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Biomedical subjects

J Lloyd

Publications and source records attributed to J Lloyd.

At least 109 records · Page 6Linked to original sources
PubMed1994

The changing cultures of health and education.

Many public sector managers are facing fundamental organizational changes, as government macro reforms in health and education reach down to the managers' agenda. Cultural changes and a new set of values are demanding new management approaches and skills as managers seek to embrace an alternative organizational environment. Seeks to draw out some practical lessons and examples where successful managers in hospitals and colleges have embraced the positive aspects of change, while still preserving those aspects and values of the public sector which have provided for stability and integrity in organizations. Sets out a balance sheet for change, considering the detailed operational issues likely to arise in implementing such changes and suggests that a sensitive and pragmatic view, focusing on process and people, as well as outcome, is likely to remain a crucial skill for effective management.

Health Care Reform↗
PubMed1994

Managing nurses and nursing: short courses as role development.

This paper describes the development over a 3-year-period of short management courses for registered nurses offered as part of a professional development educational programme by Oxfordshire Health Authority (OHA) Clinical Education and Practice Team (OXCEPT). The courses were seen as role development for staff nurses, team leaders, sisters, charge nurses and senior sisters, and the content and length of courses were altered, extended and developed in response to evaluation of the courses by tutors and participants. The emphasis is on integrating participants' clinical, managerial and educational roles, as professional practitioners managing nurses and nursing.

Curriculum↗
PubMed1994

The reliability of EMG muscle scanning.

The reliability of a surface EMG scanning procedure was investigated for the right and left aspects of 10 muscle sites using a large clinical sample of 102 chronic pain patients. Two neutral postures (sitting/standing) were systematically studied on three occasions approximately one hour apart on the same day. The multivariate analysis of RMS microvolts indicated no significant effects for Age, Gender, Muscle site, Aspect or Period. The range of the Pearson correlations was 0.41 to 0.94 when all muscle sites, aspects, postures, and periods were considered. The median correlation was found to be 0.64. The pattern of reliability was seen to be slightly higher in the upper back while sitting, and slightly higher in the lower back while standing. The results indicate that with adequate attention to skin preparation, EMG sensors held in place by hand with a light pressure produce reliable results.

Adult↗
PubMed1994

Tolerability, central effects and pharmacokinetics of intravenous ketorolac tromethamine in volunteers.

The central effects, tolerability and pharmacokinetics of multiple intravenous doses of the analgesic ketorolac tromethamine (30 mg 4 times daily for 5 days) were studied in male volunteers. In this double-blind, randomized, parallel group study, 13 subjects received ketorolac tromethamine and 7 subjects received placebo (vehicle). To determine the effects of withdrawal all subjects were then given further dosing with placebo (4 times daily) for 2 days while maintaining the double-blind nature of the previous drug assignment. Physical examinations and laboratory tests were obtained prior to the drug administration and after completion of the study. Scales for assessment of anxiety, depression, sleep and opiate withdrawal were presented to the subjects on day 2, 5, 6, 7 and 8 of the study. After 5 days of multiple intravenous doses ketorolac showed overall good systemic tolerance and safety in comparison with placebo. Myalgia and taste perversion were more frequently reported in the ketorolac group. The frequency of injection site complaints, mostly transient pain, was about 80% for both ketorolac and placebo, indicating these were likely caused by the vehicle. There were no significant changes in the scales assessing anxiety, depression, sleep and opiate withdrawal during treatment with ketorolac and after its withdrawal, suggesting that the drug has neither any major central effects nor any clear addiction potential in this dose schedule. Pharmacokinetic parameters were derived from plasma samples collected after the first and last active doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Signal for potyvirus-dependent aphid transmission of potato aucuba mosaic virus and the effect of its transfer to potato virus X.

A British isolate of potato aucuba mosaic potexvirus (PAMV) was transmitted by aphids (Myzus persicae) which had fed previously on a source of potato Y potyvirus (PVY). Nucleotide sequence analysis of the PAMV coat protein gene indicated that amino acid residues 14 to 16 from the N terminus of the coat protein have the sequence DAG, which is also found in the coat proteins of potyviruses and is required for their aphid transmissibility. A recombinant virus isolate (TXPA7) was produced in which a segment of the coat protein gene of PAMV encoding the 40 N-terminal amino acids was inserted in the genome of potato X potexvirus (PVX) in place of the segment encoding the 28 N-terminal amino acids of PVX coat protein. This isolate, and a second similar recombinant (TXPA5) in which the DAG motif was changed to YTS, were mechanically transmissible to intact plants, in which they caused slightly milder symptoms than PVX. Particles of TXPA7 reacted in immunosorbent electron microscopy with PVX- and PAMV-specific antibodies and so were antigenically distinguishable from PAMV and PVX particles, which reacted only with their homologous antibody, and from TXPA5 particles, which reacted only with the PVX antibody. Recombinant TXPA7 was transmitted by aphids that had already fed on a source of PVY whereas TXPA5 and PVX were not. TXPA7 was not transmitted by aphids that had not fed on a PVY source. It is concluded that (i) the potyvirus-dependent aphid transmissibility of PAMV results from possession of a domain which includes the DAG motif and is located near the N terminus of the virus coat protein, and (ii) potyvirus-dependent aphid transmissibility can be conferred on PVX, a non-aphid-borne potexvirus, by substituting this domain for the N-terminal part of its coat protein.

Amino Acid Sequence↗
PubMed1993

The influence of vasopressin on the arterioles and venules of skeletal muscle of the rat during systemic hypoxia.

1. In rats anaesthetized with Saffan, the spinotrapezius muscle was prepared for in vivo microscopy. Systemic hypoxia (breathing 8% O2 for 3 min) induced a fall in arterial pressure and tachycardia, together with constriction in some arterioles and venules of each section of the vascular tree and dilatation in others. 2. The vasopressin V1-receptor antagonist d(CH2)5Tyr(Me)-arginine vasopressin (20 mg kg-1 I.V.) preferentially attenuated constrictor responses induced by hypoxia in both arterioles and venules, but had no significant effect on the dilator responses. Analysis of responses in individual sections of the vascular tree suggested that the V1-receptor antagonist reduced hypoxia-induced constrictor responses in proximal arterioles (> 13 microns diameter) though not in terminal arterioles (< 13 microns), but reduced hypoxia-induced constrictor responses in both the proximal and distal venules (9-130 microns). 3. Infusion of vasopressin at 1.4, 2.8, 5.7 and 11.4 ng min-1 kg-1 i.v. for 3 min, expected to produce plasma concentrations within the range 28-228 pg ml-1, evoked rises in arterial pressure together with decreases in heart rate. There was also vasoconstriction in the proximal arterioles of spinotrapezius that was graded with vasopressin concentration (5-35% decrease in diameter). 4. Infusion of vasopressin at 1.4 mg min-1 kg-1 i.v. for 3 min with the intention of producing a plasma concentration likely to be reached or exceeded during 8% O2, evoked constriction of all proximal arterioles, though not of terminal arterioles, and constriction of all venous vessels. The magnitude of the constriction induced by vasopressin in vessels that dilated during hypoxia was just as great as in those that constricted during hypoxia. 5. We propose that vasopressin released during systemic hypoxia exerts a constrictor influence upon the proximal arterioles and all sections of the venous tree of skeletal muscle. In individual arterioles and venules the constrictor influence of vasopressin and catecholamines may be overcome by the influence of locally released vasodilator metabolites.

Animals↗
PubMed1993

A T+6 to C+6 mutation in the donor splice site of COL3A1 IVS7 causes exon skipping and results in Ehlers-Danlos syndrome type IV.

Ehlers-Danlos syndrome type IV is usually caused by mutations in COL3A1, the gene coding for type III collagen. In a woman with a milder form of this disease, analysis of type III collagen synthesised by her cultured skin fibroblasts showed an apparently shorter form of the protein. Amplification of overlapping cDNAs, encoding the triple helical region of the molecule, showed a deletion near the 5' end of the gene. Sequencing showed that exon 7 was missing from the cDNA sequence. Analysis of genomic DNA showed that this was the result of a T+6 to C+6 mutation in the donor splice site of intron 7. The proband's parents and 35 normal controls were homozygous for T+6 at this position, indicating that the C+6 mutation was causative.

Adult↗
PubMed1993

The substitution of glycine 661 by arginine in type III collagen produces mutant molecules with different thermal stabilities and causes Ehlers-Danlos syndrome type IV.

Previous studies have shown that Ehlers-Danlos syndrome type IV (EDS IV) is caused by mutations of type III collagen (COL3A1). Here we have characterised the most amino-terminal glycine substitution so far described in a patient with EDS IV. A combination of peptide mapping and chemical cleavage analysis of cDNA localised the mutation in cyanogen bromide peptide CB5. Sequence analysis showed a G to A mutation, converting glycine 661 to arginine, which was a new dominant mutation. Analysis of type III collagen secreted by cultured fibroblasts showed an overmodified mutant protein with normal thermal stability. However, the intracellularly retained form melted 2 degrees C lower than normal. This indicated that molecules resulting from the same mutation can differ in their thermal stabilities.

Arginine↗
PubMed1992

A comparative study of intramuscular ketorolac and pethidine in labour pain.

A single dose block randomised double-blind study comparing intramuscular ketorolac, 50 mg of pethidine and 100 mg pethidine was carried out in multiparous women. Pain intensity and sedation effect were recorded at inclusion to the study, half hourly for the first 2 h, then hourly until 6 h after delivery. Maternal and neonatal side effects were noted including the Apgar scores and the baby's requirements for resuscitation. All three treatments are relatively ineffective in relieving labour pain. There was no difference in the analgesic efficacy between the two doses of pethidine but both doses of pethidine were statistically more effective compared with ketorolac. There was no difference in the retrospective assessment of the three groups or when comparison was made with the previous labour. A similar number of patients required further analgesia in each group. In all three groups, no adverse effect occurred in the mother or fetus. Maternal sedation and fetal depression were statistically less in the ketorolac group. Although ketorolac had inferior analgesic effect, its use was not associated with clinically significant sequelae and it showed a superior safety profile compared with either dose of pethidine. The study was not powerful enough to detect a difference between 50 mg and 100 mg of pethidine.

Adolescent↗
PubMed1992

DuoDERM hydroactive dressing versus silver sulphadiazine/Bactigras in the emergency treatment of partial skin thickness burns.

The study compared DuoDERM Burn Pack Hydroactive Dressings (DHD) with silver sulphadiazine/Bactigras dressings (SSD/Bactigras) in the outpatient management of small partial skin thickness burns. Forty-eight patients were entered into the study, and randomly allocated into either the DHD or SSD/Bactigras group. Burn wounds were followed until complete re-epithelialization occurred. There were no statistical differences between the groups, either with respect to their composition or characteristics of healing in days, and patients' subjective responses to treatment. However, application was easier in the DHD group (93 per cent), compared with 71 per cent in the SSD/Bactigras group (P = 0.0009), and the SSD/Bactigras were easier to remove (96 per cent) versus DHD (66 per cent, P = 0.0004). Furthermore, the DHD group had significantly less dressing changes; a mean of three changes per subject in the DHD group compared with eight in the SSD/Bactigras group (P = 0.117). Two burn wounds became infected in the DHD group, and one in the SSD/Bactigras group. In this study both modalities were found to be equally suitable and effective for small partial skin thickness burns.

Adolescent↗
PubMed1992

A new method for rate of analgesic onset: two doses of intravenous morphine compared with placebo.

A new method of frequent early pain assessments for 1 hour only was used to determine time of onset of analgesia after intravenous administration of 10 mg morphine, 5 mg morphine, or placebo in a double-blind study; 79 patients were randomized if they required parenteral analgesia in the early postoperative period. Pain intensity was determined by a four-point categoric verbal rating scale and on a verbal ordinal scale from 0 to 100 (0 = no pain, 100 = worst pain imaginable) during the first hour after analgesic administration. The onset time of analgesia, assessed by 50% of patients achieving 25% reduction from their baseline pain assessment, was significantly faster for 10 mg morphine compared with 5 mg morphine (p = 0.02) and placebo (p less than 0.01). More familiar analgesic efficacy measures, including the sum of pain intensity differences and time to next analgesic dose, similarly showed the superiority of 10 mg morphine to placebo in the first hour, confirming sensitivity according to the conventional paradigm.

Adult↗
PubMed1992

Effects of spatial disruptions on reading speed for fast and slow readers.

Forty-five subjects read three paragraphs at their normal reading speed and were timed. The first paragraph was presented normally, and the others were shown either with spaces that had been filled in or with spaces that were randomized in size. The subjects' initial reading speed declined with both alterations, but to a greater extent with the filled text. Moreover, the reduction in reading speed was greater for the 10 fastest readers than for the 10 slowest readers. This pattern of performance may reflect a floor effect with slower readers in the filled condition, but the authors interpreted the results as providing further support for Hochberg's peripheral search guidance (PSG; 1970) stage of reading.

Adult↗
PubMed1992

Recruitment and maturation of small subsets of luteinizing hormone gonadotropes during the estrous cycle.

Small and medium-sized gonadotropes may enlarge and produce more LH in order to contribute to the proestrous surge. To test this hypothesis, dispersed pituitary cells from cycling female rats were separated by centrifugal elutriation into small, medium, and large fractions and labeled for LH beta antigens or mRNA (by in situ hybridization with a biotinylated oligonucleotide probe complementary to sequences encoding amino acids 28-40). The percentage of cells bearing LH beta mRNA in the pituitary cell population increased from 6 +/- 0.4% in the evening of diestrous day 2 to 16 +/- 0.7% in the morning of estrus (average +/- SEM). Over 80% of these labeled cells were large or small subtypes. The proportion of small gonadotropes labeled with LH beta mRNA declined from 43 +/- 3% at metestrus to 29 +/- 1% on the evening of proestrus as the proportion of medium-sized gonadotropes labeled for LH beta antigens (15 +/- 1%) or mRNA (17 +/- 1%) increased to 25 +/- 2% or 38 +/- 2%, respectively. Because the overall percentage of immunoreactive LH cells did not change after diestrus, small LH cells may have enlarged or increased their density to join the medium-sized pool. During proestrus, the proportion of large immunoreactive LH gonadotropes increased from 41 +/- 2% to 65 +/- 2% (by the morning of estrus) as the proportion of small or medium-sized LH cells declined to 17-18 +/- 1%, suggesting further increases in size or density. These data suggest that small or medium-sized gonadotropes are activated during early diestrus to enlarge and produce LH beta. They contribute to the increased number of cells in medium-sized and large fractions in proestrous or estrous rats. The predominance of the smaller subtypes during metestrus and diestrus suggests that LH gonadotropes may revert to a smaller or lighter subset to await activation during the next cycle.

Animals↗
PubMed1992

Maturation of follicle-stimulating hormone gonadotropes during the rat estrous cycle.

FSH mRNA is transcribed after the onset of high FSH secretion during proestrus and estrus. Pituitary cell fractions separated by size and density were studied to determine if expression of FSH mRNA activity was predominantly in one subset during the estrous cycle and to determine the source and significance of "silent FSH" cells that secrete FSH, but store too little for detection. Pituitary cells were separated by centrifugal elutriation, plated, and then exposed to 0.1-1 nM [D-Lys6]GnRH for 3 h. Media were assayed for FSH by RIA, and the cells were fixed for immunocytochemistry or in situ hybridization. The percentages of immunoreactive FSH cells in unseparated populations increased from 8% at metestrus to 12% during proestrus. Percentages of cells with FSH beta mRNA showed the same rise; however, peak levels were higher (17%) during proestrus and estrus. Small cells with FSH beta mRNA were more frequent than those with antigens early in the cycle. The largest cell fractions contained 38-44% immunoreactive cells. Only 8-21% of these cells had FSH beta mRNA, except during the morning of proestrus (33%). The distribution analyses showed that the increment in immunoreactive FSH cells during diestrus initially stemmed from smaller subsets; however, over half of immunoreactive FSH cells were large by the evening of proestrus. During the time of active transcription of FSH mRNA, more than half of the cells with FSH beta mRNA were small or medium-sized. Thus, early in the cycle, FSH beta mRNA is transcribed in the smaller cells, which may be the source of the silent FSH cells reported in previous studies. During proestrus, smaller FSH cells also secreted as well if not better than those in the unseparated population or large fractions. When they secreted more than expected from their percentages of FSH cells, this response was interpreted to be due to either the presence of cells that are immunoreactively silent or the possible removal of autocrine or paracrine regulatory factors.

Animals↗
PubMed1992

Effects on biliary tract pressure in humans of intravenous ketorolac tromethamine compared with morphine and placebo.

This study compared the effect of ketorolac tromethamine with that of morphine and placebo on biliary tract pressure. Intraoperatively, 31 anesthetized patients received either ketorolac (30 mg IV, n = 16) or morphine (5 mg IV, n = 15) after a cholecystectomy or gallstone removal. Intrabiliary tract pressure was measured 5 min after dosing. Postoperatively, 11 patients who had undergone biliary tract surgery received 10 mg of ketorolac or placebo, according to a randomized crossover design on 2 consecutive days. Intraoperatively, the biliary tract pressure did not change significantly from baseline after ketorolac administration. In the morphine group, there was significant increase in pressure over baseline. Postoperatively, there was no significant difference between ketorolac and placebo. We conclude that ketorolac has little or no effect on biliary tract dynamics; therefore, ketorolac may be a logical choice for analgesia in those situations in which spasm of the biliary tract is undesirable.

Adult↗