"I would like to become a general physician".
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Physicians, Family↗
Biomedical subjects
D Parker
Publications and source records attributed to D Parker.
Diagnostic reagents for hepatitis C virus.
The development of diagnostic methods for hepatitis C virus is presented. Special attention is paid to the selection of antigenic markers, the type of assay selected and the interpretation of results. A few of the pitfalls and ambiguities of various assays are discussed and possible future methods are described.
Antigens, Viral↗
Determinants of intention to commit driving violations.
Ajzen's theory of planned behaviour was used to measure the attitudes and intentions of a large stratified sample of drivers (N = 881) towards four driving violations. Measures were taken of respondents' attitudes to four imaginary scenarios depicting their commission of the four violations concerned. Demographic subgroups of drivers within the sample were differentiated on the basis of their beliefs about and evaluations of their commission of the violations. We were able to identify attitude items differentiating the younger, statistically more "accident liable" drivers in the sample from their older, and statistically safer counterparts. The implications of using this approach to inform future road safety campaigns are discussed.
Adolescent↗
Detection of hepatitis C virus antibodies with new recombinant antigens: assessment in chronic liver diseases.
A new serological assay to detect antibodies against hepatitis C, based on a recombinant protein (BHC10) which incorporates structural and non-structural viral antigens, was tested in 67 healthy subjects and 409 patients with various forms of liver disease. Results were compared with the current assay based on the recombinant non-structural viral antigen c100 and with the recently introduced second-generation assay, Ortho2. None of the healthy subjects was positive by any of the assays. In patients with chronic non-A, non-B hepatitis the prevalence of anti-BHC10 was 96.8%, higher than anti-c100 (83.3%, p less than 0.001) and similar to Ortho2 (94.3%). False-positive results were less frequently found when BHC10 was used. These findings show that assays incorporating structural and non-structural antigens provide higher sensitivity to detect hepatitis C virus infection and they define an almost exclusive role of hepatitis C virus in the genesis of chronic non-A, non-B hepatitis.
Adolescent↗
Serum bone alkaline phosphatase and CA 549 in breast cancer with bone metastases.
A monoclonal radioimmunometric assay for bone alkaline phosphatase (BAP) developed by Hybritech, USA, with an upper limit of normal of 40 U/l, was examined in 125 patients with breast cancer. Eleven patients who remained tumour free for 5-6 years had small intra-individual variations of BAP. The median value in 33 patients with multiple bone metastases of 60 U/l was elevated when compared with that in 40 patients with no evidence of metastases (22 U/l) and 34 U/l in 16 with limited bone disease (1-2 hot spots). By contrast, only 2 out of 25 patients with extensive local recurrence, lung, or hepatic metastases, without bone involvement showed an increase of BAP (< 200 U/l). The BAP levels were compared to total alkaline phosphatase (TAP), the breast cancer marker CA 549 (HybriBREScan). Longitudinal studies of 15 patients with bony metastases showed that TAP and BAP were well correlated only when the TAP was elevated; CA 549 and BAP could vary independently. The main use of BAP in patients with bone metastases appears to be an aid to the monitoring of treatment; however, it is not significantly raised in limited bone metastases.
Alkaline Phosphatase↗
Mentoring concepts applied to clinical practice.
An alternative to traditional forms of orientation using mentoring or related concepts is one possible solution to motivate and inspire nurses during a time when this profession is faced with nursing shortages and burnout. This article will address the advantages and disadvantages to mentoring based on a literature review and personal experience.
Education, Nursing, Continuing↗
Human responses to colonoscopy.
Registered nurses must not only anticipate the usual responses that a patient may experience during colonoscopy but also must be able to predict and prevent atypical responses. Normal healthy compensation (physiologic) and decompensation (pathophysiologic) responses as well as observable and measurable patient behaviors are included in a comprehensive assessment. In developing a plan of care, nurses must also consider the patient's past experiences, knowledge, and usual coping mechanisms. Professional nurses are responsible and accountable for diagnosing and treating human responses to actual or potential health problems. A human response framework emphasizes the multiple perspectives in which humans adapt to health and illness. This framework provides a model to clarify what constitutes a human response.
Adaptation, Psychological↗
67Ga-9N3 uptake by xenografts of human melanotic melanoma in mice.
Tumour uptake of the inert, neutral complex 67Ga-9N3 and the tumour:blood concentration ratio (1,4,7,triazacyclononane-1,4,7, triacetic acid) were measured in mice bearing xenografts of the human melanotic melanoma HX118. Between 1 and 4 h after the injection the tumour:blood ratio increased from 3.5 to 21 and the concentration of 67Ga-9N3 in the tumour decreased from 0.43 to 0.13% g-1. During the first 24 h the concentration of 67Ga-9N3 in the tumour exceeded that in all other tissues except the liver and kidneys. The tumour:blood ratio and tissue distribution of 67Ga-9N3 at 4 h were compared with those of four other complexes. The results indicated that of the five complexes 67Ga-9N3 would be the most suitable for tumour imaging at early times after administration. Imaging would not be restricted to gamma emitting 67Ga as there is also the possibility of using the 9N3 ligand to bind 111In for single photon emission computed tomography (SPECT), 68Ga for positron emission tomography (PET) or even stable Ga for direct in vivo nuclear magnetic resonance (NMR) detection.
Animals↗
Comparison of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on oral health in institutionalized, mentally handicapped adults: one-year results.
The purpose of this study was to compare the efficacy of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one-year period. Twenty-seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t-test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2-factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Research in training posts.
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Education, Medical, Graduate↗
The Minnesota Fatal Accident Circumstances and Epidemiology Study. Surveillance of occupational fatalities.
This report describes the Minnesota Fatal Accident Circumstances and Epidemiology Study (MN FACE), a new federally funded initiative to study fatal injuries in the workplace. Its primary objective is to reduce occupational fatalities. Fatalities due to falls, electrocutions, and asphyxiation caused by entry into confined spaces are currently investigated in Minnesota. MN FACE determines risk factors associated with fatalities then develops interventions for their mitigation or elimination. A comprehensive, statewide surveillance system, including state agencies, associations, organized labor, and industry, has been established to reduce the amount of bias in reporting.
Accidents, Occupational↗
Final year medical students' knowledge of practical nutrition.
An entire final-class of medical students was set a 6-part question on dietary advice to patients as commonly seen in general practice. The marks were scored by a formal, agreed system. Eighty-two per cent failed though only 2% failed the whole exam. The teaching of practical nutrition needs to be improved.
Clinical Competence↗
Improved cloning efficiency of polymerase chain reaction (PCR) products after proteinase K digestion.
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Cloning, Molecular↗
Dodecyl maltoside detergent improves resolution of hepatic membrane proteins in two-dimensional gels.
This report describes the incorporation of an alkyl maltoside detergent in two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) sample lysis buffer in order to improve resolution of protein patterns separated by nonequilibrium pH gradient electrophoresis. Membrane-associated proteins with alkaline isoelectric points form horizontal streaks on two-dimensional electrophoretograms when solubilized with conventional nonionic detergent. Dodecyl maltoside enhances protein delipidation during solubilization and improves pattern resolution and protein mobility.
Animals↗
Efficacy of an oximate-based skin decontaminant against organophosphate nerve agents determined in vivo and in vitro.
Recent Canadian research efforts have been directed towards the development of a reactive skin decontaminant (RSD) lotion active against classical nerve agents and mustard. The formulation presently under study consists of a 1.25 molal solution of potassium 2,3-butanedione monoximate (KBDO) in polyethylene glycol methylether 550. Although this formulation has shown good efficacy, concern has been expressed as to the potential toxicity of the reaction products of KBDO and organophosphate (OP) nerve agents. This report details the high efficacy of this lotion in inactivating OPs as measured by the systemic toxicity of the OP/RSD mixtures in rats. In addition, primary cultures of chick embryo neurons were also used to test the efficacy of the RSD. By relating the anticholinesterase activity in these cultures of the OP/RSD mixture to that of pure OP standards, a sensitive measure of the value of the RSD in inactivating tabun, sarin, soman and VX was obtained. Experiments with all four nerve agents in this in vitro system provided a good correlation with the in vivo data, and also indicated that the inactivation process was time- and agent-dependent and also related to the ratio of OP to RSD.
Acetylcholinesterase↗
The in vivo release of 90Y from cyclic and acyclic ligand-antibody conjugates.
Yttrium binding ligands DOTA, caDTPA and CT-DTPA were each conjugated to monoclonal antibody B72.3, labelled with 90Y and injected into mice in order to assess the in vivo inertness of the antibody-linked 90Y-ligand complexes. Levels of 90Y in femur shafts of the DOTA-B72.3 mice were low, being approximately 7 and 44%, respectively, of levels in the femur shafts of the caDTPA-B72.3 and CT-DTPA-B72.3 treated mice. This finding demonstrates the greater inertness and by implication the greater suitability for immunotherapy of the DOTA-90Y complex.
Animals↗
Obesity, blood pressure, and the sympathetic nervous system.
Obesity has long been recognized as a major risk factor for the development of hypertension. Recently, insulin level has been shown to correlate with blood pressure in clinical and population-based studies. Since insulin is a major signal in the relationship between dietary intake and sympathetic nervous system activity, the possibility that insulin-mediated sympathetic stimulation is involved in the pathogenesis of hypertension in the obese has been raised. This hypothesis, developed on the basis of studies in laboratory rodents and normal human subjects, is currently being tested in the Normative Aging Study in Boston. Utilizing epidemiologic techniques applied to this defined population, evidence in support of this hypothesis has been accumulated. The preliminary results indicate that in this population, the abdominal form of obesity is associated with higher insulin levels and increased 24-hour urinary norepinephrine excretion (an index of sympathetic activity).
Animals↗