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Biomedical subjects

A Green

Publications and source records attributed to A Green.

At least 523 records · Page 29Linked to original sources
PubMed1987

Radionuclide therapy of neural crest tumors.

The potential concentration of I 131-Meta-iodo-benzylguanidine (MIBG) in pheochromocytoma, and the successful application in diagnosis and therapy of pheochromocytoma, has led to its use in therapy in other tumours derived from the neural crest. In neuroblastoma, the concentration of MIBG is as reliable as it is in pheochromocytoma. 18 patients with a neuroblastoma were treated, leading to two complete remissions, seven partial remissions, two no change, and two progressive disease; one patient was lost for follow-up. Six adults were treated, three with a carcinoid, two malignant pheochromocytoma and one medullary thyroid carcinoma. Although follow-up is still short, preliminary results of therapeutic use of I 131-MIBG indicate that this treatment modality may be effective.

3-Iodobenzylguanidine↗
PubMed1987

Sympathetic skin response in diabetic neuropathy.

The sympathetic skin response (SSR) was studied in 47 diabetic patients selected for the presence of symptoms and clinical signs of peripheral neuropathy and in 24 normal control subjects. The SSR was present in all controls but was absent at the foot in 66% and at the hand in 27.7% of the diabetic patients. Absence of the SSR failed to correlate with other electrophysiologic parameters on routine nerve conduction and electromyographic studies. Although absent SSR was more often found in patients with symptoms of autonomic dysfunction (P less than 0.05), there was no correlation with any specific symptoms of autonomic involvement. The SSR was frequently absent, at least in the foot, in those patients with abnormal cardiac beat-to-beat variability (expiratory: inspiratory, E:I, ratio) and pupil cycle time (PCT). In addition there was a good correlation between the amplitude of the SSR and the value of the E:I ratio (r = 0.81, P less than 0.001). The SSR may be a valuable adjunct in the assessment of autonomic involvement in diabetic neuropathy, but its sensitivity requires further evaluation.

Adult↗
PubMed1987

A cohort study of neural tube defects (NTD) in Denmark covering the first seven years of life.

In the County of Fyn, Denmark, which is a well-delimited region comprising a 10% representative sample of the total population, ten complete one year cohorts of newborn were scrutinized for neural tube defects (NTD). Among 66,000 births, 71 cases with NTD were observed. The total prevalence at birth was 1.08/1,000; 0.29 for anencephaly; 0.20 for encephalocele, and 0.59 for spina bifida (SB). This is at the same level as in other Scandinavian countries. Considering only neonates born alive, 57% of the total survived until the age of 7 years, disregarding anencephaly, but only 4 of 18 SB cases and 6 of 11 encephalocele cases had no handicaps at age 7. On the average, SB patients spent 9% of their life before the age of 7 years in hospitals and encephaloceles 2%. The SB cases occupied 25 times more beds per year than the comparable age group in general and many were likely to need continued medical and social care.

Anencephaly↗
PubMed1987

Chronic administration of theophylline to rats induces a post-insulin binding defect in adipocyte glucose transport.

To determine whether adenosine is involved in long-term regulation of glucose transport in adipose tissue, we have investigated effects of administration of an adenosine receptor antagonist (theophylline) on adipocyte glucose transport. Rats were injected with theophylline (30 mg/kg, dissolved in 0.9% NaCl) daily for 7 days. Controls were injected with saline. The rats were then killed, and epididymal adipocytes were isolated. Insulin-stimulated glucose transport rates were decreased by about 25%-30% in the cells from theophylline-treated rats at all insulin concentrations tested. The half-maximally effective concentration of insulin was not altered (6.5 +/- 0.5 and 6.7 +/- 0.5 mU/l in control and treated cells respectively), suggesting a post-insulin binding defect. This was confirmed by the finding that 125I-insulin binding to the cells was not altered. Adenosine receptor number and affinity (measured on detergent-solubilized adipocyte extracts using 125I-hydroxyphenylisopropyl adenosine) was also not changed by theophylline treatment. We conclude that theophylline administration causes decreased glucose transport rates in rat adipocytes at a post-insulin binding level. Thus, chronic adenosine receptor blockade impairs adipocyte glucose transport, suggesting that adenosine is involved in long-term regulation of glucose metabolism in adipose tissue.

Adenosine↗
PubMed1987

Blindness in insulin-treated diabetic patients with age at onset less than 30 years.

The occurrence of blindness was evaluated in a population-based group of Danish patients with insulin-treated diabetes diagnosed before the age of 30 years (N = 727), identified by means of insulin prescriptions. The study comprised a retrospective cross-sectional investigation, a longitudinal observation during the subsequent approximately 8 years, and a cross-sectional ophthalmological examination of all patients still alive at the end of the 8 year observation period. Prevalence rates of registered blind at base line were 3.4 and 2.6% for men and women, respectively. The overall incidence rate for blindness was found to be approximately 1.0 per 100 person years. At the ophthalmological examination 88% of blind patients were registered by the Danish Society for the Blind. The cause of blindness in the majority of patients was proliferative retinopathy. Blindness was found to be a significant problem in insulin-dependent diabetes, with a 50-80 times higher risk of blindness than the background population.

Adolescent↗
PubMed1987

Influence of long-term aldose reductase inhibitor therapy on autonomic dysfunction of urinary bladder, stomach and cardiovascular systems in diabetic patients.

The effects of the aldose reductase inhibitor (ARI) sorbinil (250 mg/day) were tested in an open-label pilot study over 1 year, in eight diabetics with peripheral neuropathy, seven of whom had symptomic autonomic neuropathy (AN). Autonomic function studies of the urinary bladder, stomach and cardiovascular system were performed at baseline, 6 and 12 months. Six patients reported improvement in symptoms of AN by 6 months which was maintained or further improved by 12 months. Bladder sensation, as measured by cystometrographic parameters, improved at 6 months (P less than 0.02- less than 0.04), but by 12 months had reverted to baseline. Residual urine volume decreased at 6 months (P less than 0.06) and 12 months (P less than 0.06). Vagally mediated gastric acid secretion improved at 6 months (P less than 0.06); the subgroup of patients with subnormal secretion showed improvement to the normal range at 6 months (P less than 0.03). Gastric emptying of solid food was normal in six of eight subjects and showed no significant change at 6 months. Both patients with delayed emptying normalized. No change in beat-to-beat variability in heart rate with respiration was noted. Resting minimum heart rate decreased at 12 months (P less than 0.05). Glycohemoglobin levels showed no statistically significant changes. No toxic reactions were observed. These data suggest a beneficial effect of ARI treatment on symptomatic and asymptomatic manifestations of diabetic autonomic neuropathy and indicate a need for large controlled trials.

Adult↗
PubMed1987

Is there primary health care in the UK?

In the period since the Alma-Ata Declaration, there has been much activity in many countries in drawing up strategies for primary health care (PHC). This paper argues that the UK, though a signatory to the Declaration, has failed to provide an adequate framework for such a strategy, and that, in spite of the strong record of the National Health Service (NHS) as a system of social medicine, much remains to be done in order to achieve the principles of PHC. The paper analyses the record of the NHS in these areas, as set against the principles of PHC. It argues that such a review is important, not only for the NHS itself, but for some overseas students of the NHS who, through the strong links between the NHS and their own health services and the strong tradition of the NHS as a (nearly) free health system, might consider it a suitable blueprint for their own health services. THough there are a number of elements of the NHS, such as its resource allocation mechanism, that are relevant to PHC, it is argued that, as a whole, its structure may not be a suitable model.

Evaluation Studies as Topic↗
PubMed1987

Melanocytic naevi and melanoma: an epidemiological perspective.

There is growing evidence that individuals at high risk of cutaneous melanoma can be identified by the use of simple measures of benign melanocytic naevi--raised risk occurring in persons who have large numbers of naevi, or naevi with atypical clinical features. Very high risk of melanoma appears to exist in two rare groups: persons with dysplastic naevi whose families include at least two individuals who have had melanoma, and persons with giant congenital naevi. Risks of melanoma in other individuals with dysplastic naevi and in persons with small congenital naevi have not yet been quantified. Much of the published work on risk of melanoma in relation to naevi has been based on clinical series or assemblage of case reports, with great potential for bias. In such studies, naevi have often been classified into dichotomies or syndromes originally defined for pathological or clinical purposes, frequently using poorly reproducible criteria. Case-control and cohort studies of the relationship of naevi to melanoma are needed, which use reproducible criteria and designs minimizing bias, and which examine risk in relation to graded clinical and histological measures of naevi.

Dysplastic Nevus Syndrome↗
PubMed1987

The sweat test.

Explore the source record for details and available documents.

Cystic Fibrosis↗
PubMed1987

Should we screen for congenital adrenal hyperplasia? A review of 117 cases.

A total of 117 patients with congenital adrenal hyperplasia who were under the care of paediatricians at Birmingham Children's Hospital between 1958 and 1985 were reviewed retrospectively. There were 47 boys (40%) and 70 girls (60%); 30 of the 47 boys (64%) and 38 of the girls (58% of the 66 whose salt state was known) were salt losers. In all salt losers the condition was diagnosed before the age of 6 months, 90% of the diagnoses being made during the first month. The ratio of boys to girls, the distributions of salt losers to non-salt losers, and the age at diagnosis were studied in relation to the year of birth. Early diagnosis was found to be more common in children born after 1970 due partly to the introduction of a method of assaying the concentration of 17 alpha-hydroxyprogesterone in serum, partly to an increase in the number of paediatricians in the West Midlands, and partly to the appointment of a paediatric endocrinologist. A neonatal screening programme does not seem to be necessary.

Adrenal Hyperplasia, Congenital↗
PubMed1987

The HLA linked iron loading gene in an Afrikaner population.

The serum ferritin concentration was used as a screening test to identify the presence of iron overload in 599 Afrikaans subjects (300 males and 299 females) living in the South Western Cape, South Africa. Seventeen of the males with concentrations greater than 400 micrograms/l were reevaluated three and five years later. Serum ferritin concentrations were measured again and further diagnostic procedures were carried out. These included an assessment of alcohol intake and measurements of serum gamma glutamyltransferase, the percentage saturation of transferrin, and HLA-A,-B,-C, and -DR loci typing on the subjects as well as their families. Liver biopsies were performed on some affected subjects. Of the original 16 index subjects, four were diagnosed as homozygous for the HLA linked iron loading gene which is responsible for the clinical disease idiopathic haemochromatosis. Six appeared to be heterozygotes, three were heterozygotes who were also abusing alcohol, and two did not fit into any of the diagnostic groups. The calculated gene frequency was 0.082, with an expected heterozygote frequency of 0.148. The fact that no females were identified in the study suggested that the diagnostic criteria for homozygosity (serum ferritin greater than 400 micrograms/l and % saturation greater than 60%) were set too high. The data were therefore recalculated for the 300 males; when this was done the gene frequency was 0.115 and the heterozygote frequency 0.024. Two subjects were diagnosed as homozygotes in the study of family members and 37 as heterozygotes (33 definite and four probable). Both the homozygotes and nine of the heterozygotes showed mild to moderate disturbances of iron metabolism. There was considerable overlap between the phenotype expression in these nine heterozygotes and the homozygotes, probably as a result of setting the threshold for the serum ferritin concentrations at the relatively high value of 400 microgram/ml. By doing this a small subset of heterozygotes with biochemical abnormalities was identified. The results of the present pilot study suggest a high frequency of the HLA linked iron loading gene in the Afrikaner population of South Western Cape.

Adolescent↗
PubMed1987

Introduction of an ion selective sodium and potassium analyser in a paediatric intensive care unit: our experience over a 3-year period.

We describe our approach, policy and experience in establishing a sodium and potassium analyser for use by medical and laboratory staff in a satellite laboratory adjacent to a paediatric intensive care unit. The effects on patient care are difficult to quantify, but are felt to be beneficial. A reduction in 'out of hours' laboratory workload and significant financial savings have been achieved.

Child, Preschool↗
PubMed1987

Multi-centre open study of a triphasic levonorgestrel-ethinyloestradiol combined oral contraceptive ('Trinordiol').

A long-term, multi-centre open study was carried out to evaluate the efficacy, cycle control and side-effects with a triphasic, combined oral contraceptive containing levonorgestrel and ethinyloestradiol ('Trinordiol'). A total of 2517 women completing at least 1 cycle of treatment was followed up at 2 to 3-monthly intervals; the overall number of cycles on treatment was 37,090. During treatment, only 2 pregnancies occurred which were attributable to pill failure. Cycle control was good: cycle irregularities were 9.6% overall, but were most common (19.6%) during the first 3 cycles. Only 3.8% of patients withdrew from the study for this reason. Side-effects were those commonly seen with oral contraceptives, and they produced a drop-out rate of only 13.9%. There were no clinically significant effects on blood pressure or body weight. The results also suggested that 'Trinordiol' has a beneficial effect on pre-existing acne.

Acne Vulgaris↗