Biomedical subjects
A Stewart
Publications and source records attributed to A Stewart.
Etiology of childhood leukemia: a possible alternative to the Greaves hypothesis.
Whenever a country has experienced a significant decrease in infant mortality there has always been a concomitant increase in childhood cases of acute lymphoblastic leukemia (ALL). According to Greaves, this increase is the result of a new type of leukemia, which was first seen in Britain between 1920 and 1940. An alternative hypothesis is proposed which assumes that, for childhood cases of ALL, infections are competing causes of death and for juvenile myeloid leukemia (JML) the principal competitor is the sudden infant death syndrome (SIDS). The SIDS association is the result of JML originating in undifferentiated (erythro-myeloid) stem cells and having faulty erythropoiesis as a side effect. With this congenital anomaly as part of the disease process, the low oxygen pressures of deep sleep may be sufficient to cause sudden death from tissue anoxia.
The functional organization of chromosomes and the nucleus--a special issue.
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Trends in coronary heart disease mortality and morbidity in Auckland, New Zealand, 1974-1986.
Routine mortality statistics show that coronary heart disease (CHD) death rates have declined consistently in Auckland men since 1968; in women, death rates declined between 1968 and 1986 but since 1981 there may have been a reduction in the rate of decline. Data from CHD registers conducted in Auckland, New Zealand in 1974, 1981, and since 1983 as part of the WHO MONICA Project, have been used to investigate the validity and reasons for the decline in the age group 35-64 years. In Auckland age-standardized sudden coronary death rates in men declined by approximately 2% per year between 1974 and 1986; there was no apparent decline in women. There was also an indication of a decline in age-standardized definite myocardial infarction rates but again only in men; 28 day case fatality in patients with a definite myocardial infarction has not changed significantly in the period 1981-1986. These results validate the mortality trends based on death certificates and in particular the differing recent trends in men and women. The decline in CHD mortality in men without a concomitant change in case fatality and the lack of recent decline in women, suggest that changes in the natural history of the disease rather than treatment are responsible for the mortality trends. Since disease events are rare in absolute numbers, long-term monitoring of coronary heart disease in large population groups will be necessary to usefully study disease trends, particularly in women.
Myofibrillar proteins in the developing heart.
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Molecular characterization of transforming growth factor type beta 3.
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Body packing--a case report and review of the literature.
Drug smuggling by internal bodily concealment is a growing international problem. The management of a patient who swallowed packages containing heroin is described. The medical management, indications for surgery and the ethical dilemmas of treating patients with drugs concealed within the gastrointestinal tract are discussed.
International trends in stroke mortality: 1970-1985.
We compared the pattern of cerebrovascular disease (stroke) mortality in men and women aged 40-69 years in 27 countries during 1970-1985 with the decline in coronary heart disease mortality during the same period. Stroke mortality rates declined in 21 and 25 countries for men and women, respectively. In 23 countries the decline in stroke mortality in women was greater than that in men. Countries with the highest rates of stroke mortality are also those with the least favorable secular trend. The rate of decline for stroke mortality is greater than that for coronary heart disease mortality in those countries that experienced a decline in both categories. International comparisons of risk factor levels over time are required to explain the striking differences between countries.
SCBU (special care baby unit): keeping the baby breathing.
Beginning a major new series on special baby care, this article looks at the types of unit, the babies treated in them, and how respiration is maintained.
The functioning and well-being of depressed patients. Results from the Medical Outcomes Study.
We describe the functioning and well-being of patients with depression, relative to patients with chronic medical conditions or no chronic conditions. Data are from 11,242 outpatients in three health care provision systems in three US sites. Patients with either current depressive disorder or depressive symptoms in the absence of disorder tended to have worse physical, social, and role functioning, worse perceived current health, and greater bodily pain than did patients with no chronic conditions. The poor functioning uniquely associated with depressive symptoms, with or without depressive disorder, was comparable with or worse than that uniquely associated with eight major chronic medical conditions. For example, the unique association of days in bed with depressive symptoms was significantly greater than the comparable association with hypertension, diabetes, and arthritis. Depression and chronic medical conditions had unique and additive effects on patient functioning.
Regulation of expression of avian slow myosin heavy-chain isoforms.
The slow tonic anterior latissimus dorsi (ALD) muscle of the chicken contains two isomyosins, namely SM-1 and SM-2. The proportions of the two isoforms change with age, SM-2 expression increasing at the expense of SM-1. Applying a load on the wing increases the rate and extent of SM-1 replacement. Here we have demonstrated that decreasing the load by removal of the distal portion of the wing in 1-week-old chickens had an effect opposite to that of overloading in that it slowed muscle growth and the rate of SM-1 elimination. Experimental unloading of muscles previously weighted for 1 or 3 weeks slowed the growth rate of muscles, with consequent regression of relative hypertrophy; however, it did not lead to the reexpression of SM-1 myosin. This indicates that the overload-induced changes in myosin expression are not readily reversible. Nerve section produced unexpected results, in that it advanced the normal developmental shift in myosin expression toward predominance of the SM-2 isoform, similar to the effect of muscle overload.
Huge undertaking--goal: ourselves.
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HLA genotypes and variant alleles in Sudanese families of Arab-Negroid tribal origin.
The indigenous population of the Blue Nile Province, Sudan, is an Arab-Negroid admixture, although some isolates of west African origin (Fallata) have begun to intermix with the indigenous population. Consanguineous marriages are common in these Muslim families. Members of 22 nuclear families were typed for HLA class I and II antigens using complement-dependent microcytotoxicity with Ninth International Workshop (9th WS) and local reagents. Considerable polymorphism was observed at each locus with a majority of the World Health Organization (WHO)-recognized alleles represented in the parental sample, albeit at low frequency. Seven parental haplotypes carried A locus alleles which were not identical to WHO-recognized specificities. All appeared to be Aw19-related specificities. Five B locus serologic variants were observed; all appeared distinct from WHO-recognized specificities. In one family we observed a new DR-DQ association; DR4 segregated with DQw2, rather than with DQw3. As has been observed for several other genetic systems in these tribes, considerable polymorphism was found for all class I and class II gene products in spite of a high level of consanguinity. Tribal admixture and/or a selective advantage in protecting the population against disease may account for this unexpectedly high level of heterozygosity.
Follow up studies during the first five years of life: a pervasive assessment of neurological function.
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Efficacy of alternative tests for delayed-cyclic food hypersensitivity.
With the oral challenge food test (OCFT) used as the standard for delayed-cyclic food hypersensitivity diagnosis, blinded comparison studies were accomplished with 175 in vitro food specific IgE and 180 IgG radioallergosorbent tests, 180 food enzyme-linked immune complex assays, and 155 in vivo Multi-Test prick tests. The study was multi-centered, eight physicians and 37 patients participating. All of the compared tests were shown to be approximately 50% efficient when compared with the OCFT results, and, thus, nonefficacious.
Thirty years' war: a battle with insomnia.
A 72-year-old man with a 30-year complaint of intractable insomnia had a positive family history of depression. He first came to psychiatric attention in 1958, after attacking his wife. He was prescribed barbiturates, and later was given meprobamate and nitrazepam, but with no effect on his complaint. The patient tended to increase the dosage of any drug given, of his own accord. EEG sleep recording confirmed the diagnosis of nocturnal myoclonus. It was hoped that at the case conference further treatment stratagems would be suggested.
Mortality of Hanford workers.
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Having a baby on a neonatal unit: what do parents feel? How can health visitors help?
Having a baby on a neo-natal unit can be traumatic for the parents. This article looks at the role of health visitors in providing care to such families.