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Biomedical subjects

A Avery

Publications and source records attributed to A Avery.

32 records · Page 2Linked to original sources
PubMed1996

Emergency medicine journal clubs.

OBJECTIVE: To ascertain the status of journal club within emergency medicine (EM) residency programs and to describe 3 currently used formats. METHODS: The directors of U.S. Residency Review Committee for Emergency Medicine (RRC-EM)-approved residency programs were surveyed to determine the features of their programs' journal clubs. Responses to 3 questions assessing the degree of satisfaction (5-item scales from very good to very poor) with the "current format," "resident participation," and "faculty participation" from the survey were grouped according to the program director's impressions of resident and faculty "enjoyment" (2 3-item scales) and whether the journal club is a "success" (3-item scale) to develop an overall satisfaction index. Three journal club formats currently in use at EM residencies are described in detail. RESULTS: Of the 101 directors surveyed, 91 (90%) responded. The respondents' overall satisfaction index was highest when the journal club was held in the evening (p < 0.008) or at a faculty member's home (p < 0.0004). The format of the journal club (e.g., by topic, with a statistical focus, with a research design, focus, or as a clinical practice update) was not associated with the overall satisfaction index. CONCLUSION: Journal clubs associated with EM residencies vary in format and perceived success. The 3 representative journal clubs illustrate different format options.

Cross-Sectional Studies↗
PubMed1993

TGF-beta expression in the human colon: differential immunostaining along crypt epithelium.

Samples of colorectal carcinoma, adenoma and normal colorectal mucosa were examined for the expression of TGF-beta by immunohistochemistry. Immunoreactivity for TGF-beta was present in 52 out of a total of 58 samples of normal mucosa examined. In adenomas and carcinomas TGF-beta expression was observed in eight out of ten and 46 out of 48 samples respectively and was largely restricted to epithelial cells. In normal mucosa differential expression of TGF-beta was present within epithelial cells, those in the upper parts of the crypts showing enhanced immunoreactivity compared to cells in the proliferative compartment. This pattern of differential staining is consistent with TGF-beta having an important role in the control of growth and differentiation in colonic mucosa.

Adenoma↗
PubMed1993

Bronchus associated lymphoid tissue (BALT) in human lung: its distribution in smokers and non-smokers.

BACKGROUND: Bronchus associated lymphoid tissue (BALT) is a normal component of the lung's immune system in many animals and may be analogous to gut associated lymphoid tissue (GALT). This study aimed at assessing the nature and extent of BALT in human lung and determining whether its expression is induced within the human airway in response to smoking. METHODS: Paraffin embedded, formalin fixed full thickness bronchial wall sections were examined from 31 whole lung specimens derived from both smokers and non-smokers. Samples were taken from throughout the bronchial tree to include main stem bronchi, lobar bronchi and segmental bronchi, as well as first to third generation carinae. Standard 4 microns step sections were stained by haematoxylin and eosin and immunocytochemical methods to show foci of BALT. RESULTS: Examination of 256 airway sites detected 46 foci of BALT. These differed from those described in other mammals in being distributed throughout the bronchial tree, in being found in relation to bronchial glandular epithelium as well as luminal bronchial epithelium, and in lacking any accompanying M cells. Analysis by smoking status showed that the expression of BALT was significantly more common in smokers than non-smokers (82% (14/17) v 14% (2/14) respectively). CONCLUSIONS: The findings support the view that BALT in humans is an integral feature in a comparatively small proportion of lungs from non-smokers while being significantly more prominent in lungs from smokers. The tissue shows several important differences from that described in other mammals.

Adolescent↗
PubMed1987

Immersion suit insulation: the effect of dampening on survival estimates.

Immersion suit leakage values were obtained from realistic testing of helicopter passenger immersion suits using eight subjects. Simulated helicopter underwater escape resulted in mean leakages of 198 +/- 103, 283 +/- 127, 203 +/- 179, and 45.7 +/- 31.6 g (mean +/- S.D.) when wearing four different immersion suits. Suit leakages obtained from a 20-min swim test to simulate vital in-water survival actions produced leakages of 213 +/- 224, 1398 +/- 691, 145 +/- 96.5, and 177 +/- 139 g (mean +/- S.D.). Dampening of undergarments during simulated helicopter travel at an elevated cabin temperature of 30 degrees C was 115 +/- 47.3 (mean +/- S.D.; n = 4) when wearing an impermeable suit and 19 +/- 16.7 g (mean +/- S.D.; n = 4) when wearing a vapour-permeable suit. The commensurate loss of insulation with the impermeable suit at the upper level of temperature could reduce clothing insulation by 17%. A reduction of less than 5% may result under similar conditions when wearing the permeable suit. The combined dampening effect of sweating, helicopter underwater escape, and performance of vital survival actions could result in a total dampening of 247-1712 g, depending on the type of suit worn. The respective loss of insulation would be 15% and 50% respectively. This could reduce, for the 10th percentile thin man, his survival time in water at 5 degrees C from 3.5 h to between 2.4 h and 1.1 h, respectively.

Adult↗
PubMed1985

Aneurysms of the abdominal aorta. Incidence in blacks and whites in North Carolina.

We examined race and sex relative to the unexpected finding of an abdominal aortic aneurysm (AAA) at 1,665 autopsies plus 545 abdominal computed tomographic scans in subjects over the age of 50 years. We compared our demographic data with those of North Carolina and our hospital to determine if the data base was representative. White males had a higher incidence (4.2%) of AAA than any other group of race and sex (1.2% to 1.6%) or combination of groups. Although whites (2.9%) had a higher incidence than blacks (1.5%) and males (3.4%) had a higher incidence than females (1.3%), this can be attributed to the influence of the white male. The demographic data of the group studied were similar to those of our institution's admissions and to the North Carolina population. We conclude that (1) there is an increased incidence of AAA in the white male compared with the white female, black male, and black female in North Carolina; (2) there is no difference in the incidence of AAA in the white female, black male, and black female; (3) race alone may not influence the incidence of AAA as there was no difference between white and black females.

Age Factors↗
PubMed1985

Myofibroblasts in filtration operations.

Myofibroblast cells, involved with collagen production, bridge incisional sites after two filtration operations. These spindle-shaped cells appeared as early as the seventh postoperative day and progressively developed through day 14. Later reparative stages were characterized by collagen production, though myofibroblast were strikingly absent after day 14. These histopathologic data obtained from healthy cats suggest that contraction of wound sites in early post-operative period may be causative in cicatrization failures of standard filtration procedures.

Animals↗
PubMed1984

Evaluation of a home based health record booklet.

Despite the widespread use of home based child health records of varying complexity in England, there is a notable absence of their evaluation. Such a record booklet developed in the West Lambeth Health Authority has been used by parents, doctors, and community nurses to build up an independent chronological record of a child's birth statistics, health, growth, immunisation, development checks, and contacts with health services. A randomised controlled evaluation of the record, analyses of entries in it, and a survey of the views of mothers and health professionals using the record have been carried out. The need for such a record was confirmed by those questioned and analyses of entries in the booklet helped to modify and improve it. The evaluation was unable to show, however, any effect of the record on immunisation and developmental assessment service uptake. Its value in improving communication between the numerous health and other care agencies was dependent on its proper use.

Body Weight↗
PubMed1982

Ethnic differences in perinatal mortality--a challenge.

The perinatal mortality rates of mothers who delivered at St. Thomas's Hospital from 1969 to 1976 have been examined. The rate in the West Indian population was significant higher than in the United Kingdom white population. The increased West Indian mortality was confined to infants with a birth weight of more than 2.0 kg and a gestational age of more than 37 weeks. The relative risk of perinatal death for West Indian mothers compared with UK white mothers was 1.4 at birth weights of 2.5 kg to 2.9 kg, rising to 4.3 at 4.0 + kg. West Indian perinatal mortality in term babies of normal birth weight was higher in all maternal age and parity groups except parity 3, but the difference was greatest in women aged 30 or over. The African perinatal mortality rate was not significantly greater than the UK white rate although it followed the West Indian trends. Pre-eclampsia and forceps delivery were associated with a greatly increased perinatal mortality in West Indian babies. The excess West Indian mortality could not be explained completely by differences in the proportions of stillbirths and early neonatal deaths nor by the distribution of births by parity, maternal age, or social class. Possible explanations for the differences in mortality are discussed.

Birth Weight↗
PubMed1981

Prognosis in giant-cell arteritis.

In a study to assess the natural history of giant-cell arteritis, 90 patients with proved disease were followed up from the time of diagnosis. Early mortality was low and most commonly due to vertebral arteritis, but cerebral infarction did not appear to be a late complication. High maintenance dose steroids and visual loss were associated significantly with a shortened life span (p=0.0003 and p=0.0024). One-third of the patients developed chronic relapsing disease, but serious late complications were not encountered. After the initial attack has been controlled steroid dosage should be reduced to the minimum needed to alleviate symptoms.

Adrenal Cortex Hormones↗
PubMed1980

Respiratory failure revisited: acute exacerbations of chronic bronchitis between 1961-68 and 1970-76.

Factors determining survival have been analysed retrospectively in 157 admissions of 135 patients with an acute exacerbation of chronic bronchitis and emphysema causing hypoxaemia and carbon dioxide retention. All were treated with controlled oxygen therapy. The death-rate increased with the age of the patient, but was not correlated with the age of the patient, but was not correlated with the severity of hypoxaemia on admission, when the patient was breathing air. The death-rate was significantly higher in those patients in whom arterial [H+] rose above 55 nmol/1 (pH = 7.26) during controlled oxygen therapy. The absence of a rise in the arterial PCO2 during controlled oxygen therapy was not necessarily indicative of a good prognosis, since 5 out of 18 patients showing this response subsequently died in that admission. Only 28% of the 111 patients who left hospital alive survived for five years.

Acidosis, Respiratory↗
PubMed1979

The influence of obstetric procedures and social and cultural factors on breast-feeding rates at discharge from hospital.

The influence of obstetric factors on breast-feeding rates at discharge from St. Thomas's Hospital in 1969 and 1970 has been examined in 1356 primiparous mothers delivering healthy babies. Induction of labour and assisted delivery were significantly associated with lower breast-feeding rates. The association could not be explained by differences in social class, country of origin, birthweight, anaesthesia in labour, or medical reasons for induction and assisted delivery. The most likely explanation is that induction and assisted delivery are associated with delay in starting breast-feeding. However, trends in obstetric management of labour and delivery are unlikely to have a large influence on the incidence of breast-feeding compared with the influence of social and cultural factors.

Anesthesia, Obstetrical↗