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Biomedical subjects

C Fraser

Publications and source records attributed to C Fraser.

At least 73 records · Page 4Linked to original sources
PubMed1993

Alzheimer's disease: case management in a rural setting.

This article describes a case management model developed under the guidelines of the Medicare Alzheimer's Disease Demonstration. This delivery model currently provides services to over 400 Alzheimer's disease victims and their family caregivers who reside in predominantly rural communities in east central Illinois and western Indiana. Client and caregiver characteristics are provided as well as service utilization patterns. The model incorporates intervention strategies that facilitate communication and coordination of services, integrates formal and informal support systems, and allows for client advocacy and system development.

Aged↗
PubMed1991

Some factors in the choice of male or female sterilisation in Aberdeen.

In a random sample of 84 men and 167 women, medical considerations, an intransigent attitude of one partner or a fear of adverse effects, were related to the decision on which partner should seek sterilisation. Only 19% of couples felt that they had a real choice between male and female sterilisation.

Female↗
PubMed1991

Infertility--epidemiology and referral practice.

A questionnaire-based study of infertility has been carried out in two age cohorts of women in a defined geographical region. Women were aged 36-40 years or 46-50 years at the time of the survey. The prevalence of infertility (no conception after 2 years of trying) was approximately 14% in both age cohorts. However, a significantly higher proportion of younger women had sought medical help. In both age cohorts there was a higher incidence of spontaneous abortion among infertile women. These findings suggest no significant increase in the prevalence of infertility over a decade but a considerable increase in the use of medical services.

Abortion, Spontaneous↗
PubMed1991

Menstrual symptoms in women with pelvic endometriosis.

OBJECTIVE: To investigate menstrual symptoms in relation to pelvic pathology. DESIGN: A prospective questionnaire-based study. SETTING: Aberdeen Royal Infirmary, Scotland. SUBJECTS: 1250 questionnaires were sent out prior to planned admission and 1200 women (96%) brought the completed questionnaires. They comprised 598 women undergoing laparoscopic sterilization, 312 having laparoscopy because of infertility, 156 having laparoscopy because of chronic pelvic pain and 134 women undergoing abdominal hysterectomy for dysfunctional uterine bleeding. MAIN OUTCOME MEASURES: The occurrence of dysmenorrhoea, menorrhagia, menstrual regularity, premenstrual spotting, deep dyspareunia and pelvic pain in women with either endometriosis and post infective pelvic adhesions or a normal pelvis. RESULTS: Menorrhagia, menstrual irregularity and premenstrual spotting occurred with equal frequency in all groups. Deep dyspareunia, pain after intercourse and recurrent pain unrelated to menstruation or coitus was more common in women with endometriosis and those with post infective pelvic adhesions than in those with a normal pelvis. Dysmenorrhoea appears to be more prevalent among women having endometriosis. CONCLUSIONS: Menstrual symptoms, while raising a high index of suspicion for endometriosis, are not entirely reliable as indicators of disease. Dysmenorrhoea is the most common reported symptom in endometriosis sufferers. Diagnostic laparoscopy should be considered before institution of treatment in women complaining of pelvic pain and menstrual symptoms.

Dysmenorrhea↗
PubMed1990

Non-invasive brain stimulation reveals reorganized cortical outputs in amputees.

EMG responses to non-invasive electromagnetic brain stimulation (EMS) were recorded from arm muscles of congenital amputees. Responses were obtained with lower thresholds on the amputated than on the intact side and were evoked from a larger cortical area. Contracting muscles showed increased responses to EMS; the increase was more pronounced on the amputated side. Similar findings were obtained in one traumatic amputee who suffered an early amputation, but not in another patient with a late amputation. We conclude that in congenital amputees there is substantial reorganisation of the corticospinal system and that this may also occur in early traumatic cases.

Adult↗
PubMed1990

The epidemiology of infertility in Aberdeen.

OBJECTIVE: To study the prevalence of infertility, both primary and secondary, outcome of pregnancy, occupation, and uptake of medical services in a total population of women from a geographically defined area. DESIGN: A postal questionnaire survey of an age cohort of women who had completed their fertility, and who were randomly selected from the Grampian Health Board's primary care register. SETTING: Aberdeen city district. SUBJECTS: 1024 Women in the age group 46-50, of whom 130 had to be excluded. Of the remaining 894 women, 766 (86%) responded to the questionnaire. MAIN OUTCOME MEASURES: Response to questionnaire on pregnancy history, the length of time taken to become pregnant each time, and whether medical advice had been sought. RESULTS: Among the 766 women contacted, 602 (79%) reported no difficulties in having children, 56 (7%) had chosen not to have children, and the remaining 108 (14%) had experienced infertility, defined as having difficulty in becoming pregnant for more than two years. In total 68 (9%) women had primary infertility, of whom 41 (5%) eventually conceived. Of the 40 (5%) with secondary infertility, 23 (3%) conceived. Overall, 52 (7%) of the population were left with an unresolved problem of infertility. Only 67 (62%) infertile women had made use of hospital services, and a further 8 (7%) had consulted their general practitioners. Among those who conceived there was no difference in the proportion who sought advice compared with those who did not. CONCLUSION: The overall prevalence of infertility was 14%, although half of these women eventually conceived. Primary infertility was more common than secondary infertility. Only 62% of infertile women attended a hospital clinic for treatment of their infertility.

Ambulatory Care Facilities↗
PubMed1990

Recovery of elbow function in voluntary positioning of the hand following hemiplegia due to stroke.

Elbow movement during voluntary positioning of the hand (with the arm supported against gravity) is described in a longitudinal study of five patients recovering from hemiplegia due to stroke. Over a twelve month period, four of the patients improved their speed of movement, three exhibiting slightly better recovery of elbow extension, one of flexion. In some instances co-contraction of the elbow agonist and antagonist (measured just before the onset of movement) decreased with time after stroke. The effects of contrasting movements at the shoulder on elbow movement were also studied. Estimates of recovery were generally similar whether patients kept the shoulder still or made movements that were synergic or counter-synergic to those of the elbow.

Adult↗
PubMed1989

Can platelet volume predict progressive hypertensive disease in pregnancy?

Increase in platelet size has been found in conditions with increased platelet destruction and use. This increase in platelet size can be found in patients with moderate or severe hypertension in pregnancy, even in the presence of a normal platelet count. The goal of this study was to investigate whether an increase in platelet size was present before the manifestation of the disease and therefore could be used to predict the progression of the disease before it is clinically apparent. Three hundred normal primigravid pregnancies were studied between 28 and 30 weeks' gestation, and blood was taken to assess platelet count and mean platelet volume. Two hundred sixteen patients had no hypertensive problems during their pregnancy, 84 developed hypertension, 62 had mild hypertension only with diastolic blood pressures between 90 and 99 mm Hg, 13 had moderate hypertension with diastolic blood pressures between 100 and 109, and nine had severe hypertension with diastolic blood pressure above 110. No difference was found between these groups in the parameters measured. Therefore it was felt that platelet volume may not be a useful screening test in a low-risk population. A second study was carried out to investigate the serial changes in these parameters in patients at risk of progressive disease. Thirty-four patients with essential hypertension were followed from 24 weeks with serial blood sampling to study changes in platelet size. An additional 40 patients with mild pregnancy-induced hypertension were also studied. From these patient groups, 20 patients developed severe hypertension. The mean platelet volume increased significantly at least 1 week before the hypertension became clinically apparent. There was no change in platelet count at this time. It is concluded that increasing platelet size can predict which patients are likely to progress to severe disease before it becomes clinically obvious.

Blood Platelets↗
PubMed1989

Mode of delivery and future fertility.

A cohort of 22,948 women from a stable homogeneous population who gave birth for the first time between 1964 and 1983 were followed up prospectively. Analysis by mode of delivery showed that of those delivered by caesarean section 23.2% fewer had another pregnancy than those who had a spontaneous vaginal delivery. Women delivered by forceps were in an intermediate group. Miscarriage was more common in women who had been delivered by caesarean section. The relative infertility after caesarean section could not be accounted for by early sterilization, was not associated with maternal height or social status, and was only partly attributable to age.

Adolescent↗
PubMed1989

Negative intrathoracic pressure decreases independently left ventricular filling and emptying.

The mechanism for the fall in left ventricular (LV) stroke volume with normal and obstructed inspiration is controversial with changes proposed in LV preload and afterload. During respiration extending over several cardiac cycles, changes in both LV filling and emptying could occur, rendering demonstration of any responsible mechanism difficult. To evaluate the independent effects of negative intrathoracic pressure (NITP) on LV filling and emptying, we have analyzed the effects of NITP confined to either diastole or systole using electrocardiogram (ECG)-triggered phrenic nerve stimulation in six anesthetized closed-chest dogs. Lung volume was either maintained by completely obstructing the airway or allowed to increase during NITP. With diastolic NITP and the airway obstructed during phrenic nerve stimulation, LV filling volume (integrated mitral flow) significantly decreased (-37 +/- 6.1% SE) associated with increases in LV and right atrial filling pressures at end diastole relative to both atmospheric and esophageal pressures. Right atrial pressure relative to either atmospheric or esophageal pressure increased significantly more than left atrial pressure. The ensuing LV stroke volume (integrated ascending aortic flow) decreased significantly (-30.8 +/- 5.9%). With NITP confined to systole and at constant LV preload, LV stroke volume also decreased (-12.9 +/- 2.5%) associated with an increase in LV systolic pressure relative to esophageal pressure. Similar significant changes were observed despite a smaller fall in esophageal pressure when lung volume was allowed to increase during either diastolic or systolic NITP. We conclude that 1) NITP confined to diastole decreases LV filling and the ensuing LV stroke volume, most likely by ventricular interdependence; 2) NITP confined to systole also decreases LV stroke volume, presumptively by imposing an increased afterload on the LV; 3) both diastolic and systolic mechanisms should contribute to a decreased LV stroke volume during normal and obstructed inspiration; and 4) if the effects of intrathoracic pressure changes were to extend over several cardiac cycles, mechanisms exist to account for either increases or decreases in LV volumes.

Airway Obstruction↗
PubMed1989

The assessment factor most nurses forget.

Wakefulness, temperature, and cardiovascular function are just three of more than a hundred patterns that the human body follows every day. You can use the latest findings on these biological rhythms to deliver better care.

Body Temperature↗
PubMed1988

Discrepancies between the affinities of binding and action of the novel beta-adrenergic agonist BRL 37344 in rat brown adipose tissue.

The novel brown adipose tissue (BAT) selective beta-adrenergic agonist, BRL 37344, is 31-fold more potent than (-)-isoproterenol in stimulating the respiratory rate of interscapular BAT fragments. BRL 37344 is also more potent (9-fold) than (-)-isoproterenol in stimulating adenylate cyclase activity of IBAT purified plasma membranes whereas, in the same preparation, it is 81-fold less potent than (-)-isoproterenol in competition displacement studies with the beta-adrenergic ligand, [125I]cyanopindolol. We have previously demonstrated that the photoaffinity reagent [125I]cyanopindolol-diazirine selectively labels a 62 kDa protein in IBAT plasma membranes that displays pharmacological properties of a beta 1-adrenergic subtype. Relatively high concentrations of BRL 37344 (10 microM) are required to displace [125I]cyanopindolol-diazirine binding to the 62 kDa protein. Taken together, the results suggest that two different populations of beta-adrenergic receptors may co-exist in BAT plasma membranes: a small population (about 15%) of atypical beta-receptors and a large population of beta 1-receptors that exhibit high and low affinities for BRL 37344, respectively.

Adenylyl Cyclases↗
PubMed1988

Chromosomal distribution of the RTVL-H family of human endogenous retrovirus-like sequences.

We have analyzed the chromosomal distribution of a large family of human endogenous retrovirus-like sequences termed RTVL-H. In situ hybridizations suggest that these sequences are found on all human chromosomes. These results also indicate that clusters or concentrations of RTVL-H elements may exist on chromosomes 1p and 7q. Southern blotting experiments using somatic cell hybrids containing either the human chromosome 3 or the X chromosome confirm the presence of multiple dispersed RTVL-H sequences on these two chromosomes. These experiments also demonstrate that distinct RTVL-H banding patterns can be detected for each chromosome. Thus, RTVL-H probes may be useful in genome mapping studies.

Animals↗