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Biomedical subjects

A Lewis

Publications and source records attributed to A Lewis.

At least 217 records · Page 12Linked to original sources
PubMed1983

The conservative treatment of fissure-in-ano.

A randomized clinical trial assessed the value of regular anal dilatation in combination with a topical local anaesthetic in the treatment of 82 patients with a posterior fissure-in-ano. One month after treatment the fissure had healed in 43.6 per cent of patients using 2 per cent lignocaine gel alone and in 41.9 per cent of patients who also used a St Mark's Hospital anal dilator. Thus the regular use of such a dilator did not contribute to the success of conservative therapy in patients with a posterior anal fissure. A review of patients who presented with anterior or lateral anal fissures during the trial period revealed that healing was achieved in 73.3 per cent of patients without operation within 1 month of diagnosis.

Administration, Topical↗
PubMed1983

Auto-immune therapy against human allergic disease: a physiological self defence factor.

Guinea-pigs sensitised to ovalbumen excrete the antigen in their urine in a therapeutic concentration which prevents anaphylactic death after injection of a challenge dose of the ovalbumen. Sublingual administration of the correct dose of urine from allergic patients also provides therapeutic control of their allergic symptoms. The effective dose is determined by bio-assay. The Neutralisation dose is recognised by disappearance of buccal sensation to the urine. Readministration of salivary, nasal, and sweat secretions from allergic patients onto the conjunctiva also controls allergic symptoms. These procedures provide effective physiological self-defence therapies against allergic challenge in humans.

Adolescent↗
PubMed1983

Body weight and its effect on immunoreactive parathyroid hormone levels.

Immunoreactive parathyroid hormone (iPTH) levels were measured in 12 obese subjects (140-272% ideal body weight) and 10 normal lean volunteers (93-100% ideal body weight). iPTH values were not significantly different in the two groups and tubular maximum phosphate reabsorption (TmP) was comparable in lean subjects and the 4 obese patients tested. 4 obese subjects were evaluated after an average of 6.7% body weight loss, and neither iPTH levels nor TmP were affected. The data indicate that the biological effects of PTH are not enhanced in the massively obese.

Absorption↗
PubMed1982

The effect of single morning and evening rinses of chlorhexidine on the development of tooth staining and plaque accumulation. A blind cross-over trial.

A dietary aetiology for tooth staining associated with the use of chlorhexidine has been postulated. The time related activity of chlorhexidine would therefore suggest that evening rinsing would result in less staining than morning rinsing. This study measured tooth and tongue staining and plaque accumulation in a group of 18 volunteers, rinsing once at night or once in the morning with chlorhexidine in a blind cross-over design. Beverage intake during two 10-day periods was prescribed. Significantly more tooth staining, but not tongue staining, was seen with morning rinsing. Plaque accumulation showed a trend to more plaque with morning rinsing, which was not significant. The findings would be consistent with a dietary aetiology for tooth staining. However, these results emphasise the considerable duration of activity of chlorhexidine on surfaces in the oral cavity and the theory of progressive desorption of chlorhexidine from the tooth surface is questioned.

Adult↗
PubMed1982

Establishing the psychiatric liaison nurse role: collaboration with the nurse administrator.

By helping patients, families, the hospital staff deal with the emotional effects of illness, the psychiatric liaison nurse plays a significant role in patients' healing. Since this type of role may be new to the organization, the psychiatric nurse and the nursing administrator must work in tandem to ensure successful role development and entry into the hospital system, both of which are crucial to the effectiveness of the liaison nurse. In our clinical experience, these issues need careful consideration and attention by both nurse administrators and psychiatric liaison nurses. We have attempted to provide practical considerations for facilitating the success of a psychiatric liaison nurse in the hospital system and justifying the value of this role.

Administrative Personnel↗
PubMed1982

Early closure of transverse loop colostomies.

A transverse loop colostomy was constructed in 60 patients at the time of primary elective surgery and the stoma was then resected within one month under antibiotic cover. There was a single death unrelated to operation. Four patients developed faecal leakage, 1 became obstructed, and 6 had infected wounds. With the exception of colostomy closure following sutured coloanal anastomosis a transverse loop colostomy can be closed within one month of construction with acceptable morbidity.

Adult↗
PubMed1981

Laparoscopy in general surgery.

The results of diagnostic laparoscopy under general anaesthetic in 81 general surgical patients have been reviewed. A tissue diagnosis was achieved in 25 of 42 patients (60 per cent) suspected to have widespread intra-abdominal malignancy with minimal preoperative investigation. Extensive investigation, excluding only computerized tomography, failed to achieve a diagnosis in 25 patients with an intra-abdominal mass. Subsequent laparoscopy allowed diagnosis of 22 of these patients (92 per cent). Severe persistent and unexplained abdominal pain in 14 patients was diagnosed at laparoscopy in only one patient (7 per cent) and the procedure did not influence the subsequent course of events in the remainder. There was no mortality and the morbidity (4.9 per cent) compares well with that of laparotomy in similar patients. Laparoscopy failed in 5 patients (6.2 per cent) due to the presence of dense intraperitoneal adhesions.

Abdomen↗
PubMed1980

Resonance Raman spectroscopy of chemically modified and isotopically labelled purple membranes. I. A critical examination of the carbon-nitrogen vibrational modes.

Resonance Raman spectra of bacteriorhodopsin are compared to the spectra of this protein modified in the following ways: (1) selective deuteration at the C-15 carbon atom of retinal, (2) full deuteration of the retinal, (3) the addition of a conjugated double bond in the beta-ionone ring (3-dehydroretinal), (4) full deuteration of the protein and lipid components, (5) 15N enrichment of the entire membrane and (6) deuteration of the entire membrane (including the retinal). A detailed comparison of the 15N-enriched membrane and naturally occurring purple membrane from 800 cm-1 to 1700 cm-1 reveals that 15N enrichment affects the frequency of only two vibrational modes. These occur at 1642 cm-1 and 1620 cm-1 in naturally occurring purple membrane and at 1628 cm-1 and 1615 cm-1 in the 15N-enriched samples. Therefore, this pair of bands reflects the states of protonation of the Schiff base. However, our data also indicate that neither of these modes are simple, localized C=N-H or C=N stretching vibrations. In the case of the 1642 cm-1 band motions of the retinal chain beyond C-15 are not significantly involved. On the other hand, in the 1620 cm-1 band atomic motions in the isoprenoid chain beyond C-15 are involved.

Bacteriorhodopsins↗
PubMed1980

Resonance Raman spectroscopy of chemically modified and isotopically labelled purple membranes. II. Kinetic studies.

Kinetic resonance Raman spectra of native and isotopically labelled purple membranes are compared. Using these data and the assignments of the previous paper in this sequence, we have confirmed that the Schiff base is deprotonated at times that are short in comparison to M412 evolution. In addition, by monitoring the kinetic resonance Raman spectra in 2H2O with 488.0 nm excitation we have been able to characterize in more detail the vibrational features associated with this unprotonated intermediate that precedes M412. Furthermore, the kinetic spectra of fully deuterated purple membrane in H2O have allowed us to assign the 1465 cm-1 band in these spectra to the C=C stretching frequency of BR570 and the 1512 cm-1 band to the C=C stretching frequency of M412. These spectra have also provided an indication of a Raman spectral feature associated with O640 and, finally, our kinetic spectra have provided evidence that there is a significant alteration in the rate constants for the evolution of the various intermediates when the non-exchangeable protons on the membrane are replaced by deuterons.

Bacteriorhodopsins↗
PubMed1980

Single and multiple dose cotrimoxazole and metronidazole in colorectal surgery.

Cotrimoxazole and metronidazole were given prophylactically to patients undergoing colorectal surgery as a single preoperative dose or in multiple doses for 5 days. A total of 60 operations randomly divided into two groups showed that the rate of wound infection was low in both groups and there was no statistical difference between them. There were no cases of anastomotic dehiscence in those patients where the anastomosis was carried out from within the abdomen, but 7 out of 9 patients with transphincteric colo-anastomoses developed a suture line dehiscence. A greater degree of post-catheterization urinary tract infection was seen in the single dose group (which lacks statistical significance). There were no toxic effects.

Adult↗
PubMed1980

Exchange kinetics of the Schiff base proton in bacteriorhodopsin.

Using rapid mixing techniques and resonance Raman spectroscopy, we have found that the 1H/2H exchange time for the Schiff base proton of bacteriorhodopsin in purple membrane is 4.7 msec, when experiments are carried out at pH 2 or pH 7 at room temperature in the dark. We argue that diffusion of neutral water into the membrane is fast on this time scale. Also, model Schiff bases in solution have a pKa between 6 and 7, and we show that such model Schiff bases have much faster exchange rates. Therefore, we conclude that the Schiff base proton in bacteriorhodopsin is protected from interaction with the medium, probably by interaction with a protein group, and this would account for a pKa considerably higher than 6-7.

Bacteriorhodopsins↗