Search PubMed⌕ Search

Biomedical subjects

D Reid

Publications and source records attributed to D Reid.

At least 73 records · Page 4Linked to original sources

Mobility of Scottish injecting drug users and risk of HIV infection.

Nine hundred and nineteen injecting drug users (IDUs) were interviewed in Glasgow, Scotland during 1990 and 1991, as part of a wider study of HIV risk behaviour, about their injecting and sexual behaviour outside the city in the previous two years. Forty-five percent of respondents injected outside Glasgow, 6% shared needles and syringes (n/s) and 20% had sexual intercourse. Much activity occurred outside Scotland but mainly within the UK, particularly London. Predictors of n/s sharing outside Glasgow during the previous two years included current injecting with and passing on of used n/s and sexual intercourse with casual partners. Predictors of sexual behaviour outside Glasgow included passing on used n/s, having sexual intercourse with casual partners and, for females, engaging in prostitution. Glasgow IDUs are a highly mobile group and although HIV prevalence remains low within this population, considerable potential for importation/exportation of HIV and other bloodborne and sexually transmitted infections exists. Further work is required to establish why IDUs travel to, and engage in high-risk activities in locations outside their home environment, and detailed data about activities such as frequency of condom usage and n/s cleaning practices need to obtained. While there is a widespread network of services for IDUs in the UK, information provided usually relates to local services and may not fully address the needs of this mobile population. Therefore, we recommend that IDUs be provided with details of facilities such as n/s exchange schemes and drug-treatment establishments in centres to where they most commonly travel.

Blood-Borne Pathogens↗

Bone mineral density and metabolism in premenopausal women taking L-thyroxine replacement therapy.

BACKGROUND AND OBJECTIVE: Excess endogenous thyroxine causes bone loss, but the effects of exogenous thyroxine are disputed. We report on bone mass and metabolism in women taking L-thyroxine therapy. DESIGN: Cross-sectional and longitudinal studies. PATIENTS: Cross-sectional study: 40 healthy premenopausal women with autoimmune thyroiditis taking either physiological (serum TSH usually normal, 0.35-3.3 mU/l) or suppressive (serum TSH usually < 0.35 mU/l) doses of L-thyroxine; patients were also compared with previously acquired age and weight matched premenopausal volunteers with no history of thyroid dysfunction. Longitudinal study: 28 patients were followed-up > or = 1 year later. MEASUREMENTS: In all subjects bone mineral density (BMD) was measured at the anteroposterior lumbar spine and left hip (femoral neck, greater trochanter and Ward's area) using dual-energy X-ray absorptiometry, and physical activity assessed using the Framingham physical activity index. Serum osteocalcin (OC), PTH and vitamin D, and urinary pyridinoline and deoxypyridinoline excretion were measured in patients. RESULTS: Cross-sectional study: The patient groups were well matched for disease duration and physical activity although the suppressed group were slightly younger (mean 38.1 (SD 7.5) vs 43.3 (3.9) years, P < 0.05). BMD, serum OC, PTH and vitamin D, and urinary cross-link excretion did not differ significantly between the two groups. Multivariate analysis of the whole group suggested that BMD at the femoral neck and greater trochanter was related positively to weight and physical activity and negatively to thyroxine dose (microgram/kg/day) and patient age. At the lumbar spine BMD was reduced non-specifically in the presence of thyroid disease and treatment, but this effect appeared to decline with increasing duration of therapy. A similar analysis of the patient group suggested that urinary cross-link excretion correlated positively with thyroxine dose, and negatively with duration of treatment. Longitudinal study: Annualized changes in BMD were inversely related to thyroxine dose (microgram/kg/day) at all sites but achieved statistical significance only at the femoral neck and Ward's area. CONCLUSION: We did not find any effect of persistent historical TSH suppression on current bone mass, and this might relate to the relative insensitivity of older TSH assays. However, the cross-sectional and longitudinal data suggest that high daily doses of thyroxine in relation to patient body weight might adversely affect bone mass, particularly at the hip. These findings support the contention that excess exogenous thyroxine might predominantly deplete skeletal sites, such as the femoral neck, rich in cortical bone.

Absorptiometry, Photon↗

Primary post-traumatic intraorbital meningioma.

Intraorbital meningiomas are uncommon tumours that usually represent extension from a primary intracranial tumour. Trauma has been proposed by Cushing and Eisenhardt as an etiologic factor in the development of meningioma following head injury. We report a case of primary post-traumatic intraorbital meningioma and discuss its pathogenesis and management.

Adult↗

Absent friends.

Explore the source record for details and available documents.

Appointments and Schedules↗

Last gasp.

Next Monday's World No-Tobacco Day is also the last day on which smoking will be allowed in UK hospitals. Amanda Killoran and colleagues urge local health authorities to seize the initiative.

Humans↗

Epidemiology of travel.

The unprecedented scale and speed of contemporary international travel means that ever increasing numbers of travellers are exposed to unfamiliar infections and other hazards. Since 1973, surveillance has been conducted at the Communicable Diseases (Scotland) Unit on illnesses affecting returning travellers. This has helped define the perspective of illness associated with travel, to evaluate the effectiveness of pre-travel health advice and to develop a computerised data base designed to give advice on the prevention of travellers' illnesses. These and other epidemiological studies suggest that: (a) younger travellers experience more illness (b) the greater the climatic and cultural contrast between the traveller's country of origin and the destination country, the higher the risk (c) by far the commonest afflictions the traveller is likely to experience are diarrhoea and vomiting (d) the cost of travel-related illness in the UK is in excess of pounds 11 million.

Adolescent↗

Design and validation of a clinically applicable culture procedure for the generation of interleukin-2 activated natural killer cells in human bone marrow autografts.

Previous studies in animal models have suggested that bone marrow-derived interleukin-2 (IL-2) activated natural killer (A-NK*) cells can be used to eliminate residual leukemic cells both in vivo and in vitro. As part of initial studies to develop a clinical protocol to exploit this phenomenon in combination with culture purging of leukemic cells, we examined a number of variables that might affect either IL-2 stimulation of natural killer (NK) cell activity or maintenance of primitive hematopoietic cells in cultures suitable for manipulating human marrow autografts. Cytotoxicity of IL-2 A-NK cells was determined using K562 and Daudi target cells in a standard 4-hour 51Cr release assay. Primitive hematopoietic cells were quantitated using both direct clonogenic progenitor assays and the long-term culture-initiating cell (LTC-IC) assay. The latter measures a very primitive cell type that gives rise to clonogenic cells after > 5 weeks of culture on pre-established marrow feeder layers. Light-density (< 1.070 g/cm3) human marrow cells cultured at 10(6) cells/mL for 7 days at 37 degrees C in the presence of 1000 U of either natural or recombinant human IL-2 showed a marked generation of A-NK cell function that was not seen if IL-2 was not added. The cytotoxicity was the same whether the cells had been maintained in standard fetal calf serum (FCS)-supplemented medium or in LTC medium (which also contains horse serum and 10(-6) M hydrocortisone) or whether adherence of cells during the culture period was promoted or prevented. The level of NK activity in IL-2-stimulated cultures of marrow cells from patients with acute myeloid leukemia (AML) in remission was not significantly different from that obtained with normal marrow. The initial numbers of clonogenic cells in these samples were close to normal values (60%). For both normal and AML patient samples, these declined slightly during the 7-day culture period, regardless of whether IL-2 was present. Starting values for LTC-IC in patient marrow samples were markedly reduced to approximately 7% of normal values, but as in normal cultures, did not decrease further in culture with or without IL-2. These results indicate that activation of bone marrow-derived NK cells can be obtained in 7-day cultures containing IL-2 under conditions that preserve the most primitive hematopoietic cells currently detectable.

Bone Marrow Cells↗

Obstetrical anaesthesia and analgesia in chronic spinal cord-injured women.

Improved acute and rehabilitative care and emphasis on integrating patients into society after spinal cord injury is likely to result in increasing numbers of cord-injured women presenting for obstetrical care. Anaesthetists providing care to these women should be familiar with the complications resulting from chronic cord injury and aware that many may be aggravated by the physiological changes of normal pregnancy. These complications include reduced respiratory volumes and reserve, decreased blood pressure and an increased incidence of thromboembolic phenomena, anaemia and recurrent urinary tract infections. Patients with cord lesions above the T5 spinal level are at risk for the life-threatening complication of autonomic hyperreflexia (AH) which results from the loss of central regulation of the sympathetic nervous system below the level of the lesion. Sympathetic hyperactivity and hypertension result in response to noxious stimuli entering the cord below the level of the lesion. Labour appears to be a particularly noxious stimulus and patients with injuries above T5 are at risk for AH during labour even if they have not had previous AH episodes. Morbidity is related to the degree of hypertension and intracranial haemorrhage has been reported during labour and attributed to AH. We report our experience in providing care to three parturients with spinal cord injuries. Two patients had high cervical lesions, one of whom experienced AH during labour and was treated with an epidural block. The second was at risk for AH having had episodes in the past and received an epidural block to provide prophylaxis for AH. In both cases epidural blockade provided effective treatment and prophylaxis for AH.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Survey of nursing quality assurance programs in selected hospitals in Alberta, Canada.

This study represents a survey of the nursing quality assurance programs in 12 hospitals in Alberta. The objectives of the study were: to identify the nature, content and costs of the programs, to determine the extent of nurse involvement in the design and operation of the programs, and the value and importance nurses place on their programs. The major findings of the study tend to support the view that the principles of organizational change theory have not been adequately addressed in terms of nursing quality assurance programs. Generally, nurses reported that they were insufficiently informed concerning their programs. Among the study recommendations is a call for improvements in the audit tools used, with greater emphasis being placed on the patient and the nurse providing the care and more decentralization of programs to the unit level to improve staff involvement and program relevancy.

Alberta↗

A single mode fibre-optic evanescent wave biosensor.

This paper reports experimental developments in the construction and operation of a single-mode fibre-optic evanescent wave biosensor using an exposed core silica single-mode fibre embedded in a silica block. The device was able to monitor the concentration of a blue dye, Procion Blue MX-G, in overlayers of various refractive indices. The practicality of such a biosensor has been demonstrated with a colorimetric enzyme assay system. Penicillin G in the 0-0.4 mM concentration range was monitored at 633 nm by the decoloration of the starch-iodine reagent when Bacillus cereus penicillinase was immobilized over the exposed core of the monomode fibre.

Biosensing Techniques↗

Comparison of blood cultures with corresponding venipuncture site cultures of specimens from hospitalized premature neonates.

We compared the presence and identities of isolates from blood culture samples obtained by percutaneous venipuncture with those of commensal skin organisms cultured from respective venipuncture sites after skin cleansing; 677 blood and skin site culture pairs from 488 infants were compared. Organisms grew in 58 blood cultures; nine of these cultures had corresponding venipuncture site cultures that also grew organisms. Forty-two blood culture isolates were coagulase-negative staphylococci; five of these were associated with similar venipuncture site cultures. According to restriction-endonuclease fingerprinting of chromosomal DNA and plasmid analysis, three pairs of blood and venipuncture site cultures were identical and two pairs were different. Thus only 7% (3/42) of coagulase-negative staphylococcal blood isolates were associated with identical contamination at the venipuncture site. We conclude that, if the venipuncture site has been carefully cleansed, the growth of coagulase-negative staphylococci in blood cultures of specimens from premature neonates indicates bacteremia rather than skin contamination in the vast majority of cases.

Bacteremia↗

Distribution of the Na(+)-Ca2+ exchange protein in mammalian cardiac myocytes: an immunofluorescence and immunocolloidal gold-labeling study.

The present study reports on the location of the Na(+)-Ca2+ exchanger in cardiac sarcolemma with immunofluorescence and immunoelectron microscopy. Both polyclonal and monoclonal antibodies to the Na(+)-Ca2+ exchanger were used. The mAb was produced from a hybridoma cell line generated by the fusion of mouse myeloma NS-1 cells with spleen cells from a mouse repeatedly immunized with isolated reconstituted canine cardiac Na(+)-Ca2+ exchanger (Philipson, K. D. S. Longoni, and R. Ward. 1988. Biochim. Biophys. Acta. 945:298-306). The polyclonal antibody has been described previously and reacts with three proteins (70, 120, 160 kD) in cardiac sarcolemma associated with the Na(+)-Ca2+ exchanger (Nicoll, D. A., S. Longoni, and K. D. Philipson. 1990. Science (Wash. DC). 250:562-565). Both the monoclonal and the polyclonal antibodies appear to react with extracellular facing epitopes in the cardiac sarcolemma. Immunofluorescence studies showed labeling of the transverse tubular membrane and patchy labeling of the peripheral sarcolemma. The immunofluorescent labeling clearly delineates the highly interconnected T-tubular system of guinea pig myocytes. This localization of the exchanger to the sarcolemma, with an apparent high density in the transverse tubules, was also seen with immunoelectron microscopy. It is of great interest that the Na(+)-Ca2+ exchanger, as the main efflux route for Ca2+ in heart cells, would be abundantly located in sarcolemma closest to the release of Ca2+.

Animals↗