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Biomedical subjects

D M Boyle

Publications and source records attributed to D M Boyle.

At least 19 recordsLinked to original sources
PubMed1994

Realities to guide novel and necessary nursing care in geriatric oncology.

Recent acknowledgement of the prominence of cancer in the elderly has stimulated interest in this patient population at risk. Due to the newness of this interest, currently there is no formal recognized specialty of geriatric oncology that parallels pediatric oncology. However, there is growing concern and interest in identifying elder-specific indices of difficulty, disparity, and duty to optimize cancer prevention, control, therapy, support, and rehabilitation efforts for this growing population of aged patients. This article will provide a comprehensive review of relevant literature pertaining to nursing care of elderly adults who face cancer. Six realities to guide cancer nursing planning will be identified that address key patient-family-professional issues into the elder continuum.

Adaptation, Psychological↗
PubMed1991

Characterization of human progesterone receptor by high performance hydrophobic interaction chromatography.

High performance hydrophobic interaction chromatography has been used to separate progestin receptors (PRs) from human uterus and from the T47D human breast cancer cell line. Reproducible separations of high resolution were achieved using a TSK Phenyl-5PW column and a reverse salt gradient of 400 mM to 0 mM sodium sulfate in phosphate buffer, pH 7.4. Peaks of radioactivity exhibiting hydrophobic behaviour were isolated, as well as a smaller proportion of specific bound receptors located in the void volume fraction. No differences in retention times were observed between uterine and breast cell line samples. When the technique was used in conjunction with rapid vertical tube sucrose density gradient centrifugation, the 8S sedimenting PR from fresh, low-salt cytosol always eluted with a retention time of 24 min. The natural 4S receptor chromatographed as a single peak at 29 min while the 4S receptor species from high-salt cytosol appeared as two distinct peaks of radioactivity with retention times of 29 and 33 min. While specific binding was shown to occur in the void volume of the column, the origin of these receptors were indeterminate. These results would suggest that under these conditions the 8S receptor occurs as a single hydrophobic class of protein, whereas the data provides evidence that transformed 4S receptor may be proportioned into two unequal entities as a function of exposure to salt.

Breast Neoplasms↗
PubMed1991

Staffing in cardiology in the United Kingdom 1990. Sixth biennial survey: with data on facilities in cardiology in England and Wales 1989.

The Sixth Biennial Survey of Staffing in Cardiology was conducted in July 1990. This report summarises the data that were collected, together with the results of a survey of facilities in cardiology made in 1989. The total number of cardiologists in the United Kingdom, defined as individuals trained in the specialty and spending at least 40% of their time working in it, is now 323. Six individuals work part time only, making 320 whole time posts. This number has increased over the two years from 1988 to 1990 by 32, of which 23 work only in the specialty and nine as general physicians with a major interest in cardiology. The rate of increase in numbers over the past decade has been reasonably consistent with an average of approximately 4.4% per year. Thirty one districts in England and Wales still have no cardiologist and 13 other districts have little provision with an average of three (visiting) sessions each per week. The population in these 44 districts is 8.3 million. Scotland also has an inadequate distribution of service in the specialty. If recommendations for cardiac surgery and angioplasty made in the Fourth Report of a Joint Cardiology Committee of the Royal College of Physicians of London and the Royal College of Surgeons of England are to be met, we calculate that we need 63 more cardiologists in our major centres. To provide one cardiologist in every district hospital and two for larger districts would require 94 more specialists, making a total shortfall of 157 individuals. We have no excess of senior registrars to provide for a major expansion at consultant level. Time spent within the senior registrar (or academic equivalent) grade has tended steadily to decline and very few now reach the end of their contracts. The need for more individuals to pass through the senior registrar grade will be met in part by a planned reduction in the training period to three years. This will be inadequate, however, because projected retirements show that the number of consultant vacancies will increase sharply from 1997. We believe that additional senior registrar posts must be created if a serious shortfall in service provision by consultants is to be avoided. The provision of non-invasive facilities in cardiology is reasonable. The need for additional equipment for invasive cardiology has not been assessed. The number of physiological measurement technicians varies considerably between regions and is generally inadequate.

Allied Health Personnel↗
PubMed1989

Discharge from a coronary care unit: psychological factors.

Anxiety is commonly experienced by patients following myocardial infarction. The role of anxiety in the recovery/rehabilitation process is not well understood, but anxiety is thought to be one of the factors determining outcome. It is important, therefore, to understand the possible effects on anxiety of changing discharge policies in coronary care units. Anxiety was assessed in a sample of MI patients, with good or poor prognoses, assigned to either early or late discharge from a coronary care unit. Although the overall level of anxiety of the total sample was not unduly high, it was clear that there was a subgroup of individuals, high in trait anxiety and with a poor prognosis, for whom early discharge was contra-indicated. Irrespective of prognosis, it was clear that early discharge did not produce a uniform response, indicating the need to differentiate between patients when determining the optimal date for discharge.

Adult↗
PubMed1989

Staffing in cardiology in the United Kingdom 1988. Fifth biennial survey.

This is the fifth survey of staffing (consultants and senior registrars) in cardiology in the United Kingdom. Data from previous years--including the fourth survey (1986) that was not published separately--are used to show the trends over the past decade. In 1988 there were less than six cardiologists per million population. The United Kingdom, with Ireland, has fewer cardiologists than all other European countries with reliable figures. The ratio for Europe as a whole is approximately 45 per million population; the recommended figure for the United States of America is 60 per million. The distribution of cardiologists in England and Wales is still very uneven. Seven million people--nearly 15% of the population--have no immediate access to special expertise in cardiology. Women are particularly poorly represented in the specialty. This survey indicates that the crisis in staffing for cardiology continues. It will worsen as the possibilities grow for effective management of heart disease and as needs increase with the greater average age of the population. Resolution of this crisis should be a major priority in policies aimed at countering the ravages of heart disease.

Cardiology↗
PubMed1988

Enhanced phosphorylation of progesterone receptor by protein kinase C in human breast cancer cells.

Affinity-isolated progesterone receptor (PR) from human breast cancer cells incubated with [32P]orthophosphate was shown to exist as a phosphoprotein. Exposure of the cells to 10 nM phorbol-12-myristate-13-acetate (PMA) for 10 min increased by 30-40% the amount of label incorporated into the 116-kDa receptor protein. A two-fold increase in the total number of steroid binding sites was also observed in cells receiving PMA treatment. This apparent unmasking of PR binding sites by phosphorylation probably involved conformational changes to existing receptor complexes and affected the eventual state of receptor dissociation or transformation. An increase primarily in the 8 S sedimenting molecular species was observed but PMA treatment also led to the appearance of a smaller, 2-3 S form of receptor (10% of total) that was not present in control samples. When cytosols were partially transformed in vitro by ATP and salt, all molecular species of receptor (8, 4, and 2-3 S) from the PMA-treated samples consistently migrated faster in sucrose gradients. The larger amount of 2-3 S receptor in PMA-treated samples disappeared when ATP, but not salt, was the transforming agent. These results suggest a major role for phosphorylating reactions in the receptor-mediated action of steroids by regulating hormone-binding and influencing receptor transformation. Tumor promoters such as the phorbol esters may act by artificially increasing the level of processing of steroid receptor.

Breast Neoplasms↗
PubMed1986

Estrogen receptor is associated with protein and phospholipid kinase activities.

The ability of immunopurified estrogen receptor from MCF-7 cells, incubated with [Y-32P]-ATP, to conduct its own phosphorylation and to phosphorylate phosphatidylinositol and 1,2-diacylglycerol was investigated. SDS gel electrophoresis analysis of the phosphorylated products revealed three major labeled phosphopeptides with molecular weights of 57, 47 and 43 kilodaltons. Other polypeptides were detected although in much smaller amounts. When the phosphorylation system was supplemented in vitro with phosphatidylinositol, phosphatidylinositol-4-P, or 1,2-diacylglycerol and the 32P-lipids were analyzed by thin layer chromatography, PI, but not 1,2-diacylglycerol, was converted in part to 32P-phosphatidic acid and phosphatidylinositol-4-32P. Phosphatidylinositol-4-P was also phosphorylated to phosphatidylinositol-4,5-32P. An estrogen receptor-negative cell line (MDA) produced negligible 32P-polypeptides and 32P-lipids under identical conditions used for MCF-7 cells.

Breast Neoplasms↗
PubMed1986

Natural history of diabetes presenting age 40-69 years: a prospective study of the influence of intensive dietary therapy.

Two hundred and twenty-three newly-diagnosed symptomatic diabetic patients with onset age 40-69 years enrolled in a prospective study of intensive dietary management of diabetes were observed for a period of six years and the data obtained is analysed. The variables studied were weight and fasting levels of plasma glucose and insulin, and of serum total cholesterol and triglyceride. These tests were monitored throughout the study and in addition the oral glucose tolerance test was analysed at entry to the study, after six months intensive dietary management and again after 72 months. Blood pressure, electrocardiogram and the presence of posterior tibial artery pulsation were recorded at entry to the study and at 36 months and 72 months. Approximately 80 per cent of the patients were managed solely by dietary restriction for the entire six years, but 25 patients received oral hypoglycaemic drugs and 26 required insulin treatment. Weight, and fasting glucose and triglyceride values fell in the first few months of intensive dietary management. Analysis of possible risk factors in survivors and patients dead at six years showed no significant differences, apart from a higher mean age at diagnosis in those who died. During the six years of intensive dietary management the mortality from all causes in these diabetic patients was no greater than that for the general population of Northern Ireland.

Adult↗
PubMed1985

Rapid, high-resolution procedure for assessment of estrogen receptor heterogeneity in clinical samples.

Approximately two-third of the women with breast cancer may benefit from hormone therapies if the lesion contains estrogen receptor in reasonable levels (greater than 10 fmol/mg cytosol protein). Our lab and others have suggested that not only the concentration, but the various molecular form(s) of the receptor may be an important factor in predicting patient responsiveness. Until now, this heterogeneity has been determined by analysis on sucrose density gradients requiring 16 h of centrifugation. Other methodologies which can disclose the profile of receptor isoforms are compromised by irreproducibility, poor recovery, or the length of time required to perform the analysis. We believe that high-performance liquid chromatography (HPLC) in the anion-exchange and chromatofocusing modes may be able to supply more insight into receptor structure than currently available by any other method. Utilizing the high activity ligand [16 alpha-125I]iodoestradiol-17 beta (2200 Ci/mmol) and flow-through equipment to monitor conductivity, pH, and radioactivity, we are able to describe the distribution of ionic isoforms in crude cytosolic preparations of breast cancer and uterus. This "on-line" technology is rapid (chromatogram is complete within 120 min), sensitive (receptor isoforms equivalent to 1 fmol are apparent), efficient (columns typically return greater than 90% of applied radio-labeled receptor) and reproducible (due to the sophistication of modern HPLC equipment). It is clear these techniques may be used in the clinical setting to better describe the profile of estrogen receptor isoforms and should be explored as a method of correlating receptor structure with hormone function in responsive tissues.

Breast Neoplasms↗
PubMed1985

Very early intervention with metoprolol in suspected acute myocardial infarction.

A double blind randomized study of 800 patients was carried out to determine if very early intervention with metoprolol (15 mg I.V. followed by oral administration) in suspected acute myocardial infarction affected overall mortality in selected subgroups, (age, site of infarct, delay to intervention). Sudden death occurred less frequently in patients allocated to metoprolol but there was no significant difference in total mortality on discharge, at three months and at twelve months. Ventricular fibrillation after intervention was not significantly reduced. Adverse reactions did not occur significantly more frequently in patients assigned to metoprolol.

Aged↗
PubMed1984

Effect of in vivo changes in phospholipid composition on liver microsomal calcium transport.

We recently reported that the phospholipid composition of mouse liver microsomes could be altered in vivo by a combination of dietary choline deprivation and administration of the methylation inhibitors periodate-oxidized adenosine and cycloleucine (D.M. Boyle & W.L. Dean (1982) Biochim. Biophys. Acta 688, 667-670). We have now determined the effect of this in vivo change in phospholipid composition on 7 microsomal enzyme activities and 2 cytochromes. The specific contents of cytochromes b5 and P-450 were unaffected by the treatment. Similarly, NADH-cytochrome c reductase, cytochrome P-450 reductase, cyclohexane hydroxylase and Mg2+-ATPase were not significantly altered. In addition, the phospholipid/protein ratio was not changed. In contrast, Ca2+-ATPase and Ca2+ transport rates were reduced by more than 60%. This result suggests that the mouse liver microsomal Ca2+-ATPase is extremely sensitive to the phospholipid composition of the membrane in which it is embedded and that one mode of control of calcium metabolism in liver cells could be at the level of membrane phospholipid composition.

Animals↗