Search PubMed⌕ Search

Biomedical subjects

A Hammond

Publications and source records attributed to A Hammond.

At least 37 records · Page 2Linked to original sources
PubMed2000

Chemotherapy in neuroendocrine/Merkel cell carcinoma of the skin: case series and review of 204 cases.

PURPOSE: To study the use of chemotherapy for Merkel cell carcinoma (MCC) of the skin. PATIENTS AND METHODS: Twenty-five cases of MCC were treated at the London Regional Cancer Center between 1987 and 1997. Thirteen cases treated with chemotherapy were reviewed with 191 cases from the literature. RESULTS: At presentation, 24 patients had localized skin lesions (stage I) and one had locoregional involvement (stage II). Among the nine cases with recurrent nodal disease, six had chemotherapy as a component of salvage treatment. They were all free of disease at a median of 19 months (range, 12 to 37 months). In contrast, two patients who had salvage radiotherapy alone died of disease. Overall survival (OS) and disease-free survival (DFS) were 59% and 43%, respectively, at two years. Median OS and DFS were 29 months (range, 1 to 133 months) and 9 months (range, 1 to 133 months), respectively. Nodal disease developed in 12 (50%) of 24 patients with stage I disease, and distant metastases developed in six (25%) of 24. Including those from the literature, there were 204 cases treated with chemotherapy. Cyclophosphamide/doxorubicin (or epirubicin)/vincristine combination +/- prednisone was the most commonly used chemotherapy regimen (47 cases), with an overall response rate of 75.7% (35.1% complete, 35. 1% partial, and 5.4% minor responses). Etoposide/cisplatin (or carboplatin) was the next most commonly used regimen (27 cases), with an overall response rate of 60% (36% complete and 24% partial responses). The difference in response rate was not statistically significant (P =.19). Among the 204 cases, there were seven (3.4%) toxic deaths. CONCLUSION: Chemoradiation for locally recurrent or advanced disease may be an option for patients with a good performance status.

Aged↗
PubMed1999

[Fatal liver failure after corticosteroid treatment of a hepatitis B virus carrier].

HISTORY AND ADMISSION FINDINGS: A 69-year-old man, a known carrier of hepatitis B virus (HBV) after blood transfusion, developed increasingly severe jaundice with high transaminase levels after receiving steroids in high doses. Significant preceding conditions included chronic obstructive pulmonary disease, coronary heart disease, ulcerative colitis in remission and diabetes mellitus. On admission he was jaundiced and experienced pain on pressure below the right costal margin. INVESTIGATIONS: Serology demonstrated reactivated hepatitis B with an increase of the HBV-DNA concentration in serum, as well as seroconversion with HBe antigen, anti-HBc-IgM antibodies and absence of anti-HBe antibodies. DIAGNOSIS, TREATMENT AND COURSE: The history and serological findings indicated reactivation of the hepatitis B by the steroid treatment. Progressive liver failure developed. A marked reduction of virus particles in the blood occurred after a therapeutic trial with the nucleoside analog lamivudine, but the patient died of liver failure 30 days after admission. CONCLUSION: Steroids should be given to known hepatitis B carriers only if strictly indicated, because of the danger of acute deterioration of liver functions by reactivation of the disease with possibly fatal consequences. If steroids are administered, liver functions and serological hepatitis markers should be closely monitored so that any necessary treatment can be quickly initiated.

Adrenal Cortex Hormones↗
PubMed1999

A crossover trial evaluating an educational-behavioural joint protection programme for people with rheumatoid arthritis.

Joint protection (JP) is a self-management technique widely taught to people with rheumatoid arthritis (RA). JP education aims to enable people with RA to reduce pain, inflammation, joint stress and reduce risks of deformity through using assistive devices and alternative movement patterns of affected joints to perform everyday activities. Previous studies evaluating JP education methods common in the UK have identified JP adherence is poor. A group education programme was developed using the Health Belief Model and Self-efficacy Theory. Strategies used to maximise JP adherence included goal-setting, contracting, modelling, homework programmes, motor learning theory, recall enhancing methods and mental practice. A crossover trial (n = 35) was conducted. Adherence with JP was measured using an objective observational test (the Joint Protection Behaviour Assessment). Significant improvements in use of JP were recorded at 12 and 24 weeks post-education (P < 0.01). No significant changes in measures of pain, functional disability, grip strength, self-efficacy or helplessness occurred post-education, although this may have been due to the small sample size recruited. In conclusion, JP adherence can be facilitated through the use of educational-behavioural strategies, suggesting this approach should be more widely adopted in clinical practice.

Activities of Daily Living↗
PubMed1999

The effect of a joint protection education programme for people with rheumatoid arthritis.

OBJECTIVE: To evaluate the effects of an education programme in improving adherence with joint protection by people with rheumatoid arthritis (RA). DESIGN: A repeated measures design. Subjects were assessed at six weeks and one week before and six and twelve weeks after education. SETTING: Rheumatology unit in a large district general hospital. SUBJECTS: Twenty-one people diagnosed with RA (mean age 48.95 years (SD 12.54) and disease duration of 6.43 years (SD 7.7) ). INTERVENTION: An 8-hour arthritis education programme delivered over four sessions, including two hours of joint protection education designed to be typical of current UK practice. MAIN OUTCOME MEASURES: The Joint Protection Behaviour Assessment (JPBA), an observational assessment of hand joint protection methods used during kitchen activities, to measure adherence with education. Other assessments included a joint protection knowledge questionnaire, hand joint counts, hand pain visual analogue scale, the Health Assessment Questionnaire (HAQ) and HAQ Pain scale to identify any short-term changes in hand pain, pain on activity and functional status. At the beginning and end of the study subjects were interviewed to obtain their self-report of joint protection behaviours and reasons for following or not following the advice given. RESULTS: Median JPBA scores did not improve pre- to posteducation (18.4% to 23.7%; p = 0.65) and neither did hand joint count, hand pain, HAQ and HAQ Pain scores. However, joint protection knowledge improved significantly (p = 0.01) and the majority of people believed joint protection to be a beneficial strategy. Reasons for not changing behaviour included problems recalling information; joint protection being considered inappropriate as 'hands were not that bad yet'; lack of skill; and difficulties changing habits. CONCLUSION: The joint protection education programme improved knowledge but not use of taught methods. Educational strategies being used by therapists need to be focused on enhancing adherence.

Adult↗
PubMed1999

Development of the Joint Protection Behavior Assessment.

OBJECTIVE: To develop an observational assessment of the use of joint protection (JP) methods by people with rheumatoid arthritis (RA). METHODS: Subjects with and without RA were videotaped performing a kitchen activity to identify the range of JP and non-JP methods used. Behavior codes were developed for these. Seven rheumatology occupational therapists reviewed and scored behaviors as correct, partially correct, or incorrect JP methods. Test-retest and interrater agreement studies were conducted. RESULTS: The Joint Protection Behavior Assessment (JPBA) demonstrated good content validity (kappa = 0.46 to 1.00), test-retest reliability (P < 0.0001), and interobserver agreement (kappa = 0.68 to 0.88). Construct validity was supported by significant correlations with hand impairment and function variables. CONCLUSION: The JPBA is a reliable and valid assessment of the use of JP methods by people with mild to moderate hand and upper limb joint involvement, which can be used to evaluate the effectiveness of JP education programs.

Activities of Daily Living↗
PubMed1998

The use of self-management strategies by people with rheumatoid arthritis.

OBJECTIVE: To investigate seven common arthritis self-management methods used by people with rheumatoid arthritis (RA) by studying their frequency of use and the patients' belief in their benefits. Also to look at how people obtained information about such methods. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: Forty-one people with RA attending a rheumatology outpatient department at a large district general hospital. RESULTS: Twenty-three recalled receiving some self-management advice from rheumatology team members, but most stated the commonest source of information was arthritis books and leaflets (n = 29). Two-thirds used technical aids and rest on a daily basis, half used exercise and heat (half doing so daily). A quarter to a half used relaxation, joint protection and working splints (half doing so daily). CONCLUSION: People with RA reported using three or four self-management methods simultaneously to help control symptoms. In the main, believing a method to be beneficial was strongly related to its use. However, exercise and joint protection, whilst widely believed to be beneficial, were less used. People reported problems with knowing how to do these correctly, having insufficient time to practise sufficiently and difficulty in establishing habits.

Arthritis, Rheumatoid↗
PubMed1998

Fear of fat and the dream process: a correlational investigation.

Dream characteristics of 27 women from a graduate counseling program were correlated with the Goldfarb Fear of Fat Scale. Significant positive correlations were obtained for scores with recurrent nightmares (.38) and dreaming one is dreaming (.40). An inverse relationship was noted between sexual content of dreams and scores for fear of fat (-.41). Results were discussed in terms of associations among dissociation, body image, and the dream process.

Adult↗
PubMed1996

Immunogenicity of full length and truncated forms of the human immunodeficiency virus type I envelope glycoprotein.

We have monitored the immunogenicity of a V1V2 sub-fragment of gp 120 in contrast to the full length protein and to a truncated form (PR12) where the V1, V2 and V3 regions were removed. In contrast to previously published work [1] these studies show that monomeric forms of envelope are capable of inducing antibodies specific for both linear and discontinuous epitopes. These antibodies are capable of neutralising HIV infectivity. The majority of neutralising antibodies were specific for epitopes within the V2 and V3 regions demonstrating the immunodominance of these regions in monomeric gp 120. Relatively few of the antibodies were specific for the CD4 binding site, suggesting that this region is poorly immunogenic. Immunisation of rats with the PR12 truncated protein did not significantly enhance the immunogenicity of the CD4 binding site. However, the immune response generated included antibodies capable of binding to diverse primary HIV-1 and HIV-2 envelope glycoproteins. We have shown that up to 30% of sera from HIV-1 infected individuals have antibodies that are capable of recognising conformation-dependent epitopes within the V1V2 region of the clone HXB10, suggesting the presence of conserved cross-reactive epitopes. Furthermore we have shown an association between the presence of V1V2 reactive antibodies and the neutralisation titre of the sera tested suggesting that antibodies to this region contribute to the cross-reactive neutralising response.

AIDS Vaccines↗
PubMed1994

Joint protection behavior in patients with rheumatoid arthritis following an education program: a pilot study.

PURPOSE: Joint protection (JP) education is a common feature in rheumatoid arthritis (RA) treatment programs. However, no objective studies have been published demonstrating patients' behavior changes following such education. This study evaluated whether RA patients' hand movement patterns altered following a JP education program. METHODS: An assessment procedure was constructed to assess application of four JP principles related to altering patterns of hand use during common everyday activities (making a hot drink and snack meal). RESULTS: Eleven RA patients were assessed. There was no significant behavioral change at 6 weeks post-JP education (t = 10; P > 0.1). In contrast, follow-up interviews of self-perceived JP behavior showed all subjects considered JP relevant for them and seven believed they had changed to using these techniques. CONCLUSIONS: This suggests education led to attitudinal change but that behavioral change requires longer and more targeted input than is currently normally provided.

Activities of Daily Living↗
PubMed1993

Amyloid arthritis associated with IgM kappa lymphoplasmacytoid lymphoma.

Amyloid arthritis is an uncommon cause of locomotor disease and may closely resemble RA. Macroglobulinaemia is rarely associated with amyloidosis and there has been only one report of amyloid arthritis in this setting, the patient having had Waldenstrom's macroglobulinaemia. We report the occurrence of amyloid joint disease in the course of an IgM kappa B-cell dyscrasia which evolved over 16 years to an overt lymphoplasmacytoid lymphoma.

Amyloidosis↗
PubMed1993

Soft tissue sarcomas: a plea for proper management.

Although soft tissue sarcomas are relatively uncommon, they often occur in young patients and if properly treated are often curable. Unfortunately, inappropriate approaches to biopsy before adequate staging may compromise a successful outcome. The roles of diagnostic imaging (particularly magnetic resonance imaging) in adequate preoperative evaluation and staging and the fundamental principles of surgical management are discussed.

Adolescent↗
PubMed1992

The presence of uracil-DNA glycosylase in insects is dependent upon developmental complexity.

The metamorphosis of insects can, in a general way, be divided between those organisms that undergo pupation accompanied by cellular histolysis and those that gradually develop into adults without an intervening pupal stage of development. In the former case, the death of a cell population is an integral part of development that is tightly associated with massive DNA degradation during pupation. In that regard, it has been suggested that uracil-containing DNA acts as a target for the nucleolytic breakdown of DNA during histolysis in insects (Deutsch, W. A. (1987) Mutat. Res. 184, 209-215), thus placing into question how compatible the existence of uracil-DNA glycosylases would be for this form of developmental signal. As a result, we tested for the presence of a uracil-DNA glycosylase in insects representative of those having an intervening pupal stage of development and those that do not. We show here that a nonpupating insect contains a uracil-DNA glycosylase activity. Conversely, crude extracts of Drosophila melanogaster, as well as of three other insect populations that undergo pupation similar to that found in Drosophila, do not contain detectable levels of this DNA repair activity. Thus, there appears to be a consistent correlation between cellular destruction during development and the absence of a uracil-DNA glycosylase, which supports the possibility that uracil-containing DNA may play an important role in those cells targeted for death.

Animals↗
PubMed1992

Effects of C4 null alleles and homoduplications on quantitative expression of C4A and C4B.

The availability of MoAbs now allows the accurate quantification of the individual C4 isotypes, C4A and C4B. Using a sensitive two-site immunoradiometric technique to measure serum levels of C4A and C4B, we studied the relationship between genotype and phenotype and physiological factors affecting C4 expression in 129 fully genotyped healthy subjects. Our results confirm that there is extensive phenotypic overlap between genotypic groups and it was not possible to determine the presence of single null alleles from total serum C4. Of the factors which may influence C4 expression, we found that age contributes a very small influence but that gender has no effect and there was no evidence for the presence of feedback of null alleles on the expression of remaining genes. Potential problems in quantifying C4 arising from the complex relationship between isotypic identity and serotypic recognition were highlighted by the finding of reversed antigenic expression of a C4B*5 molecule which was recognized as C4A by the anti-Rg:1 monoclonal used in these studies. We also confirmed that the extended MHC haplotype associated with Felty's syndrome, HLA-B44, C4A*3, C4BQ*O, HLA-DR4, encodes an expressed, duplicated, C4A gene.

Adult↗
PubMed1992

Keratan sulphate in rheumatoid arthritis, osteoarthritis, and inflammatory diseases.

Serum concentrations of antigenic keratan sulphate determined by an enzyme linked immunosorbent assay (ELISA) with a monoclonal antibody were studied in patients with rheumatoid arthritis (RA), osteoarthritis, ankylosing spondylitis, other inflammatory diseases, and a large control group of women without arthritis. Mean keratan sulphate concentrations were low in 117 women with RA compared with 227 female control subjects matched for age drawn from a community survey. There were significant correlations between serum keratan sulphate concentrations in patients with RA and serum C reactive protein and the erythrocyte sedimentation rate. Serum keratan sulphate concentrations were also low in 29 men and women with ankylosing spondylitis and 29 patients with arthritis and high concentrations of C reactive protein. In 98 women undergoing an operation for benign breast disease there were decreases in serum keratan sulphate concentrations after the operation which correlated with doses in serum C reactive protein. No differences were found in keratan sulphate concentrations in 137 women with osteoarthritis compared with controls. Within the group with osteoarthritis there were no differences for the various joint groups and there was no obvious correlation with radiographic severity or progression. These findings suggest serum keratan sulphate is unlikely to be useful as a diagnostic marker in osteoarthritis or RA but indicate a role for inflammation in the regulation of cartilage loss.

Acute-Phase Reaction↗
PubMed1991

[Purulent parotitis in an infant].

A sibling was taken into hospital at the age of 3 weeks with an acute suppurative parotitis of the left parotid. Since birth, the child had suffered from recurrent infections. Her mother was known with recurrent furunculosis. Ultrasonography of the left parotid showed a diffuse enlarged parotid with multiple areas of necrosis. After a diagnostic puncture, a penicillin resistant Staphylococcus aureus was found. Therapy consisted of intravenous antibiotics.

Female↗
PubMed1990

Immunization against hepatitis B--what can we expect? Results of a survey of antibody response to immunization in persons 'at risk' of occupational exposure to hepatitis B.

One thousand three hundred and twenty adults at risk of occupational exposure to hepatitis B were immunized using genetically engineered surface antigen and their antibody response (anti-HBs IU/l) assessed. Sex was known for all subjects and age for 1120 (range from 17-71 years). Seven hundred and sixty-four subjects were immunized in the local Department of Occupational Health, the remainder mainly by general practitioners. Analysis of 'good responders' (anti-HBs greater than 100 IU/l) according to age and sex showed that increasing age and male sex had independent adverse effects on the likelihood of developing a satisfactory level of antibody to HBsAg. Furthermore even those most likely to respond well (young women), had a 1/5 to 1/6 failure rate to achieve greater than 100 IU/l anti-HBs. Of 63 persons who received a fourth dose of vaccine, 26 developed anti-HBs titres greater than 100 IU/l when tested after 6 months. Subjects who had a low level of anti-HBs following primary immunization were more likely to develop greater than 100 IU/l anti-HBs following a booster dose than were non-responders (less than 10 IU/l).

Adolescent↗
PubMed1989

Reduced numbers of complement receptor type 1 on erythrocytes are associated with increased levels of anticardiolipin antibodies. Findings in patients with systemic lupus erythematosus and the antiphospholipid syndrome.

In several diseases, including systemic lupus erythematosus (SLE) and autoimmune hemolytic anemias, the numbers of complement receptor type 1 (CR1) expressed on erythrocytes of patients are reduced. In patients with SLE, anticardiolipin antibodies (aCL) have been associated with positive results on direct antiglobulin tests. Because of these findings, we investigated whether the reduced expression of erythrocyte CR1 in 61 patients (53 with SLE and 8 with the antiphospholipid syndrome) might be associated with the presence of aCL. A negative correlation was observed between aCL levels and mean numbers of CR1 (rs = -0.43, P = 0.001), and a positive correlation was observed between aCL levels and the levels of erythrocyte C4d and C3d (rs = 0.33 and 0.41, P = 0.01 and 0.001, respectively), but no correlation of aCL levels with serum C4 levels was found. When the results were further analyzed according to the IgG or IgM class of aCL, levels of antibodies of both classes were negatively correlated with CR1 numbers, but only IgM aCL levels were correlated with erythrocyte C4d and C3d numbers. The levels of anti-double-stranded DNA antibodies showed no correlation with erythrocyte CR1, C4d, or C3d numbers but were negatively correlated with serum C4 levels (rs = -0.43, P = 0.002). These data suggest that aCL, or a closely related antibody specificity, may bind to erythrocytes and may be directly involved in the mechanism for reduction of erythrocyte CR1 expression in SLE patients.

Antibodies, Antinuclear↗