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Biomedical subjects

A Wilson

Publications and source records attributed to A Wilson.

At least 325 records · Page 18Linked to original sources
PubMed1991

Midbrain periaqueductal gray projections to the dorsomedial medulla in the rabbit.

The present study sought to determine the existence of projections from the midbrain periaqueductal gray (PAG) to the nucleus of the solitary tract (NTS) and dorsal motor nucleus of the vagus nerve (DMN) in the rabbit. Fast Blue injections into the NTS/DMN complex revealed a population of retrogradely labeled cells within the ventrolateral PAG. Deposits of wheat germ agglutinin/horseradish peroxidase (WGA/HRP) into the ventrolateral PAG revealed terminal label within the dorsomedial, lateral, ventrolateral, intermediate, and commissural subnuclei of the NTS. Label was also observed within the DMN and a heavy concentration encapsulated this nucleus. These data suggest that the projection from the PAG to the NTS/DMN complex may represent a substrate by which the PAG may influence autonomic and cardiovascular regulation, particularly during emotional arousal.

Amidines↗
PubMed1991

A summary index for the assessment of quality of life in angina pectoris.

When exploring the effects of anti-anginal therapy on quality of life (QL), it is essential to use concise, reliable, outcome measures which focus on those aspects of the disease which are affected by the anginal pain, and which are expected to be responsive to medical intervention. Analysis based on a single comprehensive index is preferable to the use of several indexes as it avoids the potential for conflicting inferences from multiple comparisons. In this paper, we describe the development of a QL index which summarizes the three questionnaires used in the North Karelian Quality of Life (KarQuol) study. The summary index (SI) will be used to compare transdermal and oral nitrate therapy in patients with angina pectoris, and represents the first stage in the construction of a disease-specific evaluative index for future trials.

Abstracting and Indexing↗
PubMed1991

Anti-anginal therapy and quality of life. A comparison of the effects of transdermal nitroglycerin and long-acting oral nitrates.

A total of 112 male patients with severe effort-induced angina pectoris (New York Heart Association functional classes II and III) participated in a randomized open trial consisting of a 6 month phase with 3 month treatment cross-overs. The aim of the study was to compare the effect of transdermal nitroglycerin (TN) patches and long-acting oral nitrates (LAON) on quality of life (QL). During the cross-over period 30 patients (20 on TN and 10 on LAON) withdrew from the study, over half of them within the first month. Although the results should be interpreted with some caution, they showed that improvement in QL was present for both treatments but greater during the transdermal therapy (unadjusted p = 0.07, adjusted p = 0.03). Anginal attacks were associated with improved QL scores, and fewer attacks occurred on TN (p = 0.06). Improvement in QL was most pronounced in patients whose recorded duration of angina was less than 8 years.

Administration, Cutaneous↗
PubMed1991

Bronchoalveolar lavage in the prediction of post-thoracotomy chest infection.

A prospective study was carried out on 75 patients undergoing pulmonary surgery to determine the relationship between perioperative lung flora and postoperative infections. Seventy-five patients having pleurectomy or pneumonectomy received cefuroxime prophylaxis; 1.5 g i.v. at induction followed by 6 further doses of 0.75 g i.v. over 48 h. Bronchoalveolar lavage samples were taken perioperatively via bronchoscopy in pleurectomy patients and from excised lung in patients undergoing lung resection. Patients were monitored for development of chest infection during the first 10 days after operation. Bacterial pathogens were cultured from 12 out of 54 lavage samples. The most common pathogen was Haemophilus influenzae and all the organisms were sensitive to cefuroxime. Eight patients (10.7%) developed postoperative chest infection. The likelihood of developing postoperative chest infection was 42% (5 out of 12 patients) in those patients whose lavage culture was positive for bacterial pathogens compared to 4.8% (2 out of 42 patients) for those whose culture was negative (chi 2 test, p less than 0.001). These results suggest that the culturing of bacterial pathogens from lavage samples from resected lung is a significant predictor of postoperative chest infection in patients undergoing pulmonary resection.

Bronchoalveolar Lavage Fluid↗
PubMed1991

Nurse socialization: issues and problems.

A comparative study was conducted of the professional socialization process of student nurses in three nurse education centres in South Wales. Patterns and problem areas can be identified of relevance to issues in role theory and with practical implications for the more effective implementation of Project 2000. Three cohorts of students were interviewed using a semi-structured interview schedule whilst in the introductory block and at the end of the first year. The teaching and ward staff directly involved in the socialization process were also interviewed so that their views could be compared with those of the students. There were differences between the types of ward in the opportunities they offered for role modelling. It was doubtful whether the three categories of students, teaching staff and ward staff were all employing a single conception of 'the good nurse'. The student has to find her own pathway through the divergent and often conflicting values and philosophies of the teaching staff and those in authority on the wards. It is recommended that a more unified approach be adopted to reduce the conflict which learners experience. In accordance with Project 2000, the teaching staff should act as practitioners and thereby be perceived as a professional role model with clinical credibility.

Attitude of Health Personnel↗
PubMed1991

Segment IV of a Salmonella flagellin gene specifies flagellar antigen epitopes.

Each of the two mutants isolated from a fliC (= hag, flagellin-deficient) Escherichia coli strain made motile by a plasmid carrying the fliC gene of Salmonella muenchen by selection for motility in the presence of anti-d (Salmonella flagellar antigen) serum had both lost and gained one or more subfactors of the wild-type antigen. In one mutant codon 246 was GAC (alanine) instead of GCC (asparagine); the other had a deletion of 105 base pairs, explicable by a 10bp direct repeat, starting at bases 782 and 887. The in vitro removal of a 48bp EcoRV(631)/EcoRV(679) fragment produced plasmid pLS408, which was found to lack a subfactor of wild-type antigen d but able to confer motility on flagellin-negative Salmonella sp. (and used for insertion of epitope-specifying oligonucleotides at its EcoRV site). Immunoblotting with absorbed and unabsorbed sera from rabbits immunized with E. coli with wild-type or mutated antigen d showed that the fusion proteins specified by lambda gt11 with the N-terminal part of gene lacZ joined to a restriction fragment coding for residues 145-391 of flagellin gave the same pattern of parent-specific and mutant-specific reactions as the flagellate bacteria. Four out of five similarly selected mutants had the same 105 bp deletion as the first-isolated mutant; the fifth had a 72 bp deletion made possible by a 7-base pair direct repeat, starting at positions 649 and 721. All these changes in serological character without loss of function affected segment IV, specifying residues 182 to 308 of the total of 505, where there is little homology between different flagellar-antigen alleles.

Antigens, Bacterial↗
PubMed1991

Painful sciatic neuropathy following cardiac surgery.

Ten patients developed bilateral asymmetrical lower limb sensori-motor or motor deficits associated with prominent causalgic pain after cardiac surgery. The clinical and electrophysiological abnormalities indicated bilateral proximal sciatic nerve lesions, although in several cases the distinction from a diffuse ischaemic axonopathy was difficult to make. This pattern of postcardiac surgery peripheral neurological dysfunction has not been previously described but is likely to relate either to the intra-operative posturing technique for access to the saphenous veins and/or the upright posture used to nurse patients in the immediate post-operative period and is in keeping with the previously demonstrated susceptibility of peripheral nerves to pressure palsy during cardiac surgical procedures.

Adult↗
PubMed1991

Effects of chronic ethanol on currents carried through calcium channels in Aplysia.

Voltage clamp techniques were used to monitor the effects of chronic exposure to ethanol (EtOH) on current carried through calcium channels in an identified neuron of cultured abdominal ganglia from Aplysia californica. Exposure to 200 mM EtOH for periods up to 3 weeks did not change the baseline characteristics of current carried through calcium channels, nor did it alter its acute sensitivity to either 100 mM or 300 mM EtOH challenge. The currents that we examined were equivalent when carried by calcium or barium, and EtOH had similar effects on currents carried by these two ions. The population of voltage-dependent calcium channels studied here does not show development of tolerance after chronic exposure to EtOH.

Animals↗
PubMed1991

The clinical correlates of neurological soft signs in chronic schizophrenia.

Among 16 chronic schizophrenic in-patients, all had at least one neurological soft sign (NSS), and 6 (40%) had definite neurodysfunction. NSS and TD scores were highly intercorrelated, and NSS were significantly correlated with neuroleptic drug exposure. NSS correlated positively with both positive and negative symptoms and cognitive impairment but not with cerebral ventricular size on CT. Patients with neurodysfunction had more positive and negative psychopathology, cognitive impairment and TD than those without. Cerebral ventricular sizes and family histories of schizophrenia were similar in both NSS groups. The presence of NSS may be a simple but important way of identifying a subgroup of schizophrenics with neurodevelopmental predisposing abnormalities, and vulnerability to TD.

Adult↗
PubMed1991

On scene, off duty.

Explore the source record for details and available documents.

Emergency Medical Services↗
PubMed1991

Prevention of heart disease in general practice: the use of a risk score.

Between 1987 and 1988 seven general practices took part in a pilot study of a predictive risk score for ischaemic heart disease in men aged 40-59 years. The aim was to assess the feasibility and usefulness of this score as part of a coronary prevention programme. The score was generally well received by practice nurses and general practitioners, and found to be helpful as a method of focusing preventive activity. Most chose to reveal the score to the patient, although there was some concern that this could lead to false reassurance being perceived by those with a low score but remediable risk factors. Practitioners were able to use the score as a method for identifying a priority group for intervention, and it is concluded that the risk score is a useful component of health checks.

Adult↗
PubMed1991

A patient care workstation based on user centred design and a formal theory of medical terminology: PEN&PAD and the SMK formalism.

The PEN & PAD clinical workstation is for use by clinicians for direct patient care. It is based on a highly structured and detailed medical record but is intended to be simple and intuitive to use, allowing clinicians to summarise and view information in many ways, and quickly enter information through structured forms. It also provides mechanisms for tailoring the system to individual users without compromising its overall integrity. This has been achieved by following a process of user centred design and by developing a novel formalism, Structured Meta Knowledge, to represent the terminological knowledge, the medical record, and pragmatic knowledge about clinical practice.

Ambulatory Care Information Systems↗
PubMed1991

Longer booking intervals in general practice: effects on doctors' stress and arousal.

A controlled trial was carried out to determine whether longer booking intervals at surgeries affected general practitioners' self-assessed levels of stress and arousal. Sixteen general practitioners from 10 practices took part. Surgery sessions with patients booked at 10 minute intervals (experimental sessions) were compared with the doctors' usual booking intervals of between 7.5 and 5.0 minutes (control sessions). Stress and arousal were assessed by the general practitioner before and after each surgery session using a mood adjective check list. The study included 109 experimental and 184 control sessions. The median consultation length increased from six minutes in the control sessions to seven minutes in the experimental sessions. At the end of the experimental sessions, stress scores were lower, and arousal scores higher than at the end of the control sessions (P less than 0.001). There were no significant differences between experimental and control sessions in stress or arousal at the start of the sessions. Favourable mood changes were seen more consistently in the experimental sessions than control sessions, with less than a quarter of doctors showing increased stress or decreased arousal after sessions relative to before. It is concluded that longer booking intervals are of psychological advantage to general practitioners.

Adult↗
PubMed1991

Massive transfusion: outcome in blunt trauma patients.

Over a 54-month period 6,142 patients were consecutively admitted to our Level I trauma center. Ninety-two blunt trauma patients required massive transfusion (MT) of 20 or more units of packed red blood cells (range, 20-126). Eighty-two per cent of all transfused blood was given within 24 hours of admission. Forty-eight patients (52%) were long-term survivors. Twenty-six patients died (28%) within 24 hours and 21 of these exsanguinated. Eighteen patients died greater than 24 hours: nine (50%) died from multiple organ failure, and nine (50%) died from severe closed head injury (CHI). Clinical predictors of increased mortality were: shock on admission, closed head injury, and age. Forty-three survivors were followed for a mean of 2.5 years (range, 1-5 years). No patient died during followup. All patients were home at 1 year; only four patients required continued medical assistance. Thirty-two patients (74%) returned to work. We conclude that: 1) blunt and penetrating trauma patients receiving MT have similar survival rates of 50%; 2) shock, closed head injury, and age predict increased mortality but do not preclude survival; 3) long-term outcome in blunt patients requiring MT is excellent. Post-discharge death is rare and 3/4 of the survivors return to work, justifying the high cost of acute care.

Blood Transfusion↗
PubMed1991

Consultation length in general practice: a review.

Although there is evidence that consultation length has increased in the UK over the last 20 years, it is still short by international standards, and is blamed in part by both general practitioners and the public for failure to deliver high quality care. Consultation length is determined by both doctor and patient variables and these need to be looked at when interpreting observational studies linking longer consultations to beneficial outcomes. Studies of the same doctors consulting at different rates suggest that while many aspects of a doctor's behaviour do not change, longer consultations may be associated with greater patient satisfaction and increased health education/prevention measures.

Family Practice↗
PubMed1990

Recognition of a B cell lymphoma by anti-idiotypic T cells.

Idiotypic IgM derived from a B cell lymphoma can act as a tumor-associated Ag, in that immunization with this purified protein generates an anti-idiotypic immune response that specifically suppresses tumor development. Spleens of immune mice contain T cells that proliferate in response to idiotypic IgM. However, idiotypic Ag is presented to the T cells most efficiently in its natural form at the surface of the lymphoma cells, than as soluble IgM plus presenting cells. Variant tumors that display either little or no idiotypic IgM at the cell surface, but which are otherwise indistinguishable from parental tumor, induce a weak response or fail to stimulate the T cells, respectively. Anti-idiotypic lines and clones have been derived from the splenic T cells by growth in the presence of irradiated tumor cells. Phenotypic analysis revealed that cells from both lines and clones express CD3 and CD4 Ag, but not CD8. Recognition of tumor Id, which required no added presenting cells, was inhibited by antibody against MHC class II Ag, and variably by anti-CD4. Proliferative responses were inhibited by anti-idiotypic antibodies, but also by antibodies against the constant region of the mu H chain, indicating that perturbation of the surface IgM abrogates availability of idiotypic determinants to the T cells.

Animals↗