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Biomedical subjects

J Mason

Publications and source records attributed to J Mason.

At least 127 records · Page 7Linked to original sources
PubMed1995

Cost-effectiveness league tables: think of the fans.

In a recent issue of Health Policy, Birch and Gafni argued against the use of cost-effectiveness league tables in health care decision making. They argued that league tables should be returned to where they are best used and understood--the sports pages. Recently the debate about the presentation and interpretation of cost-effectiveness data has been given an additional impetus in the UK through the publication, by the Department of Health, of the Register of Cost-Effectiveness Studies (RCES). During the production of the RCES, it became apparent that there were similarities between the decision makers' thirst for economic data and the sports fans' thirst for information about their team. In this paper we review the pros and cons of using published cost-effectiveness data in decision making, compared with the local team approach suggested by Birch and Gafni. We conclude that there are advantages from using published data, providing these are produced according to standardized methods and interpreted intelligently. Most importantly, cost-effectiveness data, whether published or generated locally, are unlikely to give decision makers a technical solution to the resource allocation problem. Rather, they should be viewed as a stimulus for local discussion and debate.

Cost-Benefit Analysis↗
PubMed1995

A new cyclosporin derivative, SDZ-IMM-125, prolongs renal allograft survival in dogs.

Previous studies in vitro and in rodent transplantation models have suggested that an analogue of cyclosporin, SDZ-IMM-125, has immunosuppressive properties at least equivalent to that of cyclosporin. As the bioavailability of the drug was considered to be greater than that of cyclosporin, it was hoped that lower doses could be used with the avoidance of nephrotoxicity. Renal allografts were undertaken between beagle dogs from two partially inbred breeding colonies. After transplantation, SDZ-IMM-125 was given orally at a dosage of 5, 7.5, 10 or 20 mg/kg/day, and graft survival compared to that in dogs given cyclosporin 10 mg/kg or in untreated animals. The results showed that SDZ-IMM-125 is immunosuppressive in dogs and prolongs graft survival up to 50 days at a dosage of 20 mg/kg/day. However, at this dose histological changes suggestive of liver toxicity were observed in one dog, and mild anaemia was produced,but there was no evidence of nephrotoxicity. Absorption profiles suggested that the drug is rapidly absorbed and metabolized, and that a more frequent daily dosage may be appropriate. Overall, there appeared to be no significant advantage for the analogue SDZ-IMM-125 over cyclosporin. The transplant model was associated with a high spontaneous renovascular thrombosis rate, particularly after cyclosporin administration, which was prevented by the daily administration of aspirin.

Animals↗
PubMed1995

The effects of the nematode peptide, KHEYLRFamide (AF2), on the somatic musculature of the parasitic nematode Ascaris suum.

AF2 is an endogenous RFamide-like peptide from the parasitic nematode Ascaris suum. The potent stimulatory effects of this peptide on the somatic musculature of Ascaris strongly suggest that it may have an important role in the motornervous system. Here we have investigated the possibility that AF2 may elicit a stimulatory action on Ascaris muscle by potentiating the actions of the excitatory cholinergic motonervous system either pre-synaptically, post-synaptically or both. In in vitro pharmacological experiments AF2 produced a dose-dependent increase in the frequency and amplitude of spontaneous contractions of Ascaris muscle strip which lasted for more than 1 h after a 3 min application of AF2 (10 nM-10 microM; N = 7). In addition, AF2 (100 nM) potentiated the contraction elicited by ACh by 43 +/- 9% (P < 0.01; N = 8). In electrophysiological recordings from muscle cells, AF2 (10-100 nM; N = 10) potentiated the amplitude of EJPs (excitatory junction potentials). For 100 nM AF2, the potentiation of the EJP was 218 +/- 48% (N = 7; P < 0.01). This effect reversed after a wash of 10 min. AF2 did not potentiate the depolarization of the muscle cell elicited by bath applied ACh. These latter two observations are consistent with a presynpatic action of AF2. AF2 (10-100 nM) generated spontaneous muscle cell action potentials in previously quiescent cells. This effect took more than 1 h to wash out. These observations are discussed in terms of the paralysis of Ascaris that is elicited by AF2.

Acetylcholine↗
PubMed1995

Client-centered hypnotherapy for tinnitus: who is likely to benefit?

In this study we prospectively analyzed 41 patients, 15 females and 26 males with a mean age of 54, who underwent three sessions of client-centered hypnotherapy for their tinnitus. Of these patients, 28 (68%) showed some benefit for their tinnitus 3 months after completing their hypnosis, and 13 (32%) showed no evidence of improvement for their tinnitus. Hearing loss was associated with a nonbeneficial outcome for tinnitus treated with hypnotherapy. Of the nonbeneficial group, 46% had a hearing loss of 30 db or more in their better-hearing ear compared to less than 15% in the beneficial group, a significant difference (X2 = 6.34, df = 1, p < 0.02). Client-centered hypnotherapy can be offered to anyone who wants to have therapy for their tinnitus; in those with significant hearing loss the benefit may be less.

Female↗
PubMed1995

Governing childbirth: the wider view.

This paper seeks to 'problematize' the British government's wider intentions for public health, as they are shaped by free-market economics and technological medicine. A variety of epidemiological studies have revealed evidence of declining health among low socio-economic populations who are particularly affected by economic and social changes. The government is responding to the potential crisis by targeting specific groups of the most visible and costly victims of public ill-health. Recipients of health care with a lower public profile, such as pregnant women, are being subjected to the same policy. Current governmental strategies are regarded as an example of a medically oriented approach that focuses on special strategies for pregnancy and birth but ignores the long-term requirements for public health.

Choice Behavior↗
PubMed1995

The DH register of cost-effectiveness studies: content and quality.

The Department of Health has recently published a register of economic evaluations of health care treatments and programmes, to assist health care decision-makers to assess the value for money from alternative ways of allocating scarce resources. If the register is to be useful, it is important that decision-makers have an appreciation of the methodological quality of the studies contained in the register, and hence the confidence that can be placed in the results. This paper outlines an approach for assessing the methodological quality of economic evaluations, and the result of its application to studies contained in the register. Comments are made about the interpretation of the existing register and the future reporting of economic evaluations.

Cost-Benefit Analysis↗
PubMed1995

Assessing the cost effectiveness of NSAID: an international perspective.

A number of factors may affect the cost effectiveness of treatments and can cause this to vary by location. These factors include the patient population, relative price levels, clinical practice patterns and incentives to health professionals and institutions such as hospitals. This paper illustrates these issues by assessing the relative cost effectiveness of 3 nonsteroidal antiinflammatory drugs (NSAID), with different levels of gastrointestinal side effects, in 3 countries. We conclude that the relative cost effectiveness of drugs is not only dependent on drug price but may also vary by country.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1995

Synthesis and purification in a single column on a high-throughput automated oligonucleotide production system.

Oligonucleotides are synthesized and purified in a single column filled with a mixture of nucleoside-loaded and underivatized, high-cross link, non-swelling polystryene beads. A new oligonucleotide production system has been developed to completely automate-the entire process of sequence entry, phosphoramidite synthesis, cleavage, deprotection, purification, quantitation, and sample collection. Up to 48 primer-length, high-purity oligonucleotides can be produced in a 24 hour period of unattended automation on the ABI 3948 DNA Synthesizer. Synthesis, cleavage, and purification occur within the unique OneStepTM column. Analyses by MicroGel capillary electrophoresis, anion-exchange HPLC, PAGE, and enzymatic digestion/HPLC routinely exhibit > 90% product purity. Stringent PCR, automated fluorescent sequencing, and genetic analysis experiments show the positive effects of the total automation of purified oligonucleotide production.

Base Sequence↗
PubMed1994

Thiotungstate-copper interactions. I. Studies on the metabolism of [185W] tetrathiotungstate and the systemic interactions of labeled pharmacological doses with copper in rats.

[185W] tetrathiotungstate was employed to study the metabolism of thiocompounds in rats after i.v. injection. At tracer levels (12.5 micrograms W) the most important plasma binding protein eluted in the position of ceruloplasmin but the association did not prevent uptake of thiotungstate by the liver. At higher dose levels (1.5 mg W) there was considerable hydrolysis immediately after injection with rapid excretion of label in urine. The [185W] tetrathiotungstate remaining in plasma was associated with albumin and the amount retained was increased by pretreatment of the rats with copper. The increased binding to albumin did not prevent hepatic uptake and over the short-term pretreatment with copper increased the movement of the isotope into subcellular organelles, probably lysosomes. The excretion in bile was increased and the label was associated with high molecular weight proteins. In liver cytosol the 185W was bound by specific, as yet uncharacterized, proteins. At the higher dose levels there was some movement to higher molecular weight proteins and this was greatly increased by the pretreatment with copper. The studies show that the metabolism of 185W tetrathiotungstate is sufficiently similar to 99Mo or 35S tetrathiomolybdate for work on the systemic interactions of thiocompounds and copper in man and animals.

Animals↗
PubMed1994

Thiotungstate-copper interactions II. The effects of tetrathiotungstate on systemic copper metabolism in normal and copper-treated rats.

The intraperitoneal administration of tetrathiotungstate to rats (6-17.4 mg W/Kg BW) caused profound changes in copper metabolism in both normal rats and in rats pretreated with copper. Plasma copper associated with albumin increased, liver copper, particularly cytosol copper, was depleted, and biliary excretion was increased. There was also a movement of copper to higher molecular weight proteins in both liver cytosol and bile. In contrast to penicillamine, tetrathiotungstate did not increase liver cytosolic apometallothionein levels and reduced the rise provoked by copper. Metallothionein-bound copper was removed. Ceruloplasmin oxidase activity was inhibited and there was evidence for increased movement of copper into subcellular organelles, probably lysosomes. It is concluded that tetrathiotungstate has a genuine "decoppering" effect and could be considered as an alternative to thiomolybdates in the treatment of copper storage diseases.

Animals↗
PubMed1994

Elevation of serum free triiodothyronine, total triiodothyronine, thyroxine-binding globulin, and total thyroxine levels in combat-related posttraumatic stress disorder.

BACKGROUND: This study was designed to assess both central and peripheral aspects of thyroid function in combat-related posttraumatic stress disorder (PTSD), with the particular purpose of finding a mechanistic explanation for an imbalance between serum levels of free thyroxine (T4) and total T4 previously observed in pilot work. METHODS: A total of 96 male combat veterans with PTSD diagnosed by DSM-III-R (72 from the West Haven, Conn, Veterans Affairs Medical Center and 24 from the Menlo Park, Calif, Veterans Affairs Medical Center) were compared with 24 male control subjects. One or more serum samples were analyzed by radioimmunoassays for levels of total T4, free T4, total triiodothyronine (T3), free T3, T4-binding globulin, and thyrotropin. RESULTS: The pilot observation of moderately elevated total T4 levels with no elevation in free T4 levels in patients with PTSD was confirmed, suggesting the hypotheses that (1) there may be an increased peripheral conversion of free T4 by deiodination to T3 or (2) there may be an increased binding of T4 secondary to elevated T4-binding globulin levels. Our findings support both hypotheses. The PTSD groups all showed a marked and sustained elevation in levels of both total T3 and free T3, as well as elevated T3/T4 ratios, supporting the increased T3 conversion hypothesis. The PTSD groups also showed a marked and sustained increase in T4-binding globulin levels, supporting the increased binding hypothesis. Thyrotropin levels did not differ between PTSD and control groups. CONCLUSIONS: These findings demonstrate an unusual pattern of thyroid alterations, featuring substantial elevations in total T3, free T3, and T4-binding globulin levels, in combat-related PTSD that differs from established endocrinopathies, such as classic hyperthyroidism, T3 thyrotoxicosis, or chronic T4-binding globulin elevation.

Adult↗
PubMed1994

Expression and shedding of intercellular adhesion molecule 1 and lymphocyte function-associated antigen 3 by normal and scleroderma fibroblasts. Effects of interferon-gamma, tumor necrosis factor alpha, and estrogen.

OBJECTIVE: To examine intercellular adhesion molecule 1 (ICAM-1) and lymphocyte function-associated antigen 3 (LFA-3) in cultures of normal and systemic sclerosis (SSc) dermal fibroblasts. METHODS: The surface and soluble forms of ICAM-1 and LFA-3 were measured by flow cytometry and capture enzyme-linked immunosorbent assay, respectively. RESULTS: Surface ICAM-1 was significantly higher on SSc fibroblasts compared with normal controls. Beta-estradiol did not directly enhance ICAM-1 or LFA-3 expression in either normal or SSc cells, but significantly augmented the cytokine-induced increase in ICAM-1. Soluble ICAM-1 (sICAM-1) and sLFA-3 were detected in fibroblast cultures. While no difference was found in the level of sLFA-3, the shedding of sICAM-1 was significantly increased (P < 0.001) in cells from SSc patients. CONCLUSION: SSc fibroblasts express intrinsically elevated levels of surface ICAM-1 and release higher levels of sICAM-1 in vitro. Increased expression of ICAM-1 by interferon-gamma and tumor necrosis factor alpha alone, and the further induction in combination with beta-estradiol may underlie an aspect of fibroblast dysfunction in SSc and the female predisposition to the disease.

Antigens, CD↗
PubMed1994

Salmonella enteritidis control programs in the United States.

A sharply rising incidence of salmonellosis in humans caused by Salmonella enteritidis (SE) in the United States between 1985 and 1989 resulted in a government-sponsored outbreak traceback program which was started in 1990. Layer flocks considered the sources of egg-implicated outbreaks would be tested for SE and the eggs from these flocks would be diverted to pasteurization plants. A program to eliminate SE from primary and multiplier breeding flocks was started at the same time. A subsequent spent hen survey and a survey of prepasteurized liquid egg material revealed that SE was much more prevalent than had been suspected, and that the highest prevalence was found in the northeastern and middle Atlantic states. Since the SE rates did not decrease during the next 2 years, a pilot project was started in 1992 in Pennsylvania, in one of the most highly affected areas. The project was designed to reduce the number of SE outbreaks by diverting eggs from SE-affected flocks and at the same time attempting to delineate the epidemiology and control aspects of the disease. With the results generated during the fist 18 months of the Pilot Project, a much larger SE prevention program will start in the same area, in October 1993.

Animals↗
PubMed1994

Purchasing and public health: the state of the union.

The purchasing role of health authorities has been in existence for two years and public health physicians are expected to play a central part within this role. While the first year was dedicated to maintaining a "steady state", differences are now appearing between authorities is the way in which purchasing is managed. Based on the views of senior managers and public health physicians working in purchasing authorities, considers how the purchasing process is developing and reports how public health medicine is perceived to be contributing to it. Identifies sub-regional resource allocation as a major factor influencing the purchasing process. Conflicting views were found on the purchasing role of public health medicine, in particular with respect to health needs assessment. As purchasing evolves it remains unclear whether pubic health medicine will come to fulfil a largely technical role, or a more wider one in which it acts as advocate for the population's health.

Data Collection↗
PubMed1994

Day surgery in Wales.

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Ambulatory Surgical Procedures↗