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Biomedical subjects

A Scott

Publications and source records attributed to A Scott.

At least 163 records · Page 9Linked to original sources
PubMed1994

The value of thallium and three-phase bone scans in the evaluation of bone and soft tissue sarcomas.

Thirty-seven patients with newly diagnosed or treated sarcomas had 47 sets of sequential thallium scans (TS) followed by three-phase bone scan (TPBS) on the same day. The diagnosis in all patients was verified by biopsy (n = 40) or long-term follow-up studies (n = 7). The sensitivity, specificity, and accuracy of TS and TPBS in detecting sarcomatous lesions was calculated: TS sensitivity was 88%, specificity 69%, and accuracy 83%; blood flow (BF) and blood pool (BP) sensitivity was 91%, specificity 54%, and accuracy 81%; delayed bone scan (DB) sensitivity was 88%, specificity 38%, and accuracy 74%. In 17 studies the flow and blood pool parts of the TPBS and TS demonstrated the soft tissue component of sarcomas, which would have been missed if only the delayed bone scan had been performed. The TS lesion to normal tissue ratio alone was not very helpful in differentiating sarcomas from benign conditions because some benign lesions are highly cellular and vascular while some malignant lesions, such as chondrosarcoma, have poor vascularity and a less cellular chondroid matrix. However, when the thallium ratio was correlated with similar ratios calculated from the BP image, it was found that if the TS lesion to normal tissue ratio exceeded the BP lesion to normal tissue ratio (12 patients), the specificity for detecting sarcomatous lesions was 100%. Nevertheless, the reverse was not true. The positive predictive value of this observation was 100% and the negative predictive value was 37%.

Adolescent↗
PubMed1994

Psychological symptom profiles in patients with chest pain.

Five-hundred and thirty-two patients with ischaemic-like chest pain referred for symptom-limited exercise thallium myocardial perfusion studies, were assessed on a range of psychosocial measures. Three groups of patients were identified on the basis of their perfusion studies: (1) normal thallium perfusion; (2) current myocardial ischaemia; and (3) past myocardial infarction (but no current ischaemia). There were no significant psychological differences between these groups on a wide range of measures which included depression, state and trait anxiety, Type A behaviour, personality, suppression of affect, locus of control, alexythymia, and hypochondriasis. Significant differences were identified, however, on measures of anger and coping style. Subjects with no current ischaemia (normal thallium perfusion and those with past myocardial infarction) had higher scores on 'immature coping' and 'anger in', than subjects with current myocardial ischaemia. These findings are discussed in the light of other published research.

Adult↗
PubMed1994

Current status of radioimmunodetection.

Radioimmunodetection is a nuclear medicine technique that depends on in vivo detection of localization of antibodies and antibody forms carrying radioactivity for the purpose of diagnosis in patients with cancer. Current methods take advantage of tracers suitable for high resolution gamma-camera imaging, such as 99mTc and 111In, for common tumors, such as colon and lung cancers. In addition, tracers such as 125I have been used for the intraoperative detection of metastatic deposits. These methods detect from 75 to 90% of metastatic deposits with high specificity, and typically contribute important diagnostic information, even in 25-40% of patients with occult disease.

Clinical Trials as Topic↗
PubMed1994

Current status of radioimmunotherapy.

Radioimmunotherapy with radiolabeled monoclonal antibodies is increasingly effective for hematopoietic tumors, with a number of investigators reporting persistent major responses. Radioimmunotherapy for solid tumors has been more difficult and only an occasional major response has been reported and these have so far not been persistent. Toxicity is predominantly hematopoietic, with platelets being most sensitive to the effects of radiation. Even at ultra-high doses (up to 28 mCi/kg of 131I), second organ toxicity has not been reached. Rational approaches to dose planning are becoming possible with improvements in dosimetry, based on quantitative SPECT and PET imaging. Current therapeutic indices for tumor/marrow, the most radiosensitive organ, are in the range of 5-10 to 1. This is probably still too low for curative treatment of solid tumors, and further refinements, perhaps based on novel antibody formulations, are needed.

Clinical Trials as Topic↗
PubMed1994

Keeping the customer satisfied: issues in the interpretation and use of patient satisfaction surveys.

Patient satisfaction and customer focus are increasingly important objectives set for health services. The patient satisfaction survey is becoming the main method of assessing this aspect of health care. In competitive environments, those institutions that show that they respond to consumers' needs are in a better position to attract funding. The use of patient satisfaction surveys in quality assurance-type activities is also increasing. In these contexts, however, the way in which patient satisfaction surveys should be interpreted and used to maximise the satisfaction of patients has received little critical attention. Problems in interpreting the results of satisfaction surveys arise from the weak conceptual foundation of patient satisfaction, which has been well documented in the literature. The objective of this paper is to show that using current formulations of patient satisfaction surveys in quality assurance-type activities and competitive environments may not lead to the maximisation of patients' satisfaction with health services. If the satisfaction of patients is to be maximised then it is necessary to extend the current conceptual basis of patient satisfaction to recognise explicitly the decision-making contexts in which the results will be used. This paper identifies the manner by which this extension should occur by considering some of the problems and pitfalls of interpreting and using the results of surveys to maximise patients' satisfaction.

Decision Making, Organizational↗
PubMed1994

Hemophilia growth and development study: baseline neurodevelopmental findings.

Reported baseline findings from the neurological assessment component of the Hemophilia Growth and Development Study (HGDS). HIV-positive (HIV+; n = 207) and HIV-negative (HIV-; n = 126) young males with hemophilia ages 6 to 18 years, were enrolled in a prospective study of their growth and development. At baseline, HIV+ and HIV- subjects were not significantly different in test performance. The number of subjects exhibiting below-average performance in three or more areas assessed was about 25% overall. For both groups, mean test scores were within the average range. Academic and adaptive skills were lower than expected based on mean IQ scores, and more behavioral/emotional problems than expected were reported by parents. Absolute CD4 cell counts per mm3 were not related to neuropsychological performance at baseline. Results suggest that the subjects with HIV were relatively free of HIV-related neuropsychological impairment at baseline and that observed differences from a general population reflect effects of hemophilia as a chronic illness.

Adolescent↗
PubMed1994

Smoking prevalence among 15-16-year-olds in Doncaster, England.

An anonymous self-completion questionnaire on smoking was completed by 2065 (60 per cent) 15-16-year-olds attending secondary schools in Doncaster in 1991. Almost one in four girls (23 per cent) and one in six boys (16 per cent) reported they were regular smokers, an overall increase of 8 per cent since a similar survey in 1988. An increase in smoking was recorded in 12 of the 14 schools which took part in both the 1988 and 1991 surveys. Differences in smoking prevalence were recorded between schools. School-based analysis is likely to be important for the development of effective local intervention. Possible reasons for the overall increase in smoking are discussed, and the need for concerted efforts to influence smoking regulation policy decisions is stressed.

Adolescent↗
PubMed1994

Streptococcal toxic shock-like syndrome: evidence of superantigen activity and its effects on T lymphocyte subsets in vivo.

Toxic shock-like syndrome is a serious complication of invasive streptococcal disease. The syndrome is believed to be the consequence of exposure to exotoxins produced by the infecting organisms which behave as superantigens. We describe two patients who fulfilled clinical criteria for this syndrome, one of whom died. Streptococci isolated from both patients were found to produce a mitogen specific for the V beta 2+ T lymphocyte subset in vitro, which had the characteristics of a superantigen. The phenotype and function of lymphocytes collected from both patients during the acute phase of their illness demonstrated a marked reduction in circulating CD4+ ('helper') and CD45RA+ ('naive') T lymphocytes expressing the V beta 2 chain, and an increase of those expressing CD8, CD45RO and the V beta 2 chain. This effect resolved within 4 weeks in the patient who survived. Proliferation assays demonstrated no T cell anergy in either patient. Stimulation of lymphocytes by superantigen in these clinical situations does not appear to cause permanent deletion of T cell subsets, as has been observed in animal models.

CD4-Positive T-Lymphocytes↗
PubMed1994

A cost analysis of early discharge and domiciliary visits versus standard hospital care for low-risk obstetric clients.

This paper presents an economic analysis of three obstetric early discharge schemes operating in western Sydney. The primary objective was to examine the net economic value of health service resources released due to each early discharge scheme. Conventional postnatal obstetric care comprised an inpatient stay of four to five days. Early discharge provided an alternative location. Clients who chose to participate in the scheme were discharged two to three days earlier than usual and visited at home by a midwife for up to seven days. Other studies of early discharge schemes have shown that resulting maternal and infant morbidity were no higher than with conventional care. This study took the form of a cost analysis. The early discharge schemes at Blacktown and Westmead Hospitals used more resources than they released, whereas the scheme at Auburn Hospital released resources in excess of those it used. Sensitivity analysis showed that the results for Westmead and Auburn Hospitals were sensitive to changes in key assumptions used in the analysis. The number of domiciliary visits per client was an important determinant of the ability of schemes to release resources in excess of their costs. The existence of early discharge provides an extra choice to clients in the location of postnatal care. The question for decision makers is whether this choice is worth the extra cost of early discharge schemes.

Australia↗
PubMed1994

Expression of liver functions in immortalised rat hepatocyte cell lines.

The differentiated hepatic function of two rat liver cell lines, P9 and SV40RH1, immortalised by transfection with SV40 DNA has been investigated in terms of the glutathione synthesis, and the activities of gamma-glutamyltransferase, glutathione-S-transferase and UDP-glucuronosyltransferase. SV40RH1 is a highly differentiated cell line at early passage, but the expression of some aspects of its differentiated phenotype is unstable and some functions are lost by passage 12-13. P9 is a less-well differentiated cell line, with relatively stable expression of functions between passages 4 and 13. In terms of differentiated function both cell lines represent a marked improvement over primary cultures of rat hepatocytes which de-differentiate rapidly within 24-48 h in culture. This retention of liver function in proliferating cell lines offers the opportunity to use such cells in in vitro toxicological studies.

Animals↗
PubMed1993

Alterations in rat hepatic drug metabolism during pregnancy and lactation.

The hepatic microsomal drug metabolism during pregnancy and lactation was studied. Four days post partum, the concentrations of cytochrome P450 and cytochrome b5 were reduced by 50% when compared with pregnant rats, at day 10 of gestation. Within this time period the N-demethylation of aminopyrine, the rate of aldrin epoxidation and the N-demethylation of demethylnitrosamine was reduced by 53, 74 and 21%, respectively. However, the rates of ethoxyresorufin-O-deethylation did not differ amongst both groups and the deethylation of 4-nitroanisole and the 4-hydroxylation of aniline was increased by 71 and 31%, respectively in lactating rats. Furthermore, the activities of UDP-glucuronyltransferase and glutathione S-transferase were increased by 21 and 27%, but those of epoxide hydrolase were reduced by 85%. Western immunoblot analysis of microsomal proteins obtained from pregnant and lactating rats shows that only proteins encoded by the genes of CYP2C6 and CYP3A1 are expressed at detectable levels, whereas the expression of CYP1A1, CYP1A2, CYP2A1, CYP2B1, CYP2E1 and CYP4A1 was not detectable in pregnant and lactating rats at a protein loading of 3 micrograms total protein per well. In contrast, in northern blot hybridization experiments, detectable amounts of mRNA of the above named isoenzymes were measurable, but at varying intensities. Based on the northern blot hybridization analysis, an approximate 4-fold and 3-fold increase in CYP2A1 mRNA and CYP3A1 mRNA was found, when lactating rats were compared with female controls or pregnant rats, at day 10 of gestation.

Animals↗
PubMed1993

Transplacental transfer of polychlorinated biphenyls induces simultaneously the expression of P450 isoenzymes and the protooncogenes c-Ha-ras and c-raf.

At day 15 of gestation, rats were injected with a single i.p. dose of 100, 250 and 500 mg/kg body weight of a mixture of polychlorinated biphenyls (PCBs) (Aroclor 1254). Seven days later, significant increases in maternal and foetal cytochrome P450, cytochrome b5 and cytochrome c (P450) reductase were found. Concomitantly, the metabolism of nitroanisole, aniline, ethoxyresorufin and benzo[a]pyrene was significantly increased, but foetal metabolism of dimethylnitrosamine was not detectable and only marginal increases in the metabolism of aminopyrine and aldrin were seen. In contrast, maternal metabolism of dimethylnitrosamine, aminopyrine and aldrin was measurable, but significant increases were determined only with the latter substrate. Transplacental transfer of PCBs resulted in increased metabolism of substrates catalysed by foetal CYP1A1 and CYP2B1, but there was no evidence for CYP2E1-catalysed reactions. Further measurements show significant increases in foetal and maternal epoxide hydrolase, glutathione-S-transferase and UDP-glucuronyl transferase activities, thus suggesting that treatment with Aroclor 1254 resulted in coordinated increases in foetal and maternal oxidative and post-oxidative drug metabolism. Western blot analysis of microsomal proteins shows the induction of foetal and maternal CYP1A1, CYP1A2, CYP2A1, CYP2B1, CYP3A1 and CYP4A1. In addition, increased expression of CYP2C6 was seen with the mother but not the foetus. Unlike the mother, foetal rats did not express CYP2E1 and the expression of the above-listed P450 isoenzymes was greater in the mother than the foetus. Northern blot analysis shows significant increases in maternal and foetal CYP1A1, CYP1A2 and CYP2B1 mRNA. An increased amount of CYP3A1 mRNA was only seen with the mother, but not the foetus. Treatment of mothers with Aroclor 1254 resulted in reduced CYP2A1, CYP2C7, CYP2E1 and CYP4A1 mRNA. Insignificant differences in the expression of foetal CYP2A1 and CYP4A1 mRNA were found, but in utero exposure to PCBs reduced the amounts of CYP2E1 mRNA and there was no foetal CYP2C7 mRNA transcript. Treatment with Aroclor 1254 increased the expression of the protooncogenes c-Ha-ras and c-raf in the mother and the foetus, but at varying intensities. Pregnancy itself was linked to an increased expression of these protooncogenes. erbA and erbB mRNA was not detected.

Animals↗