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Biomedical subjects

G Hughes

Publications and source records attributed to G Hughes.

At least 181 records · Page 10Linked to original sources
PubMed1986

Recruitment of elderly volunteers for a multicenter clinical trial: the SHEP pilot study.

Few large trials have involved the elderly, and little is known about the feasibility of recruiting such participants for study and the validity of inferences drawn from them. This article reviews the recruitment experience of the Systolic Hypertension in the Elderly Program (SHEP) pilot study. That program involved five clinical centers, and contacted approximately 75,000 persons in order to enroll a cohort of 551 individuals over 60 years old isolated systolic hypertension. The enrolled cohort was somewhat older and more highly educated than those screened. Except for deliberate oversampling of blacks and those over 70 years old, the enrolled population resembled the U.S. population, although individuals in the SHEP group were initially healthier, and more likely to have had some college education than those in the general population. There was substantial variation among sites in number of staff hours spent per participant recruited. The SHEP experience indicates that older persons are willing to volunteer for clinical trials research and that problems of inference are probably not any greater for that age group than for any other.

Aged↗
PubMed1984

Optimum cell numbers for mixed lymphocyte responses in hanging-drop microcultures.

The conditions required for optimum mixed lymphocyte culture (MLC) responses in hanging-drop (HD) microcultures in Terasaki trays have been investigated. Compared with conventional (200 microliter) MLC, HD-MLC required 5-10 times fewer cells, and 10% of the amount of culture medium and 3H-thymidine label. Peak uptake of label in HD-MLC was mutually responder-stimulator concentration dependent. Differences in response to related and unrelated lymphocytes indicate that HLA-D determinants are detected in HD-MLC.

Cell Count↗
PubMed1983

Relation between pregnancy-associated plasma protein A and fetal sex and blood group.

Maternal pregnancy-associated plasma protein A (PAPP-A) concentration was estimated in 272 pregnancies. Paired samples at 34 weeks of gestation and within 48 h before delivery were compared in relation to fetal and maternal blood group and fetal sex. The PAPP-A values were significantly higher both at 34 weeks and near delivery in rhesus-negative bearers. Mothers of male babies had higher PAPP-A values near delivery but not significantly higher at 34 weeks. This supports earlier findings that some placental hormones are higher in male bearers.

ABO Blood-Group System↗
PubMed1982

The heart in scleroderma: noninvasive assessment.

Myocardial fibrosis is found at postmortem examination in up to 80% of patient with scleroderma, yet many such patients have an entirely normal cardiovascular examination. Isometric handgrip exercise is a useful abnormality. By this method 15 patients with scleroderma (American Heart Association criteria) were compared with 15 sex and age-matched normals. Results showed that scleroderma patients had a depressed heart rate response to handgrip (p less than 0.05) and abnormal systolic and diastolic time intervals. They showed a decreased shortening of the ratio pre-ejection period to ejection time (p less than 0.05) and a lengthening of the isovolumic relaxation time compared with the control group who steadily shortened this period (p less than 0.01). These findings indicate increased stiffness and impaired contractility of the left ventricle as would be caused by an underlying fibrotic process otherwise undetectable. Immunohistological studies give support to this concept. Staining with monospecific antibodies to collagens types I to V of cardiac muscle from patients who, in life, had no overt cardiac disease, showed an excess deposition of collagens type I, III, and IV. In conclusion isometric exercise may provide a noninvasive method of unmasking subclinical fibrosis of the left ventricle in scleroderma, and immunopathological studies support these findings.

Adult↗
PubMed1981

Persistent megaloblastic anemia: a diagnostic dilemma.

A patient with sickle cell trait and pernicious anemia in relapse may appear to have sickle thalassemia because HbA2 levels can be elevated and the peripheral blood smear may contain target cells, teardrop cells, and eliptocytes. A normal hemoglobin alpha:beta chain ratio, a megaloblastic bone marrow, and correction of the abnormal hematologic morphology after administration of vitamin B12 will establish the correct diagnosis.

Adult↗
PubMed1980

Relationship of obstetric parameters to the concentration of pregnancy-associated plasma protein A.

Pregnancy-associated plasma protein A (PAPP-A) was measured by rocket immunoelectrophoresis in 272 patients at 34 weeks of pregnancy and within 48 hours before delivery. The values obtained have been compared to maternal parameters (age, weight, weight gain, blood group, rhesus factor, and parity) and to fetal parameters (sex, weight, Apgar score, rhesus factor, blood group, and placental weight). Maternal age, increased parity, and increased body weight are related to decreased PAPP-A levels. On the other hand, mothers carrying male fetuses, rhesus-negative children, and babies with Apgar scores higher than 7 at 1 minute have increased PAPP-A concentrations. These findings are discussed in relation to PAPP-A's involvement in the maternal immunologic system.

Adult↗
PubMed1980

Assay of a placental protein to determine fetal risk.

Plasma concentrations and total amounts of pregnancy associated plasma protein A were determined in 272 patients at 34 weeks' gestation by immunoelectrophoretic assay. The mean plasma concentration and mean total amount of this protein were closely related (r = 0.9643) and were significantly raised in patients who subsequently developed pre-eclampsia (28 patients), went into premature labour (12), or suffered from antepartum haemorrhage (10). Mean values in all patients delivering growth-retarded babies were also raised, but when the results for such patients who also had other complications were excluded there were no differences between the sets of means. The assays were easily performed, and they may be a useful technique for screening pregnant women to detect those at risk of developing pre-eclamptic toxaemia, although the full potential of these assays cannot be realised until the protein's function is known.

Female↗
PubMed1980

Tests of fetal wellbeing in the third trimester of pregnancy.

Five different products secreted by the fetoplacental unit into the maternal circulation were measured in 272 patients when they were 34 weeks pregnant. The most useful indicator of present pathology or future complications of pregnancy was a placental protein, pregnancy associated plasma protein. A which was raised in pre-eclamptic toxaemia, antepartum haemorrhage and premature labour. The highest values were recorded in pre-eclampsia before any signs of the disease were evident. Schwangerschafts protein 1 was also raised in pre-eclampsia and antepartum haemorrhage but only after the disease had presented. Placental lactogen was also raised in pre-eclampsia and its measurement may have some predictive value. Total oestriol was lowered in fetal growth retardation and the unconjugated steroid raised in pre-eclampsia and lowered in retarded fetal growth.

Estriol↗
PubMed1980

Outpatient laparoscopic sterilisation: Comparison between electrocautery and clip application.

In a personal prospective series of 504 day-case laparoscopic sterilisations in 1977-78, unipolar tubal electrocoagulation was compared with spring-loaded clip application. Two patients who had cautery required laparotomy because of serious bleeding and one because of accidental bowel diathermy. Clip application was free from serious complications, but caused more post-operative pain. The majority of patients were performing normal or light household duties within 24 hours of sterilisation.

Adult↗
PubMed1980

Facial paralysis of neoplastic origin: diagnosis and management.

The individual with a progressive (weeks to months) facial weakness should be considered to have a tumor involving the facial nerve until proved otherwise. All individuals experiencing a facial paralysis must undergo a thorough neurotologic evaluation to establish the etiology. Bell's palsy is a diagnosis by exclusion. While computerized axial tomography (CAT) scans, polytomography and arteriograms are extremely helpful, these studies very often fail to demonstrate intrinsic tumors involving the facial nerve. For this reason all individuals experiencing a progressive facial paralysis should have an exploration of their facial nerve from the internal auditory canal (IAC) through the stylomastoid foramen into the parotid gland. The purpose of this paper is to present a series of cases of facial paralysis having as their etiology intrinsic or extrinsic neoplasms. Clinical patterns are established, diagnostic protocols formulated and the results of surgical management reviewed.

Adolescent↗
PubMed1980

Carcinoma in situ of the ear canal.

A case of carcinoma in situ of the ear canal is presented. Review of the English literature failed to reveal a similar case. Wide local excision is the suggested mode of treatment.

Carcinoma in Situ↗