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Biomedical subjects

G Randhawa

Publications and source records attributed to G Randhawa.

At least 19 recordsLinked to original sources
PubMed2001

The changing nature of organ procurement policies and the implications for the UK.

The shift away from socialized forms of welfare over the past twenty years has changed the symbolic basis on which bodily parts are exchanged. Titmuss viewed the newly-formed National Health Service in the United Kingdom as a vehicle for institutionalizing altruistic practices, notably the voluntary "gift" of blood to strangers represented by the transfusion service. More recent advances in medical technology have made new forms of bodily tissue donation possible, including the transplantation of whole organs. Yet the excess of demand over supply is forcing a change from the principle of voluntarism on which "opting-in" procurement arrangements have hitherto rested to one of presumed consent and the system of "opting-out" adopted in other countries. The implications of this transition within the context of late twentieth century multi-cultural Britain are examined.

Altruism↗
PubMed1999

The presence of the Rb c-box peptide in the cytoplasm inhibits p210bcr-abl transforming function.

In order to test if the carboxyl terminal polypeptide of the Retinoblastoma (Rb) tumor suppressor protein, could be used to suppress the growth factor-independent growth phenotype of p210bcr-abl positive myeloid cells, we introduced a truncated form of the 3' end of the Rb cDNA encoding its last 173 amino acid residues (Rb C-box) which localize into the cytoplasm where the p210bcr-abl transforming protein is found, into myeloid cells (32D) which depends on the p210bcr-abl protein for IL3 growth factor-independent growth (32D-p210). The expression of the plasmid vectors carrying the Rb C-box cDNAs was shown to inhibit the abl tyrosine specific protein kinase activity of the p210(bcr-abl) oncoprotein and to suppress the IL3-independent growth phenotype of the 32D-p210 cells. The Rb C-box polypeptides did not suppress the growth of the untransfected 32D parental cell line in methylcellulose in the presence of IL3-conditioned medium. These results suggest that the cytoplasmic localization of the p210(bcr-abl) allows it to escape the effect of intranuclear proteins such as Rb which negatively regulate the p145(c-abl) kinase.

Animals↗
PubMed1999

Awareness and attitudes towards organ donation and transplantation among the asian population. A preliminary survey in Luton, UK.

Currently the demand for transplant organs, particularly kidneys, far outstrips the supply in the UK. This problem is particularly severe for the Asian population, which has been shown to have a disproportionately large representation on kidney-transplant waiting lists in some regions of the UK. The situation is clear: there is an urgent need to address the number of Asians requiring a kidney transplant, otherwise the human and economic costs will be very high. An exploratory qualitative study was therefore undertaken with the aim of assessing current awareness of organ donation and transplantation and to explore attitudes towards these issues in a cross section of the Asian population in Luton. It was found that nearly half of the respondents in this survey did not know what a donor card was used for, and approximately half of these had never seen one; only 6 of the 64 people interviewed had heard of the National Donor Register. Of the three people who carried a donor card, two had an immediate family member who had received a transplant. This suggests that media campaigns aimed at attracting donors from the Asian population have had limited success thus far. It appears that the vast majority of the Asian population is at the initial stage of the process of making a decision about donating their organs, that of simply knowing that transplantation takes place. Very little debate of pertinent issues seems to have taken place, which is essential for reaching a decision on whether or not to donate an organ. The study should be seen as exploratory but is nonetheless an important initial step towards the establishment of a greater knowledge and understanding of the issues affecting the low donation rate in the Asian population.

Asia↗
PubMed1998

The impending kidney transplant crisis for the Asian population in the UK.

Kidney transplantation offers the opportunity of an improved quality of life for those patients suffering from renal failure. Unfortunately, this treatment is not available to all people as this is influenced by the increasing demand for a limited supply of suitable organs. This situation is particularly alarming for the UK's Asian population with their higher susceptibility to end-stage renal failure which has resulted in a greater demand for transplants. Consequently, the proportion of Asians on transplant waiting lists is growing rapidly. Coupled with this are problems of cross-racial tissue type matching which has led to longer waiting times for a transplant. The situation is clear, there is an urgent need to address the number of Asians requiring a kidney transplant otherwise the human and economic costs will be very severe. In the short term there needs to be a greater number of donors coming forward from the Asian communities to increase the pool of suitable organs. In the long term, there needs to be greater attention on preventive strategies to reduce the number of Asians requiring renal replacement therapy.

Asia↗
PubMed1998

Specialist nurse training programme: dealing with asking for organ donation.

The issue of cadaveric organ transplantation is by its very nature emotional as it is associated with the very traumatic time of a loved one's death. Making a request for organs needs to be handled very sensitively by health professionals when discussing the issue with a family. Those nurses working in critical care areas are most likely to confront this issue and need to be equipped for dealing with ensuing events. The major challenge for the nurse is to address the concerns with brain death and organ donation in an environment of grief and sadness. Asking for organ consent is the most important element of all and needs to be done in the most sensitive manner, providing appropriate support to the donor family. To facilitate this process specialist training programmes in the nursing curriculum are imperative. Education programmes should incorporate presentations, role play situations and discussions based upon past experiences of organ requests. This would hopefully result in increased rates of donor consent and thereby a reduction in transplant waiting lists.

Curriculum↗
PubMed1998

An exploratory study examining the influence of religion on attitudes towards organ donation among the Asian population in Luton, UK.

Currently the demand for transplant organs far outstrips the supply in the UK. This problem is even more severe for the Asian population, who have been shown to be disproportionately over-represented on transplant waiting lists in some regions of the UK. Several commentators have suggested that religious and cultural traditions may be the major determinant preventing Asians from donating organs. An exploratory qualitative study was undertaken with the aim of examining the influence of religious beliefs, amongst other things, on the extent and direction of public attitudes towards organ donation in a cross-section of the Asian population in Luton. This study indicates that, in the population studied, culture and religion play a much less prohibitive part in determining the level of organ donation than previously suggested. However, there is a desire to be aware of the religious stances so that people can make a more informed decision. The emphasis should clearly been a reconsideration of the presently inadequate approaches to organ procurement and on devising and supplementing these with more appropriate ones. An example of the failure to inform effectively the relevant populations about important developments is that only two of the 32 Muslims in the survey had heard of the 'fatwa' by the Muslim Legislative Council permitting organ donation.

Adolescent↗
PubMed1997

Low frequency of p57KIP2 mutation in Beckwith-Wiedemann syndrome.

Beckwith-Wiedemann syndrome (BWS) is an autosomal dominant disorder of increased prenatal growth and predisposition to embryonal cancers such as Wilms tumor. BWS is thought to involve one or more imprinted genes, since some patients show paternal uniparental disomy, and others show balanced germ-line chromosomal rearrangements involving the maternal chromosome. We previously mapped BWS, by genetic linkage analysis, to 11p15.5, which we and others also found to contain several imprinted genes; these include the gene for insulin-like growth factor II (IGF2) and H19, which show abnormal imprint-specific expression and/or methylation in 20% of BWS patients, and p57KIP2, a cyclin-dependent kinase inhibitor, which we found showed biallelic expression in one of nine BWS patients studied. In addition, p57KIP2 was recently reported to show mutations in two of nine BWS patients. We have now analyzed the entire coding sequence and intron-exon boundaries of p57KIP2 in 40 unrelated BWS patients. Of these patients, only two (5%) showed mutations, both involving frameshifts in the second exon. In one case, the mutation was transmitted to the proband's mother, who was also affected, from the maternal grandfather, suggesting that p57KIP2 is not imprinted in at least some affected tissues at a critical stage of development and that haploinsufficiency due to mutation of either parental allele may cause at least some features of BWS. The low frequency of p57KIP2 mutations, as well as our recent discovery of disruption of the K(v)LQT1 gene in patients with chromosomal rearrangements, suggest that BWS can involve disruption of multiple independent 11p15.5 genes.

Beckwith-Wiedemann Syndrome↗
PubMed1989

Posthysterectomy carcinoma of the fallopian tube presenting as vaginal adenocarcinoma: a case report.

The clinical and pathological features of a case of adenocarcinoma of the fallopian tube with a unique presentation are described. The 68-year-old patient presented with vaginal bleeding 25 years after a vaginal hysterectomy. Pelvic examination revealed a 0.5-cm nodule of tumor involving the mucosa of the vaginal apex. At laparoscopy, the left fallopian tube was dilated and adherent to the vaginal vault. Pathological examination of the upper vaginectomy and bilateral salpingo-oophorectomy specimen revealed a primary papillary adenocarcinoma of the left fallopian tube that had invaded directly into the mucosa of the vaginal apex. Vaginal involvement, either at the time of presentation or subsequently in the course of the disease, is very rare in patients with carcinoma of the fallopian tube.

Adenocarcinoma, Papillary↗
PubMed1986

A method of performing descending venography.

With the recent development of successful methods to correct valve incompetence in the lower extremity, there is a need for a standardized approach to descending venography. This is the single test that accurately defines the site of the venous valve and demonstrates its competence or degree of incompetence. This report describes a technique of descending venography, including the details of catheter placement, injection procedure, and monitoring techniques. Interpretation of the study requires a method that analyzes both the individual valve function and the overall valvular competence of the entire extremity. Descending venography can separate patients with primary valve incompetence from those with postthrombotic valve destruction, as well as the occasional case of valve aplasia. Points on interpretation of valve function and the use of the Valsalva maneuver for "stressing" the valve are discussed. The descending venographic results are compared with the clinical state and with venous pressure findings in 78 extremities.

Arm↗
PubMed1986

Cervical thymoma.

A 45-year-old woman presented with a five-year history of neck swelling and occasional difficulty in swallowing. The clinical impression was of a thyroid nodule, and fine-needle aspiration biopsy cytology revealed a monotonous lymphoid population, raising the suspicion of Hashimoto's thyroiditis. At surgery, the mass was identified at the level of the cricoid cartilage, displacing the right lobe of the thyroid gland superiorly and extending posteriorly to the prevertebral fascia. Although a frozen-section diagnosis of malignant lymphoma had been suggested at the time of surgery, permanent sections favored a diagnosis of thymoma. Surface marker studies showed the majority of cells to be of thymic T-cell phenotype, and ultrastructural examination demonstrated a dual population of lymphoid and epithelial cells, thus confirming the presence of thymoma. Cervical thymomas are extremely rare and this case report illustrates the difficulties in diagnosis; we speculate that cervical thymoma may be an underdiagnosed entity.

Female↗
PubMedDate not supplied

Informing the UK's South Asian communities on organ donation and transplantation.

There is a growing demand for human organs for transplantation, particularly of the kidney among the UK's South Asian population which, due to problems with histocompatibility can only be met with a significant increase in the number of Asian donors. Specific attempts have only recently been made to attract donors from South Asian communities using 'ethnically-targeted mass media'. A recent pilot study sought to evaluate the effectiveness of these initiatives in providing information with regards to organ donation for the South Asian population. The findings show that detailed information related to transplantation activity had been learned only through the experience of people undergoing transplants within the community and has been transmitted through various informal networks rather than through the resources provided by the Department of Health. This paper provides an overview of who the South Asians are and how these community networks were established.

Community Networks↗
PubMedDate not supplied

Enhancing the health professional's role in requesting transplant organs.

The shortfall in organs for transplant continues in the UK. To address this problem, methods of organ procurement are continuously widening with the recent development of protocols in elective ventilation and non-heart beating donors. Until recently, the nurse's role in the success of organ procurement was largely limited to those working in intensive care units involved in cadaveric transplant and community-based nurses working with patients on kidney dialysis who may become involved with live related transplant. Involvement in organ procurement has now extended to nurses working in general wards and accident and emergency centres. It is imperative that health professionals are aware of the large numbers of patients for whom donors have not been found. They need to be aware of the possible reasons which deter relatives from giving consent for potential donors and prevent relatives themselves from becoming potential live donors. Those who are involved in the organ request process need to be alerted to the factors that affect the decision to give consent. It is hoped that these efforts will help to reduce the drastic shortage of available organs for transplant in the UK.

Family↗
PubMedDate not supplied

Return ticket.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMedDate not supplied

Organ donation: social and cultural issues.

This article explores the social and cultural issues surrounding the donation of organs for transplantation. With the increasing shortage of suitable organs, the author suggests that healthcare professionals should be more aware of such issues when discussing transplantation with potential donors or their families and highlights the need for a national information campaign.

Cultural Characteristics↗