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Biomedical subjects

A Lloyd

Publications and source records attributed to A Lloyd.

At least 145 records · Page 8Linked to original sources
PubMed1988

Antibodies to HIV are produced within the central nervous system of all subjects with all categories of HIV infection.

Anti-HIV antibodies were found in the cerebrospinal fluid of all 41 subjects tested whose serum contained these antibodies. To ensure that locally produced antibody was being detected, a sensitive assay was used to demonstrate the integrity of the blood-brain barrier. Antibodies to ubiquitous adenovirus group antigens were sought, simultaneously, in CSF and serum. A lack of adenovirus antibodies in CSF of subjects seropositive for adenovirus was required before CSF anti-HIV antibodies could be considered to be produced within the central nervous system. Of the 41 subjects tested eight were asymptomatic, eight were clinically well but had persistent lymphadenopathy, 14 were immunodeficient and had constitutional symptoms (AIDS-related complex or ARC) and 11 had AIDS. Oligoclonal banding was detected in the CSF of 16 subjects and a pleocytosis was present in 24. Neither finding clustered with a particular stage of infection. It appears that HIV infection of T lymphocytes and the central nervous system occurs simultaneously, early in the course of the infection. All HIV infected subjects are at risk of developing primary neurological as well as immunological sequelae. Currently poorly understood resistance factors must protect both lymphocytes and nervous system tissue from damage by the HIV virus, as to date, the majority of infected subjects have not become immunodeficient or developed neurological disease.

AIDS-Related Complex↗
PubMed1988

Exercise testing in patients with musculoskeletal handicaps.

To determine safe and effective exercise testing techniques for musculoskeletally handicapped individuals, 20 patients (mean age, 61 years) were studied. Types of handicaps included various degrees of paralysis of arms and legs, and leg amputations. Seventeen of the 20 patients had concurrent cardiovascular problems. All were currently hospitalized, engaged in various physical therapy exercises, and referred for exercise testing to increase rehabilitation therapy or for cardiovascular evaluation. Of 20 tests, arm ergometry was used in 15, leg or combination arm-leg ergometry in four, and treadmill in one. All patients completed testing with mean increases in heart rate (82 to 106 bpm arm, 88 to 125 other) and systolic blood pressure (114 to 127 mmHg arm, 118 to 146 other). Low-grade atrial and ventricular ectopy occurred in eight patients, decrease or plateauing of systolic blood pressure in three, increased diastolic blood pressure in two, and significant (greater than or equal to 1mm) ECG S-T segment displacement in one. With the use of appropriate equipment for each patient, exercise testing can be done safely and effectively in musculoskeletally handicapped individuals.

Adult↗
PubMed1988

Outpatient rehabilitative training in patients with cardiovascular disease: emphasis on training method.

As our ability to evaluate cardiovascular patients expands and direct oxygen consumption measurements are available, exercise prescriptions can be better individualized for each patient. By using basic principles of frequency and duration and specifically basing intensity and progression on percent of maximum oxygen consumption, protocols using various modes of exercise may be defined so that each patient entering cardiovascular training programs will gradually progress. This methodology discussion presents concise progressions for both phase II monitored and phase II nonmonitored medically supervised exercise training. The phase II monitored protocol consists of levels 1 through 6 and is designed to be completed within a minimum of six 1-hour sessions. The phase II nonmonitored protocol consists of levels 7 through 12 and is designed to be completed within 12 weeks. The ultimate goal is for each patient to safely progress to a training level that can be maintained safely and effectively by the patient. A total of 192 patients enrolled in our phase II programs have safely completed both components and are in long-term maintenance programs.

Cardiac Rehabilitation↗
PubMed1985

Micro-angiopathic haemolytic anaemia and an unusual lactate dehydrogenase iso-enzyme pattern in metastatic adenocarcinoma. A case report.

Micro-angiopathic haemolytic anaemia is an unusual but well-recognized complication of metastatic adenocarcinoma. A young black man presented with red cell fragmentation, compensated disseminated intravascular coagulation and leuco-erythroblastosis. Metastatic adenocarcinoma of the stomach was suspected but only demonstrated at autopsy. An unusual finding was the elevation of the slow-moving lactate dehydrogenase iso-enzyme (LDH5) level in the plasma which was shown to be produced by metastatic tumour cells recovered from the bone marrow.

Adenocarcinoma↗
PubMed1984

Studies on cultured fibroblasts in a case of methylmalonic aciduria.

A case of methylmalonic aciduria is described. The clinical course was unusually mild, the child surviving to the age of 8 years. Studies on cultured fibroblasts confirmed a defect in propionate metabolism which was non-responsive to hydroxycobalamin in vitro. Polyethylene-glycol-induced cell fusion with a known methylmalonyl co-enzyme apomutase-deficient cell line showed genetic complementation indicating that in this patient the defect was in one of the enzymes required for 5-deoxyadenosyl cobalamin synthesis.

Apoenzymes↗
PubMed1983

Identification of nerve growth factor receptors in primary cultures of chick neural crest cells.

Primary cultures of chick neural crest cells obtained from explanted neural tubes have binding sites for radioiodinated nerve growth factor ([125I]NGF) but not for radioiodinated epidermal growth factor ([125I]EGF). The binding of [125I]NGF was shown to be a specific and saturable process with a high affinity (Kd = 0.3 nM) for the ligand. Despite the expression of these NGF binding sites, incubation of the neural crest cultures with nerve growth factor did not induce neurite outgrowth; no morphological alterations were observed. This was not due to an inability of the cells to express a neuronal phenotype, since the neural crest cells spontaneously differentiated into neurite-bearing cells. However, the nerve growth factor binding sites do appear to be functional receptors, since nerve growth factor could produce a modest induction of ornithine decarboxylase. The quantity of nerve growth factor binding sites seemed to be independent of the phenotype expressed by the neural crest cells, since both pigmented cells and neuron-like neural crest cells exhibited binding. These findings suggest that the differentiation of neural crest cells into mature nerve growth factor-responsive neurons may involve the coupling of nerve growth factor receptors to cellular responses important in the expression of the neuronal phenotype.

Animals↗
PubMedDate not supplied

Impact of long-term complications on quality of life in patients with type 2 diabetes not using insulin.

OBJECTIVES: The complications of diabetes have the potential to greatly impact the health-related quality of life (HRQOL) of patients with type 2 diabetes. The effect of diabetic complications on HRQOL was assessed in 1233 patients with type 2 diabetes who were not using insulin. METHODS AND DATA: Patients were aged 35 and older and had stable fasting serum glucose (FSG) after washout of antidiabetic therapy. Patients who required insulin or suffered from severe cardiovascular or hepatic disease, neuropathy, or retinopathy were excluded. Patients completed the SF-36 generic quality of life questionnaire. Demographic data, including body mass index (BMI), blood glucose hemoglobin A1c (HbA1c), FSG, and the presence and severity of eight specified diabetic complications were also collected. A linear regression analysis was performed for each of the SF-36 domains and for the physical and mental health summary scales. RESULTS: The most prevalent diabetic complications were hypertension (46% of patients), peripheral sensory neuropathy (PSN; 12%), coronary artery disease (CAD; 8%), retinopathy (8%), and peripheral vascular disease (PVD; 7%). Most (73%) of the complications were assessed to be mild. PSN was associated with significantly lower scores (i.e., worse quality of life) in the mental health scale; CAD was associated with significant reductions of all but role-emotional and mental health scales of the SF-36; and PVD was associated with significantly lower physical and social functioning scales. Hypertension did not have an independent effect on HRQOL. CONCLUSIONS: The presence of even mild diabetic complications has a significant impact on patients' quality of life. Early diagnosis and treatment is essential to help prevent deterioration of HRQOL in these patients.

Adult↗
PubMedDate not supplied

The role of risk and benefit perception in informed consent for surgery.

BACKGROUND: Informed consent relies on patients' ability to understand risk information. Evidence suggests that people may extract the gist of any risk information to make medical decisions. Existing evidence also suggests that there is an inverse relationship between the perception of risk and the perception of benefit. METHOD: Seventy-one patients on the waiting list for carotid endarterectomy (CEA) were surveyed regarding their understanding and recall of the risk and benefit to health of undergoing CEA. Patients were surveyed 1 month after their initial consultation, and a subgroup was surveyed again on the day before their operation. RESULTS: Patients' estimates of their baseline risk of stroke without surgery were significantly different from what they had been told by the surgeon. Patients' estimates of stroke risk due to surgery ranged from 0% to 65% (actual local risk 2%). Patients also had unreasonable expectations about the benefit of the operation for their health. Estimates of stroke risk correlated positively with the degree of expected benefit from the operation (r = 0.29, P = 0.05). When resurveyed the day before the operation, patients' perceptions of both risk and benefit had increased significantly. The risk perception data from some patients appeared to contradict some of the predictions of the fuzzy-trace theory. CONCLUSIONS: Most patients failed to understand the risks and benefits associated with CEA. Some patients' estimates of stroke risk were actually greater than the perceived potential benefit of surgery in terms of risk reduction. The data also suggested a positive correlation between the degree of perceived benefit and the degree of perceived risk.

Cognitive Dissonance↗
PubMedDate not supplied

Development of an exercise expert system for older adults.

The purpose of this study was to develop a computerized exercise expert system (CEES) that creates tailored exercise plans for older adults. A panel of experts was selected in the areas of medicine, exercise physiology, health promotion, exercise psychology, and gerontology. The experts communicated with the principal investigator and the project members by mail, email, telephone, and expert meetings. A two-day workshop was held during the second year for the project members as well as local and national experts to review the CEES. The CEES demonstrated adequate inter-rater reliability (0.80) and criterion validity (0.70). Content validity was achieved by literature review and expert opinion. The CEES gathers information on the elder's health status, clinical factors, and exercise determinants that characterize specific barriers or incentives to exercise. The software program then develops individualized exercise prescriptions that are customized to older adults.

Adult↗
PubMedDate not supplied

Responding to change.

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Community Health Nursing↗