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Biomedical subjects

A Rudd

Publications and source records attributed to A Rudd.

31 records · Page 2Linked to original sources
PubMed2000

Variations in stroke incidence and survival in 3 areas of Europe. European Registries of Stroke (EROS) Collaboration.

BACKGROUND AND PURPOSE: Comparison of incidence and case-fatality rates for stroke in different countries may increase our understanding of the etiology of the disease, its natural history, and management. Within the context of an aging population and the trend for governments to set targets to reduce stroke risk and death from stroke, prospective comparison of such data across countries may identify what drives the variation in risk and outcome. METHODS: Population-based stroke registers, using multiple sources of notification, ascertained cases of first in a lifetime stroke between 1995 and 1997 for all age groups. The study populations were in Erlangen, Germany; Dijon, France; and London, UK. Crude incidence rates were age-standardized to the European population for comparative purposes. Case-fatality rates up to 1 year after the stroke were obtained, and logistic regression adjusting for age group, sex, and pathological subtype of stroke was used to compare survival in the 3 communities. RESULTS: A total of 2074 strokes were registered over the 3 years. The age-standardized rate to the European population was 100.4 (95% CI 91.7 to 109.1) per 100 000 in Dijon, 123.9 (95% CI 115.6 to 132.2) in London, and 136.4 (95% CI 124.9 to 147.9) in Erlangen. Both crude and adjusted rates were lowest in Dijon, France. The incidence rate ratio, with Dijon as the baseline comparison (1), was 1.21 (95% CI 1.09 to 1.34) in London and 1.37 (95% CI 1.22 to 1.54) in Erlangen (P:<0.0001). There were significant differences in the proportion of the subtypes of stroke between populations, with London having lower rates of cerebral infarction and higher rates of subarachnoid hemorrhage and unclassified stroke (P:<0.001). Case-fatality rates varied significantly between centers at 1 year, after adjustment for age, sex, and subtype of stroke (35% overall, 34% Erlangen, 41% London, and 27% Dijon; P:<0.001). CONCLUSIONS: The impact of stroke is considerable, and the risk of stroke varies significantly between populations in Europe as does the risk of death. The striking differences in survival require clarification but lend weight to the evidence that stroke management may differ between northern and central Europe and influence outcome.

Age Factors↗
PubMed1999

Expression of IL-8 by cells of the odontoblast layer in vitro.

Due to their peripheral location in the dental pulp and their cellular extension into dentin, odontoblasts are the first pulpal cells to encounter dental pathogens. The association of odontoblasts with immunoglobulins and dendritic cells during microbial invasion of dentin implies that these cells may possess a role in the innate and adaptive pulpal immune responses, however this has not been examined. A pivotal step in the innate immune response is the detection of foreign antigen and the recruitment of immune effector cells to the area. IL-8 is a potent chemotactic cytokine that plays an important role in the inflammatory response. The purpose of this study was to determine if odontoblasts are capable of expressing the pro-inflammatory chemokine IL-8. Human odontoblasts from intact, noncarious third molars were maintained in culture and exposed to Escherichia coli lipopolysaccharide (LPS) (serotype 055:B5) on day 4 for 8-10 h in a humidified 5% CO2 incubator. Control and experimental samples were assayed by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot for the production of IL-8 mRNA and protein. Analysis of the PCR products revealed that cells of the odontoblast layer maintained in this culture model constitutively expressed low levels of IL-8, which were increased in response to E. coli LPS exposure. Western blotting confirmed that the mRNA was translated into protein. These results imply that odontoblasts are capable of producing of pro-inflammatory mediators, thereby actively participating in the recruitment of neutrophils in response to bacterial by-products.

Blotting, Western↗
PubMed1987

Selection for long-term hospital care.

A formalized system for selecting patients requiring long-term hospital accommodation is described and our first two years' experience presented. Fifty patients were considered by the panel of whom 25 were designated as being suitable to be transferred to a long-term bed. Alternative solutions were considered more appropriate for the remaining 25; only 0.95% of all admissions to the unit finally required long-term hospital care.

Aged↗
PubMed1987

Investigation of anterior pituitary function in elderly in-patients over the age of 75.

Dynamic pituitary function tests were carried out on 50 randomly selected in-patients, (30 women and 20 men) over the age of 75 during early convalescence. Twenty-five subjects also had CT scans of the pituitary fossa. One male patient had hypogonadotrophic hypogonadism; another had a large prolactinoma and hypothyroidism; these were excluded from the analysis. Of the remaining 48 subjects, 14 (29 per cent) had reduced TSH responses to TRH and 28 (64 per cent) decreased GH responses to L-dopa compared with our laboratory's reference ranges. Fifteen women (51 per cent) had low basal gonadotrophin levels of which 10 (34 per cent) gave a poor LH response to LHRH and eight (27 per cent) a poor FSH response. Forty-three subjects (93 per cent) gave a good ACTH response to metyrapone. Only six subjects (24 per cent) had an apparently normal pituitary fossa; 16 (64 per cent) had partially or completely empty fossas. There was no significant correlation between the diminished pituitary responses. Only one patient had responses which suggested panhypopituitarism. There was also no significant correlation between the appearance on CT scan of the pituitary fossa and the results of the dynamic tests. It is suggested that laboratory reference range for pituitary function which have been derived from young ambulatory subjects are not appropriate for hospital in-patients over the age of 75. A series of reference ranges for such subjects is proposed.

Aged↗
PubMed1985

Tuberculosis in a geriatric unit.

All cases of tuberculosis admitted to a geriatric unit over five years were reviewed. The problems involved in diagnosing and managing the disease in the elderly are discussed, emphasizing the importance of diagnosing a treatable disease that may otherwise be fatal.

Aged↗
PubMed1985

Malignant optic nerve gliomas in adults.

Two patients with malignant optic nerve gliomas are described. The clinical courses and radiographic appearances are discussed, with emphasis on the fact that this condition should be considered in the differential diagnosis of rapid visual failure. It can now be strongly suspected preoperatively on the basis of computed tomographic scan appearances.

Adult↗
PubMed1981

A phase II clinical study of mAMSA in small cell carcinoma of the lung.

Thirteen patients with small cell carcinoma of the bronchus that had become resistant to conventional chemotherapy were given 4'-(9-acridinylamino)methanesulphon-m-anisidide (mAMSA) at a dose of 90 or 120 mg/m2 at 3-week intervals. Twenty percent of the courses at 90 mg/m2 produced marked myelosuppression. No responses were observed. Median survival from the start of treatment with mAMSA was 5 weeks.

Aged↗
PubMedDate not supplied

Investigation of platelet glycoprotein IIIa polymorphism using flow cytometry in patients with rheumatoid arthritis.

OBJECTIVES: Previous work has shown that the human platelet antigen (HPA) 1b polymorphism of platelet glycoprotein IIIa (GPIIIa) is implicated in the development of ischaemic vascular disease. HPA1b positive platelets have a lower threshold for activation and may exert a greater thrombotic tendency than those without the 1b allele. However, platelets heterozygous for the polymorphism are also more sensitive to aspirin than those homozygous for the 1b allele, which have a similar sensitivity to those without the 1b allele. A flow cytometric method has become available to identify this polymorphism. The aim of our study was to evaluate the use of this assay in patients with rheumatoid arthritis (RA) and to determine the incidence of the 1b allele in these patients. We also compared platelet aggregation and platelet/white blood cell interaction in patients with or without this polymorphism. METHODS: We enrolled 99 patients and measured platelet aggregation in whole blood and platelet-rich plasma (prp), platelet/white blood cell interaction and C-reactive protein (CRP). RESULTS: Thirty-four of the 99 patients were unsuitable for analysis because their baseline expression of GPIIIa was outwith the normal range, making the results outwith the limits of the flow cytometric method. The incidence of the 1b allele in the patients was 29%, with incidence being higher in females, although this failed to reach statistical significance. The number of circulating platelet aggregates and adenosine diphosphate (ADP)-induced aggregation in prp was significantly higher in those patients with the 1b allele. CONCLUSIONS: This method may be of use as an initial screening test.

Adult↗
PubMedDate not supplied

Casemix and process indicators of outcome in stroke. The Royal College of Physicians minimum data set for stroke.

The emphasis on outcomes measurement requires that casemix is considered in any comparative studies. In 1996 the Intercollegiate Working Party for Stroke agreed a minimum data set to measure the severity of casemix in stroke. The reasons for its development, the evidence base supporting the items included and the possible uses of the data set are described. It is currently being evaluated in national outcome and process audits to be reported at a later date.

Cerebrovascular Disorders↗