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Biomedical subjects

D Black

Publications and source records attributed to D Black.

At least 235 records · Page 13Linked to original sources
PubMed1988

Quantitative analysis of the pyridinium crosslinks of collagen in urine using ion-paired reversed-phase high-performance liquid chromatography.

A method has been developed for the simultaneous and rapid analysis of the 3-hydroxypyridinium crosslinks of mature collagen, pyridinoline and deoxypyridinoline, in samples of urine and tissue. After hydrolysis in 6 M HCl, samples were prefractionated by partition chromatography using columns packed with cellulose CF1. The appropriate fractions were freeze-dried and then subjected to high-performance liquid chromatography using a gradient system with 20 mM NH4Cl, pH 3.5, and acetonitrile, incorporating 1-octanesulfonic acid as an ion-pairing agent; the pyridinium crosslinks were detected fluorometrically. The limit of detection of both crosslinks was 1 pmol. The mean recoveries of added standard to samples ranged between 94.2 and 97.2%, and the reproducibility of the complete procedure was between 12 and 16%. An application of the method in the study of degenerative disorders of bone and connective tissue is illustrated.

Adult↗
PubMed1988

Pyelonephritis in adult women: inpatient versus outpatient therapy.

PURPOSE: The traditional treatment of acute pyelonephritis has been hospitalization and parenteral administration of antibiotics. No previous study, however, has attempted to differentiate between those patients with pyelonephritis who might be safely managed as outpatients and those in whom hospitalization is required. We therefore decided to determine whether women with pyelonephritis can be effectively and safely managed outside the hospital. PATIENTS AND METHODS: The medical records of 94 female outpatients and 100 hospitalized women treated for acute pyelonephritis at San Francisco General Hospital were reviewed. Utilizing baseline clinical and laboratory data, we compared outcome in the two groups, and computed the cost-benefit of managing pyelonephritis on an outpatient basis. RESULTS: We observed a similarity in the frequency of successful outcomes (approximately 90 percent in each group) and absence of serious adverse outcome in any outpatient. Results of urine culture were comparable in inpatients and outpatients, with Escherichia coli identified as the most common urinary pathogen in both groups. The frequency of resistance to ampicillin of E. coli and other urinary pathogens was nearly 30 percent. A cost analysis demonstrated a 7.5-fold difference between the inpatient and outpatient groups. CONCLUSION: Our findings suggest that treatment of pyelonephritis with oral antibiotics poses a safe and effective method of therapy in immunocompetent women without underlying illness. The use of ampicillin as a single agent for the treatment of pyelonephritis, however, is inadvisable. Our study also demonstrates the potential savings in managing selected patients with pyelonephritis as outpatients.

Acute Disease↗
PubMed1988

Measurement of subcutaneous fat thickness with high frequency pulsed ultrasound: comparisons with a caliper and a radiographic technique.

This paper reports the use of a 10 MHz pulsed A-scan ultrasound system to measure the thickness of subcutaneous fat and its comparison with two other established techniques. Measurements using both ultrasound and Harpenden's skin calipers were made on the abdomen, over the scapula region, over the triceps and on the front of the thigh. Computerised axial tomography (CAT) was also used to obtain measurements of subcutaneous fat over the abdomen. In most instances the different techniques were significantly correlated. The ultrasound method showed non-dependency or bias upon the size of measurement when compared with the other two techniques. In addition, the ultrasound method was considered more accurate, reproducible and sensitive compared with the caliper technique and much more convenient than CAT scanning. However, the presence of septa at some sites in the more obese subjects was revealed by CAT scanning and made ultrasound assessment at these sites more difficult.

Adipose Tissue↗
PubMed1988

Prevalence of ABO maternal-infant incompatibility in Asians, Blacks, Hispanics and Caucasians.

Previous studies suggest that race is a risk factor in ABO hemolytic disease of the newborn (ABO-HDN). In order to compare the prevalence of ABO-HDN in Asian, Black, Hispanic and Caucasian infants, we studied 10,611 consecutive births at one hospital over a 6-year period. Among group A infants born to group O mothers, the prevalence of positive DAT differed among the four groups (p = 0.007), and was highest in Asians (50%) and lowest in Caucasians (31%). However, the proportions of infants who required exchange transfusion were not different (p = 0.351). Among group B infants born to group O mothers, the prevalence of positive DAT was not different among the four groups (p = 0.26) and none of these 166 group B infants with a positive DAT result required exchange transfusion. Our findings suggest that there are small ethnic differences in the prevalence of positive DAT results in group A infants born to group O mothers, but the prevalence of clinical disease which requires exchange transfusion does not differ significantly among Asian, Black, Hispanic and Caucasian infants.

ABO Blood-Group System↗
PubMed1988

Recovery of function after hip fracture. The role of social supports.

Previous studies have found that social support may reduce mortality after myocardial infarction and reduce overall mortality among the elderly. To determine whether social support also influences the recovery of function among patients who have had hip fractures and to describe other potential predictors of recovery after hip fracture, 111 patients with hip fractures were interviewed and examined before discharge from the hospital. The functional status of surviving patients was assessed again 6 months later. Patients who had a greater number of social supports had more complete recovery of their prefracture level of function (r = .21; P = .04). This association was strongest for patients over 60 years old (r = .31; P = .006); among these patients, this association remained statistically significant after adjustment for other significant (P less than .05) predictors of recovery: arm strength, mental status, and serum albumin. Additional studies should be done to test whether interventions to increase social supports can improve the recovery of function among elderly patients with hip fractures and other illnesses. In the meantime, health professionals should counsel elderly patients about the potential rehabilitative and preventive benefits of social supports.

Activities of Daily Living↗
PubMed1988

Effects of treatment for isolated systolic hypertension on cognitive status and depression in the elderly.

The Systolic Hypertension in the Elderly Program (SHEP) was designed as a feasibility study and in part dealt with the effects of the treatment of isolated systolic hypertension on cognitive status and depression. Subjects were 60 years of age or older with a systolic blood pressure of 160 mmHg or greater and diastolic of less than 90 mmHg; free of several specified illnesses or chronic conditions. These volunteers were randomly assigned to treatment (n = 443) and placebo (n = 108) groups. The behavioral assessments at baseline and 1 year later were the SHORT-CARE instrument for depression, cognitive impairment, and disability and other tests of cognitive status (Digit Symbol Substitution and the Trail Making tests). Although the treatment regime was highly successful in controlling the hypertension, it did not have a significant impact on changes in cognitive function or level of depression; a behavioral benefit was not evident but the results are consistent with the view that an effective treatment regime for isolated systolic hypertension in the elderly can be behaviorally safe.

Aged↗
PubMed1988

Assessment of self-poisoning patients by psychiatrists and junior medical staff.

Case notes of patients admitted to hospital or seen in the casualty department following an overdose were assessed in a standardized way. The medical records were deficient in several important areas, especially for those patients seen in casualty and not referred to a psychiatrist. If only selected patients were to be assessed by psychiatrists, closer monitoring of the psychiatric assessments and management initiated by junior medical staff would be required. Although the poor records may reflect lack of motivation as much as lack of education, there was no significant relationship between the doctors' attitudes towards self-poisoning patients in general and the standard of their assessments.

Attitude of Health Personnel↗
PubMed1988

Father kills mother. Issues and problems encountered by a child psychiatric team.

The child whose mother is killed by his or her father has to cope with the trauma of violence, the grief associated with the loss of both parents simultaneously, dislocation and insecurity regarding where and with whom they will live, stigma, secrecy, and often massive conflicts of loyalty. These issues and how they affected the 28 children of 14 families in which the father had killed the mother are examined. Recommendations for practice based on this clinical experience are proposed.

Adolescent↗