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Biomedical subjects

J Hargreaves

Publications and source records attributed to J Hargreaves.

At least 37 records · Page 2Linked to original sources
PubMed1997

A national survey of the complications of endometrial destruction for menstrual disorders: the MISTLETOE study. Minimally Invasive Surgical Techniques--Laser, EndoThermal or Endorescetion.

OBJECTIVES: To study the frequency of complications of endometrial resection and ablation for menstrual disturbances and the influence of the experience of the operators. DESIGN: Prospective survey with additional retrospective reporting by theatre staff. SETTING: 300 National Health Service and independent hospitals in the United Kingdom (excluding Scotland). POPULATION: 10,686 women registered by 690 doctors (1-222 cases/doctor) from April 1993 to October 1994. METHODS: Mailings were sent to relevant medical and non medical staff at every hospital to ascertain who performed the operations. These doctors were asked to complete a questionnaire detailing their previous experience. Completed patient registration forms were returned each month. Theatre contacts returned lists of cases reported in theatre registers. MAIN OUTCOME MEASURES: Perioperative, post-operative and delayed complications by method of surgery and experience of operator. RESULTS: Two directly related deaths were reported. Laser and rollerball ablations were associated with least operative and post-operative complications. Combined loop and rollerball diathermy was associated with a higher rate, but with fewer immediate operative complications than loop resection alone. Endometrial thinning agents were not associated with decreased complications. Fibroids were associated with increased operative haemorrhage. Early post-operative complication rates ranged from 0.77% to 1.51%. Six-week follow up in 82.5% of the women revealed few complications (1.25% to 4.58%). Increasing operative experience was associated with fewer uterine perforations in the loop resection alone group (chi 2 for trend, P < 0.001), but had no effect on operative haemorrhage in any group. CONCLUSIONS: These procedures were used widely in 1993 to 1994 with low morbidity and mortality. The techniques may be relatively easily learned in the apprenticeship system without compromising safety. Combined diathermy resection appears safer than loop resection alone, but laser and rollerball ablation were safest.

Adult↗
PubMed1996

Possible relationship between chronic fatigue and postural tachycardia syndromes.

Postural tachycardia syndrome refers to the development of symptoms such as light-headedness, visual blurring, palpitations and weakness on assuming an upright posture; these symptoms are relieved by resuming a supine posture. This syndrome is occasionally associated with idiopathic hypovolemia, impaired vasomotor tone, deconditioning and autonomic neuropathy, but has not been reported in association with chronic fatigue syndrome (CFS). We describe five patients who satisfied the CFS criteria of the Centres for Disease Control and Prevention. Upright tilt-table testing induced significant hypotension and increased heart rate in all five patients, consistent with clinical and autonomic manifestation of postural tachycardia syndrome.

Adult↗
PubMed1996

Relations between aggregative, viscoelastic and molecular properties in gluten from genetic variants of bread wheat.

Glutens differing in their low- and high-molecular-weight glutenin subunits (LMW-GS and HMW-GS) were extracted from genetic variants of bread wheat. Their composition was analysed by electrophoresis, the glutenin size distribution was determined by size-exclusion chromatography. Rheological measurements in the dynamic regime and electron spin resonance spin-labelling experiments gave data on the viscoelasticity and the protein flexibility of the glutens, respectively. In glutens differing in their HMW-GS, a relation is observed between the composition, aggregative properties, segmental flexibility and viscoelastic behaviour. This is not found in glutens with different LMW-GS. However, the proportion of rigid polypeptide segment is related to the height of the elastic plateau in all cases. The organisation of the protein network in gluten is discussed in reference to this data.

Electron Spin Resonance Spectroscopy↗
PubMed1996

Credit where credit's due--work-based learning in professional practice.

Professional education is constantly changing. It is important to value practice as an integral part of professional education. Work-based learning offers a vehicle for the linking of theoretical and clinical academic development. The tripartite agreement between employer, student and university can be beneficial to all parties.

Clinical Competence↗
PubMed1995

The ACC1 gene, encoding acetyl-CoA carboxylase, is essential for growth in Ustilago maydis.

Acetyl-CoA carboxylase [ACCase; acetyl-CoA:carbon dioxide ligase (ADP forming), EC 6.4.1.2] catalyses the ATP-dependent carboxylation of acetyl-CoA to form malonyl-CoA. We have amplified a fragment of the biotin carboxylase (BC) domain of the Ustilago maydis acetyl-CoA carboxylase (ACC1) gene from genomic DNA and used this amplified DNA fragment as a probe to recover the complete gene from a lambda EMBL3 genomic library. The ACC1 gene has a reading frame of 6555 nucleotides, which is interrupted by a single intron of 80 bp in length. The gene encodes a protein containing 2185 amino acids, with a calculated M(r) of 242,530; this is in good agreement with the size of ACCases from other sources. Further identification was based on the position of putative binding sites for acetyl-CoA, ATP, biotin and carboxybiotin found in other ACCases. A single ACC1 allele was disrupted in a diploid wild-type strain. After sporulation of diploid disruptants, no haploid progeny containing a disrupted acc1 allele were recovered, even though an exogenous source of fatty acids was provided. The data indicate that, in U. maydis, ACCase is required for essential cellular processes other than de novo fatty acid biosynthesis.

Acetyl-CoA Carboxylase↗
PubMed1995

Molecular flexibility in wheat gluten proteins submitted to heating.

Prolamin proteins are responsible for the network that gives wheat dough its viscoelastic properties. Non-prolamin depleted gluten was prepared under conditions that preserve its functionality. Electron Spin Resonance (ESR) was used to provide information about the dynamics of the protein at temperatures between 5 and 90 degrees C by specific spin labelling of its cysteine residues. The spectra were of a composite type, resulting from at least two populations of spin labels largely differing in molecular mobility. The correlation time of the less mobile nitroxide radicals was determined by saturation transfer ESR. Upon heating there was a transfer from the slow to the fast moving population of radicals, and an increase of mobility of this last catagory that followed the Arrhenius law. The effect of temperature on molecular flexibility was reversible. This was not the case for purified, polymerised glutenin subunits extracted from gluten. Urea created similar modifications on gluten as heat.

Electron Spin Resonance Spectroscopy↗
PubMed1994

An evaluation of post-registration students experience of higher education.

The Diploma in Professional Studies in Nursing and Midwifery (DPSN/M) was planned to help experienced nurses and midwives to study at a higher education level. The main aim of the course is to inform and improve practice, thus supporting research based, reflective, professional development. In this paper the students experience of the Management of Care Delivery (MCD) unit of the course is evaluated by use of a semantic differential scale, the Hoste Grid. The results show a positive expectation of the unit which is shaken, but not destroyed, by the process of experiencing the course and its assessment. The study also highlights some of the difficulties of conducting educational research.

Attitude↗
PubMed1993

The use of midazolam and flumazenil for invasive radiographic procedures.

This study has examined the use of flumazenil to improve recovery following sedation with midazolam in elderly patients undergoing invasive radiological procedures. Forty patients received either flumazenil or placebo in a randomized double-blind fashion following midazolam sedation. Nalbuphine 10-15 mg was given for premedication. All but one of the patients in the flumazenil group were fully awake immediately following the reversal agents compared to only one in the placebo group (P = 0.016). This statistically significant difference remained after 20 minutes (P = 0.029). There were no adverse effects on heart rate, blood pressure, forced expiratory volume in one second, vital capacity or oxygen saturation. The majority of patients (78% overall) could not recall their procedure. All patients said that they would be willing to undergo a similar technique in the future.

Aged↗
PubMed1989

Rapid assay and identification of human haemopoietic growth factors.

In order to facilitate the identification of human haemopoietic growth factors (HGFs), in complex conditioned media from limited cell sources, we have developed a method for the rapid assay of HGFs using bone marrow stem cells (BMSCs) obtained by Percoll density gradient enrichment of non-adherent cells from long-term human bone marrow culture. These BMSCs provide the basis for a 72 h assay where proliferation is triggered by the presence of GM-CSF, G-CSF and IL-3. The assay is up to 1000 times more sensitive than the conventional colony assay in detecting the presence of HGFs. We also describe methods for the rapid separation and identification of HGFs using fast protein liquid chromatography (FPLC) with phenyl-Superose and Mono Q columns. This enables individual HGFs present in complex conditioned media to be rapidly identified from the elution profile of HGF activity determined in the BMSC assay.

Biological Assay↗
PubMed1988

Benzodiazepine premedication in minor day-case surgery: comparison of oral midazolam and temazepam with placebo.

Ninety day-case or short stay patients were allocated to three groups in a double-blind study. The groups received oral midazolam 15 mg, oral temazepam 20 mg or placebo approximately 1 h before surgery. Midazolam was superior to temazepam regarding anxiolysis, sedation and amnesia, but temazepam was superior to placebo. However, delay in immediate and late recovery occurred significantly more often in the patients receiving midazolam than in those receiving temazepam or placebo.

Adolescent↗
PubMed1988

Ruthenium red staining reveals surface fibrils and a layer external to the cell wall in Streptococcus salivarius HB and adhesion deficient mutants.

Ruthenium red staining revealed both the long and short classes of cell surface fibril in thin sections of Streptococcus salivarius HB, indicating that the fibrils contained polyanionic polymers, probably polysaccharides. Also visible was a 16.2 +/- 2.2 nm thick ruthenium red staining layer (RRL) outside the 16.7 +/- 2.2 nm thick cell wall. The fibrils could not be seen after conventional glutaraldehyde and osmium fixation. The RRL was protease resistant and was not involved in septum formation. Loss of the fibrils after protease treatment coincided with a decrease of 54% in cell surface hydrophobicity, indicating that cell surface hydrophobicity was due partly to fibrils and partly to the RRL. There was no correlation between the lengths of fibrils as measured on whole cells after negative staining and on thin sections of ruthenium red stained cells. The thickness of the RRL was the same in three adhesion deficient mutants--strains HB-7, HB-V5 and HB-V51--with various fibril lengths. However, a completely bald mutant, HB-B, had a significantly thicker RRL than S. salivarius HB, although it was unable to adhere to buccal epithelial cells, and it could not co-aggregate with Veillonella parvula V1. The RRL therefore did not contain adhesins.

Bacterial Adhesion↗
PubMed1986

Intravenous anaesthesia for cystoscopy: a comparison of propofol or methohexitone with alfentanil.

Sixty out-patients undergoing cystoscopy were allocated randomly into two groups. No premedication was given. Induction of anaesthesia was preceded by intravenous alfentanil 7 micrograms kg-1 given over 20 s, followed by methohexitone 1.5-2 mg kg-1 or propofol 2 mg kg-1, given over 20 s. Anaesthesia was maintained by increments of alfentanil, methohexitone or propofol, given as required.

Adolescent↗
PubMed1985

Meptazinol as an analgesic adjunct to total intravenous anaesthesia in cystoscopy patients.

Sixty-four unpremedicated patients undergoing cystoscopy received either intravenous meptazinol 2 mg/kg or saline in equivalent volume in a randomised, double-blind manner immediately before induction of anaesthesia with Althesin. Inclusion of meptazinol reduced the total dose of anaesthetic required, allowed a more rapid recovery and was associated with less movement in response to surgery. The patients in the control group tended to hyperventilate, and had lower end-tidal CO2 tension (p less than 0.001), and also higher pulse rates during surgery (p less than 0.01) than the meptazinol group. However, the patients who received meptazinol had a more frequent incidence of complications during induction and recovery (p less than 0.05).

Adjuvants, Anesthesia↗