Search PubMed⌕ Search

Biomedical subjects

J Barton

Publications and source records attributed to J Barton.

At least 55 records · Page 3Linked to original sources

Biochemical markers of bone turnover in girls during puberty.

OBJECTIVE: Bone turnover and the rate of bone growth increase dramatically during puberty. A number of new assays for the estimation of bone resorption and formation rates have been developed over recent years, and puberty acts as a convenient model for evaluation of these measurements. The aim of this study was to explore the interrelationships between pubertal development, biochemical markers of bone turnover, insulin-like growth factor I and oestradiol in healthy pubertal girls. SUBJECTS: Ninety-one healthy girls (ages 11.6-15.5 years) were studied. All subjects were apparently healthy, and were not taking medications known to influence calcium homeostasis. Breast examination was performed to assess pubertal stage according to Tanner. The adult reference range for biochemical markers of bone turnover was obtained from concurrent studies on 42 healthy premenopausal women ranging in age between 20 and 45 years. DESIGN AND MEASUREMENTS: Blood samples were obtained from subjects between 0800 and 1000 h. Urine samples were collected between 1330 and 1600 h. We measured total and bone specific alkaline phosphatase, osteocalcin, and type I procollagen carboxyterminal propeptide as markers of bone formation. Tartrate resistant acid phosphatase, carboxyterminal pyridinoline cross-linked telopeptide, creatinine corrected urinary deoxypyridinoline, immunoreactive urinary pyridinolines, and urinary galactosyl hydroxylysine were measured as markers of bone resorption. RESULTS: Bone turnover as reflected by each of the markers was maximal in mid puberty (breast Tanner stages II and III) and decreased towards adult levels in late puberty (P < 0.001). However, the magnitude of the mid-pubertal increase differed between markers. In particular, the pubertal increase in levels of bone specific alkaline phosphatase, osteocalcin and urinary deoxypyridinoline were higher than the increase shown by the other markers. All markers were significantly lower after the menarche. Circulating insulin-like growth factor I and insulin like growth factor binding protein-3 were not important determinants of pubertal changes in bone turnover. In contrast, there was a significant negative correlation between oestradiol and all markers of bone formation and resorption during puberty. CONCLUSIONS: The greater pubertal increase in levels of bone specific alkaline phosphatase, osteocalcin and urinary deoxypyridinoline suggests that these markers may be relatively more sensitive as indicators of skeletal health during puberty. The differences between markers may reflect differences in the bone specificity of the analytes, or differing mechanisms of production and clearance. The negative correlation between oestradiol and markers of bone resorption and formation suggests that this hormone may be responsible for the reduction in bone turnover in late puberty.

Acid Phosphatase↗

Effects on health of a change from a delaying to an advancing shift system.

OBJECTIVES: Shift work can lead to a range of problems for some people that seem to result from the disturbance of the circadian system, and can broadly be classified as: disturbances of sleep, impaired physical and psychological health, and disturbed social and domestic life. The main attempt to try to reduce these problems has focused on the design of the shift system, and the identification of the most problematic features of the shift system. One such feature is believed to be the direction of shift rotation. Systems that advance are thought to be more problematic than those that delay. The present study examines the change in the direction of shift rotation from a delaying to an advancing system on health and wellbeing. METHODS: Self reported measures of tolerance to shift work were taken two months before and six months after the change. These included sleep difficulties, gastrointestinal problems, psychological ill health, chronic fatigue, social and domestic disruption, job satisfaction, and satisfaction with the shift system. RESULTS: The change from a delaying to an advancing system resulted in an increase in sleep difficulties between successive afternoon shifts, but a decrease in social disruption. There was little evidence of impaired health on the advancing compared with the delaying system. CONCLUSIONS: The increase in sleep difficulties was thought to result from the undesired adaptation of the circadian system to night work, as a result of the afternoon shifts now following a series of night shifts, whereas previously they followed a series of morning shifts. The decrease in social disruption was thought to result from the specific sequence of the shifts and the discontinuous nature of the shift system, in particular, the long week-end off every third week. Lack of reported health related differences are explained in terms of the relatively unharmful nature of the shift system in question, and the relatively short time span over which the study was conducted.

Adult↗

A classification of nursing and midwifery shift systems.

A classification of 122 shift systems worked by nurses and midwives in the larger general hospitals (400+ beds) in England and Wales was made. The systems were classified along two main dimensions: the degree of flexibility for shift rostering (either regular, irregular or flexible); and the speed of rotation between night and day work (either a permanent night shift or systems of fast or slow internal rotation). This resulted in nine possible categories of shift systems. The most common shift system was a flexible day shift with a permanent night shift. Other features of the systems are discussed, e.g. the start times and durations of shifts, and the relative influence of flexible rostering on these features. This classification is a prerequisite for a further research project aimed at identifying those features of shift systems which are likely to cause the least detrimental effects for the individual nurses concerned.

Adaptation, Psychological↗

Radiotherapy for pleomorphic adenoma of the parotid gland.

A study was made of 187 patients with parotid pleomorphic adenoma treated by radiotherapy. This followed surgery but with incomplete removal or tumor spillage. In the early years of the study radiotherapy was given by radium needle implant done usually at the time of surgery, but from the late 1960s beam-directed external radiotherapy with a head shell was used most commonly. A 3-field technique or wedge pair was the standard technique. The median age was 46 with nearly half the patients (87/187) aged between 40 and 60, and the ratio of women to men was 1.4:1 (110:77). Median follow-up for all patients was 14 years. One hundred fifteen patients had radiotherapy immediately after their first operation with a recurrence rate of 0.9% (1/115). Of the 115 there were 2 cases of radionecrosis (1 major, 1 minor), 1 case of permanent facial nerve palsy, 1 Frey Syndrome (post-gustatory sweating), and 1 salivary fistula. Seventy-two patients had radiotherapy delayed until one or more recurrences had been surgically treated. Nine (12.5%) of these developed yet further recurrence after radiotherapy. There were 2 cases of radionecrosis (1 major), 4 cases of facial nerve palsy (3 of which were complete), 16 cases (22.2%) of Frey Syndrome, and 1 case of malignant change in a parotid tumor. In addition one squamous cell carcinoma developed at the site of a needle implant 25 years later. Recurrences after radiotherapy continued beyond 20 years of follow-up. Patients having unsatisfactory surgery due to spill at operation or residual tumor left behind should have radiotherapy immediately and not delayed until local recurrence occurs because of the increased morbidity and the higher incidence of yet further recurrence.

Adenoma, Pleomorphic↗

Gene-dosage mapping of 30 DNA markers on chromosome 21.

Using a slot-blot method for the dosage of single-copy sequences, the copy numbers of 30 chromosome 21 markers were assessed in the blood DNA of 11 patients with partial trisomy or monosomy 21 and in the DNA of a patient-derived human-hamster hybrid cell line carrying a microduplication of chromosome 21. The physical order of these markers on chromosome 21 was thereby determined.

Aneuploidy↗

Biliary obstruction secondary to shrapnel.

Foreign bodies of the biliary tree represent infrequent causes of obstructive jaundice. We report a patient who developed biliary obstruction from metal shrapnel, 44 yr after a war injury. From our review of the literature, the syndrome of shrapnel-induced obstructive jaundice may occur many years after the initial injury. In the majority of patients, the missile lodges in the liver parenchyma, and migrates to the common bile duct. Complications from this injury include cholangitis, pancreatitis, and liver abscesses. As demonstrated by this case, computed tomography scan and endoscopic retrograde cholangio-pancreatogram may reliably detect this infrequent occurrence. With the development of therapeutic biliary procedures, many foreign bodies can be removed endoscopically. Thus, one should consider shrapnel-induced biliary obstruction in those patients with obstructive jaundice and prior combat injury.

Cholangiopancreatography, Endoscopic Retrograde↗

Angiotensin converting enzyme inhibitors. 10. Aryl sulfonamide substituted N-[1-carboxy-3-phenylpropyl]-L-alanyl-L-proline derivatives as novel antihypertensives.

Compounds 1a-g consisting of enalaprilat covalently bonded to aryl sulfonamides, including several known thiazide diuretics, were synthesized and tested for ACE inhibitory and diuretic and overall antihypertensive effects. All compounds were potent ACE inhibitors in vitro, with IC50 = 6.5-85 nM. At 10 mg/kg iv or ip in the rat, 1a-g inhibited the AI pressor response by 76-100%; inhibition declined significantly upon oral dosing. Compounds 1a and 1f at 100 mg/kg ip in the sodium-depleted, spontaneously hypertensive rats reduced blood pressure 28-35% and 41-42%, respectively. Compounds 1a and 1f elicited natriuresis and kaliuresis without accompanying volume increases in the rat; 1c at 25 mg/kg iv induced delayed diuresis. Compound 1f has been chosen for further development.

Angiotensin-Converting Enzyme Inhibitors↗

The effect of chewing sorbitol-sweetened gum on salivary flow and cemental plaque pH in subjects with low salivary flow.

The purpose of this work was to study the effect of chewing a sorbitol-sweetened gum on whole and parotid salivary flow rates, and on the cemental plaque pH response to a sucrose rinse challenge, in subjects with low salivary flow. The results show that chewing a flavored sugarless gum significantly increases salivary flow rates in individuals with dry mouth. Additionally, chewing the sorbitol-sweetened gum effectively prevents the fall in cemental plaque pH generally seen in response to a sucrose challenge. This indicates that chewing a sorbitol-sweetened gum provides a palliative and possibly a protective benefit for people who suffer from dry mouth.

Chewing Gum↗

Effect of sorbitol sweetened breath mints on salivary flow and plaque pH in xerostomic subjects.

The purpose of this study was to assess the effect of a sorbitol sweetened breath mint on salivary flow and plaque pH in subjects suffering from xerostomia. The breath mints effectively increased whole and parotid salivary flow rates during a 10-minute test period. Additionally, the mints reduced the acidogenic effect of a 10% sucrose rinse, as measured by changes in plaque pH. This change was presumably caused by the sialogogic action of the mints. The efficacy of sorbitol sweetened breath mints as a palliative, and possibly therapeutic aid for individuals with xerostomia compares favorably with the results of an earlier study similarly testing the effects of sorbitol sweetened chewing gum.

Dental Plaque↗

Radionuclide ventriculography and two dimensional echocardiography as predictors of left ventricular performance during aortic vascular surgery.

Sixteen consecutive patients scheduled for elective aortic vascular surgery underwent preoperative LVEF determination employing two dimensional echocardiography (2DE) and radionuclide ventriculography (RNV). Measured and derived indices of cardiac function were recorded before and after induction of anaesthesia, aortic cross-clamping and aortic unclamping. Induction of anaesthesia was associated with significant decreases in mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI) and with a highly significant decrease in left ventricular stroke work index (LVSWI). Aortic cross-clamping was associated with significant increases in MAP and systemic vascular resistance (SVR) whereas aortic unclamping was associated with a significant decrease in SVR. Preoperative LVEF, as measured by RNV and 2DE, were similar. Resting ejection fractions correlated poorly with both preoperative cardiac indices and with changes in indices of left ventricular performance seen intraoperatively. Preoperative ejection fraction determination did not predict intraoperative left ventricular performance. Preoperative exercise scanning may prove more informative.

Aged↗

Isolation and characterization of Pseudomonas putida R-prime plasmids.

A number of enhanced chromosome mobilizing (ECM) plasmids derived from the wide host range plasmid R68 have been used to construct R-prime plasmids carrying a maximum of two map minutes of the Pseudomonas putida PPN chromosome, using Pseudomonas aeruginosa PAO as the recipient. For one ECM plasmid, pMO61, the ability to form R-primes did not correlate with the ability to mobilize chromosomes in intrastrain crosses, suggesting that different mechanisms are involved. Physical analysis of one R-prime showed that 3.5 kb of chromosomal DNA had been inserted between the tandem IS21 sequences carried by the parent ECM plasmid.

Chromosome Mapping↗

Physiologic effects of doxapram in idiopathic apnea of prematurity.

Twelve premature infants with significant apnea of prematurity while receiving therapeutic doses of aminophylline were given an intravenous infusion of doxapram, 2 or 2.5 mg/kg/hr. The ventilatory effects of the medication were monitored by means of face mask spirometry and airway occlusion studies. Doxapram therapy was associated with significant increases in minute ventilation, tidal volume, mean inspiratory flow, and airway pressure 100 msec after occlusion. Respiratory frequency and the relative duration of inspiration and expiration were unchanged. Paco2 decreased significantly during the infusion. The apnea attack rate, monitored by continuous recording, was significantly reduced after the first 6 hours of therapy. Six hours after starting doxapram, mean arterial blood pressure was significantly elevated, and continued to increase during the 24 hours of therapy. Doxapram is effective in treatment of apnea of prematurity refractory to aminophylline, and appears to act by increasing respiratory center output.

Aminophylline↗