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Biomedical subjects

A Sinclair

Publications and source records attributed to A Sinclair.

At least 55 records · Page 3Linked to original sources
PubMed1995

Remedies for common family ailments: 7. What's new in POMs to Ps?

Tagamet and Pepcid PM-two potent H2 antagonists for dyspepsia, heartburn and other conditions produced by excess acid in the stomach-are now available from pharmacies without prescription. Making these effective medicines more widely available should help many indigestion sufferers. (NB: these medicines are not recommended during pregnancy or for the under-16s). Indigestion can sometimes be prevented by avoiding spicy foods, alcohol and stress. Enquire about other symptoms and if necessary refer the patient to a doctor. A pharmacist should be consulted if the patient is already taking other medication. Other medicines recently available from pharmacies without prescription are the antacid Mucaine, and Adcortyl in Orabase and Corlan pellets for gum and mouth lesions. Eczema patients can now obtain Hydrocortisone Topical direct from the pharmacy. It was previously not allowed to be sold to treat eczema Haemorrhoid sufferers can now obtain Anusol Plus (containing hydrocortisone) direct from the pharmacy. Hay fever patients can now get Syntaris Nasal Spray without prescription.

Family Health↗
PubMed1995

Remedies for common family ailments: 9. Haemorrhoids.

Haemorrhoids or piles are varicosities in the anal canal caused by local pressure. Sometimes they prolapse. Symptoms may include itching, discomfort, pain and bleeding. Haemorrhoids are common in pregnancy. Constipation aggravates piles, so a healthy diet with plenty of water and fibre is advisable. Some sufferers need an appropriate laxative as well. Cleanliness of the anal area is important. Proprietary moist toilet tissues are sold for this purpose and can be soothing and helpful. Relief of symptoms is by haemorrhoid creams, ointments and suppositories. Active ingredients typically include antiseptics, anti-inflammatories, anti-pruritics and local anaesthetics. Many are available from pharmacies without a prescription. If in doubt, always refer the patient to a doctor. For example, rectal bleeding may be due to some more serious condition, or pruritus to anal thrush. In the case of children the advice of a doctor should be sought.

Family Health↗
PubMed1994

'Common sense and a thick hide'. Physicians providing care to their own family members.

OBJECTIVE: To determine how frequently physicians treat their relatives in 17 categories of care, their reasons for deciding to treat, and their level of comfort with this practice. DESIGN: Mailed survey. SETTING: Rural, suburban, and urban practices in Oregon. SUBJECTS: Two thousand fourteen physicians in the following specialties: general practice, family practice, general internal medicine, general surgery, orthopedic surgery, obstetrics/gynecology, and pediatric medicine. RESULTS: One thousand two hundred ninety-two questionnaires (64%) were returned. Minor prescribing was done most frequently, followed by routine pediatric care, physical examinations, and minor surgery. All other forms of care occurred rarely, and there appears to be a gradient based on the level of complexity, seriousness, and potential for conflict with privacy. In general, older, male, and rural physicians provided more services to family members than their younger, female, and urban counterparts. General and family practitioners performed the most family care; general internists, the least. The most important reasons for providing care were convenience for the patient and request from relatives. Providers were most comfortable providing care to their children and least comfortable providing care to their grandparents. CONCLUSIONS: There is a wide range of practice, depending on the nature of the care and provider characteristics. Physicians report treating their own family members rarely and face significant dilemmas when doing so.

Adult↗
PubMed1994

Characteristics and perceptions of nicotine patch users.

BACKGROUND: Although transdermal nicotine patches are frequently prescribed to aid in smoking cessation, little information exists about their use in general medical practice. In clinical studies, nicotine patches have been found to be effective when used in conjunction with nonpharmacologic interventions, such as physician counseling and follow-up visits. This study examines the characteristics and perceptions of patients regarding treatment with nicotine patches. METHODS: Patients filling or refilling prescriptions for a nicotine patch at 17 pharmacies were asked to complete a questionnaire. RESULTS: Seventy-six questionnaires were returned. Thirty-six percent of the respondents first learned about the nicotine patch from the media, 32% from friends, family, or co-workers, and 25% from their physicians. Most respondents (87%) had requested the patch, whereas only 9% had been asked by their prescriber to try the patch. Most of the surveyed smokers were highly motivated to quit, and 86% smoked at least one pack per day. Eighty percent indicated they had received a clear message from their physicians to quit, 56% said their physician had counseled them about relapse, and 55% had follow-up arranged. A quit date had been set by 37%, and only 24% reported the use of self-help materials. Approximately one half of smokers (54%) who had started using the patch indicated that they continued to smoke. CONCLUSIONS: Most respondents were good candidates for the nicotine patch based on how much they smoked and their motivation to quit. Direct-to-consumer advertising may have influenced many smokers to request treatment with the patch. Physicians should recognize that some persons may use the patch as a "quick fix," as very few respondents used the number of nonpharmacologic interventions that have proved useful in nicotine patch clinical trials. Physicians should follow the progress of patch users to ensure that they completely stop smoking during treatment.

Administration, Cutaneous↗
PubMed1994

Remedies for common family ailments: 4. Insect bites and stings.

For going abroad, taking the correct anti-malarial medication should have high priority. Insect-repellents are a useful preventative. Products to treat insect bites and stings include astringents local anaesthetics antihistamines corticosteroids and crotamiton.

Humans↗
PubMed1994

Remedies for common family ailments: 3. Hay fever and allergic rhinitis.

Hay fever is an allergic reaction to pollen, and is seasonal (Spring to Autumn). Allergic rhinitis is a similar allergic reaction to substances such as house-dust mite, fungal spores or animal hairs, and tends to occur throughout the year. Both are common in the population, affecting one in five to one in ten. Apart from avoiding the offending substance as much as possible, treatment consists of prevention or of relieving the symptoms. Drugs include antihistamines sodium cromoglycate and corticosteroids. Homoeopathic remedies are also worth considering. Many antihistamines are available over the counter, and a steroid preparation (Beconase) and sodium cromoglycate are about to be changed from prescription-only to being sold in pharmacies. Some antihistamines cause drowsiness. A doctor should be consulted in the case of children or pregnant women, and of patients with heart and other conditions, or who are already taking other medications.

Female↗
PubMed1992

Flow resistance of coaxial breathing systems: investigation of a circuit disconnect.

A clinical incident involving an undetected disconnection occurred during the use of a CPRAM coaxial breathing circuit. The flow resistance of this circuit was evaluated and compared with that of a Bain circuit to determine the factors involved. A differential pressure transducer was used to monitor the pressure drop across each circuit during simulation of controlled ventilation with a fresh gas flow of 6 L.min-1. An Ohio V5 anaesthesia ventilator was adjusted to different flow rates and tidal volumes and a test lung simulated an airway resistance of 2.7 cm H2O.L-1.sec and a compliance of 0.05 L.cmH2O-1. Absolute pressure at the ventilator was also monitored when the circuit was disconnected from the test lung. The CPRAM circuit displayed a pressure drop from the ventilator to the endotracheal tube of 6.3 cm H2O at 60 L.min-1, about twice that found with the Bain. A disconnection at the tracheal connector produced an absolute pressure at the ventilator of 9.6 cm H2O with the CPRAM and 5.5 cm H2O with the Bain. Since the ventilator low pressure alarm was preset to 9.2 cm H2O, the alarm provided a warning with the Bain but not the CPRAM. The elevated flow resistance of the CPRAM circuit was attributed to a restriction in the flow area at the patient end of the circuit. Capnographs or adjustable low-pressure alarms provide more reliable monitoring for breathing circuit disconnects.

Anesthesia, Closed-Circuit↗
PubMed1991

Shiverer jimpy double mutant mice. V. Correlation of genotype and myelin proteins.

We have reexamined the levels of myelin basic protein (MBP) and proteolipid protein (PLP) in the brains of mice bred to carry both the shi/shi and jp/Y hypomyelination defects. The genotype of each putative double mutant was confirmed by direct DNA analysis: shi/shi by Southern blot analysis, and jp/Y by restriction enzyme analysis of polymerase chain reaction-amplified fragments. MBP and PLP levels were assessed by immunoblotting. All putative double mutants were found to be shi/shi. However, examination of the PLP locus revealed both jp and wild-type genotypes, the latter produced by an expected crossover. Animals proven to be shi/shi*jp/Y had no detectable MBP or PLP; those proven to be shi/shi*+/Y (the crossover) had no MBP but had PLP. These results differ from an earlier report of both MBP and PLP in the brains of presumed shi*jp animals.

Animals↗
PubMed1991

Search for a retroviral cause for sarcoidosis: no evidence from peripheral blood studies.

Twenty six patients with sarcoidosis of recent onset or with severe progressive disease were studied for evidence of retroviral infection. Peripheral blood mononuclear cells (PBMC) were cultured in vitro and stimulated with phytohaemagglutinin and interleukin-2. Induction of syncytia (SI) and production of reverse transcriptase (RT) were sought as indicators of possible retroviral infection. PBMC from two patients showed syncytia formation and in one of these two there was associated production of low levels of reverse transcriptase. The remaining patients showed neither RT nor SI activity. The predominantly negative results of this study indicate that sarcoidosis is unlikely to be of retroviral aetiology; however, cell populations from sites of active disease should be studied before drawing this conclusion.

Adult↗
PubMed1990

Failure of ADCC to predict HIV-associated disease progression or outcome in a haemophiliac cohort.

Antibody-dependent cell-mediated cytotoxicity (ADCC) has been described in a number of virus infections and occurs in HIV infection. In spite of numerous studies on the ability of HIV-positive sera to mediate ADCC, it remains unclear whether ADCC has any functional significance. Here we examine serial serum samples from a cohort of haemophilia patients who became infected from a common source in 1984, and show that there is no significant difference in ADCC values between those who remained asymptomatic and those who progressed to disease. This study does not compare effector cell function and clinical status and does not exclude activity against different target cell lineages in vivo.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1990

The epidermal location and possible feeding site of Psorergates ovis, the sheep itch mite.

Skin biopsies from two Merino sheep heavily infested with Psorergates ovis were immersed in liquid nitrogen and cut into vertical frozen sections stained with lipophilic Sudan IV or Oil Red O and haematoxylin. A survey of the lateral distribution of mite sections showed a majority (ca 80%) were in or within 0.2 mm of the follicle mouth. A survey of vertical distribution showed no mite penetration deeper than inner stratum corneum where 57% of mite sections were seen; 30% were within outer stratum corneum or scurf; 13% were on the outer surface and less than 1% were detached. Lipid was the only material seen within stained mites at a location considered to be gut. This was supported by dosing sheep with quinacrine, taking biopsies at Day 6 and Day 14 and examining frozen sections under blue light. Fluorescent lipid was seen at a location considered to be mite gut. From these results it was recommended that acaricide treatments against P. ovis be lipophilic and administered transepidermally because less than 15% of mites were at a superficial location likely to be reached by topical application.

Animals↗
PubMed1988

Butter-enriched diets reduce arterial prostacyclin production in rats.

Rats were fed diets containing 10%, 30% or 50% energy as fat derived predominantly from butter or lard. The protein content of the diets was maintained at 20%. After three weeks on the diets, the rats were killed and the following parameters measured: prostacyclin production in vitro from abdominal aorta and mesenteric artery; platelet aggregation to ADP and thrombin; fatty acid composition of the phospholipids in plasma, thoracic aorta and liver; smooth muscle reactivity and release of endothelial derived relaxing factor (EDRF) from aortic endothelium stimulated by acetylcholine. There was no significant effect of increasing fat content of the diets (neither lard nor butter) on platelet aggregation. In contrast, prostacyclin production in both the mesenteric artery and the abdominal aorta fell in a concentration-dependent manner in the butter-supplemented rats. However, no effect on prostacyclin production was detected in arteries from the lard-supplemented animals. The effects of the diets on prostacyclin (PGI2) production correlated very well with the changes in plasma, aortic and liver phospholipid arachidonic acid (AA) and eicosapentaenoic acid (EPA) contents. AA decreased in a concentration-dependent manner in the rats fed the butter-enriched diets but did not change in those fed the lard-enriched diets, whereas EPA rose in a concentration-dependent manner in the butter-fed rats and was unchanged in the lard-fed animals. The clear-cut effects of the butter-enriched diets on aortic phospholipid fatty acid composition and aortic PGI2 production were accompanied by a significant reduction in smooth muscle relaxation to EDRF.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

HTLV-1 infection in tropical spastic paraparesis: lymphocyte culture and serologic response.

All 17 patients with tropical spastic paraparesis (TSP) in a series seen in the United Kingdom have antibodies to the human T cell leukemia virus type 1 (HTLV-1). Cultured peripheral blood lymphocytes from these patients formed multinucleated giant cells and reacted with sera and monoclonal antibodies to HTLV-1 in a manner identical to adult T cell leukemia-lymphoma (ATLL) patient lymphocytes. Western blot analysis failed to reveal any marked difference in the antigens recognized by sera from TSP and ATLL patients. The sera from TSP patients, their asymptomatic relatives and ATLL patients were titrated using the following assays: enzyme-linked immunosorbent assays (ELISA), particle agglutination, antibody-dependent cell-mediated cytotoxicity, and pseudotype neutralization. There were significantly stronger serologic responses in the TSP patients than in their relatives or ATLL patients. High antibody titers in the presence of replicating virus often reflect the antigen load; however, these data are also consistent with the suggestion that neurologic damage in TSP may be immunologically mediated.

Adult↗
PubMed1987

Synthetic peptide homologous to beta protein from Alzheimer disease forms amyloid-like fibrils in vitro.

Progressive amyloid deposition in senile plaques and cortical blood vessels may play a central role in the pathogenesis of Alzheimer disease. We have used x-ray diffraction and electron microscopy to study the molecular organization and morphology of macromolecular assemblies formed by three synthetic peptides homologous to beta protein of brain amyloid: beta-(1-28), residues 1-28 of the beta protein; [Ala16]beta-(1-28), beta-(1-28) with alanine substituted for lysine at position 16; and beta-(18-28), residues 18-28 of the beta protein. beta-(1-28) readily formed fibrils in vitro that were similar in ultrastructure to the in vivo amyloid and aggregated into large bundles resembling those of senile plaque cores. X-ray patterns from partially dried, oriented pellets showed a cross-beta-conformation. A series of small-angle, equatorial maxima were consistent with a tubular fibril having a mean diameter of 86 A and a wall composed of pairs of cross-beta-pleated sheets. The data may also be consistent with pairs of cross-beta-sheets that are centered 71-A apart. [Ala16]beta-(1-28) formed beta-pleated sheet assemblies that were dissimilar to in vivo fibrils. The width of the 10-A spacing indicated stacks of about six sheets. Thus, substitution of the uncharged alanine for the positively charged lysine in the beta-strand region enhances the packing of the sheets and dramatically alters the type of macromolecular aggregate formed. beta-(18-28) formed assemblies that had even a greater number of stacked sheets, approximately equal to 24 per diffracting domain as indicated by the sharp intersheet reflection. Our findings on these homologous synthetic assemblies help to define the specific sequence that is required to form Alzheimer-type amyloid fibrils, thus providing an in vitro model of age-related cerebral amyloidogenesis.

Alzheimer Disease↗