Biomedical subjects
J Dukes
Publications and source records attributed to J Dukes.
Communications. Reading matters.
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At the cutting edge.
In the second of two articles, Jim Dukes and Rosemary Stewart look at how protocols can be implemented successfully.
Patient protocols: commissioning, design and use.
The author begins by considering existing definitions of 'protocol' and related terms and later develops this into a discussion of how they work. Among other things, we learn from this article that methods of designing protocols have a significant influence on their implementation, creating a problem for organizations attempting to introduce protocols to promote uniform treatment. While the advantages and disadvantages of protocols are summarized, such a summary is to some extent unrevealing. It has to be appreciated that medicine is practised by social groups governed by informal arrangements which protocols may disturb. Furthermore, by making medical procedures explicit protocols may open up social and moral problems which have previously been concealed.
Systolic cardiac murmurs in boxers.
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A spongiform encephalopathy in a cat.
A cat which developed a change of temperament, with muscle tremors, ataxia and pupillary dilatation was suspected and later confirmed histopathologically to have a spongiform encephalopathy. The case is of special interest in view of the widespread concern about spongiform encephalopathies as a result of the recent epidemic of bovine spongiform encephalopathy.
The effect of four chemical forms of selenium on mammary tumor incidence in BALB/c female mice treated with 7-12-dimethylbenz[a]anthracene.
The study was conducted to determine the effect of four forms of selenium on inhibition of DMBA-induced mammary tumors. BALB/c virgin female mice were fed the AIN-76 diet containing 0.2 or 2.0 ppm Se as selenite, selenate, selenomethionine, or selenocystine prior to and for 6 months post DMBA-treatment. At necropsy, mammary glands were histologically treated for confirmation of adenocarcinomas and the livers were removed for analysis of glutathione-peroxidase (GSHPx) activity and selenium concentrations. Dietary levels or forms of selenium had no effect on body weights. Inorganic selenium fed at 2.0 ppm Se (selenite and selenate) decreased mammary tumor incidence, but organic selenium (selenomethionine and selenocystine) had no effect on mammary tumor incidence. Hepatic GSHPx activity was highest with the 2.0 ppm selenium as selenocystine diet, but hepatic selenium levels were highest with the 2.0 ppm selenium as selenite. This study showed that the dietary form of selenium affects inhibition of mammary tumorigenesis. Furthermore, the study suggested that the pathways for selenium incorporation into GSHPx and for tumor inhibition are different.
Family ties of heroin addicts.
Families of black, male heroin addicts of low socioeconomic class were compared with families of schizophrenics and high-achieving normal controls. The hypothesis was that heroin addicts are enmeshed with their parents or parental surrogates in alliances across generational lines and in reversals of the hierarchical organization of their families that, clinically, appear to perpetuate the addictive behavior. Family members chose representations of their hiertarchical relations to show closeness and distance between family members. There were significant differences among the three groups. Heroin addicts' families had the highest number of representations in which offspring were equal to or higher in the hierarchy than the parental generation and in which closeness was represented between two family members across generational lines. High achievers' families had the lowest scores; schizophrenics' families were in the middle. The results support clinical observations of heroin addicts' families and offer a guide for therapy.