Search PubMed⌕ Search

Biomedical subjects

H Mitchell

Publications and source records attributed to H Mitchell.

At least 127 records · Page 7Linked to original sources
PubMed1986

Prospective evaluation of risk of cervical cancer after cytological evidence of human papilloma virus infection.

846 women with cytological evidence of human papillomavirus infection on their Papanicolaou smears in 1979 were followed for the subsequent development of cervical malignant disorders. Carcinoma-in-situ developed in 30 women during the next 6 years, compared with an expected number of 1.9 by general population incidence figures, giving a relative risk of 15.6. The risk was greatly increased (38.7) in women younger than 25 years when the cytological diagnosis of human papillomavirus infection was made.

Adolescent↗
PubMed1985

The sensitivity of placental trophoblast cells to intraplacental and allogeneic cytotoxic lymphocytes.

The NK-susceptibility of trophoblast cells to allogeneic and autologous intraplacental natural killer (NK), antibody-dependent (K), and mitogen-induced cell-mediated cytotoxicity was studied, using untreated and neuraminidase-treated trophoblast cells from normal, full-term deliveries. The work was preceded by systematic studies of placental cell separation and labelling techniques, and the effects of these techniques on the NK target, K562. The results indicated that maternal NK cells are present among intraplacental lymphocytes, but that their activity is lower than that of peripheral blood lymphocytes and they are not stimulated by interferon to the same extent as peripheral blood lymphocytes (PBL). Trophoblast cells were rarely susceptible to allogeneic NK cells, with low cytotoxicity at high effector-target cell ratios in only two of five experiments. Interferon (IF)-boosted NK cells mediated some cytolysis of trophoblasts in three of four experiments, but high effector/target cell ratios were also required for the effect to be observed. The trophoblast cells could be lysed, however, by K cells and lectin-induced cytotoxicity. Removal of surface sialic acid by neuraminidase treatment of the trophoblast cells had little effect on the susceptibility of these cells to unstimulated NK cells (one of four experiments), but resulted in susceptibility to IF-boosted NK cells in four of four experiments. Normal trophoblast cells did not compete in IF-NK(K562) assays and neuraminidase-treated cells competed weakly in only one of three such experiments, indicating that the NK "target structure" is only weakly expressed on human trophoblast cells. Intraplacental lymphocytes lysed autologous trophoblast cells to a lower extent than allogeneic PBL.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibody-Dependent Cell Cytotoxicity↗
PubMed1985

The psychosexual histories of young women with bulimia.

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. In this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more likely to describe their libido as 'above average.' Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.

Adolescent↗
PubMed1985

Perception of life event stress in patients with chronic duodenal ulcer. A comparison of the rating of life events by duodenal ulcer patients and community controls.

Stress is often claimed by doctors and patients to be an aetiological factor in peptic ulcer disease. The aim of the present study was to investigate whether ulcer patients perceive that they would react more strongly than normal to life event stress. Seventy-three patients with duodenal ulcer and their sex- and age-matched controls rated 81 events for the amount of distress and life change they considered the events would cause them personally. With regard to individual events, only one difference emerged: female patients rated promotion at work significantly lower for distress than did controls, when event experience was taken into account. There was a systematic tendency for ratings of male patients to be lower than those of controls. These observations suggest that duodenal ulcer patients do not perceive that their reaction to life events would be in excess of normal.

Adolescent↗
PubMed1984

Baseline characteristics of patients in the National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry.

The efficacy of PTCA was evaluated in several subgroups of patients. Of special clinical interest were the comparisons between subgroups of patients with multivessel disease vs 1-vessel disease, unstable angina vs stable angina, older age vs younger age, and female sex vs male sex. As a prerequisite for such comparisons, baseline characteristics of patients in the subgroups were examined. Compared with the subgroup with 1-vessel CAD, the subgroup with multivessel CAD had more elderly patients (age 65 years and older) and more of these patients had previous MI or CABG. PTCA was more often unsuccessful in patients with multivessel CAD because of inability to pass the catheter across the lesion. The subgroup of women tended to be older than men, and more women had severe and unstable angina, although fewer had multivessel CAD, previous MI or previous CABG. The PTCA success rate was 5% lower in women because of a greater frequency of inability to pass the lesion. Compared with younger patients, older patients had a higher prevalence of severe angina, multivessel CAD and lesions with larger diameters. The older patients had a 5% lower PTCA success rate, once again because of a greater frequency of inability to pass the lesion. The learning experience with PTCA was measured by the overall success rate as well as by the rate of ability to pass the lesion and the rate of dilating it once it was passed. These rates improved significantly by the investigators' case accumulations and independently by calendar year. Multivariate prediction of crossing the lesion and of overall success showed that favorable lesion characteristics and increasing physician experience were more important than the patient characteristics just discussed, although both female sex and multivessel CAD remained significant independent risk factors.

Age Factors↗
PubMed1984

Effect of investigator experience on percutaneous transluminal coronary angioplasty.

The NHLBI PTCA Registry collected clinical data on 3,101 PTCA procedures performed at 105 clinical centers between September 1977 and September 1981. To investigate the "learning curve" from introduction through the early application of this new therapy for revascularization, success rates and complication rates were examined by calendar year and according to investigator experience. Success rates improved by calendar year, from 54% in 1979 to 66% in 1981. Investigators with fewer than 50 cases had a success rate of 55%. After an investigator had performed 150 procedures, the success rate was 77%. The increase in success rate was largely the result of a dramatic increase in the ability to cross the narrowing with the catheter, and was accounted for by experience and improved equipment. Patient selection for PTCA was characterized by sex, age, previous CABG, number of diseased coronary arteries and stable Canadian Heart classification over time. Reflecting the increase in the success rate was the decrease in the need to perform elective CABG. Emergency CABG, death and MI rates were low (1% mortality, 5% nonfatal MI) and did not change significantly with time or with investigator experience.

Angina Pectoris↗
PubMed1984

Further look at dextropropoxyphene with or without paracetamol in the treatment of arthritis.

The analgesic effects of dextropropoxyphene and paracetamol and that of a combination of the two drugs were assessed in 24 patients who suffered from either rheumatoid arthritis or osteoarthritis. Dextropropoxyphene, which had a marginal effect on pain score, led to a more significant effect on patient well-being, particularly when it was the first drug given in the sequence. The addition of paracetamol had more of a negative than a positive effect on pain score and well-being.

Acetaminophen↗
PubMed1983

Problems of interpretation of serum concentrations of alpha-foetoprotein (AFP) in patients receiving cytotoxic chemotherapy for malignant germ cell tumours.

Serial determinations of serum alpha-foetoprotein (AFP) concentrations are well established in monitoring the response to therapy of malignant germ cell tumours. Using a radioimmunoassay (RIA) with a sensitivity down to 2kul-1 the majority (57%) of 28 patients with non-AFP producing germ cell tumours had measurable immunologically-reactive AFP in their serum while on treatment. Follow-up for 11-43 months (mean 27) without evidence of tumour activity indicated that this immunologically-reactive AFP was unlikely to be produced by tumour. In patients where the initial serum AFP was raised prior to chemotherapy the AFP concentration did not fall to the normal range at the end of the treatment in 16 (32%) of 41 patients. Follow-up of these patients for 9-48 months (mean 27) has resulted in 5 (12%) relapses in this group. Serum AFP greater than 20kul-1 three months after stopping chemotherapy was a good indicator of residual active tumour and 4 (57%) of 7 patients in this group relapsed. The production of detectable serum AFP is probably related to the type of chemotherapy used and only 7 (14%) of 51 patients treated for gestational choriocarcinoma had detectable AFP concentrations while on cytotoxic chemotherapy. The problem of interpretation of serum AFP concentration in patients with malignant germ cell tumour stresses the need to determine whether there are differences between AFP produced by germ cell tumours and that produced at other sites as a basis for a sensitive assay system able to discriminate between them.

Adolescent↗
PubMed1983

A counsellor in general practice: a one-year survey.

A counsellor was included within the professional staff of a practice of 11,000 patients cared for by five partners. A review of her work over a 12-month period is described. Eighty-seven patients were counselled in 197 sessions. Thirty-five per cent of first appointments and 22 per cent of subsequent appointments were not kept. The problems dealt with most frequently were anxiety and stress, marital troubles and abortion. Patients perceived the service as giving relief by allowing them to talk and helping them to work out their problems.

Adolescent↗
PubMed1982

Septic arthritis caused by Pasteurella multocida.

A patient with rheumatoid arthritis developed an infection in the right hand after she administered an antibiotic capsule to her cat. Two weeks after this, septic arthritis developed in her right knee. The organism isolated was Pasteurella multocida, which is part of the feline normal oral flora. The infection was treated with penicillin and drainage.

Anti-Bacterial Agents↗
PubMed1981

Effect of antihypertensive therapy on plasma catecholamines in renal failure patients.

The influence of antihypertensive therapy on plasma norepinephrine (NE) was examined in 58 patients with moderate chronic renal failure (CRF). Six normotensive patients not receiving antihypertensive medicines (mean serum creatinine 2.4 +/-.2 mg/dl) had a modest but significant increase in NE compared to normals in both supine (230 vs. 173 pg/ml, P greater than .05) and upright (482 vs. 377 pg/ml, P less than .05) positions. A striking increase in NE (supine 673 +/- 55, P less than .001; upright 1089 +/- 88 pg/ml, P less than .001) was observed in 34 CRF patients receiving antihypertensive regimens containing diuretic, beta-blocker, or vasodilator drugs either individually or in combination. Vasodilator therapy was associated with the highest levels of NE. In 17 further CRF patients receiving the sympathetic suppressants clonidine or methyldopa in addition to other medicines, NE values were similar to untreated, normotensive patients (supine NE 254 +/- 40 pg/ml; upright NE 474 +/- 61 pg/ml). The age, degree of renal impairment, plasma renin activity, and number and dosage of antihypertensive medicines did not account for these differences in NE. The results suggests that NE levels are modestly increased in normotensive, untreated CRF patients, but are dramatically increased by antihypertensive therapy, particularly vasodilator therapy. Clonidine or methyldopa therapy, however, is associated with significantly lower NE values in these patients despite the concomitant use of vasodilator agents.

Antihypertensive Agents↗