Design a clinical information system.
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Data Collection↗
Biomedical subjects
A P Smith
Publications and source records attributed to A P Smith.
Dyskeratosis congenita and nasopharyngeal atresia.
Dyskeratosis congenita is a multisystem disorder with an increased incidence of neoplasia and opportunistic infections. A case is reported as a cause of complete nasopharyngeal atresia.
Adenocarcinoma↗
The common cold, pattern sensitivity and contrast sensitivity.
Results from two studies involving challenge with respiratory syncytial viruses showed that volunteers who developed colds were more sensitive to a visually distracting pattern presented prior to virus challenge than were volunteers who did not get a cold. Volunteers with sub-clinical infections reported more illusions after virus challenge than they had done before, whereas uninfected volunteers and those with colds tended to report fewer illusions on the second test. These effects did not occur when volunteers were challenged with either a coronavirus or rhinovirus. Overall, the results confirm that behavioural measures may be related to susceptibility to subsequent illness, and that viral infections may influence visual perception. They also show that the effects vary according to the nature of the infecting agent, which agrees with results from studies looking at other aspects of behaviour.
Adolescent↗
Multiple fetal anomalies in the first trimester; detection using transvaginal ultrasound and therapeutic abortion using mifepristone (RU486) in conjunction with gemeprost vaginal pessaries.
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Abnormalities, Multiple↗
Effects of breakfast and caffeine on performance and mood in the late morning and after lunch.
The aim of the present study was to examine the effects of breakfast and caffeine on performance, mood and cardiovascular functioning in the late morning and after lunch. Forty-eight subjects were tested at 07.45 and subjects then assigned to one of the four conditions formed by combining caffeine and breakfast conditions. Subjects in the caffeine condition were given a dose of 4 mg/kg, the caffeine manipulation being double blind. At 11.15 subjects were given another coffee (subjects remained in the same caffeine condition) and had lunch at 12.30. Performance was examined prior to lunch (11.30) and after lunch (14.00). Effects of breakfast on recognition memory (lower false alarm rate) and logical reasoning (reduced accuracy) were found in the late morning but not after lunch. However, a semantic processing task was performed more slowly by the breakfast group after lunch. Caffeine improved performance on a sustained attention task, the logical reasoning task and semantic memory task. Subjects given caffeine also reported greater alertness and feelings of well-being, whereas the effects of breakfast on mood changed from the late morning to early afternoon. Few interactions between breakfast and caffeine conditions were obtained.
Adult↗
Effects of influenza and the common cold on the Stroop color-word test.
Two experiments examined the effects of experimentally induced upper respiratory viral infections on selective attention. In Exp. 1, 61 adults were challenged with a cold-producing virus; analysis showed no effect of infection or illness on performance of the Stroop task. In contrast to this the results of Exp. 2, involving 27 adults, showed that influenza increased distractibility from irrelevant stimuli.
Adult↗
Effects of time of day, introversion and neuroticism on selectivity in memory and attention.
Two experiments examined the effects of time of day, introversion and neuroticism on selectivity in memory and attention. The first experiment showed that none of these factors interacted with task priority, which suggests that such variables do not produce the same changes in selectivity as do exogenous factors such as noise. In Exp. 2, colour names were read more quickly in the late afternoon than in the early morning, whereas patches of colour were named more quickly in the morning. Results from the Stroop interference condition showed that subjects classified as extraverts on the basis of Eysenck Personality Questionnaire scores were less susceptible to distraction than those scored as introverts, but the size of this effect was influenced both by time of day and by whether the subjects scored as stable or neurotic on the questionnaire.
Arousal↗
Mechanisms of abnormal glucose metabolism during the treatment of acute severe asthma.
Twenty-five patients with acute severe asthma were treated with oxygen, corticosteroids and either salbutamol or aminophylline by intravenous infusion. Blood glucose, plasma insulin and glucagon were measured during the first 24 hours of treatment. Salbutamol and aminophylline rapidly caused hyperglycaemia, accompanied by a rise in insulin and a fall in plasma glucagon. At first the increase in plasma insulin was insufficient to restore normoglycaemia, but by 24 hours homeostasis was restored. The early submaximal insulin response was attributed to the fasting caused by breathlessness. There was no evidence of an increase in hormone secretion caused by direct beta 2-adrenergic stimulation of the pancreatic islets. The effect of corticosteroids on blood glucose over the period of study was considerably less than the contribution of either salbutamol, or aminophylline.
Acute Disease↗
Psychological stress and susceptibility to the common cold.
BACKGROUND: It is not known whether psychological stress suppresses host resistance to infection. To investigate this issue, we prospectively studied the relation between psychological stress and the frequency of documented clinical colds among subjects intentionally exposed to respiratory viruses. METHODS: After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer. RESULTS: The rates of both respiratory infection (P less than 0.005) and clinical colds (P less than 0.02) increased in a dose-response manner with increases in the degree of psychological stress. Infection rates ranged from approximately 74 percent to approximately 90 percent, according to levels of psychological stress, and the incidence of clinical colds ranged from approximately 27 percent to 47 percent. These effects were not altered when we controlled for age, sex, education, allergic status, weight, the season, the number of subjects housed together, the infectious status of subjects sharing the same housing, and virus-specific antibody status at base line (before challenge). Moreover, the associations observed were similar for all five challenge viruses. Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association between stress and illness. Similarly, controls for personality variables (self-esteem, personal control, and introversion-extraversion) failed to alter our findings. CONCLUSIONS: Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.
Adolescent↗
Plasma adenosine concentrations during adenosine-induced respiratory stimulation in man.
Intravenous infusion of the nucleoside adenosine stimulates respiration, probably at least partly by an action in the carotid bodies, and also potentiates the ventilatory response to hypoxia, suggesting that it might be involved in the control of breathing. Whether the effects of adenosine occur at concentrations likely to be achieved in vivo is unknown and was investigated in 7 patients with arterial catheters inserted for diagnostic purposes. During intravenous infusion of adenosine (Maximum dose per min: mean 130 micrograms kg-1) mean minute ventilation increased from 5.5 to 10.9 l min-1 while mean plasma adenosine concentration in the aortic arch increased from 0.07 to 1.2 microM. In 3 patients ventilation first increased without a detectable increase in aortic adenosine concentration, suggesting a possible intra-pulmonary effect of adenosine, although increased concentrations were apparent at higher doses. Micromolar concentrations of adenosine are probably achieved in vivo in tissues during hypoxia. The present results show that at such concentrations adenosine stimulates respiration and are consistent with the suggestion that adenosine release may mediate or modulate the ventilatory response to hypoxia. A possible intra-pulmonary effect of adenosine merits further study.
Adenosine↗
The combined effects of noise, nightwork and meals on mood.
The present paper describes a laboratory study on the acute effects of a combination of noise and nightwork on subjective mood. Subjects tested in the presence of noise felt more alert than those tested under quiet conditions. Circadian variation in alertness was also reported, but the noise did not change the shape of the alertness rhythms. The only exception to this was found after the mid-shift meal. Subjects tested under quiet conditions felt less alert after the meal than before it, whereas those tested in the presence of noise reported that they were more alert in the post-meal period. These results suggest that noise and nightwork produce independent effects, whereas noise and meals influence similar mechanisms.
Adult↗
Immunophenotypic study of lymphocyte predominance Hodgkin's disease.
An immunophenotypic study of 17 cases of diffuse lymphocyte predominance Hodgkin's disease and 20 cases of nodular lymphocyte predominance Hodgkin's disease, along with eight of mixed cellularity and five of nodular sclerosing Hodgkin's disease, is reported. The atypical cells in nodular lymphocyte predominance Hodgkin's disease showed only minor differences from the published consensus. However, the atypical cells in diffuse lymphocyte predominance Hodgkin's disease showed an immunophenotype which was commonly B-cell positive (59%), but in a minority of cases LeuM1 (24%) or epithelial membrane antigen (12%) positive; none of the cases was Ber-H2 positive. These results do not differ greatly from our findings in nodular lymphocyte predominance Hodgkin's disease, but do diverge from the published consensus for diffuse lymphocyte predominance Hodgkin's disease. The question as to whether morphology or immunophenotype should form the primary diagnostic criterion for the definition of lymphocyte predominance Hodgkin's disease is discussed.
Antigens, Differentiation, Myelomonocytic↗
Noise and aspects of attention.
The paper reviews research on the effects of noise on attention. An experimental study of noise and selective attention is then described. The results showed that noise has different effects on tasks requiring focused attention and categoric search, with noise impairing performance on the focused attention task and having little effect on the search task. This effect of noise did not interact with time of day, level of anxiety, or cognitive failure. Noise did not influence the size of the Eriksen effect, although this did change at different times of day. Neither noise nor any of the other factors had a significant effect on the place repetition effect.
Adolescent↗
Does the substitution of cisplatin in a standard four drug regimen improve survival in small cell carcinoma of the lung? A comparison of two chemotherapy regimens.
Ninety five patients with small cell carcinoma of the lung were randomly assigned to one of two chemotherapy regimens (VACE or CVACE), each consisting of six cycles at three week intervals. The VACE regimen consisted of six cycles of vincristine 1.2 mg/m2, doxorubicin 40 mg/m2, and cyclophosphamide 700 mg/m2 on day 1 plus etoposide 110 mg/m2 daily for three days. The CVACE regimen was identical to the VACE regimen for cycles 3 and 4; cycles 1, 2, 4, and 6 consisted of etoposide 110 mg/m2 for three days plus cisplatin 100 mg/m2 with mannitol diuresis on the second day. Forty eight patients received VACE and 47 CVACE. Side effects resulted in withdrawal of four patients receiving VACE and six receiving CVACE. Three deaths were attributed to VACE and one to CVACE. Median survival did not differ between the two treatments overall, though there was a small increase in median survival in partial responders receiving CVACE. It is concluded that replacing four of the six cycles of VACE (vincristine, doxorubicin, cyclophosphamide, and etoposide) with etoposide and cisplatin conferred no overall advantage.
Adult↗
Problems and approaches in studying membrane opioid receptors.
Considerable progress has been made in recent years in understanding opioid receptors at the molecular level. Several laboratories have reported purification of opioid receptors by standard procedures involving solubilization of brain membranes in nondenaturing detergent, followed by affinity chromatography and other fractionation methods. In addition, several alternative approaches have been used with some degree of success. Several investigators have labeled receptors with covalent ligands, then characterized them under denaturing conditions such as SDS gel electrophoresis. Antibodies have been prepared to several pure or partially pure opioid receptor preparations that can be used to (1) map the brain regional distribution of opioid receptors, (2) determine the role of specific regions of the receptor molecules in ligand binding and in interaction with other functional molecules, (3) compare the structural features of different opioid receptor types, and (4) purify receptors further. One group also has reported cloning of the cDNA for an opioid-binding protein using antibodies as affinity ligands to purify receptors from solubilized material and the application of gene cloning techniques. The successful use of these varied approaches ensures that future progress in this field will be rapid. The purification, reconstitution, and detailed structural characterization of different opioid receptor types appears feasible within a few years. The next challenge in the molecular understanding of these receptors will be to identify and characterize the second messenger systems in the cell membranes that mediate their pharmacological functions.
Animals↗
Respiratory virus infections and performance.
Minor illnesses, such as colds and influenza, are frequent, widespread and a major cause of absenteeism from work and education. Yet the clinical symptoms of such illnesses may not be so great as to stop people from working or from carrying out everyday activities. It is therefore important to determine whether these viral infections alter central nervous system function and change performance efficiency. Data on this topic are almost non-existent, which in part reflects the difficulties inherent in carrying out such studies. In real life it is almost impossible to predict when such illnesses will occur, and difficult to establish which virus produced the illness. This problem was overcome by studying experimentally induced infections and illnesses at the Medical Research Centre (MRC) Common Cold Unit in Salisbury. Results from this research programme show that: (i) colds and influenza have selective effects on performance; (ii) even sub-clinical infections can produce performance impairments; (iii) performance may be impaired during the incubation period of the illness; (iv) performance impairments may still be observed after the clinical symptoms have gone. These results have strong implications for occupational safety and efficiency and it is now essential to assess the impact of naturally occurring colds and influenza on real-life activities.
Absenteeism↗
Opioid-binding protein (OBCAM) is rich in beta-sheets.
Based on circular dichroism (CD) and the sequence-predictive method, the opioid-binding cell adhesion molecule (OBCAM) consisted of one half beta-sheets and one fourth alpha-helices. This is consistent with significant sequence homology of the protein to several members of the immunoglobulin (Ig) superfamily, particularly cell adhesion molecules, which are rich in beta-sheets. Hydropathy analysis suggests that hydrophobic and hydrophilic regions were evenly distributed along the sequence, but the NH2- and COOH-termini were hydrophobic. Hydrophobic moments and Fourier-transform amphipathic analyses further suggest that residues 23-30 and 83-93 were amphipathic beta-sheets. The overall conformation of OBCAM was unaltered by adding linoleic acid, which is required for opioid ligand binding.
Animals↗
Estimated fetal weight in twin pregnancy: how good are we?
Ultrasonic assessment of fetal weight derived from multiple measurements of the fetus has become accepted in clinical practice as being useful in singleton pregnancies. Several different formulae for estimating fetal weight have been derived from differing measurements of the fetus, such as biparietal diameter, trunk circumference, and femur length. To date, there has been no attempt to evaluate such a technique in multiple pregnancy. This study aims to see whether the formulae derived for singleton pregnancy are applicable to twin pregnancies. Estimated fetal weight will be derived by mathematical modelling from ultrasonic measurements made within a week of delivery and the results compared with the actual birthweight to give an indication of how good such estimated fetal weights are. Factors to be considered in the analysis include whether there are differences between Twin I and Twin II, differences of presentation with twins and differences by gestation at delivery.
Birth Weight↗