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Biomedical subjects

A Reid

Publications and source records attributed to A Reid.

At least 91 records · Page 5Linked to original sources
PubMed1995

Vascular emergencies: what's in season?

Seasonality in ischaemic coronary artery disease is well documented with a winter/summer variation the commonest pattern. The influence of seasonal variation on events in other vascular territories is less well documented. The incidence of ruptured abdominal aortic aneurysm and emergency lower-limb ischaemia was analysed on a monthly basis over a 5-year period. A total of 372 ruptured abdominal aortic aneurysms occurred with a peak incidence in spring and autumn; however, no seasonal pattern was seen in the rate of emergency admissions with lower-limb ischaemia (n = 606). The explanation for this seasonal pattern in ruptured aneurysms is unknown. The haemodynamic adjustments to changes in climate require further study.

Aortic Aneurysm, Abdominal↗
PubMed1995

The changing workload of a surgical unit with a vascular interest.

OBJECTIVES: To examine the changing relationship between general and vascular surgical workload on a vascular "firm", over a 6-year period. DESIGN: Retrospective review. SETTING: Leicester Royal Infirmary and Professorial Surgical Unit, U.K. 1987-1992. METHOD: Analysis of audit of all surgical admissions. Relation of vascular surgery to general surgery. RESULTS: There has been a slight decrease (5%) in the number of general surgical elective admissions. Overall, the number of general surgical admissions, both elective and emergency, show a slight increase of about 3%. In contrast the number of vascular admissions increased by 42%. Of the general surgical procedures carried out 75.9% were either minor or intermediate, whereas 92.5% of vascular procedures were coded as major or higher. There has been a three times increase in the number of carotid endarterectomies, a similar increase in the number of the femorodistal bypass grafts and a halving of the number of major amputations. There has also been a five times increase in the number of angioplasties carried out. CONCLUSIONS: Our figures show the progressive, rapid increase in vascular surgical workload, compared to general surgery, and the need for the continued expansion of vascular surgery as a speciality.

Abdominal Pain↗
PubMed1995

Quality of life following infragenicular bypass and lower limb amputation.

AIMS: To objectively assess the quality of life after femorodistal bypass and compare this to quality of life achieved following primary limb amputation. DESIGN: Retrospective review. SETTING: Leicester Royal Infirmary, U.K., 1988-1993. METHODS: A self-assessment postal questionnaire containing scales measuring emotional disorder, social functioning and mobility was sent to 112 patients who had previously undergone femorodistal bypass (n = 86) or primary limb amputation (n = 26). RESULTS: Further analysis demonstrated that a secondary procedure (PTA or graft revision) to maintain graft patency did not adversely affect quality of life. Additionally, patients undergoing secondary amputation after graft failure had an identical quality of life to those undergoing primary amputation. CONCLUSIONS: These data illustrate that the quality of life after successful femorodistal bypass is higher than after primary or secondary amputation. To attain the maximum quality of life in patients with critical ischaemia, femorodistal bypass should be performed wherever feasible.

Aged↗
PubMed1995

Metallothionein expression in human breast cancer.

Metallothioneins are ubiquitous low molecular weight proteins characterised by high cysteine content and affinity for binding heavy metals. Abnormal metallothionein function and expression have been implicated in various disease states, including neoplasia. The aim of this study was to investigate metallothionein expression in human breast carcinoma. Sections of routinely fixed and processed blocks of tumour from 100 consecutive cases of primary operable breast carcinoma were stained for metallothionein using a recently developed monoclonal antibody and a standard immunohistochemical technique. Expression was scored on the basis of microscopical assessment of percentage of tumour cells staining. One patient was lost to follow-up and excluded from the study. A significant association (P < 0.0001) was observed between metallothionein expression and tumour type, with low levels being observed in tumours of good prognostic type. There was also a significant association with local recurrence (P < 0.02) and a significant difference (P < 0.02) in both survival and disease-free interval between tumours showing low and high levels of expression, the latter indicating a poor prognosis. No relationship was observed with patient age, tumour size, lymph node stage, histological grade, vascular invasion, menopausal status or oestrogen receptor status. The assessment of metallothionein expression in human breast cancer appears to provide prognostic information and may have important implications for understanding its development.

Breast Neoplasms↗
PubMed1994

Spinal supersensitivity to 5-HT1, 5-HT2 and 5-HT3 receptor agonists following 5,7-dihydroxytryptamine.

The present study examined functional supersensitivity to 5-hydroxytryptamine (5-HT) and 5-HT ligands selective for 5-HT1, 5-HT2 and 5-HT3 receptors in two tests for nociception following the spinal administration of 5,7-dihydroxytryptamine (5,7-DHT). Intrathecal pretreatment with 5,7-DHT 30-100 micrograms (following desipramine) produced a selective depletion of spinal cord 5-HT levels of > 80% and augmented the antinociceptive action of 5-HT in the tail flick and hot plate tests. The tail flick test was the more sensitive test for expression of this action. Supersensitivity was observed with the 5-HT1 receptor ligands CGS 12066B (7-trifluoromethyl-4-(4-methyl-1-piperazinyl-pyrrolo[1,2-a] quinoxalinedimaleate), RU 24969 (5-methoxy-3-(1,2,4,6-tetrahydro-4-pyridinyl)1H indole succinate), TFMPP (m-trifluoromethylphenyl-piperazine HCl), mCPP (1-(3-chlorophenyl)piperazine dihydrochloride) and 5-Me-ODMT (5-methoxy-N,N-dimethyltryptamine hydrogen oxalate) but not with the 5-HT2 receptor ligand DOI ((+/-)-1-(4-iodo-2,5-dimethoxyphenyl)-2-aminopropane HCl) or the 5-HT3 receptor ligand 2-Me-5-HT (2-methyl-5-hydroxytryptamine maleate) in the tail flick test. In the hot plate test, supersensitivity was observed only with 5-Me-ODMT. Intrathecal pretreatment with fluoxetine, a 5-HT uptake inhibitor, potentiated the action of 5-HT but not any of the other 5-HT1 receptor ligands examined. These results indicate that supersensitivity occurs with 5-HT and 5-HT1 receptor ligands but not with 5-HT2 or 5-HT3 receptor ligands. Both the loss of uptake sites and receptor upregulation may contribute to enhanced activity of 5-HT, but for other ligands, only the latter mechanism appears to occur.

5,7-Dihydroxytryptamine↗
PubMed1994

Common congenital heart defects. Long-term follow-up.

Dramatic advances in the diagnosis and treatment of patients with congenital heart disease (CHD) have profoundly increased their survival rate. More than 500,000 patients in the United States with functionally significant congenital cardiac defects have reached adulthood. The focus of this article is to present an overview of the long-term surgical outcomes of the following common congenital heart defects: atrial septal defect, pulmonary stenosis, ventricular septal defect, coarctation of the aorta, aortic stenosis, tetralogy of Fallot, and transposition of the great arteries.

Adult↗
PubMed1993

Chronic critical leg ischaemia must be redefined.

The Second European Consensus Document on Chronic Critical Leg Ischaemia defines critical limb ischaemia in non-diabetic patients as rest pain or tissue necrosis (ulceration or gangrene) with an ankle systolic pressure (ASP) of less than or equal to 50 mmHg, or a toe pressure of less than or equal to 30 mmHg. The aim of this study was to investigate whether this definition is able to predict the outcome of patients with severe lower limb ischaemia and thus to determine the relevance of the definition in clinical practice. We have analysed 148 severely ischaemic limbs in 133 non-diabetic patients who presented with rest pain, tissue necrosis or a combination of these symptoms. Fifty-one percent of these limbs fulfilled the current definition with an ASP < or = 50 mmHg; 49% had an ASP > 50 mmHg and were thus not defined as critically ischaemic according to the current definition. We have compared actuarial limb salvage and mortality rates in patients with an ASP < or = 50 mmHg to those patients with an ASP > 50 mmHg. The 1 year limb salvage and mortality rates for ischaemic limbs fulfilling the European Consensus Document criteria were 78.7 and 36.7% respectively, compared to rates of 73.9 and 17.3% in patients who were not defined as critically ischaemic under the current definition. There were no significant differences between 1 year limb salvage or mortality rates between the two patients groups (p = 0.843, 0.078, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Tinnitus in pregnancy.

The presence of tinnitus in pregnancy was investigated by a postal questionnaire survey. A group of pregnant women attending the ante-natal clinic and a control group of non-pregnant members of the nursing staff at the Royal United Hospital in Bath were studied. The prevalence of tinnitus in the pregnant and non-pregnant women was compared. Both groups were similar in age, previous noise exposure and the presence of ear disease or operations. Twenty-five per cent of the pregnant women reported tinnitus compared with 11% of the control group. Chi-square analysis of this data gives a value of chi 2 = 4.07, d.f. = 1, P < 0.05. The result of our survey shows that there is significantly increased prevalence of tinnitus in pregnant women compared with a similar non-pregnant control group. This association has not been previously reported.

Adult↗
PubMed1993

The prevalence of perilymphatic hypertension in subjects with tinnitus: a pilot study.

This study investigated the prevalence of perilymphatic hypertension (raised perilymphatic pressure) in a population of subjects with tinnitus. A review of the literature showed how changes in perilymphatic pressure could affect tympanic membrane displacement measurements. This review also revealed that perilymphatic hypertension was more likely to occur in young females (less than 45 years) than in other subjects. An experiment was designed to test 32 subjects, who were divided into four groups according to their age and sex. These subjects underwent several routine audiological tests and were then tested with the tympanic membrane measurement system to determine the perilymphatic pressure of both ears. Statistical analysis of the experimental results showed that the young females had raised perilymphatic pressure. This was significantly higher than the perilymphatic pressure of the other test groups and of that of a normal population. The young females also exhibited other symptoms indicative of raised perilymphatic pressure. The raised pressure was thought to be due to an increase in fluid pressure which is more likely to occur in females due to variations in the levels of circulating hormones with menstrual irregularities, pregnancy and the menopause.

Adult↗
PubMed1993

Determination of B-cell clonality in paraffin-embedded lymph nodes using the polymerase chain reaction.

Formalin-fixed, paraffin-embedded tissue from B-cell malignant lymphomas (26), reactive lymphadenopathies (8), non-B-cell malignancies (5), and atypical lymphoproliferative lesions (7) were analyzed for clonal immunoglobulin heavy chain gene rearrangement by the polymerase chain reaction (PCR), using consensus primers for the variable and joining regions of the gene. By employing a high-resolution gel electrophoresis technique, we were able to demonstrate one or two dominant bands, indicating a clonal population, in 15 of the 23 cases (65%) of B-cell lymphoma in which amplification occurred. Six of six reactive lymph nodes in which amplification occurred produced a multi-banded pattern indicative of a polyclonal population. This improved PCR technique allows a clearer distinction between clonal and polyclonal patterns than other previously proposed methods. It also works well in paraffin-embedded tissue and may therefore be a useful adjunct to the diagnostic armamentarium applied to archival material.

Base Sequence↗
PubMed1993

Barriers to adherence to preventive services reminder letters: the patient's perspective.

BACKGROUND: Despite an emerging consensus as to which preventive services are appropriate, a minority of patients receive them. Although adherence to recommendations for some interventions has increased, research studies have shown that adherence rates can be further improved through a better understanding of patient attitudes and motivations regarding preventive services. METHODS: Using components of the Patient Path Model, this study examined the response to patient reminder letters for cholesterol screening sent to 1077 adult patients between August and October 1990. The research strategy incorporated both quantitative and qualitative methods, including a telephone survey and focus group interviews of nonresponders to the reminder letter. RESULTS: Three hundred seven patients were surveyed by telephone to ascertain their reasons for nonresponse. One hundred fifty-four (50.2%) did not recall receiving the reminder letter, 84 (27.4%) recalled receiving the letter but did not recall its content, and 69 (22.5%) recalled both receiving the letter and its content. No consistent reason for nonadherence emerged among the 69 nonresponders who recalled the reminder. Twenty-seven of the nonresponders who did not recall receiving the cholesterol reminder participated in the focus groups. The participants stressed the importance of distinguishing the reminder letter from a bill, conveying a personally relevant message, and addressing logistical barriers to preventive services. CONCLUSIONS: Careful attention to the format and content of patient reminder letters is necessary to improve adherence to preventive services recommendations.

Adult↗
PubMed1992

Noradrenergic mediation of spinal antinociception by 5-hydroxytryptamine: characterization of receptor subtypes.

The present study examined the involvement of spinal noradrenergic mechanisms in spinal antinociception by the 5-hydroxy-tryptamine (5-HT) receptor-selective agonists CGS 12066B (5-HT1B; 7-trifluoromethyl-4(4-methyl-1-piperazinyl)-pyrrolo[1,2-a]quinoxaline), TFMPP (5-HT1C; M-trifluoromethylphenyl-piperazine) and DOI (5-HT2; 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane) using the rat hot plate test. Effects of alpha-adrenoreceptor antagonists (phentolamine, yohimbine), the adrenergic neurotoxin 6-hydroxydopamine, and the selective noradrenergic uptake blocker desipramine were determined. CGS 12066B, TFMPP and DOI produced dose-related antinociception. The antinociceptive effect of each agent was reduced by pretreatment with both phentolamine and yohimbine (15-60 micrograms). Pretreatment with 6-hydroxydopamine (100 micrograms, intrathecal) for 7-10 days, which reduced spinal cord levels of noradrenaline by 87%, inhibited the action of TFMPP (and 5-HT), but not CGS 12066B or DOI. Pretreatment with desipramine (25 mg/kg, systemic) potentiated the action of TFMPP but not CGS 12066B or DOI (or 2-methyl-5-HT). These results suggest that antinociception by TFMPP is dependent on release of endogenous noradrenaline from the spinal cord, while that produced by CGS 12066B and DOI is not. As TFMPP exhibits a close similarity to 5-HT in these experiments, the 5-HT receptor subtype being activated to induce noradrenaline release may either be a 5-HT1C or a 5-HT1S subtype. Other mechanisms account for the observed blockade of the action of CGS 12066B and DOI by alpha-adrenoreceptor antagonists.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1991

Noradrenergic and purinergic involvement in spinal antinociception by 5-hydroxytryptamine and 2-methyl-5-hydroxytryptamine.

The adrenergic involvement in spinal antinociception by 5-hydroxytryptamine (5-HT) and 2-methyl-5-hydroxytryptamine (2-Me-5-HT) was examined using the alpha-adrenoceptor antagonists phentolamine, yohimbine and prazosin, and the neurotoxin 6-hydroxydopamine. Intrathecal pretreatment with phentolamine and yohimbine (7.5-30 micrograms), but not prazosin (30 micrograms), reduced the action of 5-HT and 2-Me-5-HT in both the tail flick and hot plate tests. Pretreatment with 6-hydroxydopamine (100 micrograms) reduced (5-HT) or increased (2-Me-5-HT) antinociception in the hot plate test, while tail flick responses were largely unaffected. In other experiments, 8-phenyltheophylline, an adenosine receptor antagonist, reduced the action of 5-HT, but not 2-Me-5-HT, in both tests. These results indicate that (a) antinociception by both 5-HT and 2-Me-5-HT involves some form of interaction with spinal alpha 2-adrenoceptors, but the nature of the interaction for these two agents is different because only 5-HT is dependent on endogenous noradrenaline, (b) release of adenosine from the spinal cord contributes to spinal antinociception by 5-HT but not by 2-Me-5-HT.

Analgesics↗