Biomedical subjects
Publications and source records attributed to J George.
Infection associated with earrings is a particular problem in girls aged five to 11 years and in patients with dermatitis. Potentially fatal septicaemia due to beta-haemolytic streptococci may occur. There is a need for greater public awareness of the problem and of the potential benefit of silver jewelry.
All patients referred by general practitioners (GPs) over a year period to a geriatric day hospital were assessed at home. Sixty-one patients were referred and 33 (54%) were accepted for day hospital attendance, Alternatives were found for the remaining 28 (46%). Day hospitals are underused by GPs and there is confusion between the different functions of day hospitals and social service day centres. Guidelines to assist in patient selection are provided.
A survey of the knowledge of and attitudes towards cervical cytology screening in various locations in Tower Hamlets showed that 77 per cent of women in the sample reported that they had a smear test, and 86 per cent knew about them, although a small group of active elderly were unlikely to know much about the test or to have had one. Only 11 per cent of the 600 women under 65 understood that cervical cytology was to prevent cancer, whereas 71 per cent thought that it was to detect cancer. Of the 205 women who recalled their experience of the test, all had some difficulty. Two-thirds were embarrassed, and 54 per cent had pain or discomfort, which included all those women who did not feel embarrassed. Forty-three per cent had been informed of the result of their tests and about one-quarter of those took steps to get the result. Seventy-one per cent of the women had had their first test done before the age of 35, but only 9 per cent after the age of 45. A quarter of those screened had only had one test done. The women considered that more publicity about the test, the knowledge that a woman doctor would do the test, and more encouragement by health professionals would be improvements most likely to increase the uptake of screening. The possibility of a service offering immediate results should be explored by means of a pilot study.
A random sample of 140 elderly people aged over 75 was selected from the age-sex register of an urban general practice to assess the provision and use of aids and adaptations in their homes. Many of the aids that the elderly had were faulty, including half of the walking aids and 15% of hearing aids, reading spectacles, and dentures, and up to half of the aids were not used. Yet despite this underuse there were many disabled elderly people who required aids for the bath and toilet. When screening of elderly people is carried out in general practice assessment of aids and adaptations should be included to see that they are provided where needed, are used, and are adequately maintained.
A comparative study on the microbiological and spectrophotometric methods for estimation of rifampicin in urine was carried out in 15 individuals. The urinary levels of rifampicin were determined on 2nd, 8th and 15th days at 3 hour, 6 hour and 24 hour samples by the above methods after administration of 600 mg rifampicin. The results suggest that the microbiological assay is more sensitive than spectrophotometric method. The difference was highly significant in all the cases by paired t-test. Incidentally it was also noticed that urinary excretion of rifampicin was comparatively more on 15th day.
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When keratinocyte cultures become confluent, their prostaglandin E2 synthesis is suppressed. To determine whether the injury response is characterized by increased prostaglandin E2 synthesis, an in vitro injury model was developed. When confluent keratinocyte cultures were focally lethally irradiated using ultraviolet light B, a dose-dependent increase in prostaglandin E2 synthesis was induced by the injury. After irradiation, confluent cultures' prostaglandin E2 synthesis increased for 2 days to 8-fold more than controls, then decreased to control values by day 6. Increased prostaglandin E2 synthesis was first detected 8 h after injury. Focal irradiation of non-confluent cultures (killing isolated colonies) caused no change in prostaglandin E2 synthesis, indicating that culture continuity must be disrupted before synthesis increases. In addition, partial irradiations of petri dishes demonstrated that enhanced metabolism was confined to cells adjacent to the injury site and was not mediated by a soluble factor. When confluent and injured cultures were incubated with [14C]arachidonic acid, and the products formed analyzed by thin layer chromatography, 10-fold more prostaglandin E2 microgram protein was seen in irradiated cultures relative to confluent controls. The products formed by each group were the same, and no consistent increases in metabolites other than prostaglandin E2 were observed. The increased synthesis of prostaglandin E2 by injured cultures was apparently due to an increase in cyclooxygenase activity as determined by kinetic experiments. These data indicate that the pattern of metabolism of arachidonic acid seen in non-confluent cultures is similar to that seen in injury, and that cell-cell contact modulates enhanced prostaglandin E2 synthesis.
The training of the 72 Senior House Officers working in geriatric medicine in the Yorkshire Region was assessed by questionnaire. Most of the 67 respondents considered their training requirements in geriatric medicine had been fulfilled and experience had been gained in acutely-ill and long-stay elderly patients. However, there were deficiencies in the provision of topic teaching, case presentation meetings, rehabilitation instruction, and in experience of the day hospital and domiciliary assessment visits. Attention to the training requirements of the Senior House Officer grade could help to improve care of the elderly in both hospital and general practice.
BamHI endonuclease and methylase were found to exhibit a kinetic preference for linear pBR322 DNA substrates containing the recognition site in a central location. The Km values for substrates having the recognition site in a terminal location were approximately 3-fold greater than those with a centrally located site. This phenomenon may be partially due to facilitated transfer of the enzymes to the recognition site over nonspecific flanking sequences. The exploitation of facilitated transfer by these enzymes has been inferred from studies demonstrating kinetic preferences for longer DNA substrates. The reaction rates of the endonuclease were 9-fold greater with full-length pBR322 DNA than with a 74-base pair derivative. The methylase exhibits a kinetic preference for longer substrates but only under conditions of comparatively higher DNA concentrations. In addition, the methylase has the property of increasing long chain preference with increasing salt concentrations up to 120 mM. Increasing salt concentrations decreased the endonuclease's preference for longer substrates. Nonspecific inhibition studies revealed qualitative and quantitative differences between the two enzymes under catalytic conditions. These studies suggest that BamHI endonuclease and methylase interact with nonspecific DNA in different ways.
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We studied data from 500 health care workers to answer the question: Are health care workers at risk for infection during an outbreak of nosocomial Legionnaires' disease? These workers were employed at a hospital where eight cases of nosocomial Legionella pneumophila serogroup 1 pneumonia occurred over a 4-week period. The source was potable water. Acute-phase blood samples were collected on the day the water supply was decontaminated, convalescent samples were collected 4 to 6 weeks later from 373 subjects, and a single serum sample was obtained from an additional 127 subjects. Antibody titers to L. pneumophila were determined by an indirect immunofluorescent antibody (IFA) technique and by a microagglutination assay with the epidemic strain as the test antigen. Subjects who had an IFA titer of greater than or equal to 1:256 were retested with an anti-human IgM conjugate. None of the 373 health care workers had a fourfold rise in antibody titer. The geometric mean antibody titer of 73.8 for the 500 health care workers was significantly higher than that of 68.1 for 976 blood donors (p less than 0.01). Only 2.4% had recent infection as evidenced by a microagglutination test, despite the fact that 84% were susceptible. We conclude that in the setting of a short-term outbreak of Legionnaires' disease caused by contaminated potable water the risk of infection among health care workers is low: 2.4% or less.
Seventy-four patients over 65 years with electrophysiologically confirmed polyneuropathies were reviewed. Common causes were diabetes (27%), neoplasms (13%) and the Guillain-Barré syndrome (11%). In only 28% was no cause identified.
Ten healthy male volunteers were each studied on four separate occasions to assess the role of regular caffeine and alcohol intake on caffeine elimination. Antipyrine disappearance was also studied as an established quantitative test of hepatic microsomal function. Regular caffeine intake in high doses for 1 week failed to alter either antipyrine or caffeine pharmacokinetics. In contrast, alcohol intake of 50 g/day significantly prolonged caffeine half-life by 72% (P less than 0.005) and diminished caffeine clearance by 36% (P less than 0.0005). However, antipyrine kinetics were unaltered. These results demonstrate that alcohol, in amounts commonly consumed, is a strong inhibitor of caffeine metabolism.
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