Biomedical subjects

J J Deeks

Publications and source records attributed to J J Deeks.

45 records · Page 3Linked to original sources

PubMed1993

Oral [111In]DTPA scintigraphic assessment of colonic transit in constipated subjects.

Patterns of colonic transit were assessed by a simple radioisotopic technique using 3.7 MBq of orally administered [111In]DTPA in 16 control subjects and 37 patients with intractable constipation. Normal subjects showed rapid diffuse spread of isotope through the colon resulting in low activity in all regions of interest (ROI). Activity was lost to feces at 24 hr and was virtually complete by 72 hr (median 94%, range 71-100%). Five constipated patients showed normal transit. Those with colonic inertia (N = 26) showed a significantly slowed geometric center of isotope compared to controls (P < 0.001), falling below the normal range at 48 hr. Percentage activity curves showed the major site of isotope hold-up to be in the transverse colon and splenic flexure. Other constipated patients (N = 6) showed late delay of the geometric center of isotope and accumulation of activity in the descending and rectosigmoid colon, compared to controls, at 96 hr. Oral [111In]DTPA colonic scintigraphy is a useful clinical test in the investigation of constipation.

Administration, Oral↗

PubMed1993

The cohort effect and Helicobacter pylori.

A total of 631 serum samples collected in 1969, 1979, and 1989 from adults and children were screened for Helicobacter pylori by Western blot analysis. Results showed that H. pylori seroprevalence has become less frequent over the 20-year period. By studying seropositivity by year of birth, the magnitude of a cohort effect of H. pylori seropositivity was estimated. The odds of being seropositive decreased by 26% per decade, P = .008 (95% confidence interval, 8%-41%). Estimates of seroprevalence adjusted for both age-specific variation and the cohort effect suggest that most seropositivity in adults occurs by the age of 15 years. The implication of these findings is that H. pylori infection is becoming less frequent and is predominantly acquired in childhood.

Adolescent↗

PubMed1993

In-vitro synthesis of total protein and placental protein PP14 by the fallopian tube mucosa: variation in relation to anatomical site, the ovarian cycle and the menopause.

De-novo synthesis and secretion of protein by short term explants of mucosa from each anatomical section of the Fallopian tube and endometrium of pre-menopausal (n = 25) and tubal mucosa of post-menopausal (n = 5) women were studied by demonstration of incorporation of radiolabelled L-[35S]methionine and one-dimensional SDS-polyacrylamide gel electrophoresis. A consistent finding in 25 pre-menopausal women was the presence of a 25 kDa protein band synthesized by tissue obtained throughout the ovarian cycle. Western blotting demonstrated that this protein band contained placental protein 14 (PP14)-like immunoreactivity in the proliferative (n = 2) and luteal phase (n = 2) of the ovarian cycle. To determine if there is quantitative variation in total protein and PP14 synthesis and secretion during the ovarian cycle, the total quantities of protein and PP14 synthesized were determined by Coomassie Brilliant Blue staining and radioimmunoassay respectively. Analysis of the results of total protein assay revealed statistically significant differences in relation to the anatomical origin of the study tissue (P < 0.01), the stage of the ovarian cycle (P < 0.04) and the manner in which each anatomical site varied during the ovarian cycle (P < 0.01), the endometrium being significantly different from the Fallopian tube. When the data for PP14 synthesized by the Fallopian tube mucosa were analysed, these effects were not seen. PP14 was not detected in the culture media of Fallopian tube mucosa obtained from post-menopausal women.

Adult↗

PubMed1992

Studies on the immediate and delayed leucocytosis elicited by brief (30-min) strenuous exercise.

Eight healthy male volunteers exercised for two 30-min sessions starting 3 h apart on an electronically braked cycle ergometer at a work load (mean 155.9 W, SD 33.4 W) which required an oxygen consumption that was 70% of their maximal rate of oxygen uptake. Venous blood samples were taken through an indwelling cannula over a period of 6 h beginning shortly before the first bout of exercise and were analysed for routine haematological parameters and for lactate, noradrenaline, adrenaline and cortisol. Both bouts of exercise induced an immediate leucocytosis due to rises in lymphocytes and neutrophils but only the first exercise bout induced a substantial delayed neutrophilia. In at least five subjects, changes in lymphocyte and platelet numbers were correlated (Spearman's rank procedure, P less than 0.05) with simultaneous changes in the plasma concentrations of lactate, noradrenaline and adrenaline over the 6-h period studied. Increases in the plasma concentration of cortisol due to exercise correlated positively with the percentage changes in neutrophil numbers at 3 h and 6 h. These results are consistent with the suggestion that the immediate and delayed leucocytosis induced by exercise are mediated respectively by catecholamine and by cortisol.

Adult↗

PubMed1992

Assessment by prolonged ambulatory manometry of the effect of oral cisapride on proximal small bowel inter-digestive motility.

The effects of cisapride, given orally at standard therapeutic dosage (10 mg tds), on proximal small bowel interdigestive motility in ten healthy volunteers was assessed by prolonged ambulatory manometry. Cisapride did not alter the duration of the MMC cycle, duration of phase II or the propagation rate of phase III in either the daytime or nighttime periods. However, when compared to studies, in which subjects received no drug, both nighttime and daytime phase II mean contractile amplitude, but not contractile incidence, were significantly increased (P < or = 0.001) by cisapride. Cisapride significantly increased the incidence of distally propagated clustered activity. We conclude that the major effects of cisapride on healthy small bowel motor function is to increase the mean contractile amplitude and incidence of distally propagated clustered activity.

Administration, Oral↗

PubMed1991

Risks of delivery during the 20th to the 36th week of gestation.

Using routinely collected maternity discharge data from 250,000 women in Scotland, we examined the risks of late spontaneous abortion and preterm delivery during the period 20 up to 36 weeks of gestation. Gestational age is treated as a fetal survival time and the risks of delivery associated with a history of spontaneous abortion, induced abortion and perinatal death are examined in a survival model controlling for several demographic and socioeconomic variables. The main objective of the study is to identify factors which are associated with high relative hazard of delivery early in the period, but with decreasing relative hazard of delivery as pregnancy progresses. The factor most clearly associated with converging hazards is a history of two or more spontaneous abortions, and this may reflect the tendency to repeat pregnancy outcome.

Abortion, Induced↗

PubMedDate not supplied

The effectiveness and safety of vaccines against human anthrax: a systematic review.

We report on the results of a systematic review of existing controlled clinical trials undertaken to assess the effectiveness and safety of vaccines against human anthrax in relation to disease incidence and side-effects. Two articles retrieved by electronic and hand search fulfilling some of the inclusion criteria underwent a quality assessment by a group of reviewers. Data synthesized from the two trials showed that estimates of overall effectiveness and safety favour treatment (overall odds ratio 0.16; 95% confidence interval 0.07-0.34). The route of inoculation appears to make little difference to the effectiveness of the vaccines; however, one study shows that the incidence and severity of side-effects are significantly higher with the killed vaccine than with the alum-based placebo (overall odds ratio 0.16; 95% confidence interval 2.38-27.17).

Animals↗

PubMedDate not supplied

Pressure sore prevention: using and evaluating risk assessment tools.

The Department of Health issued clinical practice guidelines in June 1995 concerning the prevention and treatment of pressure sores (United Leeds Teaching Hospital NHS Trust, 1995). The guidelines were produced through a combination of review of the research evidence, debate in expert panels and wide consultation (Hitch, 1995). This article reviews the section of the guidelines concerning risk assessment. It looks at the research evidence evaluating risk assessment tools, noting problems which exist in interpreting the evidence, and the conclusions that can be reasonably drawn from it. It also discusses the idea of developing and evaluating risk assessment protocols based on routinely used risk assessment tools to ensure that the information acquired through such assessments is used appropriately to allocate effective preventive interventions.

Humans↗

PubMedDate not supplied

A systematic review of the evidence for rapid access chest pain clinics.

To determine the impact of rapid access chest pain clinics (RACPC) on patient management, a systematic search (1966-2000) was performed of electronic databases, recent conference abstracts, citations of all identified studies, and by contact with other researchers. Studies of any design were included. Assessment of eligibility, methodological quality of studies and data abstraction was conducted independently by two reviewers. Outcome measures were sought in terms of admission rate of patients without acute coronary syndrome detection rate of acute coronary syndrome unrecognised by the GP, timing of specialist assessment of patients with stable angina and speed and accuracy of detection of those with non-cardiac chest pain. Nine relevant studies were found, but all had methodological flaws when considered as evaluative studies. All clinics described reviewed patients within 24 hours of referral. Only three studies made comparisons with control groups, none of which were randomised, and a further three provided follow-up data only. Limited data were found for all four outcome measures, indicating possible benefits of RACPCs. However, all findings could be explained by potential biases in the original studies. In conclusion, the evidence base for the introduction of rapid access chest pain clinics is poor. The introduction of these clinics should include a randomised prospective evaluation of their worth.

Ambulatory Care↗