Search PubMed⌕ Search

Biomedical subjects

E Lewis

Publications and source records attributed to E Lewis.

At least 37 records · Page 2Linked to original sources
PubMed1999

Setting up a school asthma clinic.

There is a high level of non-compliance with medication among teenagers with asthma. A school asthma clinic was set up to reduce non-compliance by encouraging adolescents to take control of their asthma management. A reduction in asthma-related problems was noted at the school.

Adaptation, Psychological↗
PubMed1999

Persistent tyrosinemia detected by thin-layer chromatography.

Screening for tyrosinemia is not routinely performed worldwide. Using a low expense thin-layer chromatography (TLC) for amino acids we detected a high frequency of transient tyrosinemia with secondary hyperphenylalaninemia in some newborns. Serum follow up showed the need to introduce adequate therapy in these babies.

Chromatography, Thin Layer↗
PubMed1999

A comprehensive screening program in South Brazil.

We present the experience and figures about a screening program in South Brazil carried on in Porto Alegre, capital of the Southern Brazilian State. We present the tests performed routinely in our laboratory, the prevalence of some diseases and tests for infectious diseases to be added in the most comprehensive regional program in our country.

Brazil↗
PubMed1998

A novel member of the transforming growth factor-beta (TGF-beta) superfamily from the filarial nematodes Brugia malayi and B. pahangi.

Transforming growth factor-beta (TGF-beta) superfamily genes encode products controlling pattern formation, cell differentiation, and immune-mediated inflammation. Members of this superfamily are known in multicellular organisms from mammals to the model nematode Caenorhabditis elegans. Using PCR with oligonucleotides complementary to highly conserved motifs in the TGF-beta superfamily, we first isolated a genomic clone from the filarial nematode Brugia malayi. This gene, termed Bm-tgh-1 (TGF-beta homolog-1), spans 2.5 kb of genomic DNA and contains seven exons. Transcripts of this gene are poorly represented in cDNA libraries, but a full-length cDNA was isolated by RACE from B. pahangi (Bp-tgh-1). The tgh-1 genes from the two species are >98% identical at the nucleotide and amino acid levels, differing at 18/1576 base pairs and 5/428 amino acids; all nonsynonymous substitutions are in the long N-terminal propeptide. They show a high level of similarity throughout all seven exons to a C. elegans gene on cosmid T25F10. Homology to other members of the TGF-beta superfamily is restricted to the C-terminal domain which contains the mature active protein. Key features shared with other members of the superfamily include the tetrabasic proteolytic cleavage site to release an active C-terminal peptide, seven cysteines arrayed in identical fashion, and conserved sequence motifs. tgh-1 is most similar to the BMP-1 subfamily involved in developmental signaling in nematodes, insects, and vertebrates. RT-PCR on first-strand cDNA from both Brugia species, with primers specific to the 3' end, showed that tgh-1 is not expressed in the microfilarial stage, but is detectable in the mosquito-derived infective larvae and is maximal in maturing parasites around the time of molting in the mammalian host. Adult parasites show a relatively low level of expression. The identification of tgh-1, and its preferential expression in developing parasites, suggests that it may be involved in key developmental events in the complex filarial life cycle.

Amino Acid Sequence↗
PubMed1998

Amphetamines in hair by enzyme-linked immunosorbent assay.

Human hair was collected from the occipital crown region of the head from several subjects; these hair samples were presumptively positive for amphetamines by a previously evaluated immunoassay. Hair was washed briefly with methanol to remove external contamination, then extracted with hot methanol for 2 h to recover the drugs. The extracts were evaporated to dryness, reconstituted in buffer, and analyzed using a new enzyme-linked immunosorbent assay (ELISA) technique adapted for the detection of amphetamines in hair. Gas chromatography-mass spectrometry was used as the reference technique. Cross-reactivity of several related compounds was evaluated by equating the inverse of the ligand concentration at 50% antibody binding to the affinity constant for each compound. The ratio of a compound's affinity constant to that for d-methamphetamine was used to derive percent crossreactivity. These experiments yielded values of 30.8% for d-amphetamine, 7.4% for I-methamphetamine, 4.3% for phentermine, 2.9% for I-amphetamine, and <1% for ephedrine, methylenedioxyamphetamine, and methylenedioxymethamphetamine. Cross-reactivity of unrelated compounds was found to be non-existent. The optimum cutoff concentration was determined by receiver operating characteristic curve analysis to be 300 pg/mg and the observed limit of detection was 60 pg/mg. Intra-assay precision at 300 pg/mg was 3.3% (coefficient of variation, CV), and the interassay CV was 10.5%. The sensitivity and specificity of the method were 83% and 92%, respectively.

Amphetamine-Related Disorders↗
PubMed1998

Use of an objective structured clinical examination in evaluating student performance.

BACKGROUND AND OBJECTIVES: The objective structured clinical exam (OSCE) is increasingly being used to evaluate student clinical performance. However, scant literature exists pertinent to this approach in evaluating family medicine clerkship performance. In this study, we assess 8 years' experience with a family medicine clerkship OSCE. METHODS: Eight annual clerkship OSCEs and the performance of 696 students are described. Comparisons of faculty evaluation, written exam, and OSCE performance are made for 335 students. Post-OSCE student and faculty feedback regarding OSCE validity and utility is also presented. RESULTS: Student performance is highest in medical history taking and physical examination and lowest in information-sharing stations. OSCE results appear to be relatively consistent on a year-to-year basis. OSCE, faculty evaluation, and written exam results have low overall levels of correlation, particularly in assessing performance that differs substantially from the mean. Students and faculty agree that the OSCE experience reflects skills that students should possess, but there is less agreement that the OSCE reflects clerkship-related learning and actual student performance. Both students and faculty derive insight from the OSCE regarding the definition of specific learning needs. CONCLUSIONS: The family medicine clerkship OSCE we describe appears to provide consistent measures of student performance. Although content validity is high, further assessment is needed to assure construct validity. The OSCE experience provides students with a rich resource for defining clerkship-related learning needs. Study results strongly suggest that OSCEs, faculty evaluations, and written exams provide differing measures of student performance. The reasons for these differences merit further exploration.

Clinical Clerkship↗
PubMed1997

Risk of hospitalization because of aseptic meningitis after measles-mumps-rubella vaccination in one- to two-year-old children: an analysis of the Vaccine Safety Datalink (VSD) Project.

OBJECTIVE: To assess the level of increased risk, if any, of hospitalizations for aseptic meningitis after Jeryl-Lynn mumps strain measles-mumps-rubella (MMR) vaccine in the Vaccine Safety Datalink population. STUDY DESIGN: A possible increased risk of aseptic meningitis 8 to 14 days after receipt of MMR was observed in a preliminary screening analysis of automated data from the Vaccine Safety Datalink (VSD) project Year 2 analysis. To further evaluate this association a retrospective 10-year matched case-control study was undertaken in the four health maintenance organizations (HMOs) in the VSD project. Cases ascertained from a broad scan of the automated data were validated against a standard case definition. Two controls matched on age, sex, HMO and HMO membership were assigned per case. RESULTS: The VSD project involves the cooperative collection of automated vaccination and medical outcome data from four large HMOs that currently have 500,000 children younger than 7 years of age under surveillance. Review of automated screening results from the first 2 years of data revealed a possible increased risk of aseptic meningitis 0 to 14 days after MMR with a relative risk of 3.61 (95% confidence interval, 1.0 to 13.1) although the total number of cases was small. Although the automated data had suggested a possible association of aseptic meningitis with MMR containing the Jeryl-Lynn strain of mumps, review of validated hospitalized cases during the observation period did not reveal evidence of an increased risk of aseptic meningitis after MMR containing the Jeryl-Lynn strain of mumps (odds ratio < 1.0 for all analyses). CONCLUSION: Although it is recognized that hospitalized cases represent a minority of the total cases of aseptic meningitis, it is reassuring that in this evaluation no increased risk of aseptic meningitis after MMR vaccine was found.

Case-Control Studies↗
PubMed1997

Prolonged use of coloured overlays for classroom reading.

Ninety-three children in a primary school and 59 children in two first-year classes of a secondary school were asked individually to observe a paragraph of random letters arranged to resemble text, and to compare the perceptual effects on its clarity of coloured plastic sheets overlaid on the text. A total of 29 colours were compared using 10 coloured plastic sheets and 19 pairwise combinations of sheets, one superimposed on another. The resulting colours sampled CIE 1976 hue angle (huv) and saturation (suv) systematically and efficiently. All the children who reported beneficial perceptual effects (53 per cent) were given their preferred overlay or combination of overlays to use as and when they wished. When the children were examined three months later the children tended to choose a colour similar to one they had chosen previously. Ten months later, 22 per cent of those offered the overlaps were still using them of their own volition. These children, but not those who had ceased to use their overlay(s), read randomly ordered simple words more quickly with their overlay than without. In a second independent group of children referred to the Norfolk Sensory Support Service, who used overlays routinely, the reading speed was similar with a grey or clear overlay; and slower than with the chosen coloured overlay, suggesting that reduction of contrast was not the critical factor. In a third independent group of children in a primary school in Kent, the increase in reading speed with the chosen overlay predicted the children who continued to use their overlay during the ensuing eight weeks.

Attention↗
PubMed1996

Entomopathogenic nematode (Heterorhabditidae and Steinernematidae) spatial distribution in turfgrass.

Understanding the temporal and spatial distribution of entomopathogenic nematodes is essential for determining the role of these insect parasites in soil communities and ultimately for their use in suppression of pest insect populations. We measured the vertical and horizontal distribution of endemic populations of entomopathogenic nematodes (Steinernema carpocapsae and Heterorhabditis bacteriophora) in turfgrass. Vertical distribution was determined by taking soil cores every 3 h from 05.00 to 23.00 h, over 4 days, and dividing the cores into 8, 1 cm deep sections. Steinernema carpocapsae was recovered primarily near the soil surface: 50% of positive sections were recovered in the thatch or first 1 cm of soil. S. carpocapsae recovery was lower during the middle of the day and none were recovered in the upper section. H. bacteriophora was recovered uniformly throughout the top 8 cm of soil and its vertical distribution did not change over the course of the day. Horizontal distribution was measured as the number of nematodes recovered from cores taken from 12 randomly selected 0.3 x 0.8 m sections from within four 15.3 x 15.3 m plots. Samples were collected biweekly over a 9-month period. H. bacteriophora had a patchier distribution than S. carpocapsae and both nematode species had more patchy distributions then their potential hosts. Our results support the hypothesis that these two species of nematode utilize different foraging strategies; S. carpocapsae primarily a surface adapted ambusher and H. bacteriophora as a cruise forager.

Animals↗
PubMed1995

Incidence proportion of and risk factors for AIDS patients diagnosed with HIV dementia, central nervous system toxoplasmosis, and cryptococcal meningitis.

We undertook this study to determine the incidence proportion of and risk factors for AIDS patients diagnosed with human immunodeficiency virus (HIV) dementia, central nervous system (CNS) toxoplasmosis, and cryptococcal meningitis. A historical cohort of 487 consecutive inpatients with AIDS treated by San Francisco General Hospital inpatient and outpatient services entered the study. We abstracted all available records for demographic information, diagnoses, and dates of death and estimated the incidence proportion of AIDS patients diagnosed with major CNS complications using the Kaplan-Meier method. We used the Cox proportional hazards model to analyze the effect of demographic factors on the hazard (risk per unit time) of diagnosis with these CNS conditions. The estimated incidence proportion of patients diagnosed with HIV dementia within 1 and 2 years of AIDS diagnosis increased from 0.10 to 0.18. Corresponding proportions were 0.10 and 0.19 for CNS toxoplasmosis and 0.10 and 0.14 for cryptococcal meningitis. Only HIV dementia was independently associated with increasing age at AIDS diagnosis (relative hazard [RH] of 2.75 for ages 41-50 [95% confidence interval, 1.08-6.98]; RH of 4.73 for ages > 50 [95% confidence interval, 1.41-15.87]) and with injection drug use (RH of 2.03; 95% confidence interval, 1.19-3.47). HIV dementia, CNS toxoplasmosis, and cryptococcal meningitis are about equally common complications in patients with AIDS, but only HIV dementia is associated with increasing age at AIDS diagnosis and injection drug use.

AIDS Dementia Complex↗
PubMed1995

Transcription factor AP-2 regulates expression of the dopamine beta-hydroxylase gene.

Expression of the gene encoding the neurotransmitter biosynthetic enzyme dopamine beta-hydroxylase (DBH) is regulated in a tissue-specific pattern, and transcription is influenced by environmental stimuli. Using the promoter proximal region of the rat DBH gene and nuclear extracts from SHSY-5Y neuroblastoma cells, a DNA-protein complex was identified that is competitive with oligonucleotides containing the recognition site of transcription factor AP-2. DNase footprint analysis identified an AP-2 binding site between -136 and -115 of the DBH promoter. Mutation of that AP-2 site results in a sevenfold reduction of basal reporter gene expression, but second messenger-stimulated activity is retained. Cotransfection of an AP-2 expression vector and a DBH promoter-reporter construct into cultured cells results in a sixfold stimulation of reporter gene expression, demonstrating the ability of AP-2 to trans-activate the DBH promoter. These results identify a new regulatory element on the rat DBH gene and suggest that the AP-2 site plays a role in maintaining basal levels of DBH transcription.

Base Sequence↗
PubMed1994

Managing expectations between patient and nurse.

With increasing consumer interest in the cost and quality of healthcare, it is imperative that patients' expectations of nursing care be recognized and managed. This concept is critical to the continued viability of any healthcare institution in the current competitive market. The authors describe the process that one hospital undertook in looking at patient satisfaction with nursing care, the modification of a patient satisfaction tool, and the development of a quality model of care.

Humans↗
PubMed1993

The effect of pergolide and MDL 72974 on rat brain CuZn superoxide dismutase.

It has previously been shown that both the dopamine receptor agonist, pergolide, and the monoamine oxidase inhibitor, (-)-deprenyl, can cause induction of CuZn superoxide dismutase in the rat striatum. We have now confirmed this effect of pergolide (0.04 mg/kg i.p.) as being localised to the striatum, but not the cerebellum, and shown it to take 3 weeks to develop. Furthermore, we have found that MDL 72974, a more specific monoamine oxidase inhibitor than (-)-deprenyl, failed to bring about such an induction either at a low selective monoamine oxidase B inhibitory dose, or at a higher non-selective dose.

Allyl Compounds↗