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Biomedical subjects

J Gale

Publications and source records attributed to J Gale.

At least 37 records · Page 2Linked to original sources
PubMed1988

Development and evaluation of modifications to the Sickness Impact Profile for head injury.

Three modifications were made to the Sickness Impact Profile, a behavior-based measure of health status, to improve its sensitivity to the effects of head injury. (1) Additional items were included to capture head injury sequelae and behaviors typical of young adults, the age group to which head injury most frequently occurs. (2) Subjects individually excluded behaviors irrelevant to them, thus allowing the score to better reflect injury-related changes. (3) The different areas of functioning on the Sickness Impact Profile were reweighted to reflect global judgments of the construct's contribution to overall functioning rather than the sum of the item contributions. Only the first modification is head-injury specific. The others, are relevant to any disease or injury. The performance of the modifications was evaluated in a longitudinal study of 102 head injured and 102 comparison subjects tested at 1 and 12 months after injury. The evaluation of the modifications was based on their ability to distinguish head injury from comparison subjects and on the strength of their relationship with measures of brain dysfunction. Despite a few statistically significant improvements in discrimination, differences of a practical degree were not obtained. The standard Sickness Impact Profile performed well and is recommended for evaluation of day-to-day functioning in head injury studies.

Activities of Daily Living↗
PubMed1988

Failure of Chlamydia trachomatis to pass transplacentally to fetuses of TO mice infected during pregnancy.

Mice (strain TO) were inoculated with a human strain of Chlamydia trachomatis (serovar E) either 14 days before the detection of a vaginal plug (day 1 of pregnancy), or from one to nine days thereafter. The organisms were given via the intraperitoneal route (ip) or intravenously with an additional intravaginal inoculum (iv + ivag). Mice were killed on day 18 of pregnancy and the contents of the uterus examined. Chlamydiae were isolated from at least one placental disk of about a quarter of the mice. Organisms given via the ip route established placental colonisation more effectively. Thus, placental colonisation was detected in five of 16 mice given chlamydiae by the ip route (in six of eight placentas in one mouse), whereas colonisation occurred in only a single placenta from one of nine mice infected via the iv + ivag routes. Chlamydiae were isolated from 13 (6.25%) of 208 placentas examined; the degree of colonisation was variable and the individual placentas were colonised independently. Chlamydiae were not recovered from fetal tissue, even when there was heavy placental colonisation. Nor were they isolated from maternal spleens, even though there was antibody to C. trachomatis in all maternal sera; the titres were in the range 4-2048, depending on the time of chlamydial challenge. These experiments show that C. trachomatis did not cross the placenta and that the pregnancy outcome in these mice was not affected.

Animals↗
PubMed1986

Infertility in mice infected genitally with a human strain of Chlamydia trachomatis.

Progesterone-treated C3H and TO mice were inoculated genitally with a human C. trachomatis strain, serovar E, designated N.I. 1 or with 2SP control medium. Of the C3H mice serving as controls 93% had litters by the end of a 6-month period compared to 31% of mice infected with chlamydiae. This infertility could not be explained by tubal occlusion, since the oviducts appeared normal at autopsy. Some of the mice were induced to superovulate. Eggs were never recovered from the oviducts on the inoculated sides of infertile mice although they were sometimes found in the lumen of the uninoculated oviducts. In contrast, eggs were recovered routinely from both oviducts of control mice. In addition, eggs and/or their accompanying cumulus cells could be seen in the periovarial space of mice inoculated with chlamydiae, indicating a failure of the transportation of eggs to the oviduct. This could explain the high incidence of ectopic pregnancies in women after chlamydial infection. No adverse effect on fertility was seen in TO mice inoculated genitally with strain N.I.1. Of the mice given 2SP medium, 73% had litters, but 87% of the mice inoculated with chlamydiae were also fertile. There was, however, a significantly greater variation in the birth weights of mice born to infected TO mothers than those born to control mice. This difference in the susceptibility of mouse strains suggests that a genetic predisposition should also be considered for man.

Animals↗
PubMed1986

Salpingitis in mice induced by human strains of Chlamydia trachomatis.

Human strains of Chlamydia trachomatis were inoculated unilaterally into the genital tracts of female TO, CBA, CBA/nu and C3H mice via the intrauterine route or under the ovarian bursa. Inflammatory changes were not seen in the oviducts or uterus of mice given two laboratory-adapted LGV serovars (L1 and L2), although chlamydiae were recovered from the lower genital tract. However, salpingitis and endometritis occurred after each of three chlamydial strains (serovars D and E) had been inoculated. Oviduct inflammation was seen for up to 6 weeks after inoculation but reached maximum severity usually after about 2 weeks, the lumen sometimes being occluded by exudate and necrotic debris. Pathological changes were seen often in both oviducts indicating canalicular spread of the organisms through the uterus. Pre-treatment of the mice with progesterone had an enhancing effect in that the lesions developed more rapidly; such treatment, in halting the oestrous cycle, probably made a larger number of target cells available for more efficient infection. Involvement of the oviduct on the uninoculated side occurred more rapidly in T-cell impaired nude mice than in immunologically normal mice, although there was little or no effect on the severity of the oviductal changes. There was evidence that the susceptibility of different strains of mice to chlamydial salpingitis varied. Thus, inflammatory changes in C3H mice were more severe than in TO mice and the changes in C3H and CBA strains were longer lasting than those in TO mice. This suggests that a possible genetic predisposition in the human situation should not be ignored. Finally, one chlamydial strain of low passage produced more severe salpingitis in mice than another strain of similar passage. By analogy different chlamydial strains may not be of equal pathogenicity in the human situation.

Animals↗
PubMed1985

Development of a chronic canine model for measurement of absorption by substrate appearance in portal venous blood.

Research in absorption physiology requires animal models which closely resemble the in vivo situation. The description of a new canine model satisfying these requirements is the objective of this report. Dogs were instrumented with indwelling portal vein and carotid artery catheters, a catheter jejunostomy and an electromagnetic flow measuring probe around the portal vein enabling continuous flow recordings. Following intrajejunal infusion of nutritive substrates in the conscious animal, absorption was measured as the product of porto-arterial substrate difference and portal venous flow. The model was validated in five mongrel dogs: (1) Catheters and flow measuring device function over several months. (2) The sensitivity of the method was evaluated following intrajejunal infusion of l-glycine-l-tyrosine and its constituent amino acids. A significant portoarterial concentration difference of both amino acids enabling quantitative measurement of absorption resulted when the peptide was infused at 4 mmoles/hour (20 mM solution, 200 ml/h). (3) Infusion of complete nutritive formulas caused a significant increase in portal venous flow whereas neither saline nor the amino acids or the peptides investigated had a comparable effect. (4) A validation experiment by implantation of a second flow probe distal to the chronically implanted device provided evidence that granulomatous tissue forming around the probe does not alter the accuracy of the flow recording. In summary, this method permits for the first time quantitative measurement of absorption by appearance rates in portal venous blood instead of by disappearance from the intestinal lumen.

Amino Acids↗
PubMed1985

Psychiatric aspects of respirator treatment and pulmonary intensive care.

The interrelations among physiology, psychology, and technology have been explored in this chapter with respect to respirator treatment and to pulmonary intensive care. The comprehensive care of these patients mandates an understanding of not only the mechanical aspects of ventilators, but also the psychological impact that these devices and intensive care settings may have on patients, their families, and the health care professionals committed to their care.

Carbon Dioxide↗
PubMed1984

Decreased leukotriene B4 synthesis by polymorphonuclear leukocytes from male patients with diabetes mellitus.

Leukotriene B4 (LTB4) synthesis and release by polymorphonuclear leukocytes (PMNL) from 17 male patients with type I diabetes mellitus was decreased (407.1 +/- 55.6 vs 709.4 +/- 62.7 ng/30 X 10(6) cells/10 min, mean +/- SE, p less than 0.001) as compared with 17 normal subjects matched for sex and age. There was an inverse correlation (r = -0.50, p less than 0.04) between LTB4 synthesis and plasma glucose concentration in the diabetic patients. The same correlation (r = -0.71, p less than 0.01) was observed in three diabetic patients studied weekly for one month. Because LTB4 is a potent chemoattractant and stimulates PMNL function, the defect in its synthesis may contribute to the predisposition to infections in the diabetic patient.

Adult↗
PubMed1984

The role of the routine clinical history.

Twenty-two final year clinical medical students, twenty-two pre-registration house physicians and twenty-two post MRCP (U.K.) registrars were studied during the clinical interview by the method of videotape-stimulated recall. It was found that the course of the clinical interview was determined by three thinking processes. There was no significant difference between the students, house offers and registrars in the extent to which their interviews displayed these thinking processes. Taking all subjects together, however, there was a significant difference in overall frequency of usage of the processes. The results show that students and doctors largely conduct the clinical interview according to either demands of their own interpretation of clinical information as it is gathered or the requirements of the routine but usually by a combination of both. The active role of the interviewer in following his/her own interpretative needs is the most important feature of our findings. The routine inquiry was used by all groups as a failsafe or background search mechanism. Increased knowledge of these thinking processes among students and teachers of medicine may lead to a more realistic and efficient balance in the teaching and learning of the clinical history.

Education, Medical, Graduate↗
PubMed1983

An interactive microcomputer program for calculation of combined parenteral and enteral nutrition for neonates.

A responsive, iterating program is described (available on diskette from first author), which enables the physician to formulate a balanced, total parenteral nutrition (TPN) for low-birth-weight and sick newborns. The program allows for the possibility of TPN or simultaneous intravenous, intraarterial, and oral feeding. It calculates the overall balance of fluids, nutrients, calories, electrolytes, minerals, trace elements, and vitamins. It features the integration of algorithms and limit tests of nutritional balance, to produce a feeding program that can be modified by clinical considerations of the physician, specific for each patient. The entire procedure can be accomplished, and a record of the entries and orders to the pharmacy and to the ward staff printed, within about 4-5 min. The program, which is written in BASIC, can be accommodated within and operated with a 16K byte microcomputer, equipped with a monitor, a printer, and a diskette or other program storage device.

Computers↗
PubMed1982

Clinical problem solving: the beginning of the process.

The diagnostic thinking process is often described as one of hypothesis generation and testing. Yet descriptions of the clinical problem solver's thinking prior to generation of the first diagnostic hypothesis are lacking. This paper reports a study of this phase in students, house officers and registrars. Theories of pattern recognition are seriously questioned. It is shown that these subjects make immediate active interpretative or evaluative responses to initial items of clinical information elicited. These responses cannot be described as 'diagnostic hypotheses', but are important working interpretations. Implications for teaching are discussed.

Diagnosis↗
PubMed1977

Audiotape and booklet self-instructional materials in physiology: an evaluation of their effectiveness and acceptability in the pre-clinical curriculum.

Audiotape and booklet self-instructional materials in physiology have been evaluated for their effectiveness and acceptability in the pre-clinical course. Learning effectiveness was determined by comparison of pre-test and post-test scores on multiple choice tests, and acceptability was determined by scores on a specially constructed and validated Likert type questionnaire. It is concluded that in three out of the four physiology topics studied, audiotape and booklet was a significantly more effective method of study than the conventional method of text books and lecture notes. Self-instructional material in the form of audiotape and booklet is acceptable to students both in absolute terms and when compared with other methods of learning. Use of the self-instructional material enabled students to achieve the required learning objectives.

Audiovisual Aids↗
PubMed1977

Accumulation of carbon dioxide in oxygen hoods, infant cots, and incubators.

The concentration of carbon dioxide in the air of oxygen hoods, infant cots, and incubators was found to be as high as 1% v/v (30 times the "fresh air" level of about 320 microliter/liter). The physiological and clinical implications of the consequent long-term exposure of infants to atmospheres of such composition are discussed.

Beds↗
PubMed1976

Changing attitudes of medical teachers towards medical education.

If medical education is to improve, this is largely dependent upon the attitudes of clinical teachers towards their own teaching and their students' learning. The aims and objectives of our workshop method of medical teacher training therefore includes some in the affective domain. Based on the theory of cognitive dissonance the experience-linked practical problem solving approach of the workshop encourages behaviour change, presuming this to cause 'attitude change'. Testing by means of a specially constructed and validated Likert-type attitude scale shows that attitudes do improve significantly and consistently over the 5 days of our workshops. A follow-up study shows these effects to be maintained and taken back to the participants' own medical schools.

Attitude of Health Personnel↗