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Biomedical subjects

F J Smith

Publications and source records attributed to F J Smith.

At least 73 records · Page 4Linked to original sources
PubMed1994

Abdominal abnormalities in AIDS: detection at US in a large population.

PURPOSE: The authors studied the prevalence of abnormalities at abdominal ultrasonography (US) in patients with acquired immunodeficiency syndrome (AIDS), the temporal change in prevalence, and the use of US to correlate clinical indications with these abnormalities. MATERIALS AND METHODS: From 1983 to 1991, 899 AIDS patients were seen, representing 89.36% of the 1,006 AIDS patients in the province during that time. Of these, 414 underwent 684 US studies, 399 of which were able to be reviewed. RESULTS: US results showed abnormalities in 264 of the 399 studies, including splenomegaly (n = 124), lymphadenopathy (n = 83]), gallbladder and bile duct abnormalities (n = 80), hepatomegaly (n = 77), and ascites (n = 54). Clinical indications with the highest frequency of abnormal findings included hepatosplenomegaly (n = 337) and abnormal liver function tests (n = 270). Lymph nodes more than 3 cm in diameter (in 10 of 83 patients with enlarged nodes) always represented an abnormality other than reactive hyperplasia. The percentage of abnormal results went from 25% in 1984 (two of nine studies) to 81% in 1990 (77 of 95 studies). CONCLUSION: The prevalence of abdominal abnormalities depicted at US in AIDS patients has increased since 1983.

Abdomen↗
PubMed1993

Missing links: Weber-Cockayne keratin mutations implicate the L12 linker domain in effective cytoskeleton function.

We have identified mutations in keratins K5 (Arg331Cys) and K14 (Val270Met) in two kinships affected by the dominantly-inherited skin blistering disease, Weber-Cockayne epidermolysis bullosa simplex (EBS-WC). Linkage analysis, DNA sequencing and clinical and ultrastructural analysis are combined to provide the first detailed description of classical EBS-WC. Both phenotypes show similar blistering on trauma, indicating that both mutations compromise the structural resilience of the basal keratinocytes by affecting the keratin cytoskeleton. The location of these mutations in the L12 linker, which bisects the alpha-helical rod region of intermediate filament proteins, identifies another keratin mutation cluster leading to hereditary skin fragility syndromes.

Age of Onset↗
PubMed1993

The variability of processing of technetium-99m DTPA renography. Role of interpolative background subtraction.

In quantitative renography, observer-dependent selection of renal outlines and background regions may account for considerable variability. This study of differential renal function with Tc-99m DTPA scintigraphy compares interpolative background subtraction with the authors' routine techniques; the latter involves background-subtracted uptake on data integrated over 1-3 minutes after injection. Other techniques considered were omission of background subtraction and use of 1-2 minute integration. The normal range was established in 24 hypertensive patients who had a normal angiogram and a normal radiometric glomerular filtration rate. The test set of 52 other hypertensive patients included 27 with renal artery stenosis. All techniques correlated well with the routine method (r > or = 0.98); however the interpolative background technique was unique in preserving the depiction of renal asymmetry but reducing the variability of replicate measurements (P < 0.05). Reduced renal function increased the variability of routine measurements, but the interpolative background subtraction method performed better in this instance (P < 0.01). Thus, the new technique appears to improve the definition of renal outlines and increase the reliability of measurements of differential renal function.

Algorithms↗
PubMed1993

Meal initiation occurs after experimental induction of transient declines in blood glucose.

Previous studies have shown that a brief rise in plasma insulin followed by a transient fall and rise in blood glucose precede the initiation of feeding in nondeprived rats. In this study, a cholinergic agonist, bethanechol chloride, which is known to induce a brief spike in plasma insulin, was infused intravenously in an attempt to induce transient declines in blood glucose and meal initiation in free-feeding rats. When the blood glucose response to bethanechol chloride administration met the criteria for a transient decline in blood glucose, meal initiation occurred within 20 min in nine out of ten trials. However, if the blood glucose response to bethanechol chloride administration failed to meet the criteria for a transient decline in blood glucose, meal initiation did not occur. The frequency of successful induction of feeding was higher in the late light cycle (80%) compared with the early light cycle (14%) of the photoperiod. These results suggest that cholinergic stimulation can induce feeding only after a brief fall and rise in blood glucose. The blood glucose and behavioral responses to the cholinergic stimulus appear to be strongly dependent on the metabolic state of the animal. These results further strengthen the evidence for a causal relationship between transient declines in blood glucose and meal initiation in free-feeding rats.

Animals↗
PubMed1992

Experimental reproduction of phytobezoars.

In a series of in virtro experiments (n = 64) using the mature flowers or seeds and pappus hairs of Karoo bushes Chrysocoma ciliata, Dimorphotheca cuneata, Eriocephalus ericoides, Gazania krebsiana and Gnidia polycephala, small phytobezoars were formed from material of E. ericoides, G. krebsiana and G. polycephala either alone or in combinations. The ratio of fibre to liquid used was found to be optimal around 1: 7 and milling of material enhanced bezoar formation. Time and pH did not appear to significantly affect the formation of bezoars. Other factors were either standardised or not studied. In a small in vivo trial, 4 groups of one sheep and one goat each were fed 10% of either C. ciliata, E. ericoides, G. polycephala seeds and pappus hairs, or a mixture of all 3, added to a basal diet of milled lucerne fed for up to 31 d. Small phytobezoars were formed in the goats but not the sheep receiving C. ciliata, and G. polycephala material. It was concluded that phytobezoars could form in goats or sheep eating large quantities of mature flowers or seeds of several Karoo bushes.

Animals↗
PubMed1992

Gastroduodenal involvement in chronic granulomatous disease of childhood.

Obstruction of the gastric outlet as a complication of chronic granulomatous disease (CGD) is uncommon. The usual findings in a barium examination of the upper gastrointestinal tract are irregular antral mucosal folds and antral narrowing. There is typically a sharp demarcation of the affected area from the normal proximal stomach. The authors report a case of CGD of childhood in which there was diffuse gastric involvement with extension into the duodenal cap. The patient recovered with conservative therapy after a diagnostic exploratory laparotomy.

Adolescent↗
PubMed1991

Racial targeting of AIDS programs reconsidered.

Most health professionals understand the importance of targeting behaviors, not groups, for disease prevention. Yet with regard to acquired immune deficiency syndrome (AIDS) education programming, target groups have been defined by salient demographic traits, including race, in part due to incomplete knowledge about risk behaviors in various groups. As a result, community and school-based education programs have suffered some mistrust and resentment. This article reports the findings of original research on attitude and behavioral differences between and within racial groups for a college student sample, in response to AIDS education programming. Differences in baseline attitudes and behaviors showed that AIDS-related risk cannot be primarily associated with minority group status. Implications on refinement of targeting strategies are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Inconsistencies and misperceptions putting college students at risk of HIV infection.

College students are often viewed as being at high risk for human immunodeficiency virus (HIV) infection, due to their needs to engage in exploratory behavior and their needs for peers' social approval, and their sense of invulnerability. The proportion of adolescents who are sexually active is known to be relatively stable; however, the amount of unsafe sex taking place on the college campus is still in question, as well as the relationship between dating patterns and HIV-risk behavior. In this study college students' self-reports of sexual and dating practices were related to sexual frequency and condom use. The results highlight the amount of unprotected sexual behavior in the college group and the difficulty in assessing adolescents' risk of HIV transmission on the basis of self-reported sexual activity and dating behavior. Key issues to target in educating college students about HIV infection are the roles of planning and spontaneity in dating and the fact that inaccurate self-perceptions of monogamy and abstinence may lead them to assume falsely that they are safe from sexually transmitted diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Community pharmacy: a method of assessing quality of care.

Generalisability theory is presented as a research method for assessing the quality of health advice. The theory is applied to make a comprehensive assessment of primary health care advice given by community pharmacists. A random sample of pharmacies from all London postal districts were selected and visited for set periods throughout one year. During these visits all consultations on health or the use of drugs between pharmacists and clients were tape-recorded. Nine characteristics were derived by an external criterion panel on which the quality of advice in a random sample of consultations (50) was assessed using rating scales. Following the application of generalisability theory, operational conditions for the assessment were selected to obtain a generalisability coefficient of around 0.8. Nearly half the consultations achieved satisfactory scores on at least three-quarters of the criteria on which they were assessed. However almost a third were considered satisfactory on less than a quarter of the criteria, most of these being satisfactory on none of them. Performance regarding disease prevention/health promotion activity was poorest. Thus the quality of most consultations was found to be either very good or very poor, relatively few occupying the middle ground.

Analysis of Variance↗
PubMed1990

Transient declines in blood glucose signal meal initiation.

Transient declines in blood glucose concentration are proposed to be signals that induce meal initiation in free-feeding rats. This assertion is based upon the following evidence: (1) the observation that a transient declines in blood glucose preceded each meal; (2) attenuation of transient decline in blood glucose by i.v. glucose led to a delay in meal initiation; (3) declines in blood glucose were endogenous and that if access to food was denied during and after a decline in blood glucose and then restored, meal initiation was not observed until after another transient decline; (4) experimental induction of transient declines in blood glucose that mimic the pattern of blood glucose prior to spontaneous meals resulted in meal initiation; (5) a transient spike of insulin was observed just prior to the transient decline in blood glucose that precedes meal initiation; (6) in rats with total subdiaphragmatic or hepatic vagotomy, normal transient declines in blood glucose occurred but meal initiation was observed only after approximately 55 percent of the declines; (7) since infusions of other substrates (amino acids, ketone bodies, hexoses) failed to delay or block meal initiation, this signal appears to be specific for glucose. These studies, conducted in our laboratories over the past five years, suggest that transient declines in blood glucose with the necessary shape and magnitude are reliable signals for feeding that are detected by central nervous system glucose receptive elements and are mapped into meal initiation.

Animals↗
PubMed1990

Community pharmacists and health visitors.

An extended role for pharmacists in primary health care is currently being pursued by the pharmacy profession. An independent enquiry into pharmacy concluded that pharmacists were an underused resource and recommended a wide-ranging development of their role. The recommendations of this inquiry were endorsed by the government in its 1987 primary health care white paper Promoting better health.

Community Health Nursing↗
PubMed1988

Short term effects of fructose on blood glucose dynamics and meal initiation.

We have previously shown that small (-11%) transient (approximately 18 min) declines in blood glucose which precede feeding are causally related to meal initiation under free-feeding conditions. We have also shown that IV infusions of glucose (20 mg) that blunt these declines can delay meal initiation. In order to test the specificity of exogenous glucose to delay meal initiation, the ability of another hexose, fructose, to block meal initiation was studied. Since oral and IV fructose have been reported to cause transient hypoglycemia, we also used fructose in an attempt to mimic transient declines in blood glucose and measure the latency to meal initiation. Continuous monitoring of blood glucose and meal pattern was performed in chronically cannulated female rats. When fructose (20 mg) was infused IV during transient declines in blood glucose, meal initiation occurred with a normal latency. During the early dark phase, IV fructose was followed by a slight decrease at the lowest dose or increase in blood glucose at higher doses and no feeding behavior was observed. In the light phase, however, a transient dose-dependent decrease in blood glucose was observed. Furthermore, three types of blood glucose response patterns were identified. Meal initiation occurred only following changes in the blood glucose trajectory that mimicked the spontaneous transient declines in blood glucose. The other two patterns were not followed by meal initiation. Similar effects on blood glucose were observed following oral administration of a range of fructose doses (0.25-0.75 g) in 2-hour fasted rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1986

Functional coupling between transient declines in blood glucose and feeding behavior: temporal relationships.

To assess the strength and time course of the functional coupling between transient declines in blood glucose and meal initiation, access to food was prevented throughout declines followed by restoration of access to food when glucose returned to baseline. Neither preventing access to nor the absence of food affected the time course of the decline in blood glucose and the latency to food seeking behavior. When access to food was restored six to eight minutes after the blood glucose returned to baseline, no food seeking behavior or feeding occurred until after a second decline in glucose had occurred about one hour later. However, when access to food was restored before glucose returned toward baseline, feeding began within two minutes. Blood glucose did not decrease following presentation of novel foods and feeding occurred rapidly without a prior decline in blood glucose. Therefore, transient declines in blood glucose strongly signalled food seeking and meal initiation but this functional coupling was of short duration (approximately 12 min) and persisted less than six minutes after the blood glucose had returned to baseline. The transient decline in blood glucose appears to be an endogenous, glucose dependent cue for food seeking and meal initiation.

Animals↗