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Biomedical subjects

C Norton

Publications and source records attributed to C Norton.

At least 37 records · Page 2Linked to original sources

Providing appropriate services for continence: an overview.

This article gives an overview of continence services, detailing the policies which should inform service provision. The author highlights the role of the specialist continence adviser and suggests relevant questions to be asked for the future development of a service which can be accessed by and meets the needs of all its users.

Adolescent↗

Creation and characterization of E-selectin- and VCAM-1-deficient mice.

A variety of adhesion molecules have been identified which mediate the interaction of leukocytes with endothelial cells. In order to define the role of individual molecules in inflammation we have produced lines of mice which are deficient in the synthesis of specific adhesion molecules. Null mutations were introduced into the genes encoding E-selectin or vascular cell adhesion molecule-1 (VCAM-1) in embryonic stem cells and these cells were used to produce lines of mice carrying the mutation. E-selectin-deficient mice were viable and exhibited no developmental defects. The roles of E- and P-selectin in the influx of neutrophils were examined using these mice. The data suggest that the two selectins are functionally redundant in mediating neutrophil emigration in a model of chemically induced peritonitis. VCAM-1-deficient mice are not viable. Analysis of VCAM-1 gene expression in wild-type embryos and phenotypic analysis of VCAM-1 -/- embryos suggests that VCAM-1 is required for development of the extraembryonic circulatory system and the embryonic heart.

Animals↗

A bronchial butterfly.

We report on an asthmatic patient who accidentally inhaled the small metal backing ("butterfly") of a nose stud, which she wore daily. Despite administration of nebulized salbutamol, postural drainage, and the use of rigid and fibreoptic bronchoscopes, attempted removal of the butterfly remained unsuccessful. Spontaneous expulsion of the butterfly occurred two months following inhalation. We suggest that consideration should be given by nose stud jewelry manufacturers to a more secure fixing device.

Adult↗

Hypoxia-mediated induction of endothelial cell interleukin-1 alpha. An autocrine mechanism promoting expression of leukocyte adhesion molecules on the vessel surface.

Tissue injury that accompanies hypoxemia/reoxygenation shares features with the host response in inflammation, suggesting that cytokines, such as IL-1, may act as mediators in this setting. Human endothelial cells (ECs) subjected to hypoxia (PO2 approximately 12-14 Torr) elaborated IL-1 activity into conditioned media in a time-dependent manner; this activity was completely neutralized by an antibody to IL-1 alpha. Production of IL-1 activity by hypoxic ECs was associated with an increase in the level of mRNA for IL-1 alpha, and was followed by induction of endothelial-leukocyte adhesion molecule-1 and enhanced expression of intercellular adhesion molecule-1 (ICAM-1) during reoxygenation. During reoxygenation there was a three- to five-fold increased adherence of leukocytes, partly blocked by antibodies to endothelial-leukocyte adhesion molecule-1 and ICAM-1. Suppressing endothelial-derived IL-1, using either antibodies to IL-1 alpha, specific antisense oligonucleotides or the IL-1 receptor antagonist, decreased leukocyte adherence to reoxygenated ECs, emphasizing the integral role of IL-1 in the adherence phenomenon. Mice subjected to hypoxia (PO2 approximately 30-40 Torr) displayed increased plasma levels of IL-1 alpha, induction of IL-1 alpha mRNA in the lung, and enhanced expression of ICAM-1 in pulmonary tissue compared with normoxic controls. These data suggest that hypoxia is a stimulus which induces EC synthesis and release of IL-1 alpha, resulting in an autocrine enhancement in the expression of adhesion molecules.

Animals↗

Hospital use patterns for children in the United States, 1983 and 1984.

The hospital discharge rate of children less than 15 years of age in the United States declined 12% from 1983 to 1984. This was the first time in the 20-year history of the National Hospital Discharge Survey that there was a statistically significant decrease in children's hospital discharge rates in a 1-year period. The change occurred during a period when prospective hospital payment systems were introduced and when prepaid group health plans and alternative systems of providing health care were expanding. The unprecedented decrease in children's hospital use was evaluated using data from the National Hospital Discharge Survey. This is a continuous survey in which data from a national sample of medical records of discharged patients are collected. Children's hospital use rates were reviewed by age, sex, region, and expected principal source of payment. Significant decreases in discharge rates were found for the age group 1 to 4 years and for all children with private insurance. The patterns and changes in hospital use by diagnostic category were also investigated. The major finding was a 19% decrease in children's discharge rate for diseases of the respiratory system. Mortality statistics and data from the National Health Interview Survey were evaluated for indications of changes in children's health status or use of physician services accompanying the decline in hospital use. Although there were fewer deaths due to respiratory diseases for children less than 5 years of age in 1984 than in 1983, most measures of health status were unchanged. The only significant change in physician use was a decrease in the percentage of acute conditions that were medically attended, also among children less than 5 years of age. It is important to continue monitoring children's hospital use patterns, as well as their health status and use of alternative health services, to further assess the impact of changes in the organization and financing of health services.

Adolescent↗