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Biomedical subjects

D G Cramp

Publications and source records attributed to D G Cramp.

At least 19 recordsLinked to original sources
PubMed1998

Clinical decision support, systems methodology, and telemedicine: their role in the management of chronic disease.

In this paper, the design and evaluation of decision support systems, including those incorporating a telematic component, are considered. It is argued that effective design and evaluation are dependent upon the adoption of appropriate methodology set firmly within a systemic framework. Systems modeling is proposed as an approach to system design, with evaluation adopting an approach incorporating evaluability analysis and formative and summative evaluation, including the use of stakeholder matrix analysis. The relevance of such systemic methodology is demonstrated in the context of diabetes and end-stage renal disease as examples of the generic clinical problem of the management of chronic disease.

Chronic Disease↗
PubMed1989

ANABEL: intelligent blood-gas analysis in the intensive care unit.

ANABEL (ANalysis of Acid-Base status by Evaluating Lisp) is a prototype medical intelligent decision-support system aiming to assist clinicians in an Intensive Care Unit environment with the interpretation of blood-gas measurements. Its architecture is based on the merging of representations for declarative (domain-descriptive) and procedural (problem-solving) medical knowledge. The system performs diagnosis in two stages (tentative and differential) by first evaluating elementary computational units of procedural knowledge (procedures) and then abstracting their symbolic outputs in generating text. Thus, a 'semantic trace' is built which reflects the system's line of reasoning in reaching its conclusion. This paper describes the design aspects, development and clinical validation of ANABEL.

Acid-Base Imbalance↗
PubMed1989

Of mice and men--data capture in the clinical environment.

We have considered the problem of data capture in the critical care area. Review of previous work on the use of alternative input devices for speed and accuracy of data entry yields conflicting information but suggests that requirements depend on input task, data type and skill of the user. We have performed comparative studies of the QWERTY keybord, cursor control keys, mouse and graphics tablet for data entry in two intensive therapy unit (ITU) environments. The graphics tablet proved overall the best of the devices studied. We report the potential applications of this type of input device.

Computer Systems↗
PubMed1982

Plasma lipid alterations in patients with chronic renal disease.

Hyperlipidemia is common in patients with renal disease. This fact may be of great clinical relevance in view of the overwhelming evidence associating disturbed lipid metabolism and atherogenesis. Thus, hyperlipidemia may predispose to vascular disease in patients with chronic renal disorders and premature atherosclerosis could be an important risk in renal disease and a major factor limiting survival of patients on long-term maintenance hemodialysis. The aim of the present review is to present a brief but clinically relevant description of lipoprotein physiology and then to survey the now considerable literature concerned with lipoprotein and thus lipid abnormalities in patients with renal disease. A particular emphasis is placed on the role of the plasma lipoproteins in forming an integrated and controlled pathway for lipid metabolism, and how altered regulatory control within the pathway may be associated with pathogenic mechanisms. Finally, the evidence for accelerated development of vascular disease associated with these lipid abnormalities is briefly considered.

Apolipoproteins↗
PubMed1982

Total cholesterol, high density lipoprotein-cholesterol and triglycerides after a standardized high-fat meal.

Total cholesterol, high density lipoprotein (HDL)-cholesterol and triglycerides were measured fasting and at 20, 40, 60, 120 and 180 min after a high-fat meal in 22 healthy subjects. Both HDL-cholesterol and total cholesterol fell during the first 20 min after the meal whereas the mean triglyceride level increased during the observation period. In 8 of the subjects the maximum triglyceride level was reached before the end of the observation period and their fasting HDL-cholesterol level was significantly higher than in the rest of the subjects. The higher the fasting HDL-cholesterol concentration, the more rapidly the triglyceride levels returned towards initial values. The study supports the concept that the degradation rate of triglyceride-rich particles is dependent on the HDL-cholesterol level. It also suggests the use of non-fasting triglyceride values in addition to HDL-cholesterol as independent predictors in longitudinal studies for CHD.

Adolescent↗
PubMed1980

The mechanism of hyperlipidaemia in nephrotic syndrome--role of low albumin and the LCAT reaction.

Diminished autologous LCAT activity was found in patients with proteinuria. This was due to substrate limitation and albumin appeared the most likely limiting factors. It is suggested that low albumin can contribute to the hyperlipidaemia of nephrotic syndrome through its role on the LCAT reaction. Evidence of the ability of triglyceride to enhance homologous LCAT activity was also noted.

Adolescent↗
PubMed1979

The effect of metoprolol on plasma lipids.

Fifteen hypertensive patients entered a single-blind study to examine the effects of metoprolol (100 mg twice daily) on fasting plasma lipids. In 12 patients who completed the study, non-esterified fatty acid concentrations fell, but cholesterol and triglyceride levels were unchanged after 12 weeks' treatment. These results conflict with earlier reports of the effect of metoprolol on plasma triglyceride concentrations.

Adult↗
PubMed1979

An evaluation of a simple polyacrylamide gel electrophoresis system for lipoproteins and its use for the characterisation of hyperlipoproteinaemia.

The use of polyacrylamide gel electrophoresis as a screening procedure for the characterisation of hyperlipoproteinaemia is described. Sixty-one samples were investigated and classified by four different methods: (1) chemical profile derived from visual appearance and estimation of total cholesterol and triglyceride; (2) 'SML' profile by nephelometry; (3) electrophoresis on agarose gel; and (4) electrophoresis on polyacrylamide gel. Polyacrylamide gel electrophoresis showed the closest correlation with the chemical profile when compared with the other two methods. Polyacrylamide gel electrophoresis was found to be a rapid, reliable, and satisfactory procedure for plasma lipoprotein phenotyping.

Blood Protein Electrophoresis↗
PubMed1978

The integrative role of lecithin:cholesterol acyl transferase in triglyceride clearance.

There is evidence that not only lipoprotein lipase (LPL) but also lecithin:cholesterol acyl transferase (LCAT) are involved in the directional flow of triglyceride (TG) from endogenous very low density lipoproteins (VLDL) and chylomicrons as part of a general energy storage pathway. Evidence is given to suggest that LCAT plays an integrative role in this process.

Animals↗
PubMed1977

Plasma lipoprotein patterns in patients receiving dialysis therapy for chronic renal failure.

A study is reported of the prevalence, nature and possible aetiology of the hyperlipidaemia found in a group of 74 patients receiving maintenance dialysis. Sixty patients were receiving haemodialysis and 14 peritoneal dialysis. Sixty-four per cent of the male and 83% of the female patients had a lipoprotein abnormality which was predominantly of the Type IV pattern, probably due to a combination of increased hepatic triglyceride synthesis and diminished peripheral clearance.

Adolescent↗
PubMed1977

Plasma triglyceride secretion and metabolism in chronic renal failure.

Endogenous very low density lipoprotein triglyceride (VLDL-TG) production rate has been studied in 13 patients with chronic renal failure who were not on dialysis treatment. In these patients the VLDL-TG plasma concentration was significanlty raised when compared with the control group; the fractional turnover rate was reduced but the absolute turnover rate was increased. The results suggest that increased hepatic production of VLDL-TG is a contributory factor to the hypertriglyceridaemia of chronic renal failure.

Female↗
PubMed1977

Metabolic response to intravenous salbutamol therapy in acute asthma.

In patients suffering from an acute attack of asthma the effects of salbutamol infusion (10 microng/min) on their plasma concentrations of non-esterified fatty acids (NEFA), triglyceride, insulin, and glucose were compared with those in a group of asthmatics not requiring infusion. Salbutamol was found significantly to increase the plasma concentrations of glucose and insulin while having little effect on NEFA or triglyceride. However, NEFA concentrations were found to be significantly increased in patients with an acute attack of asthma at the time of their admission to hospital. This increase is attributed to the stress of the asthmatic attack itself.

Acute Disease↗