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Biomedical subjects

A Day

Publications and source records attributed to A Day.

At least 109 records · Page 6Linked to original sources

Knowledge and attitudes of health care staff about HIV infection in a health district with low HIV prevalence.

The level of awareness of HIV related problems and their implications for health workers were investigated in Oxford, where the problem of HIV infection has not reached the levels of other metropolitan areas. Four hundred nurses and doctors in Oxford were surveyed to ascertain their knowledge about HIV infection, their attitudes to care of HIV patients, and to examine the relationship between knowledge and attitudes. The response rate was 64%. Professional groups differed in their knowledge and attitudes, and staff lacked some basic information about HIV transmission and safety relevant to hospital care. Accurate knowledge about HIV infection and positive attitudes to the care of HIV patients were highly correlated. However, anxiety about HIV infection, which could interfere with the optimum care of patients, affected one quarter of staff surveyed. Implications for staff training are discussed.

Attitude of Health Personnel↗

Recovery from anaesthesia in children.

There are no published comprehensive surveys of paediatric recovery room experience and the incidence of complications. A prospective survey was made of 16,700 consecutive admissions to the recovery room at the Royal Manchester Children's Hospital during the years 1985-1988. The incidence of respiratory complications was low, with laryngospasm 0.85%. The incidence of hypotension was higher than that in adult studies; over 50% of children recorded a decrease in blood pressure in the recovery room of more than 20%, compared to values before operation. The incidence of vomiting in the recovery room was also lower than in comparable adult studies. Certain aspects of recovery room practice changed during the 4 years of the study; these included routine oxygen administration, parents in the recovery room, and our approach to postoperative analgesia. The implications of these changes are discussed.

Anesthesia Recovery Period↗

The group-specific protein marker: a possible indicator of syphilis, not human immunodeficiency virus infection.

We wished to compare the frequency of group-specific (Gc) phenotypes in the general population with that in people with human immunodeficiency virus (HIV) infection to find out whether the Gc protein is a marker for susceptibility to HIV infection. We determined the phenotype frequency in 1083 randomly selected serum samples obtained from the Canadian Influenza Survey Studies and compared it with that in 263 serum samples obtained from the Federal Centre for AIDS and the Syphilis Serology Proficiency Testing Laboratory. No association between Gc phenotype and HIV status was found. However, there was a strong association between the Gc protein 1f/1f phenotype and syphilis.

Acquired Immunodeficiency Syndrome↗

A transposon with an unusual arrangement of long terminal repeats in the green alga Chlamydomonas reinhardtii.

We have isolated a 5.7-kbp dispersed moderately repeated DNA sequence (TOC1) from the mutant OEE1 gene of the Chlamydomonas reinhardtii strain FUD44. The copy number (2 to over 30) and genomic locations of TOC1 elements vary widely in different C. reinhardtii strains. Our standard laboratory photosynthetic strain exhibits a high degree of TOC1 instability during short periods of mitotic growth. TOC1 appears to be a retrotransposon: it contains LTRs and an oligonucleotide stretch that corresponds to a conserved pentapeptide of reverse transcriptase. TOC1 is an unusual retrotransposon: it is not flanked by a target site duplication in the OEE1 gene, the left end of TOC1 only contains a fraction of the LTR the remainder of which is present at its right end and TOC1 does not start with a 5' TG and end with a 3' CA. In most cases, TOC1 excision leaves behind a complete solo LTR sequence (577 bp) and in one case a deleted solo LTR sequence (191 bp). Solo LTR sequences form a separate family of repeated sequences in most of the strains tested.

Base Sequence↗

Automated percutaneous discectomy: preliminary experience.

In 1985, Onik, described a new automated lumbar disc aspiration technique that utilizes a probe with the guillotine cutting technology used in vitrectomy and arthroscopic instrumentation. The probe's small size (2 mm in diameter) minimizes the risk of nerve injury, while its automated action permits rapid, safe removal of disc material. The technique and our preliminary results in patients treated with this method are described.

Dermatologic Surgical Procedures↗

Trial of a new acellular pertussis vaccine in healthy adult volunteers.

Immunogenicity and reactogenicity of a new acellular pertussis vaccine were tested in healthy adults. The vaccine contained three constituents of Bordetella pertussis; filamentous haemagglutinin, pertussis toxin (PT) and fimbriae bearing agglutinogens 2 and 3. The constituents were separately purified, treated with formaldehyde and combined with one of two aluminium adjuvants. Subjects received one dose of vaccine or an appropriate adjuvant-only preparation and were monitored for clinical responses for 7 days. Results with the two forms of vaccine were similar. Of 35 vaccinees, none had a temperature higher than 37 degrees C or a severe reaction, one had a moderate reaction (possibly due in part to intercurrent infection) and nine had mild reactions confined to localized discomfort and/or erythema or induration at the injection site. All vaccinees had good serum antibody responses to vaccine antigens measured by ELISA and for PT, by neutralization of its effects on Chinese hamster ovary cells.

Adjuvants, Immunologic↗

Alcohol misuse in patients attending a genitourinary clinic.

Two hundred male and 200 female attenders at a genitourinary clinic were studied to determine the prevalence of alcohol misuse. The CAGE Questionnaire was used to estimate the presence of probable alcohol misuse, and the General Health Questionnaire (GHQ) was used to assess psychiatric morbidity. Over 18% of men and over 12% of women were found to be alcohol misusers as measured by the CAGE Questionnaire. Their characteristics are reported, and the implications of the findings considered.

Adolescent↗

Non-psychotic psychiatric disorder after childbirth. A prospective study of prevalence, incidence, course and nature.

The psychiatric state of 483 women was examined antenatally and at 3, 6, and 12 months postpartum. Comprehensive assessments were made of all women antenatally and of subgroups of the full sample postnatally. Psychiatric state was assessed using the General Health Questionnaire, the Present State Examination and the Montgomery and Asberg Depression Rating Scale. In terms of PSE criteria, the point prevalence of non-psychotic psychiatric disorder antenatally was found to be 6.0%; and postnatally it was estimated to be 8.7% at 3 months, 8.8% at 6 months and 5.2% at 12 months after delivery. These prevalence rates were compared to the rate in a general population sample of non-puerperal women and found to be no greater. In a subgroup of the full sample, the incidence of psychiatric disorder in the year following delivery was estimated to be 15.1%, which is close to a figure previously reported for women in the community. The onset of psychiatric disturbance was soon after delivery in most instances; and, for the majority, the episode of disturbance lasted for 3 months or less. The distribution of PSE Catego classes and syndromes among the antenatal and postnatal samples were found to be similar to those in the non-puerperal comparison sample. Thus, the prevalence, incidence, and nature of non-psychotic psychiatric disorder in the 12 months following delivery do not appear to distinguish it from such disorders arising at other times.

Adolescent↗

Social adversity, low birth weight, and preterm delivery.

A prospective study of 483 pregnant women was undertaken to examine possible associations of social and psychiatric factors with both low birth weight (less than 2500 g) and preterm delivery (less than 37 weeks' gestation). As few babies were born before term (n = 14) or with a low birth weight (n = 14) further analyses were conducted to investigate predictors of absolute birth weight and gestational age. Low income was found to be an independent predictor of birth weight when birth weight was treated both as a dichotomous and as a continuous variable. Unemployment was found to be associated with absolute birth weight. Although this effect was statistically accounted for by low income, a low income was frequently caused by unemployment. Smoking independently predicted absolute birth weight and tended to be associated with preterm delivery. None of the factors investigated was associated with gestational age. In contrast with previous findings, factors such as social class, adverse life events, and psychiatric state were not associated with birth outcome. The mechanism underlying the association between low income and low birth weight requires further investigation.

Female↗

Psychiatric disorder and gynaecological symptoms in middle aged women: a community survey.

In a community survey 521 women aged 35-59 were selected at random from all patients registered in two groups practices. They were interviewed at home and assessed by means of standardised psychiatric measures and detailed gynaecological inquiry. Levels of psychiatric morbidity were found to be within the expected range for such a sample. Both psychiatric morbidity and the personality dimension of neuroticism were significantly associated with gynaecological symptoms, including dysmenorrhoea and premenstrual tension, some symptoms of excessive menstruation, and flushes and sweats but not disappearance of menstruation for over six months. Current psychiatric state was significantly associated with recent adverse life events and with indices of psychiatric vulnerability (neuroticism and previous psychiatric history), suggesting possible aetiological links with gynaecological symptoms. The findings of this study have implications for the management of gynaecological complaints in general practice.

Adult↗

Evaluation of out-patient counselling compared with general practitioner care following overdoses.

In a randomized prospective treatment study, 80 overdose patients (not requiring intensive psychiatric intervention) received either brief out-patient counselling or were returned to the care of their general practitioners with advice on management. There was little difference in outcome between the two groups. However, two sub-groups of patients benefited more from out-patient counselling than from general practitioner care, these were: (a) women, and (b) patients with dyadic problems. Counselling following overdoses should be focused on groups of patients such as these who are most likely to benefit from it. Further work is needed to identify treatment approaches that will help other groups who take overdoses, especially men.

Adult↗

Retrosplenial amnesia.

A 39-year-old man developed retrograde and anterograde amnesia following haemorrhage from an arteriovenous malformation situated near the splenium of the corpus callosum. MRI studies demonstrated damage to the splenium, and to a region containing the retrosplenial cortex and the cingulate bundle. The fornix was anterior and inferior to the site of maximal damage, but may have been involved; the stria terminalis was probably spared. Structures known to be important in memory but spared by the lesion included the hippocampus, thalamus, and basal forebrain. The retrosplenial cortex receives input from the subiculum and projects to the anterior thalamus, thus providing an alternative route between hippocampus and thalamus. Perhaps more importantly, medial temporal structures involved in memory receive anterior thalamic input directly via the cingulate bundle and indirectly through a relay in the retrosplenial cortex. We suggest that this thalamocortical portion of Papez' circuit may be important in memory, and that lesions of the cingulum and retrosplenial cortex may cause amnesia by disrupting this pathway.

Adult↗

Automated percutaneous diskectomy: initial patient experience. Work in progress.

A new method has been developed for percutaneously decompressing herniated lumbar disks. The method entails gaining access to the disk space through the use of an introduction system and a cannula. A 2-mm aspiration probe called a Nucleotome is then placed through the cannula into the disk space, and the nucleus pulposus is aspirated. Thirty-six patients have undergone the procedure, with a successful result in 31. There were no significant complications encountered, and the procedure is now being done on an outpatient basis. These preliminary results indicate that automated percutaneous diskectomy has the potential to replace laminectomy in the treatment of uncomplicated herniated disks.

Humans↗

A hairpin plastid genome in barley.

A linear plastid genome of a barley albino plant derived from anther culture has been characterized. The monomeric genome is 21 kb long. This molecule has a hairpin structure. We discuss the possible origins of this genome.

Journal Article↗