Biomedical subjects
Publications and source records attributed to B Power.
Nurses and patients prefer the administration of injections via an indwelling subcutaneous cannula. Patients undergoing intermediate and minor surgery need improved pain relief. The algorithm provides a safe and acceptable mechanism for administering subcutaneous opioids more frequently.
Non-toxigenic Corynebacterium diphtheriae infections are being reported with increasing frequency. We present two cases of C. diphtheriae endocarditis requiring early valve replacement. Both cases were complicated by cerebral embolic phenomena and pseudoaneurysm formation in lower limb arterial vessels. Non-toxigenic C. diphtheriae septicaemia must be excluded when 'diphtheroids' are isolated from blood cultures.
PROBLEM BEING ADDRESSED: As the Canadian population ages, family physicians encounter increasing numbers of elderly people with medical, functional, psychological, and social difficulties. In the past two decades, most regions of Canada have developed systems of specialized geriatric services, available on a consultative basis, to assist family physicians evaluating and managing elderly patients with these difficulties. For many family physicians, however, it is often unclear which of their elderly patients are likely to benefit from referral to these geriatric services. OBJECTIVE OF PROGRAM: Using an interdisciplinary approach, specialized geriatric services seek to optimize health, maximize function, promote independence, and prevent or delay institutionalization of elderly people. Yet not all elderly people benefit from referral to specialized geriatric services. This article offers a clear and clinically practical framework to help family physicians identify elderly patients in their practices who are likely to benefit from referral to specialized geriatric services. MAIN COMPONENTS OF PROGRAM: By synthesizing previous work on the concept of frail elderly persons into a 2 x 2 matrix, the level and intensity of geriatric intervention most appropriate for different segments of the elderly population is clarified. CONCLUSIONS: Using the simple approach described in this article, family physicians should be able to use available geriatric resources easily and efficiently to optimize the health and function of their elderly patients.
Explore the source record for details and available documents.
Three studies of intravenous heroin abusers, in electoral wards in the north and south of central Dublin and in Dun Laoghaire, were undertaken in 1982-84. One hundred and one out of the 203 intravenous injectors in these three studies are known to have been tested in Dublin for infection by the Human Immunodeficiency Virus (HIV) and 87 of the 101, or 86% are HIV Positive. Ninety two had also been tested for Hepatitis B infection (Hab) and 76 of the 92 were positive for the hepatitis antigen. The majority of those at present known to be HIV Positive in the Republic of Ireland are, or were, intravenous drug users.
Effective management and efficient use of resources are prerequisites for a high quality service. Marketing skills are now essential for nurses. These consist of nurses being able to prove they can offer an economically viable service and to argue the case for more resources. Regular use of patient questionnaires will elicit opinions on standards of care. The health service's biggest resource is its staff: improving channels of communication and creating areas of accountability will fulfil its potential.
Absolute rates of immunoreactive atrial natriuretic peptide (ANP) secretion were measured in vitro at 37 degrees C in noncontracting preparations of combined right and left rat atria at constant distending pressures of 0 or 5.1 mmHg in presence of 0.2 mM extracellular Ca2+ concentration [( Ca2+]o), 10 microM ryanodine, and either 1 microM saxitoxin or 10 microM tetrodotoxin. By systematic deletion of external Na+, K+, Mg2+, Cl-, or HCO3-, and reduction of [Ca2+]o, and by selective ion transport inhibitors, neither net transplasmalemmal fluxes of Na+, Cl-, HCO3-, and Mg2+ nor ryanodine-sensitive Ca2+ release from sarcoplasmic reticulum (SR) was found necessary for stretch augmentation of secretory rate (Ra). Ra 1) was near zero within 20 min when extracellular Na+ concentration = 0 and [Ca2+]o = 20 microM and within 5 min or less after preincubation with caffeine, 8-chlorophenylthioadenosine 3',5'-cyclic monophosphate, or at 18 degrees C; 2) was significantly decreased by Cd2+, Ni2+, the isoquinoline H-7, and trifluoperazine but not 100 microM ryanodine; 3) was increased by neomycin; and 4) had an apparent activation energy of 18.5 +/- 4.1 x 10(3) cal/mol between 23 and 42 degrees C. These experiments strongly implicated transplasmalemmal Ca2+ influx and cAMP but not SR Ca2+ release in control of Ra under the experimental conditions studied.
Recent evidence has demonstrated regional synthesis of insulin-like growth factor I (IGF-I) in rat brain, which is also known to contain widespread specific type I IGF receptors. In order to precisely define sites of IGF-I mRNA synthesis, and their relationship to IGF-I receptor sites, we have applied the techniques of in situ hybridization and in vitro receptor autoradiography in rat brain. Frozen sections of adult rat brain and liver were hybridized with 32P-labeled cDNA inserts for human IGF-I (780 base pairs) or a positive control transthyretin cDNA (1430 base pairs) probe, or a series of negative probes, followed by film or emulsion autoradiography. Receptor autoradiography was performed on similar sections using 125I-IGF-I in buffer, some chambers containing excess unlabeled IGF-I. Hybridization of IGF-I probe was clearly seen only in three major brain regions: the olfactory bulb, hippocampus and cerebellum, whereas transthyretin only hybridized to choroid plexus as expected, and other probes showed no hybridization. In olfactory bulb, hybridization was greatest in the internal granular and mitral cell layers, with lower levels in the glomerular layer, where IGF-I receptors were concentrated. In hippocampus, hybridization was to pyramidal cells of Ammon's horn in CA1 and CA2 layers and dentate gyrus, with some labeling in CA3. IGF-I receptors were most dense in CA2, CA3, CA4, and dentate gyrus. In cerebellum, hybridization was to the granule cell layer, with IGF-I receptors primarily in the adjacent molecular layer. We have clearly demonstrated precise sites of local IGF-I synthesis in adult rat brain, adjacent to, and sometimes overlapping sites of high density IGF-I receptors.(ABSTRACT TRUNCATED AT 250 WORDS)
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The rat transthyretin gene, 7.3 kilobase pairs (kb) long, with 14.5 kb of 5' flanking and 12.2 kb of 3' flanking region was cloned and characterized. The gene contained four exons. A "TATA box" sequence (5'-TATATAA-3') and a "CAAT box" sequence (5'-GTCAAT-3') were located 23 and 95 nucleotides upstream, respectively, from the major transcription start site. Nucleotides -51 to -189 were highly conserved (93% homology between rats and humans, 97% homology between rats and mice). Tandem repeats of sequences of 5'-AC-3' and 5'-ACACATGC-3' in the 5' flanking region, of 5'-GAAA-3' in the first intron, and of 5'-GT-3' in the third intron of the gene were observed. Using specific cDNA probes, tissue specificity and regulation of transthyretin mRNA biosynthesis during embryogenesis were analyzed. Transthyretin expression occurred first in the yolk sac, then decreased when expression increased in fetal liver. Presumptive choroid plexus cells in the inner lining of the neural tube expressed transthyretin early in gestation (11 days before birth) with a maximum immediately preceding the spurt of brain growth around birth. Partial hepatectomy of adult rats induced both an acute phase response and regenerative growth in liver. The decrease in transcription of the transthyretin gene in liver, which is characteristic for the acute phase response, was overridden by stimulation of gene expression after partial hepatectomy. This stimulation also affected transthyretin expression in choroid plexus.
Specific cDNA and oligonucleotide probes were used to study the appearance of transthyretin mRNA in developing rat brain using Northern gel analysis, cytoplasmic dot hybridization, and in situ hybridization. Transthyretin mRNA in embryonic rat brain was found to be confined to the epithelial layer of the choroid plexus primordia appearing first in the fourth ventricle, followed by appearance in the lateral ventricles, and subsequently in the third ventricle. Transthyretin mRNA was localized in these cells from early stages of neuroepithelium differentiation, showing that it is a sensitive marker for the differentiation of the choroid plexus within the fetal brain.
This study investigated the effect of colloidal bismuth subcitrate and cimetidine on Campylobacter pylori in peptic disease. In 74% of 135 patients with peptic disease diagnosed at endoscopy C pylori was detected before treatment. Compared with cimetidine, colloidal bismuth subcitrate significantly decreased the incidence of C pylori after six weeks of treatment (p less than 0.001). In the colloidal bismuth subcitrate group, subsequent healing of the lesion was correlated with the clearance of C pylori, unlike in the cimetidine group. C pylori was strongly associated with the presence of histological gastritis, which was decreased by colloidal bismuth subcitrate (p less than 0.001).
Explore the source record for details and available documents.
A 44-mer, complementary to the coding region of bovine adrenal medullary proenkephalin A mRNA (ProEnkA mRNA) has been synthesized as a specific probe for this mRNA. Northern-blot hybridization analysis identified a single band in an RNA extract from bovine, ovine and porcine adrenal medullae. The molecular size of these hybridized bands (1400-1600 nucleotides) was in excellent agreement with that reported previously using cloned cDNA probes. In situ hybridization on bovine and ovine adrenal sections revealed that ProEnkA mRNA was localized selectively in cells at the outer margin of the medulla, a region rich in adrenaline-containing cells. This study both confirms and extends previous findings with cloned cDNA probes on the presence of high concentrations of ProEnkA mRNA in cells at the periphery of the adrenal medulla. In addition, it demonstrates the usefulness of synthetic oligodeoxyribonucleotides as specific and sensitive probes for the study of proenkephalin A gene expression.
Serial section electron micrographs of mouse atria stretched in vitro show that myocytes have cell processes which tunnel into adjacent myocytes for 8 microns or more. The tunneling cell processes (TCP) (diam 4-6.2 microns) lack myofibrils and organelles associated with atrial peptide secretion. The glycogen-rich TCP cytoplasmic matrix contains conspicuous tubules and vesicles originating from endoplasmic reticulum and resembling free sarcoplasmic reticulum (SR). TCP are surrounded by a plasmalemma derived from their myocyte of origin, the plasmalemma of the tunneled myocyte, and an intervening narrow compartment continuous with the interstitial space. Profiles having the characteristics cytoplasmic structure of TCP are also found both in the interstitial space between myocytes and near the longitudinal terminations where myocyte ends about on the interstitial space. We suggest that TCP tubules and vesicles may proliferate and/or transport in response to stretch, might be free SR, and may respond to stretch-activated changes in ionic composition or potential of the surrounding myocyte and narrow intercellular compartment.
The ultrastructural bases of exocytotic extrusion of atrial peptides were reexamined in electron micrographs of thin-sectioned or freeze-fractured mouse atria. Exocytotic extrusion was demonstrated in both thin-sectioned and freeze-fractured atrial myocytes. Ultrastructural evidence suggested that the necks of plasmalemmal caveolae may constitute preformed pathways for extrusion of secretion from granules fusing with caveolae. Multiple subsarcolemmal foci with peripheral Golgi cisterns and accumulations of granules, indicating peripheral processing of secretory proteins, were striking features of mouse and rat atria, and were present but rare in sheep and dog atria. Conspicuous focal ellipsoidal deposits, a new structure, approximately 1.6-4.6 micron long and approximately 0.8-1.8 micron wide, consisting of amorphous cytoplasmic material that is penetrated peripherally by tubules connecting with secretion-containing "multivesicular bodies," were present in some mouse atrial myocytes, but were absent in myocytes of mouse ventricle and rat, dog, and sheep atria.