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Biomedical subjects

H Ward

Publications and source records attributed to H Ward.

At least 109 records · Page 6Linked to original sources
PubMed1991

Women's health: potential for better coordination of services.

OBJECTIVE: To determine the proportion of women attending a genitourinary medicine clinic (GUMC) who are in need of contraception and the proportion of women attending a family planning clinic (FPC) who may require screening or treatment for sexually transmitted disease (STD). DESIGN: Cross-sectional survey. SETTING: A large FPC (17,600 attendances by women a year) and a large GUMC (20,060 attendances by women a year) in an inner London health district. SUBJECTS: All clients attending the two clinics in consecutive weeks (356 GUMC and 335 FPC). In addition a non-random cluster of other women attending the same clinics later in the year were interviewed in depth (21 GUMC and 20 FPC). RESULTS: Of women at the GUMC 10.4% (95% CI 7.2-13.6) were at risk of unwanted pregnancy and not using contraception. Women aged under 20 years and women not registered with a general practitioner (GP) were more likely to be in this group. A further 13.8% may have been using contraception unreliably as they were not obtaining contraception from a GP or FPC. Of women at the FPC 1.8% (95% CI 0.3-3.2) complained of symptoms of genitourinary infection. In-depth interviews showed that some women assumed the staff at both clinics would counsel them in all aspects of sexual health. CONCLUSIONS: The opportunities presented at GUMCs to reduce the incidence of unwanted pregnancy and the opportunities presented at FPCs to reduce the incidence and prevalence of STD should not be missed.

Adult↗
PubMed1990

Comparison of ofloxacin with doxycycline in the treatment of non-gonococcal urethritis and cervical chlamydial infection.

The efficacy of ofloxacin was compared with that of doxycycline in the treatment of non-gonococcal urethritis (NGU) and cervical chlamydial infection in an open randomized study. In total, 182 men and 100 women were enrolled: 92 men and 50 women received ofloxacin at a dose of 400 mg once daily for seven days, and 90 men and 50 women received doxycycline at a dose of 100 mg twice daily for seven days. All women and 42 men, that is 29 men in the ofloxacin group (32%) and 13 in the doxycycline group (14%) were chlamydia-positive on entry into the study. Patients were reviewed on completion of the treatment course (day 8) and two weeks later (day 22). Clinical cure rates for NGU in assessable patients in each treatment group were similar; 73% in the ofloxacin group and 63% in the doxycycline group at day 8, and 70% and 90% in the respective treatment groups on study completion. Repeat tests for chlamydiae were negative for all male and female patients at both day 8 and day 22. Both ofloxacin and doxycycline were well tolerated. We conclude that ofloxacin given at a dose of 400 mg once daily for seven days is a safe and effective alternative treatment for NGU and cervical chlamydial infection.

Adolescent↗
PubMed1989

Nondysenteric intestinal amebiasis. Colonic morphology and search for Entamoeba histolytica adherence and invasion.

There is controversy regarding the presence of colonic mucosal abnormalities or mucosal invasion by Entamoeba histolytica in patients with "nondysenteric intestinal amebiasis." To determine the role of E. histolytica in causing symptoms and mucosal changes and to detect if mucosal invasion by E. histolytica is present in nondynsenteric intestinal amebiasis, we evaluated 24 E. histolytica-infected patients (stool microscopy positive for E. histolytica) and 12 noninfected controls who presented with chronic gastrointestinal symptoms, but without dysentery, to a clinic in Calcutta. The colonic mucosa was evaluated at colonoscopy, and mucosal biopsies obtained from the cecum, sigmoid colon, and rectum were evaluated by light microscopy, indirect immunofluorescence microscopy, and scanning electron microscopy. At colonoscopy mucosal ulcerations were absent in all the controls and all except one of the E. histolytica-infected patients. E. histolytica trophozoites or cysts were not seen in the lamina propria or on the luminal surface in any infected patient by light and immunofluorescence microscopy. On scanning electron microscopy, structures that resembled rounded E. histolytica trophozoites were seen on the luminal surface in two of 19 cecal specimens from the infected patients. Moderate or severe mucosal inflammation was frequent on light microscopy in both the E. histolytica-infected patients and the noninfected controls with the cecum involved in two thirds of both groups. Antibodies to E. histolytica were detected in serum of 25% of study patients and 58% of controls. Mucosal inflammation did not correlate with stool positivity for E. histolytica or seropositivity for ameba antibody.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Molding of laser energy by shaped optic fiber tips.

The development of a new technique for laser recannalizing atheromatous vessels has inherent problems concerning heat damage to the vessel walls. A theoretical analysis of 2,100 light rays in large bulb end (output end) fibers compared to a standard flat end fiber showed (1) a much higher-intensity focus; (2) a 125.4% increase in number of output rays (with respect to number of input rays) in the convergent output beam, due to multiple reflections/refractions ("stars" and "triangles") and standing waves, in the large bulb end, compared to 48.6% in the flat end; (3) 83.69% energy in the converging beam of the large bulb end, compared to 46.1% energy in the flat end; and (4) a rapidly divergent beam after focus. Hence, theoretically a wide area of plaque could be burnt off more rapidly with less heat conduction into the vessel walls. Coupling efficiency was experimentally shown to be greatly increased by also having a bulb at the optic fiber input end.

Arteriosclerosis↗
PubMed1987

Airway responses in vitro following C5a des Arg-induced hyper-responsiveness in vivo in rabbits.

The mechanism of C5a des Arg-induced airway hyper-responsiveness in rabbits was investigated. Airway smooth muscle from rabbits which had been pretreated in vivo, was studied in vitro. Tracheal rings, segmental bronchial rings, subsegmental bronchial spirals and lung parenchymal strips were all prepared from each rabbit lung. Although C5a des Arg produces hyper-responsiveness to histamine in vivo, which is inhibited by indomethacin, the airway smooth muscle responses in vitro from control, C5a des Arg and C5a des Arg plus indomethacin pretreated rabbits did not differ. The neutrophil counts in the tracheal and subsegmental bronchial specimens were increased in the C5a des Arg-treated group. Indomethacin significantly (P less than 0.05) inhibited the neutrophil influx in the subsegmental bronchi. It is concluded that intrinsic smooth muscle function is unaltered following C5a des Arg-induced hyper-responsiveness in vivo.

Airway Resistance↗
PubMed1987

Plasma amino acid clearance as an indicator of hepatic function and high-energy phosphate in hepatic ischemia.

A major function of the liver is to maintain normal levels of plasma amino acids. This function may depend in part on tissue levels of high-energy phosphate. Experiments were performed in adult mongrel dogs to assess the relationship between plasma amino acid clearance (PAAC) and tissue high-energy phosphate after 90 minutes of warm hepatic ischemia. In addition, when PAAC was assessed in the anhepatic dog, PAAC fell to low levels after hepatectomy. After 90 minutes of warm ischemia, both tissue adenosine triphosphate (ATP) and PAAC fell to low levels, with PAAC similar to those levels observed in anhepatic dogs. Recovery of ATP and PAAC progressed over a 48-hour period but did not reach control values. Mortality rate was 33% in a group of 12 animals at 48 hours after ischemia. At 24 hours after ischemia, total free plasma amino acid levels were significantly higher in those animals that were dying as compared with those that were surviving (4352 mumol/L versus 2850 mumol/L; p less than 0.05). There was a strong correlation between PAAC and ATP (r = 0.81). PAAC appears to be an indicator of hepatic functional recovery and tissue ATP levels after ischemia.

Adenine Nucleotides↗
PubMed1986

Proteoglycan synthesis in suspension cultures of Swarm rat chondrosarcoma chondrocytes and inhibition by exogenous hyaluronate.

Conditions were established for short-term primary suspension culture of chondrocytes from the Swarm rat chondrosarcoma. Proteoglycan and hyaluronate synthesis on Day 0 to Day 2 in culture was investigated and compared with that for plated cultures. Incorporation of [35S]sulfate into proteoglycans was the same for both suspension and plated cultures. 35S-Proteoglycan synthesis decreased by about 80% between Days 0 and 1 irrespective of culture conditions. Suspension culture chondrocytes synthesized proteoglycans which were very similar to those made in plated cultures, with respect to hydrodynamic size, glycosaminoglycan, chain length, and composition. [3H]Hyaluronate synthesis accounted for 18 and 23% of the total 3H-glycosaminoglycans synthesized from [3H]glucosamine by suspension and plated cultures, respectively. Suspension culture chondrocytes responded to exogenous hyaluronate (1 mg/ml) by reducing their 35S-proteoglycan synthesis by about 50%. [3H]Hyaluronate synthesis was inhibited by 13% under these conditions. The inhibition was dependent on the concentration of exogenous hyaluronate and reached a plateau level within 2 h. Plated chondrocyte cultures showed little or no response to hyaluronate. Suspension cultures of chondrocytes were prelabeled with [3H]lysine and lysed, and a heavy membrane fraction (12,000g) was extracted with the detergent 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate. A Sepharose-hyaluronate affinity gel was used to show that the extract contained hyaluronate binding 3H-labeled proteins and evidence was obtained suggesting that these came from the external face of the plasma membrane.

Animals↗
PubMed1986

Lectin activation in Giardia lamblia by host protease: a novel host-parasite interaction.

A lectin in Giardia lamblia was activated by secretions from the human duodenum, the environment where the parasite lives. Incubation of the secretions with trypsin inhibitors prevented the appearance of lectin activity, implicating proteases as the activating agent. Accordingly, lectin activation was also produced by crystalline trypsin and Pronase; other proteases tested were ineffective. When activated, the lectin agglutinated intestinal cells to which the parasite adheres in vivo. The lectin was most specific to mannose-6-phosphate and apparently was bound to the plasma membrane. Activation of a parasite lectin by a host protease represents a novel mechanism of host-parasite interaction and may contribute to the affinity of Giardia lamblia to the infection site.

Agglutination↗
PubMed1986

Long term model for evaluation of myocardial metabolic recovery following global ischemia.

Myocardial ATP levels remain depressed following significant periods of ischemia (Isc) despite reperfusion (Rpf). Neither the rate of in vivo ATP return following global Isc nor the factors which influence recovery have been defined. In order to determine the time course to complete the return of ATP levels and evaluate methods of enhancing recovery of ATP levels, we have devised a chronic canine model of global Isc. In this model serial ventricular biopsies can be taken in the awake animal over several days without reoperation which allows an investigation of the recovery of the myocardium following a uniform global insult to be performed. Recovery of ATP levels has been shown to depend, at least in part, on the availability of precursors and the activity of the ATP regenerating enzymes. Because complete recovery of ATP levels takes days, short term (hours) models have limitations. Previous attempts at enhancing ATP recovery following Isc have been only partially successful because either the degree of depression was not great or the period of observation was short, resulting in incomplete return. To identify the best precursor choice, we previously measured the activity of the AMP regenerating enzymes, adenosine kinase (AdK) (adenosine----AMP) and adenine phosphoribosyl transferase (APRT) (adenine----AMP). Because APRT activity was 20 fold higher than AdK with similar Km values for substrates, it appeared that adenine (A) is preferred to adenosine for AMP regeneration in the dog's myocardium. The formation of 5-phosphoribosyl 1-pyrophosphate (PRPP) may also be rate limiting and, therefore, the effect of ribose (R) on ATP recovery was also evaluated. Recovery of ATP levels was assessed in three groups: (1) normal saline (NS), (2) A (20 mM) in normal saline (A/NS) or (3) A with R (80 mM) in normal saline (A/R) were infused (1.0 ml/min) into the right atrium of dogs for 48 hours following Isc. In all groups, ATP levels fell to between 46-60% of pre-Isc levels during Isc. In the NS dogs, ATP levels continued to fall slightly to 46% pre-Isc levels during the first four hours of Rpf after Isc. By 24 hours no appreciable recovery had occurred and the measured ATP was only 51% of the pre-Isc value. Even by seven days, ATP had not returned fully, and by extrapolation, complete recovery required 9.9 +/- 1.4 days. Treated dogs showed, however, that ATP recovery could be significantly enhanced.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenine Nucleotides↗
PubMed1986

Killing of Giardia lamblia by human milk lipases: an effect mediated by lipolysis of milk lipids.

Killing of Giardia lamblia by fresh human milk requires the presence of bile salt, a known activator of bile salt-stimulated lipase, the major lipase in human milk. Purified enzyme did not kill the parasite even in the presence of activator unless milk lipids were also present in the reaction mixture. Free fatty acids had a marked giardiacidal effect, a phenomenon supporting the view that fatty acids, released during hydrolysis of milk triglycerides, are responsible for the killing of G. lamblia by human milk. Bile salt-independent lipolysis took place in milk during storage at 4 C. This lipolysis correlated strongly with activity of lipoprotein lipase, also present in human milk. During such storage, raw human as well as bovine milk developed giardiacidal activity that could be prevented by inactivation or inhibition of the milk lipases by pasteurization or addition of eserine to the milk, respectively, before storage.

Bile Acids and Salts↗
PubMed1985

Primary closure of wounds in burned tissue: experimental and clinical study.

Penetrating wounds in burn tissue may become infected, therefore primary closure of such wounds has only been recommended for lacerations of the face. To determine if wounds in burned areas can be closed primarily if seen early, we created partial- or full-thickness thermal burns in guinea pigs (n = 54) and made incisions through the burned tissue. One side was closed primarily at variable time intervals postburn. Infectious complications were determined by observation and the quantitative bacterial smear technique. All wounds closed primarily at 24 hours or longer postburn became infected. Wounds closed primarily at 4 hours postburn had fewer infectious complications than wounds left open (p less than 0.05). We also reviewed our experience with 23 multiply injured burn patients over an 11-year period who had peritoneal lavage or exploratory laparotomy. There were no wound infections in 12 patients with incisions closed primarily in unburned areas or in 11 patients with wounds through burned tissue. We conclude that lacerations or surgical incisions in burned tissues seen early (less than 12 hrs) postburn should be treated as wounds in unburned patients. Wounds in burned tissue seen late (greater than 24 hrs) postburn should be considered contaminated.

Animals↗