearest facilities, for varying reasons which included, for poorer respondents, need to attend frequently distant public facilities and, for wealthier respondents, loyalty to old family doctors and use of company-related doctors. The mobility of the higher status respondents afforded them considerable choice of locations used for health care and their attendance was much more convenient than that of lower status respondents. Utilization rates were somewhat higher in the high status sites although not to the extent found by some earlier studies in similar settings.

Developing Countries↗