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Biomedical subjects

D Black

Publications and source records attributed to D Black.

At least 145 records · Page 8Linked to original sources
PubMed1993

Simple measurement of femoral geometry predicts hip fracture: the study of osteoporotic fractures.

Based on engineering principles, geometric measurements of femoral size should be related to femoral strength and the risk for hip fracture. To evaluate whether a simple measurement of femoral geometry is associated with hip fracture risk, we obtained dual x-ray absorptiometry scans of the proximal femur on 8074 white women age 67 or older. During an average of 1.6 years of follow-up, 64 participants suffered hip fractures. In all fracture cases and in a random sample of 134 women who did not subsequently suffer a hip fracture, we measured hip axis length (the distance from greater trochanter to inner pelvic brim), neck width, and the neck/shaft angle on the scan printout, with the observer blinded to subsequent fracture status of the participant. Results were analyzed using multiple logistic models, and odds ratios were determined. After adjustment for age, each standard deviation decrease in femoral neck bone mineral density increased hip fracture risk 2.7-fold (95% confidence interval 1.7, 4.3), and each standard deviation increase in hip axis length nearly doubled the risk of hip fracture (odds ratio = 1.8; 95% CI 1.3, 2.5). The relationship between hip axis length and fracture risk persisted even after adjustment for age, femoral neck density, height, and weight. A longer hip axis length was associated with an increased risk of both femoral neck (OR = 1.9; 95% CI 1.3, 3.0) and trochanteric fractures (1.6; 1.0, 2.4). We found no significant association between the neck width (1.1; 0.8, 1.5) or the neck/shaft angle (1.4; 0.9, 2.2) and risk of hip fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1993

Sequence analysis of herpes simplex virus gB gene homologs of two platyrrhine monkey alpha-herpesviruses.

Homologs of the herpes simplex virus gB gene were identified in two alpha-herpesviruses of platyrrhine monkeys, Herpesvirus saimiri 1 (HVS 1) and H. ateles 1 (HVA 1). These genes were cloned and sequenced in their entirety. Analysis of the predicted amino acid sequences indicated that the gB glycoproteins of these two viruses are of similar size, have 10 Cys residues and 5 potential N-linked glycosylation sites which align exactly with those in other primate alpha-herpesvirus gB polypeptides, and have a similar distribution of predicted secondary structural features, all of which indicate a conserved structure of the gB polypeptide. Alignment of these two gB sequences with those of four other primate alpha-herpesviruses (SA 8, B virus, HSV 1 and HSV 2) revealed localized regions of extensive sequence divergence as well as highly conserved regions. On comparison of the six primate virus gB sequences, the gBs of the two platyrrhine monkey viruses form a subgroup separate from that of the four catarrhine virus gBs. The degree of relatedness of the HVA 1 and HVS 1 gB sequences to each other was equivalent to the degree of relatedness between the human and the cercopithecine monkey virus gB sequences.

Amino Acid Sequence↗
PubMed1993

Bronchodilator response to nebulized salbutamol in elderly patients with stable chronic airflow limitation.

The bronchodilator response to 5 mg nebulized salbutamol was studied in 20 elderly patients with stable chronic airflow limitation. Salbutamol produced significantly greater increases in FEV1 and FVC compared with placebo although there was no difference in subjective sensation of breathlessness. Spirometry can be successfully used to assess respiratory function in appropriately selected elderly patients with chronic airflow limitation.

Aerosols↗
PubMed1993

Socioeconomic status: the prime indicator of premature death in Australia.

The link between socioeconomic status and health has long been recognised. This study of deaths among Australian men aged 15-59 years demonstrates that during the 20-year period, 1966-86 the number of premature deaths was dramatically reduced among all socioeconomic groups, primarily as a result of falls in death rates due to heart disease, stroke and trauma. However, the marked differences in death rates according to social class remain, to the extent that if men of all social classes had the same mortality experiences as professional and technical workers the overall death rates for Australian men would be reduced by 60%. Socioeconomic status is the most important indicator of health status among Australians.

Adolescent↗
PubMed1993

Anti-P antibodies are associated with psychiatric and focal cerebral disorders in patients with systemic lupus erythematosus.

In a cross-sectional study, 62 patients with systemic lupus erythematosus were assessed using standardized psychiatric and psychological methods; systemic disease activity was scored using the British Isles Lupus Assessment Group and the Lupus Activity Criteria Count indices. IgG and IgM anti-P antibodies were measured by ELISA using a synthetic 22 amino acid peptide as the relevant antigen. IgG and IgM anti-P antibodies were significantly associated with neuropsychiatric disorders (psychiatric and neurological) but failed to distinguish patients with psychiatric disorders from those with neurological disorders. These antibodies were not associated with cognitive impairment or systemic disease activity.

Antibodies↗
PubMed1993

Psychiatric referrals within the general hospital: comparison with referrals to general practitioners.

The increase in referrals to a new consultant psychiatrist within a teaching hospital was documented. During 1987/88 there were 279 consecutive referrals from physicians and surgeons (159 out-patients and 120 ward-consultation requests) which were compared with 184 consecutive GP referrals over the same period. Hospital referrals tended to be older, and less socially disadvantaged, but with psychiatric disorder of similar severity to GP referrals. They were more likely to have a concurrent physical diagnosis, and demonstrate somatisation. The latter was not confined to patients without physical disorder; half of the patients classified as 'psychological reaction to physical disorder' showed somatisation. ICD-10 appeared to perform better than ICD-9 or DSM-III for somatoform disorders, but a comprehensive classification system is still needed for liaison psychiatry. Personal discussion with the referring doctor was most common among the ward-consultation requests; in this situation the referring doctor usually continued primary management of the patient.

Adult↗
PubMed1992

Hormone therapy to prevent disease and prolong life in postmenopausal women.

PURPOSE: To critically review the risks and benefits of hormone therapy for asymptomatic postmenopausal women who are considering long-term hormone therapy to prevent disease or to prolong life. DATA SOURCES: Review of the English-language literature since 1970 on the effect of estrogen therapy and estrogen plus progestin therapy on endometrial cancer, breast cancer, coronary heart disease, osteoporosis, and stroke. We used standard meta-analytic statistical methods to pool estimates from studies to determine summary relative risks for these diseases in hormone users and modified lifetable methods to estimate changes in lifetime probability and life expectancy due to use of hormone regimens. RESULTS: There is evidence that estrogen therapy decreases risk for coronary heart disease and for hip fracture, but long-term estrogen therapy increases risk for endometrial cancer and may be associated with a small increase in risk for breast cancer. The increase in endometrial cancer risk can probably be avoided by adding a progestin to the estrogen regimen for women who have a uterus, but the effects of combination hormones on risk for other diseases has not been adequately studied. We present estimates for changes in lifetime probabilities of disease and life expectancy due to hormone therapy in women who have had a hysterectomy; with coronary heart disease; and at increased risk for coronary heart disease, hip fracture, and breast cancer. CONCLUSIONS: Hormone therapy should probably be recommended for women who have had a hysterectomy and for those with coronary heart disease or at high risk for coronary heart disease. For other women, the best course of action is unclear.

Breast Neoplasms↗
PubMed1992

Psychiatric disorder and cognitive impairment in systemic lupus erythematosus.

OBJECTIVES: To determine the point prevalence of psychiatric disorder in patients with systemic lupus erythematosus (SLE). To investigate associations between psychiatric disorder and social stress, cognitive impairment, systemic disease activity, and corticosteroid therapy. METHODS: A cross-sectional study of 73 consecutive patients with SLE assessed using standardized psychiatric and clinical research methods. RESULTS: Current psychiatric disorder was present in 15 patients (20.5%) and was significantly associated with social stress, lack of social support, and impairment on 2 tests of cognitive function (Verbal Fluency Test and Benton Visual Retention Test, Part A, number of errors). There was no association with systemic disease activity or corticosteroid therapy. Cognitive impairment on 2 or more tests was found in 26% and was associated with clinical evidence of central nervous system (CNS) disease, but not systemic disease activity or corticosteroid therapy. CONCLUSIONS: The point prevalence of psychiatric disorder in this cohort of patients with SLE was found to be similar to that observed in patients with rheumatoid arthritis. It was independently associated with social stress and 2 indicators of cognitive impairment, but not with systemic disease activity or corticosteroid therapy. Marked cognitive impairment was present in a significant percentage of patients even when there was no overt evidence of CNS involvement.

Adult↗
PubMed1992

Site-matched calcaneal measurements of broad-band ultrasound attenuation and single X-ray absorptiometry: do they measure different skeletal properties?

Because of the differences in the interactions of ultrasound and x-ray waves with bone, quantitative ultrasound (QUS) techniques may yield information about skeletal status not accessible by regular bone densitometry (BD) techniques. However, relatively strong correlations have been reported between broad-band ultrasound attenuation (BUA) and several x-ray-based BD methods. We assessed the precision and association of single x-ray absorptiometry (SXA) and BUA of the calcaneus. We examined both BUA and SXA at the calcaneus using special software for matching the regions of interest. An algorithm was derived and applied to correct the observed correlation coefficients for the attenuation effect caused by the precision errors for BUA and SXA. In a group of 33 volunteers covering a wide range of age and calcaneal bone mineral densities, the site-matched and precision-adjusted correlation coefficient between BUA and SXA was r = 0.58, with a standard error of the estimate (SEE) of 14.41 dB/MHz, or 17.08%. For the subgroup of 25 women the correlation was stronger, with r = 0.72 and SEE = 11.53 dB/MHz, or 14.33%. SXA precision was 0.79% for the regular region of interest (ROI) and 1.22% for the site-matched ROI. BUA precision was 2.76% for the entire subject group and 1.63% for women of age 40 or older. The observed correlation coefficient between ultrasound and x-ray based techniques of the order of 0.7 is significant, but it leaves about 50% of the variability unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1992

The carboxy-terminal extension of the collagen binding domain of fibronectin mediates interaction with a 165 kDa membrane protein involved in odontoblast differentiation.

Terminal differentiation of the odontoblast is characterized by an elongation and a polarization of the cell. The change in the cell shape and the reorganization of the cytoplasm involve the microfilament system. An immunological approach has previously implicated a transmembrane interaction between fibronectin and vinculin in the control of odontoblast differentiation. A 165 kDa protein localized on the cell-surface of odontoblasts mediated this interaction. In order to define the nature of the interaction of the 165 kDa protein with fibronectin, peptides were prepared by proteolytic cleavage of fibronectin with alpha-chymotrypsin. The results indicate that the 165 kDa protein interacted with a 62 kDa peptide located towards the amino-terminal extremity of fibronectin, but not with a 47 kDa related fragment. Both these 62 kDa and 47 kDa peptides included the collagen-binding domain and were retarded on a heparin-Ultrogel column. Microsequences demonstrated that the 62 kDa and 47 kDa fragments had the same amino-terminal extremity and that the larger fragment was extended in the carboxy-terminal direction. This carboxy-terminal extension of the collagen binding domain of fibronectin is implicated in the interaction of this molecule with the 165 kDa protein. On the other hand, odontoblasts differentiated normally when tooth germs were cultured in the presence of GRGDS synthetic peptide, suggesting that RGD-dependent integrins were not involved in odontoblast differentiation. Staining of dental mesenchymal cells in primary culture and of differentiated odontoblasts in situ with antibodies directed against the beta 1-subunit of integrins confirmed previous observations and showed that although beta 1 integrins are involved in the attachment of cultured dental cells, they are not implicated in the process of odontoblast differentiation.

Actin Cytoskeleton↗
PubMed1992

Father kills mother: post-traumatic stress disorder in the children.

Results of a study of over 100 children whose father killed their mother have been summarized and principles for practice have been formulated. All children orphaned by the death of one parent at the other's hands should be seen as soon as possible in a child psychiatry department and assessed. An immediate crisis intervention will probably be needed if they witnessed the killing to prevent PTSD. Bereavement counselling will be helpful in most cases. The caretakers will need support and help with their own mourning. Placement, access and custody, compensation, seeing the body, attending the funeral and dealing with family conflict will all need consideration. Long-term follow-up and further research are recommended.

Bereavement↗