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Biomedical subjects

D Clarke

Publications and source records attributed to D Clarke.

At least 217 records · Page 12Linked to original sources
PubMed1980

Adhesion of enteropathogenic bacteria to cells in tissue culture.

Adhesion to the intestinal mucosa is the primary determinant of virulence among bacteria causing intestinal disease. Most current test systems involve the use of animal or foetal tissue. This paper illustrates the ability of enteropathogenic bacteria to adhere to mammalian cells. The test described enables considerable differences in adherence to be demonstrated between bacterial strains.

Animals↗
PubMed1979

Severe hypertension in primary aldosteronism and good response to surgery.

11 patients with primary aldosteronism have been encountered over 11 years and submitted to surgery in a provincial teaching hospital serving a population of 3 million. Contrary to classical teaching, the hypertension has usually been very severe. Precise identification of the site of the lesion preoperatively has been possible by the measurement of adrenal-vein aldosterone levels, and results of surgery have been excellent. The iodocholesterol adrenal scan also correctly identified the site of the adenoma in 5 out of 7 patients in which it was used. Adrenal venography was of little value except in siting catheters.

Adenoma↗
PubMed1979

Glucose promotes whole-body protein synthesis from infused aminoacids in fasting man. Isotopic demonstration.

15N-glycine constant infusion, with plateau urea enrichment as the endpoint, demonstrated a clear increase in whole-body protein synthesis when glucose was added to aminoacid infusion in fasting men. Whole-body protein-breakdown rates remained unchanged. There was an unexpected fall in whole-body nitrogen turnover when the subjects were changed from an oral intake to either of the intravenous programmes: this finding, not previously reported, may be due to the decrease in gastrointestinal enzyme synthesis and intestinal-lining cell-turnover when oral intake is replaced by total parenteral nutrition.

Administration, Oral↗
PubMed1978

Treatment of patients with transposition of great arteries and pulmonary vascular obstructive disease.

Twenty-two patients with transposition of the great arteries with or without ventricular septal defect and one with double outlet right ventricle, d-malposition, and severe pulmonary vascular obstructive disease were treated surgically. All were cyanosed and had very limited exercise tolerance. Preoperatively, systemic arterial oxygen saturation (SaO2) varied from 45 to 79% (mean 65), haemoglobin was 13 to 23 g/dl (mean 19). Pulmonary arteriolar resistance was 6.4 to 35 units m2 (mean 17). In the patients with a ventricular septal defect the Mustard operation was done without closure of the ventricular septal defect, and in the 3 patients with intact ventricular septum the Mustard operation was combined with creation of a ventricular septal defect. All patients survived the operation and improved. Postoperative SaO2 ranged from 75 to 96% (mean 89) and haemoglobin from 10.6 to 17.8 g/dl (mean 14.0). This improvement was significant (P less than 0.05). Five patients have had a postoperative cardiac catheterisation. The pulmonary arteriolar resistance remains high in all. Postoperative follow-up varies from 4 to 40 months (mean 14 months). So far there have been no late deaths and all patients remain improved.

Adolescent↗
PubMed1977

An experimental comparison of three courses in history-taking skills for medical students.

Since clinical training often fails to equip medical students with essential history-taking skills, more effective teaching methods required to be developed. As previous work had suggested that training which included televised demonstrations of history-taking and practice with simulated patients might be superior to traditional methods, it was decided to evaluate this experimentally. Thirty students beginning the Oxford Clinical Course were randomly selected and allocated to a traditional or one of two experimental courses. Both experimental courses used television and simulation but differed in the way the history-taking demonstrations were presented. After completing these courses, each student was asked to take a history from a simulated patient. Rating of the videotapes of these interviews showed that the two experimental groups obtained much more information and used many more of the required skills than students assigned to the traditional course. The experimental students were also rated more favourably by the simulators and recorded more data in their case histories. It is concluded that these short courses were practical, very effective, and could be augmented by a self-teaching programme in history-taking skills.

Clinical Competence↗
PubMed1977

New wonder cloth?

Explore the source record for details and available documents.

Bacteria↗
PubMedDate not supplied

The prognostic significance of large mediastinal masses in the treatment of Hodgkin's disease. The experience of the Institut Gustave-Roussy.

At the Institut Gustave-Roussy we undertook a study of 154 patients with clinical stages I and II Hodgkin's disease treated by irradiation to evaluate the prognostic significance of the mediastinal mass size. The population under study included those patients treated at our institute and entered into the H2 and H5 E.O.R.T.C. trials between 1972 and 1981. Patients were divided into three groups for purposes of analysis; large mediastinal masses (MT ratio greater than or equal to 0.35) were noted in 20 cases (13 per cent), moderate mediastinal invasion (MT ratio less than 0.35) was observed in 60 cases (39 per cent), and 74 patients (48 per cent) had no mediastinal involvement on presentation. Intrathoracic relapses were more frequent in those patients with mediastinal involvement at presentation (p less than 0.001) but there was no statistically significant difference between those patients with 'large' masses and patients with 'small' masses. Additionally multivariate analyses showed that neither the presence nor the size of mediastinal disease adversely affected relapse free survival or overall survival. These results can perhaps be linked to the technique of radiotherapy where a 'split course' technique was habitually used for large masses and the radiation fields were routinely modified during treatment according to the tumour response. Consequently we do not advocate the routine use of extensive primary treatment such as combined modality therapy utilizing MOPP chemotherapy for all patients presenting with bulky mediastinal masses. Rather chemotherapy should be reserved for those tumours which are particularly voluminous (MT ratio greater than 0.50) where primary radiotherapy may potentially result in unsatisfactory late pulmonary complications. We also advise the use of combined modality therapy for those patients who may additionally have certain unfavourable prognostic factors which we have previously identified.

Adolescent↗
PubMedDate not supplied

Addictive behavior of older adults.

Very little is known about addictive alcohol use by older people. In the present paper personal effects reasons for drinking (i.e. drinking for the effects of alcohol) and concerns about drinking were used as indicators of addictive drinking behavior among a sample of 826 people aged 65 and older who participated in survey interviews in their homes. The relationship of addictive drinking behavior to frequency of drinking, quantity of drinks per occasion, and depressant drug use was examined. Alcohol use was higher among males and young-old (aged 65-74), while depressant medication use was higher among females and old-old (aged 75+). However, with the exception of use of over-the-counter medications containing codeine (which was significantly higher among current drinkers), no relationship existed between alcohol use and use of depressant medications. Personal effects reasons for drinking and concerns about drinking were related both to alcohol and depressant medication use. Frequency of drinking was associated with higher endorsement of both personal effects and social reasons, whereas volume of alcohol consumption (drinks per drinking day) was associated only with personal effects drinking. In addition, use of depressant medications by drinkers was significantly related to consuming alcohol for personal effects reasons (but unrelated to consuming for social reasons) and with having concerns about one's own drinking. These results suggest that even within the generally low levels of alcohol consumption of older people, addictive-use patterns emerge. In addition, the results confirm the importance of including depressant medication use in evaluating the drinking behavior of older people.

Age Factors↗