Biomedical subjects
A James
Publications and source records attributed to A James.
Detection of a recessive major gene for high IgE levels acting independently of specific response to allergens.
The genetic control of the total IgE, the immunoglobulins E involved in allergy, remains still unclear. Although high IgE levels were found to be determined by a recessive major gene in several studies, other modes of inheritance were also reported. Moreover, at least two different genetic mechanisms controlling the IgE regulation have been suggested: one involved in the specific IgE response and the other one in the nonspecific response. To better understand the genetic mechanisms controlling IgE variation, we performed segregation analysis of IgE levels by ignoring or taking into account the specific response to allergens (SRA). Analyses were conducted using the class D regressive model, in a sample of 234 Australian nuclear families randomly selected during the winter months, when IgE levels are the lowest (basal). SRA, when included as a covariate in the model, was defined by one of the three following criteria: (1) raised specific IgE level for one or more allergens, (2) positive skin test for one or more allergens, and (3) at least one of the (1) or (2) criteria. When the presence of SRA is ignored, the familial transmission of total IgE level is compatible with the segregation of a recessive major gene and residual familial correlations. When the presence of SRA is accounted for in the analysis, whether defined by criteria (1), (2), or (3), there is still evidence for a recessive major gene controlling IgE levels but residual familial correlations are no longer significant. In addition, no interaction between this major gene and SRA is shown here. Our results suggest that this gene, which accounts for 28% of the variation of the trait, may be involved in the control of basal IgE production, independently of specific response to allergens.
Maximum and medium security: the interface.
This paper examines transfer delays for patients moving between medium and maximum security hospitals. Delays appear to be getting shorter and Special Hospitals in particular respond very quickly to requests for admission. Recommendations are made for further improvements in transfer procedures. The authors argue that with closer working relationships between clinicians in Special Hospitals and Regional Secure Units, and the new proactive approach to transfers, the system will become increasingly flexible and responsive. Consequent improvements in the quality of care in Special Hospitals are anticipated, making the arguments for closing them, in turn, less convincing.
Theoretic effects of mucus gland discharge on airway resistance in asthma.
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Snippets from mammoth cardiology meeting.
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Shining Northern light on the gut.
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UK guidelines to prevent postoperative clots.
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Marine pollution and limb reduction defects.
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The use of the axial CT scan in intra-articular fractures of the calcaneum.
The axial CT scan has become part of our routine management of os calcis fractures. This investigation helps distinguish between tongue and joint depression type fractures, gives important information regarding the fracture pattern in the anterior calcaneum and the degree of comminution of the sustentaculum tali and the subtalar joints. The scan is also useful in determining direction of movement of the body fragment.
The end of the second most expensive health care system in the world: some geographical implications.
In Canada, there has been an increasingly, vociferous debate over the future of a health care system which is based on 5 principles: comprehensiveness; public administration; universality; portability; and accessibility. In part, this debate is a policy tug-of-war among provincial governments, special interest groups and the public who on one side want to maintain the principles of the health care system and on the other want to control costs within the system. The outcome of this policy tug-of-war is demonstrated through an analysis of the funding of health care in the province of Ontario, Canada in general, and the closure of hospital beds specifically. The analysis shows that in attempting to restructure the system, rationalization and growing spatial inequality are occurring simultaneously. The analysis calls into question the whole strategy of bed closures as a method of controlling health care costs. These conclusions have implications for other national health care systems where hospital bed closures have also been used as a strategy in controlling health care costs.
Adolescent onset psychosis. A clinical and outcome study.
58 psychotic adolescents between the ages of 12 and 17 diagnosed according to RDC criteria were matched with psychiatric comparisons and followed-up using a two stage design. Information upon the group as a whole was obtained using death records, criminal records and data from the Oxford Record Linkage System. A sub-sample of 21 matched pairs were interviewed using the Schedule for Affective Disorders and Schizophrenia--Life time version (SADS-L) and the Adult Personality Functioning Assessment (APFA). The outcome of adolescent schizophrenia was poor with 78% continuously ill and socially handicapped. Outcome was better for bipolar disorders and schizo-affective disorders and similar to psychiatric comparisons.
Effects of lung volume and surface forces on maximal airway smooth muscle shortening.
The effects of lung volume and surface forces on airway smooth muscle shortening were studied in isolated perfused rat lungs. The lungs were inflated via the trachea with gas or Krebs solution (n = 12 each) to volumes equivalent to gas inflation pressures of 5 (low), 15 (medium), and 25 (high) cmH2O (n = 4 each). At each volume, two of the four lungs were perfused with methacholine (10(-2) M) and then all were perfused with Formalin for fixation. The amount of smooth muscle shortening present in transverse sections of the airways was determined by comparing the observed outer perimeter of the smooth muscle layer with its calculated relaxed perimeter. In the control lungs, mean shortening was < or = 10% in all groups except the liquid-filled lungs at low lung volumes [33 +/- 12% (SD)]. In the methacholine-stimulated lungs, mean shortening was between 45 and 56% at medium and low lung volumes in gas- and liquid-filled lungs, respectively, and approximated the degree of shortening required to cause airway closure. At high lung volume, less shortening was observed in the methacholine-stimulated lungs, either liquid (34 +/- 17%) or gas filled (16 +/- 19%; P < 0.05 compared with liquid filled). The effects of lung volume in liquid-filled lungs and the differences in response between gas- and liquid-filled lungs demonstrate, respectively, that both lung tissue recoil and surface forces act to oppose shortening of maximally stimulated smooth muscle.(ABSTRACT TRUNCATED AT 250 WORDS)
Limited airway narrowing: why doesn't everyone have asthma?
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Reinjury prevention follow-through for clients with cumulative trauma disorders.
OBJECTIVES: Fifteen subjects with upper extremity work-related cumulative trauma disorders were involved in a quality improvement study to determine their self-reported degree of follow-through with reinjury prevention regimens. The effect of cuing was also studied. METHOD: During occupational therapy, subjects were involved in an educational session that focused on recommendations in ergonomic equipment, therapeutic maintenance techniques, body mechanics, and work simplification techniques. Follow-through with reinjury prevention education was evaluated and rated via telephone interviews approximately 2 weeks (T1) and 4 weeks (T2) after the educational session. Subjects did not know the questions they would be asked at T1, but were cued that their progress would be checked again at T2. Dependent t tests were conducted to compare the mean number of recommendations for which complete follow-through was expected with the mean number of recommendations at T1 and T2 that were implemented completely. RESULTS: A significantly lower degree was found of absolute completion of recommendations at T1 and T2 than had been anticipated (p < .002). No significant difference between T1 and T2 was found, indicating that cuing at T1 had little effect on subjects' actual follow-through rate. CONCLUSION: The implications of these findings for occupational therapists support the need for further research in reinjury prevention and employer education.
Activities of daily living capabilities and values of long-term-care facility residents.
OBJECTIVE: The Minimum Data Set for Nursing Home Resident Assessment and Care Screening was used to compare staff-report and self-report of residents' capabilities in eight activities of daily living (ADLs) in one long-term-care facility (LTCF). METHOD: The relative values residents placed on independence in each of the eight ADLs were compared with their self-reported capabilities in those ADLs. Subjects were 30 LTCF residents ranging in age from 45 to 96 years. RESULTS: Residents perceived themselves to be significantly more capable than did staff members for dressing (p < .05), toileting (p < .01). locomotion (p < .05), and personal hygiene (p < .001). For five of the ADLs, residents tended to report high capability in the ALDs they valued most. CONCLUSION: These findings support the need to include resident self-assessment in treatment planning, because staff members' and residents' perceptions of ADL capabilities may differ.
Giant mucinous ovarian tumor with low malignant potential with foci of well-differentiated mucinous adenocarcinoma masked by massive obesity. A case report.
A giant (64-kg) mucinous tumor with low malignant potential and foci of well-differentiated mucinous adenocarcinoma was removed from a massively obese (250 kg) woman. This case represents the largest tumor of this type reported to date.